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The unused small colon microcolon contains a small amount of inspissated mucus or grayish meconium. A fissure could be the cause, if negative then consider either malrotation or Necrotizing enterocolitis. Small PH can be observed. Wettstein, announced a patent application in a paper "On the Artificial Preparation of the Testicular Hormone Testosterone Androstenoneol. Patients with TCA present with a large variety of symptoms. For those patients who are overweight, added pressure on the lungs can increase the effort required to breathe, so encouraging patients to safely lose excess weight is important. There are a number of potential disruptions to global food supply that could cause widespread malnutrition.
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Comments will be used to improve web content and will not be responded to. Thank you for taking the time to provide feedback. It will be used to make improvements to this website. Skip to content Skip to site navigation. What would you like to do? It is not known exactly why older cats lose weight, but it is thought it may be at least in part because their bodies become less able to digest nutrients, particularly fat and protein. Low protein digestibility also seems to affect mature and geriatric cats.
The incidence of low fat and protein digestibility tends to occur in the same cats. A marked decline apparently becomes particularly prevalent after around age Whatever the precise reason, weight loss in older cats is not good news. Emaciated cats had a significantly higher risk of death compared with cats in optimal body condition.
Perez-Camargo et al demonstrated that body weight, lean body mass, and fat mass decline in cats over the age of 12 years, particularly in the last 1 to 2 years of life. Even in younger cats, low body weight can be a concern. Mechanisms causing loss of lean body mass in kidney disease Mitch WE The American Journal of Clinical Nutrition 67 pp explains more about this problem in humans.
It is therefore extremely important to monitor your cat's weight and to keep him or her eating. I recommend weighing your cat at least weekly. There are links on buying scales suitable for weighing cats here. Muscle wasting is also common in CKD cats. This is partly because most CKD cats are elderly and the elderly are prone to sarcopaenia, which is the age-related loss of muscle.
CKD cats may also suffer from cachexia. Cachexia is defined as a metabolic syndrome in which inflammation is the key feature and so cachexia can be an underlying condition of sarcopenia.
Recently, cachexia has been defined as 'a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle mass with or without loss of fat mass.
The prominent clinical feature of cachexia is weight loss in adults. CKD is one such underlying illness. Although the prevalence of cachexia in dogs and cats with CKD has not specifically been measured, it appears to be relatively high and likely has negative clinical effects.
Since creatinine , one of the measures of kidney function, is a by-product of muscle, cats who lose a lot of muscle may have reduced creatinine levels, because they cannot produce as much creatinine. The Merck Veterinary Manual states "Serum creatinine levels can be falsely lowered in patients with severe muscle wasting. Over months cats can down regulate their protein needs and switch to use other pathways, but in the short and intermediate term, muscle will be catabolized.
The resulting muscle wasting and decreased mass reduces the serum level of creatinine Cr measured. You may therefore think your cat's CKD is improving because the creatinine is falling, when in fact this is not the case.
Cats with hyperthyroidism also tend to lose a lot of muscle, which is an additional headache if your cat has both CKD and hyperthyroidism. Dietary omega-3 fatty acid supplementation increases the rate of muscle protein synthesis in older adults: It concluded "Omega-3 fatty acids stimulate muscle protein synthesis in older adults and may be useful for the prevention and treatment of sarcopenia.
When considering a food for their CKD cats, many people focus on its phosphorus and protein levels, but it is also important to consider the calorie content, especially if you want your cat to keep on or gain weight and muscle. A healthy cat needs approximately calories per day per pound of body weight, or possibly more if the cat is particularly active. The National Research Council states that a lean adult cat weighing 5 lbs needs around calories a day, and a lean adult cat weighing 10 pounds needs around calories a day.
The World Small Animal Veterinary Association Global Nutrition Committee makes similar recommendations for the average healthy adult cat at a healthy weight. This level of intake is unlikely to be sufficient for older cats. In Feeding older cats - an update in new nutritional therapies Sparkes A Topics in Companion Animal Medicine 26 1 pp, Dr Sparkes states that older cats need more calories than younger cats, preferably in the form of protein.
He adds that older cats also seem to do better when fed a diet containing prebiotics , antioxidants and essential fatty acids. Many sources, including the National Research Council, also believe that chronically sick cats need more calories, possibly as many as twice the number of calories as healthy cats. So obviously, feeding a teaspoonful of food a day is not going to be enough to maintain your CKD cat's weight, let alone increase it if your cat is too thin.
Another thing to consider is the water content of the food. Although increased fluid content can be helpful for CKD cats, who are at risk of dehydration, the downside is that such foods may make the cat feel relatively full while providing insufficient calories for the cat's needs. This is often the case with simple foods that consist largely of meat or fish.
Lower fat foods may also contain fewer calories. Therapeutic kidney diets are more calorie dense than standard maintenance diets. You can check the calorie content of some US foods here canned and here dry. I am working on adding the calorie content to the UK food data tables. Stanley Marks discusses feline dietary and calorie needs in Diagnostic and therapeutic approach to the anorectic cat , Presentation to the World Small Animal Veterinary Association World Congress The ins and outs of managing feline chronic kidney disease Codi M Today's Veterinary Technician has a formula Box 1 for calculating the daily energy requirement for neutered CKD cats.
PetSci has a calorie calculator. Some manufacturers provide data about the metabolisable energy ME of their foods. With a higher ME, your pet's body will receive more energy from a smaller amount of food. This can be helpful for CKD cats who tend not to have much appetite. Food Composition and Requirements.
The usual guidelines for CKD cats are to feed a diet which has added potassium and essential fatty acids but which has reduced levels of protein, phosphorus and sodium. It is helpful to understand the reasoning behind these recommendations.
If you asked most people what was the main nutritional step to take for a cat with kidney disease, they would probably say "feed low protein. This section discusses the role of protein in kidney disease and if and when to reduce the levels of protein which you feed. Protein is a molecular structure made up of a number of amino acids which are essential for the body to repair and maintain itself.
Cats have a higher need for protein than many other species because, unlike dogs or humans, they cannot manufacture certain of these amino acids e. These missing amino acids are only found in meat and corn gluten meal , and therefore cats must ideally eat meat in order to obtain these amino acids. This is why cats are known as obligate carnivores.
When people feed a cat a vegetarian diet which I definitely do not recommend for any cat , they provide these amino acids in the form of supplements, but cats are optimally designed to obtain them from meat.
The National Research Council NRC guidelines indicate a minimum daily protein requirement and a recommended daily protein allowance of 2. Let's crunch some numbers based on these recommendations:.
These levels sounded low to me, and research indicates they probably are. The study states that " approximately 1. This study provides evidence that nitrogen balance studies are inadequate for determining optimum protein requirements.
Animals, including cats, can adapt to low protein intake and maintain nitrogen balance while depleting LBM.
Loss of LBM and an associated reduction in protein turnover can result in compromised immune function and increased morbidity. The minimum daily protein requirement for adult cats appears to be at least 5. Further research is needed to determine the effect, if any, of body condition, age and gender on protein requirements. On this basis, a 10lb 4.
To complicate matters, older cats may have higher protein requirements. Pet Education has an overview of protein requirements in cats. Studies performed on humans and rats with CKD found that feeding reduced levels of protein appeared to be beneficial and might help prolong life.
Therefore researchers wondered if a lower protein intake might have a similar beneficial effect for cats. In many of the early studies in cats, the cats had a large percentage of their kidneys surgically removed in order to induce kidney failure; this is not the way kidney disease tends to develop in most cats, who usually have chronic kidney disease rather than acute kidney injury.
Even so, the results were not necessarily what might have been expected. Some of the cats fed the high protein diet did develop transient hypokalaemia low potassium levels , which might have been because the low protein diet contained more potassium. No real differences were seen after a year, and there was no change in GFR in any group. A vet from Ohio State University College of Veterinary Medicine stated with regard to this study "recent findings in cats with induced renal insufficiency suggest that feeding diets restricted in protein may not be necessary for this species.
In Effects of dietary p rotein intake on re nal f unction Supplement to Compendium on Continuing Education for the Practising Veterinarian 21 Dr Finco stated "the negative results from the second study indicate that protein restriction in cats with renal disease remains to be proven as an effective maneuver for ameliorating progression of renal disease".
These studies seem to indicate that a reduced protein intake is not necessarily of any real benefit to CKD cats. However, there are also some studies into the use of therapeutic kidney diets , which have reduced protein levels rather than extremely low protein levels along with other attributes ; and more sensibly, research began to focus on cats with naturally occurring CKD.
In Survival of cats with naturally occurring chronic renal failure: Some of the cats presumably in both groups were also given phosphorus binders.
The cats fed the therapeutic kidney diet survived longer than the other cats, but it is not clear whether this was due to the reduction in phosphorus intake rather than the reduction in protein intake. This is the first prospective dietary study involving naturally occurring feline CKD cases where survival from first diagnosis has been assessed.
The studies described above were focusing on whether a reduced protein intake might slow the progression of kidney disease and help the cat live longer. The other issue is whether feeding reduced protein might help the cat feel better. This study found that feeding a therapeutic kidney diet helped to keep BUN levels lower and appeared to help prevent metabolic acidosis in cats with more advanced CKD.
Thus in this study the therapeutic kidney diet not only appeared to reduce the number of deaths, but the cats also exhibited fewer signs of illness. This is because, during the breakdown of dietary protein in the digestive process, waste substances are created which are filtered out of the blood by the kidneys and excreted via urination. This is sometimes referred to as the removal of nitrogenous wastes.
Contrary to popular opinion, BUN and creatinine are not toxins themselves. However, BUN levels correlate with uraemic toxin levels, i. If you feed a reduced protein diet, this reduces the amount of nitrogenous wastes that must be processed by the kidneys. This usually leads to a reduction in BUN levels and in turn the cat will often feel and act better.
These clinical signs, that are often referred to as uremia, can be caused by an accumulation of the breakdown products of protein metabolism sometimes referred to as nitrogenous waste products. This protein comes from both the protein in your animal's diet, as well as mobilization and degradation of their own body's protein stores. Consumption of protein in amounts greater than what your animal needs to maintain normal bodily functions can exacerbate these clinical signs.
Anemia enhances the weakness and reluctance to eat in animals with renal failure. Anemia can occur for several reasons with renal disease, but one factor that is believed to make it worse is excessive dietary protein. Nitrogenous waste products are believed to contribute to anemia by reducing the life span of red blood cells. The waste products may also enhance blood loss by leading to the formation of gastrointestinal ulcers and a reduction in blood clotting ability.
It must also be remembered that when vets recommend therapeutic kidney diets, they are not only recommending reduced protein levels. Therapeutic kidney diets have other attributes, for example reduced protein diets also tend to contain less phosphorus, and phosphorus control is extremely important in CKD cats.
These foods also contain additional levels of potassium and essential fatty acids see below. You can read more about the attributes of therapeutic kidney diets on the Which Foods to Feed page. Of course, nothing is ever simple when it comes to cats, so there are also potential downsides with reduced protein intake. One common problem with reduced protein for cats, as you might expect, is weight loss. One study using healthy cats, Determining protein requirements: In study one, percent weight loss increased in a linear manner with decreasing protein intake.
Feeding cats with different nutritional needs: As a result, there may or may not be weight loss, but there will be muscle wasting as well as a deterioration in the hair coat quality.
Because protein is component in antibodies, immune function may be compromised; anemia may be exacerbated due to the lack of building blocks for hemoglobin; albumin levels may decrease and tissue healing will be affected. Protein is a preferred flavour, so if a cat is already inappetant, restricting protein may result in inadequate intake of all nutrients, and the protein intake may fall below that required for normal function. Slowing the progression of chronic renal failure Grauer GF states "There are, however, potential undesirable effects associated with dietary protein reduction.
Reduced protein diets are also of concern for cats with metabolic acidosis, because, according to Nutrition and renal function in cats and dogs: Sufficient, High Quality Protein. As discussed previously, during the breakdown of dietary protein in the digestive process, waste substances are created which are filtered out of the blood by the kidneys and excrete d via urination.
Unfortunately damaged kidneys find it harder to do this, which is why your CKD cat may feel poorly. You will note the reference to not feeding more protein than your cat's body needs to maintain normal function.
This is the crux of the matter. You do not want to feed an extremely low level of protein so your cat suffers weight loss and malnutrition; but nor do you want to be loading your cat's body with unnecessarily high levels of protein which contribute to your cat feeling ill. The goal in CKD is not to feed low protein or high protein. The goal is to feed sufficient protein with the correct balance and number of amino acids to maintain the cat's health and body weight, but in a form which needs as little breaking down as possible.
When talking about CKD, that is what we mean by "high quality protein", not reaching for organic, high quality meat. In addition to the amount of protein, patients with CKD should receive protein of high biologic value.
For most people, the easiest way to achieve this is to feed a therapeutic kidney diet because these diets have a protein level in this range. This does not mean they are low protein foods. If you find your cat starts to exhibit weight or muscle loss, you could consider trying one of the therapeutic kidney diets with protein at the higher end of the suggested range. A good choice would be egg whites. If you cannot persuade your cat to eat a therapeutic kidney diet see Which Foods to Feed for tips on how to do this , you can also check the food data tables to find other foods which are relatively low in protein; but don't forget the therapeutic kidney diets have other important attributes, and the protein they do contain is good quality from the CKD perspective, something which is not always easy to replicate with non-therapeutic kidney foods.
When To Feed Reduced Protein. IRIS Stages 1 and 2. Because of the potential downsides of protein restriction, it is not necessarily a good idea to feed reduced protein food in all cases.
However for cats with proteinuria , it states "feed a renal clinical diet" regardless of the stage the cat is in. The study concludes "Our results suggest that cats with early renal insufficiency fed a test food designed to promote healthy aging, over a 6 month period, were more likely to have stable renal function evidenced by stable serum SDMA concentrations compared with cats fed owner's-choice foods. It is also difficult to compare the effect of the therapeutic kidney diet because not enough is known about the alternative foods that were fed.
Other vets believe that it is better to wait until the disease is more advanced before starting a therapeutic kidney diet. M anaging chronic diseases in cats Veterinary Medicine Little S states "Don't restrict dietary protein for cats experiencing mild to moderate chronic renal insufficiency creatinine 1. These cats require adequate protein and calories to maintain body weight and to avoid muscle wasting and anemia. If your cat also has hyperthyroidism, it can be even more of a concern since hyperthyroid cats are prone to weight loss and muscle wasting.
Diet and nutritional management for hyperthyroid cats Peterson ME the man who discovered hyperthyroidism in cats states that "The major problem that I have with some of the prescription kidney diets is that they restrict protein to the point that some cats — especially those with concurrent hyperthyroidism —will continue to catabolize their own muscle mass despite adequate control of the thyroid condition.
Unfortunately, it can often be easier to switch a cat to a reduced protein diet when the cat is stable with lower numbers. Treatment recommendations for CKD in cats International Renal Interest Society says that introducing a therapeutic diet "may be accomplished more easily early in the course of CKD, before inappetance develops. If you are concerned, consider adding foods with high biologic value but minimal nitrogenous waste to your cat's therapeutic kidney diet.
If you decide not to feed reduced protein to your CKD cat, please do ensure that your cat has a low phosphorus intake and an increased essential fatty acids intake. IRIS Stages 3 and 4.
Cats who are in Stages 3 and 4 would therefore also be advised to eat a therapeutic kidney diet. Another factor to consider is your cat's BUN level. Since BUN is influenced by protein intake, it does often help the cat feel better if you restrict protein intake as your cat's BUN levels rise. In Slowing the progression of chronic renal failure Dr GF Grauer states that "As the renal failure progresses, additional dietary protein reduction will likely be necessary.
You may panic if you cannot get your cat to eat a reduced protein food. Take a deep breath. M anaging chronic diseases in cats Veterinary Medicine Little S states "Never try to force an anorexic patient with chronic renal insufficiency to eat a protein-restricted diet.
Instead, concentrate on encouraging anorexic patients to eat. See the Which Foods to Feed page for more tips on getting your cat to eat the therapeutic kidney diet and what to do if you can't succeed. Consider feeding tube intervention e. See the Persuading Your Cat To Eat page for more information on feeding tubes and tips on getting your cat to eat.
Whatever you do, monitor your cat's weight and muscle status closely. Controlling phosphorus levels is extremely important for CKD cats, because high phosphorus levels are very damaging to their health and can make the disease progress more quickly.
This is such an important topic that I have an entire page devoted to phosphorus control. Please read it and do everything you can to keep your cat's phosphorus levels low - it can make all the difference to your cat's wellbeing and can also prolong survival. Just as cats need a diet relatively high in protein, so they also need relatively high levels of fat compared to a human or dog.
Older cats may process fat less efficiently than younger cats, which may be a factor in weight loss. Fat does not result in a lot of waste products like protein, so processing it is not a strain on the kidneys; plus cholesterol is not an issue for cats the way it is for humans. Studies indicate that cat foods containing even higher amounts of fat are safe.
In most therapeutic kidney foods, the fat content is increased to compensate for the lower protein levels. Some senior cat foods also have relatively high levels of fat and relatively low levels of protein; as a bonus, they often also have low phosphorus levels. Therefore, if your cat won't eat a therapeutic kidney diet, it is worth considering senior foods, although do check the protein level is not too low. The kidneys cannot process sodium as effectively in CKD, which increases the risk of hypertension high blood pressure in humans.
It is the naturopathic doctor's ostensible role to identify this root cause, in addition to alleviate suffering by treating symptoms. Avoid doing any harm- Naturopaths never use treatments that may create other conditions which could harm the patient, they only employ methods and medicinal substances which minimise the risk of harmful side effects and use the least force necessary to diagnose and treat.
Any therapy used must not interfere with the natural healing process by masking symptoms this is considered suppressive and should be avoided. Therapists will acknowledge, respect and work with the individual's self-healing process and the natural life force of the individual should be supported to encourage healing. Treat the whole person - A persons health must go beyond treatment of immediate symptoms, and should treat the entire person's well being.
Since total health also includes spiritual health, naturopaths encourage individuals to pursue their personal spiritual development. This cooperative relationship between doctor and patient is essential to healing.
Prevention - Naturopathic practitioners emphasise the prevention of disease, assessing risk factors, and susceptibility to disease then make necessary interventions, in partnership with their patients, to prevent illness. The emphasis will be on building health, not fighting illness. This is done by fostering healthy lifestyles, healthy beliefs, and healthy relationships. Traditional Naturopaths The healing power of nature, is the central tenet of Traditional Naturopathy.
Bacteria and viruses, which are always present, seldom cause problems in a healthy body. According to naturopathic practice, disease occurs when toxins that have accumulated internally — often due to incorrect lifestyle, a poor diet, and improper care of the body - weaken a person.
While conventional medical treatments may rid the body of symptoms, these treatments alone do not bring about true healing. Rather than trying to attack specific symptoms and diseases, Traditional Naturopathy offers a holistic approach to the individual that supports the body in finding its way back to homeostasis.
Traditional Naturopathy is not a medical practice. While prescribing drugs and pharmaceuticals, performing surgery, and other invasive procedures clearly have their place in the hands of properly trained medical doctors, these practices are outside the scope of Traditional Naturopathy and are at odds with its fundamental principles.
Instead Traditional Naturopaths focus on educating clients to lead healthier lives and on the use of naturopathic modalities such as light, water, herbs, healthy foods, and exercise to cleanse and strengthen the body and support its natural healing process.
Fuller definitions of Complementary and Alternative therapies can be found on our pages: Our guide to Complementary Therapy in the UK was set up to provide information about these therapies, how they function and how they may help you.
Currently we list Therapists and Alternative Medicine Providers in the following areas: Research revealed that Guides and Directories on the web tended to provide information either about therapies or just list therapists, so in an effort to combine these two areas resulted in the birth of the Complementary Therapies Guide.
Good easy to understand information about the various therapies available, some well known and some not so, was one of the prime aims of the guide. What to expect and what to look for when choosing a therapist , is often a confusing and tricky choice to make, especially as it concerns your health and wellbeing. Therapists need the opportunity to advertise their businesses to a wide range of the public.