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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.
Wondering whether your cat could benefit from a therapeutic or homemade diet for kidney disease? Kidney-Check could help you find the answer. This simple saliva test can help you assess your cat’s kidney function without leaving home. Learn more about Kidney-Chek here.
Overview of Kidney Disease in Cats
Before talking about the nutritional management of kidney disease in cats, there are a few details you need to know about this condition.
The kidneys filter waste products out of the bloodstream but when they stop working properly, those waste products begin to accumulate and disease develops. Chronic kidney disease (CKD)—characterized by the progressive loss of kidney function—is the most common form of kidney disease in cats. Common symptoms include lethargy, poor coat quality, weight loss, and loss of appetite.
Polycystic kidney disease (PKD) 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. As they grow in size and number, however, they cause progressive 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.
Nutritional Management of Kidney Disease
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.
When it comes to managing kidney disease through dietary modification, there are three primary factors to focus on.
1. Restricted High-Quality Protein
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 Content
When the kidneys start to shut down, they can no longer filter out phosphorus efficiently. High concentrations of phosphorus in the blood lead to an even faster decline in kidney function. Therapeutic diets for cats with kidney disease ideal dietary phosphorus content for cats with kidney disease typically contain no more than 0.5% phosphorus on a dry matter basis.
3. Limited Sodium Content
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.
It’s also important to ensure that your cat gets plenty of moisture. Cats with kidney disease often experience an increase in urination which may lead to dehydration. A high-moisture diet supports hydration, especially for cats who don’t drink a lot of water on their own.
Are Prescription Diets an Appropriate Choice?
Some cases of kidney disease in cats are best managed with a therapeutic diet. Prescription renal diets contain controlled levels of phosphorus and sodium—they may also be restricted in protein or other nutrients. It’s best to follow your veterinarian’s advice if they recommend a prescription diet to address specific nutritional concerns.
While a prescription diet may be the best option in some cases, they’re not perfect. These foods tend to be high in carbohydrates, often with added sugar, artificial flavors, and potentially low-quality animal by-products.
If you can’t find a suitable prescription product, homemade cat food might be a viable alternative. Be sure to choose a veterinarian-formulated recipe, however, to ensure that your cat’s nutritional requirements are met.
Problems With Homemade Cat Food for Kidney Disease
Many homemade cat food recipes contain too much phosphorus, sodium, or protein for a cat with kidney disease. Protein is essential for obligate carnivores like your cat, but it’s important to keep it in balance for cats with kidney disease. If you restrict dietary protein too much, your cat’s body may begin to metabolize protein stored in muscle to meet its needs for specific amino acids.
In cats without adequate fat stores, tissue breakdown may also be prompted by a need for energy. The inclusion of digestible carbohydrates like rice in homemade cat food may help spare the use of body proteins to meet energy requirements. It also helps ensure nutritional adequacy without going overboard on protein or fat.
Homemade raw diets may not be appropriate for all cats with kidney disease. These diets may be too high in phosphorus—especially if they include raw bone. Lyn Thomson, BVSc of Feline-Nutrition.org, finds, however, that CKD patients do well on raw food that contains ground bone. In patients where blood phosphate levels start to approach unsafe levels, she simply administers a 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 blood work.
The Best Homemade Cat Food for Cats With Kidney Disease
The best diet for cats with kidney disease is tailored to their specific requirements. A nutritionally balanced homemade cat food recipe formulated by a veterinarian is a great place to start, but you and your vet may need to make adjustments according to your cat’s nutritional profile.
To help you get started, we’ve included a recipe developed by Dr. Meredith Wall, BA, BVSc. Dr. Wall completed a Bachelor of Veterinary Science at the University of Sydney in 2012 and a combined clinical nutrition residency and Ph.D. at Massey University in 2022.
You can find the original recipe (with accompanying updates, tips, and supplement recommendations) on her website here.
Chicken and Salmon Homemade Cat Food for Kidney Disease
This recipe has been specifically formulated for cats with kidney disease. Dr. Wall stresses the importance of preparing the recipe as directed—swapping ingredients may change the nutrient composition of the food. If you have questions about the recipe, its nutritional features, or how to use it, contact the Veterinary Nutrition Group directly.
NOTE: Dr. Wall recommends using a digital kitchen scale to ensure accurate measurements. Measure all quantities precisely – do not estimate.
- 470 grams of raw boneless, skinless chicken thigh
- 30 grams of pink salmon, including bones and skin (canned in water)
- 90 grams of salted butter, softened
- 220 grams of cooked short- or medium-grain white rice
- 100 grams of raw pumpkin or butternut squash (peeled)
- 60 grams of raw chopped spinach, kale, or Swiss chard (stems removed)
Supplements Needed (per 1-kilogram batch):
- 7 milliliters of Nordic Naturals pet liquid omega-3 supplement
- 5 grams of NOW psyllium husk powder
- 2 (1000g) capsules of NOW taurine supplement (contents only)
- 1 (25mg) tablet of Source Naturals iron supplement (crushed)
- 3 capsules NOW Daily Vits Multivitamin/Mineral supplement (contents only)
- 2 level teaspoons of NOW calcium carbonate powder
- ½ level teaspoon of NOW potassium chloride powder
- 2 (500mg) tablets of Nature’s Way choline supplement (crushed)
- 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 psyllium husk powder and fish oil. Mix well.
- Add the remaining supplements then stir until well combined.
- Let the mixture cool completely.
- Transfer to a tightly covered container (or divide into portions) and refrigerate or freeze.
Nutrition (per 1kg): 27.8% calories from protein, 54.8% calories from fat, 17.4% calories from carbohydrates, 0.71g phosphorus per 1000 kcal, and 70% moisture content.
Feeding Tips: This recipe makes about 1 kg (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 it in plastic. If the food doesn’t stick together, try individual containers.
Dr. Wall notes that while the initial investment in the recommended supplements may be high, they’ll last you through many batches. She cautions her readers against using any supplements other than the ones listed. Availability of supplements can be highly variable, but we’ve included links to the ones currently available on Amazon or Chewy below.
#1 Nordic Naturals Omega-3 Pet Liquid Supplement
This unflavored liquid supplement blends easily into this homemade cat food mixture and the included dropper makes it easy to measure out the right dosage. It’s sourced from a combination of anchovy and sardine oils and contains both EPA and DHA.
#2 NOW Psyllium Husk Powder
Rich in soluble fiber, this psyllium husk powder is finely ground and easy to measure with a teaspoon. To ensure the proper dosage, however, it’s best to weigh out the 5 grams you need.
#3 NOW Taurine (1,000 mg) Capsules
This taurine supplement comes in 1,000 mg capsules. Though the cellulose capsules shouldn’t be harmful to cats, it’s best to empty the supplement out so it can be blended into the mixture more thoroughly. You can also purchase 500 mg capsules, but you’ll need to use twice as many.
#4 Source Naturals Iron (25 mg) Tablets
Iron is a key component of hemoglobin, the compound in blood responsible for carrying oxygen. This supplement comes in tablet form with 25 milligrams of iron per tablet. The tablet should be finely crushed before mixing it into your homemade cat food blend.
#5 NOW Calcium Carbonate Powder
Finely powdered, this calcium carbonate supplement is designed to support healthy bones and teeth. Because some cats with kidney disease develop hypercalcemia when fed a renal diet, your veterinarian may recommend adjusting the dosage for this supplement.
#6 NOW Potassium Chloride Powder
Potassium supports healthy muscle and nerve function. Because potassium needs to be balanced with other minerals like calcium and sodium, veterinarians may recommend adjusting the dosage for some cats. This potassium supplement comes in a fine powder that is easy to measure and blend into the homemade food mixture.
#7 Nature’s Way Choline (500 mg) Tablets
This supplement contains 500 mg of choline bitartrate per tablet and should be finely crushed before use in the recipe. Choline is a precursor to acetylcholine, a neurotransmitter essential for healthy brain function.
Cats suffering from kidney disease require regular vet appointments to check blood work and monitor the progression of the disease. If your cat is taking medication, regular blood work will help you keep track of how well it’s working. It may also help inform your vet if the dosage of specific nutrients needs to be adjusted.
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 their kidneys. Before you try homemade cat food, do your research to make sure you understand what you’re getting yourself (and your cat) into.