This is a long post about the best diet for a cat with kidney disease.
There are a lot of options and there’s not necessarily a “right” answer!
My own 14-year-old cat Scout was diagnosed with early stage 2 Chronic Kidney disease in may 2019.
First things first, I am not a vet. Anything you choose to follow here must be discussed with your cat’s vet. This post is information to add to your ongoing research. You are the best advocate for your own cat.
IN THIS POST:
Best diet for cats with kidney disease – what cats need
Is protein bad for cats with kidney disease?
What I feed my cat with kidney disease
Raw diet for cats with kidney disease
Hills K/D feline and royal Canin prescription diets
Commercial diets for cats with kidney disease
Best food for dogs with kidney disease
Best diet for cats with kidney disease – what cats need
For a cat with kidney disease, you must feed a high-moisture food that is low in phosphorus.
Traditionally, a lot of veterinarians will recommend a diet for cats with chronic kidney disease (CKD) that is:
high moisture
low phosphorous
low or moderate protein
The difficult part is the protein. must you feed low protein or a lot more moderate protein? I personally believe a raw diet with moderate protein is healthiest for cats with kidney disease, but I’ll get to that below.
Let’s look at each of the above bullets in a lot more detail.
Lots of water for cats with kidney disease
One of the most crucial things for your cat with kidney disease is to make sure he’s drinking a lot of water.
You can help your cat get a lot more water by:
Providing your cat with multiple water bowls in different locations
Buying a pet water fountain
Feed mostly raw or canned food
Add a tablespoon of water to meals
If you need to feed dry food, add water to it
Eventually, some cats with a lot more advanced kidney disease will need additional fluids through an IV.
Low phosphorus food for cats with kidney disease
It’s crucial for cats with kidney disease to eat a diet low in phosphorus.
If you feed your cat a kidney support prescription diet, it will be low in phosphorus.
Limiting phosphorus in a CKD cat’s diet helps to delay the progression of kidney disease. This is because the kidneys of a CKD cat can no longer excrete excess phosphorous the way a healthy cat does.
Eventually, a cat with kidney disease will have high levels of phosphorus in their blood which may cause a lack of appetite and weakness.
How much phosphorus is ok for a cat with kidney disease?
If you feed your cat a prescription diet specifically for cats with kidney disease, the phosphorus level will be low enough.
Always ask your cat’s vet, but here is the info I have found:
Phosphorus by dry matter basis – around .4 to .6%
The kidney support prescription foods I mention in this post all have a phos level of around .4 to .6% on a dry matter basis.
Some people may choose to feed a non-prescription option for whatever reason, which I only recommend with the support of your cat’s vet. in that case, you want to find a food that has a phosphorus range on a dry matter basis around .5 to .7%.
This post recommends a phosphorus range on a dry matter basis for cats with kidney disease as .3 to .6%. The Facebook group I belong to recommends keeping the phos to around or below .7% on a dry matter basis. You must always ask your cat’s vet what is best.
What to look for on cat food labels
Unfortunately, you typically won’t find the phosphorus information on a lot of cat food labels. This is because healthy cats don’t need restricted phosphorus.
In the “guaranteed analysis” info on the label, phosphorus is typically not provided and if it is, it’s not on a “dry matter basis.” To get the “dry matter basis,” you will likely need to email or call the company and request what the phosphorus level is on a dry matter basis. They must be ready to supply this info for you.
Adding a phosphorus binder
Prescription diets for cats with kidney disease will all have proper low phosphorus levels. I go into a lot more details on several brands below.
However, if your cat won’t eat any of the low-phosphorus foods, another option is to add a phosphorus binder to your cat’s meals.
A phosphorus binder prevents your cat from absorbing the phosphorus in her food. You must talk with your cat’s vet before adding a phosphorus binder to make sure it’s ideal for your certain cat.
Get a phosphorus binder here.
The kidney support prescription food from Darwin’s includes a natural phosphorus binder in the recipe.
Protein for cats with kidney disease
Protein is not bad for cats with kidney disease; it’s the phosphorus in the protein.
Since phosphorus content is related to protein content, cats with kidney disease will need to eat a diet with less protein than a cat with healthy kidneys.
We want to limit the protein for a cat with kidney disease but limiting the protein too much can have other health issues such as muscle wasting.
So the question is, must you feed your cat a low protein diet such as Hill’s K/D or is it better to feed a diet with a lot more moderate protein such as Darwin’s kidney support?
There is no “right” answer here, but I believe a a lot more moderate protein diet is best for a cat considering that cats are carnivores.
Which brings me to …
What to feed a cat with kidney disease?
While you or your cat’s vet might have an ideal diet for your cat in mind, the reality is you have to feed something your cat will actually eat!
My own CKD cat Scout gets a couple of options in rotation. He is absolutely picky, so I mix it up for him to keep his interest and weight up.
The majority of my CKD cat’s diet includes:
Darwin’s raw kidney support (prescription)
Royal Canin Renal support canned (prescription)
I also mix in a small amount of royal Canin renal support dry food (prescription).
Dry food is not ideal for a cat with kidney disease considering that the moisture is removed, but sprinkling a bit on my cat’s raw or canned food encourages him to eat more. He thinks kibble is a treat!
Now, here are some a lot more details on options to feed your cat with kidney disease.
I’m going to share info on:
Raw diet prescription (Darwin’s)
Canned and dry prescription (Hill’s or royal Canin)
Non-prescription canned options
Raw diet for cats with kidney disease
My cat Scout is in the process of switching to a mostly 100% raw diet from Darwin’s.
Darwin’s is a sponsor of That Mutt.
The reason I want my cat to eat a raw diet is because cats are carnivores and real, fresh meat is healthy for them! My dogs have also eaten a raw diet over the years. I believe it’s the healthiest option for a lot of dogs and cats.
Darwin’s prescription raw food for cats
Darwin’s is the only company that uses raw cat food prescription formulas.
The company’s kidney support formula is specifically created to meet the nutrition requirements for a cat with kidney disease. The food has a a lot more moderate protein level than other prescription diets (48% protein on a dry matter basis), which is a huge plus!
Darwin’s kidney support formula is:
high moisture
low phosphorus
moderate protein!
made with real, fresh meat
hormone-free and antibiotic-free
no grains, added fillers or chemical preservatives
The Darwin’s kidney support formula includes a natural phosphorus binder to minimize phosphorus absorption. It also has boosted vitamin B levels to replace the vitamins CKD cats lose through frequent urination.
Learn a lot more about the food here.
Since Darwin’s kidney support is a prescription diet, you will need a prescription from your cat’s vet to order.
How to get a prescription from your cat’s vet
Darwin’s makes it really easy for you to get a prescription. You can simply send this link to your vet. If your vet would like to see the nutrition information of the food, here is a link to the guaranteed analysis.
If your cat’s vet is hesitant about feeding a raw diet, you can also suggested the idea of lightly cooking the meat. The company says that doing so will not cause the meat to lose its nutrients.
When your vet doesn’t support a raw diet
Unfortunately, not all vets are supportive of raw diets. I made the choice to find a new vet because Scout’s original vet politely declined not to go over options beyond the brands she carried in her office.
I wanted healthier options for my cat so I was lucky to find a holistic vet in our area. The drive is 20 minutes additionally but it’s worth it to have a vet on board with what I believe in – feeding my family pets natural, fresh food whenever possible.
Homemade raw cat food for cats with kidney disease
Some people choose to feed a homemade raw diet or a homemade cooked diet to their cat with kidney disease using ingredients that include meat, organ meat, eggs and egg shells. Egg shells are typically used rather than raw bone because egg shells have less phosphorus than bone.
I am not experienced in homemade raw cat food recipes for cats with kidney disease, but it can be made with the ideal research and support of your vet.
Now, as much as I’d like to recommend a raw diet for all cats with kidney disease, I also know some people are not comfortable feeding a raw diet for whatever reason.
Here are some canned and dry food options …
Hill’s science diet K/D and royal Canin prescription diets
If your cat has kidney disease, there is a good chance your vet will recommend:
Hill’s Prescription diet K/D (kidney disease) or
Royal Canin Renal Support
Most vets in the U.S. sell one or both of these brands in a canned and dry version and there are several different flavors (and textures of canned food) to try.
Hill’s and royal Canin prescription diets are created to meet the health requirements of a cat with chronic kidney disease, but there are some drawbacks to these foods that I’ll get to now.
Potential issues with Hill’s and royal Canin:
The canned options are much healthier than dry food
Royal Canin and Hill’s are low in protein – enjoy for weight loss
Read ingredients – these foods consist of grains & fillers
Raw or canned prescription food is healthier for cats than dry food of any kind.
The dry prescription food option is there for cats who are picky and refuse to eat canned or raw food. We know there are lots of picky cats out there! If you can’t get your cat to eat canned or raw food, add water to her dry food (if she’ll eat it) to help her get a lot more water in her diet.
Since extreme weight loss is a side effect of kidney disease, you want to do what you can to keep your cat’s weight up.
For me, that indicates feeding a food with a lot more moderate protein diet such as Darwin’s, but royal Canin has a bit a lot more protein than Hill’s.
Protein percentage in Hill’s, royal Canin and Darwin’s by comparison:
Hill’s KD canned pate with chicken: 30% (dry matter)
Royal Canin canned renal support “E” flavor: 33.5% (dry matter)
Darwin’s kidney support chicken: 48% (dry matter)
*I confirmed the above info with each company.
I highly recommend Darwin’s due to the a lot more moderate protein level. You can also try mixing Darwin’s and royal Canin as I make with Scout.
Ingredients in your cat’s food
It’s a good idea to read the ingredients of the food you choose to feed your cat.
The ingredients in the Hill’s K/D dry food is not ideal for a carnivore. It consists of brown rice and corn gluten meal as the top two ingredients. here are the top 15 ingredients (from their website).
Hill’s K/D dry cat food (chicken):
Brown Rice, Corn Gluten Meal, Pork Fat, ocean Fish, Cracked Pearled Barley, whole Grain Wheat, Brewers Rice, Wheat Gluten, chicken Liver Flavor, Egg Product, Soybean Oil, Pea Protein, chicken Meal, Dried Beet Pulp, Fish Oil
The Hill’s renal canned food is better than their renal dry food. here are the first 15 ingredients of the pate with chicken canned:
Hill’s prescription diet feline K/D canned (pate with chicken):
Water, Pork Liver, Chicken, Egg Product, Brewers Rice, Sugar, chicken Fat, chicken Liver Flavor, modified Rice Starch, Powdered Cellulose, Fish Oil, Calcium Sulfate, Potassium Citrate, Guar Gum, Soybean Oil
By comparison, royal Canin canned “E” flavor:
First 15 ingredients: Water sufficient for processing, pork by-products, chicken liver, chicken, chicken by-products, brewers rice flour, salmon, brewers rice, powdered cellulose, pork plasma, fish oil, potassium citrate, guar gum, calcium carbonate, carrageenan
And royal Canin’s dry “A” flavor:
First 15 ingredients: Brewers rice, corn, chicken fat, wheat gluten, corn gluten meal, chicken by-product meal, soy protein isolate, powdered cellulose, natural flavors, wheat, chicory, fish oil, calcium carbonate, sodium silico aluminate, potassium chloride
You can see from the above examples how canned food has better ingredients than the dry food, in addition to having the moisture your cat needs.
Darwin’s kidney support is BY far the healthiest:
First 15 ingredients: chicken thigh Meat, Turkey Hearts, chicken Hearts, Beets, Zucchini, Turkey Livers, chicken Livers, Celery, Fish Oil, Egg Whites, Parsley, Gelatin, Oyster shell Pwdr, Cod Liver Oil, Dandelion root Pwdr, lnulin
It’s not that Hill’s and royal Canin are bad for your cat. They are created for cats with kidney disease, and I give my own cat royal Canin on rotation with raw food. It’s just that I want you to be aware of all options so you can make the best choice for your certain cat and situation.
Finally, I want to bring up the option of feeding your chronic kidney disease cat a non-prescription canned option …
Commercial cat food for cats with kidney disease
The reason I suggest this option is because:
Prescription foods are expensive
Low protein prescription foods can cause weight loss
Some cats refuse to eat all of the prescription foods
Sometimes when your cat has kidney d