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Dietary modification is one of the few effective treatment options for cats with kidney disease. A diet restricted in phosphorus and sodium that is formulated with restricted highly digestible animal proteins helps protect kidney function and reduce the workload to keep your cat well.
Therapeutic diets are readily available in both dry and wet foods for cats, but there are other options available for cats with renal disease. If you want to have complete control over the quality and nutritional composition of your cat’s diet, it’s worth considering homemade cat food.
A Quick Overview Of Kidney Disease In Cats
Before talking about nutritional management of kidney disease in cats, there are a few details you need to know about this condition.
There are several different forms of kidney disease in cats, but chronic kidney disease (CKD) is the most common.
The kidneys filter waste products out of the bloodstream but when they stop working properly, those waste products begin to accumulate. Common symptoms of CKD include lethargy, poor coat quality, weight loss, and loss of appetite.
Another form of kidney disease in cats is polycystic kidney disease (PKD). This is an inherited condition that causes fluid-filled sacs called cysts to grow in the kidneys. At birth, these cysts are small enough that they don’t cause issues, but they will eventually grow in size and number, doing more and more damage to the cat’s kidneys. Eventually, as kidney function declines, the cat can go into kidney failure.
According to the Cornell Feline Health Center, the diagnosis of kidney disease typically involves blood tests and urinalysis to evaluate kidney function. These tests measure the concentration of waste products in your cat’s blood as well as other factors that indicate abnormal kidney function.
Unfortunately, there is no definitive cure for the various forms of kidney disease.
Dietary modification is generally the best option, though some cats may need additional therapy to control hypertension, anemia, high phosphate levels, and urinary protein loss. Your veterinarian is the best person to determine what kind of treatment will work best in your cat’s specific case.
Nutritional Management Of Kidney Disease
When it comes to managing kidney disease through dietary modification, there are three primary factors to focus on:
- Restricted high-quality protein
- Low phosphorus content
- Relatively low sodium content
Increased intake of omega-3 fatty acids and B vitamins may help as well. It’s also important to ensure that your cat gets plenty of moisture in his diet. Cats with kidney disease often experience an increase in urination which may lead to dehydration if the cat doesn’t drink more water or have enough moisture content in their diets to compensate.
1. Restricted High-quality Protein Is Easier For Your Cat’s Body To Process.
For years, a low-protein diet was recommended for cats with kidney disease, but extreme protein restriction may lead to protein deprivation with accompanying loss of muscle mass and declining body condition. Rather than feeding very low amounts of protein, consider feeding your cat restricted amounts of highly digestible, low-waste proteins derived from animal sources.
2. Low-phosphorus Foods Will Help Maintain Kidney Function.
When the kidneys start to shut down, they can no longer filter out phosphorus efficiently. High concentrations of phosphorus in the blood lead to even faster declination of kidney function. The ideal phosphorus content of a diet for cats with kidney disease is no more than 0.5% on a dry matter basis.
3. Limited Sodium Content Helps Prevent Kidney Damage.
High sodium intake can increase your cat’s blood pressure and may worsen kidney damage. This being the case, most therapeutic diets for kidney disease are low in sodium. Martha G. Cline, DVM, ACVN, notes that the sodium content of the typical renal diet for cats with kidney disease ranges from 0.5 to 1 gram per 1,000 kcal.
Are Prescription Diets An Appropriate Choice?
Prescription and therapeutic diets specifically formulated for kidney disease typically check all the boxes in terms of caloric density, restricted protein, and controlled sodium and phosphorus levels, but they can sometimes leave something to be desired in terms of nutritional quality.
These foods tend to be loaded with carbohydrates (often low-value grains like corn and wheat). They often contain added sugar and potentially low-quality animal by-products.
Some brands are a little better than others. Blue Buffalo Natural Veterinary Diet K+M Kidney + Mobility Support wet food, for example, doesn’t contain by-products and it is made with quality sources of protein like chicken, beef, and chicken liver. It is, however, still very high in carbohydrates and contains carrageenan as a thickener.
The only way to truly control the quality and formulation of your cat’s diet may be to make the food yourself.
Making your own cat food can be tricky because you have to make sure it is nutritionally balanced, but once you find the right recipe all you have to do is reproduce it. The best place to start is with a recipe formulated by a licensed veterinarian or veterinary nutritionist.
What Does Homemade Cat Food For Kidney Disease Look Like?
Any nutritionally balanced homemade cat food should meet (but ideally exceed) the Association of American Feed Control Officials’ (AAFCO) minimum nutritional requirements for cats. According to AAFCO, adult cats require a minimum of 26% protein and 9% fat on a dry matter basis.
The trouble with traditional homemade cat food recipes is that they may contain too much phosphorus and sodium. They may also have too much protein, depending on your vet’s recommendations.
A homemade cat food for cats with kidney disease should be aligned with the dietary modification recommendations made above. It should also be made with fresh, high-quality ingredients. Source your proteins from human-grade facilities that have been certified by the FDA and the USDA. Consider grass-fed meats, free-range poultry, and wild-caught fish.
Protein is an absolutely essential element in a diet for obligate carnivores like your cat, but it’s important to keep it in balance for cats with kidney disease.
If you restrict the protein content of the food too much, you’ll end up increasing the ratio of the other two macronutrients: fat and carbohydrate. This is why many homemade cat food recipes for kidney disease contain added carbohydrates like rice or fresh veggies.
The upside of including carbohydrates in your cat’s diet is that they provided an added source of dietary fiber and antioxidants. They also help keep the caloric density in balance. Carbohydrates contain only 4 calories per gram while fat contains 9 calories per gram.
While you’re thinking about homemade cat food for your cat, you may find yourself considering raw food. Raw food is generally a healthy option for cats, especially when it consists only of fresh meat, organ meats, raw bone and is nutritionally formulated and balanced.
However, raw diets may not be appropriate for all cats with kidney disease.
There is some concern that the inclusion of bone in a raw food diet might increase the phosphorus content too high for cats with kidney disease. Lyn Thomson, BVSc of Feline-Nutrition.org suggests, however, that it’s really the calcium: phosphorus ratio that matters most.
In her own practice, Thomson finds that CKD patients do well on a raw food that contains ground bone. In patients where blood phosphate levels start to approach unsafe levels, she simply administers phosphate binder.
If you’re concerned about your cat on a raw food diet, discuss the options with your veterinarian and keep a close eye on your cat’s bloodwork.
Generally speaking, a raw food diet checks all the boxes that a nutritious diet for cats with kidney disease should. It features high-quality, digestible animal protein with high levels of moisture. Organ meats provide natural sources of B-vitamins. Wild-caught prey contains high levels of essential fatty acids, though diets founded on farmed meats may require some omega-3 supplementation.
The Best Homemade Cat Food For Cats With Kidney Disease
This recipe was developed by Dr. Meredith Wall, BA, BVSc. Wall completed a Bachelor of Veterinary Science at the University of Sydney in 2012 and a combined clinical nutrition residency and PhD at Massey University in 2022.
In an in-depth article published in January 2020, Wall answers the question: “Should I feed my cat with chronic kidney disease a raw diet.” The article discusses the potential problems with protein restriction and explores the subject of supplementation as part of a raw diet for cats with kidney disease. After testing and evaluating the nutritional content of several recipes, she settled on the following recipe as her primary recommendation.
NOTE: Wall recommends using a digital kitchen scale to ensure accurate measurements. Measure all quantities precisely – do not estimate.
- 470 grams raw chicken thigh (skinless and boneless)
- 30 grams canned pink salmon (including bones and skin)
- 90 grams salted butter, softened
- 220 grams cooked short-grain white rice
- 100 grams raw pumpkin, chopped
- 60 grams raw spinach (stems removed)
- 1 gram iodized table salt
- 7ml Nordic Naturals omega-3 pet liquid
- 5g Now Foods psyllium husk powder
- 2 capsules (contents only) Now Foods taurine (1000g each)
- 1 capsule (contents only) Thorne Research Basic B Complex
- 6 capsules (contents only) Thorne Research BioMins with copper and iron
- 2 level teaspoons Now Foods calcium carbonate powder
- ¼ level teaspoon Now Foods potassium chloride powder
- 3 tablets (crushed) Country Life choline tablets
- 2 drops Now Foods natural E-oil
- Steam the rice until it is a little overcooked – it should be very soft.
- Allow the rice to cool slightly then measure out to 220 grams you need into a bowl and stir in the softened butter until it melts.
- Combine the pumpkin and spinach in a microwave safe bowl with a teaspoon of water. Cover with plastic and microwave until the pumpkin is very soft.
- Let the veggies cool then mash them together.
- Gently sauté the chicken until cooked through then mince very fine – you can also leave the chicken raw, but only if you use fresh, human-grade chicken.
- Stir the canned salmon into the cooked white rice then add the pumpkin, spinach, and chicken.
- Mix the ingredients thoroughly then add the iodized salt, psyllium husk powder, and fish oil. Mix well.
- Add the contents of the taurine, B complex, BioMins capsules.
- Crush the choline tablets and add them to the mix with the vitamin E oil, calcium carbonate powder, and potassium chloride powder.
- Mix all of the ingredients very well then transfer to a tightly covered container and refrigerate or freeze.
Nutrition (per 1kg): 27.8% calories from protein, 54.8% calories from fat, 17.4% calories from carbohydrate, 0.71g phosphorus per 1000kcal, and 70% moisture content. The omega-6 to omega-3 ratio is 2.9.
Feeding Tips: This recipe makes about 1kg (2.2) pounds of food, so you may need to freeze some of it to keep it fresh. Fresh food should only be refrigerated for about 3 to 5 days. If you plan to freeze it, try portioning it out and rolling the food into a ball before wrapping in plastic. If the food doesn’t stick together, try individual lidded containers.
Can You Substitute Any Of The Supplements In This Recipe?
Dr. Wall hails from Australia and thus has chosen to use supplements readily available in that country. While you can find Thorne, NOW Foods, and Country Life supplements online directly from the brand, a significant number of them are available on Amazon as well.
Wall notes that while the initial investment in the recommended supplements may be high, they’ll last you through many batches. Dr. Wall cautions her readers against using any supplements other than the ones listed, but you might be able to find similar options if you can’t find the right product in stock.
None of the alternative supplements I found were a perfect match for the supplements Dr. Wall suggests, but here are a few options that come close.
Want a quick look at the products reviewed in this article? In the comparison table below, we’ve highlighted some of the most important features of each product. You’ll find more detailed information about each product later in the article.
Pure Micronutrients Omega-3 Fish Oil supplements contain a similar omega-3 to omega-6 ratio and each softgel contains the same 1000mg of fish oil. This could be an appropriate substitute but, again, make sure to ask your veterinarian.
- This supplement is available on Amazon but because it contains nothing more than psyllium husk powder, it should be fairly easy to find a substitute. You would need about 3.5 capsules of Sunergetic Premium Psyllium Husk Fiber Supplement to achieve the recommended 5g dosage. If you’re looking for another powder supplement, Micro Ingredients Pysllium Husk Powder contains 5g per scoop.
- This powdered supplement is available on Amazon. But a very similar product is Nutricost Calcium Carbonate Powder. Each teaspoon of the NOW Foods formula contains 3400mg calcium carbonate while the Nutricost formula contains 650mg per scoop. You’ll need four servings of the NOW formula or about 3.5 servings of the Nutricost formula.
- This is another product available on Amazon. A similar option might be Bulk Supplements Potassium Chloride Powder or Nutricost Potassium Chloride Powder. The first of these would require 7 servings of 200mg each. The Nutricost formula is identical to the NOW formula in serving size and potassium chloride content but the tub contains more than 4 times the amount at roughly only half the cost.
- This product is available on Amazon but because it contains only vitamin E oil there are plenty of alternatives. When shopping, however, you should be careful to choose a pure, undiluted vitamin E oil like Cocojojo 100% Pure & Undiluted Full-Spectrum Vitamin E Oil. The dosing may be tricky, however.
- The NOW Formula requires just 2 drops, or about 63 IU (31.6 IU per drop). The Cocojojo formula comes in an 8-ounce versus 1-ounce bottle and, at 75,000 IU per bottle, averages about 13 IU vitamin E per drop. You’d need about 5 drops of the Cocojojo formula.
- This formula is available on Amazon, so it’s best to stick with Dr. Wall’s recommendation here. Other formulas contain a similar nutrient profile, but the amounts are very different.
- NATURELO B Complex capsules contain only 5mg thiamin per capsule while the Thorne Research formula contains 100mg thiamin per capsule. You can’t just use more of the NATURELO capsules in the homemade cat food recipe, however, because some of the amounts are the same or nearly the same (such as riboflavin and vitamin B6). Increasing the dose could result in an excess of certain vitamins.
- This formula is available on Amazon, so it’s best to stick with Dr. Wall’s recommendation here. There are similar options but, again, with different formulations.
- NOW Supplements Full Spectrum Mineral Caps contain all of the same minerals and Vitamin D3 but, again, the amounts are much different per serving. Healthy Origins Chelated Multi Mineral capsules also contain a similar nutrient profile, but the serving size is 2 capsules versus Thorne’s 4. Even if you were to double the dose of the Healthy Origins supplement, the amount per serving wouldn’t line up close enough. Even the Rx Vitamins Mineral Powder which is specifically formulated for cats doesn’t hit the mark.
#9 Country Life
- These Country Life choline tabs are available on Amazon but because they contain only choline bitartrate there are other options available as well. You’d need 3 capsules of the Country Life formula or about 3.2 capsules of Nested Naturals Choline Bitartrate. You’d need about 2.3 capsules of Solgar Choline 350mg tablets, so it’s really just easier to use 3 Country Life tabs.
If you’re concerned about buying so many individual supplements, it might be possible to use a supplement formulated for renal support, though this option isn’t perfect.
VetriScience Laboratories Renal Essentials tablets, for example, are designed to support kidney health. They contain a variety of plant extracts along with EPA, DHA, potassium, and several B vitamins. The phosphorus content is 8mg per 2 tablets.
CAUTION: Before swapping out the recommended supplements for a renal support supplement like the formula from VetriScience, be sure to consult your veterinarian or a veterinary nutritionist to ensure that it is an appropriate switch and won’t throw the nutritional content of the recipe out of whack.
Are Premixes A Good Option?
If you’ve considered raw or homemade cat food before, you’ve probably come across the idea of premixes in your research.
A premix is a product that contains all the additional nutrients your cat needs on top of protein and fat. They typically come in the form of powder that you mix in with your choice of meat to create a homemade cat food diet. You’ll be adding water as well, so the recipe will be highly digestible and rich in moisture.
Premixes are a great way to simplify the process of making homemade cat food, but keep in mind that they’re formulated for healthy cats.
If your cat has kidney disease, talk to your vet before using one of these products. You may need to evaluate the nutritional breakdown of the premix to make sure it doesn’t contain too much phosphorus or sodium. It’s also worth noting that adjusting the amount of meat to achieve a restricted protein recipe might throw the nutritional balance off.
With your vet’s approval, one of the following premixes could be a good option:
This premix is fully fortified with vitamins, minerals, and essential amino acids. It also contains a proprietary blend of prebiotics, probiotics, and enzymes to support digestive health.
A single 20.32-ounce jar of this premix makes up to 37 pounds of raw food. The smaller 1.25-ounce packets each make 2 pounds of raw food.
Young Again suggests using multiple meat sources and recommends at least 1/3 of the meat come from pork to supply the selenium your cat needs. If you’re including ground bone in your cat’s raw diet, choose the original Young Again Carnivore Raw (without calcium) formula.
For every 2 pounds of meat, Young Again recommends adding ¾ to 1 cup of water and 2 salmon oil capsules. This is the appropriate amount to use with a 1.25-ounce packet of the premix, but you’ll need to scale it up to use larger servings from the tub.
This premix is intended for use with raw cat food recipes. It contains the nutrients necessary to meet AAFCO nutritional guidelines for cats of all life stages. The premix is sold in a trial size or a large size.
To use this premix, My Natural Cat recommends combining ½ cup of the premix with 1 ½ cups of water in a large bowl. They recommend adding 2,000mg of salmon oil then whisking the mixture well to combine. You then add 2 pounds of raw meat along with ½ pound of raw liver or three tablespoons of chicken liver powder and mix well.
Once you’ve made the food, you can portion is as desired and freeze the portions you won’t be able to use within 3 to 5 days.
Both of these premix recipes contain about 2.5:1 calcium to phosphorus and only 160mg of sodium per ¼ cup serving (4.5 ounces fresh food when prepared).
Total Cat recommends mixing ¼ cup of premix with 1 cup of cold water and whisking thoroughly before whisking in 2 raw egg yolks (these are optional). Simply add 2 pounds of raw meat without bone and combine before dividing into portions.
Cats suffering from kidney disease require special care. It’s important to keep regular appointments with your vet to check your cat’s bloodwork and to monitor the progression of the disease. If your cat is taking medication, regular bloodwork will help you keep track of how well it’s working.
The most important thing you can do for a cat with kidney disease, however, is find a diet that meets your cat’s nutritional needs without putting too much stress on his kidneys.
The ideal diet for a cat with kidney disease is one made with restricted high-quality, digestible animal protein along with limited phosphorus and sodium content. Homemade cat food gives you complete control over cat’s diet, though it’s important to follow a vet-formulated recipe. If you aren’t confident in making your own cat food, a therapeutic or prescription diet might be a good alternative.
Before you try homemade cat food for yourself, do your research to make sure you understand what you’re getting yourself (and your cat) into.