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    Assisting Cats & Dogs with Impaired Kidneys

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    Oliver relaxing, he doesn't know what all the fuss is about.

    Kidney (renal) disease is usually diagnosed by your Vet from a set of blood test results, which show higher than normal levels of creatinine and urea. Symptoms that support diagnosis include: excessive thirst, frequent urination, loss of appetite, weight loss, lethargy, vomiting, and a urine smelling breath.
    Together, this information indicates that the kidneys are not fully functional and are somewhat struggling to do their work. Detected early enough there’s lots you and your Vet can do for you cat or dog to prolong lifestyle and vitality.

    My 19-year-old cat was diagnosed with renal damage several years ago. He is quite a lethargic cat and does drink and urinate quite often. However, he is still in good health, has a good quality of life, has a great appetite and is truly loved (one of life’s greatest medicines).
    Oliver is a work in progress as I am continuously learning new ways in which I can assist him to maintain his health and slow down the deterioration of the kidneys. I believe the raw diet I make for him, the oils, supplements and herbs are the reasons why he is still with me today. I also have to give credit to Oliver’s Vet who took the time to really make sure of what we were dealing with and how best to prolong a quality lifestyle. However, there is always more to learn and the more we understand about the nature of the problem the more help we can give.

    The kidneys are essential for life. They are responsible for:

    -The conversion of inactive Vitamin D into its ‘biologically active form’ called ‘
    Calcitriol,’ essential for the absorption of calcium into the blood from the gut.

    -The production of
    erythropoietin, which regulates the amount of red blood cells circulating in the blood.

    -The production of an enzyme called
    renin, which assists to regulate the amount of potassium and sodium in the blood and as a result, has a major effect on the blood pressure.

    -The production of
    L-carnitine. This amino acid is synthesized in the liver and kidneys. It is essential for the oxidation of fats for use as energy. In the case of impaired kidneys, L-carnitine may not be being produced in sufficient quantity. L-carnitine can easily be supplemented into the diet. If your cat or dog has impaired kidneys ask your Vet about adding this amino acid to their food.

    -The kidneys are responsible for the removal of wastes from the blood and into the urine for excretion from the body.

    Before we look at the variety of ways in which you can support your pet at home in conjunction with medications your Vet may have prescribed, I would like to briefly run through the difficulties faced by damaged kidneys. This will greatly assist your understanding of what your pet needs and certainly help you to ask the Vet important questions when it comes to prolonging quality of life.

    When our pet consumes foods containing vitamin D (such as egg yolk, oily fish), the kidneys are responsible for converting this ‘inactive form of Vitamin D’ into an ‘active’ form of vitamin D called ‘calcitriol.’ When kidneys are damaged this may not be carried out. If left untreated, calcium in the diet will not be effectively absorbed into the blood from the gut. Without calcium, the bones cannot maintain their health. As calcium phosphate is the structural component of bone, this is really important. My own cat with kidney disease takes 0.13ml of calcitriol daily.

    When the blood calcium levels are low the Parathyroid glands in the neck will secrete parathyroid hormone (PTH) to extract calcium from the bones. This causes the bones to weaken and deteriorate. Unfortunately most Vets do not address this problem. Thankfully I found a wonderful vet who prescribed me with synthetically made Calcitriol, the ‘active’ form of Vitamin D, which will maintain Oliver’s calcium levels and as a result, maintain strong bones.

    When the Kidneys are impaired there is usually an excessive production of the enzyme ‘
    renin.’ Renin released into the blood stimulates the liver to produce angiotensinogen, which is converted into angiotensin I. Angiotensin I then stimulates the lungs to produce ACE which converts the angiotensin I into angiotensin II.
    Once angiotensin II is in the blood, it targets several areas of the body to make the following changes:

    -
    It increases blood pressure by signaling the pituitary gland to release anti-diuretic hormone. This causes more water to be retained in the body.
    -It stimulates the arteries to constrict which increases the blood pressure.
    -
    The adrenal glands are stimulated to produce aldosterone, which causes the reabsorption of sodium and the excretion of potassium. Again, this increases blood pressure.

    In summary the excessive production of renin from the kidneys causes a domino effect of problems which all lead to high blood pressure. If left untreated your pet’s life is at risk and quality of life will not be maintained as long as it could.

    A popular pharmaceutical medicine prescribed for cats with renal problems is ‘Fortekor.’ Fortekor acts as an ACE inhibitor, preventing angiotensin I from being converted into angiotensin II. By blocking this process the blood pressure can be maintained and as a result, the load on the damaged kidneys is reduced.

    From my own experience though, Vets are very good at prescribing Fortekor but very few take the blood pressure of the pet, which would indicate how well the medication is doing.
    My cat unfortunately still had high blood pressure whilst taking 2.5mg of Fortekor every day. I never knew this until I changed Vets to get a second opinion.

    Again, I am truly thankful that the Vet who took Oliver’s blood pressure brought it to normal with a pharmaceutical drug called ‘ Amlodipine maleate.’ If the high blood pressure had remained undetected it could have caused major problems in the body including blindness. My advice is to have your pet’s blood pressure taken so that preventative measures can be taken.
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    Oliver having his blood pressure checked at the Vets.

    For your information, ‘Amlodipine maleate’ is a human drug that is also used for cats and dogs. It works by slowing down the rate at which calcium moves into the heart and blood vessel walls. This essentially relaxes the muscles of the heart and blood vessels resulting in a lower blood pressure.

    As my cat's high blood pressure was essentially being caused by an overactive thyroid gland, he was taken off the amlopidine and placed on a pharmaceutical drug for hyperthyroidism.

    Hyperthyroidism is often diagnosed with Renal Disease in cats. This results in the over production of thyroid hormones T3 and T4. Thyroid hormones are responsible for metabolic rate, regulation of body temperature, regulation of fats, protein and carbohydrates and the rate at which the kidneys carry out their filtration work.
    This problem can also be treated with medications from your Vet. Once diagnosed and treated, this will take the pressure off damaged kidneys with a view to extending their life as long as possible.

    However, when hyperthyroidism is treated with pharmaceutical drugs, the kidney filtration rate can slow down to the point at which they fail quicker. From the extensive research I carried out, sometimes hyperthyroidism is better left untreated in order to maintain what is left of the kidneys. Hyperthyroidism increases the filtration rate of the kidneys. If your pet is surviving on kidneys which are more than 80% disfunctional, maybe an increased filtration rate is just what is needed to prevent toxic build up in the blood.

    I now treat Oliver with herbal supplements which have taken away most of the symptoms of hyperthyroidism. Is it a cure?....no, but in my opinion, it certainly beats giving him pharmaceutical drugs which have nasty side effects. His kidneys appear to be functioning well considering the damage that has already been done.

    The herbs I give him are a combination of bungleweed, lemon balm, valerian, skullcap and hawthorn berries.
    I must say that this is not what my veterinarian advised. If your pet has these problems, your decision must be based on veterinary advice and your own research. My choice to place Oliver on herbal medicine is a personal choice and the decision to do so did not come lightly. I feel confident I am doing the best for my cat.

    How can we help our animal at home?

    -Make sure there is the correct balance of calcium and phosphorus in the diet.

    - Feed a high quality, human grade, mostly raw diet. (see my article on ‘The Raw Diet.’

    - Add nutritious supplements into the diet including Coenzyme Q10, L-carnitine and antioxidants such as Vitamins C, E and A, selenium and grape seed extract.
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    - Minerals such as magnesium and potassium are essential for the kidneys so ask your Vet about adding these into the diet. I was advised to add ‘low sodium based salt’ to my cat’s food (which is predominantly made of potassium). It makes the food more tasty too.

    - I believe phytonutrients are also great additions into any diet, especially when the body needs extra help. I recommend spirulina, chorella, barley grass and wheat grass. I give my cat an 1/8-teaspoon a day of a mixed green powder called ‘Supergreens.’ I actually take it myself too.
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    - Include a digestive enzyme and probiotic powder into the food to assist digestion and absorption of all the great nutrients you are feeding your pet.

    - be sure to add a high quality fish oil and an Omega 6 oil such as borage seed oil of blackcurrant oil on a daily basis. Fish oil is known to decrease high blood pressure amongst other great benefits.

    - There is some controversy over whether to feed a low protein diet or a high protein diet to a pet with renal damage. After much research on this topic, I am a firm believer and advocate of a high quality, human grade, high protein diet. Senior dogs and cats with renal impairment require quality protein if they are to have a fighting chance against this disease. (Read my article on ‘Degenerative diseases and how we can slow them down.’)

    - Avoid dried cat and dog biscuits. They are not only highly processed and loaded with carbohydrates, the protein is of extremely low quality and is of little use to a body which is craving good quality protein for new cell growth and repair. Dry biscuits will also dehydrate your pet, this is detrimental for the kidneys.

    - If you are still a follower of the commercial pet food, at least purchase the highest quality wet food you can, if possible organic.

    - Include a good supplement mix. Dr Bruce’s ‘Vets All Natural’ in Australia, has some great supplements that can improve any diet. They also sell an excellent grain mix that can be added to raw meat. Its very simple to prepare and far more healthy than anything from a can.

    - If possible introduce some raw foods such as egg yolk, plain yoghurt, chicken necks.

    - There are two well known brands of raw food for cats and dogs in Australia that can be bought ready made, packaged and frozen called ‘Big Dog Barf’ and ‘Dr Billinghurst BARF diet.’

    My suggestions are all based on the well-proven theory that if we put excellent fuel into our sick pet, at least they will have a fighting chance to maintain strength, vitality and quality of life through difficult times.


    If a really healthy diet is maintained, blood pressure is regularly checked, a great Vet supplies your pet with exactly what they need, the kidneys should be able to work as best they can with the minimum amount of stress placed on them. Oliver is doing well considering his kidneys have been damaged for years. I’ll keep you posted on how he is going. It's a work in progress…..

    Oliver in his younger days
    19yrs old and looking great Big O, I love you my furry friend.

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