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Therapeutic diets and phosphate binder use in cats with CKD

Caney SM. An online survey of dietary and phosphate binder practices of owners of cats with chronic kidney disease. J Feline Med Surg. 2017 Oct;19(10):1040-1047.


Chronic kidney disease (CKD) is a common health condition in elderly cats, approximately affecting more than 30% of cats over the age of 10 years. Common signs include weight loss, increased water intake and urine volume, poor appetite and vomiting.  Because hypertension is common among cats with CKD, systolic blood pressure measurements are recommended when CKD is suspected or diagnosed.

The goal of this study was to learn more about UK cat owner experiences with CKD, primarily focusing on feeding of therapeutic renal diets (TRD) and the use of intestinal phosphate binders (IPBs) through an online survey. The author comments that prior clinical studies report that feeding a special diet with a phosphate-restricted therapeutic aim is associated with increased survival times for cats with CKD.

In this study, a total of 859 owners participated in the survey.  It was noted that most of the cats (n=620, 72.18%) had two or more signs associated with CKD at the time of their diagnosis. Polydipsia was most commonly found (n=462, 53.78%) followed by weight loss (n=426, 49.59%).  The diagnosis of CKD had been made solely at the time of a wellness examination in 94 cats (10.94%), showing that ‘wellcat’ checks were being promoted.  Blood pressure was evaluated in 371 (43.19%) of the cats, a smaller number than would be expected, with anti-hypertensive treatment prescribed in 100 (26.95%) of these cats.

A large majority of the owners had received a veterinarian’s recommendation to feed a therapeutic renal diet (n=780, 90.80%). Compliance following the recommendation was good since overall 571 (66.47%) owners were feeding some TRD. Of those cats where no recommendation was made, only 7.04% were feeding a TRD.

Awareness of intestinal phosphate binders (IPB) was considered low in this study with 321 owners (37.81%) having received a recommendation for use of one of these products as a therapy.  Most owners were using either lanthacium carbonate (Renalzin, Bayer Animal Health) or a calcium carbonate and chitosan combination (Ipatikine, Vetoquinol). The majority of owners using an IPB (n=178) reported that their cat accepted the treatment within 4 weeks of initiating therapy. IPBs are particularly indicated where a TRD is not or cannot be used or in the cases where the therapeutic diet is not sufficient to control serum phosphate levels.

The author concludes that the study reveals how powerful the recommendation of a veterinarian can be in achieving compliance to suggested treatment of this condition. (VT)

See also:
Morgan SK, Willis S, Shepherd ML. Survey of owner motivation and veterinary input  of owners feeding diets containing raw animal products. Peer J.  Mar 2;5:e3031. doi: 10.7717/peerj.3031