Dear Dr. John,
My husband and I had four cats and lost one to pancreatitis. Now our 15-year-old cat has apparently developed chronic kidney disease. Our vet has placed him on a prescription diet called K/D. Our cat’s most recent blood numbers of significance are SDMA 17, BUN 42, and Creatinine 2.9 and were slightly increased since its previous blood draw.
Our cat does not like the prescription food at all and will barely eat it. We have an appointment to learn how to give him fluids under the skin, but our other cat seemed to wince every time we did that, and we don’t want to cause our cat any pain. We have even thought of seeking the treatment by an acupuncturist. How should we proceed? D.S.
Dear D.S.,
Chronic kidney disease (CKD) is a condition that afflicts many older cats. The optimistic news is that these patients can be maintained for fairly long periods of time with good supportive care. I had one patient that lived for almost four years on special diets and subcutaneous fluids. If your other cat winced when being given fluids, you might just need a lesson in technique because it is not painful if done properly.
The blood values you have shared are not too bad for an older cat. SDMA should be under 14, BUN under 37, and Creatinine under 2.3 under the lab values I use but they can differ slightly depending on the lab and their reference ranges. So you can hopefully keep your cat maintained for some time to come!
The K/D diet is an excellent renal support diet, but I have seen it have some palatability issues. You can contact Hills, who makes it, about improving the taste or add something like water or tuna juice. You can talk to your veterinarian about trying an appetite stimulant such as mirtazapine. Alternatively, your veterinarian could help you explore other commercial renal diets made by Purina or Royal Canin. Lastly, there are homemade diets that you can find online. Acupuncture is documented as a helpful integrative approach to CKD, but I have no experience with it. Good luck.
Dr. John de Jong owns and operates the Boston Mobile Veterinary Clinic. He can be reached at 781-899-9994.
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