Search Results for: obesity

Lisa A. Pierson, DVM

---

French translation

When was the last time you saw an obese lion?  How about a chubby cheetah?  Or a fat tiger?  Have you ever seen an overweight leopard or panther?  If you have ever watched nature programs on TV, I am sure that you know the answer to the questions just posed.

The answer is “never.”

The next questions are also easy ones to answer – even if you are like me and turn your head when scenes of wild carnivores eating their prey pop up on the television screen!

Do these wild cats eat a dry food diet that is full of starchy carbohydrates in the form of grains?  Do they eat a water-depleted diet in the form of dry kibble?  Is their diet one that derives much of its protein from plants (versus meat) as is true of many dry food diets?

The answers are, again, simple:  “no,” “no,” and “no.”

There was a wonderful program on the TLC channel a few years ago entitled Honey We’re Killing the Kids.  This program addressed the obesity epidemic in this country – starting with what we are feeding to our children.  Americans are eating themselves right into an early grave but that is their choice.  Our cats, on the other hand, do not have a choice and are stuck with whatever their human caregiver decides to put on their dinner plate and we owe it to them to feed a healthy diet.

This webpage could be aptly named Honey, We’re Killing our Pets.

If you have not read my article entitled Feeding Your Cat: Know the Basics of Feline Nutrition, I urge you to do so now and then come back to this page.  In order for you to understand how to tackle feline obesity, you must first understand how to properly feed a cat.  After all, cats, like humans, do not become obese if they are eating a healthy, species-appropriate diet with their caloric intake properly balanced with their caloric expenditure.

Please note that I used the word “healthy” in the above statement.  People and animals can, indeed, maintain an appropriate weight even when eating an unhealthy diet.  So, to that end, it is very important to understand that even if you have a cat that is at an appropriate weight, this does not necessarily mean that he is eating a healthy diet.

As outlined in my Feeding Your Cat article, your cat has a much better chance of optimal health if he is fed a canned food diet instead of dry kibble.

Dry food is not a healthy diet for any cat because it is:

1. water-depleted which is highly detrimental to the feline urinary tract;
2. too high in carbohydrates which alters the blood sugar balance in many cats and contributes to obesity;
3. derives much of its protein from plants, not animals, which runs counter to the metabolic design of the strictly carnivorous feline.

Please click on the links below to read more about the key issues associated with feline obesity.

Why are there so many fat cats?

How to evaluate your own cat’s weight

We owe it to our cats to feed them properly

Recognizing fat versus muscle

Implementing a safe weight-loss program

How fast should my cat lose weight?

How much should I feed?

Consider calories, not just ounces

Multiple cat households

Mistake made with Bennie – protein malnourishment

Case study – Molly

Case study – Bennie

Why Are There So Many Fat Cats?

Type of diet – dry kibble

Obligate carnivores are designed to meet their energy needs with calories supplied by protein and fat – not by carbohydrates.  The average prey (birds, mice, rabbits, etc.) of a wild cat is made up of only 3 – 5% of calories from carbohydrates.  Now consider that dry kibble diets generally range from 35% – 50% carbohydrate calories and you will see a serious disconnect between what the cat is designed to eat and what Man insists on feeding to them.  Dry foods flood the cat’s system with 5-10 times (500% – 1,000%) more calories from carbohydrates than what would be found in a wild cat’s prey.

According to Dr. Zoran’s paper The Carnivore Connection to Nutrition in Cats, carbohydrates are minimally used for energy by the cat and those that are not used are converted to, and stored as, fat.  The so-called “light” diets that are on the market have targeted the fat content as the nutrient to be decreased but, in doing so, the pet food manufacturers have increased the grain fraction (because grains are always cheaper than meat), leading to a higher level of carbohydrates.

Hence, many overweight cats eating these diets are still obese.  These “light” products are among the most species-inappropriate, unhealthy diets available to cat caretakers.  Many caretakers feed very small amounts of these diets hoping that their cat will lose weight but feeding a small amount of a diet that is inappropriate for the species is not the answer!  The caretaker usually just ends up with a crabby cat that is often still overweight.

Why are dry foods so high in carbohydrates?  Think ‘profit margin’.  Grains are cheap.  Meat is expensive.

Why are dry foods so popular?  Because they are cheap and convenient.

Our cats are a ‘captive audience’.  They depend on us, with our opposable thumbs and the common sense part of our brains engaged, to feed them a diet that promotes health – one that they would be eating if left to their own devices in a natural setting – not one that is just cheap and convenient.

Important note:  Feeding the least expensive canned food is far better than feeding the most expensive dry food.
When considering the issue of obesity, consider that dry food is only 10% water and canned food is 78% water.  Therefore, dry foods are more calorie-dense than canned food.

Method of feeding

Another very significant issue contributing to the obesity epidemic is the method in which dry food is often fed. Many people free-feed their cats.  However, think about what your human child’s waistline would look like if you put out a bowl of very palatable high carb food for them to eat whenever they wanted to!

Some cats will properly regulate their intake when dry food is free-fed but many will not.

There are three main reasons why cats tend to overeat when free-fed high carb dry food.  The first reason is because the pet food manufacturers do not play fair when manufacturing dry food.  They coat the kibble with extremely enticing animal digests which makes this inferior source of food very palatable to the target animal.  (Think about the last time you sat down with a very tasty meal or snack.  Did you eat well past the point that your stomach was satisfied in terms of ‘fullness’?  We all keep eating when we shouldn’t…….simply because it tastes good.)

The second reason that some cats tend to consume too many calories when eating dry food is because an obligate carnivore is designed to be satiated when he has consumed an adequate amount of protein and fat.  Carbohydrates do not seem to send the “I’m full and can now stop eating” signal to a cat’s brain like protein and fat do.

The third reason why some cats overeat is boredom.  This is especially true for indoor-only cats.

Of course there are many cats that are free-fed high carb dry food that do not gain an excessive amount of weight.  This variability exists in the human population also. Some living beings are simply more food-oriented than others.  Unfortunately, even these cats – regardless of their weight – are still being fed an unhealthy diet.

Activity level

An indoor-only cat will usually not burn off as many calories as an outdoor cat.  Also, as mentioned above, indoor cats often eat out of boredom (just like humans) and end up overweight.  Of course, the safest place for a cat is indoors but just because a cat lives its life inside, this does not mean that he has to be overweight.

Interact with your cat as much as possible using tassel toys, etc.  This will not only burn off calories but will also alleviate boredom.  Many people use laser lights but I always feel sorry for the cat since they are never able to actually catch their ‘prey’!  Some people hide small bowls of canned food around the house to make their cats roam around looking for their ‘prey meal’.

Here is a video of Bennie running back and forth in chasing 20-25 pieces of dry food (EVO grain-free) that he is getting as a treat.  This game allows for 20-25 calories out of his 180 calorie daily allotment.

Please do not fall for the marketing gimmick of the “Indoor Cat” formulas of food.  Cats did not suddenly stop being obligate carnivores just because they stepped inside under a roof.  These diets often have an atrocious list of ingredients and are usually loaded with high carb grains.

Here are two pictures of a cat that, on the outside, appeared to be at an acceptable weight – even on the thin side.  He was being fed a high carbohydrate dry food diet and you can see what his insides looked like.  All of the light colored tissue is fat.  There is so much fat inside of this cat that his kidneys (oval, pink organs) are barely visible.  Some of you may also have heard of ‘omental fat’ that human nutritionists and doctors talk about when discussing risk factors for death in overweight humans.  On the left side of the top picture and the right side of the bottom picture – you will see omental fat.

Right kidney surrounded by fat

Left Kidney engulfed in fat

Is Your Cat Overweight?

You may be wondering if your cat really is overweight.  Generally speaking, I find that humans tend to think that a chubby cat is ‘cute’ and ‘healthy’ when, in reality, the cat is carrying around too much fat.

Note that you should be able to easily feel the ribs with just a slight fat pad over them.  Cats should also have a waist when viewed from above.  They should not have any fat pads over their shoulders and if you pick up their skin, you should not feel thick fat underneath.

Their top line (backbone and back of the head) should be well-muscled and not terribly prominent (too thin) or hard to feel (too fat).

The top line is the preferred area to assess/monitor during a weight loss program or as the cat ages.  This part of the body gives a very good indication of the overall body weight/condition of the cat.

Important note:  I do not consider loose skin on the underside of the cat’s abdomen to be a sign of being overweight.  Many cats (males and females) have this ‘doolap’ and if it is just loose skin – and not fat – this is nothing to be concerned about.  (My Amber – sporting her new ‘lion cut’ hairdo – gave me permission to post her doolap for the world to see.  She is well-muscled and not overweight…….but could use a tummy tuck.)

Feeding Your Cat for Health

The feeding of dry food plays a very significant role in many of the diseases that plague our cats including obesity, diabetes, urinary tract problems, and inflammatory bowel disease.

See Feline Urinary Tract Health for a discussion of how a water-depleted diet causes a great deal of suffering in our cats.

Regarding feline diabetes, the links between dry food and this serious disease are two-fold:

• Excess carbohydrates wreak havoc on many cats’ glycemic (blood sugar) balance.

• Cats on dry food are much more apt to be overweight or obese.  Fat cells secrete a substance that can cause insulin resistance – leading to a diabetic state.

Most people are familiar with the Atkins diet which is based on a high protein/moderate fat/low carbohydrate calorie distribution.  Personally, I think that this diet is a bit extreme for humans since we are designed to consume carbohydrates in the form of vegetables and whole grains.  However, the cat is definitely designed to eat an Atkins-type of diet due to their metabolic make up that defines them as obligate carnivores.

This status is reflected by their lack of enzymatic pathways to efficiently utilize high levels of dietary carbohydrates.  This is why the feline species-appropriate diet is often referred to as the “Catkins Diet.”

It is important to understand the basic three elements of food/calories:

• *protein
• fat
• carbohydrates

It is best to list foods in terms of caloric composition which reflects the percentage of total calories that come from protein, fat, and carbohydrate. The caloric breakdown of these three nutrient classes must add up to 100% of total calories.  Therefore, if one class of nutrient is decreased, one, or both, of the other two must increase.

*A very important note about protein: Not all proteins are created equal.  Proteins can either be from animals or plants.  What defines cats as obligate (strict) carnivores is their need to consume protein from other animals – not plants.

Protein derived from animal tissues has a complete amino acid profile. (Amino acids are the building blocks of proteins. Think of them as pieces of a puzzle.) Plant-based protein does not contain the full compliment (puzzle pieces) of the critical amino acids required by an obligate carnivore. The quality and composition of a protein (are all of the puzzle pieces present?) is also referred to as its biological value.

Humans and dogs can take the pieces of the puzzle in the plant protein and, from those, make the missing pieces. Cats cannot do this. This is why humans and dogs can live on a vegetarian diet but cats cannot. (Note that I do not recommend vegetarian diets for dogs.)

Grains (corn, wheat, soy, rice, etc.) are made up of proteins (plant-based – poor biological value) and carbohydrates.

Most dry foods are heavily grain-based but it is important to recognize that pet food  companies are sneaky.  Many of them put “grain-free” on the label but then fill up the food (and increase their profit margin) with peas and potatoes which are high in carbohydrates and are plant-based protein sources but are not technically “grains.”

Because the protein in dry food is often heavily plant-based, the overall protein content in this type of food earns a lower biological value score when compared to the protein in canned foods which is usually animal (meat)-based.

And, the grains/potatoes/peas in dry food also contribute a high carbohydrate load to your obligate carnivore’s body.

Because plant proteins are cheaper than meat proteins, pet food companies will have a higher profit margin when using these ingredients.

Dry food addicts:  Unfortunately, many cats have been fed dry food for their entire lives.  It is no wonder that they are conditioned to eat this unhealthy diet.  If I had a dime for every time I have heard someone say “but my cat really….really likes his dry food” I would be wealthy.

People like cookies and potato chips but that does not mean that these food items constitute a health diet.

Cats that have grown up on dry food find the consistency of canned food very foreign and often refuse to even give it a try.

My cats had been fed a 100% dry food diet for their entire lives.  When I started introducing canned food to them in December of 2002, their ages ranged from 2 to 10 years.  They all looked at me like I had rocks for brains…..wondering what in the world that wet stuff was in their food bowls.  It took a very frustrating, three month-long period of time to get them off of dry food and eating canned food.  After transitioning to canned food, I took it one step further.  In March of 2003, I transitioned them to a balanced homemade raw or semi-cooked meat diet and I could not be happier with their health.

See Tips for Transitioning Dry Food Addicts to Canned Food.

Low carbohydrate dry foods:  There are three dry foods on the market that are lower in carbs than most dry foods but please do not think that these foods are a healthy option to low-carb canned food.

Three lower-carb dry foods on the market are Innova EVO, Wellness CORE, and Young Again.  While these foods do address the high carb issue, they are still water-depleted diets that should not be fed to a species that has an inherently low thirst drive.  Dry food sets your cat up for serious urinary tract problems.

Cats are designed to obtain water with their food since their normal prey contains approximately 75%  water.  Dry foods only contain 10% water whereas canned foods contain  approximately 78% water.  Canned foods therefore more closely approximate the natural diet of the cat and are better suited to meet the cat’s water needs.

People often say “but my cat drinks a lot of water so he must be getting enough!”

Because cats have a low thirst drive, they do not make up the hydration deficit at the water bowl when consuming a dry food diet.

It has been shown that cats on canned food – when compared to dry food-fed cats – consume double the amount of water when all sources (from the food and the water bowl) are considered.  This also means that their urine output is increased significantly which promotes urinary tract health by frequently ‘hosing out’ your cat’s bladder of crystals and any inflammatory debris.

Please understand that this necessitates more frequently cleaning of their litter box or the addition of more litter boxes in the home.  We need to always be respectful of the cat’s fastidiously clean nature and and have a clean litter box available for them at all times.

In addition to being water-depleted, these grain-free dry foods are high in phosphorus which is not a good mineral to have in abundance – especially for senior cats that may have marginal kidney function.

A third – and very important – issue is that these three dry foods are verycalorie-dense.  For instance, dry EVO contains a whopping 612 calories/cup.  Most dry foods are ~400 calories/cup or less.  Considering that the average 10 pound cat only needs about 200 calories per day to maintain their weight, you can see that 1/3 of a cup of EVO meets these caloric needs yet many people feed far more of this diet than 1/3 of a cup.

Combine a very palatable diet with high caloric density and throw in the fact that many people free-feed their cats dry food and you have a perfect recipe for obesity when these dry foods are fed. You can use these products as transition foods in order to cut the carbs in the diet but you must be very aware that these diets are very calorie dense and a ‘little bit goes a long way.’  Portion control of these diets is a must!

A fourth issue is that these diets, like all dry foods, are cooked for a very long time at very high temperatures.   Many vital nutrients are damaged or destroyed by this harsh cooking process and then Man has to guess which ingredients, and in what form and amount, will need to be added to restore the health of the diet.  Man is just not as smart as nature which makes it impossible to know exactly what has been damaged and how to restore the food to an optimal level of nutrition.

Ok…..we have discussed the fact that canned food is better for cats than dry food so the question is……what do we look for in a canned food?

Please see Commercial Food for a more detailed discussion on this subject.

Ideally, for an otherwise healthy cat, we want to feed a high protein/moderate fat/low carbohydrate canned food.  In other words, a mouse.

In terms of caloric breakdown that means approximately:

• 45% protein (or more)
• 45% fat (or less)
• 10% carbohydrate (or less)

Keep in mind that when you are reading the Cat Food Composition chart, the protein, fat, and, carbohydrate calories (the first three columns) must add up to 100%.

Unfortunately, many commercial cats foods that fit the above criteria contain fish.  As is common knowledge, fish can be contaminated with heavy metals such as mercury.  Also, research has shown that fire retardant chemicals (PBDEs) are more highly concentrated in fish and there is a strong link between these chemicals and hyperthyroidism.  As well, fish is one of the most common hyperallergenic proteins for cats.

When choosing a canned food, think ‘feathers and long ears’….ie…poultry and rabbit and not so much fish.  Fish-based cat foods can be used to help transition dry food addicts to canned food but cats tend to get fixated on it and then will not eat a more suitable diet of poultry or rabbit.  Therefore, try to wean your cats off of fish as soon as possible.

Some cats do fine with beef but this protein source also tends to be hyperallergenic in some cats so I recommend staying away from beef if your cat has any gastrointestinal problems such as vomiting or diarrhea.

We have established the fact that canned is better than dry for overall health but…….. can a cat get fat on high protein/low-carb canned food?

You bet he can!

Even though high protein/moderate fat/low-carb canned food is a much more species-appropriate diet that is much less apt to cause obesity, a cat that eats more calories than he is burning off will end up with too much fat on his body.

However, most cats – especially those that were never overweight – can maintain a nice weight on free-fed canned food but portion control may be needed for some cats that need to lose weight.  Some cats that have lost weight with portion control can then switch over to free-fed canned food but most of these once-chubby cats cannot and will need portion control for life.

Many veterinarians recommend Hill’s Prescription r/d but I would never feed this diet in either the canned or dry form to any cat in my care.  Both forms are low quality diets and are too high in carbohydrates.  Canned r/d = 37% carbs and the dry = 36%.  These foods also contain a list of ingredients that are not species-appropriate.

Note that dry r/d was the diet that Molly had been on when she came to me – in horrible shape.  It is an atrocious diet.

Recognizing Fat versus Muscle

I recently heard a well-meaning fellow rescuer proudly comment that two of her foster cats had become “beefy” as if this was a favorable condition.  Unfortunately, she was missing the concept of what constitutes a healthy weight gain.  These cats had put on fat – not muscle so there was now nothing “beefy” about them.  They were soft as marshmellows……far too fat.   This person also fell into the all-too-common trap of not recognizing that these cats were actually at a healthy (lean) weight when they came into her foster care and were now overweight and not as healthy.

This foster person was feeding a high carb, dry food diet.

The lack of recognition of fat versus muscle is a very common problem that I see.  People must understand that there is a big difference between lean muscle mass and fat.  I often hear about people feeding dry food to “fatten” their cats up.  And, unfortunately, that is exactly what high carb food does – it adds too much fat to the body.  These cats would be much better off on a high protein, moderate fat, low carbohydrate canned food which would promote lean muscle mass instead of fat deposits.

Unfortunately, many humans end up ‘killing them with kindness’ and feed their pets right into obesity.

Remember…..think ‘Catkins diet’ for your obligate carnivore – high protein (animal-based – not plant-based), moderate fat, low carbohydrate.

Implementing a Safe Weight Loss Program

The biggest hurdle to overcome on the way to a svelte body for your cat is their fixation on dry food.  Please see Tips for Transitioning Dry Food Addicts and pay special attention to the statements regarding Hepatic Lipidosis (fatty liver disease).

Hepatic lipidosis (HL) is a life-threatening condition that can occur when a cat is either completely anorexic (not eating anything) for 48 hours or more or is consuming less than 50-75% of his daily caloric needs over several/many days.  It more commonly occurs when overweight cats are not consuming enough calories but cats that are carrying a proper amount of weight can also end up with HL.

These ‘calorie starved’ cats end up with fat deposition in their liver which destroys the liver cells.

Because HL can become an issue if weight loss occurs too rapidly in cats, I strongly urge you to invest in a scale – preferably a digital one that weighs to the nearest ounce or half ounce.  It is always a good idea to weigh all cats several times each year regardless of whether they are on a weight loss program or not.  Weight loss can be an early sign of disease so it is always helpful to monitor all cats’ weight on a regular basis.

For skittish cats, go slowly with the introduction of the scale.  You do not want them to be afraid of it!  Take a week or so to just feed them treats on the scale so they see it as a good thing.  My cats are trained to get on the scale when I just put it on the floor and say “scale” because they know they will get a treat if they do so.

If you decide to put the scale on the floor, make sure that it is a hard floor and not carpet.

Bennie was very well-trained to get on the scale:

Important:  Note that many human baby scales have a base that is narrower than the tray and may tip if the cat steps on the end of the scale versus closer to the middle. This will scare the cat and damage the scale.

Also, do not let your cat leave the scale on their own unless you have given them permission to do so. (Don’t laugh…some cats can be trained….sort of….)  If they are allowed to leave on their own, make sure you hold down the opposite end so they do not tip the scale.

This Red Cross Baby Scale weighs to the nearest 1/2 ounce and has a wide base so it won’t tip if your cat is trained to walk onto it.

Here is a Salter Baby and Toddler scale but note that it does not have a wide base.

I would never attempt to handle extreme cases like Molly and Benny without closely monitoring their weight every 2-3 days but even cats that only have a few pounds to lose should be monitored.

Safe Rate of Weight Loss

Please understand that your overweight cat took months to get into his current condition and that it will take months to safely lose the weight.  This is not a race but it is critical for you to stay the course and not give up.

A safe rate of weight loss is 1 – 2% of their current body weight per week.

For example, if your cat weighs 20 pounds, he can safely lose up to ~6 ounces per week. (20 pounds X16 ounces/pound = 320 ounces.  2% of 320 = ~ 6 ounces.)

1% would be 3 ounces per week – or 3/4 pound/month.

As your cat loses weight, the amount of weight that he should lose each week will decrease.

For example, if your cat is down to 16 pounds, his weight loss should slow to ~2.5 -5 ounces each week which represents 1-2% of 16 pounds.

How Much Should I Feed?

I cannot stress this enough – I can give you a formula that will provide an approximation of the optimal caloric intake for a safe weight-loss program but the bottom line is that you need to weigh your cat every 3-4 days to make sure that he is not losing weight too rapidly – or not losing weight at all.

Why is weighing your cat so important?  Because:

1) Every cat is different in terms of how they metabolize food and their caloric needs.

2) We have no way of knowing if the calorie information given out by the pet food companies is accurate.

Also, as stated above, it is very important to pay attention to your cat’s top line (back bone area) and the back of his head for signs of excessive loss of muscle mass.

There are three ways to arrive at a starting figure for the amount of calories to be fed.

First method:

The most accurate way is to calculate how many calories your cat is currently eating to maintain his not-so-svelte figure.  Then take 80% of those calories as a starting point.  Check the bag of dry food that you are feeding and see if it lists the calories/cup.  Most dry foods do list the calorie content on the bag but canned foods do not.  See the Cat Food Composition chart to see if the canned food that you are currently feeding is listed.

Second method:

Since most people free-feed dry food, the amount of calories consumed in a day is not known. In this case, figure out what you think your cat *should* weigh and plug that number into this formula:

Required calories per day = [13.6 X optimal lean body weight in pounds] + 70

Most female cats should weigh a nice, lean 10 -11 pounds.  Most male cats should fall into the 11 -13 pound range.

Using an optimal body weight of 12 pounds as an example, we come up with 233 calories/day as a starting point.

[13.6 X 12 pounds] + 70 = 233

This formula provides a very generous starting point (usually far too generous) so be aware that some (most) cats will not lose weight when eating the number of calories generated by this formula.  I would suggest feeding according to this formula for 10–14 days (or less) and then re-evaluating the caloric needs based on the cat’s weight loss, or lack thereof.

Of course, if during that period of time your cat is losing weight too rapidly, you will need to increase his calorie intake immediately but I can’t imagine any cat losing too much weight on the amount of calories that this formula generates.

If he is maintaining his weight on the number of calories provided by the above formula, reduce the amount by 20%.

General comment:  In my experience, I need to get patients down to ~180 calories/day, or even less, before they lose weight.

Third method (the ‘keep it simple’ method):

Too fat?  Feed less than what you are feeding.  Too thin?  Feed more than what you are feeding.  Just right?  You are feeding the correct amount.

Again, let the scale be your guide!

Consider Calories and Composition, Not Just Ounces

An average canned food contains ~30 calories/ounce.  The plain chicken and plain turkey Wellness products contain ~40 calories/ounce.  Some of the lower quality canned foods only contain ~20 calories/ounce.  So you can see by this wide range that you need to pay attention to calories – not just ounces of food.

For high protein/low fat snacks you can offer small pieces of chicken but remember that you are feeding a small cat, not a human.  A little bit of food can be significant in terms of calories.

Chicken meat:

Raw, lean, skinned leg/thigh meat  =  ~34 calories/ounce.

Cooked, lean, skinned leg/thigh meat  =  ~50 calories/ounce.

This site is a good source for calorie/nutrient content of many foods.

Multiple-Cat Households

Getting a single cat to lose weight in a multiple-cat household can be a challenge especially in a house like mine where the cats are free-fed.

Fortunately, many cats lose weight successfully even when they are free-fed canned food. For this reason, I would suggest simply getting all cats in the house to transition to a 100% canned food diet (free-fed or meal-fed) and then monitoring your overweight cat.  In most cases you will see a nice weight loss for the chubby cat and the other cats may lose a bit of weight but usually do not become too thin.  Of course, every cat is different and must be monitored individually.

If after a few weeks of the new diet for all of the cats, your chubby cat has not lost any weight, you will then have to figure out how to implement portion control.

If your cats are used to being free-fed, they can get used to being meal-fed.  This will make it much easier to deal with a feline obesity project.

It has been shown in humans that eating small meals more frequently keeps the metabolism ‘reved-up’ and helps with weight loss.  Given that small cats in the wild eat 8-10 (or more) small meals each day, it is also beneficial for your cat (both mentally and physically) to eat smaller meals more frequently.  If you work a regular job, then feed in the morning….again when you get home from work….and then before you go to bed.  This last feeding is especially important if you want to sleep through the night!

Even though most cats will adapt well to meal-feeding by increasing their calorie consumption at each feeding so that their total daily intake remains the same, there are some cats that do better when food is available to them more frequently than 3 times per day.

Bennie and Molly were two sweet obesity projects that were housed with my foster kittens.  This presented a dilemma with respect to Bennie because the kittens were being free-fed canned food and he needed portion control.

Molly, on the other hand, lost weight nicely even when there was canned food in front of her at all times.

To remedy the problem with Bennie, I set up a cage so that the kittens could go inside and eat at any time but Bennie could not enter the cage because the opening was too small.  I used a notched piece of PVC pipe as a rigid spacer to hold the door open the right amount.  I then used velcro strips to hold the door closed against the pipe. This cage happened to have a convenient feature in that the top opened so that could access the cage without having to open the door.

I covered the cage with towels so that Bennie could not see the food inside which would have been hard on him mentally.

Kitten leaving the creep cage after eating.

If you have a thin cat that does not eat very much at one sitting and is a die-hard ‘grazer’, then you can use a creep cage (if there is enough size difference between the thin and chubby cat) or you can leave canned food (please….no dry food….) out some place high up but only if your fat cat cannot jump up to get the food.  Be aware that once your chubby cat loses some weight, they will be able to jump up on just about anything if they smell food.

Some people have cut holes in boxes/crates that will allow a thinner cat to enter while not allowing a larger cat to gain access.

Other people have figured out ways to prop a door so that it is barely open…..just enough for a thin cat to enter the room where food is kept.

The problem with these methods – the cage, box/crate, room, or putting food up high – is that you really need a significant size disparity or a cat that can’t jump high.  Unless a cat is extremely obese like Molly and Bennie were, most cats can squeeze through an opening or muster up enough energy to jump up to get food.

Another option is MeowSpace.  This is a feeder system that can be programmed to work (open) off of a cat’s microchip.

Mistake made with Bennie

As mentioned above, Bennie was living in my foster room with other adults and kittens.  All were being free-fed canned Wellness (chicken or turkey).  This feeding protocol left me unable to monitor Bennie’s calorie intake so I had to be extra vigilant in monitoring his weight.

For the first few weeks, Bennie lost just a bit over 2% of his body weight per week.  He was bright, alert, and playful.  He continued along at this rate but 2 months into his program, he was approaching a 3% loss per week and I noticed a loss of muscle mass along his top line.

The problem was two-fold:  Bennie clearly was not consuming enough calories but the other issue was that Wellness is low in protein (30% of total calories) when compared to a cat’s normal prey of mice and birds (~50%, or more, of total calories) and that, coupled with his low food intake, combined to cause overall protein malnutrition which resulted in the loss of muscle mass.

This is a very important point!  The goal of weight loss for any living being is loss of fat while maintaining, or even building, muscle mass.  However, since our cats are not going to the gym, we aim for simply a maintenance of muscle mass.

As soon as I switched Bennie to a higher protein, lower fat diet, the change in his body was incredible.  The high protein (~45% of total calories) diet provided Bennie with the needed protein to quickly (within 3-4 weeks) regained much of his lost muscle mass along his head and backbone (top line).

Once Bennie’s top line filled back in, portion control of his higher protein diet enabled Bennie to start to lose fat again while he maintained his muscle mass.

Cats definitely can lose weight safely on Wellness (see Molly’s story below) but I would prefer using a higher protein diet or supplementing a lower protein diet (like Wellness) with some muscle meat chunks.

By adding lean muscle meat to a lower protein/higher fat diet like Wellness, you will increase the protein calories and ‘dilute out’ the fat calories.

When supplementing a commercial food with plain chunks of meat (chicken or turkey thigh or breast meat, for example) you must understand that meat is not balanced with respect to calcium levels.  When a cat eats his prey, he is consuming meat and bones.  The bones supply the necessary calcium in the diet.  Meat, alone, contains very little calcium.

Do not feed any more than ~15% of the total diet as plain meat.  For example, if you are feeding 6 ounces of canned food, you can replace 1 ounce of canned food with 1 ounce of meat so that you will be feeding 5 ounces of canned food + 1 ounce of meat for a total of 6 ounces of food. The added meat is now ~16% of the diet (1/6 = ~16%)

If your cat will eat this meat in chunk form, this will have the added benefit of promoting dental health.  Leave the meat in a large enough piece (or pieces) so that he has to chew it with his molars.

Chicken gizzards are also good for promoting dental health because they are more tough/fibrous than muscle meat in the form of thigh or breast meat.

I prefer to feed this meat raw because raw meat is tougher to chew than cooked meat.  You can rinse the meat off with water of if you are worried about the raw issue, you can par boil the meat so that the surface bacteria are killed.  Aim for just the outside ~10% to be cooked.

 

Molly’s and Bennie’s Weight Loss Journey

Molly and Bennie are two very sweet cats who were literally crippled by their owner’s misguided feeding practices.

Molly = 20.5 pounds.  Healthy weight = 10-11 pounds.  She is a small-framed cat.

Bennie = 27.5 pounds.  Healthy weight = 13-14 pounds.

Skip to Bennie

Molly

…made a great pillow for kittens…

Bennie

Let’s start with Molly’s story and see how she got to be obese on Hill’s Science Diet Light dry food – a diet that is atrocious in terms of quality and one that is inappropriate to be feeding to any cat.

Molly was adopted as a kitten from TLC Adoptions in 1997.  She was fed a diet of dry food only.  When her owners noticed that she was getting too heavy, they started feeding her Science Diet Light dry food.  She continued on her path to obesity and ill-health.  Molly was returned to the adoption agency in 2004 – terribly obese and limping from carrying around so much fat.  If she laid down on her side, it was very difficult for her to get up.  Molly’s coat was a mess – oily and full of dandruff.

Her obesity prevented her from being able to clean herself properly and the result of this was a painful skin inflammation and infection around her anus and vulva – extending to her lower abdomen.

Unfortunately, I do not have a picture of her at her worst but see below for a picture of Bennie’s rear end/abdomen to get an idea of what Molly looked like.  Here is a picture of the sanitary shave that I did for Molly.  Hair traps urine, feces and heat making the area harder to keep clean and more susceptible to infection and inflammation.

One thing that this picture does not show is the skin fold dermatitis within the folds of her vulva. There was a large fat layer on either side of her vulva that trapped moisture and bacteria.  Since she was unable to clean herself, this resulted in a painful inflammation and infection.

After Molly was returned to TLC Adoptions, she was adopted to a man who ended up feeding her another very inappropriate and unhealthy diet that was prescribed by a veterinarian.  The diet was Hill’s r/d in the dry form.

Molly was fed a small amount of this food in a separate room twice daily.  This man then put a shock collar on her and put the transmitting wires around the food bowls (filled with an inappropriate diet of dry food) that were being left out for his other cats – all of which who were terribly overweight also.  Unfortunately for Molly, she was the one being focused on.

At this point, Molly was in great danger of developing hepatic lipidosis (“fatty liver”) which can be fatal if not treated in time.

Molly did not like the Hill’s r/d and was now being shocked every time she tried to squelch her hunger pains when going toward the food bowls filled with what she had been eating her entire life.

This wonderful, sweet cat was very depressed, confused, jumpy (from the shock collar) and in grave danger of becoming fatally ill.

Within hours of hearing of Molly’s horrible situation, I called the man to discuss having her returned to TLC Adoptions.  She would then be placed in my home for careful monitoring – both medically and nutritionally.

He agreed, saying that he was “tired of the mess that she was leaving around the house.”

Molly’s rear end was so sore and itchy from her lack of ability to groom herself, that she was dragging her rear-end on the floor and furniture in an attempt to clean herself and to relieve her discomfort.  The discharge from around her vulva was black and messy.

If you cringe at the above comments, just think how poor Molly felt!  Cats, by nature, are very clean/fastidious creatures and when they can’t clean themselves properly, it becomes a very stressful situation for them.

 

The First Day of the Rest of Molly’s Life…..

……and the beginning of a VERY frustrating time for me!

3/28/04

Molly is a horrible Kibble Addict and needs a 12-step program in the worst way.  I have said many, many times on various internet groups and during my consulting work that *all* cats *can* be switched to a proper diet of high protein/low-carb canned food and NO DRY FOOD, if the human is patient enough and tries enough tricks but I can tell that Molly is going to be a tough one.

Molly is fed dry food on arrival.  Trying to force a diet change on a stressed animal is never a good idea.  A few more days on a lousy diet is not going to matter but I will continue to offer canned Wellness, Fancy Feast, and lower quality canned foods like Friskies.  Unfortunately, she will not have any part of this healthier diet.

3/30/04

Molly is a pretty laid-back cat…not terribly stressed and she has had a couple of days to acclimate to her new surroundings.  I would give her more time on dry food if she was a nervous type of cat but since she is not……it is time to get serious.  I am starting to syringe-feed her *pureed canned chicken Wellness.  This is done very gently and slowly so as to not create a food aversion.  Interestingly, Molly does not fight the syringe-feeding so I am not too worried about a food aversion resulting from this feeding method although I will keep it in mind as a possibility.

*I puree the Wellness in a blender – one 5.5 ounce can with about 4-5 TBS of water added.  Important:  Run it through a wire strainer!  If you don’t do this, your syringe will clog.  (The food is thick – even with the added water – but if you bang the strainer on your bowl repeatedly, the food will flow through it.)

Amount fed:  Using the formula above to arrive at an approximate figure for needed calories, I make sure that Molly consumes 180 calories/day (one 5.5 ounce can of Wellness chicken) as a starting level.  Adjustments will be made based on her weight loss progress, or lack thereof.

Molly will be weighed every 2-3 days.

One 5.5 ounce can + 4 TBS of water is ~150 cc.  Molly had no trouble taking 50 cc at each meal.  She was fed 50 cc 3x/day.

See the Cat Food Composition chart for the calorie content of many commercial foods.

4/18/04

I have switched many kibble addicts to canned food and have never lost a battle but Molly is my toughest patient yet.  I have actually ended up in tears on more than one occasion out of utter frustration.  I know that the only hope for Molly to lead a normal life….one where she can run, jump and play – and clean herself properly… is for her to get off of dry food and start eating a proper diet of high protein/low-carb canned food or a balanced homemade diet…….but she has other ideas.

I have tried many tricks with her. Tuna, crumbling dry food or parmesan cheese on top of the canned food, dipping the dry food in a tiny bit of canned or even just the juice from the canned.  I have tried cooked and raw chicken and cooked fish.  I put a bit of canned food on her paw to see if she would clean it off.  No way.  Molly will not even eat a piece of dry food that has so much as touched any part of canned food!

In a nutshell, Molly does not recognize anything but dry kibble as food.

(Since Molly will be put back up for adoption, I want to get her on a commercial canned food instead of the homemade diet that I feed to my own cats.  Most people are not prepared to Make Cat Food and so switching her to a canned food is more appropriate.)

Now….before you get too discouraged by the above ‘frustration’ narrative, please understand that I was being a bit impatient with regard to Molly’s diet change.  She was a foster cat that needed to eventually find a loving home of her own and so I wanted things to move along a bit more quickly than was realistic for Molly.

PLEASE do not rush the diet transition.  PLEASE be patient and do not give up.  And be sure to read this regarding transitioning stubborn kibble addicts and pay close attention to the comments about Hepatic Lipidosis.

To give you an example of the timeframe that I am talking about, my own herd of kibble addicts (yes….I fed a 100% dry food diet for ten long years before I saw the error of my ways…..) took 3 months to switch from dry to canned.  And, yes, I was frustrated by the slow process but my cats were going to be with me for life and I was committed to the long, slow battle of wits and tricks. It really is not a race – but you do need to get to the finish line.

4/20/04

Molly goes to the clinic for a dental cleaning and ends up needing a couple of teeth extracted.  Because of her reluctance to eat canned food on her own, a feeding tube is put in which makes both of our lives MUCH…much easier!!  I can now feed her with much less stress to both of us and in much less time.  We are both very relieved.

Thanks for the new dress but does it come in a darker, more slimming color?

5/7/04

2.5 weeks after the feeding tube was put in, Molly returns to her carnivorous roots and starts licking the pureed Wellness from the syringe and eating canned food from a plate.  She is living in my foster room with other cats and kittens and I think that it is helping her to watch them eat their canned food. I will not remove the tube until she proves to me that she will consume enough calories by eating canned food on her own.

5/10/04

The feeding tube is removed since Molly is eating on her own.

Molly finally gets it!!

From 3/28/04 – 5/10/04 = 43 days => 30 ounce weight loss.

~5 ounces lost per week

Her original weight was 20.5 lbs or 328 ounces.

5 ounces is 1.5% of 328.

7/18/04

Molly’s BIG DAY!!!!

Molly gets to go to her forever home!  (Thank you, Maurine….)

Molly’s Weight Loss Progression on 5 ounces/day of canned Wellness

Molly’s new mom was removing about 1 heaping tsp from the 5.5 ounce can of Wellness leaving 5 ounces as Molly’s daily intake.  This resulted in a nice weight loss pace.

3/28/04 – 7/18/04 (16 weeks)

20.5 pounds => 17.1 pounds = a loss of 3 pounds, 5 ounces —- 3.3 ounces/week = 1% of her body weight lost/week

3/28/04 – 9/1/04 (22.5 weeks)

20.5 pounds => 16.25 pounds = a loss of 4 pounds, 4 ounces —- 3.0 ounces/week

3/28/04 – 12/22/04 (38.5 weeks)

20.5 pounds => 14.8 pounds = a loss of 5 pounds, 10 ounces — 2.3 ounces/week

Backslide……..

Well…..sometime in early 2005, Molly conned her mom into feeding her more than the 5 ounces.  Her intake was increased to 7-7.5 ounces/day which was a 40 – 50% increase over the amount that she was losing nicely on.  To us humans, a 2 ounce portion of food does not seem like a lot but you can see that jumping from 5 ounces to 7 ounces is a huge increase (40%!) in her caloric intake.

5/26/05

Molly weighs 16 pounds – a gain of 1.2 pounds in 5 months!  Even at this weight, however, there is a noticeable difference in how she moves.  She walks much better and no longer limps…..but…..she still cannot clean her rear end.

Her intake is reduced to 6 ounces/day.

9/1/05

16.25 pounds

6 ounces/day is proving to be too much for Molly.  Back to 5 ounces/day!

3/13/06

15.1 pounds => A loss of 1.1 pounds in 6 months.  She has a nice waist but still has a lot of fat around her shoulders.  She is active and running around and feels great!

9/12/07

It has now been 1 1/2 years since I have weighed Molly.  (I think that Molly has breathed a sigh of relief since she has not seen me walking up her driveway….scale in hand…..for her Jenny Craig weigh-in.)  On a good note, she now has a good looking, thin, boy-kitty friend named Pablo, also rescued by TLC Adoptions.  Molly and Pablo have actually been chasing each other around – pretty good for a chubby 10 year old girl and a 9 year old boy!  This sure makes me smile considering that Molly could barely walk when she first came to me.  She now runs and jumps and plays like a normal cat!

4/17/08

13.2 pounds

I am ecstatic…….I just visited Molly and she looks fantastic!  Her coat is incredibly shiny….no more of her former greasy coat loaded with dandruff.  Molly is very active and happy…..she now runs and jumps and plays like a normal cat.

Her backbone and head are well-muscled which means that she has lost a great deal of fat while maintaining great muscle tone.

She has been on 5.5 ounces of Wellness Chicken and Herring canned food per day and I could not be happier with the way that she looks.  She is still carrying a bit of fat (I am still thinking that there is a 10-11# kitty in there somewhere) but, overall, I am extremely happy with the way that she looks!!

Molly, Pablo, and their mom are all moving to Arizona soon so, sadly, I had to kiss Molly goodbye.  It has been a wonderful 4 year journey to get Molly back to being an active, healthy cat……an experience that I will truly treasure for life.

6/24/08

11.8 pounds

As you can see by her weight, she has lost more fat and looks great.  She has been eating the same amount but the key to her weight loss has been an increase in exercise in her new, very large home.

However, this is a very sad update……Molly has been extremely active and playful up until today.  It appears that she has had a stroke and it is doubtful that she is going to survive.

6/25/08

It is with great sadness that I announce the passing of our sweet Molly.  Molly was a very special girl.  She was incredibly kind, affectionate and very gentle. Molly was a wonderful companion to Maurine’s 90+ year old mother – providing Mrs. H with great comfort in her remaining days as the elderly woman dealt with advancing Alzheimer’s disease.  I know that Maurine will always be grateful for the comfort that Molly provided for her mother.

Thank you, Molly, for all that you taught me during our journey to find your inner svelt and healthy cat.

8/26/08

Bennie (see his full story below) went to live with Maurine on 7/9/08.  Although no kitty can ever replace our sweet Molly, Bennie is doing a great job of earning the key to Maurine’s heart.

---

Bennie

7/30/07

Bennie was dumped at a city dog/cat ‘pound.’  His owners cited “health issues” as the reason for abandoning Bennie.  What fate were they expecting for him?  Did they really think that cats like Bennie get adopted?  Sadly, the ‘fate’ in my neck of the woods is euthanasia for cats like Bennie.

Bennie is only 4 years old.

8/2/07

A shelter volunteer sends me an email wanting to know if there is any room at Dr. Pierson’s Fat Camp for Obese Felines…..knowing what a sucker I am for nutrition ‘projects.’  I cringe….wanting another foster cat like want a hole in my head.  But….then I start praying that Bennie is not a diabetic and I know that I cannot just delete the email and continue on with my day.  (Diabetes is not an uncommon illness that plagues cats that eat an inappropriate diet of dry food.  Add in the issue of obesity and the chances rise significantly.  See diabetes for more information.)

8/7/07

I break down and go to the shelter to meet Bennie.  I review his lab work and there are no abnormal values. Hopefully, he will dodge the diabetes bullet since he is still young and will spend the rest of his life on an appropriate diet.

Bennie was such a good boy for his bath.  He just plopped over on his side and seemed to really enjoy it when I gently washed his horrible skin condition and trimmed all of his overgrown claws.

There is a question as to just how much Bennie weighed when he entered the shelter.  The technician recorded 30 pounds on 7/30/07 but I question the accuracy of that value since only 8 days later, he weighed 26.5 pounds. I really hope that he did not weigh 30 pounds on the impound day because that would represent a very drastic and unhealthy rate of weight loss and fluid loss.  (Dehydration will also result in weight loss.)

I am going to use 27.5 pounds as a starting weight for Bennie as of the day that he was turned into the pound – 7/30/07.  I will use 26.5 pounds as his starting weight on the day that he came into my care which was 8/7/07.

Bennie will be weighed every 2-3 days.

His severe dermatitis/scalding will being treated with Preparation H until the scabs and loose skin comes off:

8/8/07

I observe what may be one of the “health issues” that his owners were referring to when they abandoned Bennie.  He is going in and out of his litter box up to 3 times within 30 minutes.  He is passing small amounts of urine each time.  This scenario illustrates why it is so important to use a clumping litter (always UNscented) for all cats.  Clumping litter allowed me to appreciate the following information:

• Bennie was able to pass some urine and was not completely blocked which would have been a life-threatening emergency.

• His urine balls were very small – grape size – indicating cystitis (bladder inflammation).

Many people make the big mistake of jumping to conclusions that the above signs are due to an infection and automatically think that antibiotics are warranted.  At least 95% of cats under 10 years of age that are not diabetic, in kidney failure, or have hyperthyroidism but are showing these signs have sterile cystitis – NOT an infection.  “Sterile” means that the inflammation is *not* due to an infection and antibiotics are *not* warranted.

Please see Feline Urinary Tract Health for more information.

In order to diagnose a bladder infection properly, a cystocentesis must be done.  This is a procedure that involves putting a needle directly into the bladder through the abdominal wall.  It is not painful for the cat and it ensures that a clean sample is obtained for a culture and sensitivity.  A C & S tells us if there actually is an infection present and which antibiotic to use on the bacteria that was grown in the culture.

But…..Bennie is too fat to easily perform a cystocentesis on so I had to do what I could to help make the decision to put him on antibiotics or not.

Bennie urinated in an empty litter box that was near his regular litter box and I could see that the urine contained blood.  The urine specific gravity (urine concentration) was high (1.050) which told me that the probability of an infection causing his cystitis was extremely low.  He is only 4 years old and is not diabetic, nor in kidney failure. Therefore, he will not be put on antibiotics.

Important note:  The presence of blood does NOT necessarily mean that an infection is present.  We must stop abusing antibiotics in these cases.

I will count on a high moisture diet of all canned food (with added water if he will accept it) to help keep his bladder flushed out and I will monitor his clinical signs.  I will also give him a bit of Buprinex for the pain since cystitis can be painful.  Cystitis is thought to be highly linked to stress and Bennie has been under tremendous stress lately.  Also, Pain => Stress.  Therefore, pain management is very important in moderate to severe cases of cystitis.

8/11/07

Weight = 26 pounds, 4 ounces

Bennie is losing ~1 ounce/day which is just under the 2% per week rate that is considered to be a safe rate of weight loss.

He is being free-fed canned Wellness with some meals of the raw rabbit diet that I make for my own cats thrown into the mix. (See Making Cat Food.)  I either feed it raw or lightly cooked depending on his mood.  I do this in order to increase the protein in the diet and decrease the fat.  (Wellness is a good commercial food but it is lower in protein calories than I would like for a weight loss diet.)

That said, I did not add any extra meat to Molly’s Wellness and she lost weight at a nice rate and maintained her muscle mass.

Please do not add more than ~15% (by weight) plain meat to any commercial food.  Otherwise, you will risk feeding an unbalanced diet since there is no calcium in plain meat. (I feed a raw meat and bones diet to my cats.  The ground bone provides the necessary calcium.)

Bennie is not exactly a big eater.  I am lucky to get him to eat 5 ounces/day of the Wellness/rabbit mix for a total of ~180 calories/day.  Some days he eats even less – closer to 140 calories/day.  I am happy with the daily intake of 180 calories but 140 calories is less than his calculated needs for a safe weight loss.  He is not acting hungry and is not begging for food and is bright and alert and seems perfectly happy but given his very low caloric intake, I am worried about malnutrition.

Important:  Keep in mind that Bennie is just one individual cat and that his lack of caloric intake illustrates just how *very* important it is to have an accurate scale during this process to ensure that the patient is not losing weight too quickly!  Please error on the side of caution with your own cats and work with your veterinarian during the implemented weight-loss program to ensure that hepatic lipidosis does not set in and a safe rate of weight loss is maintained.

After 4 days of  using only Preparation H, I switched to corn starch to keep the area dry.  I still applied a bit of Prep H to the few remaining scabs to soften them in order to facilitate removal.

8/13/07

Weight = 26 pounds, 2.5 ounces

8/16/07

Weight = 25 pounds, 15.5 ounces

8/18/07

Weight = 25 pounds, 13.0 ounces

 

Bennie is now trained to get on the scale when I ask him to!

Bennie’s cystitis seems to be clearing on its own as is the usual course for sterile cystitis.  The urine balls are getting bigger and less in number and I do not see him going to the litter box frequently when I am with him.  I have not been able to observe his urine directly since he is going to the litter box every time.

There is a joke in veterinary medicine that says most cases of cystitis get better in 7-10 days with antibiotics and in a 1 – 1.5 weeks without antibiotics. Antibiotics need to stop being overused for this condition (sterile cystitis).

8/19/07

Up to this point, Bennie has been eating 4-5.5 ounces of Wellness per day.  Sometimes I do mix in some Fancy Feast Chicken Feast to get him to eat more but from here on out, he is on his own with 100% Wellness available at all times.  He is now running (well….I wish that he was “running”) with my other foster cats (1 adult and 2 kittens) and so I will not be able to monitor his intake but will keep a very close eye on his weight and his top line.

8/22/07

Weight = 25 pounds, 5.5 ounces

Bennie has lost too much weight (7.5 ounces) in the past 4 days but he is acting like he feels great!  He is starting to play with Penny:

Even though the introduction to the other cat and kittens was done slowly (they were in separate rooms with a screen door between them for almost 2 weeks), Bennie may have eaten less over these past few days due to the stress of being in a new environment with new roommates.

Progress report:

8/7/07 –  8/22/07 = 15 days……18.5 ounces lost = 8.6 ounces/week = a little over 2% per week.

8/23/07

Weight = 25 pounds, 5.5 ounces

8/24/07

Weight = 25 pounds, 5.5 ounces

It is odd that he has weighed the same for the past 3 days but I am relieved that the rapid weight loss has stopped.

He had 2 golf ball-size urine balls in his litter box within 12 hours.  This is a vast improvement from 8/8/07 when he was urinating very small amounts frequently.

8/25/07

Weight = 25 pounds, 5.0 ounces

8/27/07

Weight = 25 pounds, 4.5 ounces

8/29/07

Weight = 25 pounds, 1.5 ounces

After one month of eating a species-appropriate diet of canned food and no dry food…..and losing 2.5 pounds, Bennie finally feels like playing!

9/1/07

Weight = 24 pounds, 12.25 ounces

Progress report:

8/7/07 –  9/1/07 = 25 days…..28 ounces lost = 7.8 ounces/week

Now that he is down to 24.75 pounds, 2% of his current weight is ~8 ounces.  So Bennie should not lose anymore than ~ 8 ounces/week…… or ~1 ounce/day.

9/3/07

Weight = 24 pounds, 8.25 ounces

9/7/07

Weight = 24 pounds, 2.0 ounces

9/10/07

Weight = 23 pounds, 15.5 ounces

Weekly progress report:

9/3/07 – 9/10/07 = 1 week…..8.75 ounces lost this past week

Overall progress report:

8/7/07 – 9/10/07 = 34 days…..lost 2.5 pounds (40 ounces) = average of 8.2 ounces/week.  This represents a total weight loss of 9.4%.

This is *much* faster than I had planned for his weight loss program but he is becoming more active and playful each day and is still very bright and alert.  He is still being free-fed canned Wellness – only the grain-free ones.  There is food available to him 24/7.

Not yet, Bennie, but you’re getting there!

9/12/07

23 pounds, 12 ounces

Bright, alert and playful – interacting with the other cats.  I am still concerned that he is losing weight too fast and I hope that he is not quietly working on a case of hepatic lipidosis – or becoming malnourished.

Even though I am not a fan of Fancy Feast, I fed him some today……. but he really is only slightly more interested in FF than he is in Wellness.

9/14/07

23 pounds, 9 ounces

Even though Bennie is losing weight a bit more rapidly than I had planned for him, he is becoming more active and appears to be feeling great every day.  However, please do not allow your cat to lose weight this quickly.  Please stick to the 2% per week weight loss as a maximum.

I am continuing to free-feed him canned Wellness with a bit of Fancy Feast thrown in.  The Fancy Feast does not make up more than ~10 -15% of his diet.  Fancy Feast has always bothered me in terms of quality since it is a bit like “kitty crack”……meaning that most cats just love it and I have a jaded eye regarding the ingredient(s) that are contributing to this tremendous palatability.  I have no idea what is in the “artificial flavors” and prefer not to feed a lot of this food.  There is also the issue of by-products.  You will find my views on that issue here.

9/16/07

23 pounds, 7.5 ounces

Bennie tried to run up some stairs – the same stairs that he would only slowly lumber up a few weeks ago.  He actually sort of jumped up them!  Ok….it was not terribly graceful but it was a start.

9/19/07

23 pounds, 2.0 ounces

9/12/07 – 9/19/07 weekly progress report:

He has lost 10 ounces this past week.  That is 2.6% of his body weight.  (10 ounces is 2.6% of 23 pounds, 12 ounces……or stated another way…….23 pounds, 12 ounces is 380 ounces.  10 divided by 380 = 2.6%.)

9/21/07

22 pounds, 15.0 ounces

9/25/07

22 pounds, 10.0 ounces

9/29/07

22 pounds, 2.5 ounces

Bennie is becoming more active each day.  He used to slowly lumber across the room when I would call him…or he would just lie around and not move.  Now he is walking briskly in order to follow me around the room.

9/19/07 – 9/29/07 progress report:

He has lost 1 pound in 10 days.  This works out to be ~3% of his body weight per week.  He is losing weight too quickly.  I need to find a diet that he likes better so that he consumes more calories/nutrients.

10/6/07

21 pounds, 11.5 ounces

Bennie has lost 7 ounces in the past 7 days which represents just under 2% of his body weight.  He is becoming even more affectionate than he already was…..if that is even possible!  Bennie is a very affectionate cat but, in the past, he would tend to wait for me to come to him.  He was so large that he did not want to move around much.  Now I am tripping over him!!  He is constantly underfoot gazing up at me begging to be acknowledged and petted.

I am also happy to report that he actually broke out in to a run….ok…a medium trot…..to go after Dexter in play!  He is also running up a couple of steps in the foster room versus just lumbering up them.

One issue that makes me a bit sad, however, is that Bennie really wants to be with humans.  I am not able to spend much time with him and I am really looking forward to getting him adopted into a loving home with people who will appreciate his great personality and who will also feed him correctly.

Bennie will be available for adoption after he loses a bit more weight…….but good homes are so hard to find.

10/13/07

21 pounds, 1.5 ounces

Bennie has lost 10 ounces in 7 days.  This represents a 2.9% loss this week and is not a safe rate of weight loss.  Even though he is becoming more active and playful each day, I am concerned about him.  I recently had to bring in 2 new foster cats and while Bennie is very good with other cats, I feel that this has stressed him to the point that he has decreased his calorie intake to a dangerous level.  I will be moving him to another room to see if that results in an improved appetite.

10/15/07

21 pounds, 0.0 ounces

I am not happy with the way that Bennie’s body looks.  He is losing too much muscle mass along his backbone and over the top of his head which is due to inadequate protein intake – ie – protein malnutrition.  Also, he stands a very good chance of not consuming enough essential vitamins and minerals with such a low food intake which will result in overall malnutrition.

Since he has been in with other foster cats, I have no idea how much he has been eating.  He is not thrilled with Fancy Feast anymore and will not eat plain meat baby food (supplemented with calcium and taurine) or any of the rabbit diet that I make for my cats.  I will start supplementing a small amount of EVO dry food – even as much as I hate dry food.  He will get 1/2 ounce (75 pieces) each day which will add 65 calories to his total caloric intake.

I will turn the EVO feeding into a game where I throw the pieces – one at a time – around the room so that he runs for them and gets some exercise.

10/17/07

21 pounds, 0.0 ounces

Playing with a mouse toy.

10/20/07

20 pounds, 12.75 ounces

Bennie seems a bit quiet today and would only eat 25 of his 75 pieces of EVO.  I am worried about hepatic lipidosis.

10/22/07

20 pounds, 15.5 ounces

Bennie has been confined to an adjoining room so that I can monitor his food intake.  He is separated from the other foster cats by a screen door (so he does not get too bored) and he likes to lie by the door and watch them.

He only ate 4 ounces of Fancy Feast today for a total of 110 calories.  That is not enough food for him.  He would not eat EVO today.

10/23/07

20 pounds, 14.0 ounces

Bennie is not eating very well.  He is still very affectionate but is not as active as he usually is.  I have started to syringe-feed him pureed canned Wellness.  (12 ounce can of Wellness + 3 TBS water.  Puree in blender, then run through a strainer.)

Blood drawn for CBC and panel.

All liver enzymes are normal except for one that is very slightly elevated.  An ultrasound of his liver showed no abnormalities but with his decrease in appetite, he runs the risk of developing hepatic lipidosis.  I will continue to syringe-feed him until I can put a feeding tube in him.

10/24/07

21 pounds, 1.0 ounces

Bennie is not happy about the syringe feeding and neither am I.  He is trying very hard to be good but it is very stressful for both of us.  The stress involved with syringe-feeding can cause a food aversion but more importantly, it is impossible to get enough calories into him via this method.  He will have a feeding tube put in tomorrow.

10/25/07

21 pounds, 3.5 ounces

Bennie did well with the general anesthesia.  While he was under, he got his teeth examined and cleaned.  (Anytime any of my cats go under anesthesia, they get a thorough dental exam and cleaning.)

I am feeding him pureed Wellness – Turkey and Salmon since it is lower in fat and higher in protein than the plain Chicken or Turkey.  I am adding in chicken baby food (meat only – no grains, no corn starch and no vegetables) to increase the protein calories and lower the fat content of his diet.  The food is being supplemented with vitamin E, B-complex, taurine, and calcium.  Meat baby food – without supplementation – is a very unbalanced diet.

Bennie is feeling much better this evening since he has been fed several meals through the tube.  He is purring up a storm and rolling over for belly rubs.  He will stay in his own room for most of the day, for now, so that he is not stressed by the other cats and I will feed him 4-6 small meals/day via the feeding tube.  I will let him out with the other cats for a couple of hours/day as long as he does not seem too stressed.

He is not being fed anymore dry EVO unless it is during a play session where I throw 25 pieces for him one at a time.

Video of feeding Bennie via his feeding tube:

This is not the best video….but it does show how relaxed Bennie is during his feeding.  I am feeding him ~60 cc at a time – filling two 30 cc syringes before getting started.  It takes me about 7-8 minutes to slowly inject the food through the tube.  If I go any faster, I see him swallowing as if the food is coming back up his esophagus.

The food is always ‘chased’ with about 5-7 cc of water to keep the tube flushed.

The collar that I made for him is a safe collar.  It is a strip of elastikon tape folded lengthwise on itself so that it is not sticky.  I cut two slits in it on the left and right side of center for the tube to feed in and out of.  The two ends of the collar are taped together.  This collar would break apart if he ever got it caught on anything.

I added a strip of elastikon tape to the tube itself just to provide more bulk/friction so that it does not back itself out of the holes in the collar.

11/1/07

21 pounds, 0.0 ounces (the same as he weighed on 10/17/07)

I am feeding Bennie enough via his feeding tube to maintain his weight. I do not want to see him in a negative energy balance for weight loss at this time.  For the first week of feeding him with the tube, he was getting 60 cc of food 4 times/day for a total of 240 calories.  The food that I am feeding is still a mixture of Wellness Turkey and Salmon with chicken baby food mixed in with added supplements for balance.

Feeding Bennie 4 times/day is a bit of a hardship with my busy schedule so he is now being fed 70 cc 3 times/day and he has canned Wellness available at all times if he chooses to eat on his own.  He is back out in the large foster room with the rest of the cats and seems to be doing well.  He is very happy to see me when I come into the room and he rubs around my legs.

11/6/07

21 pounds, 0.0 ounces

Bennie is feeling great and so I will start to cut back on his calories to get him back on the road to a thin body.  I will be feeding him 200 calories/day.

11/28/07

20 pounds, 6.5 ounces

Average loss of 0.9% per week.

I removed Bennie’s feeding tube today.  He had the tube in for 5 weeks but I really only used it for the first 2-3 weeks.  For the past ~2+ weeks, he has only received a few meals via the tube while I monitored his food intake. I probably could have removed it 2 weeks ago but wanted to play it safe.

12/1/07

20 pounds, 3.5 ounces

Bennie is playing really well these days and he actually ran after another foster cat and tackled him in play.  They were grooming each other afterward.  This is quite a breakthrough for Bennie.  I have never seen him move so fast!  I also saw him roll over today like a normal cat.  He was not able to do that when he was so obese.

12/11/07

19 pounds, 14.5 ounces

Bennie finally broke through the 20 pound barrier!  And…..he can even jump up on this very high bed effortlessly!  Once I knew that he was jumping up onto the bed, I put a carrier there for him to use to get down.

A cat as large as Bennie should not be jumping down on his little legs.  If he were to do so, he could injure his joints and other soft tissues (tendons and ligaments).  In fact, he jumped out of my lap a few days ago when I was sitting on a low step.  He then limped off on his right front leg.  He needs to lose a few more pounds before it will be safe for him to jump down off of anything.  Damage to joints and soft tissues……a sad reality of obesity…..

Bennie is currently eating 5 ounces of canned Wellness – either plain Chicken or plain Turkey.  (200 calories/day)

12/18/07

19 pounds, 15.5 ounces

I am not happy with Bennie’s topline.  He is losing too much muscle mass around his back bone and head.  While Molly maintained her muscle mass when losing weight on Wellness, this diet is a proving to be too low in protein for an optimal weight loss program for Bennie.

Bennie was switched to a higher protein diet with 45% of the calories coming from protein.

12/24/07

20 pounds, 2.5 ounces

Video of Bennie playing:

I have not been spending as much time playing with him as I should be.  As with all diets…..it is calories in and calories out and Bennie needs to burn off more calories.  The exercise will not only help him to lose weight but it will also build muscle.  Hopefully, he is gaining muscle mass due to the fact that he is now on a higher protein diet.

I will be cutting back on his food slightly and exercising him twice daily for at least 10 minutes each time – or until he chooses to stop.

1/5/08

20 pounds, 0.5 ounces

Bennie is feeling great and he is playing well and for a longer period of time each day.  Just like with humans, cats need to exercise!  And…..just like with humans, their level of fitness will increase as time goes on.

I am very happy with Bennie’s top line after only 18 days on the higher protein diet.  His backbone has filled in with muscle and it is not prominent like it was a month ago.  Wellness Chicken and Turkey canned foods derive only ~30% of their calories from protein.  The Wellness Turkey & Salmon provides ~37% of its calories in the form of protein.

1/11/08

19 pounds, 13.5 ounces

~1% weight loss this week

1/22/08

19 pounds, 11.0 ounces

Bennie has lost ~8 ounces in the past month.  I am trying to run him around with a tassle toy twice daily – if my schedule permits it.

The muscle around his backbone and head is much greater since I switched him to a higher protein diet 1 month ago.

1/25/08

19 pounds, 8.5 ounces

1/29/08

19 pounds, 10.5 ounces

2/5/08

19 pounds, 9.5 ounces

Bennie’s weight loss seems to have stalled a bit but that is actually a good thing. He has been putting the muscle back on that he lost when he was not consuming enough calories.

2/23/08

19 pounds, 2.0 ounces

Bennie has been eating approximately 180 calories/day.

Here is a video of Bennie jumping up onto the bed. He flies now!!

It has taken Bennie almost 3 months to lose this last ONE pound but that is just fine.

3/5/08

18 pounds, 15.5 ounces

I am keeping a close eye on Bennie’s backbone and head area.  Both of these areas are filling in very nicely.

He ran really fast today when chasing his tassel toy!

3/9/08

19 pounds, 0.5 ounces

Bennie’s muscle mass continues to improve on the higher protein diet.  The back of his head is still filling in and is close to being normal now.  His top line is also normal with plenty of muscle around this backbone.

I have been feeding him some large chunks of chicken thigh meat for his dental health.

Bennie was a bit clueless when I first put the chunks of meat in his bowl.  He had that look on his face that my own cats get….”Mommy….please cut my meat for me.”  My cats are horrible about eating chunks of meat and their teeth are suffering for it.  I told Bennie to “tap into your inner carnivore and chew it!”  He figured it out because it was gone when I came back to his room.

3/13/08

18 pounds, 14.0 ounces

Bennie has lost 4 ounces (1/4 pound) in the past 20 days.

3/22/08

18 pounds, 10.5 ounces

Bennie has lost 6 ounces in 2 weeks.  This is just shy of 1% per week which I am very happy with.

3/30/08

18 pounds, 7.5 ounces

Bennie did not get any cooked chicken this weekend but he has been getting 22 pieces of dry EVO (20 calories) daily (or ever other day) that I throw (one at a time) around the room for him to run after.  I told him that I am not trying to tease him but, instead, I want to make him work a bit for his food!  Plus, it is a bit of a game for him.

4/5/08

18 pounds, 6.0 ounces

Bennie has lost 4.5 ounces in 2 weeks.  He is on target for losing 1/2 pound/month.

I would like to see him at ~14 pounds (I reserve the right to revise that….) so that means he needs to lose another ~4 pounds which may take another ~ 8 months.

4/10/08

18 pounds, 6.0 ounces

I think that Bennie is getting a few too many ‘sprinkles’ of EVO…..

4/15/08

18 pounds, 4.0 ounces

4/24/08

18 pounds, 1.0 ounce

His topline is now well-muscled and he is thriving on.  He is also very energetic when he plays and can run fast , turn on a dime and easily jump up on things ….just like a cat should be able to do.

For comparison – Day 1 picture….pre-8.5 pound loss:

Bennie and his buddy, Beau

5/3/08

18 pounds, 0.0 ounces

5/8/08

18 pounds, 0.0 ounces

I recently rescued a litter of kittens that are in an adjoining room to my foster room where Bennie is.  They are being free-fed canned (adult) Wellness but if their bowls are empty, it is hard for me to feed them and not give Bennie a tiny bit (less than a teaspoon).

I don’t like to see Bennie get frustrated when he sees me feeding the kittens so his weight loss has stalled a bit (for the past 2 weeks) but we will get back on track soon.  It won’t hurt him to be on a bit of a break from his weight loss – as long as he is not gaining weight.  I knew that this would be a marathon – not a sprint – when we started down this road 9 months ago.

I really am anxious to find Bennie a home of his own but it is going to be hard to find someone to stay the course with his program.  We have come so far and it would kill me to see someone adopt him who will not be committed to keeping him on track for at least another 2 pound weight loss. Or worse…..adopt him to someone who will allow him to become obese again.

5/10/08

17 pounds, 14.0 ounces

Bennie broke through another barrier!  It is so nice to see the ’17 pounds’ above.

He ran like crazy today for his tassel toy.  It is a joy to see him act more and more like a real cat every day.

The one sad part for Bennie is that his buddy, Beau, just got adopted by a wonderful family.  I need to get Bennie in a home of his own.  He is really tired of being in my foster room and cries when I leave him.  Bennie LOVES people and is a very affectionate lap cat.  As soon as I sit down……he is in my lap.  He loves to be brushed and craves more attention than I can give him…..

5/22/08

17 pounds, 10.5 ounces

6/3/08

17 pounds, 9.0 ounces

I can sure see why people fail at getting their cats to lose weight in multiple cat households.  Bennie is living with 5 kittens who need to eat a lot.  It is hard to say “no” to him when he sees the kittens eating and can smell the food.

I have been feeding the kittens 3-4 times/day and Bennie has to go into a large cage for about 15 minutes while they eat so instead of feeding him 2.4 ounces twice daily, he is getting smaller portions more frequently. I never put him into the cage without some food as I think that would be mental torture for him!

I sometimes take 1/2 tsp of Wellness canned food and smear into a plastic Lean Cuisine dish so that he has to work a bit to lick it out of the corners.  This keeps him busy while the kittens are eating.  It reminds me of when my mom used to let my brother and I lick the beaters with cookie dough on them!

6/22/08

17 pounds, 6.5 ounces

It has taken Bennie almost 3 months to lose just one pound.  As you can see by the picture below, Bennie is still too heavy.  He still has more fat on his frame than he should have.

I find that people allow their cats to carry far more fat on their bodies than they should.

Bennie and I will keep moving forward. Slowly but surely……. he will eventually end up fit and trim!

7/1/08:

A bitter sweet announcement………..

It is with great sadness that I announce the passing of our sweet Molly on 6/25/08 due to a stroke.  Even though we miss her terribly, we take comfort in the fact that she had a wonderful 4 years with her adoptive ‘mom,’ Maurine.  Her final days were spent watching the wildlife out the window of their new home in Arizona and playing with her kitty friend, Pablo.

When Molly first went to live with Maurine, she was a wonderful and comforting companion to Maurine’s elderly mother who was suffering from Alzheimer’s disease.  Maurine’s mother really brightened up when Molly came to live with them and she enjoyed having Molly sleep with her and keep her company on the couch.  We all know how soothing the presence of a furry one can be and Molly really did her ‘job’ well.

Now….on a happier note, in Molly’s honor, Maurine has decided that Bennie needs to move to Arizona to keep her and Pablo company.  I could not be happier….except, of course, if we still had our Molly…..

I know that Molly would approve of Bennie’s move to Arizona….knowing that she will never be replaced in Maurine’s heart but, instead, she would be thrilled to know that another once-obese kitty will have a chance at a healthy life with her ‘mom’.

The timing of Bennie’s new adventure into his hopefully forever home could not be better. (I say “hopefully” because Pablo also has to approve of his new housemate….)  Bennie’s weight loss has really stalled in my cat room.  He is currently at:

17 pounds, 8.0 ounces

He has not lost any weight in the past 3 weeks.  He is still on 1.5 ounces of Feline’s Pride 3 times per day for a total of 4.5 ounces per day but his weight is not budging. And….truth be told……he is also getting a tiny bit of Wellness and a few pieces of EVO…and I think that the calories are adding up.  It is just so hard to deny him when he smells the Wellness that the kittens are getting.

This is a picture of one of my foster kittens coming out of their feeding cage.  This is a very large cage that I have covered with towels so that Bennie cannot see their food.  They are young and need food available to them for most of the day….but I have to keep Bennie from getting to it.  In order to do that, I cut a short piece of PVC pipe and notched it so that the cage bars would fit into it.  I then wedged it so that the door would not close all the way but would stay open just enough for the kittens to squeeze through but not Bennie.  I used velcro strips to close the door against the pipe:

It has also been impossible to exercise Bennie because there are 7 kittens living with him and they all run for the tassel toy….and Bennie just sits back and watches.

Instead of feeding him less, I will keep him at the same level and ask Maurine to do the same.  If I fed him less, I would worry about nutrient malnutrition so we need to increase his exercise to burn off calories. 

Since he will be going from my foster room to a 3,000 square foot house I want to see if an increase in activity level will cause him to drop the needed weight.  Maurine has bought tassel toys, a food scale, and a scale for Bennie so she will keep working at his weight loss program.

I would love to see Bennie get down to ~16 pounds, but if he never lost another ounce, he is so much healthier than he was when he came to live with me 11 months ago.

I can’t say enough nice things about Bennie. He has been a joy to work with….and cuddle with for the past year.  He is kind, gentle, and very affectionate and I will truly miss him…….

7/3/08:

17 pounds, 5.0 ounces

7/8/08:

17 pounds, 6.5 ounces

I just fed Bennie a good sized meal (4 ounces) before packing him up to make the 8 hour drive to his new home.  I rented a large SUV so that Bennie could ride in style in a big cage with a large litter box and nice cushy bed.  Bennie is microchipped and wore a collar with 2 phone numbers on it for the trip.

7/9/08:

17 pounds, 1.5 ounces – On Maurine’s scale.

7/15/08:

17 pounds, 3.0 ounces

Bennie traveled well and settled in nicely.

Bennie and Pablo:

8/10/08:

16 pounds, 13.0 ounces

Wow!!  I am thrilled with the fact that Bennie has lost weight nicely in his new home.  His food amount has stayed the same or maybe increased a bit but the key is that he is in a large home getting lots of exercise.  Maurine reports that he does run through the house!

It is so wonderful to see him happy in his new home and he took to Maurine very quickly.  He is a lap and bed snuggler. In fact, there are times when Pablo is in Maurine’s lap and Bennie joins in.  That is a lot of fur in one lap! (Pablo usually is the gentleman and jumps down….leaving the lap for Big Ben.)

4/14/09:

18 pounds, 7.0 ounces

Well…….things fell apart a bit over the past 6 months with Bennie consuming too many calories leading to a 1 pound, 10 ounce weight gain.  Bennie has been getting 3 meals per day and Maurine was going to cut out lunch but I recommended to keep feeding 3 times per day but just cut the calories down for each meal.

Maurine thinks that Bennie was probably getting ~250 calories/day which proved to be too much for him.  Bennie needs to stay at 200 calories, or less, in order to lose weight.  250 calories is 25% more than 200 calories so it is a significant increase.

6/22/09:

18 pounds, 15.0 ounces

Hmmmmm……stricter portion control needs to be implemented.

7/10/09:

18 pounds, 14.0 ounces

8/13/09:

18 pounds, 6.0 ounces

A loss of 8 ounces in 1 month – now we are headed back in the right direction!

10/9/09:

18 pounds, 4.0 ounces

1/3/10:

17 pounds, 14.0 ounces

A loss of 6 ounces in 3 months.  It is nice to see ’17’ again!

We are going to hold him at 200 calories/day for now but will re-evaluate him in 1 month and adjust his caloric intake from there.  My biggest concern is that the chance of developing diabetes increases significantly with every pound of fat on any body – human or cat.  Diabetes is a very serious and complicated disease to treat.  Therefore, I really do want to see Bennie lose more weight.

When I asked Maurine if Bennie runs around much her reply was:

“YES!  He and Pablo chase each other around the house several times a day, plus they both bat the “mousies” around the room…plus crazy meowing Ben races around the house by himself, chasing who-knows-what and hollering at ‘it.’  Sometimes Ben thunders up and down the hall and does the ‘slip and slide’ thing on the hall rug in the morning before breakfast.”

Reading that report put a huge smile on my face!  To understand my elation at Bennie’s ‘re-birth,’ one only has to look at Bennie’s first few pictures above…..taken when he was terribly obese…..discarded by his thoughtless humans when they dumped him at the ‘pound’…..

3/27/10:

17 pounds, 5.0 ounces

Bennie has lost 9 ounces since 1/3/10.  He is still eating 200 calories/day divided between 3 meals.

6/8/10:

16 pounds, 15.0 ounces

It has been awhile since Bennie has seen the number ’16’ in the pound column!  He is still eating 200 calories of a 45% protein diet per day divided into 3 meals.  Bennie continues to be very playful and active and he is as affectionate as ever.

6/18/11:

17 pounds, 13.0 ounces

Bennie has put on almost 1 pound since his last weigh-in so Maurine is going to watch his calorie intake a bit more closely.

He is still feeling great and is his usual lovable furry self but I would like to see him get back to the 16 pound range.

9/25/11:

20 pounds, 3.0 ounces

19/22/11:

20 pounds, 9.0 ounces

12/14/11:

21 pounds, 4.0 ounces

Bennie continues to gain weight which is very disappointing.  I really fear that he is going to end up with diabetes if he does not lose weight.  Diabetes can be a very difficult and time-consuming disease to manage and is highly linked to excess body fat in both humans and animals.

3/24/12:

20 pounds, 9.0 ounces

Mid June 2012:

19 pounds, 8.0 ounces

7/27/12:

19 pounds, 9.5 ounces

10/10/12:

19 pounds, 12.0 ounces

1/23/13:

19 pounds, 6.0 ounces

4/24/14:

21 pounds, 3.0 ounces

Very sad update….We lost Bennie to kidney cancer in the middle of 2015.  He left behind many people and “Pablo,” his best fur-buddy, who miss him terrible.

---

Updated February 2013
Partially updated June 2014
Partially updated November 2016
Lisa A. Pierson, DVM

Lisa A. Pierson, DVM

---

Hello CatInfo readers,

I am often asked what led to the creation of catinfo.org and what fuels my passion for doing as much as I can to help cats from all over the world live long and healthy lives.

The second part of the question is easy to answer: I really love cats.

The first part of the question takes a bit more explaining.

I never imagined that I would become such an outspoken veterinarian regarding matters of optimal feline nutrition and care given that my primary focus straight out of veterinary school was equine medicine.  I never dreamed that I would end up writing pages and pages detailing how to make a healthy diet for cats, or passionately discussing the prevention and management of feline diabetes and urinary tract diseases, or writing about the dangers of ‘dry pilling’ cats, or putting a litter box-cleaning video on the internet especially considering the fact that the World Wide Web was years away from even existing when I graduated from the University of California, Davis School of Veterinary Medicine in 1984!

So how did I become so deeply passionate about cat nutrition, general care, and the various medical conditions that affect the cats that we share our lives with?

Austin, Robbie, and Anne Jablonski.

Let’s start with Austin who I am pretty sure was a long lost love from a former life.  I adopted Austin from a shelter when he was 4 years old.  His time was running out and I am a sucker for the adults that nobody wants.  Plus, brown tabbies really do something for me.  Our hearts were instantly connected and when I had to say goodbye to him in 1998, I was devastated.  I still cry over him.

After losing Austin, I wanted to do something to honor him so I started volunteering with a local cat rescue organization, TLC Adoptions, to pay tribute to my very sweet boy. Over the next 13 years, I rescued and placed approximately 550 cats and kittens in homes. Unfortunately, I saw very quickly that we could never adopt our way out of the overpopulation crisis since the math just does not add up.  There are FAR more kittens being born each minute than there are available homes.

The answer lies in getting humans to become more responsible about spaying and neutering.

During my years of involvement in the rescue world, I spent many long hours doing TNR work (Trap/Neuter/Return) of feral (wild/unowned) cats in order to prevent the suffering endured by homeless cats and kittens living in a concrete jungle, and to try to make a dent in the large number of unwanted kitties that lose their lives in shelters every day.

I would often go on periodic 3-4 day-long trapping marathons to stabilize large feral colonies using traps that I designed and built for increased efficiency.   This would entail starting to trap at around 7 or 8 PM, staying out until 4 or 5 AM, then performing surgery until all of the cats were spayed or neutered.  After a few hours of sleep, I would get up and start all over again.

I wish that I could say that rescue work is all about warm and fuzzy feelings – and no sadness – but that could not be further from the reality of the situation.  After spending 13 years heavily involved in rescue work – and having it exact a tremendous toll on my heart – I am now taking a break and concentrating more on helping cats live better lives all around the world through my website.

So how does my precious Robbie fit into this picture?

If not for Robbie this website would probably not exist and I might still be feeding my cats a very unhealthy diet of dry food.  Robbie is the cute brown tabby that adorns the top of all catinfo.org webpages and who, if given the chance, would spend his life wrapped around my neck.

I call Robbie the “best ‘mistake’ of my life.”

I have had many animals grace my life but my bond with Robbie is one of the deepest I have ever had the privilege to experience.  He truly is my furry little soul mate.

Robbie took his first breath at 1 AM on April 6, 2001 when, at the last minute, I decided to do a C-section on his feral mother.  I had spayed 6 pregnant cats the day before and was emotionally spent over the death of 27 kittens.  I was exhausted at that late hour and it would have been much easier to perform a routine spay on Robbie’s mother but I simply could not take the life of one more living creature.

It is necessary in rescue work to spay pregnant cats. This is a fact of life given the lack of available homes. I had spayed many pregnant cats in the years before Robbie’s birth and I have spayed many more since then but that night a split second decision was made to bring Robbie into the world and he has been my constant companion ever since.

I immediately called my decision a “mistake” because bottle feeding 6 newborns was not an easy task but Robbie has quite literally changed my life so it is a decision I have never regretted.

Ok, so who is Anne Jablonski and how does she figure into the creation of catinfo.org?

Robbie had been dealing with diarrhea for most of his life and being the dutiful vet that I was, I tried every prescription diet available.  None of them helped and I now cringe and get angry when looking at the ingredients through much more knowledgeable eyes.  Now that I know what it means to be an obligate carnivore with a low thirst drive, I would have to be stranded on a desert island with no other food source to consider putting those diets into a cat’s food bowl.

In December, 2002, at the suggestion of a friend of mine, I joined the Yahoo IBD group out of desperation.  Nothing the veterinary community had to offer was helping – including the poor quality prescription diets, steroids, metronidazole, etc.

At the time, I was feeding all of my cats a combination of Hill’s Science Diet Light dry food and Iams Less Active dry food with some NutroMax dry thrown in for variety.  No canned food was fed because I came from the ‘old school’ which is full of not-terribly-well-educated people, like myself at the time, who feel that dry food is healthier than canned food.

Unfortunately for our cats, this could not be further from the truth and when humans starts to realize this, we will have fewer sick cats in our world.

Anne was the co-moderator of the IBD group and after a warm welcome, she said in her  always-polite delivery……“Um….Dr. Pierson….do you think you might consider feeding your cats a better diet?”

Since I have never had much of an ‘I-am-the-doctor-and-know-better’ type of ego, I listened carefully to what she had to say after replying “Really?  Hill’s Science Diet is not a healthy food?  But it says right on the label that it is ‘Veterinarian Recommended’!”

Side note:  Sadly, many of my colleagues do, indeed, recommend products made by Hill’s (and Purina) and this is a testament to the fact that most veterinarians are not well-versed in proper feline nutrition and simply defer to companies like Hill’s and Purina whose marketing budgets are huge.  These large budgets include substantial sums of money dedicated to sponsoring – including very heavy advertising – our professional meetings and infiltrating veterinary schools to get students ‘married’ to their products.

Coincidentally, just after Anne’s comment, I picked up our profession’s most recent Journal of American Veterinary Medical Association (the Dec. 1, 2002 issue) which contained, under Timely Topics in Nutrition, Dr. Debra Zoran’s wonderful article entitled The Carnivore Connection to Nutrition in Cats.

I immediately read it and a light bulb came on over my head.

I went to the cupboard and read the ingredients on the bags of dry food and also noted the low moisture content while keeping in mind that cats have an inherently low thirst drive and are designed to get water with their food.

I cringed.

So, do some cats live long lives on this type of diet?  Yes, they do but I am more interested in feeding a diet that promotes thriving and not simply surviving.

I want to feed a diet that gives my cats the best chance of avoiding gastrointestinal disturbances, diabetes, obesity, and urinary tract diseases – including life-threatening and painful urethral blockages and bladder inflammation (cystitis).

One of the most important pages on this website is the Urinary Tract Health page which states:

If I could have the reader of this webpage take away just one word from this discussion, it would be “water“.  If your cat is on a properly hydrated diet of 100% canned food – and no dry food – you stand a very good chance of never needing to read this webpage.”

Think of canned food as flushing out your cat’s the bladder several times a day.  If the bladder is ‘rinsed out’ frequently, your cat is much less apt to suffer like Opie did as shown below.

A very smart veterinary urologist has stated:  “Dilution is the solution to the pollution.”  This means that water flowing through the bladder will dilute crystals, protein, mucus, and cellular debris in the bladder.  This “pollution” comprises material that could turn into stones/plugs that would block the cat’s urethra.

Please do not make the very common statement:  “But my cat drinks a lot of water so I know he is getting enough!”

Cats have a very low thirst drive and it has been shown that they consume approximately double the amount of water when fed canned food (78% water) versus dry food (10% water).  This is taking into consideration the water they consume from their food plus the water bowl but please note that cats on canned food rarely drink.  This is because they are on a properly hydrated diet and are getting a large amount of water through their food.

This issue  becomes clearer when we understand that a cat’s normal prey is ~70% water and they evolved as a desert dwelling species.  If prey was available, their extra water needs were minimal.

Opie is a painful example of the suffering often caused by dry food.

He was a stray cat that would have died a very slow, painful, and miserable death if TLC Adoptions had not rescued him in 2008.

There is nothing in bags of cooked-to-death, water-depleted, heavily plant-based protein, high carbohydrate diets that makes any sense to me.

Nothing about dry cat food comes close to resembling the properly-hydrated, low carb, animal protein diet that a cat is designed to eat.  When looking at bags of dry food, I see plenty of moisture-deficient species-inappropriate, profit margin-driven ingredients that make the stockholders of pet food companies very happy.

Dry foods are also contaminated with bacteria, storage mites, and dangerous – and life-threatening – mold spores and toxins which make cats sick more often than people realize. 

Vomiting and diarrhea are very common feline problems that veterinarians deal with on a daily basis.  However, it amazes me how infrequently the food – especially dry food – is looked at as a source of the patient’s illness.

Thanks to Anne and Dr. Zoran’s article, I made a firm commitment on December 22, 2002 to start working toward removing all dry food from my cats’ diet.

Unfortunately, my 7 cats at the time had other ideas.  They ranged in age from 1.5 – 10 years and had been fed a 100% dry food diet for their entire lives.  I had 7 die-hard kibble addicts on my hands which made for a VERY frustrating next 3 months.

See Tips for Transitioning Dry Food Addicts to Canned Food which emphasizes using patience, time, and tricks to get cats off of all dry food.

By March, 2003, I had won the battle and had gotten all dry food out of my house.  My cats had finally found their inner carnivore and were eating a 100% canned food diet.  They now had more energy and the overweight ones were slimming down.

And most importantly, Robbie’s diarrhea had vastly improved.

I was happy that my four-legged family was finally eating a water-rich diet with low carbohydrates, and meat (not plants) as their protein source but I was becoming frustrated over the lack of control that I had with respect to the ingredient quality and composition (the caloric distribution between protein, fat, and carbohydrate) of commercial canned foods.

With Anne’s guidance, I started making my own cat food.  To be honest, I felt liberated with my newfound control over what was going into my cats’ food bowls and, for the first time in his life, Robbie had formed stools!

Interestingly, my Making Cat Food page is the second most visited page on this site – second only to the Feeding Your Cat: Know the Basics of Feline Nutrition page.  I am pleasantly surprised to know that there are so many people willing to make cat food!

Making your cat’s food may sound like a daunting task but if you knew what an idiot I am in the kitchen you would be impressed by just how easy it is.

If I can make cat food, anybody can.

I spend a few hours in the kitchen (my least favorite room in the house) 4-6 times each year making the food which then goes into the freezer.  For me, this is a very small amount of time out of my life to ensure that I have complete control over what goes into my cats’ food bowls.

That said, my goal with this site is simply to get people to stop feeding dry food and to switch to canned food.  As noted on my Commercial Canned Cat Food page, I would MUCH rather see someone feed the cheapest canned food (Friskies, etc.) than the most expensive dry food.

Why?  Because nearly all canned foods address the 3 main issues with feeding cats:

1) They all contain an appropriate amount of water for a species with a low thirst drive – so cats won’t have to suffer like Opie did.

2) Most canned foods are low in carbohydrates (Hill’s products and some Purina products are notable exceptions).

3) The protein is more apt to come from meat and not plants (grains/vegetables).

So, in summary, my love of Austin led me to rescue work which resulted in Robbie entering my life.  Robbie’s chronic diarrhea led me to Anne.  And because of Anne’s gentle nudging, I began to look at the food I was putting into my best friends’ food bowls with a more critical eye.

And my deep love of cats and keen interest in internal medicine and nutrition led to the creation of catinfo.org.

As my time permits, I will continue to write new articles for this site as well as update current writings.

I’m often asked why I don’t write a book.  My reason?  We never stop learning and growing.  Once something is in print, it cannot be updated – unlike this website.

You will notice that there is a date at the bottom of every page showing when the last revision was written.  Keeping the site current is extremely time consuming but I do my best as time permits.

Thanks to all of you and your quest for knowledge, this website has become quite popular with approximately 3 million visitors each year.  Many of you have added a link to catinfo.org on your own websites which has resulted in more cats getting fed and cared for optimally.

If you have found your way to this site, your cats are very lucky to have you care deeply enough about their well-being to put the time in to research ways to promote optimal feline health.  It is my hope that the information contained here will improve the quality and length of your cat’s life.

Happy reading!

Dr. Pierson and Robbie

---

September 2011
Reviewed November 2016
 Lisa A. Pierson, DVM

Lisa A. Pierson, DVM

---

Feeding tubes save lives and are not used as often as they should be for anorexic patients.

Unfortunately, when most people hear the term “feeding tube,” they tend to panic – feeling like this is the end of the road for their cat.  However, feeding tubes should not necessarily be viewed as a doom and gloom overly heroic measure.

I often hear people say “oh, I would never put my cat through that!”

Unfortunately, these folks are not recognizing the tremendous value of feeding tubes to support ill patients while they heal from a temporary illness or injury. Most cats are not bothered by the tubes at all!  The human is the one who is bothered by it as the cat just goes about its daily routine.

Anyone who has ever tried to syringe-feed an ill cat for very long recognizes the stress that is involved for both the cat and the human.  Not only is it very time-consuming, but the critical issue is that it is often very difficult to meet the caloric and hydration (water) needs of the cat with this method. 

Feeding tubes are not right for every situation and case selection requires thoughtful consideration – keeping the patient’s best interest in mind – not the human’s.  For cats that are suffering from a chronic, terminal illness such as renal failure or cancer, it is my feeling that a feeding tube is not necessarily appropriate to use in these cases.  It is a matter of personal choice  to prolong the inevitable in our pets and caregivers need to think long and hard before they put a feeding tube in a patient with a terminal illness when euthanasia may be a much more humane and loving decision to make.

Feeding tubes do require a short period (~10 minutes) of general anesthesia to place and this is often a concern when the patient is very debilitated.  This is why it is better to put a feeding tube in an anorexic patient sooner rather than later.

See below for some pictures of feeding tubes that can be used to greatly reduce the stress to both the feline patient and the human caregiver.  Please note that most cats don’t even notice them and they can eat and drink with them in if they choose to do so.

The first tube that is shown is a pharyngostomy (“P”) tube.  It goes into the side of the neck as shown and enters the back part of the oral cavity and then heads down the esophagus. Most veterinarians prefer to use an esophagostomy (“E”) tube which goes in lower down the neck.  Either tube works well but E tubes are the most common feeding tube used.

Another type of feeding tube is called a PEG tube and is shown at the bottom of this page.  This type of tube takes more expertise to place and must stay in for a minimum of 2-3 weeks unlike P or E tubes which can be removed at any time.  PEG tubes also have a higher risk for complications associated with them.

Each case has to be considered individually when deciding which type of tube to use.

Here are some pictures of some of my patients/foster cats with feeding tubes:

May 2006:  Poor Chase (abandoned by his owners) was very sick with hepatic lipidosis (“fatty liver” disease), pancreatitis, and IBD.  His hepatic lipidosis made it critical that he receive adequate nutrition to save his life but given his illness, he was unwilling to eat.

If syringe feeding was attempted, he would salivate copiously and would not swallow the food.  (Note the thick, ropey saliva coming from his mouth in the picture below.)  It would also trigger more vomiting causing a great deal of stress for both of us so a feeding tube was put in place and he was fed a very small volume of pureed canned food every 2 – 3 hours.

It is highly doubtful that he would have survived without a feeding tube.  You can see the tip of it hanging off to his right.  Chase did vomit many times with this tube in place but, fortunately, the tube never came up which can be a complication when feeding tubes are used in vomiting cats.

September 2006:  Chase is now healthy and in a loving home.

November 2011:  Chase is still healthy and happy.

Here you can see the tube entering the side of his neck and the sutures holding it in place.  This area needs to be kept clean and neosporin, or another antibiotic ointment, applied.

Above and below are two pictures of a makeshift collar that I used to keep Chase’s tube in place.  It is fashioned in such a way that it will breakaway if caught on anything.  You can also use body wraps like shown below but if the weather is too hot, I prefer to just use a safety type of collar.

Another option is to order a Kitty Kollar which is designed to use with a feeding tube but, honestly, I do not like this product.  It is far too bulky.  I tried one of them on my own cats and ended up cutting the fabric open in several places and, using needle nose pliars, I removed all of the bulk stuffing.  But even after all of that, I still did not like the collar and went back to my thin, non-bulky homemade collar.

Chase would never have had the pleasure of wearing his Santa hat had it not been for a feeding tube.  This very handsome boy posed for this picture December, 2006.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Here is Misty with her feeding tube in place after she had to have a kidney removed.  She is wearing a ‘Critter Wrap’ that held her tube in place but these wraps are ‘overkill’ and they keep the cat too hot and do not allow them to  groom themselves…and basically annoy the heck out of the poor cat…..so I prefer to use my homemade collar.

Here is Misty eating with her tube still in place. Once she was eating well on her own, I removed the tube. (By the way…I had her ‘dress’ on up side down in this picture….oops….no wonder she walked funny since it was goosing her in the armpits…) Misty is now back in her adoptive home. (She was my original rescue and in order to keep the costs down, I did the surgical aftercare at my home before sending her back to her adoptive parents.)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Molly was extremely obese and it was drastically affecting her health.  She could barely walk and could not clean herself and was, in all probability, headed for diabetes.  The problem was that she absolutely refused to eat canned food and getting her on a healthy diet was her ticket to a happier and healthier life.  She had already been returned to our adoption agency because of her lack of cleanliness.

Molly was being fed a small amount of a very low quality and species-inappropriate diet of Hill’s dry r/d and a shock collar was being used to keep her away from her housemates’ food.  Since dry food is a very unhealthy and illogical diet for a carnivore and is the type of food that led to Molly’s debilitated physical state, it was critical that she be transitioned to a canned food diet.

Unfortunately, she had other ideas and wanted to continue eating dry food so a feeding tube was put in when she was under anesthesia for a dental cleaning.  She was then fed pureed Wellness for the next 2.5 weeks.  At that time, she started eating canned food on her own and the tube was removed.  She eventually lost 7 lbs (going from 20 lb to 13 lb) and enjoyed the next several years as a happy and active kitty…..even jumping with ease on to a very high bed to sleep with her ‘mom.’

Molly looks grumpy in the picture above but she really was a very sweet and gentle little girl.  Shortly after these pictures were taken, I figured out how to make a nice breakaway collar so that she would not have to wear this awful dress.

As you can see by these pictures, a feeding tube does not restrict their activity.  Molly was able to hang out with her buddies like a normal cat.

 

From my Feline Obesity page:

6/25/08

“It is with great sadness that I announce the passing of our sweet Molly.  Molly was a very special girl.  She was incredibly kind, affectionate and very gentle. Molly was a wonderful companion to Maurine’s 90+ year old mother – providing Mrs. H with great comfort in her remaining days as the elderly woman dealt with advancing Alzheimer’s disease.  I know that Maurine will always be grateful for the comfort that Molly provided for her mother.

Thank you, Molly, for all that you taught me during our journey to find your inner svelt and healthy cat.”

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Some of you may have seen Bennie on my Feline Obesity page.  Bennie had his feeding tube in for about 5 weeks.  I only used it for the first 2-3 weeks but I kept it in for another ~2 weeks just to make sure that he was going to eat well on his own.

When it came time to feed him, he would crawl in my lap and purr away.  He was not bothered by the tube at all and would play like a normal cat during the 5 weeks that the tube was in place.

This is not a very good movie but it was the best that I could do without help.

Please note that the tube is not left long and flopping around like shown below.  Otherwise, it could get caught on something.  The end of the tube is poked through a hole in the collar on the right side of the neck to hold it in place.  (See the third picture on this page – Chase’s picture above.)

The next two pictures were taken just a few hours after Bennie had the feeding tube put in.  As you can see, he is none the worse for wear after his trip to the clinic which also included a dental cleaning – which I always do if I have any of my cats under general anesthesia.

As soon as I brought him home from the clinic and gave him a meal through his tube, he was much brighter and more alert than he had been prior to the tube placement.  After his first feeding, he rolled over for a belly rub.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

And finally, my much loved Sundance…..

Even though these are not good pictures of a PEG tube, I had to put them on this page to honor my precious boy.  I rescued Sundance from the ‘euthanize list’ at our local shelter.  He weighed a nice 10 pounds at the time.  He was then adopted out to what I thought was a loving home but the people returned him to me 2 years later as an emaciated 4.5 pound cat.

They had not sought any veterinary care for what turned out to be lymphoma.  I immediately put a PEG tube in him and within a couple of months he returned to a robust 10 pounds of pure love.  Unfortunately, Sundance lost his battle with cancer and I had to put him to sleep which darn near killed me.  I still cry over him and that was 10 years ago….

You can see the PEG tube port near Sundance’s shoulder.  This tube went directly into his stomach entering from the left side just behind the ribcage.  Sundance was never bothered by this tube and lived a fairly normal life for the 3-4 months that it was in.

I do want to comment that if the diagnosis of terminal lymphoma would have been made prior to the tube placement, I would have opted for euthanasia rather than to prolong the inevitable with a feeding tube.  This is because he was experiencing occasional severe pain when eating.  The lymphoma was in his head/sinus area which made it hard to diagnose.

If your veterinarian recommends a feeding tube for your sick kitty, please do not hesitate to utilize this life-saving tool.

---

Updated November 2016
Lisa A. Pierson, DVM

Lisa A. Pierson, DVM

---

Cat Food Ingredients
Composition of Cat Food
By-products in Cat Foods
Cost and Quality of Cat Foods
Calculating Protein/Fat/Carbohydrate Percentage of Cat Foods (This may give you a headache…..)
Protein/Fat/Carbohydrate/Phosphorus Chart
Contacting Pet Food Companies
Do Not Recommend
Raw Meat and Bones Diets – comments only/no list

---

Before you get too confused when reading this page, I will say at the outset:  I would much rather see a cat eat any canned food versus any dry food – regardless of the price-point of the canned food.  This includes Friskies, 9-Lives, Fancy Feast, etc.

Canned food is healthier than dry food because:

1. All canned foods contain an appropriate (high) amount of water which is critical for urinary tract health.  Please see Opie’s page – Feline Urinary Tract Health.
2. The protein in canned food is more apt to be higher in animal-based protein versus plant-based protein – contrary to most dry foods.  Keep in mind that we are feeding cats (strict carnivores) not cows.
3. The carbohydrate level of most canned foods is lower than that of most dry foods.

There is no dry food that covers all of the very important points listed above.  None – because all dry food is, well, dry (water-depleted).

If your cat is a dry food addict, please see Tips for Transitioning Dry Food Addicts to Canned Food.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Note:  If you are tempted to write to me to ask about a particular food, please see Contacting Pet Food Companies below.

If you need more help past what is contained on this extensive website – including this page – see Consultation Service.

Specific advice regarding selecting a cat food will not be provided via email.

General comment:  For healthy cats, pick canned foods that are below 10% calories from carbohydrates, at least 40% calories from protein, and approximately 50% fat calories or less.

For cats with kidney disease, please consider trying this food:

Dave’s Restricted Diet – it is restricted in phosphorus but contains a higher amount (when compared to the so-called “prescription” renal diets) of animal-based protein to help support your cat’s carnivorous body.  As my readers know, I will not feed any of the “prescription” renal diets to any cat in my care.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Important notes:

• “Grain-free” does not necessarily mean “low-carb.”  Many companies add in large amounts of potatoes or peas which are high in carbohydrates but are not “grains.”

• Grains and vegetables contribute to both the carbohydrate and protein content of food but understand that the protein from these ingredients is plant-based, not animal-based.  As explained in my Feeding Your Cat: Know the Basics of Feline Nutrition, cats are strict carnivores and need to get their protein from other animals – not plants.

Therefore, when comparing two foods with the same percentage of protein, it is very important to note the quality (biological value) of the protein.  Plant-based proteins are very low in quality/biological value.

• I often get asked for my opinion on dry foods that are relatively low in carbohydrates – e.g. – Young Again.  The people who ask me this question have not read this website – including the Urinary Tract Health page – and have not taken a good long look at Opie’s pictures on that page.  Otherwise, they would know just how strongly opposed I am to the feeding of dry food to cats – no matter what the ingredients are, or what the carbohydrate level is.

I wonder how many people would continue to condone the feeding of a water-depleted diet to cats if they had a cork inserted into their urethra and experienced the subsequent excruciating pain that occurs when a urethra becomes obstructed.  After experiencing the tremendous suffering that commonly occurs when cats are fed dry foods I would bet that their love affair with dry food would end very quickly.

Carbohydrates are not the only issue that we need to focus on when feeding cats.  The water content of the food is also critical given the low thirst drive of the feline species.

Contrary to popular belief, cats do not drink enough water from a bowl to make up for the hydration deficit caused by feeding dry food.  Studies have shown that when cats are fed water-rich diets (canned or homemade diets) that mimic their prey (~70% water), they rarely drink from a water bowl yet their intake of water is double what it is when dry food (5-10% water) is fed.  This is taking into account the water from the food as well as from the water bowl.

If you do not want to read any further and want three quick bullet points, here they are:

• Get the dry food out of your cat’s diet.

• See the Cat Food Composition chart.  Feed canned food with less than 10% of calories from carbohydrates.  Next, look at the fat and protein.  In general, aim for higher protein (at least 40%) and lower fat (~50% or less).

• If you are caring for a diabetic cat that is on insulin please read Feline Diabetes – especially the STOP sign section – and make sure that you understand the highly probable need to decrease the insulin dosage if you are decreasing the carbohydrate intake of your cat.

---

When determining the quality of a pet food, there are two main factors involved:

• ingredients – what is in the food – with amount of each item an important issue but this information is not available on the label

• composition – the percentage of calories that come from protein, fat, and carbohydrate sources – also not on the label – see the Cat Food Composition chart

I realize that the “not on the label” comments are frustrating but welcome to the world of pet foods where the manufacturers are not required to put much usable information on their packaging – unlike the case with food targeted for humans.

Unless you are dealing with an allergy to a specific ingredient, the composition of a diet is generally more important than the ingredients as long as you pay attention to where the protein is coming from (i.e.- animals versus plants).

The composition of a feline diet is important because cats are designed to eat a high protein (~50% of calories, or more), moderate fat (~40% of calories or less), and very low carbohydrate (1-2% of calories) diet.

Unfortunately, this fact is at odds with the issue of profit margin given that carbohydrate and fat sources are cheaper than animal-based protein sources.

Ingredients

When looking at the ingredient list on a label, it is very important to keep in mind that the label tells us nothing about the amount of each ingredient.  This is where the issue of composition (discussed below) helps us out.

For instance, if you see species-inappropriate, ingredients such as rice, potatoes, peas, broccoli, blueberries, etc., on the label, you know that the amount of these inappropriate items must not be very high if the carbohydrate level is low.

On the other hand, if we are dealing with a known allergy to any ingredient, we do not want that ingredient to be present in any amount so that is where the ingredient label does provide value.

Here are a few general guidelines that I like to focus on:

• Feed canned food only (or homemade) – no dry food.

• Stick with poultry (chicken and turkey) and rabbit as the bulk of your cat’s diet.

• I like to see liver in the diet but not as the first ingredient.  Liver is high in vitamin A and D which can be overdosed.  Liver only represents ~5% of a cat’s natural diet.  Liver is cheap which is why it often appears first on the list in some diets.

• Fish – I do not feed fish to cats for the following reasons:
  • high allergy potential (manifested as skin allergies or inflammatory bowel disease, and possibly asthma)
  • toxin/mercury contamination
  • PBDEs (fire retardant chemicals) – PBDEs are potent thyroid disruptors
  • often high in phosphorus and magnesium
  • highly addictive – the cat will not eat anything else

If you want to feed a fish-based food as a treat, please limit it to once or twice a week.  (I do not feed any fish to my cats.)

• Beef is another food allergen for some cats but many cats do just fine with beef.

• Think ‘feathers and long ears’ and not as much ‘horns and fins.’

• Muscle meat (e.g., “chicken” or “turkey”) versus by-products is a debatable subject.  See the by-product section below.

Be aware that most of the grain-free/by-product-free/muscle meat choices such as Wellness, Nature’s Variety, EVO 95%, etc., are high in fat and relatively low in protein in order to keep the profit margin high.

Given this fact, I can’t help but wonder if Friskies, 9-Lives, etc. (all by-products, no muscle meat) may actually be better diets because many of these by-product foods are higher in protein and lower in fat than the more expensive diets that are free of by-products.

High protein/low fat is especially important for cats trying to lose weight but do be aware that some of the highest protein by-product foods are high in fish and we do not want to feed a lot of fish as noted above so choose wisely.

See the Composition section below for more details.

• Moisture content:  Here is where a company can really increase their profit margin.  Most canned foods are ~78% water which helps keep a cat properly hydrated given their low thirst drive. This leaves 22% (100% – 78%) as dry matter (ie – food/calories/nourishment, fiber, and ash).  I recently encountered a pouch food with 87.5% moisture.  Subtracting 87.5% from 100% left only 12.5% dry matter.  You can readily see that the food with only 78% moisture has nearly double the amount of dry matter in the can/pouch.  Water is cheap yet this particular company is billing this 87.5% moisture-food as a “premium” food and is charging a premium price for it.

I have noticed that many of the products that come in pouches are very high in moisture content and are not giving you much ‘bang for your buck.’  Water is a critical nutrient but if you think your cat will benefit from more water in his diet than the usual 75-78% because he has urinary tract issues, you can just add water on your own.

Stick with foods that have a maximum guaranteed analysis figure of no more than 78% moisture so you are not paying a lot of money for water.

Note: I am trying not to make this subject too complicated.  However, for the sake of completeness, I do need to mention ash (mineral) content.  Ash is what his left over when all of the protein, fat, carbohydrates, fiber, and water are removed and is what remains after the cremation process of any living being. Ash is part of the ‘dry matter’ in the above example.  The higher the ash content, the less actual food (calories) is in that dry matter.

Please don’t get bogged down with the issue of ash right now.  However, understand that if you are comparing two foods with equal dry matter, the one with the lower ash value is going to give you more food (calories) in the can.

• Grains do not belong in cat food although I will discuss this issue in more detail below.  They are there to add cheap bulk to the food and increase the profit margin of the company. When you see a food called “Chicken and Rice,” please understand that the rice is there to appeal to a human who is not educated regarding the cat’s obligate carnivore status.  Please do not reward these companies by purchasing their products.

• Vegetables:  Cats have no dietary need for vegetables yet companies play on the fact that the average person really does not understand the obligate carnivore status of the cat.  Note that on, for one example, Hill’s Nature’s Best dry food there are 5 pictures: 1) rice 2) peas 3) wheat 4) carrots 5) fish or chicken.

Do you see that the above ingredients (1-4) are simply catering to what many humans perceive as healthy items to be included in their own diet?  These first 4 ingredients add to the carbohydrate load of the diet (30% of calories in this case) and also represent a plant-based source of protein which you now understand is species-inappropriate for a cat.

Also note that wheat is a very hyperallergenic ingredient that does not belong in cat food.  These ingredients simply increase the profit margin of the companies and are marketing ploys to get unsuspecting consumers to purchase their species-inappropriate diets.

In addition to the above issues, note that Hill’s does not put an ear of corn on the front of the bag since most people know that corn is not the most nutritious vegetable available yet if you look at the first ingredient in this food, it is cheap, species-inappropriate corn.

Why didn’t they put a picture of the very first ingredient – which makes up the bulk of the food – on the outside of their bag?

Another marketing ploy that Hill’s is now incorporating into their labeling is the substituting of the word “corn” with “maize.”  Maize IS corn and since this company is well aware of the fact that consumers are becoming more savvy about pet food ingredients, they are now trying to disguise the corn in their diets by calling it “maize.”  These deceptive marketing practices should be abhorred and certainly not rewarded with you purchasing dollars.

• Ingredient splitting

We all know that ingredients are listed in descending order by weight but that does not tell the whole story.  Manufacturers are required to be very specific when naming their ingredients which works in their favor because it allows the grain fractions to be split up so that they are listed below the meat.  Study this unhealthy ingredient list for Hill’s dry i/d:

Chicken by-product meal, brewers rice, corn gluten meal, whole grain corn, etc.

Many consumers will simply focus on the fact that “chicken” is the first word on the list.  However, when all of the grain sources are added together, they often total more than the animal-based ingredient that is listed first.

Also consider that meat or by-products (not meals which are dry) are high in water weight and therefore lower in protein density.  Grains are lower in water and higher in protein density.  This means that diets like the one listed above derive most of their protein from plant sources.  This would be fine if we were feeding cows or horses.

A note about ‘meals’:  Yes, they are higher in protein by weight when compared to “chicken” but they are also heavily processed (cooked at a high temperature until ~95% of the water is gone).  This intense processing destroys and alters nutrients.

Given the ‘ingredient splitting’ issue and the fact that most commercial canned foods contain some species-inappropriate ingredients, we have to look at the composition of the food to determine if it is a reasonably appropriate diet to feed.

Composition

Composition refers to the breakdown of the 3 basic food components that provide calories:

• protein
• fat
• carbohydrate

One of the most confusing aspects of food evaluations involve the terms:

• as fed (‘wet weight’)
• dry matter basis (‘dry weight’)
• metabolizable energy (ME) – calories that come from protein/fat/carbohydrate

The most accurate way to evaluate food is to consider the calories (ME) that come from the protein, fat, and carbohydrate fractions.  This allows us to compare various diets without worrying about their different water (moisture) levels.

Keep in mind that the percentage of calories from protein/fat/carbohydrate must add up to 100%.  Therefore, if you lower one fraction either one or both of the other fractions must rise.  It is like a 3-way teeter totter.

If we want to keep the carbohydrates below 10%, that leaves 90% left over to split up between fat and protein.  Given that animal-based protein is expensive and fat is cheap, it is not surprising that, in the interest of profit margin, pet food companies are now making high fat diets.

With the introduction of the ‘low-carb’ diets, in marched the high fat diets.  However, on a good note, most cats do very well on the relatively high fat diets.

Important point:  Cats are designed to process fats much more efficiently than carbohydrates.

When using the Cat Food Composition chart, the general rule is to look for choices that are ~ < 10% carbohydrates.

Next, look for one that is higher in protein (preferably ~40% or higher) and lower in fat (preferably ~50% or less).

Pet food labels

Unfortunately, pet food labels (“Guaranteed Analysis”) give us very little usable information regarding composition since they do not list the carbohydrate percentage and they only list the protein and fat and water in terms of minimums and maximums which are, by definition, inaccurate.

For instance, if a food states that the fat is a minimum of 6%, it could very well be much higher than that.  Any value listed as a “minimum” or “maximum” is inaccurate and not very helpful.

Human food labels list the actually measured grams of protein, fat and carbohydrate – not just minimums and maximums.

All is not lost, however.

Let’s say you pick up a can of food that is free of grains (including whole grains and flours) and vegetables (including starchy potatoes).  You know that this food is going to be very low in carbohydrates.

However, you still have no idea what the fat and protein levels are.

What is really crazy is that the pet food manufacturers are allowed to list fat as a ‘minimum’ – not a ‘maximum.’ This gives them free-rein to make high fat (read: high profit margin) pet foods.

An example using the can’s Guaranteed Analysis values follows:

I often hear people say that you can determine the carbohydrate content of a food by adding up the water (“moisture”) + protein + fat + fiber + ash and then subtracting the sum from 100%.  Unfortunately, this can be extremely misleading in some cases.

Since profit margin is a pet food company’s number one priority, you can bet that the protein (expensive) will be pretty close to the minimum value listed on the can but the fat (cheap) may be much higher.

Let’s use Wellness canned Chicken as an example of how misleading the carbohydrate calculation from the label values can be:

Guaranteed Analysis:

• Protein (min) 10.0%
• Fat (min) 6.0%
• Fiber (max) 1.0%
• Moisture (max) 78.0%
• Ash (max) 1.8%

If you add up all of those numbers, you get 96.8%.  Subtract this from 100% and you get 3.2% carbohydrates on a wet-weight basis.  However, values should be considered on a dry matter basis (DMB).  In order to convert that 3.2% into a dry matter basis, we must divide it by the dry matter in the food which, in this case, is at least 22%.  I say “at least” because the moisture is listed as a maximum so it could be less than 78%.  (100% – 78% moisture = 22% dry matter.)  3.2% divided by 22% = 14.5% carbohydrates on a DMB.  Most of us would walk away from a food with that carbohydrate level.

However, when I obtained the more accurate measured values (versus minimums and maximums) from the company, it turns out that the fat content is closer to 11% – not 6% as listed on the label (as a minimum) and the protein was actually 12% not 10%.  The moisture content was measured at 73% – not 78%.   The wet-weight carbohydrates measured at 1.7% and the carbohydrates on a DMB were 6.5%.

So you can see by the above example (14.5% versus 6.5%) just how misleading it can be to try to evaluate the carbohydrate content by looking at the guaranteed analysis values on the can.  When using the values on the can, the carbohydrate number came up at more than double the actually measured amount – and the fat content appeared to be about half of the actually measured amount.

However, keep in mind that all food products are going to vary from batch-to-batch so it is conceivable that one batch of Wellness Chicken may actually be closer to the 14% carbohydrates if the protein and fat amounts are closer to the minimums for that batch.  The same is true for all of the numbers on the Cat Food Composition chart, although hopefully to a much lesser degree since the chart is based on ‘typical nutrient analysis’ figures – not vague minimums and maximums.

I often hear people get far too fixated on a chart’s numbers – comparing a food that is 3% versus 8% of calories from carbohydrates without realizing that the food marked “3%” today could be 8% with the next batch…..and the food marked “8%” could be 3% on the next batch.

Nothing in life is 100% consistent but I would much rather base my decisions on the ‘typical nutrient analysis’ values rather than the values found on the can under minimums and maximums.

Important point:  Do not fall for labels that state “95% meat.”  Why?  Because “meat” can simply be high-fat meat trimmings.  The word “meat” includes fat as well as protein so “meat” does not necessarily mean “high protein.”  Keep in mind that lean meats go to the human market and the high-fat meat trimmings are routed to the pet food market.

Example:  Natura EVO 95% Chicken & Turkey:

• Protein calories = 25%
• Fat calories = 73%
• Carbohydrate calories = 2%

Does this annoy me?  You bet it does given how much some of these so-called ‘premium’ diets cost.  Considering their price tag, it would be nice to see a higher protein/lower fat level – especially for any chubby cat that is on a weight loss program.  Otherwise the cat can end up in a state of protein malnourishment when the calories are restricted for weight loss.  (See my Feline Obesity page.)

However, as noted above, cats do not necessarily need diets that are >50% protein and <40% fat.  For instance, years ago when I was involved with rescuing and adopting out cats and kittens, I fed them adult canned Wellness – Chicken or Turkey.  (I used Wellness because it was available in 12 ounce cans which are more economical than the smaller cans.)

• Protein calories = ~30%
• Fat calories = ~65%
• Carbohydrate calories = ~5%

The cats and kittens all did well but as I have learned more about optimal feline nutrition, I would not choose a diet this low in protein and so high in fat.

Note that kittens do not need “kitten” food.  They just need plenty of canned, species-appropriate (low carb/meat-based) adult food.  Keep in mind that there are no mice running around in the wild with “kitten” or “adult” stamped on them.  Kittens eat just what their parents eat – just more of it on a per-pound-of-kitten basis.

By-products

This is an area of controversy.  However, by-products have a much worse reputation than they deserve.  By-products are normal parts of a carnivore’s diet and consist of some very nutritious organ meats such as liver, spleen and kidney.  On the other hand, by-products can also include feet and feathers which are of very low biological value.  The problem is that it is impossible for the consumer to determine the quality of by-products contained in any food and the quality can vary with each company and batch of food.

As just stated, by-products that end up in cat food include very nutritious items but they also contain organs that have been deemed “unfit for human consumption.”  Organs that show signs of disease such as cancer or infection are re-routed from the human meat market to the pet food market.   The fact that cats eat by-products in the wild cannot be disputed.  However, by-products that are consumed fresh ‘on the hoof’ are not the same as those that have been designated as unfit for human consumption.  Therefore, the two situations are not entirely comparable.

That said, I strongly feel that the ‘anti-by-product’ movement has been taken to an extreme and I would much rather see a cat eat an all-by-product canned food than any dry food.

My preference would be to see muscle meat (“chicken,” “turkey,” etcera) as well as some by-products since that would mimic nature.  Again, cats eat ‘by-products’ as part of their natural diet and who are we to say that we can omit liver, spleen, kidneys, etc., from a cat’s diet and not have them experience a potential deficiency?

The whole issue of by-products or no by-products is a personal one.  We also have to pick our battles with our cats.  For instance, many cats love Friskies, 9-Lives, and Fancy Feast varieties that contain by-products and we all know how picky cats can be and how important it is for them to eat – especially when they are ill or are diabetic and must eat on schedule.

On a personal note, my parents’ cat ate only Friskies canned food (Classic Pates – no gravy foods due to the higher carbohydrates) since he was rescued from the euthanasia list at our local shelter when he was 5 months old up until he was 18 years old.  Tyke is now 20.5 years of age and has kidney disease so he is on a homemade diet but he is in great shape and still runs up and down the hallway like a kitten.

On a favorable note, at least by-products:

1. are not hyperallergenic if coming from an animal the cat is not allergic to,
2. do not contribute a carbohydrate load to the food, and
3. are of animal origin – not plant origin.

It also makes much more sense to include some animal-derived by-products in a carnivore’s diet than it does to add potentially hyperallergenic, high carbohydrate grains like corn, wheat, rice, or soy.

Note that soy is also a thyroid disruptor and it has absolutely no logical place in cat food – especially given how common hyperthyroidism is in cats.

Cost and Quality

If you have read this entire page up to this point, you will understand how difficult it is to talk about the “quality” of pet foods.

On the one hand, we have the issue of by-product quality always being a big question/unknown, but on the other hand, the more expensive foods that are void of by-products are very high in fat and relatively low in protein.

So….it is a very frustrating trade-off.

That said, I will attempt to address this issue below.

Economics must be factored into any decision regarding what we feed our pets.  The foods listed below can be quite expensive and may be outside of a person’s budget so let’s look at this further and prioritize things a bit.  Of course all levels of quality can be mixed and matched according to a person’s budget and the needs – and always-picky taste buds – of the cat.  Some cats really like the all by-products foods better than the foods without any by-products so this is where ‘taste bud negotiation’ comes into play.

If you want your cat to eat a by-product-free food but all he wants is Friskies or 9-Lives, play around with the percentage of each.  He may eat the no-by-product foods at 80% if you mix in 20% of the with-by-product foods…..or 50:50….or……

Generally speaking, there are 4 basic categories of canned food:

• Products that contain all by-products and no muscle meat such as Friskies and 9-Lives.  Please note that Friskies has started to add rice to some varieties of these foods which is very disappointing as it just adds carbohydrates to an otherwise low-carb food.

• Products that have a muscle meat listed as a first ingredient followed by by-products.  Examples include some varieties of Fancy Feast.  (Always read the labels because some flavors of Fancy Feast start with by-products as a first ingredient and do not list any muscle meat after the by-products making these varieties fit into category 1.)

• Products that contain only muscle meat and no by-products but also contain high carbohydrate ingredients such as grains, potatoes, peas, or other vegetables.

• Products that contain only muscle meat and no by-products or carb-contributing ingredients.

I would use the carbohydrate content as my guide – feeding the lowest carb choice.  After considering carbs, look at the protein and fat amounts.

If the carbohydrate content of a food is high, that tells you that a substantial portion of the protein in the food may be coming from plants – not animals.

Remember that whole grains are a source of carbohydrates and protein.  So if you see something like “whole grain corn” in the food, this tells you that some of the protein listed on the can is coming from plants, not animals.

While most canned foods are low in carbohydrates, the Hill’s Science Diet line of canned foods are notable exceptions.  Many of these foods (both the prescription and non-prescription foods)  are very high in carbohydrates and are not diets that I would recommend feeding.

For the math-inclined, I have added a section below showing two methods to roughly calculate the percentage of carbohydrates in food.  You can skip this section if you plan to use the Cat Food Composition chart or plan to call the company for more accurate ‘typical nutrient analysis’ values.

Calculating the Protein, Fat, Carbohydrate Percentages

(Even though I discuss above just how inaccurate the labels are, I will include this section anyway.  You can skip this section if you don’t want a headache.)

You will see conflicting carbohydrate values listed for the same food depending on how the value is calculated.  There are three basic methods used to calculate the value of an individual nutrient:

1. As a percentage of food weight (includes water)
2. As a percentage of dry matter
3. As a percentage of calories

When determining the carbohydrate content of a food, method 2 and 3 will yield roughly the same number.

Even though it is preferable to discuss nutrition in terms of the percentage of calories that a nutrient provides, most pet food manufacturers list their products’ nutrients in the form of percentage of weight.

Nutrient information may be listed in two different formats on the manufacturers’ websites.  One is the guaranteed analysis (GA) figures (should be on all websites and on the side of the actual can of food).   However, as discussed above, GA values are only minimums and maximums and can be very misleading.

The other format is the actual measurement of the ingredients in one (or more) sample of the food.  These values more accurately reflect what is in the product.

Even though the GA values are not terribly accurate, they can provide a roughguesstimation of the contained nutrients.

To calculate the approximate weight of the carbohydrate in a food, add up the values for moisture, protein, fat, fiber, and ash and subtract this value from 100%.  Here is an example from the PetGuard website for their Organic Chicken and Vegetable Entree:

GUARANTEED ANALYSIS:
Crude Protein 9.0% Min
Crude Fat 7.0% Min
Crude Fiber 1.0% Max
Moisture 78.0% Max
Ash 2.3% Max

If we add up the above figures, and then subtract this value from 100%, we come up with a rough idea of the carbohydrate content of this food: 3%.

But we are not finished yet.  The value of 3% needs to be converted to a ‘dry matter basis’ (DMB) for accuracy.  This calculation takes the water component out of the equation and then allows values for canned and dry foods to be comparable.

For the DMB value, we see that there is 78% water in this food.  That leaves 22% as dry matter.  If we take our 3% and divide it by 22% we come up with 14% carbohydrates (by weight) on a dry matter basis.  With further calculations (see below) to compute the calories from carbohydrates, we come up with a value of 11%.

Calculating the percentage of calories from the carbohydrate part of the diet can be done with a few equations (shown below).

Again, less than 10% of a carnivore’s calories should be derived from a carbohydrate source.

When calculating the percentage of calories derived from the proteins, fats and carbohydrates we use the figures of 3.5 calories contributed by every gram of carbohydrate.  For every gram of protein, 3.5 calories are provided and for every gram of fat, 8.5 calories are added.

For these calculations, you don’t have to worry about converting the values to DMB  since the water content does not matter when looking at the percent-of-calories issue.  (You must stay consistent, however, by using all figures leaving the water in [as fed or “wet weight”], or using all figures taking the water out [DMB]) This is the nice thing about ‘percent calories’ values – you can compare canned and dry food and not worry about the vastly different moisture content of the two types of foods.

We will use the PetGuard example above – keeping in mind the limitations for accuracy when using GA numbers:

GUARANTEED ANALYSIS:
Crude Protein 9.0% Min
Crude Fat 7.0% Min
Crude Fiber 1.0% Max
Moisture 78.0% Max
Ash 2.3% Max

We see that 9% of this food is made up of protein (9 grams of protein per 100g of food) so 9 X 3.5 = 31.5 calories from protein.  Repeating the calculation for the 7% fat, we get 7 X 8.5 = 59.5 calories and from our calculations above, we know that this food is 3% carbohydrates.  3 X 3.5 = 10.5 calories from carbohydrates.

31.5 + 59.5 + 10.5 = 101.5 total calories per 100 grams of food

To calculate the percentage of overall calories from each food source, divide each amount by the total calories:

Protein: 31.5 divided by 101.5 = 31%

Fat:  59.5 divided by 101.5 = 59%

Carbohydrate:  10.5 divided by 101.5 = 10%

To double-check your math, add up the percentages to make sure they equal100%.

31% + 59% + 10% = 100%

Now…..go take some aspirin.  :>)

Dusty and Dylan growing up together

Protein/Fat/Carbohydrate/Phosphorus Chart

I spent hundreds of hours during the summer of 2012 working to create the Cat Food Composition chart and I just repeated the task, updating the chart in March 2017.  This was a daunting and incredibly time-consuming endeavor as it involved calling approximately 50 pet food companies – up to 4-6 times for many companies – and sending follow-up emails.  After receiving the data, there was a lot of number crunching to be done.

It is important to understand that I only accepted typical nutrient analysis (TNA) data for the Food Chart – not guaranteed analysis (GA) figures which are only the minimums and maximums that are listed on the can.   GA values, by definition, are inaccurate since there is no ceiling for a minimum and no floor for a maximum.  A diet that is labled as having a minimum of 6% fat could actually be considerably higher.  Fat should be required to be listed as a maximum, not a minimum, considering how cheap fat is.  Pet food manufacturers should not be given free rein (with a minimum set but no maximum) to include so much fat in their diets which then leads to diminished protein levels.

The data required to be included on the Cat Food Composition chart is very basic.  In fact, several companies have the information right on their website.

On the other hand, it was extremely difficult to get data from many of the companies.  Several refused to provide it stating that it is “proprietary” information.  This attitude shows a complete disregard for the consumer’s right to know what they are feeding their pet.

I will not use or recommend any products manufactured by companies that exhibit a lack of total transparency with respect to basic nutrient information.  There are too many other companies to choose from that are more cooperative.

It is up to the reader to do their own research if they are interested in feeding a diet that is not on the Cat Food Composition chart.  This means calling the company and requesting ‘typical nutrient analysis‘ (TNA) – not ‘guaranteed analysis’ (GA) figures which can be found on the can of food.

Also, since formulations (recipes) can change for any product at any time, it is up to the individual to call the respective companies if the most current information is desired.

Contacting Pet Food Companies

Unfortunately, it can be like pulling teeth to get usable information from pet food companies.  Some companies are better than others but you have to be persistent with many of them.

If a company does not willingly divulge TNA information, then I will not  use their products.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Use the following dialog when calling the companies:

“I would like to know the percentage of calories that come from protein, fat, and carbohydrates.”  This is also known as the “metabolizable energy (ME) profile.”

If they do not have ME values, at least obtain dry matter values and you can calculate the ME yourself using the math (formula) tutorial above.

Stress that you do not want the GA figures as they are nothing more than minimums and maximums and this information (as it pertains to protein and fat but not carbs or phosphorus) is already contained on the can.

Again, values expressed as minimums or maximums are, by definition, inaccurate since there is no ceiling or floor with regard to the amounts.

If you have a cat with kidney or urinary tract problems, you will also want to ask:

“How many milligrams of phosphorus are in the food per 100 kcal?”

Many companies will give you the phosphorus value in terms of dry matter percentage and will not provide the mg/100 kcal value.  As a point of reference, a value below 1% dry matter is favorably low.

This is a complicated subject that is impossible to cover in one webpage article.  If the reader needs more detailed help, I am available for phone/Skype consultations.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

The frustrations associated with:

• trying to pick a suitable commercial cat food based on the very limited information provided on pet food labels;
• the numbers of species-inappropriate ingredients contained in commercial foods, and
• the fact that the low carb choices are so high in fat and low in protein,

led me to start making cat food.  I fully realize that this is not the direction that most people want to go in so I wrote this page in order to help the reader as much as possible.

Keep in mind that I am no more privy to the inner workings of any of these companies than the reader.  I am at the mercy of what they put on their websites or provide verbally – just like all of you are.

One ingredient that has caught my attention lately is carrageenan.  If one does a PubMed search of carrageenan, they will find many references to “carrageenan-induced inflammation” which is very disturbing in light of how common IBD (inflammatory bowel disease) is in cats.  Please see this link to an interesting study showing carrageenan to be an inflammatory mediator in human intestinal cells.

Unfortunately, many commercial canned products contain carrageenan.  If your cat has chronic diarrhea or vomiting, I suggest trying to find a food without this ingredient listed but just know that your choices will be limited.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Do Not Recommend

The following is a list of companies that were not forthcoming with TNA data for their products. Given that there are plenty of other choices on the market, the consumer should not support companies that do not respect the consumer’s right to quickly and easily obtain vital nutrition information.

Addiction

Authority (Petsmart private label)

Good Natured (Petsmart private label)

Grreat Choice (Petsmart private label)

Simply Nourish (Petsmart private label)

Nutrisca (Dogswell brand)

Party Animal

Feline Natural (K9 Natural)

Blackwood

Raw Meat and Bones – “Balanced” Diets

6/23/16 – general comments:

Notice that I put the word “balanced” in quotation marks.  The dialog below will address this issue as it relates to the bone content of with-bones diets because many of these commercial products are not properly balanced with respect to the amount of bone included.

As noted above, I am not any more privy to information about commercial pet foods than the reader is.  I am not a ‘fly on the wall’ in these companies’ manufacturing plants.  I have no idea how clean or contaminated their process is and I have no idea how much bone material is included in these diets.

For information on the dangerous contamination in Darwin’s pet food, resulting in the death of a kitten and severe illness in other pets, see:

https://www.fda.gov/AnimalVeterinary/NewsEvents/ucm596555.htm

I will not feed any commercial raw diet to any cat in my care.  Please see my Making Cat Food page for more information.

Regarding bone content:  The more bone material that is contained in the product, the higher the profit margin is for the company.

In a nutshell, when feeding some (which ones??) of the commercial with-bones diets to our cats, we are forcing them to consume far more bone material than they would be eating in the wild.

Think about it:  When you watch Nat Geo Wild and you observe a lion take down a cape buffalo and eat it, that lion walks away leaving close to 100% of the skeleton (bones) behind for the smaller animals/vultures to pick over.  They consume very little bone material.

Now look at the other end of the spectrum – the small, wild or domestic, cat that eats a whole mouse or bird – meat and all, or most, of the bones.

When the two are compared – large and small cats – you can see that there is a wide variation in bone consumption.  However, the larger the prey animal (buffalo vs mouse), the higher the bone-to-meat ratio so the small cat is not consuming as much bone (relative to the meat) when it eats a mouse when compared to a lion eating an entire cape buffalo.

So how much bone material relative to muscle meat/organs is optimal for our small cats to consume?  I don’t know that there is a correct answer to that question but I do know that the range is wide and some cats may be able to handle more bone material than others.

But what does “handle” really mean?  Does it mean that they are barely dodging the constipation ‘bullet’ or are lucky enough to not end up with a life-threatening urethral obstruction due to too much bone (minerals) in their diet?

My strong feeling is that cats should not be fed ground up whole carcasses (e.g., rabbit, chicken, duck, etc.) because it forces them to eat more bone material than is optimal/safe.

The more bone material contained in the diet, the more minerals are filtered through the kidney and end up in the bladder.  Minerals (calcium, phosphorus, magnesium, etc.,) are building blocks of crystals/stones which can obstruct the ureter or the urethra – especially in male cats since their urethra is longer and narrower than a female’s urethra.

I am EXTREMELY passionate about, and sensitive to, the tremendous amount of suffering that cats with urethral obstructions have to endure.  Many “blocked” cats end up with a ruptured bladder resulting death.  The process is slow and painful.

But if the patient is lucky enough to be taken to a veterinarian before it loses its life?  Well, the client is faced with a huge vet bill and the patient must endure being catheterized (often more than once) and several days in the hospital in a very unhappy state.

See Opie’s story and pictorial here to witness the suffering that a blocked cat must endure.

Next, many veterinarians drastically ‘jump the gun’ and start talking about penis amputation (perineal urethrostomy) before the poor cat is given a fighting chance to keep his penis and go forward being fed a more appropriate diet.

Also understand that because bones contain a lot of phosphorus, the typical with-bones diet is unsuitable for cats with chronic kidney disease.

If you have visited this page in the past, you will note that I have removed all names of the raw/with-bones diets that were listed here previously.  Since I have no idea what the bone-to-meat ratio is in any of these diets, no product names will be listed here.

If you are tempted to write to me asking which raw/with-bones diet I would recommend, please don’t.  I have not taken the time to scrutinize (including calling the companies) the dozens of options on the market and, as stated elsewhere on this webpage, I make my own cats’ food so that I can control the bone content, etc.  I am not interested in feeding any of the commercial raw/with-bones products to my cats.

All that said, I am sure that there are many healthy, well-balanced (with respect to bone-to-meat ratio) products on the market but which ones fall into that category?  It is up to the reader to do their own research and come to their own conclusion.

Otherwise, please see my Making Cat Food page.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Even though I am hoping that you have read my Feeding Your Cat: Know the Basics of Feline Nutrition article and will not be feeding any dry food in the future, I had to add a link to this commentary on the ‘breed-specific’ dry foods that are currently being marketed by companies obviously desperate to gain more market share by hoping that the consumer will actually believe the absurd claims that they make regarding these diets.  Please see this link for more information.

---

Partially Updated March 2017
Lisa A. Pierson, DVM

Lisa A. Pierson, DVM

---

French translation

Spanish translation

Introduction

Warning:  Before reading even the first sentence of this webpage, you must commit to reading past the STOP sign below.

The first section of this paper discusses the detrimental impact of dietary carbohydrates on the blood glucose balance and insulin response of cats as a species – with pre-diabetic and diabetic patients being especially susceptible to the negative effects of high carbohydrate diets.

However, if your cat is receiving insulin and you switch to a low carb diet –without lowering the insulin dosage – you will be putting your cat at significant risk for a hypoglycemic crisis.  This is discussed under the STOP sign section below.

I receive many emails each week asking for food recommendations for diabetic cats.  Answers:

1) NO DRY FOOD but see Tips for Transitioning Dry Food Addicts to Canned Food if you are dealing with a dry food addict.  All cats can be transitioned to an appropriate diet (no dry food) if the owner is patient enough.

2) See Cat Food Composition chart and stay below 10% carbohydrate calories (the third column).  There are many suitable low carbohydrate choices available depending on your cat’s preference and your budget.  Many cats do well on Friskies Classic Pates and Fancy Feast.

Stay away from food with gravy – they are high in carbohydrates. The same is true for most food with sauces.  Higher protein/lower fat is also the goal.  However, you will note that most commercial foods are low in protein and high in fat.  Why?  Because protein is expensive and fat is cheap  This is one of many reasons why I make my own cat food.

3) See Commercial Foods when you are ready to learn more about evaluating pet foods.  Cats are obligate carnivores and are designed to eat other animals (meat, organs, etc.) – not grains and vegetables which only serve to enhance the profit margin of pet food companies and load the food up with carbohydrates.

1) and 2) are very important. 3) can wait until you are not so overwhelmed.

The two most important initial goals when faced with a diabetic patient are:

1) Get them on a low carb diet ASAP but pay close attention to the STOP sign section below.

2) Learn how to home test.

Note that I do not recommend any ‘prescription’ diets – including the ones sold for diabetes.  They are expensive, low in quality, contain species-inappropriate ingredients, and are not necessarily low in carbohydrates.

There is absolutely no reason to spend your hard-earned money on veterinarian-prescribed diets.

Dry food addicts:  I do not support the feeding of any dry food to any cat for many reasons (water depletion, high in carbohydrates, high in plant-based proteins, bacterial and fungal mycotoxin contamination, cooked-to-death which destroys nutrients, very calorically dense, etc.), but while you are working on theTips for Transitioning Dry Food Addicts to Canned Food, please substitute your cat’s high carb dry food with either EVO or Young Again.

Understand that neither of these dry diets are healthy options for your cat long-term.  See Urinary Tract Health.  Read the content in the grey box at the top but also scroll down to Opie’s pictures for a sad look at the tremendous suffering caused by feeding water-depleted diets to cats.  Urethral obstructions and cystitis are extremely common problems seen in cats fed dry food.  Urethral obstructions are painful, life-threatening (ruptured bladder) and very expensive to treat.  Cystitis is also extremely painful and often causes the cat to stop using the litter box.

Please do not say “but my cat drinks plenty of water so dry food is just fine for him/her!”  Many studies have shown that when all water sources are considered (food and water bowl) cats on canned food consume double the amount of water when compared to a dry food-fed cat.  This is in spite of the fact that cats on canned food rarely drink water from a bowl.  Cats on dry food do not make up their water deficit at the water bowl – no matter how much wishful thinking humans engage in to justify the feeding of this type of diet.

It can be fairly argued that water is one of the most important ‘nutrients’ for all living beings.  Dehydration is a very serious issue and your diabetic cat is in a precarious situation as it is.  We don’t need to compound their disease state by compromising their hydration status.

In addition to the fact that all dry foods are water-depleted, they are extremely calorically dense and adipose tissue (fat) causes insulin resistance => diabetes.  EVO and Young Again are even more calorie-dense than other dry foods because they are high in fat.  Therefore, careful portion control is very important.

I am a firm believer that all cats will eventually eat canned food if the human implements a healthy dose of patience and perseverance as discussed in my Tips for Transitioning paper linked above.  It can be harder or easier with a diabetic cat.  The difficult part is due to the fact that they must eat when receiving insulin so it is harder to use hunger as an incentive.

However, many diabetic cats have a ravenous appetite which can aid in the transition to canned food.

I see people ‘throw in the towel’ and give up far too soon on these stubborn, dry food-addicted cats.  Some cats will take several weeks to several months to make the switch.  Be patient and don’t give up!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Carbohydrates

Diabetes is one of the most common feline endocrine diseases and, while we do  not know all of the causes of this complex disease, we do know that many diabetic cats cease needing insulin or have their insulin needs significantly decrease once their dietary carbohydrate level is lowered to a more species-appropriate level than that found in many commercial foods – especially dry kibble.

Feeding a high carbohydrate diet to a diabetic cat is analogous to pouring gasoline on a fire and wondering why you can’t put the fire out.  While some cats are more sensitive to the detrimental effects of carbohydrates than others, the bottom line is that cats are obligate carnivores and are not designed by nature to consume a high carbohydrate diet or one that is water-depleted (dry kibble).

If you have not read my articles entitled Feeding Your Cat: Know the Basics of Feline Nutrition and Urinary Tract Health I urge you to do so.

Although all dry foods are too high in carbohydrates (except as noted above) and too low in water (causing many cats to suffer tremendously from extremely painful and life-threatening urethral obstructions and cystitis), please be aware that some canned foods (especially ones with gravy/sauce) also contain far too many carbohydrates making them very poor choices for cats.

All canned foods made by Hill’s are too high in carbohydrates.  This includes all of their ‘prescription’ diets including m/d and w/d.

As a side note, here is an excerpt from a paper that I am working on entitled Veterinarian Prescribed Diets/Over-the-Counter Options:

‘Prescription dietʼ is an industry-coined term trademarked by Hill’s and holds no legal meaning.

In other words, these diets contain no ingredient that actually requires a prescription. The term ‘prescription diet’ is simply a clever marketing tool between Hillʼs and veterinarians. The sale of these diets is restricted (by Hillʼs, not by law) to veterinarians only. In return, Hillʼs enjoys a boost in perception of quality brought about by this professionʼs endorsement of their products.  However, this perception of quality is undeserved and this incestuous relationship jeopardizes the integrity of the veterinary profession.

There is nothing magical about the veterinarian-prescribed diabetes-management diets.  In fact, several of them such as Hill’s m/d and w/d (dry and canned), Purina DM dry, and Royal Canin DS (dry) are far too high in carbohydrates making them very inappropriate choices for all cats but especially diabetic patients.  Purina DM canned is sufficiently low in carbohydrates (~7%) but it is expensive and it is predominantly liver which should not make up the bulk of a cat’s diet.  There is absolutely no reason to spend money on this product.

Obesity

In addition to the dietary carbohydrate level, we also need to address the issue of ‘portion control‘ (managing caloric intake) of any food that we choose to feed to our cats because obesity is a very important factor to consider when discussing both the causes and treatments of diabetes.  Adipocytes (fat cells) secrete a substance that makes the cells of the body resistant to insulin (Type 2 diabetes).

Portion control has recently become even more important because as pet food manufacturers move toward making more low carbohydrate foods, this process is selecting for high fat diets.  Keep in mind that we get our calories from 3 nutrient classes:  proteins, fats, and carbohydrates.  The percentage of calories that come from these 3 nutrients must add up to 100%.  Therefore, if we lower the percentage of carbohydrates in the food to < 10%, that means that 90-95% of the total calories must come from fat and protein.  Given the fact that fat is cheap and protein is expensive, you can see that profit margin drives pet food manufacturers to produce high fat/low protein foods when they make low carb products.

Fat contains 9 calories per gram whereas proteins and carbohydrates are only 4 calories per gram. Therefore, fatty foods are very calorically dense making portion control important to consider.

If your cat is overweight,  please see Feline Obesity but you need to understand that it is beyond the scope of a webpage to explain how to implement a safe weight loss program at the same time that you are dealing with an unregulated or newly diagnosed diabetic cat.  This can be a tricky situation since an unregulated diabetic cat is starving internally – at the cellular level – and restricting calories, in some cases, can be very dangerous.  I am available for phone consultations if the reader wishes to discuss this situation in more detail.  (My email address is provided at the bottom of this page.)

On the flip side, weight loss exhibited by any cat is often the first sign of illness – including diabetes –  so I make it a point to weigh my cats at least every 2-3 months – more frequently when they reach ~10 years of age.

I strongly urge all cat caregivers to purchase a scale such as the American Red Cross Baby Scale or the Salter Baby and Toddler scale – especially if you are trying to implement a safe weight loss program.  (I prefer the Red Cross one because it has a wide base allowing the cat to walk onto it without tipping it.)  Make sure that you verify that the scale is reasonably accurate by weighing items that you know the weight of.

Lack of exercise (activity level) has also recently become an issue that is gaining more attention as it relates to both the cause and management of feline diabetes.

Even though we need to be careful to not necessarily assume that what is ‘right’ for a human is also ‘right’ for a cat, the need to consider carbohydrates, obesity, and activity level should come as no surprise since these factors are are also significant issues in human diabetes.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Very Critical Points

If you do not read any further on this webpage, please understand the following principles.  Your cat’s life literally depends on your understanding of these issues.

Many cats that are in a diabetic state no longer need any insulin when they are finally fed an appropriate low-carbohydrate diet.

Others will always need some insulin but the amount necessary to maintain proper blood glucose levels is nearly always significantly reduced once the patient is on a low carbohydrate diet.

Please re-read the previous two paragraphs carefully.

If you change your diabetic cat’s diet to one with lower carbohydrates, he will, in all probability, IMMEDIATELY (not days or weeks later) require a reduction in his insulin dosage.  He may also immediately go into ‘remission’ and not need any insulin at all.

If this warning is ignored, you may very well end up with a cat in a hypoglycemic crisis (dangerously low blood sugar) which can result in death, or brain damage.

If you take only one point away from this page, it needs to be the understanding that if you stop pouring carbs into your cat by switching to a low-carb canned food diet (or even a dry food diet with lower carbs than you have been feeding), you MUST be aware of the probable immediate and significant impact on your cat’s insulin needs.

If I could shout this from the rooftops, I would.

Frequently, I hear of reports of cats that ended up near-death – or actually did die – from insulin overdoses because lay caregivers and veterinarians did not understand this basic concept.

I often hear my colleagues support the change to a low carbohydrate diet but then recommend “re-testing in a week or two” while the caregiver continues to administer the same amount of insulin. This very common lack of recognition of the immediate effects of low carb diets on the blood glucose level of the diabetic patient often results in a dangerous hypoglycemic state.

Or – the caregiver reads this article and decides to change the diet on their own and does not understand the need to lower the insulin dosage.

When someone understands half of the concept (changing to a low-carb diet), but does not understand the other half of the concept (the highly probable need to lower the insulin dosage) disaster often strikes.

Remember the statement that I made above?  The one about pouring gasoline onto a fire?  If you stop pouring gas on a fire, there is going to be an immediate reaction of that fire when its fuel is taken away.  That fire is not going to take weeks or a month to respond.

In this analogy it would not be a big issue if you kept ‘drowning’ that dying fire with water but in this instance water = insulin and a hypoglycemic crisis can ensue if more insulin is given than is needed by the body.

Of course, carbohydrates are not the only fuel for a diabetic ‘fire’ but they play a very significant part in contributing to high blood sugar levels in a diabetic cat.  If you minimize this issue – and do not lower the insulin accordingly –  you really will be ‘playing with fire’ with regard to the safety of your cat.

So you say – “OK!!  I get it!  I understand that my cat may very well need a lower dose of insulin – or may not need insulin at all – once I stop pouring gasoline (carbs) onto his diabetic fire, but how do I know what dosage of insulin to give?  How do I know what impact the new diet is going to have on his insulin needs?  How do I keep my cat safe?”

This is where in-home blood glucose monitoring comes into play.

Trying to manage a diabetic cat without home testing is a bit like driving a car with a paper bag over your head.

A human who cares about his own safety would never inject himself with insulin without testing his blood sugar beforehand.  The goal is to treat our diabetic cats the same way.

The best way to arrive at the optimal dosage of insulin and the optimal dosing frequency is by home testing.  Note that I said “optimal.”  Many diabetic cats have survived with a set amount of insulin being administered twice daily with the dosage determined by periodic glucose curves performed at a veterinary clinic if their owners will not, or cannot, home test.  However, this is not the safest and most physiologically sound way to manage a diabetic patient so I urge all diabetic cat caregivers to strongly consider home testing.

Every case is different and definitive recommendations with respect to how far to lower the insulin dosage (when you start the diet change) cannot be given without knowing the specifics of each case.  There are many crucial factors to be considered:

• carbohydrate content of the original diet
• carbohydrate content of the new diet
• how fast the change to a low carb diet is made
• how carb ‘sensitive’ the cat’s body is
• how quickly the cat’s body responds to the decrease in carbs
• how the cat, in general, reacts to insulin
• has the cat ever been positive for ketones in his urine
• current dosage of insulin
• current blood glucose levels of the patient
• etc.

 

I urge you to keep the lines of communication open between you and your veterinarian while learning to home test and implementing the diet change.  That said, it is unfortunate that many veterinarians are not well-versed in the management of feline diabetes and all too often do not fully understand the strong connection between diet and blood sugar levels.

It is also very frustrating to note that many veterinarians either are not aware that home testing is possible (despite the subject being discussed in many veterinary journals and at many continuing education meetings) or just simply do not support this life-saving tool.

Additional help and support can be found on the Feline Diabetes Message Board and I urge all diabetic cat caregivers to join this forum as a support system to be used in conjunction with your veterinarian.

Keep in mind that with all internet forums, the experience and knowledge base of the participants will vary.

If posting to forums is not within your comfort zone and you would like additional help, I am available for consultations.  Please understand that I cannot offer advice via email.  Feline diabetes can be a very complicated disease to optimally manage and it would not be ethical or time-efficient to attempt to address individual case management of this disease via email.

If you have read Feeding Your Cat: Know the Basics of Feline Nutrition along with the first part of this webpage and are convinced that you need to start feeding your cat(s) correctly (low-carb – canned or homemade – food) and want to skip the rest of this paper, please head right to the changing the diet safely and the home testing sections below.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

If you want to know more about the physiology of diabetes and why a low carbohydrate diet is so important for this species, please click on the first four links below.

The basics of diabetes

The cat’s unique metabolism

Carbohydrates, obesity and diabetes

Optimal nutrition for all cats

Switching the Diabetic Cat to a Low Carbohydrate Diet – SAFELY!

In-home blood glucose monitoring

Urine collection for ketone and glucose testing

 

The Basics of Diabetes

All cells in the body use glucose (“blood sugar”) as their source of energy.  However, in order for glucose to provide nourishment to the cell, the glucose must get inside the cell.  Insulin, which is produced by the pancreas, is the substance that tells the ‘front door’ of the cell to open in order to let the glucose inside.  If this system is disrupted for any reason, the glucose cannot enter the cell and subsequently, the level of glucose increases in the blood stream (hyperglycemia) and the cells go ‘hungry’.

There are two types of diabetes.  Type 1 and Type 2.  Type 2 is the more common form in both humans and cats.

Type 1 occurs when the beta cells of the pancreas are not able to produce enough insulin.

Type 2 is characterized by two problems.  The first, as in Type 1, is a diminished ability of the pancreas to secrete insulin.  The second issue is one ofinsulin resistance.  In other words, the receptors on the cell wall that would normally open the door to the cell to let the glucose in when insulin ‘knocks’, stop ‘listening’ to the insulin. The cells ‘resist’ the signal that the circulating insulin is sending and the glucose is not transferred to the inside of the cell, resulting in an elevated blood glucose (hyperglycemia) and cellular ‘starvation’.  The elevated blood glucose, in turn, sends a signal to the pancreas telling it to secrete more insulin.  The elevated insulin may somewhat override the insulin resistance resulting in more glucose entering the cells, but eventually the pancreas can become exhausted or ‘burned out’.

Glucose toxicity results from chronic hyperglycemia.  Glucose toxicity wreaks havoc on the entire body – especially the pancreas and its insulin-producing cells.  A vicious cycle then ensues as the insulin-producing cells are damaged resulting in less insulin being produced.

Here is a picture of the pancreas.  It is the long, flat, pink organ in the center.  The dark red organ below it is the spleen.  The white tissue is all fat. This is also called “omental fat” and some of you may have heard or read about this type of fat in humans.  It is the fat that is carried around the abdomen and is associated with significant health problems.

The Cat’s Unique Metabolism

In my article, Feeding Your Cat: Know the Basics of Feline Nutrition, I explain what it means to be an obligate carnivore.  For a more technically detailed presentation of this subject matter, please see Dr. Debra Zoran’s wonderful article entitled The Carnivore Connection to Nutrition in Cats.

Cats are obligate carnivores and, as such, are uniquely adapted to consume a diet that is high in protein, contains a moderate amount of fat, and includes a very small amount (2-3 percent) of carbohydrates.  Since nature designed them to ingest very few carbohydrates, cats lack many of the important enzymes that are necessary to process this type of food efficiently.

With the above information in mind, consider the fact that the carbohydrate level of most dry foods is between 35-50 percent with some of the lower quality dry foods being even higher.

The three main ‘take-home’ words from my Feeding Your Cat article are“proteins” (animal versus plant), “water”, and “carbohydrates.”   For this article, the most important of the three subjects is carbohydrates.

Carbohydrates, Obesity and Diabetes

Most people are aware that diabetes is more common in overweight humans than it is in people closer to an optimal weight.  The same is true for cats.  Fat (adipose) cells produce a substance that causes the cells of the body to become resistant to insulin.  This increase in insulin resistance is the hallmark of Type 2 diabetes.  As mentioned above, this is the most common form in the cat.

Cats are designed to utilize proteins and fats for their energy – not carbohydrates.  They are lacking the necessary enzymes to efficiently utilize carbohydrates to meet their energy needs.  When the carbohydrate level of an obligate carnivore’s diet is higher than it should be – remember that a bird or a mouse is only 2-3 percent carbs and that most dry foods contain between 35-50 percent carbs – the excess carbohydrates are stored as fat.  The increased fat cells, in turn, promote Type 2 diabetes via an increase in insulin resistance.

That said, if calories in exceed calories out – no matter whether the calories come from protein, fat, or carbohydrates – the cat will gain weight.  This is why portion control is important no matter what diet you are feeding.

Mindy (left) is nice and lean and full of energy.  Molly (right) was rescued from  a home where only dry food was free-fed and she had become terribly obese.  She could barely walk and could not even clean herself.  She has gone from 20.5 pounds to 13 pounds simply by eating a low-carbohydrate canned food and having all dry food removed from her diet.  She now runs, jumps and plays like a normal cat!  For more on her story see Obesity – Molly’s story.

Not all carbohydrates are created equal, but it is safe to say that obligate carnivores – especially diabetic ones – do not benefit from carbs at a level above what would be in their natural diet regardless of the type.  But that said, carbohydrates are characterized by their Glycemic Index (GI) and their Glycemic Load (GL) which are measurements that reflect how high and how rapidly a specific carb causes a rise in blood glucose when ingested and the overall impact that particular carb has on the diabetic state.  The higher the GI/GL of a carbohydrate, the worse the result will be for a diabetic patient although GI/GL of various ingredients has not been studied in cats like it has been in humans.

The Glycemic Index and Glycemic Load values of different food sources are very important to consider for people trying to manage their own diabetes.  However, I do not like to concentrate on these values for cats because then it sounds like there may be “good” carbs versus “bad” carbs for cats.  The bottom line is that humans are designed to utilize carbs whereas cats are not.  What we can say is that some carbs, such as the grain flours, are worse (higher GI/GL) than other carbs, but ideally, we should strive to keep the carb level of the feline diet at a level which would be found in nature.

More in-depth information can be found here:

Postprandial glycemia in cats fed a moderate carbohydrate meal persists for a median of 12 hours — female cats have higher peak glucose concentrations

Hypercarnivory and the brain: protein requirements of cats reconsidered

 

Unfortunately, pet food labels are extremely lacking in useable information.  All that is required to be listed is the ‘guaranteed analysis’ which are only minimums and maximums which are, by definition, inaccurate.  Also, it is not required to list the carbohydrate content.

It is sometimes stated that you can subtract all of the percentages on the label from 100 percent in order to give you an approximate percentage of the carbohydrates contained in any product. In other words, subtracting the protein, fat, water, fiber, and ash/mineral content from 100 percent will leave you with the percentage of carbohydrates contained in the diet in the diet on a ‘wet matter’ or ‘as fed’ basis.  However, because the guaranteed analysis values are only listed as minimums and maximums with no ‘floor’ or ‘ceiling,’ you can see where this type of calculation can lead to a very erroneous conclusion with respect to the carbohydrate content.  Also, you need to convert this number to dry matter basis or ‘calories from’.  If you use ‘as fed’ values, they will be misleadingly low.

More on this subject can be found on my Commercial Foods page.

Also see Cat Food Composition chart.

Optimal Nutrition for All Cats

I long for the day when veterinarians start thinking outside of the Big Four ‘box’ and stop being so ‘married’ to Hill’s, Purina, Iams, and Royal Canin since there are higher quality – and less expensive – diets available over-the-counter (non-prescription).

We have all heard the phrase ‘locking the barn door after the horse is gone’.  This applies to how we feed our cats with respect to the diseases that they commonly develop secondarily to being fed a low quality, species-inappropriate diet.  For instance, when looking at feline diabetes, notice that the rationale behind the diabetic prescription diets is to provide a decreased carbohydrate level in the food to ‘treat’ a diabetic cat.

However, why not recommend a decreased level of carbohydrates for allobligate carnivores to possibly prevent diabetes?  Why are we always addressing treatment rather than prevention?  Why aren’t more veterinarians making common sense-based recommendations for their healthy patients in order to prevent diseases such as diabetes, IBD, urinary tract disorders, etc., that are, in many cases, strongly linked to a high carbohydrate/grain-laden/water-depleted diet?

The subject of fiber is also widely discussed with respect to feline nutrition and diabetes.  It was once thought that a high fiber diet would be beneficial for blood glucose control in the diabetic cat but this recommendation has since fallen out of favor.  Please see The Carnivore Connection to Nutrition in Cats for more details.  A cat’s natural diet is very low in fiber.  Cows and horses are designed to eat a high fiber diet – not cats – yet many veterinarians still recommend diets like Hill’s w/d (a high fiber/high carbohydrate diet).

Let’s take a look at some of the ingredients and the carbohydrate content in several diets that are often prescribed by veterinarians for diabetic cats.  I have underlined the sub-optimal and species-inappropriate ingredients.  For a more in-depth look at reasons why these ingredients do not constitute optimal nutrition, please see Feeding Your Cat.

In summarizing the points in that article, please take note of the fact that the Hill’s Prescription products listed contain no muscle meat.  By-products or organ meats are used instead.  (Please see my discussion regarding by-products which can be highly nutritious sources of protein but can also include low quality ingredients and diseased organs.)

In addition, note the high carbohydrate levels in all of the listed products except for the Purina canned DM.  Also notice the common usage of high glycemic index grain flours and the use of hyperallergenic ingredients (corn, wheat, soy, and yeast).

Powdered cellulose is fiber source obtained from plants/trees.

The carbohydrates listed are on a dry matter basis.

Hill’s Prescription dry m/d:   (18% carbohydrates)

Chicken By-Product Meal, Corn Gluten Meal, Pork Fat, Brewers Rice, Wheat Gluten, Powdered Cellulose, Pork Protein Isolate, etc.

Hill’s Prescription canned m/d:  (16% carbohydrates)

Pork by-products, pork liver, water, corn starch, powdered cellulose, soy protein isolate, chicken fat, etc.

Hill’s Prescription dry w/d:  (37% carbohydrates)

Brewers Rice, Chicken By-Product Meal, Corn Gluten Meal, Powdered Cellulose, Chicken Liver Flavor, Soybean Oil, etc.

Old version: Chicken by-product meal, corn gluten meal, brewers rice, rice flour, powdered cellulose, chicken liver flavor*, soybean oil…..preserved with BHT, BHA and ethoxyquin

Notice that they finally removed the BHT, BHA, and ethoxyquin but they made the diet even more unhealthy than it was previously by making it predominantly brewers rice instead of an animal-based protein source (chicken by-product meal).

Hill’s Prescription canned w/d with* chicken:  (26% carbohydrates)

Water, Pork Liver, Pork By-Products, Chicken, Powdered Cellulose, Corn Starch, Oat Fiber…..Chicken Liver Flavor, etc.

*Please be aware that the word “with” means that a product is required to contain only 3% of the ingredient – in this case, chicken.  The word “flavor” means that the product is not required to have any of the ingredient present.

Now let’s look at two Purina products:

Purina dry DM:  (18% carbohydrates)

Poultry by-product meal, soy protein isolate, corn gluten meal, soy flour, animal fat preserved with mixed-tocopherols (source of Vitamin E), corn starch, animal liver flavor, etc.

Purina canned DM:  (3% carbohydrates)

Liver, poultry by-products, meat by-products, water sufficient for processing, chicken, salmon, oat fiber, salmon meal, artificial and natural flavors, etc.

Purina canned DM Savory Selects:  ( 10% carbohydrates)

Water sufficient for processing, chicken, liver, wheat gluten, meat by-products, corn starch-modified, soy flour, artificial and natural flavors, etc.

If I had to choose between the Hill’s and Purina choices, I would pick the Purina canned (regular) DM.  But fortunately, we do have other choices.  One of the biggest mistakes I see veterinarians make is choosing a diet based on addressing a single disease entity.   This is very narrow-sighted.

The Purina canned DM favorably addresses the overall carbohydrate level but it also contains corn, wheat, and soy and it contains predominantly liver versus a muscle meat.  These ingredients are certainly not what a cat would choose to eat in the wild.  Note that there is a negative relationship between soy and thyroid health.  Given how common hyperthyroidism is in cats, I will not feed soy to any cat in my care.

I choose to feed a cat for overall health, not just to address one disease state such as diabetes – especially when there are products available that are even lower in carbohydrates and contain far superior ingredients for carnivores than the products listed above – and are less expensive.  When I look at the Hill’s and Purina ingredients, these are not products that I would choose to feed to my patients or my own cats.

Switching the Diabetic Cat to a Low Carbohydrate Diet

Caution:  This must be done very carefully if the patient is already on insulin.  See above if you have not already read the Critical Points section.

If your cat is not on insulin because he was just diagnosed with diabetes, then you can change the diet more rapidly – either immediately (‘cold turkey’) or within 2-3 days.  More on this issue below.

Unless the patient’s clinical signs warrant immediate insulin administration, I try a diet change – with no insulin – for 3-5 days to see what impact the new diet will have on the blood glucose. In most cases, I do not agree with waiting much longer than a week to start insulin. This is because you will have the best chance of getting your cat into remission (cease needing insulin) if both diet and insulin are used very early on.  The longer your cat’s body is under the effects of glucose toxicity, the more his body will be damaged and the less chance of remission he will have.

When I have a new diabetic patient present to me, the two most important tasks are:

1) getting the patient onto a low carbohydrate diet – preferably canned and not dry

2) teaching the client how to home test

If your cat is already on insulin, the safest way to implement a diet change is to incorporate home testing into your management protocol.  

You also need to discuss any diet change with your veterinarian but be aware that many vets underestimate the degree to which the insulin dosage needs to be lowered when a low-carb diet is implemented.   This puts the patient at significant risk for life-threatening hypoglycemia.

For example, let’s consider a cat that is currently eating Hill’s Prescription dry w/d with 37% of its calories coming from carbs and he is suddenly switched to a canned food with less than 10% carbs.  If the insulin is not lowered accordingly, an overdose of insulin will occur.  Please do not underestimate the favorable impact that a low-carb diet has on decreasing the blood glucose level of a cat. As stated at the beginning of this page, many cats no longer need any insulin once on a low carb diet.  Others have a drastic decrease in the amount of insulin needed to maintain an optimal blood glucose level.

The goal is to get your cat off of dry food and on to a 100 percent canned food diet but if your cat is on insulin, this must be done carefully – especially if the cat refuses to eat canned food.

Giving a full dose of insulin to a cat that is not eating can result in life-threatening hypoglycemia.

Many of the tips that I offer in the Transitioning Dry Food Addicts to Canned Food section of my Feeding Your Cat article can be used for diabetic cats but be cautious as you implement them if you are also injecting insulin.

A non-diabetic cat can very safely handle the ‘tough love’ 12-18 hours period of time without food that is often necessary to get them to change their diet but this does not apply to a diabetic patient. Therefore switching a stubborn diabetic cat can be more difficult.  It is not impossible but the process does have some complicating factors.

With a stubborn cat that is a dry food addict, approach the diet transition slowly and with a high dose of patience.  For cats that like canned food but are still eating a 100% dry food diet, the transition can proceed much more rapidly aslong as the blood glucose is being monitored **at home** and the insulin is being adequately adjusted downward.  I cannot stress this last point strongly enough.

When defining “rapidly,” I have, as noted above, switched many cats from dry to canned ‘cold turkey’ without any digestive problems (vomiting or diarrhea) – especially those cats that are already eating some canned food in addition to their dry food.  However, you can also error on the side of caution and go slower than I would – taking ~1 week to make the switch.

With regard to the issue of diarrhea and a diet change – I don’t mind a bit of loose stools (tooth paste +/- with a bit of pancake batter consistency) and tend to keep on with the canned food diet.  These loose stools often firm up within a few weeks on the new diet.

Some cats will vomit when changed to canned food. The transition must be slowed down for these patients because it is very important for them to have food ‘on board’ in order for the insulin to have something to work with.

There are many cases of success stories on the Feline Diabetes Message Board that discuss cats ceasing to need insulin once all dry food (or high carb canned food) was removed from their diet.

In-Home Blood Glucose Monitoring

Few humans with diabetes would dream of trying to mange their disease without the use of a glucometer (“meter”) to test their blood glucose level prior to injecting insulin.  Injecting insulin blindly – into a human or a cat – puts the patient at significant risk for developing life-threatening hypoglycemia (low blood sugar).

This includes feline patients that have their doses determined with glucose curves done at a veterinary hospital.  This is because your cat’s insulin needs can change for a variety of reasons (infection, stress, anorexia, etc.) and also because the curve generated at the vet clinic is influenced by stress hyperglycemia which is a false increase in blood glucose due to the cat’s internal reaction to this stress. This can then result in a higher dosage of insulin being prescribed than will be needed by the patient when they are at home.

Believe me, I understand that the issue of home testing can be quite intimidating at first.  Most people become very stressed when first learning of their cat’s diabetes diagnosis and can’t even imagine injecting their cat with insulin, let alone getting a blood sample from their ear!

Awhile back I decided to pretend that I was a new diabetic cat owner.  I went to test 7 cats in my home (my own and foster cats).  Needless to say, it was frustrating – and not as easy as I was expecting it to be – but I finally got them all tested.

Several cats took 5-7 pokes (in different sessions) to get enough blood for a reading.

Only 1 out of the 7 ‘guinea pigs’ gave up enough blood the first time to get a reading.

I, on the other hand, was bleeding like a stuck pig. The lancet was going through the cat’s ear and right into my finger. I was bleeding. The cat was not.  I started practicing what I preach and got a cotton ball to protect my finger while I kept working to find the ‘sweet spot’ in the cats’ ears so that I could get a blood sample from them.

The moral of the story?  Be patient. Be kind to yourself.  Give it time and it will come.  Maybe not the first day and maybe not even the first week but most people (and cats) get the hang of home testing.

Oh…and cat ears tend to bleed a bit easier after they are poked a few times.  Do not worry about this!  It is a good thing and your cat’s ears will be fine!

A very valuable resource and a great group of supportive people can be found at the Feline Diabetes Message Board. On a daily basis, board members talk newbies through the trials of learning how to home test. It is always fun to see these scared, apprehensive new people master home testing and then go on to help others after they get the hang of it.

If you or your veterinarian need some convincing that home blood glucose monitoring is critical to the optimal management of feline diabetes, there are many veterinary journal and PubMed articles discussing the value and validity of blood glucose monitoring of cats.

Two veterinary journal articles can  be found here and here that verify the reasonable accuracy of these meters for use in diabetic pets.

Sadly, many of my colleagues either do not introduce their clients to this life-saving tool or, worse yet, dissuade their clients from the practice of home monitoring.  This lack of pro-active management has resulted in the death of many cats and the less-than-optimal management of countless others.

That said, there are rare cats that will not allow home testing.  I say “rare” because if the cat allows insulin injections, they will almost always allow you to test them – eventually – so don’t give up too quickly and do not assume that your cat will not allow you to home test.

Meters, test strips, lancets, lancet pens:

 

The meters that are used by humans can also be used to successfully monitor a diabetic cat.

You do not need a meter designed especially for pets such as the AlphaTrak which costs ~$100 and uses very expensive test strips (over $1 per strip). The cost of the meter is not as much of a factor as the ongoing cost for the test strips.

There are many meter models to choose from.  You can often get the meters for free (or around $10) when you purchase 50 – 100 strips since the manufacturers want to get you locked into buying their strips.  (Think about cheap printer prices – they are cheap because the companies want to get you locked into buying their expensive ink cartridges.)

Ebay is also a good place to buy strips but watch the expiration dates.

There are two important factors to consider when buying a meter:

1) cost of strips (range $0.35 – $1.20 each)

2) amount of blood needed  (range = 0.3 – 1.0 microliters)

I have had good luck managing patients with the Walmart Relion Micro or the newer Relion Confirm.  Both of these meters use only 0.3 uL. The Confirm has  few more features than the Micro but they are overkill for what you really need.  Either meter will work just fine. These meters and their strips are inexpensive when compared to other strips and the meters have been shown to be reasonably accurate.

Other favorites include the Ascencia Contour and the Accucheck Aviva.

The TrueTrack has not been getting very good reviews on the Feline Diabetes Message Board lately so you may want to to stay away from that meter.

Also, the Freestyle Lite has had several reports of testing far too low so I would not purchase that model.

I suggest that you take your cat and your new meter to your vet for comparison with their blood analyzer or the meter they use in-house (as long as it has been shown to be accurate by comparison with table top analyzer).  Make it a point to take your glucometer with you every time you take your cat to your vet so that you can run comparisons.

Use the same drop of blood from the cat’s ear for comparison with your vet’s glucometer.  They are not going to be exactly the same but they will hopefully be within 15 – 20% of each other or better.

It is important to get a meter that uses ‘wicking’ test strips which all of the meters mentioned above use.  These strips automatically draw the blood into the testing area as soon as the edge of the strip contacts the edge of the blood drop. This is in contrast to the type of meters that use strips requiring that the blood be dropped directly onto the test strip.

Lancets (the ‘pokers’) range in size from a large 25 gauge to a very small 33 gauge.  However, most companies do not state the gauge size on their lancet boxes so it can be confusing when trying to figure out which lancets to buy.  Generally speaking, when you see lancets labeled “ultra-fine” or “ultra thin”, that denotes a very fine lancet size (31,32,33 gauge).  Exception to the word “ultra” is the LifeScan One Touch UltraSoft lancets.  They are 28 gauge and many people have good luck with those.

Keep in mind that the lancet has nothing to do with the meter.  You do not have to use the same brand of meter and lancet.

The larger the number, the smaller the lancet point.  The smaller the lancet point, the harder it is to get enough blood but the more comfortable it will be for your cat so you can see that it is a trade-off.

However, contrary to what you may think, most cats don’t even feel the lancet stick.   I think they ‘feel’ the nervousness of the human even more!  What bothers them the most is the restraint and sometimes the noise of the lancet pen.

This noise of the pen is why some people do not like using it and, instead, just use the lancets freehand.

Most people like to use a lancet in the 28-29 gauge range especially when first starting out since it can be frustrating enough to get blood without having to deal with an ultra-fine lancet.

Some people like to use an even larger lancet (25 – 27 gauge).  They are happier with the blood flow and their cats don’t seem to mind the larger size.  Other people have had great luck with the lancets that are much finer – more in the 31-33 gauge range.  It all depends on how good of a ‘bleeder’ your cat is.

You will have to experiment to see what size of lancet works best for you and your cat but you will probably be able to use a smaller lancet after a few weeks as your cat’s ears ‘learn’ to bleed.

One example of the lancets that I have used is the Life Scan One Touch FinePoint Lancets (purple ones) which, according to the chart above, is a 25 gauge lancet. (No gauge number is listed on the box but I assume that the chart is accurate.)

I have also used the Life Scan One Touch UltraSoft Lancets  (white ones shown in picture above) which are 28 gauge.

The FinePoint lancets will provide a large enough drop of blood more consistently than the UltraSoft lancets.  Again, you can start with a larger lancet but then move to a smaller lancet once your cat’s ears start to bleed easier and you start to get the hang of where to test on the ear.  Many people start to use smaller lancets within 2-3 weeks (or sooner) of learning how to home test.  Or…they need to use the smaller ones right from the beginning because their cat does not favor being poked with the larger ones.

Most meters come with 10 lancets but they vary in size depending on the company.

Each meter kit should also come with a lancet device (lancet pen) that you can adjust to give a deeper or more shallow penetration of the lancet.  The pen that I have has 7 settings (7 is the deepest penetration) and I find that the 5 works well.

As mentioned above, some people prefer to ‘freehand’ the lancet. In other words, they do not use the pen but, instead, they just hold the lancet in their hand and poke their cat’s ear that way.  The nice part about doing it freehand is that you can see exactly where you are poking relative to the blood vessel.  When using the pen, you can’t tell exactly where the lancet tip is going to end up.

Testing your cat:

Be sure to test yourself first so that you become familiar with the use of the glucometer – especially the way the strips ‘sip’ up the blood drop.

The most common mistake that I see people make is that they do not hold the ear gently but firmly against the tip of the lancet pen.  Instead, they let the ear fall away from the pen.  If this happens, the lancet will not penetrate the ear.

Vein location – notice the vein (red line) running along the perimeter of the ear:

Aim for the shaded area shown here:

Here is a pictorial webpage that demonstrates the testing procedure.  It is outdated (2001) with respect to meter brand and the comment on blood drop size. (Thankfully, the newer meters do not require a 1.5 uL drop.)

You will find that there are several different opinions and techniques recommended for the testing procedure and, with time, you will figure out which ones work best for you and your cat.

For instance, the pictorial page linked above shows the person approaching the cat head-on (in order to test the inside of the ear, versus the outside) which I find makes many cats nervous.  They tend to want to back away from the person and so I would much rather stay behind them as described and shown below.

However, as the author of this page points out, there is minimal hair on the inside of the cat’s ear which may be an important consideration when testing a long-haired cat.  Long hair can interfere with the blood drop formation.  Vaseline may help with the formation of the blood drop on these cats.

This page also discusses the use of warming devices for the ear which I have never tried.  Maybe if I had warmed the ear on my test subjects discussed above, I would have had better luck getting blood the first or second time.

Be aware that if you do not have anything against the ear other than your own finger, you may stick yourself especially if using a lancet pen versus freehand.  As shown in the third movie below, a small cotton ball or tissue can be used to protect your finger.

Here is a very good movie  that  demonstrates the testing procedure.  This movie shows the operator using the lancet free-hand.

Another movie is located here.  This movie shows the veterinarian using a 25 gauge needle instead of a lancet.  I do not recommend this method.  A 25 gauge needle is overkill and will cause more trauma and pain for your cat than is necessary – especially since the newer meters do not require a large blood drop.  The blood drop shown in this movie is about 20 times more than you need.

Some people like to use a warm sock filled with rice to increase the blood flow to the ear but I find it cumbersome and annoying to have to use one more item when testing a cat. Do what works best for you.

After you have poked the ear with the lancet, you may need to ‘milk’ the blood up to the punctured area for just a couple of seconds.

These movies show the patients being star pupils with minimal restraint.  However, in reality, not all cats are this good about testing.  Most of them, however, do improve with time.

It is very important to be patient and move slowly and calmly.  Also, the best time to try this procedure for the first time is when your cat is sleepy.  Keep in mind that there is a learning curve for both of you and the less nervous you are, the better off both of you will be.  Rest assured that the procedure will most likely get easier as you polish your skills so please do not get discouraged early on in the learning process.

When first starting to test a new patient, I click the pen several times around the cat’s ear to make sure he gets used to the noise.  Depending on the cat, I may or may not poke him in that first session.

When first testing very skittish cats, I simply lightly restrain them and click the pen a few times – without poking them – and then feed them a treat and let them go.

You do not have to get a test on the first try or even on the first day.  Most people are not successful on the first day.  Give it time and try again later that day or the next day.

Offering the cat his favorite treat in conjunction with the testing may help keep him calm and persuade him to view this procedure in a more positive light.

Baby steps and positive reinforcement (treats) are very important when approaching any type of training.  First impressions are lasting ones so there needs to be a balance between being gentle but firm with your cat.

Although certainly not necessary, it may be easier on your nerves if the first test is done under supervision at your veterinarian’s office.  You can also check in with the Feline Diabetes Message Board to see if there are any members living near you who can help you learn how to home test.  There are many wonderful members of this board who are spread all over the world and who are willing to help a newbie learn how to home test.

Everyone has their preference when it comes to methods used to handle their cat and every cat also has their own idea of what level of restraint they will tolerate.  The least amount of restraint that can be used to get the job done is obviously going to make this less stressful for both of you.  If you can test them, unrestrained, while they are just hanging out on their favorite chair, that is optimal.

Please note that in the following pictures the test strip should already be in the meter but I did not have any at the time these pictures were taken.

The method that works best for me when testing a fidgety cat, is to kneel on the floor with the cat between my knees.  We are both facing the same direction and there is very little firm restraint involved. I just try to prevent the cat from going forward.  I am right handed so it is easiest for me to test the right ear but it is best for the cat to alternate between ears to keep one from getting sore.

I use gentle pressure with my left hand on the left side of the cat’s head to, hopefully, keep him from shaking his head while the blood drop is forming.  I hold the right ear with my left thumb and index finger and my right hand handles the lancet pen.  It is easiest for me to test the outside edge of the right ear but alternating between the inside and outside margins of each ear is optimal.  (Again, please note that the test strip should already be in the meter at this point.)

The blood vessel runs along the margin of the ear.  Aim for the upper outer (or inner – toward the other ear) edge of the ear anywhere from half to three-quarters of the distance up the ear from the base toward the tip.  (See pictures above where I marked the ear with a pen.)

A tricky issue to contend with is the cat’s instinct to shake his head during those few critical seconds when you are waiting for the blood drop to form.

After the lancet is used, I lay it down but continue to gently hold onto the ear and keep a few fingers of my left hand on the left side of his head to prevent him from shaking off the forming drop of blood.  Of course, if he is allowed to do so, the drop of blood will go flying and you will have to start over again.

If a drop has not formed quickly, you can try to ‘pump’ the blood into the puncture area with your right hand.  This involves a gentle squeeze and release, squeeze and release just below the puncture site.  Another technique involves gently ‘milking’ the blood up the vein from the base of the ear.  This whole process takes about 5 seconds or less.

With most meters, you have about 2 minutes to fill the test strip with blood once the strip is inserted into the meter so don’t insert it too soon.  Insert the strip after the cat is in place and ready to be tested.  Two minutes is generally plenty of time but if the meter ‘times out’ simply remove the test strip and re-insert it.

Once you have a large enough blood drop, touch the tip of the strip to the edge of the blood drop so that the strip will sip the blood into its chamber.  Do not try to ‘scoop’ or ‘scrape’ the blood off the ear and onto the test strip.  It must be drawn up by the test strip via capillary (‘sipping’) action.

The most common problem that I encountered when first starting to test cats with the glucometer was not getting the test strip confirmation window filled.  When this happens, the meter will give you an error message.  You will then have to get a new strip and start again.  If the blood drop was too small and all of the blood has been drawn up by the test strip – but it is not enough – do not try to get more blood from the puncture site and reapply the test strip to the ear.  That will not work.  As soon as blood enters the strip, the meter starts counting down and adding more blood at this point is futile.

Try to make a habit of watching the test strip window as you are touching the strip to the drop of blood. If your blood drop is large enough, this will ensure complete filling before taking the strip away and will result in a successful sampling.  With a bit of practice, you will also learn not to ‘jump the gun’ and apply the test strip before you have a large enough blood drop to fill the confirmation window.  If the drop looks too small, be patient and try to gently ‘pump’ or ‘milk’ the blood into the puncture area as discussed above.

After the test strip is filled, lay the meter down and gently hold off the puncture site with the cotton ball that you were using to protect your finger.  Necessary holding times will vary but usually 10 seconds or less will be sufficient.

Please be forewarned that you may want to cry and throw the meter when first attempting to test your cat’s blood glucose!  There is definitely a learning curve associated with this procedure – for both you and your cat – and the frustration level can be very high initially.  Take a deep breath, stay calm, keep a sense of humor, (drink a glass of wine…eat some chocolate……) and accept the fact that it may take you many tries at different times over the span of a few days to start consistently getting samples.  The calmer you are, the better off your cat will be.

Do not get discouraged if the first few times do not go well.  If success has not been met after 2-3 sticks (or if the cat is very nervous, after only 1 stick) feed him the treat you have standing by and let him go.  You can try again in a few hours.  You do not need to master this on the first try! 

As already mentioned, a group of very caring and knowledgeable people can be found on the Feline Diabetes Message Board.  They can often talk you down off of the ‘ledge of frustration’ that comes along with learning how to home-test.  Many of the members have a great deal of very practical experience in dealing with feline diabetes.

Managing a cat with diabetes can be very overwhelming, to say the least, and communicating with others who are faced with the same issues can be very helpful.  As with any online group, be sure to do your own homework.

Collecting Urine for Ketone and Glucose Measurements

Diabetic ketoacidosis (DKA) is a very serious and life threatening condition which can result from unregulated diabetes.

DKA can result from:

• not enough food
• not enough insulin
• high level of insulin resistance secondary to infection, inflammation, obesity, etc.

When sugar cannot get inside of the cells for any of the reasons above, the body ends up starving at the cellular level so it starts to burn fat for fuel.  When this happens, ketones are released into the blood stream and then end up in the urine.

Therefore, it is important to be able to test diabetic cats for urine ketones – daily, if possible – whenever there is a threat of DKA.

With regard to using urine sugar (glucose) levels to manage a diabetic cat, I must stress that this is very far from optimal. Urine glucose testing is a very crude way to manage a diabetic cat but if home testing as described above is not possible, then urine glucose testing is better than no monitoring at all.

See this video for more information:

Conclusion

While writing this webpage, I decided to see what information is available on the internet with respect to feline diabetes.  I was quite disturbed to see so many authors of the various websites, and posters in chat groups, still continuing to recommend a high complex carbohydrate/high fiber diet. A very critical point is being missed:  Cats are obligate carnivores and a high carbohydrate diet is detrimental to their health, in general, and will make diabetic regulation much more difficult and diabetic remission (no longer needing insulin) almost impossible.

Also, high fiber diets run counter to a cat’s natural diet and research has shown that high fiber diets do not favorably impact a diabetic cat like that observed in a diabetic dog or human.

Fortunately, there has been a great deal of focus on feline diabetes in the past couple of years so when you are searching the internet, be sure to pay attention to the date on the webpage for the most recent information.

The “Catkins” diet (high protein, moderate fat, low carbohydrate) is in and the illogical high carbohydrate/high fiber diets are, thankfully, out.

---

Updated June 2014
Partially updated November 2016
Lisa A. Pierson, DVM

Lisa A. Pierson, DVM

---

If you do not want to read this entire webpage, please review this shortened version:

Feeding Your Cat – Short version – 4 pages  (updated November 2013)

Many readers of this website have kindly donated their valuable time to translate this important information into various languages.  Please click PDF options for more information.

---

Diet is the brick and mortar of health.  This web page lays out some often-ignored principles of feline nutrition and explains why cats have a better chance at optimal health if they are fed canned food (or a balanced homemade diet) instead of dry kibble.

Putting a little thought into what you feed your cat(s) can pay big dividends over their lifetime and very possibly help them avoid serious, painful, and costly illnesses.  An increasing number of nutrition-savvy veterinarians, including board-certified veterinary internists, are now strongly recommending the feeding of canned food instead of dry kibble.

The three key negative issues associated with dry food are:
1) water content is too low
2) carbohydrate load is too high
3) type of protein – too high in plant-based versus animal-based proteins

In addition, dry food is very heavily processed which includes being subjected to high temperatures for a long time resulting in alteration and destruction of nutrients.

Dry food is also often contaminated with bacteria, fungal mycotoxins, storage mites/cockroaches and their feces, etc.

Most people who are concerned about their own nutrition have heard nutritionists say “shop the perimeter of the grocery store.”  This statement refers to the push to get humans to focus on fresh food – not overly processed food found in boxes and cans.

Where do you think kibble would reside in this scenario?  Definitely not in the “perimeter”!  There is nothing fresh about this source of food and it certainly does not come close to resembling a bird or a mouse.

Also keep in mind that dry foods are not refrigerated and they sit in warm warehouses, on pet store shelves, and in your cupboards for weeks or months before your pets consume them.  Fats can easily become rancid, and bacteria will proliferate, in this type of environment.

There is no doubt that dry food is responsible for far more intestinal problems, and other diseases, than most veterinarians and cat owners realize.

Please click on the links below to read more about optimal nutrition for cats.

But my cat is “fine” on dry food!

The importance of animal proteins, versus plant proteins

Fresh vs highly processed with synthetic supplements

Problems with carbohydrates in dry cat foods

Cats need to eat water-rich food

Reading a pet food ingredient label

Marketing labels

‘Prescription/therapeutic’ diets

Common medical problems associated with dry food

Diabetes

Kidney disease

Cystitis/Urethral blockage/Urinary tract infection/Crystals

Inflammatory Bowel Disease

Hairballs

Obesity

Hepatic Lipidosis (fatty liver disease)

Dental disease

Asthma

The safety of dry food

Tips for Transitioning – Getting dry food addicts to eat canned food

Home prepared raw/semi-cooked and commercial raw meat diets

What I feed to my cats

Some final thoughts

---

My Cat is Doing Just “Fine” on Dry Food!

Every living creature is “fine” until outward signs of a disease process are exhibited. That may sound like a very obvious and basic statement but if you think about it……

Every cat with a blocked urinary tract was “fine” until they started to strain to urinate and either died from a ruptured bladder or had to be rushed to the hospital for emergency catheterization.

Every cat on the Feline Diabetes Message Board was “fine” until their owners started to recognize the signs of diabetes.

Every cat with an inflamed bladder (cystitis) was “fine” until they ended up in severe pain, started passing blood in their urine, and began to refuse to use their litter box because they associated it with their pain.

Every cat was “fine” until the feeding of species-inappropriate, hyperallergenic ingredients caught up with him and he started to show signs of food intolerance/IBD (inflammatory bowel disease).

Every cat was “fine” until that kidney or bladder stone got big enough to cause clinical signs.

Every cancer patient was “fine” until their tumor grew large enough or spread far enough so that clinical signs were observed by the patient.

The point is that diseases ‘brew’ long before being noticed by the living being.

This is why the statement “but my cat is healthy/fine on dry food” means very little to me because I believe in preventative nutrition – not locking the barn door after the horse is gone.  I don’t want to end up saying “oops……I guess he is not so fine now!!” when a patient presents to me with a medical problem that could have been avoided if he would have been feed a species-appropriate diet to begin with.

Of course, in order to be on board with the preventative nutrition argument, a person has to understand the following facts:

1) All urinary tract systems are much healthier with an appropriate amount of water flowing through them.

Dietary water and urinary tract health

2) Carbohydrates can wreak havoc on cats’ blood sugar/insulin balance.

Postprandial glycemia

3) Cats inherently have a low thirst drive and need to consume water *with* their food.  (A cat’s normal prey is ~70 – 75% water – not the very low 5-10% found in dry food.)

4) Cats are strict carnivores which means they are designed to get their protein from meat/organs – not plants.

The Carnivore Connection to Nutrition in Cats

Cats Need Animal-Based Protein

Cats are obligate (strict) carnivores and are very different from dogs in their nutritional needs. What does it mean to be an ‘obligate carnivore’?  It means that your cat was built by Mother Nature to get her nutritional needs met by the consumption of a large amount of animal-based proteins (meat/organs) and derives much less nutritional support from plant-based proteins (grains/vegetables). It means that cats lack specific metabolic (enzymatic) pathways and cannot utilize plant proteins as efficiently as animal proteins.

It is very important to remember that not all proteins are created equal.

Proteins derived from animal tissues have a complete amino acid profile.  (Amino acids are the building blocks of proteins.  Think of them as pieces of a puzzle.)  Plant-based proteins do not contain the full complement (puzzle pieces) of the critical amino acids required by an obligate carnivore.  The quality and composition of a protein (are all of the puzzle pieces present?) is also referred to as its biological value.

Humans and dogs can take the pieces of the puzzle in the plant protein and, from those, make the missing pieces.  Cats cannot do this.  This is why humans and dogs can live on a vegetarian diet but cats cannot.  (Note that I do not recommend vegetarian diets for dogs.)

Taurine is one of the most important nutrients present in meat but it is missing from plants.  Taurine deficiency will cause blindness and heart problems in cats.

The protein in dry food, which is often heavily plant-based, is not equal in quality to the protein in canned food, which is meat-based.  The protein in dry food, therefore, earns a lower biological value score.

Because plant proteins are cheaper than meat proteins, pet food companies will have a higher profit margin when using corn, wheat, soy, rice, etc.

Veterinary nutritionists and pet food company representatives will argue that they are smart enough to know *exactly* what is missing from a plant in terms of nutrient forms and amounts – nutrients that would otherwise be in a meat-based diet.  They will then claim that these missing elements are added to their diets to make it complete and balanced to sustain life in an obligate carnivore.

Does anyone really think that humans are that smart?

This is the kind of arrogance that has led to fatal errors in the past.  Not all that long ago (1980s) cats were going blind and dying from heart problems due to this arrogance.  It was discovered in the late 1980s that cats are exquisitely sensitive to taurine deficiency and our cats were paying dearly for humans straying so far from nature in order to increase the profit margin of the pet food manufacturers.

There are several situations that can lead to a diet being deficient in taurine but one of them is using a diet that relies heavily on plants (grains, etc.) as its source of protein.  Instead of lowering their profit margin and going back to nature by adding more meat to the diets, the pet food companies simple started supplementing their diets with synthetic taurine.

This may be all well and good for this particular problem, but how do we know that we are not blindly going along unaware of other critical nutrients that are missing from a plant-based diet?

Why are nutritionists so arrogant to think that we can safely stray so far from what a cat is designed by nature to eat?

Also note that synthetic taurine is manufactured from a chemical reaction and all taurine (at least that I know of) comes out of China.  Given that country’s horrible track record with regard to food safety, I certainly would not want to depend on taurine from China’s chemical synthesis to meet my cats’ taurine needs.

With regard to the overall protein amounts contained in dry versus canned food, do not be confused by the listing of the protein percentages on the packaging.  At first glance, it might appear that the dry food has a higher amount of protein than the canned food—but this is not true on a dry matter basis which considers the food minus the water.  Most canned foods, when figured on a dry matter basis, have more protein than dry food.  And remember, even if this was not the case, the percentage numbers do not tell the whole story. It is the protein’s biological value that is critical.

Let’s ask ourselves the following question:  How many cats become ill or die from these species-inappropriate diets yet the patient’s diet is never even questioned as a possible cause of the illness or death?  We cannot answer that question definitively but I have no doubt that the answer would be “many”.

Do cats survive on these heavily (synthetically) supplemented plant-based diets?  Yes, many of them do.

Do cats thrive on these diets?  No, they do not.

Please pay special attention to the words *survive* versus *thrive* as there is a very big difference between the two states of health.

Fresh vs Highly Processed with Synthetic Supplements

There are two basic ways to meet our nutrient needs:

• Eat fresh food with a short ingredient list – or at least one that does not resemble a science experiment full of long names that are hard to pronounce.

• Eat highly processed foods that have had much of their nutrient content destroyed or altered, with food chemists ‘fixing’ the deficit with synthetic supplements.  This type of unhealthy diet is consumed under the assumption that humans know exactly what was destroyed or altered during processing and what needs to be added back and in what form and amount.

Again, people are simply not that smart.

While canned food is not ‘fresh,’ per se, dry food undergoes a harsher processing.  It has been cooked at very high temperatures for a long period of time.  The extensive cooking required to remove most of the water from the food (70% moisture reduced to 5-10% moisture) significantly alters the biological value of the protein sources and damages other vital nutrients.

Nutritionists then have to guess which nutrients – in what form and amounts – were destroyed by this cooking process and then try to add them back into the diet.  Occasionally ‘real food’ is used instead of synthetic supplements but those long and hard-to-pronounce names on the ingredient list describe chemically synthesized nutrients.

Given that humans will never be as smart as nature – we will never know every detail of a cat’s normal prey – it is obvious that there is a risk when greed cause humans to stray so far from a cat’s natural diet.

Back to top

We Are Feeding Cats Too Many Carbohydrates

Note:  I have stopped using the term “grain-free” since it has become somewhat meaningless.  Many companies (e.g., Blue Buffalo) tout that their products are “grain free” but then they just load up the food with high carbohydrate ingredients like potatoes and peas which are not grains but still contribute a significant carb load (and plant-based protein) to the food.  The “grain-free” descriptive has become very deceptive and misleading.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

In their natural setting, cats—whose unique biology makes them true carnivores–would not consume the high level of carbohydrates (grains, potatoes, peas, etc.) that are in the dry foods (and some canned foods) that we routinely feed them. You would never see a wild cat chasing down a herd of biscuits running across the plains of Africa or dehydrating her mouse and topping it off with corn meal.

In the wild, your cat would be eating a high protein, high-moisture, meat/organ-based diet, with a moderate level of fat and with only  approximately 1-2 percent of her diet consisting of carbohydrates. The average dry food contains 35-50 percent carbohydrate calories.  Some of the cheaper dry foods contain even higher levels.

This is NOT the diet that Mother Nature intended for your cat to eat.

Many canned foods, on the other hand, contain approximately less than 10 percent carbohydrates.

Please note that not all canned foods are suitably low in carbohydrates.  For instance, most of the Hill’s Science Diet (over-the-counter) and the Hill’s ‘prescription’ diets are very high in carbohydrates and are not foods that I would ever choose to feed.

Cats have a physiological decrease in the ability to utilize carbohydrates due to the lack of specific enzymatic pathways that are present in other mammals, and they lack a salivary enzyme called amylase.

Cats have no dietary need for carbohydrates and, more worrisome is the fact that a diet that is high in carbohydrates can be detrimental to their health as explained below.

With this in mind, it is as illogical to feed a carnivore a steady diet of meat-flavored cereals as it would be to feed meat to a vegetarian like a horse or a cow, right?  So why are we continuing to feed our carnivores like herbivores? Why are we feeding such a species-inappropriate diet?  The answers are simple.  Grains/potatoes are cheap.  Dry food is convenient.  Affordability and convenience sells. 

However, is a carbohydrate-laden, plant-based, water-depleted dry food the best diet for our cats?  Absolutely not.

Obligate carnivores are designed to eat meat/organs – not grains/vegetables – and they need to consume water with their food as explained below.

Cats Need to Eat Water-Rich Food

Opie’s pictorial at Feline Urinary Tract Diseases is a ‘must see’ for any cat caregiver who insists on feeding dry food.

The first paragraph of that page is as follows:

If I could have the reader of this webpage take away just one word from this discussion, it would be “water.”  If your cat is on a properly hydrated diet of 100% canned (or homemade) food – and no dry food – you stand a very good chance of never needing to read this webpage. 

Water is an extremely important nutrient that contributes to overall health in every living creature.  Couple this with the fact that cats do not have a very strong thirst drive when compared to other species, and you will understand why it is critical for them to ingest a water-rich diet. The cat’s lack of a strong thirst drive can lead to low-level, chronic dehydration when dry food makes up the bulk of their diet especially if they have any level of kidney insufficiency. 

A cat’s normal prey contains approximately 70 – 75 percent water.  Dry food only contains 5-10 percent water whereas canned foods contain  approximately 78 percent water.  Canned foods therefore more closely approximate the natural diet of the cat and are better suited to meet the cat’s water needs.

I hear the reader saying: “But my cat drinks a lot of water so dry food is just fine for him!”

A cat consuming a predominantly dry food diet does drink more water than a cat consuming a canned food diet, but in the end, when water from all sources is added together (what’s in their diet plus what they drink), the cat on dry food consumes approximately half the amount of water compared with a cat eating canned food.

Water intake of cats on dry vs canned food

Put another way, a cat on a canned food diet consumes approximately double the amount of water consumed by a cat eating dry food when all sources (food and water bowl) are considered.

This is a crucial point when one considers how common kidney and bladder problems are in the cat.

Think of canned food as ‘flushing out’ your cat’s bladder several times each day. 

Please keep in mind that when your cat starts eating a more appropriately hydrated diet of canned food, his urine output will increase which is a very good thing for bladder health.

Because of this increase in urine production, litter boxes need to be scooped more frequently or more boxes need to be added to the home.

Please see The Litter Box From Your Cat’s Point of View for reasons why I strongly feel that clumping litter is the only sanitary choice of litter to use for cats.  Non-clumping litters do not allow you to remove all of the urine and are not sanitary litters.

Back to top

Learn How To Read a Pet Food Ingredient Label

For more details regarding pet food ingredient labels, see Commercial Foods.

Note:  If you are tempted to write to me to ask what food you should feed to your cat, understand that specific advice cannot be provided via email.  If someone wants to discuss the information contained on this site in more detail, an appointment for a phone consultation needs to be set up.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Before you get too confused and frustrated when reading this section, I will say at the outset:  I would much rather see a cat eat any canned food versus any dry food – regardless of quality level of the canned or dry food.  This includes Friskies, 9-Lives, Fancy Feast, etc., canned options.

I am so tired of seeing cats suffering tremendously from blocked urethras and other urinary tract diseases because of Man’s love affair with dry food.

Try not to drive yourself nuts when picking out a canned cat food.  The fact that you are feeding canned food and not dry food is 90% of the battle so just do the best that you can – given the information below, the information on the Commercial Foods page, and also the Cat Food Composition chart linked in the sidebar for future reference.

When using that chart, just focus on the first four columns and the last column if you care about calories/can.  The first four columns show the caloric distributionwhich is the best way to analyze food.  I ignore the dry matter basis columns.

I mentioned above that you should refrain from “driving yourself nuts” but after becoming increasingly frustrated with the commercial pet food industry in 2003, I started making my cats’ food.  See Making Cat Food for more information.  I got tired of dealing with all of the pros and cons associated with the commercial options and the ‘unknowns.’

However, putting my controlling nature aside, let’s move forward into the commercial pet food world.

When reading this section, two words need to be firmly in your mind:

• composition (the percentage of protein, fat, and carbohydrate in the food)
• ingredients

Unfortunately, pet food labels are not held to the same standard as human food labels.  This means that pet food labels are seriously lacking in usable information when compared to a package of food for a human.

The “guaranteed analysis” numbers that you find on a can of food for protein, fat, and water (moisture) are listed as “minimums” and “maximums” which, by definition, are inaccurate.  Plus, the labels never list the carbohydrate amount which is very frustrating because we are trying to stay under 10% carbohydrate calories.

This makes it impossible to accurately evaluate the food in terms of composition unless you are willing to call the company and ask for their ‘typical nutrient analysis‘ which is data that comes from testing an actual batch of food.

During the summer of 2012, I spent over 1,000 hours calling ~45 pet food companies to gather data for my Cat Food Composition chart.  However, understand that pet food companies can change their formulations at any point in time so if you desire the most up-to-date information, you will need to call the individual companies.

The ingredient list can help us out – but only in some ways.  For instance, if you do not see high carbohydrate ingredients such as grains, potatoes, peas, etc., listed on the label, it is a safe bet that the food is low in carbohydrates.

However, if these high carbohydrate ingredients are listed, you have no idea of theamount in the food and, therefore, no knowledge of the carbohydrate level.

Without knowing the actual amount of each ingredient, we have no indication of the impact of the ingredient on the nutritional profile of the food.  Only the composition value will answer that question. This is why it is important to not just consider the list of ingredients but to also look at the Cat Food Composition chart, or call the company for the information.

A good example of the above issue is a food like canned Wellness. At first glance, this food may be dismissed as inappropriate for a carnivore because it contains several high carbohydrate ingredients in the form of fruits and vegetables, including potatoes which are very high in starch (carbohydrate). However, the low carbohydrate level (3-5%) tells us that the amount of fruits and vegetables is very low.

Again, we would like to stay under 10% of calories coming from carbohydrates.

Grains and potatoes should be absent from a cat’s diet but, unfortunately, they are cheap so they are included in many commercial cat foods. Think ‘profit margin’. Grains/potatoes are cheaper than meat.

Stay away from food with gravy and sauces because they usually use high carbohydrate thickeners.

Soy contains phytoestrogens and soy also negatively influences the thyroid gland.Given how common hyperthyroidism is in the cat, soy has no business being in cat food. Unfortunately, soy is a common ingredient used by many pet food manufacturers – especially Purina – because it enhances their profit margin.

When considering allergies, the ingredient list is useful since we don’t care how much of the offending ingredient is in the food.  The bottom line is that we don’t want any of the ingredient to be present.  Fish/seafood, beef, lamb, corn, wheat, and soy tend to be the most hyperallergenic ingredients for the cat – especially fish/seafood.

By-products are always a controversial subject but it makes much more sense to feed animal-based by-products to a cat than it does to feed grains or potatoes.  Therefore, do not shy away from the more economical foods like Friskies or 9-Lives if you cannot afford the more expensive canned foods without by-products.

I would much rather see a cat eating an all-by-product canned food than any dry food.  This is because even the cheaper canned foods have the ‘Big Three’ covered:

1) high in water

2) usually low in carbohydrates

3) the protein is from animals – not plants

By-products are not necessarily low quality protein sources. In fact, they can be extremely nutritious. However, there is more variability when quality is being considered when compared to muscle meat.

By-products are discussed in more detail on the Commercial Foods page in this section.

The higher priced canned foods that I referenced above, have a muscle meat listed as the first ingredient. A muscle meat will be listed as “chicken,” or “turkey,” etc., not “chicken by-products” or “chicken by-product meal,” or “chicken broth” or “liver”.

“Chicken meal” is technically a muscle meat but the term “meal” denotes that it has been rendered (cooked for a long time at very high temperatures) and is lower in quality than meat that has not been as heavily processed. A “meal” product is more commonly found in dry foods. By-products can include feet, intestines, feathers, egg shells, etc., which are less nutritious (less biologically valuable/digestible) than meat.

Avoid foods listing “liver” as a first ingredient.  (Example: Purina’s prescription diet DM canned for feline diabetic patients.  There are far better options available that are healthier and not as expensive.)

Liver is a very nutritious organ meat – and should be present in small amounts – but it should never be the first ingredient as it is very high in vitamin A and possibly D and you don’t want to feed too much of those vitamins. Liver is cheaper than muscle meat so it will increase a company’s profit margin when used in high amounts.

Preservatives are important ingredients that we need to pay attention to.  BHA, BHT, and ethoxyquin are extremely questionable in terms of safety.  Please note that Hill’s has always used BHT, and ethoxyquin in many of their products although recently I have noticed that these chemicals have been removed from some of their foods.  Be sure to check the current labels.  Other companies abandoned the practice of using these chemicals as preservatives long ago – opting for more natural and safer methods.

Also, please take note of a recent deceptive move by Hill’s whereby they have incorporated into their labeling the word “maize” as a substitute for the word “corn”.  Maize IS corn and since this company is well aware of the fact that consumers are becoming more savvy about pet food ingredients, they have decided to try to disguise the corn in their diets by calling it “maize”.  Hill’s is hoping that consumers stay ignorant regarding the fact that maize is corn.

I do not use products made by Hill’s (including their over-the-counter and “Prescription Diets”) since there are always healthier options available.

Marketing Labels

Marketing labels such as “natural,” or “premium,” or “veterinarian recommended,” or “prescription” are not necessarily indicative of high quality so please be careful not to fall into that trap.

“Indoor only” is another meaningless marketing  label that is nothing more than an enticing gimmick. This label originally started out in the dry food market but it has now made its way to canned food labels.  Cats did not stop being obligate carnivores just because we put a roof over their heads.

If you are thinking about feeding any ‘breed-specific’ food, please see this link for some straight-forward comments about the utterly absurd claims that these companies make regarding these diets. A Siamese is no different from Persian or a Maine Coon – or an ‘alley cat’ – when considering optimal dietary composition. No matter the breed, the cat is still an obligate carnivore.

Royal Canin was one of the first companies to come out with these breed specific diets as a marketing gimmick.

The labels on Hill’s over-the-counter products contain a statement that says “Veterinarian Recommended.”

Unfortunately, many of my colleagues do, indeed, recommend products made by Hill’s (as well as Purina, Iams, and Royal Canin) and this is a testament to the fact that most veterinarians are not well-versed in proper feline nutrition and simply defer to these large companies that have huge marketing budgets.  These large budgets include substantial sums of money dedicated to sponsoring – including very heavy advertising – our professional meetings and infiltrating veterinary schools to get students ‘married’ to their products.

Keep in mind that a large marketing budget does not equate with the manufacturing of high quality or healthy products. 

Back to top

‘Prescription/Therapeutic’ Diets

Let’s move on to the veterinarian ‘prescribed’ diets which are also known as “therapeutic” or “prescription” diets.

“Prescription/therapeutic diet” is another label that is certainly not indicative of a high quality diet or one that is necessary.

These diets represent an area of the commercial cat food industry that is very misleading and, quite frankly, a source of embarrassment for this profession.

Many of these very expensive products contain corn, wheat, and soy which have no logical place in your cat’s diet.  These diets are often very high in carbohydrates and, of course, all of the dry versions are water-depleted.  Many of them also contain by-products as the main – and often only – source of protein.

While by-products can be very nutritious (and this really is the least of my concerns regarding these diets), they are cheaper than muscle meat so one would think that as much as these diets cost, the companies could include some muscle meat, in addition to by-products, for a more consistent source of high quality protein.  (See by-products on the Commercial Food page for more details.)

Study the ingredient list for Hill’s dry i/d while keeping in mind that cats are obligate carnivores.

This dry food is 29% carbohydrates on a dry matter basis and is, of course, water-depleted.  The ingredients are as follows:

Chicken By-Product Meal, Brewers Rice, Corn Gluten Meal, Whole Grain Corn, Pork Fat (preserved with mixed tocopherols and citric acid), Powdered Cellulose, Dried Chicken, Chicken Liver Flavor

The base ingredients and composition mirror those of many dry foods found in pet stores and supermarkets.  Also, this is a very good example of the ingredient splitting rule.  This rule states that ingredients have to be listed very specifically which works in the pet food manufacturers’ favor.  It allows the grain fractions to be broken up into smaller components which places them lower on the list since ingredients are listed by weight.  However, when all of the grain fractions are added up, their contribution to the diet (including the protein content) often greatly outweighs the first ingredient.

I have asked many times on VIN (Veterinary Information Network – the who’s who of veterinary specialists from all over the world) just what makes this diet worthy of being called a “Prescription Diet for Feline Gastrointestinal Health” or, for that matter, what makes it an optimal diet to feed to any cat? I have never received an answer and the VIN threads have had Hill’s representatives participating.  My questions about the quality and composition of their prescription diets are always met with dead silence.

It is important to note that most of these diets do not have robust clinical feeding studies supporting their safety for long-term feeding or even for use in treating the various diseases they target.

On the contrary, we have plenty of evidence to show that feeding water-depleted, high carbohydrate, plant-based diets to carnivores does not honor their carnivorous make-up but, instead, promotes disease in this species.

It is also critical to understand that there is no independent agency overseeing these diets’ medical claims.  None. Zero.  Including the FDA.

The fox is definitely guarding the henhouse and the FDA shows no interest in remedying the situation.

The FDA has ‘punted’ the responsibility of scrutinizing these diets for efficacy, safety, and suitability to the veterinarian but most veterinarians are very poorly educated in the area of nutrition. This field of study is not emphasized in veterinary schools and the minimal course work that is required, is often taught by people who have strong ties to the pet food industry.

These are also usually the same people who are advising general practitioners on all matters of nutrition.  After recognizing this situation, you will see an obvious and very significant conflict of interest.  In the end, the members of my profession allow Hill’s, Purina, Iams, and Royal Canin to dictate what ends up in our patients’ food bowls.

Here is an excerpt from the “Veterinarian-Prescribed Diets/OTC Options” paper that I am working on:

‘Prescription Diet’ trademark – marketing tool creates false perception

As an example of the serious lack of regulatory oversight, Hill’s secured trademark status for the term “prescription diet” in 1990 thus reinforcing the perception that, like prescription medications, their diets are subject to intense scrutiny and testing.  However, nothing could be further from the truth.              

There is a strong argument to be made that no trademark protection should be granted for any marketing label containing the word “prescription” given the strong potential to seduce the buyers of these products into a false sense of security growing out of the assumption that anything  labeled “prescription” has been put through multiple layers of regulatory and testing paces.                

If any product – including food – is allowed to carry a “prescription” label, it needs to be held to the same standards as a prescription medication.  Otherwise, the word “prescription” becomes no more than a marketing label, and as such, should hold no more credibility than any other marketing slogan.

To quote the FDA/CVM Communications Staff Deputy Director:              

“‘Prescription diet’ is an industry-coined term and holds no legal meaning.”              

In other words, these diets contain no ingredient that actually requires a prescription.  The trademarked term “prescription diet” is simply a clever marketing tool between Hill’s and veterinarians.  The sale of these diets is restricted (by Hill’s, not by law) to veterinarians only.  In return, Hill’s enjoys a boost in perception of quality brought about by this profession’s endorsement of their products.  However, this perception of quality is undeserved and this incestuous relationship jeopardizes the integrity of our profession.

End excerpt

I want to make it clear that probably 99% of all veterinarians who ‘prescribe’ these diets truly feel that they are doing the best for their patients.  The companies (Hill’s, Purina, Iams, Royal Canin) that manufacture the ‘alphabet’ diets have done a wonderful job marketing their products to veterinarians, making it difficult to refrain from falling into the trap of using them.

These companies make it very easy for us.  If a cat comes in with kidney disease?  We can just grab k/d, or NF, or LP without any critical thought.  If a cat comes in with a urinary tract problem?  Easy – take some c/d off the shelf.  Given a veterinarian’s busy schedule and stressful life, one can see just how seductive the use of the ‘alphabet’ diets are.

However, contrary to what is often believed by both the veterinarian and the client, the ‘therapeutic/prescription’ diets sold in veterinary hospitals are not formulated for optimal health of a carnivore and, in many cases, are actually detrimental to the patient’s health. 

In addition, they are simply not necessary and do not optimally address the problems they claim to treat.

Add to this the very high price tag on these diets and we have what I consider to be a very big ‘black eye’ for the profession.

The only time I ever use a prescription diet (canned s/d) is discussed here on the Urinary Tract Health page. Canned s/d is occasionally used but only temporarily (~2-4 weeks) pending re-evaluation of the patient.

Instead of defaulting to the ‘alphabet’ diets, I can always find an over-the-counter diet or formulate a homemade recipe for my patients that leaves more money in the client’s wallet and much better nutrition in the cat’s food bowl.

Regarding making cat food:  People often overestimate what it takes to make a nutritious meal for their cat and assume that it means slaving away in the kitchen every day.  I can assure you, it is much easier than that. Since 2003, I have spent a few hours in the kitchen 4-6 times a year making food for my cats which is a very small price to pay for the control that I have over what goes into their food bowls.

I do not feed any commercial food to my own cats and I would definitely never feed them any “prescription” diets.

I would love to see veterinarians stop being so ‘married’ to the diets they reach for every day and learn the basics of optimal feline nutrition and start considering the use of higher quality, lower cost, over-the-counter – or homemade – diets.  Their patients – and their clients’ bank account – will be a lot better off for it.

Back to top

Common Feline Health Problems and Their Ties to Diet

There is a very strong and extremely logical connection between the way that we are currently feeding our obligate carnivores and many of the life-threatening diseases that afflict them.

Diabetes:  Diabetes is a very serious – and difficult to manage – disease that is not uncommon in cats.  We do  not know all of the causes of this complex disease but what we do know is that many diabetic cats cease needing insulin or have their insulin needs significantly decrease once their dietary carbohydrate level is decreased to a more species-appropriate level than that found in many commercial foods.

Given this fact, and given what we know about how the cat processes carbohydrates, it is not a stretch to say that high carbohydrate diets could very well be a significant factor in causing diabetes in some cats.

Please see this paper discussing the elevated blood glucose in cats after eating a high carbohydrate meal:

Postprandial glycemia

There are countless cases of successful diabetic remission when cat caregivers remove all dry food and all high carbohydrate canned food from their cat’s diet.

In addition to the issue of carbohydrates and how they affect the blood sugar level of some cats, dry food is very calorie dense, is very palatable, and is usually free-fed. This often leads to obesity.

Fat cells produce a substance that makes the other cells in the body resistant to insulin.  This promotes the diabetic state.

It is very important to understand the impact that a low carbohydrate diet has on the insulin needs of a diabetic cat.

If you have decided to start feeding your diabetic cat a low carbohydrate diet, please do not change the diet until you review my Feline Diabetes page – especially the STOP sign section – otherwise you will be putting your cat in danger.

Please also be aware that many veterinarians underestimate the favorable impact that a low carbohydrate diet has on the insulin needs of the patient and they do not lower the insulin dose enough.  If the insulin is not lowered accordingly, an overdose of insulin will occur which can be life-threatening. 

I strongly suggest that all caretakers of diabetic cats home-test to monitor blood glucose levels using a standard glucometer as a matter of routine.  Careful monitoring is especially important when implementing a diet change.

Many veterinarians prescribe expensive diets such as Purina DM (Diabetes Management) and Hill’s m/d but you can do much better for your cat (and your pocketbook) by feeding other more nutritious – and lower carbohydrate – canned foods.  See the Cat Food Composition chart.  You should aim for a diet that derives less than 10% of its calories from carbohydrates.

The less expensive foods like Friskies, 9-Lives, and Fancy Feast are also fine to feed.

Kidney Disease (CKD – formerly called “CRF”):  Chronic kidney disease is probably the leading cause of mortality in the cat.  It is troubling to think about the role that chronic dehydration may play in causing or exacerbating feline kidney disease.

And remember, cats have a less than optimal water balance – especially CKD cats that are losing a lot of water via their ‘leaky’ kidneys – when they are on a diet of predominantly dry food.  The prescription dry ‘renal diets’ such as Hill’s k/d – which are commonly prescribed by veterinarians – contain only a small amount of moisture (~10% versus 78% for canned food) leaving your cat in a less than optimal state of water balance.

I have no other word for dry ‘renal’ diets other than “atrocious” given their water-depletion, low protein amount, and the low biological value of the protein (plant vs animal-based) that they are comprised of.  I would have to be stranded on a desert island with no other food source before I would ever consider feeding these diets to any cat in my care.

Regarding hydration, I must say that I find it truly amazing when I hear about the very large numbers of cats receiving subcutaneous fluids while being maintained on a diet of dry food.  This is an extremely illogical and unhealthy practice and every attempt should be made to get these cats on a diet that contains a higher moisture content. 

Please also note the following list of the first four ingredients of Hill’s dry k/d after reviewing this section on reading a pet food label – and bearing in mind that your cat is a carnivore.

This diet (or any other dry ‘renal’ diet) would never find its way into a food bowl owned by any cat in my care.

The first three ingredients are not even a source of meat and the fourth ingredient is a by-product meal which is not necessarily an unhealthy source of protein but it would be nice to see some muscle meat (“chicken”) in this product.

Brewers rice, corn gluten meal, pork fat (preserved with mixed tocopherols and citric acid), chicken by-product meal

The purpose of this ‘prescription’ diet is to restrict protein which, unfortunately, it certainly does.  However, please understand that there are no studies showing that restricting protein to this level will prevent further deterioration of kidney function. 

‘Renal’ diets restrict protein to the point that many cats – those that are not consuming enough of the diet to provide their daily protein calorie needs – will catabolize (use for fuel) their own muscle mass which results in muscle wasting and weight loss.

This internal breakdown of the cat’s own muscle mass will cause an increase in creatinine (and BUN) which needs to be cleared by the kidneys. The rise in creatinine and BUN, and muscle wasting, can lead to an often-erroneous conclusion that the patient’s CKD is worsening.

Of course, the same deterioration can occur in any cat that is not consuming enough protein, but the level of protein in these diets is not only at anextremely low level, it is in an incomplete form for a carnivore.  Note that they are often made up mainly of plant proteins – not meat proteins – especially the dry versions.

Back to top

• Cystitis (bladder inflammation), Urethral Blockage, Bladder/Kidney Stones:

Please see Feline Urinary Tract Health for a more detailed discussion. The first paragraph on that webpage states:

If I could have the reader take away just one word from this discussion, it would be “water”.  If your cat is on a properly hydrated diet of 100% canned food – and no dry food – you stand a very good chance of never needing to read this webpage.

Cystitis is an extremely common and very painful problem in the cat. Stones are also very common and can lead to a life-threatening urinary tract blockage.

I sincerely hope that these pictures of Opie make a huge impact on anyone who is still not convinced that dry food causes significant suffering in many cats.  Rest assured that veterinarians deal with blocked cats extremely frequently which is heartbreaking considering how rarely cats block when on all canned food – especially with added water.

Cystitis can lead to inappropriate urination (urinating outside of the litter box) and stones can cause a fatal rupture of the bladder by blocking the outflow of urine.

Any cat that is repeatedly entering the litter box but not voiding any urine is in need of IMMEDIATE medical attention!  

This is one reason why it is so important to use a clumping (scoopable) litter.  Clumping litter allows you to see just how much, if any, urine is being voided.

It is important to note, however, that “crystals” are not the same thing as stones.  Crystals are often a normal finding in a cat’s urine and it is not necessarily appropriate to put the cat on a “special urinary tract” formula when these are found in the urine.

Important: I often see too much clinical significance placed on the identification of crystals in the urine without regard to how the urine sample was handled.  It is very important to understand that crystals will often form onceoutside of the body within a very short (30-60 minutes) period of time.

If the veterinarian does not examine the urine right away and either sends it to an outside laboratory or uses a free-catch sample that the owner brought from home, an erroneous diagnosis of crystals may be made.  This is called a “false positive” report and results in unnecessary worry on the part of the owner and often leads to the cat being placed on an inappropriate, low quality diet.

With regard to overall kidney and bladder health, I cannot stress strongly enough how important water is in both the prevention and treatment of diseases involving this organ system.

When a cat is on a diet of water-depleted dry food, they produce a more highly concentrated urine (higher urine specific gravity – USG) and they produce a lower volume of urine (often half of what a cat on canned food produces) which means that a higher concentration of crystals will be present in the urine.

This increases the chance of these crystals forming life-threatening stones.  It is also thought that the highly concentrated urine may be very irritating to the bladder wall in some cats, predisposing them to painful cystitis.

Please keep in mind that a cat has a very low thirst drive and is designed to get water with their food.  A diet of canned food will keep a proper amount of water flowing through the urinary tract system and help maintain its health.

Adding 1-2 TBS of water (plain or flavored – such as tuna water, clam juice, chicken or beef broth) per meal is also very beneficial.  Make your own tuna water by taking one can of tuna and mixing the contents into 3 cups of water.  Mash it up and let it sit for ~15 minutes.  Pour the water into covered ice cube trays.  Freeze to prolong the freshness.  Use covered trays to keep the water tasting and smelling fresh.

Water fountains may also help cats consume more water but feeding a water-rich diet is much more effective in increasing your cat’s water intake than water fountains or multiple bowls of water sitting around your house.

If you are still worrying about small amounts of crystals in your cat’s urine, consider this analogy:

Crystals in cat urine are as normal as the leaves that fall on your driveway.  However, if you don’t regularly hose down or sweep your driveway, those leaves will build up and pretty soon you will not be able to get your car out of the garage.

This is what happened to Opie above.  His ‘driveway’ (urethra) got blocked and he was unable to pass any urine resulting in a tremendous amount of suffering and a life threatening situation.

If you picture crystals as the leaves in this analogy, it is easy to see how canned food does a better job of flushing out your cat’s bladder – several times each day – than dry food does.

To repeat, crystals are not necessarily an abnormal finding in cat urine. However, they can become a problem if Man continues to insist on feeding the cat a water-depleted diet.

Urine pH is also often considered when discussing urinary tract problems but we really need to stop focusing so heavily on pH. Again, a proper amount of water in the diet is the important issue here – not urine pH.

Many of the often-prescribed feline lower urinary tract diets are formulated to make the urine acidic but it is thought that these low magnesium, acidifying diets may actually exacerbate painful cystitis. Also, these acidifying diets often end up promoting calcium oxylate stone formation and can also lead to hypokalemia (low potassium in the blood) which can cause or exacerbate kidney disease.

It is also important to note – for those people still stuck on worrying about the urine pH – that there are many factors which determine the pH of urine and only one of them is diet.

Urine pH varies throughout the day and using one pH measurement from a single urine sample is very misleading and is not terribly helpful information.

With regard to dry food and urinary tract health, aside from the lack of water in this type of diet, there is also a correlation between the consumption of a high carbohydrate diet and the formation of struvite crystals as shown by this study because carbohydrate diets promote an alkaline urine.

Veterinarians often prescribe Hill’s Prescription dry c/d for urinary tract problems but again, these diets are only ten percent water and contain a high level of species-inappropriate ingredients and questionable preservatives.  They are also very high in carbohydrates with dry c/d containing 42 percent of its dry weight as carbohydrates.

Please note the first few ingredients in c/d while remembering that your cat is a carnivore:

Previous formulation:

Brewers rice, chicken by-product meal, corn gluten meal, pork fat (preserved with mixed tocopherols and citric acid),chicken liver flavor, taurine, preserved with BHT and BHA

Newer formulation:

Brewers rice, corn gluten meal, chicken by-product meal, pork fat (preserved with mixed tocopherols and citric acid), chicken, chicken liver flavor, fish oil,

Note that Hill’s removed the BHA and BHT but are now using more corn gluten meal and less chicken by-product meal.

Diet is not the only issue involved with cystitis but it is an important one and one that we can control.  Stress is also thought to play a very significant role in cystitis and even cats that are fed a 100 percent canned food diet may experience bouts of cystitis.

This is a very frustrating disease to deal with and one that the veterinary community does not have all the answers for.  What we do know is that decreasing stress and increasing the water content of the diet are the most important management issues to address.  The water content of the diet is easy to control – feed canned food with added water.  The stress issue is another matter and is not always easy to address since cats can be very sensitive and are often ‘silent’ in their stress.

Cystitis can be extremely painful and it is very important to address pain management in these cats.  Remember:  pain = stress and we are trying to minimize the stress in these patients.

Buprenex is a good choice for a pain medication and I often dispense it for the client to have on hand for chronic cystitis patients – as long as the client understand the critical importance of close monitoring of the patient to make sure he is passing urine and is not obstructed.  (I say “he” because males have a long, narrow urethra and are much more apt to block than females but females can also experience an obstructed urethra.)

Buprenex is superior to Torbugesic which has been used for pain management in the cat in the past.  (Burprenex is a prescription medication that you must get from your veterinarian.)

Unfortunately, many veterinarians overlook pain medications as a very important part of the treatment of this common feline problem.

A very important note on antibiotic usage in these cases:  Most cases of cystitis are sterile.  In other words, they are not the result of an infection and the patient should not be placed on antibiotics.

Only ~1% of cats with cystitis that are under 10 years of age have a urinary tract infection, yet many veterinarians place these patients on antibiotics when these drugs are not warranted.  Most cats under 10 years of age produce a very concentrated urine (USG greater than 1.035) and bacteria do not grow well in concentrated urine.

In cats over 10 years of age, infections are more common but that still does not mean that older cats with cystitis should automatically be put on antibiotics.  The reason that an older cat is more prone to urinary tract infections is because kidney disease is more common in this age group and so these cats will have a more dilute urine which is not as hostile to bacterial growth.

Diabetes and hyperthyroidism are also more common in cats over 10 years of age and both disease render the patient more prone to urinary tract infections.

That said, only ~20% – or less – of all older cats that present with lower urinary tract signs (see Feline Urinary Tract Health – Cystitis) actually have an infection so ~80% of this age group exhibiting these clinical signs do not need to be put on antibiotics.

A urine culture and sensitivity (C & S) should be run to check for an infection, especially if the patient has a low urine specific gravity or is diabetic.  It must be kept in mind that even with a low USG, most cases of cystitis are not due to an infection.  This is why it is important to run a C & S before placing the patient on antibiotics.

Antibiotics are NOT harmless drugs and they need to be used with more critical thought than is currently happening in both human and veterinary medicine.

This is especially true of Convenia.  Please do not allow that drug to be injected into your cat without reading my Convenia webpage first.

A C & S test identifies the bacteria (if present) and tells the veterinarian which antibiotic is appropriate.  The urine for a C & S needs to be obtained by way of cystocentesis which involves using a syringe and needle to obtain urine directly from the bladder.

This is not a painful procedure for the cat and this method is the only way to obtain a sample for accurate information in order to properly treat with antibiotics.  One problem, however, is that a sample may be difficult to obtain without waiting a couple of hours since cats with cystitis urinate frequently and often do not have enough urine in their bladder to get a good sample.

To get around this problem, your veterinarian can give the your cat a dose of subcutaneous (just under the skin) fluids.  The patient is then put into a cage without a litter box.  Within a couple of hours (or less), the bladder is usually full enough to obtain a urine sample via cystocentesis.

We have to stop treating all cases of cystitis with antibiotics without supporting evidence of an infection!

Cystitis will often recur in these patients and this painful health problem can be very frustrating to deal with.  On a good note, most cats will have their clinical signs spontaneously resolve even without any treatment.  In fact, it has often been said, jokingly, that a cat with cystitis will often stop exhibiting clinical signs within seven days with antibiotics and in one week without antibiotics.

Unfortunately, when people don’t understand this issue, antibiotics often get the credit when they had nothing to do with the patient’s improvement. When this happens, the abuse of antibiotics continues.

Inflammatory Bowel Disease (IBD): IBD can cause vomiting, diarrhea, and/or constipation in the cat.  IBD can also present with weight loss as the only clinical sign.   There are many unanswered questions with respect to this disease process, but it is logical to start to “treat” a gastrointestinal problem in the cat with a species-appropriate diet considering that it is food that ‘bathes’ the problem area.

Too often these cats are treated with a high level of steroids and a prescription grain-laden dry food diet.  I feel very strongly that this common therapeutic regimen dismisses the very significant role that a proper diet plays in our IBD patients.  There are an impressive number of anecdotal reports of cats that were terribly ill with IBD that exhibit dramatic improvement when all dry food was removed from their diet and a grain-free/low-carb canned food was fed instead.

Taking it even one step further, there are many reports of cats with IBD that improved tremendously on a balanced homemade diet. (See Making Cat Food for a balanced recipe.)

Some cats do need steroids (temporary or long-term) but we need to focus more heavily on feeding these patients an appropriate diet rather than simply relying on immunosuppressive medications.

Back to top

Hairballs: The frequent vomiting of hairballs can be a symptom of IBD.  “Frequent” is hard to define, in this case, but if your cat is vomiting hairballs on a weekly basis do not just assume that this is simply normal feline behavior.

I often receive emails asking what the best diet is to feed to cats suffering from hairballs.  The bottom line is that as much hair as possible should be prevented from getting into the cat in the first place.  This is accomplished with daily brushing or, in some cases, shaving the cat if hairballs are creating serious problems.

I understand that shaving cats is not an easy task and is, therefore, not a ‘quick fix’ for this problem but it is an option for serious cases.

Amber can only be shaved when she is under general anesthesia.  Therefore, almost every summer she gets a dental cleaning and body shave to keep her comfortable during the hot summer months.  She never had a problem with hairballs even with a full coat but she is a lot happier without her long hair when the weather is hot.

Hairball problems are not just associated with long hair coats.  Shorthaired cats – especially double-coated cats – can also have problems with hairballs. However, a healthy intestinal tract should be able to deal with hair normally ingested by the cat.

That said, if we want to help our cats out in this area, we need to brush them daily.

Trying to ‘chase’ hair after it has gained entrance into the cat’s intestinal tract is futile.  Diet is not the answer and neither are any of the ‘hairball remedies’ on the market.  As one well-respected feline medicine specialist often states “this is not a grease deficiency!”

Obesity:  Obesity is an extremely common and very serious health problem in cats.  Overweight cats are four times more likely to develop diabetes than cats that are at an optimal weight.

Obligate carnivores are designed to meet their energy needs with a high protein, moderate fat diet with little to no carbohydrates. Carbohydrates are minimally used for energy and those that are not used are converted to and stored as fat.  The so-called “light” diets that are on the market have targeted the fat content as the nutrient to be decreased.  The choice is then to raise either the protein or carbohydrate content of the diet, or both.

Since animal-based protein (meat and organs) is more expensive than carbohydrates (grains/potatoes/peas), pet food manufacturers raise the carbohydrate levels in these foods making them very species-inappropriate and unhealthy.

An optimal weight loss diet should be:

• high in protein (over 40% of calories),

• moderate in fat (under 50% of calories),

• low in carbohydrates (under 10% of calories), and

• high in water.

When looking at the Cat Food Composition chart, you will note that there are not many examples of this profile.  Why?  Because fat is cheaper than protein.  The calories from protein + fat + carbs must = 100%.  If the carbs are kept below 10%, that leaves 90-95% of the calories to be divided between protein and fat.

Protein is expensive.  Fat is cheap.  Therefore, low carb diets are usually high in fat.

Examples of nice profiles include Friskies Classic Pates, some Fancy Feast varieties, Weruva Paw Lickin’ Chicken, Tiki Puka Puka Luau, and Tiki Koolina Luau.

You will notice that many of the higher protein diets are fish-based but it is not a good idea to feed fish to cats.  Or, at least not as their main diet.  Fish can be high in mercury, high in PBDEs (fire retardant chemicals linked to hyperthyroidism), high in phosphorus (not good for older cats’ kidneys) and can be very addicting.  It is best to feed poultry-based diets to cats.

Water content of the diet is very important.  Studies have shown that cats lose weight much easier on canned food versus dry.  Dry food is very calorically dense and is high in carbohydrates which are not as satisfying to a cat as protein is.

Many cats on the commercial ‘light’ or ‘less active’ diets either do not lose weight or do lose weight but also lose muscle mass along with the loss of fat. This is not our goal. The goal is to lose fat while maintaining muscle mass.

In several studies, cats fed a high protein/low carbohydrate diet lost weight but maintained their lean body mass in comparison to cats fed a high carbohydrate/low fat diet.

Many caretakers feed very small amounts of these “light” diets hoping that their cat will lose weight.  However, feeding a small amount of a diet that is inappropriate for the species is not the answer! The caretaker often ends up with either a crabby, overweight cat or a thinner cat that may have lost too much muscle mass.

See Molly’s and Bennie’s story of weight loss on this site’s Feline Obesity page to read about how these sweet cats went from inactive obese cats that could barely walk or clean themselves to healthier, happier felines.

Molly’s veterinarian had prescribed Hill’s Prescription dry r/d for her and instructed her caretaker to feed Molly only very small portions – and to put a shock collar on her to keep her away from her housemates’ food.  This is obviously not sound – or humane – obesity management advice.

Hill’s Prescription r/d is a very poor quality, high carbohydrate (35%) diet that contains the following inappropriate and unhealthy ingredients including a high level of fiber which a feline intestinal tract is not designed to process:

Previous formulation:

Chicken by-product meal, corn meal, powdered cellulose 18.5% (a source of fiber),corn gluten meal, chicken liver flavor, vegetable oil, taurine, L-carnitine, preserved with BHT, BHA and ethoxyquin

Current formulation:

Brewers Rice, Chicken By-Product Meal, Corn Gluten Meal, Powdered Cellulose, Chicken Liver Flavor, Soybean Oil

Note that Hill’s removed the BHA and BHT but a plant-based protein is now the predominant protein source instead of an animal-based protein. This diet is even more unhealthy than it used to be.

There are much more species appropriate – and less expensive – ways to address feline obesity.  However, if you are contemplating the use of the grain-free, high protein/low carb dry foods, please understand that these diets are very calorie-dense and often lead to  weight gain, in addition to being detrimental to urinary tract health because of their water-depletion.

Hepatic Lipidosis (Fatty Liver Disease): This is the most common metabolic liver disease of cats.  Cats that go longer than ~3 days without eating, for any reason, are in danger of developing this serious, and often fatal, disease. Even though thin cats can end up with hepatic lipidosis, overweight cats are much more prone to experiencing this disease.

Feeding a high-protein, low-carbohydrate canned diet helps keep cats at an optimal, healthy body weight and, in turn, makes them less likely to end up with fatty liver disease.

Dental Disease:  Long-standing claims that cats have less dental disease when they are fed dry food versus canned food are grossly overrated, inaccurate, and are not supported by studies.  This frequently stated (among veterinarians and lay people) myth continues to harm cats by perpetuating the idea that their food bowls need to be filled up with an unhealthy diet in order to keep their teeth clean.

The idea that dry food promotes dental health makes about as much sense as the idea that crunchy cookies would promote dental health in a human.

First, dry food is hard, but brittle, and merely shatters with little to no abrasive effect on the teeth.  Second, a cat’s jaws and teeth are designed for shearing and tearing meat – not biting down on dry kibble.  Third, many cats swallow the majority of their dry food whole.

There are many factors – known and unknown – that contribute to dental disease cats such as genetics, viruses, diet, and the fact that cats do not brush their teeth like humans do. There remain many unanswered questions concerning the fact that cats often suffer from poor dental health but one very obvious answer lies in the fact that humans feed cats a diet that does not even come close to what they would eat in their natural state.

When cats consume their prey in the wild, they are tearing at flesh, hide, bones, tendons, and ligaments. This is a far cry from the consistency of dry or canned food.

Neither dry kibble nor canned food comes close to mimicking a cat’s normal diet of mice, birds, rabbits, etc. Given what a cat does eat in nature, it makes much more sense to be feeding part of the diet in the form of large chunks of meat (as large as you can get your cat to chew on) or gizzards (tough and fibrous) which a cat’s teeth are designed to chew. Raw meat is ‘tougher’ to chew than cooked meat so I prefer to use raw meat – or lightly baked to kill the surface bacteria – to promote dental health. See Making Cat Food – Dental Health.

Notice the phrase “part of the diet” in the above sentence.  It is very important to understand that plain meat (ie – without bones or another source of calcium) is very unbalanced since there is minimal calcium in meat.  Remember that when a cat eats his normal prey, he is consuming the bones along with the meat.

When fed as a supplement to most commercial canned foods, it is safe to feed ~15 – 20% of the daily calories in the form of plain meat.  For example, if a cat is eating 6 ounces of canned food per day, you could feed him 5 ounces of canned food plus 1 ounce of chunked muscle meat per day.

When people ask me “how often should my cats be fed chunks of meat?”, I reply “how often do you brush your own teeth?”

And speaking of brushing teeth, this is, by far, the best way to promote your cat’s dental health.  See this video for more information.

Please pay close attention to the statement in the video regarding a thorough dental exam by your veterinarian before starting a brushing program.

Many cats have very painful mouths but show no outward signs of this pain.  If you try to brush your cat’s teeth in the face of a painful mouth, you will end up with a cat that is scared – along with developing a strong aversion to toothbrushes.  If this aversion occurs, you may never get him to accept tooth brushing once you have addressed the painful mouth with your vet.

With regard to frequency, once-daily is optimal.  By the time 72 hours have passed, the film on the teeth becomes permanent so shoot for at least every other day.

Please understand that I am not saying that canned food is necessarily better for teeth than dry food.  For optimal dental health, a cat should not be eating either canned or dry food since neither food type promotes a healthy oral cavity but we have to work with what is practical in a typical home setting and feeding a cat a ‘whole carcass prey’ diet is not terribly practical – even if it would be great for their teeth.

The compromise is to at least give them some muscle meat to chew on, in addition to brushing their teeth if possible, and to stop fooling ourselves into thinking that dry food promotes dental health in our cats.

I am often asked about ‘dental’ diets such as Hill’s t/d but if someone has read to this point on this webpage, it will be understood that these diets represent the epitome of ‘tunnel vision’ nutrition.  All ‘dental’ diets are all dry (water-depleted), all are all high in carbohydrates, and all contain species-inappropriate ingredients, and as such, even if they do impart any measurable effect on dental health, they wreak havoc on the rest of the body.

It is wise to feed for the health of the *whole* cat, not just one part of him.

Hill’s t/d (34% carbohydrates):

Chicken By-Product Meal, Brewers Rice, Corn Gluten Meal, Powdered Cellulose, Whole Grain Corn, Pork Fat (preserved with mixed tocopherols and citric acid), Chicken Liver Flavor

Feline Asthma/Allergic Airway Disease:  Many cats have had their respiratory symptoms (coughing/difficulty breathing) subside considerably, or disappear completely, once they were placed on a grain-free canned food diet, or a meat-based homemade diet.  Some of these struggling cats may have been reacting to storage mites or cockroach antigens that are present in dry foods, or they may have been reacting to the gluten (protein fraction) part of the grains that are present in dry foods.

Sadly, many cats exhibiting debilitating lung disease are simply put on an immunosuppressive dose of steroids – while still being fed an inappropriate diet.  While steroids are necessary in many cases of airway disease, they are not addressing the root of the problem which can, in many cases, be an allergy to proteins in the form of species-inappropriate grains, and insect antigens.

Steroids can cause diabetes in cats and also render them vulnerable to infections from viruses, bacteria, and fungal agents so it is very important to make sure you have ruled out diet as a cause of the cat’s respiratory symptoms.

 

Back to top

The Safety of Dry Food

Dry food is far from a clean, safe, and pathogen-free source of food for your cat. Please see this section on my Making Cat Food page which details just a few of the many pet food recalls due to contamination of commercial pet food with deadly chemicals,  bacteria (salmonella, etc.), fungal mycotoxins, and storage mites.

The issue of rancid fats in dry food is also discussed on the Making Cat Food page.

Fungal mycotoxins are deadly chemicals produced by molds. Molds are very common contaminants of grains but molds can be found in many different food sources.  In mid January 2011, 200 cows died from eating moldy sweet potatoes that were mixed into their feed.

There is no doubt in my mind that many cats and dogs have become ill from the contaminants that are often present in dry pet foods yet nobody (including the veterinarian and pet owner) puts 2 + 2 together and realizes that the diet is the source of the pet’s illness.

Keep in mind that dry foods are not refrigerated and they sit in warm warehouses, on pet store shelves, and in your cupboards for weeks or months before your pets consume them leading to increased bacterial growth and rancid fats.

At the very least, dry food should be kept in the refrigerator but it is better to just refrain from feeding this type of food completely.

Back to top

Transitioning Dry Food Addicts to Canned Food

Printer Friendly – Tips for Transitioning section only.

This is the hard part. Cats, like children, often resist what is best for them.  The two most frequent comments that I hear from people when trying to convince them to feed their cats a healthier diet are “my cat won’t eat canned food” and “but my cat really likes his dry food.”   Children really like potato chips and ice cream but that certainly does not mean those food items constitute optimal nutrition.

The transition process often involves much more than just plunking down a new food item.  Time, patience and tricks are often required.

One reason that cats like dry food so much is because the pet food companies do not play fair when manufacturing this sub-optimal food source.  They coat the kibble with extremely enticing animal digest sprays which are very pleasing to a cat – making a poor quality diet very desirable to the target animal.

In addition to the aforementioned coating of dry food with animal digests, another issue  is one of a crunchy texture which is very different from canned food.  Cats are very resistant to such a drastic change in the texture of their food.

If you are convinced that getting your cat off of dry food is the way to go, read on for some tips on how to accomplish this.

The key is to do it slowly and with patience and incorporate various tricks for the stubborn cats. The most important issue is actually making the change, not how fast you accomplish it. 

I must say that my cats tested every ounce of patience I had over a 3 + month period of time during their transition from dry to canned food.  They had been on dry food their entire lives and did not recognize canned food as food.  My cats ranged in age from 2 years to 10 years at the time of the transition.

The single biggest mistake I see people make time and again is to say that their cat “won’t touch” the new food and then panic and fill up the bowl with dry food.   In many cases, it is simply not that easy to get cats off of dry food. (See Molly’s Story for a look at one very stubborn cat.)

There are two categories of cats – those that will eat canned food and those that will be extremely resistant to eating anything other than dry food.  If your cat falls into the first category, lucky you. These cats will take to it with the attitude of “finally – an appropriate diet for my species.”   In this case, if your cat has been on all dry food, or only receives canned food as an occasional ‘treat’, start by feeding canned food in increasing amounts.  Gradually decrease the dry, taking about a week to fully switch the cat over to 100 percent canned food.

Some cats may experience softer stools during the transition.  I do not worry if this happens and tend to ‘ride it out.’  If diarrhea results from the diet change you will either need to experiment with different canned foods or slow the transition down and do it over a period of several weeks.

Note that in over 40 years spent in this profession, I have never met a cat that needed dry food to stay healthy but some need to be transitioned more slowly than others.

The average cat should eat ~180 – 220 calories per day which will be found in 5-6 ounces of the average canned food.

However, note that high protein/low fat/low carb foods like Weruva Paw Lickin’ Chicken and some Tiki Cat varieties are very low in calories (see the Cat Food Composition chart – far right column) so you will need to feed much more than 5-6 ounces which can get quite expensive.

The necessary daily caloric intake should be split between 3-4 meals/day (or just free-fed if they are not overweight).

When determining how much you should be feeding your cat once transitioned to canned food, keep it simple.  Too fat?  Feed less.  Too thin?  Feed more.

Now….for the stubborn cats……

If you are unlucky like I was, and your cat does not recognize the fact that he is a carnivore and would live a healthier life if eating canned food, (or a homemade diet) then you will have some work to do.  Some cats that have been on dry food for their entire life will be quite resistant to the diet change and may take several weeks or longer to make the transition to a healthier diet.

For ‘resistant-to-change’ cats, you will need to use the normal sensation of hunger to help with the transition. For this reason, it is very important to stop free-feeding dry food.  This is the first, and very critical, step.  You need to establish set mealtimes. They are not going to try anything new if their bowl of junk food is in front of them 24/7.

Cats do not need food available at all times. It really is okay for them to experience a hunger pain!  That said, it was very hard for me to listen to my cats begging for food even though I was strong in my conviction that I was heading them in the best direction for optimal health.  It truly was a stressful time for me and them.  Actually, I think it was harder on me!

This is where many people fail and just give in and fill up the dry food bowl.  There were a few times when I had to call my ‘sponsor’ and was instructed to “just leave the house if you can’t take looking into those eyes!”  I left the house. Those pitiful little cries of “I have not had food for two WHOLE hours!” were hard to take.  But, lo and behold, they were just fine when I returned.  Not one cat had died from hunger.

On the other hand, do not attempt to withhold food for long  periods of time (greater than 24 hours) with the hope that your cat will choose the new food.  You need to ‘convince’ them that a high quality canned food  really is good for them, rather than to try starving them into it – which does not work anyway.  Allowing a cat to go without food – especially an overweight cat – for a long period of time (greater than 48 hours) can be quite dangerous and may result in hepatic lipidosis (fatty liver disease).

Hepatic lipidosis can also develop when a cat consumes 50% or less of his daily caloric requirements over a period of many days.  The definition of “many” varies from cat-to-cat.  For this reason it is important to understand that you need to have some idea of the calories from canned food combined with the calories from dry food that your cat is consuming on a daily basis while you are implementing the transition to canned food.

I have never seen a cat develop hepatic lipidosis when consuming at least 15 calories per pound per day.  This number is figured on lean body weight, not fat weight.

If your cat weighs 18 pounds but really should weigh 12 pounds, please make sure that he is consuming  ~180 calories per day.  (12 pounds lean body mass X 15 calories/pound/day = ~180 calories/day)

In reality, the cat in the above example would probably be completely safe at only 150 calories per day.

If you have a small female cat that should only weigh 9 pounds, please make sure that she is consuming at least 135 calories per day.

Canned foods never list the calorie content on the can but many dry foods do list this information on the bag.  A rough guideline for the calorie content of most canned foods that are 78% moisture is ~30 calories/ounce but can range from 20 to 40 calories/ounce as shown by the chart linked above.

Most cats will lose some weight during the transition to canned food.  Given that a very high percentage of cats are overweight to begin with, this is a favorable result of the diet change – as long as they do not lose too much weight too fast.  A cat should never lose more than 1-2% of his body weight per week.

I highly suggest that all cat caregivers weigh their cats periodically especially if they are over 10 years of age.  This will help ensure a safe transition to a healthier diet and, in general, weight loss is often the first sign of ill health for any reason.  I make it a point to weigh my cats at least once each month especially since they are now over 10 years of age.

Here is a scale that is reasonably priced:  Salter Baby and Toddler scale.  It weighs to the nearest  1/2 ounce and has a ‘hold’ button on it  that helps obtain an accurate weight even for a cat that is moving around a bit.

Here is another scale that may be even better because its base is as long as the scale.  Red Cross Baby Scale. This is important for cats that are trained to walk onto it otherwise, scales like the Salter one linked above may tip.  This would scare the cat and harm the scale.

All of my cats lost weight during the three months that it took to switch them to canned but none of them became too thin.  They slimmed down to a nice lean body weight – losing fat while maintaining their muscle mass.  They also became much more active.

If your cat is overweight, please see the Feline Obesity page.

Resign yourself to the fact that you will be very frustrated at times and you will be wasting canned food as they turn up their nose at it.  Also, you may want to immediately switch your cat to a dry food that has fewer calories from carbohydrates than most dry foods. (e.g., EVO)

The low-carb dry foods are very high in fat and therefore are very calorie dense.  These foods must be portion-controlled otherwise, your cat may end up gaining weight.  Note that dry Innova EVO has 612 calories per cup.  One quarter of a cup contains 153 calories so be very careful to pay attention to how much of these high calorie dry foods you feed.

The caloric needs of an average cat can range between 150 – 250 calories/day depending on their lean body weight and activity level.

The low-carb dry foods are also very high in phosphorus.  This is especially detrimental for cats with compromised kidney function.

And, of course, these low-carb dry foods are water-depleted – just like all dry foods – putting your cat at risk for serious urinary tract problems.  They are also cooked at very high temperatures in order to dry them out.

I do not recommend these dry foods for long-term feeding for all of the reasons stated above.   Please use them only as transition diets.

Be sure to stay away from any “light” varieties since those types of foods are very high in carbohydrates.

Here are some various tricks for the stubborn ones.

Keep in mind that different tricks work on different cats:

• If your cat has been eating dry food on a free-choice basis, take up the food and establish a schedule of 2 – 3 times per day feedings.  I really do prefer just twice-daily feedings when trying to transition them.  A normal, healthy hunger response after 12 hours goes a long way to convince them to try something new.

If you want to take the transition very slowly, you can feed the amount that your cat normally consumes in a 24 hour period – split up into two feedings to get him used to meal feeding.  Many people, however, are unsure as to how much their free-fed cat really eats so I would start off by figuring out the calories that your cat needs to maintain his weight if he does not need to lose any weight.

Leave the dry food down for 20 minutes, and then remove any uneaten portion.  Repeat in 8-12 hours depending on if you are feeding 2 or 3 times per day.  During the first few days of transitioning to a set schedule, you can offer canned food during the dry food meals, or in-between meals.  The stubborn ones, however, will not touch it.  Do not despair – all cats will eventually eat canned food if their caregiver is determined, methodical, and patient enough.  Once your cat is on a schedule you will notice that he is more enthusiastic about food during his proper mealtimes and will be much more inclined to try something new.  

Again, most cats only need 150-250 calories/day.  The dry food bag should tell you how many calories are in a cup of food but if it does not, you can call the company.

• Once the cat has transitioned to canned food, I prefer to either free-feed them (if they are not too fat) or to put out a meal 3-4 times per day. Small cats in the wild eat 8-10 small meals per day. I do not worry about leaving canned food out for up to 12 hours at a time. Keep in mind that a lion is not going to eat his entire prey immediately.

• Once you have established scheduled mealtimes, you will most likely need to start feeding a bit less at each mealtime in order to get the normal sensation of hunger to work in your favor.  Again, we are trying to use the normal sensation of hunger to help us out.  We are not trying to starve the cat into the diet change.

• Once your cat is on a schedule of meal-feeding instead of free-feeding, try feeding a meal of canned food only.  If he will not eat it – and the very stubborn ones won’t – try not to get frustrated – and do not put down dry food.   Try some of the other tips listed below.   If he still will not eat the canned food, let him get a bit hungrier.  Offer the canned again in a couple of hours – or just leave it out.  Some cats will be more apt to try something new if they keep walking by it and seeing/smelling it.  Try a different brand/flavor or a different ‘trick.’  Once it has been ~18 hours since he has eaten anything, give him just a small amount (1/4 of a cup – or less if it is EVO) of his dry food – keeping track of his daily caloric intake.

• Remember to be patient.

• Exercising your cat with a tassel toy before feeding can also help stimulate his appetite.

• Cats’ noses are much more sensitive than ours are.  They can smell the dry food in the cupboards.  I suggest either putting it in the refrigerator or putting it in a tightly sealed container.  If they can smell it, they will hold out for it.  Some people recommend getting it out of your house completely, but this is not possible when you are dealing with a very stubborn cat that needs a bit of time and patience to make the transition happen.

• The following worked for my cats:  Sprinkle a very small amount of tuna – or any other favorite treat (some cats do not like fish and would prefer cooked chicken) – on top of the canned food and then once they are eating this, start pressing it into the top of the new food. (The “light” tuna is better than the fancy white tuna because it has a stronger smell.  Or, Trader Joe’s makes a Cat Tuna that is very stinky.)  Be careful to decrease the amount of fish as soon as possible.  Health problems can occur with a predominantly fish-based diet.  Plus, you do not want to create a situation where your cat will only eat very fishy foods.

• Make sure that any refrigerated canned food is warmed up a bit.  Cats prefer their food at ‘mouse body temperature’.

• Try offering some cooked (or raw – whole meats, rinsed well or partially baked) chicken or meat baby food.  One of the goals is to get your cat used to eating food that does not crunch.  He needs to get used to a different texture.  Also, chicken is a great source of protein to point him in the proper direction toward a high protein, low carbohydrate diet.  If he eats the chicken, he may head right into eating canned food.  Then again….he may not.

• Try sprinkling some parmesan cheese on the canned food.  Most cats love parmesan cheese and this trick has been very successful for me.

• Try a product called FortiFlora – feline version.  Most cats LOVE FortiFlora and this has recently become my favorite trick.  This is a probiotic made by Purina but you are not going to use it for its probiotic properties.  You are just going to use it as a flavor enhancer.  The base ingredient in FortiFlora is animal digest – the very substance that makes dry food so very enticing to cats. The directions say to use 1 package/day – and you can use this much if you want to – but this amount is not usually necessary.  You may only need ~1/4 of a package – or much less – with part mixed into the food and part sprinkled on top of the food just as you would use salt and pepper on your own food.

FortiFlora can be purchased online but an easier product to find is Temptations treats.  I trap a lot of feral cats for spaying/neutering purposes and this is one of the best baits that I can use.  These tasty treats can be found at most pet stores.  Put a few in a baggie and crush them with a hammer.  Use the crushed treats as described for the FortiFlora above.

• There are numerous freeze dried meat treats on the market that you can also sprinkle on top of the canned food.  Halo’s Liv A Littles is a popular choice.

• Speaking of texture, a common question is “can I just soak the dry food in water?”  I hedge more than just a bit at this question.  Dry food often has a very high bacterial content.  Mold is also often found in dry food.  Both organisms flourish in moist environments. There have been many deaths of dogs and cats secondary to eating mold mycotoxins, vomitoxins and aflatoxins which often contaminate the grains found in dry food.  If you want to try the trick of wetting down the dry food to alter the texture, please leave it out for only 20-30 minutes then discard it.

• Try dipping some dry food pieces in the juice from the canned food.  Some cats may refuse to eat it if the dry food even touches the canned food.  But if he will eat it with a bit of canned juice on it, try the ‘chip and dip’ trick.  Scoop up a tiny bit of canned food onto the piece of dry food. Put them on a separate plate from his small portion of dry food.  Some cats will eat their small portion of dry and then go investigate the dry food with a tiny bit of canned on it.

• Going one step further, try adding a few small pieces of the canned food to the small portion of dry food.  Your cat may pick around the canned food but will get used to the smell – and texture – even if he does not eat any pieces of the new food.

• Crush some dry food and sprinkle it on the top of the canned food.

• If you do not think it will upset your cat, try gently rubbing a bit of canned food or juice on the cat’s gums  This may get him interested in the taste and texture of the new food – but do it gently.  You do not want to make this a stressful situation and create a food aversion.  (This trick is commonly used to get just-weaned kittens used to eating canned food.)

• If you do not think it will upset your cat, use your finger to put a tiny bit of canned food or juice on his paw for him to lick off.  This has not worked for me in the two cats I have tried it on but it is another idea.  Make sure you do it without stressing your cat.  Again, you do not want to create a food aversion.

• If you have a multiple cat household, some cats like to eat alone in a less stressful environment, so you may need to take these cats into a separate, quiet room to think about the error of their ways – their carbohydrate/dry food addiction. Once in a quiet setting, away from the other cats, two of my cats would eat canned food/tuna ‘meatballs’ by hand.  Not from a bowl, mind you, but only from my hand. I’m not sure who was being trained. They did eventually start eating from a bowl after a few hand feedings.

• Try various brands and flavors of canned foods.  Try Friskies, 9-Lives, Fancy Feast, etc.  Many cats prefer the foods that are all by-products and turn their noses up when offered the by-product-free diets like Wellness, etc. You can worry about feeding a a different canned food later if you want to and you can always mix different types of food together.  The initial goal is just to get your cat used to eating canned food and not dry kibble.  And remember what I said above. I would much rather see a cat eating a canned food like Friskies, 9-Lives, or Fancy Feast rather than any dry food.

• Syringe-feeding is also another option but has to be done with finesse and patience so as to avoid a food aversion.  If you choose to syringe-feed, your goal is not to feed him a full meal.  Sometimes just syringing a 1-2 cc’s can ‘jump-start’ your cat into eating the canned food – maybe not the first time but it will at least get him to taste the new food and experience a foreign texture. The best way to syringe-feed is to kneel on the floor with your cat between your legs so he is facing the same way as you are.  Then, using a small (1cc/TB) syringe, slip it in the side of his mouth and give about 1/2 cc at a time.  He may spit it out but you are just trying to get him used to the taste and texture, not stress him.

Few canned foods will make it through the tip of a syringe but human meat baby food works well for this trick. You can also water it down a bit if you need to.

If you want to use canned cat food instead of baby food, you will need to cut the end off of the syringe so that the opening is as big as the barrel.  Make sure that the tip is smooth.  If you do not want to cut the tip of the syringe off, you will need to puree a pate (versus chunks) type of food.  I puree Wellness for this.  I run it through the blender with a small amount of water (~3-4 tablespoons/5.5 ounce can).  Then I strain it to remove anything big enough to clog the small tip of the syringe.  Wellness is also a balanced diet – unlike human baby food.

Even though human baby food is not a balanced diet for long-term use, it is a great tool that can be used to help transition a cat to a texture that he is not used to.

• I did have to take drastic measures for a foster cat named Molly.  She was dangerously obese (20 lbs – double what she should have weighed) and would not eat canned food even after two weeks of syringe-feeding her.  She needed to go in for a dental so while she was under general anesthesia, I put in a feeding tube.  This took the stress off of both of us.  After two weeks of feeding her via the tube she started licking the canned food from my fingers then suddenly decided it was time to eat it.  She then started to finally lose weight.  Before the 7 lbs weight loss, she could barely walk, could not clean herself, and was quite possibly headed for diabetes.
• Don’t give up.  One of my barn cats ate dry food for the first 12 years of her life.  She would never touch the canned food that the other cats ate. Then, one day, she found her ‘inner carnivore’ and started eating canned food out of the blue!  I was shocked.  That was 4 years ago and she has been on a 100% canned food diet since she made the switch.

These are just a few tricks that you can try.  Different tricks work on different cats.  The key is to be patient.  Remember, it took me three months to get my cats on 100% canned food.  Most cats, however, will not take this long.

Back to top

 

Homemade Diets and Commercial Raw Meat Products

Many people have a strong negative reaction to the idea of feeding their cat raw meat but this is what a carnivore is designed to eat.  Keep in mind that there are no hibachis or stoves in the wild.  Also, wild cats do not always consume their prey in its entirety immediately upon killing it so the meat that they eat is not always from a fresh kill.

Cats are very different from humans with respect to their susceptibility to ‘food poisoning’. Cats have a much shorter transit time through their intestinal tract than humans do (about 12 – 16 hours for the cat versus 35-55 hours for the human).  This is a very important point because the more time bacteria spend in the intestinal tract, the more they multiply, eventually leading to intestinal upset.

That said, not all sources of raw meat are created equal.  For instance, I will not feed pre-ground supermarket meat in a raw form.  I buy only whole cuts of meat which can be thoroughly rinsed prior to grinding or they can be partially baked to kill the surface bacteria.

Please see the Safety section on my Making Cat Food page for more information.

A properly handled and prepared raw or semi-cooked meat diet has much less bacteria in it than many commercial dry foods.  Commercial pet foods may also contain high levels of mold toxins from grains which are never a danger in a grain-free raw meat diet.

Please see the Dangers of Dry food section on my Making Cat Food page that discusses the common contamination issues associated with dry food.

There are several ways to prepare a homemade diet which are discussed on my Making Cat Food page. My cats have been thriving for the past 11 years on a diet that I prepare using either ground whole carcass rabbit (fed raw) from a reputable farm, or whole meats (chicken thighs) from Whole Foods Market that I grind myself after partially baking.  I add just a few supplements and water to complete the diet.

Note that the picture of the blue containers below is an old one. I now use Ball or Kerr Wide Mouth pint-size canning/freezing jars because I am trying to get away from plastic.

People are often overwhelmed or intimidated by the idea of making their cat’s food but, in reality, it’s quite simple – as long as you follow a balanced recipe.  I make cat food once every few months and freeze it.  Making your own cat food doesn’t mean slaving in the kitchen every day–trust me, if it did, I wouldn’t be doing it.

A few hours in the kitchen 4-6 times a year is a very small price to pay for having complete control over what goes into your cat’s food bowl.

If you are interested in preparing your own cat food, see Making Cat Food.  Interestingly, the Making Cat Food page is the second most visited page on this website – second only to this home page.  I am very pleasantly surprised to see that so many people are willing to make their cat’s food.

One common mistake people make when feeding a home-prepared diet is thinking that a cat can live on meat alone – without bones as a source of calcium.  While meat must be the primary component of a feline diet, there is not enough calcium in meat (without the bones) to provide a proper calcium-to-phosphorus ratio.

Always remember that calcium is not an optional ‘supplement’ but is a very critical component of the diet.

The bones must be ground with the meat (preferable), or bone meal must be added to the recipe.  (I am a stickler for using fresh bone – not bone meal.)

Another way to feed a raw meat diet is to purchase ready-to-feed frozen commercial pet diets.  Many people feed these diets with great results. Unfortunately, as is also true with canned foods, these products vary a great deal with respect to quality and ingredients.

Many of these products use only poultry backs and necks which have a very high bone:meat ratio and, subsequently, a very high mineral load.

Some products also contain items such as vegetables in a much higher quantity than would be found in a cat’s natural diet. Plus, the vegetables in these diets are obviously not predigested as they would be if consumed with the cat’s prey. This is a very important point that many people seem to forget when deciding to feed vegetables to carnivores.  Cats do not have a physiologic requirement for vegetables and actually lack the enzymes needed to break down this food source for efficient utilization.

If you choose to feed a commercially prepared raw pet food, you must do some homework – including calling the company to see if they have had their food analyzed for things like phosphorus amount and the calcium-to-phosphorus ratio.

The Ca:Phos should not be any higher than 1.8:1.0 and the overall phosphorus level should not be above ~1.5% dry matter.

You should also look at the percentage of vegetables and fruits.  Less than 5% is reasonable.

Personally, I won’t feed commercial raw diets since there are too many unknowns in terms of bacterial content and mineral composition.  I prefer to make my own.

Back to top

Some Final Thoughts

Congratulations if you have made it to this point in this article.  You must really care about feeding your cat a healthy diet and are open to new ideas regarding their nutritional needs.  This paper has outlined what constitutes optimal nutrition for an obligate carnivore in a home environment as well as discussed some diseases that a poor diet can cause.

The most common complaint that I hear from people is that their cat will NOT eat canned food and will ONLY eat dry food.

My cats fell into this category which was not surprising since they had been on a 100 percent dry food diet their entire lives and ranged in age from 2 -10 years at the time of the transition to a healthier diet.  It took me several months to convince them that they are carnivores and need meat – and not in a dry, overly processed form that also includes far too many carbohydrates and too little water. It was a little rough, at times, since two of my cats get very crabby with their housemates when they are hungry. These boys were occasionally taken into a separate room during the transition period and fed some dry food because I do not like unrest in my home.

Who?  Me??  Crabby?

Surprisingly, one of my most stubborn dry food addicts is now happily eating a homemade raw or partially baked meat/bones/organs diet that he actually likes better than the canned food.  To be very honest, it does my heart good to see my little carnivores gnawing on meat – eating a diet that was meant for their species.  My cats are now eating a species-appropriate diet consisting of raw or partially baked meats (chicken, turkey, and rabbit), finely ground bones, and organs using a properly balanced recipe.

Some people feed part homemade and part commercial canned for variety and convenience.  However, I prefer to stick to only what I make for them and do not feed any commercial food.

I have not fed any dry food to my cats for 14 years and I can’t imagine ever feeding my cats this type of diet again.  Cats do not need, or benefit from, any dry food in their diet.  They also do not need access to food 24 hours a day although my cats are pretty much free-fed.

Many people who are at work all day worry that their cat will suffer without access to food continuously.  A healthy cat will not perish if she does not have food available at all times.  However, I routinely left canned food out for up to 12 hours at a time for my foster cats and kittens when I was involved in rescue work.  Keep in mind that a cat’s gastrointestinal tract is much different from ours.

If you are worried about leaving canned food out, you can always leave part of the food out at a normal (‘mouse body’) temperature and part of it frozen.  The frozen portion will thaw within a few hours and will add some time to the freshness of the food.  This is also a great trick if you need to be gone for 24 hours or if your pet sitter can only come every 24 hours when you go on vacation.

There is never any reason to revert back to putting out a bowl of dry food since cats should be checked on – including having their litter box cleaned – at least once every 24 hours anyway.  Normally litter boxes should be cleaned at least twice-daily so if they are only going to be cleaned once-daily, you should consider adding another box or two….keeping mind that once there are more than 2-3 ‘items’ in a box, it is dirty and needs to be scooped in order to be fair to your cat(s).

Everyone’s lives are different and there are several ways to successfully feed your cat high quality nutrition.   The goal of this paper is to arm you with knowledge regarding the special dietary needs of your cat so you can make an informed decision on how and what to feed while striking a balance that works for both of you.

Back to top

---

PDF options for this paper:

English:  Short version – 4 pages  (updated November 2013)

English:  Full version – 18 pages  (older writing – August 2010)

 

Spanish (short version) – 7 pages:

La alimentación de su gato: Conozca los fundamentos de nutrición felina

Swedish (short version) – 13 pages:

UTFODRING AV KATT – GRUNDERNA I NÄRINGSLÄRA FÖR KATT

French – 28 pages:

Nourrir votre chat : Connaître les bases de la nutrition féline

Chinese – 15 pages:

貓的飼養：了解基本的貓科營養學

Dutch  (short version) – 4 pages:

Wat geef ik mijn kat te eten: de basisbeginselen van kattenvoeding

Italian (short version) – 5 pages:

Nutrire il vostro gatto: conoscere le basi della nutrizione felina

Italian – 20 pages:

Nutrire il vostro gatto: conoscere le basi della nutrizione felina

Arabic (short version) – 11 pages:

إﺇطﻁعامﻡ قطك: أﺃساسﯿﻴاتﺕ تغذﯾﻳة اﺍلقطط

دﺩ. لﯿﻴزاﺍ مﻡ. بﯿﻴرسونﻥ،٬ طﻁبﯿﻴبة بﯿﻴطرﯾﻳة

Turkish (short version) – 6 pages

Kedinizi Beslemek: Kedigil Beslenmesinin Temellerini Bilin

Russian (short version) – 6 pages

Кормление кошки: основы питания кошек

---

Updated May 2014
Updated November 2016
Lisa A. Pierson, DVM