SUMMARY:
ROYAL CANIN Veterinary DietTM/MC
feline RENAL LP 21TM/MC (dry) and RENAL
LPTM/MC (pouch) are complete cat foods
with restricted phosphorus levels and reduced protein and sodium content
to aid in the dietary management of chronic renal failure in cats.
| INDICATIONS:
|
CONTRAINDICATIONS: |
| -- |
For the management of
chronic renal failure in adult cats |
-- |
Growing kittens |
| |
|
-- |
Pregnant
or lactating queens |
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RATIONALE:
Dietary management of cats with chronic renal failure (CRF) is aimed at
improving clinical symptoms, minimizing vitamin, mineral, and electrolyte
imbalances, and slowing disease progression. In order to achieve these
goals, levels of phosphorus, protein, potassium, sodium, B-complex vitamins,
and fat have been modified in RENAL LP 21TM/MC
(dry) and RENAL LPTM/MC (pouch).
Energy:
In cats with chronic renal failure, it is important to provide sufficient
energy to minimize catabolism of either dietary or endogenous protein.
Protein catabolism contributes to the production of nitrogenous waste
products and the clinical symptomology of uremia.
Non-protein energy can be provided as either carbohydrate or fat. Fat
is preferred for the patient with renal failure as it increases the energy
density of the diet. This translates to less volume of food fed on a daily
basis, as compared with maintenance diets.
RENAL LP 21TM/MC and RENAL LPTM/MC
are formulated with relatively high fat contents and high energy density.
Protein:
Cats with chronic renal failure have a reduced ability to excrete both
nitrogenous and non-nitrogenous protein catabolites. The accumulation
of these metabolic by-products in the circulation is one of the major
causes of uremic symptoms and laboratory abnormalities with renal failure.
Clinical studies have shown that modifying dietary protein intake in
the cat can reduce blood urea nitrogen (an index of nitrogenous waste
products), as well as provide clinical benefits. In addition to reducing
the level of nitrogenous waste products, protein restriction may also
reduce the intake of dietary phosphorus. Protein restriction also decreases
the renal solute load, thereby lessening the severity of the polyuria
and polydipsia.
Minerals:
Dietary phosphorus restriction has been shown to slow the progression
of renal disease. Hyperphosphatemia is a common finding in chronic renal
failure. Increased serum phosphorus concentrations lead to a decrease
in the activity of the enzyme alpha-hydroxylase in the kidney, contributing
to a decreased production of calcitriol and an increased production of
parathyroid hormone.
Parathyroid hormone is considered a uremic toxin. It contributes to
anemia, neurotoxicity, soft tissue calcification, and renal osteodystrophy.
Phosphorus restriction decreases the production of parathyroid hormone
and slows the progression of renal disease.
Hypokalemia has been shown to be a common electrolyte abnormality in
cats with chronic renal failure. Indeed, as many as 30% of cats with chronic
renal failure may be hypokalemic. Conversely, 13% of cats with chronic
renal failure may be hyperkalemic. Therefore, diets fed to cats with chronic
renal failure should have adequate, but not excessive, dietary potassium
levels. The level in RENAL LP 21TM/MC
(dry) and RENAL LPTM/MC (pouch) should
reduce the risk of hypokalemia, but monitoring potassium status in all
cats with chronic renal failure should be emphasized.
Systemic hypertension has been reported in cats with chronic renal failure.
In addition, hypertension has been implicated in the progression of renal
failure. Sodium homeostasis is primarily regulated by the kidney. With
advanced renal failure, the kidneys can no longer excrete adequate amounts
of sodium, and the excess dietary sodium may contribute to hypertension.
Therefore, dietary sodium intake should be controlled to assist the management
of hypertension.
RENAL LP 21TM/MC (dry) and RENAL LPTM/MC
(pouch) have been clinically proven to significantly reduce the concentrations
of blood urea nitrogen, phosphate and parathyroid hormone.
Furthermore, RENAL LP 21TM/MC
(dry) and RENAL LPTM/MC (pouch) has
been clinically proven to slow the progression of renal disease in cats.
In a study of 50 cats with naturally-occurring renal disease, cats fed
RENAL LP 21TM/MC (dry) and RENAL LPTM/MC
(pouch) survived twice as long after diagnosis as cats fed a maintenance
diet.
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Special Tips:
Inappetance
is a common symptom in cats with renal failure. Therefore, food intake
should be monitored to ensure adequate daily caloric intake. Warming the
food to body temperature may improve palatability, as will adding water
to make a "gravy" with the dry. Try feeding "little and
often” and, if necessary, enteral feeding should be considered.
Cats with renal disease
are at risk of becoming dehydrated. Therefore, counsel the owner to be
aware of this risk and make sure that fresh drinking water is available
at all times.
Cats with renal disease
need to urinate more frequently. The cat’s litter box may need to
be cleaned more frequently to ensure that the cat continues to be comfortable
using it.
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REFERENCES:
Elliott J, Syme HM, Markwell PJ. Acid-base balance
of cats with chronic renal failure: Effect of deteriorating renal function.
J Small Anim Pract. 1993;44:261-8.
Elliott J, Syme HM, Reubens E, et al. Assessment of
acid-base status of cats with naturally occurring chronic renal failure.
J Small Anim Pract. 2003;74:145-51.
Syme HM, Barber PJ, Markwell PJ, et al. Prevalence of
systolic hypertension in cats with chronic renal failure at initial evaluation.
J Am Vet Med Assoc. 2002;220(12):1799-804.
Elliott J, Barber PJ, Syme HM, et al. Feline hypertension:
clinical findings and response to antihypertensive treatment in 30 cases.
J Small Anim Pract. 2001;42(3):122-9.
Syme HM, Markwell PJ, Elliott J. Aldosterone and plasma
renin activity in cats with hypertension and / or chronic renal failure.
J Vet Intern Med 2002;16:354.
Elliott J, Rawlings JM, Markwell PJ, et al. Survival
of Cats with naturally occurring Chronic Renal Failure: Effect of Dietary
Management J Small Anim Pract. 2000;41: 235-242.
Barber PJ, Elliott J, Markwell PJ, et al. Effect of
dietary phosphate restriction on renal secondary hyperparathyroidism in
the cat. J Small Anim Pract1999;40:62-70.
Barber PJ, Elliott J, Markwell PJ, et al. Effect of
conventional dietary management of renal secondary hyperparathyroidism
in the cat. J Small Anim Pract1999;40: 62-70.
Markwell PJ, Barber PJ, Rawlings JM, et al. Recent advances
in the dietary management of chronic renal failure in cats. Recent Advances
in Animal Nutrition in Australia 1999;12: 115-119.
Elliott J, Barber PJ, Rawlings JM, et al. Effect of
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Markwell PJ, Bauer JE, Rawlings JM, et al. The impact
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review of data from clinical and experimental studies. Journal of Animal
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Barber PJ, Rawlings JM, Markwell PJ, et al. Effect of
medical management of feline hyperthyroidism on parameters of renal function
and calcium metabolism. Proceedings of the BSAVA Congress 1996: p 194.
Barber PJ, Rawlings JM, Markwell PJ, et al. Treatment
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Crocker R, Bauer J, Malcik K, et al. Effects of urinary
polyunsaturated fatty acids on urinary eicosanoids in chronic renal failure.
J Vet Intern Med 1996;10:166.
Barber PJ, Rawlings JM, Markwell PJ, et al. Effect of
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Barber PJ, Rawlings JM, Markwell PJ, et al. The role
of calcitriol in feline renal secondary hyperparathyroidism. Proceedings
of the 5th Annual Congress of the European Society of Veterinary Internal
Medicine 1995;58-59.
Harte JG, Markwell PJ, Moraillon R, et al. Dietary management
of naturally occurring chronic renal failure in cats. J Nutr 1994;124:
2660S-62S.
Smith BHE, Frith N, Markwell PJ. Effects of dietary
management of renal disease on certain biochemical parameters. Animal
Chemical Society Newsletter 1994.
Zoran D, Harte J, Senior D, et al. Effects of polyunsaturated
fatty acids on indices of renal function. J Vet Intern Med 1994;8(2):167.
Markwell PJ, Harte JG, Moraillon R, et al. Dietary management
of naturally occurring renal disease in cats. Proceedings of the Waltham
Symposium on the Nutrition of Companion Animals 1993:65.
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