Search Results for: urinary diseases

Lisa A. Pierson, DVM

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   French translation
   Spanish translation

 

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Lower urinary tract clinical signs

Cystitis

Urethral obstruction/Opie’s story

Urinary tract infection

Urinalysis/Dietary issues

Prescription diets

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Lower Urinary Tract Clinical Signs

Patients may exhibit one more more of these signs:

• Straining to urinate – with and without production of urine
• Frequent trips to the litter box – with and without production of urine
• Crying while urinating
• Excessive licking of the genital area
• Blood in the urine
• Urinating in places other than in the litter box
• Posturing (squatting) in the litter box for a long period of time  (Note that sometimes people think that their cat is constipated when he/she is really showing signs of a lower urinary tract problem.)

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Cystitis

Cystitis, also known as Interstitial Cystitis, refers to inflammation of the bladder wall leading to painful, frequent voiding of small amounts of urine.  This is one reason why clumping (scoopable) litters should be used.  Scoopable litters will enable the feline caregiver to keep track of the size of the urine clumps to see if they are smaller than usual, as well as the number of urine clumps to determine if the cat is urinating more frequently than usual.

Cats with cystitis will often have many small urine balls in the litter box.

If the cystitis is severe enough, there will be blood in the urine but this blood is not readily apparent once the urine is voided into the litter.

Important:  The presence of blood in the urine does *not* necessarily mean that an infection is present.

Cystitis can be a very painful condition!  The patient will often start to associate the litter box with his/her pain.  This can lead to litter box aversion which causes the patient to urinate elsewhere.  In these cases, there may be fewer urine balls in the litter box than usual.

Important:  These cats need pain medication such as buprenorphine (Buprenex).

What causes cystitis?  I wish that the veterinary community knew the answer to that question in all cases.

What we do know is that cystitis often appears to be linked to stress.  The highly concentrated urine that results from being fed a water-depleted (dry food) diet may also be a significant factor in some cats.  The concentration of urine is reflected by the urine specific gravity (USG) number found on the urinalysis report. The higher the number, the more concentrated the urine.

(See the Urinalysis/Dietary Issues section below for information and a video regarding how to obtain a urine sample from your cat for a USG measurement.)

We know that bladders are ‘happier’ with more water flowing through them which helps to flush out debris (mucus, cells, crystals) and keep the urine diluted.  Dilute urine is thought to be less irritating to the bladder wall.  Therefore, we see far more cases of cystitis in dry food-fed cats than in cats eating canned food.

We also know that 99% of cystitis cases in otherwise-healthy patients are *not* due to a bladder infection – contrary to popular belief.  The erroneous belief that cystitis is always secondary to an infection leads to the rampant abuse of antibiotics.

It is very troubling to witness the very common practice of ‘shotgun’ treating these patients with antibiotics when most of these cases are sterile (sterile = no infection) cystitis.

It is also very frustrating to see these poor cats leaving the veterinary clinic with no pain medication!

To repeat:  We know that stress plays an important role in the cause of cystitis.  Can you think of anything more stressful than pain?

See the vicious cycle?  Stress can cause cystitis.  Cystitis is painful.  Pain is very stressful.

Crystals are not thought to be a significant cause of cystitis.  This is another very common misconception among both lay people and veterinarians leading to, in many cases, inappropriate usage of acidifying prescription diets which can potentially lead to calcium oxalate stones and exacerbate the bladder inflammation.

That said, dietary management must be considered on a case-by-case basis and one-size-fits-all recommendations with respect to diet composition cannot be given.  That said, I will give one ‘one-size-DOES-fit-all’ statement and that is “canned food is always better than dry food due to the appropriate water content in canned foods.”

Bladder stones (aka “uroliths” or “cystoliths”) may or may not contribute to cystitis.  However, it is important to examine the urinary tract with radiographs or ultrasound to look for stones.  Due to the expense, some people opt to not radiograph or ultrasound the cat on the first visit but, given how common stones are, I would highly recommend checking for stones even on the first visit.

Radiographs and ultrasound each have their pros and cons with respect to imaging the urinary tract and the accuracy/usefulness of each examination method depends on the quality of the equipment and the skill of the operator.

Radiographs – providing there is not a lot of stool in the colon to obscure the view – may reveal a stone in the urethra, whereas U/S will not show this area.

Ultrasound exams have some benefits over radiographs but it is also very highly dependent on operator skill.  Ultrasound can pick up stones that may not show up on radiographs.

In some complicated cases, both imaging methods are needed to obtain a diagnosis.

Andrew

Treatments for sterile cystitis include:

1. Pain medication;
2. increasing water consumption with a canned food diet, etc.;
3. decrease the patient’s stress – not always easy since cats can be very ‘silent’ in their stress and we may not always be aware of what is bothering them;
4. glucosamine/chondroitin sulfate/hyaluronic acid products such as Cosequin or Trixsyn may help but studies have not supported them as being beneficial. That said, they don’t seem to have any downsides and may be worth a try.

Tricks used to increase water consumption:

1. water fountain;
2. flavored waters such as tuna water, chicken or beef broth, clam juice, lactose-free cat milk (CatSip), etc. – can be kept in covered (to prolong fresh smell and taste) ice cube trays or frozen in uncovered trays and then transferred to ziplock bags;
3. add plain water to canned food – ~1 TBS per meal – or whatever amount your cat likes.

You can make your own tuna water by taking a can of tuna and adding 3 cups of water. Break up the tuna and let it sit for awhile (~15 minutes, give or take) and then pour the tuna water into covered ice cube trays.

3 cups of water fills two 16-cube trays.

After warming the flavored ice cubes to ‘mouse body’ temperature you can:

1. add to canned food or
2. set out as a separate drink of water.

Subcutaneous fluids may also need to be administered at home by the owner in order to increase urine flow.  However, this can be stressful and is usually reserved only for severe cystitis cases involving dry food addicts that are on their way to transitioning to canned food.

To repeat a very important point:  Bladder infections are not a common cause of cystitis.  Sadly, the rampant abuse of antibiotics when addressing feline urinary tract issues in cats shows that this fact is being ignored.  The most important ‘treatments’ are increasing water consumption and lowering stress.

Cats, unlike other species including humans, have a natural defense mechanism in which they produce a more highly concentrated urine. (USG >1.040)  Few self-respecting bacteria want to float around in concentrated cat urine.

Before considering the use of antibiotics in cystitis patients,  a culture and sensitivity (C & S), in addition to a standard urinalysis,  should be run on urine obtained via cystocentesis.  This involves a needle going through the abdominal wall, directly into the bladder. This sounds much worse than it really is.  The patient does not feel the needle going in but, instead, may simply object to being held on his or her back.

Free-catch urine samples (urine voided onto an exam table or into a litter box) should not be used for a C & S due to the issue of contamination which will often give a false positive result.  In other words, bacteria will grow on the culture that may not even be in the patient’s bladder or kidney.

The ‘culture’ part of this test shows if an infection exists or not. The ‘sensitivity’ part of the test is run only if a bacterial colony grows.  This half of the test tells us which antibiotic is the best one to choose for the type of bacteria that was grown.

One difficulty that we run into when trying to get a ‘clean’ sample (via cystocentesis) from a cystitis patient is that most of these patients present with an empty bladder.  Or, they void all of their urine once the veterinarian starts to palpate (feel) the bladder through the abdominal wall.

To get around this, the patient can be given a dose of pain medication and some subcutaneous fluids and placed in a cage without a litter box for 1-3 hours. This should result in the patient’s bladder filling up enough to obtain a sample for a urinalysis and a C & S.

Please ask your vet to put your cat in a cage in the quietest part of the hospital and put a towel over the cage door to decrease stress.

A note about cost:  Many  veterinarians do not run a C & S on their cystitis patients because they are worried about running up a client’s bill.  However, I cannot stress strongly enough that this is often a pay me now or pay me later issue.

I have seen countless cases where both the veterinarian and the client are ‘chasing their tail’ by pouring needless antibiotics into their sterile cystitis patients. This not only results in added expense and stress for the client, but please also consider the added stress to the patient’s mind and body and the significant potential for promoting bacterial resistance.  Most cats are not happy about taking medications and all medications have negative side-effects. 

This “tail chasing” often results in far more cost to the client than would have been incurred if a C & S would have been run when the patient first presented with clinical signs.

There is a joke in veterinary medicine that states:  “Sterile cystitis patients get better in 1 week with antibiotics and in 7 days without antibiotics.”

The good news is that cystitis often resolves within a few days to a week.

The bad news is that it tends to recur – especially in patients that are fed dry food and/or continue to live in a stressful environment.

See below for further discussion of Urinary Tract Infections.

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Urethral Obstruction – Opie’s Story

The urethra is the tube that drains urine from the bladder to the outside.  It can be partially or completely blocked with mucus, stones, inflammatory cells, or crystals.  This is a life-threatening – and very painful – condition which can result in the bladder rupturing within 24 hours of a complete urethral obstruction – leading to death soon after.

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.

Males are much more prone to blocking than females because the male urethra is much longer and more narrow than a female’s.

The following pictorial shows what Opie had to go through when he blocked. It is highly unlikely that he would have had to suffer like this if he had been fed a proper, species-appropriate diet of water-rich canned food instead of dry food.  Opie was found lying in a backyard crying – minutes away from rupturing his bladder due to a urethral obstruction.

A one week stay in the emergency clinic resulted in a $4,000 vet bill.  Another $350 bill was incurred 3 weeks later when Opie had to have a stricture broken down in his urethra.  Catheterization of the delicate urethra can damage the tissues and result in a stricture which will obstruct urine flow.  Repeated catheterizations can set your cat up for serious problems.

Opie’s case is a very good illustration of the fact that proper nutrition (NO dry food) is a ‘pay me now or pay me later’ issue.

Opie was sedated and a catheter was passed up his urethra in order to break up the obstruction before his bladder ruptured.  His bladder was then flushed to try to remove any debris that could cause him to block again.

Is it possible for a cat to block when on a 100% canned food diet?  Yes, it is possible, but it is highly unlikely.  When water is flowing through the bladder, crystals, mucus, and cellular debris will be much less apt to build up and cause an obstruction.

Also, when water is flowing through the bladder, the urine is more dilute which is thought to be less irritating to the bladder wall in some cats.  Less irritation means less inflammatory cells and mucus to block the urethra.

Think of canned food as rinsing out your cat’s bladder many times each day.

A procedure called a perineal urethrostomy (PU) is often performed on blocked cats with the hope of preventing future obstructions.

A PU removes the penis and part of the urethra and leaves the patient very prone to urinary tract infections for the rest of his life.  Also, the surgery site can stricture at a later time.

I strongly believe that this procedure is performed far too early in many cases before a properly hydrated diet is tried.  Please give this procedure a lot of thought before consenting to it.

In December 2012 I consulted with 6 owners of blocked cats over a 10-day period of time. (Yes, this cause of suffering is that common…)  Unfortunately, one was unable to get to a veterinarian in time and his bladder ruptured resulting in a very slow and painful death.

The other 5 cases were being threatened with penis amputation (PU surgery) by the primary care veterinarian.  I am happy to report that, one year later, all cats are doing well – with their penis intact.  They are, of course, eating only a water-rich diet and no dry food.

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Urinary Tract Infection

Urinary tract infections can occur anywhere along the tract from the kidneys to the urethra.  Most infections gain access to the bladder when bacteria travel up the urethra from the outside world.  From the bladder, the infection can ascend to the kidneys.

Please note that when the abbreviation “UTI” is used, the ‘I’ must be defined. Does “I” mean infection?  Or does it mean inflammation?

It is very important to understand the difference if we are to stop overusing antibiotics and start using more pain medications when cats exhibit signs of urinary tract problems.

Studies have shown that otherwise healthy cats (no kidney disease, diabetes, or hyperthyroidism) – that are showing signs of urinary tract discomfort – have only a ~1-2% chance of having a UT infection yet antibiotics are prescribed very frequently for these patients.  The veterinary (as well as human) medical community needs to address this very serious problem involving the overuse/abuse of antibiotics.

Roughly 99% of these otherwise healthy cats have sterile (no infection) cystitis.  This is because the feline is very good at saving water to stay hydrated which results in a very concentrated urine. (Urine Specific Gravity [USG] >1.040)  Concentrated urine is a very hostile environment that does not readily support bacterial growth.  Therefore……

Urinary tract infections are rare in cats without a concurrent disease such as kidney insufficiency, diabetes, or hyperthyroidism.

What about the other population of cats with diseases such as kidney insufficiency, diabetes, or hyperthyroidism?  Cats with chronic kidney disease (CKD) and hyperthyroidism often produce a more dilute urine (USG <1.030) which is a friendlier environment for bacteria.  Unregulated diabetic cats often have glucose (sugar) in their urine which makes a nice culture medium for bacteria.

However, even cats with CKD, hyperthyroidism, or diabetes that are showing signs of lower urinary tract disease have a less than 30% chance of having a urinary tract infection.  (Several studies have been done in this area and the results have varied but all have shown less than 30%.)  This fact illustrates why it is very important to run a culture and sensitivity.

Urine Culture and Sensitivity (C & S)

As described above in the Cystitis section, this is a two-part test that is used to check to see if an infection is present (culture) and what antibiotic(s) would be the most appropriate to use for the strain(s) of bacteria present (sensitivity).

Please note that I emphasized “if” in the previous sentence.  It is very important to confirm that an infection actually exists rather than to subject your cat to the administration of an unnecessary, and potentially dangerous, antibiotic without proof that it is needed and is the correct one.

Culture results are reported over a period of 3 days – at a minimum.  The typical sterile cystitis report will read:

24 hours – no growth

48 hours – no growth

72 hours – no growth

If there is an infection present, the report will read something like “moderate growth of e.coli – sensitivity pending.”  This means that the next report will give your veterinarian important information necessary to pick the best antibiotic for your cat’s infection.

Cultures can be classified in 3 ways:

1) diagnostic – the initial culture before starting antibiotics to confirm that an infection is present and to identify the bacteria, assess the number of bacterial colonies to quantify the level of infection (cfu – colony forming units per milliliter of urine), and to determine the organisms’ susceptibility to various antibiotics

2) therapeutic – performed 3-5 days after starting antibiotics (after a positive diagnostic culture) to assess antibiotic efficacy or it is sometimes performed 3-5 days before cessation of antibiotic administration

3) surveillance – performed 7-14 days after the last antibiotic dose to check for relapse or re-infection

Relapses are defined as recurrences caused by the same species and strain of microorganism that were found in the diagnostic culture within several weeks of stopping antibiotic therapy.

Re-infections are defined as recurrent UT infections caused by a different organism. The only way you can differentiate relapses from re-infections is to compare the results of the initial culture obtained prior to antibiotic usage to those of cultures obtained during and/or after discontinuation of the antibiotic.

Relapses represent a possible antibiotic treatment failure that may have resulted from improper antibiotic choice, dose and duration of therapy, lack of owner or patient compliance, failure of the patient to absorb an orally administered drug, deep-seated infections, failure to identify predisposing factors, or acquired drug resistance.

Re-infections, on the other hand, usually represents failure to recognize and eliminate predisposing factors associated with continuing dysfunction of host defenses, or UT infections caused by procedures such as catheterization or perineal urethrostomy (PU) surgery. Frequent re-infection is an absolute indication to evaluate the patient for anatomic, metabolic, and immunologic disorders that may compromise normal host defenses.

It is important to understand that when a cat has had his penis amputated (PU surgery) a vital barrier to infection has been removed.

For a patient’s first time infection, therapeutic and surveillance cultures are not usually performed due to cost and added stress for the patient.  However, they should be considered in all recurrent UT infection cases, otherwise the veterinarian and owner may find themselves running in circles.

To repeat an important point:  Cats with a urine specific gravity above ~1.040 have a very low chance (~1-2%) of having a urinary tract infection.

Cats with a USG below ~1.030 have a higher chance of having an infection.

If a patient presents with lower urinary tract signs, and has a low urine specific gravity or is a diabetic cat that is spilling sugar in his urine, and if an in-house analysis of the urine indicates that an infection may be present, the patient may be started on a broad spectrum antibiotic pending the C & S result.

If the culture turns up negative, the antibiotic can be discontinued.  Or if the culture comes up positive but shows that the bacteria are resistant to the antibiotic that has been chosen, the correct antibiotic can be started.

At least in these cases, the needless – or wrong – antibiotic will have been given for only 3 days instead of for a much longer period of time.

An important note regarding the long-acting antibiotic called Convenia:

Because this drug stays in the body for a very long time (up to ~60 days) it is one of the newest antibiotics to be terribly overused/abused.  Veterinarians and lay people are seeing it as a quick and easy fix to their problems because they don’t have to give it once or twice daily like with other antibiotics.  It is typically given by injection.  If a second one is administered, it is given again in 2 weeks. However, keep in mind that if an adverse reaction occurs, you cannot retrieve the drug from the body.

Convenia can cause severe anemia, as well as other serious health problems.  (Please see the Convenia – Worth the Risk? webpage on this site.)  There is a report on VIN (Veterinary Information Network) from a general practitioner who dealt with two cats that died within 10 days of receiving Convenia.  They were otherwise healthy cats and had normal red blood cell counts prior to receiving Convenia.  There is no absolute proof that Convenia caused their deaths but there is an extremely high index of suspicion that this drug was the culprit since this class of drugs is known to cause anemia.

I also dealt with case of severe anemia post-Convenia in an otherwise healthy cat.  The emergency clinic was able to save the patient’s life after a 1 week stay in the hospital.  The bill was over $6,000.

Please do not allow this drug to be given if the cat is able to be medicated with a safer antibiotic.

Baytril is another antibiotic that is frequently overused. This drug can cause blindness (very rarely) so I do not take its use lightly.

Clavamox is the most common broad-spectrum antibiotic that is administered to cats.  It causes vomiting and/or diarrhea in some cats but it is one of the safer choices of antibiotics.  It comes in pill or liquid form. I greatly prefer the pills because they are very palatable and can be crushed and added to canned food, or administered in a small piece of a Pill Pocket.

Never use a whole Pill Pocket since they are too large making it far more likely that the cat will bite down on the pill versus swallowing it whole.  I do not like ‘pilling’ cats so if your cat will not eat crushed clavamox tablets in tasty canned food or baby food or in a Pill Pocket, then use the liquid formulation.  (See the Pilling Cats webpage on this site.

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Urinalysis/Dietary Issues

Laboratory analysis of urine (UA) can be done on samples obtained in various ways but you need to be aware that some tests are not accurate on free-catch samples that you have obtained at home.

Due to the delay in testing of the sample (by more than 30 minutes once the urine has been voided), temperature changes, and the lack of sterility of a free-catch sample, interpretation of a urine sample obtained at home can be very misleading.

One example of a test that is accurate is the urine specific gravity.  This is also one of the most important numbers on the UA.  I routinely (3-4x/year) check my cats’ USG from free-catch samples obtained by slipping a flat (versus a deep/narrow) tablespoon under them when they are urinating.

A low USG can be an early indication of kidney insufficiency so I like to monitor any cat over 10 years of age several times each year.

Watch this video for information regarding obtaining free-catch urine samples:

When assessing a patient’s urine concentrating status, it is always much better to take multiple readings so that you can see an average over time – versus relying on just one reading, at one static point in time, from a UA report.  Therefore, some people buy their own refractometer in order to check their cat’s USG at home.  If you do purchase one, make sure that it is labeled for use with urine.  The RHC-200 ATC (automatic temperature compensation) linked here has been sold on eBay for as little as $50.

The RHCN-200 ATC is billed as a “Heavy Duty Version of the RHC-200 ATC and features an easy-to-calibrate knob” versus the need to use a small screwdriver (easily lost or misplaced) for the RHC-200 ATC model.  Either one will be fine because you don’t have to calibrate the unit very often.  In fact, my 36 year old one has only been calibrated a few times in its life but I would suggest that you calibrate yours ~once or twice a year with distilled water which will have a specific gravity of 1.000.  Calibration is very easy.  Just apply a couple of drops of distilled water onto the refractometer window then adjust the refractor line to 1.000 with the screwdriver or the knob.

A urine culture and sensitivity is not accurate from a free-catch sample due to contamination issues.  However, on rare occasions we may run a C & S from a midstream sample that is caught in a sterile container but interpretation must take into consideration the collection method.  If the C & S comes back negative on a free-catch sample, this result is helpful but if it comes back positive, you cannot be sure if the bacteria are from the bladder/kidney or from the very end of the urinary tract or the patient’s hair that surrounds the vulva or penis.

A check for crystals is also not accurate because crystals can form once outside of the bladder in as quickly as 20 – 30 minutes.  This problem of a ‘false positive’ can be an issue with urine obtained from a free-catch sample at home, as well as one obtained via cystocentesis that is sent to an outside lab due to the same time delay.  If your vet wants to accurately assess for crystals, the urine must be looked at ‘in-house’ within 20 – 30 minutes of cystocentesis or the urine being voided.

pH also may not be accurate in urine samples obtained at home.

A cystocentesis is the best method to obtain urine which will yield the most accurate results.

A few definitions, along with comments:

pH:

pH refers to the acidity or alkalinity of, in this case, urine.  pH is often mentioned when discussing diet and crystals but is focused on far too heavily.

While keeping in mind that cats are obligate carnivores (see Feeding Your Cat: Know the Basics of Feline Nutrition), it is important to understand that a meat-based (carnivorous) diet naturally leads to an mildly acidic urine.

Grains, on the other hand, promote a more alkaline urine due to their carbohydrate level as shown by this study.

Due to humans’ focus on profit margin, diets higher in grains (higher in carbohydrates than a cat’s natural diet) have flooded the market – along with pet food manufacturers’ unscrupulous advertising onslaught designed to persuade the feline caregiver to think that feeding a water-depleted, grain-laden dry food diet constitutes optimal nutrition.

Keep in mind: Meat is expensive.  Grains are cheap.

Meat (animal-based protein) promotes a mildly acidic urine which is normal for the cat.

Grains (plant-based protein and high carbohydrate content) promote an alkaline urine.

As mentioned below in the Crystal section, struvite crystals are more apt to form in an alkaline urine and calcium oxalate crystals are more apt to form in an acidic urine.  Many ‘urinary tract’ diets – including some of the prescription diets – overly acidify the diet past what would be normal for a cat eating a species-appropriate diet.  These diets can dissolve struvite stones but will lead to other problems, such as calcium oxalate stones, if they are fed past the therapeutic time frame.

Please understand that we would rarely have to address pH or crystals if cats were fed a water-rich diet.  However, due to the fact that humans insist on feeding cats species-inappropriate, water-depleted diets in the dry form because they are cheaper and more convenient to deal with and because many cats are addicted to them, members of this species continue to suffer with urinary tract issues.

For many years, struvite (magnesium, ammonium, and phosphorus) was the predominant mineral mixture found in cat urine due to the species-inappropriate level of grains in cat food.  Knowing this, humans stepped in and started acidifying commercial cat food with things like dl methionine – instead of cutting into profit margin by removing the grains and going back to meat.

The so-called ‘urinary tract formulas’ were born.

Unfortunately, in trying to ‘fix’ a cat’s unnatural alkaline urinary pH – caused by human greed in the first place – pet food manufacturers created even more problems by adding urinary acidifiers in the form of dl methionine, etc., which led to the formation of calcium oxalate (CaO) crystals/stones in many cats.  Suddenly, there were far more patients suffering with CaO crystals/stones than there were patients with struvite crystals/stones.

One of the most serious problems with this fact is that CaO stones can only be removed with surgery. There is no way to dissolve them with dietary manipulation.  Struvite stones, on the other hand, are more amenable to dissolution with dietary manipulation.

Most stones found in the kidney are CaO and since we cannot dissolve them with dietary manipulation and since surgery to remove kidney stones (versus bladder stones) is not a safe option, it is easy to see how damaging the effects of feeding an acidifying diet can be if used for long periods of time.

Other systemic problems, including kidney damage and low potassium, can be seen in conjunction with the feeding of these acidifying diets, as well.

It is also important to note that diet is not the only factor involved in determining urine pH.  The timing of the cat’s meals is also a factor.  ‘Post-prandial alkaline tide’ refers to the fact that urine pH will become more alkaline after eating a large meal. Therefore, it is suggest that cats eat multiple small meals throughout the day to help keep the pH in a normal range.  Small cats in the wild eat 8-10 small meals per day.

pH can also be affected by certain medications, vomiting, chronic kidney disease, urinary tract infection, diet, stress, and as already discussed, the timing of the last meal.

If humans would just go back to feeding cats a species-appropriate diet – i.e. – one that has a water content that mimics a cat’s normal prey and one that is based on meat, not gains – instead of trying to artificially manipulate a species-inappropriate diet of grains by adding acidifiers, the vast majority of urinary tract problems would be solved.

 

• Crystals are most commonly either calcium oxalate (CaO) or struvite (a mixture of magnesium, ammonium, phosphate).

• Calcium oxalate crystals are more apt to be formed in an acidic environment.

• Struvite crystals are more readily formed in an alkaline environment.

• A small amount of crystals is not an abnormal finding in cat urine and the cat should not be automatically put on a prescription diet such as Hill’s Prescription c/d, etc.

• Crystals are often erroneously diagnosed because they can form once the urine has been removed from the bladder.  Therefore, when urine is sent off to an outside laboratory, or a sample is brought from home, a report of “crystals” is somewhat meaningless since you have no idea if they were actually present within the patient.  This misdiagnosis – and overemphasis of the significance of urinary crystals if they are present in the bladder – leads to the client becoming alarmed and the patient needlessly being put on a low quality – and potentially dangerous – diet such as one of the prescription ‘urinary tract’ diets.

Think of crystals in cat urine like leaves on your driveway.  Both are normal findings.  However, if you never hose (or sweep….during a water shortage :>)) down your driveway, the leaves will build up and then you won’t be able to get your car out of the garage.

If crystals are allowed to build up, the urethra can become blocked leading to a life-threatening situation.  A blocked cat can end up with a ruptured bladder – resulting in death – within 12 -24 hours of complete obstruction.

If there is not enough water flowing through the bladder on a regular basis the following will happen with respect to crystals:

• The urine specific gravity goes up meaning that the urine becomes more concentrated.  When this happens, the crystals are more apt to become ‘super-saturated’ in the urine and form stones.

• Mechanical removal is compromised.  When there is ample water flowing through the bladder the cat will urinate more frequently – voiding up to double the amount of urine per day.  This frequent urination of a higher volume of urine helps to remove the crystals instead of letting them build up to block the urethra.

• If there are large numbers of crystals and the cat also has cystitis (inflammation of the bladder leading to mucus production and cellular debris), the crystals can combine with the mucus and inflammatory cells and make a ‘plug’ that can block the urethra.

Keep in mind that it is very important to have enough large litter boxes with CLEAN clumping (scoopable) litter in accessible places so that your cat is very willing to use them frequently and not ‘hold his urine.’

More frequent voiding of urine will lower the chances of stones being formed and will make the bladder wall less likely to become inflamed.

Litter boxes should always be scooped at least twice daily.

Urine Specific Gravity (USG):

As noted previously on this webpage, USG is a measurement of the concentration of the urine.  It is one of the most important values on the UA report.

USGs should be measured on more than one occasion to check for consistency.  A dilute USG would be around 1.015 (stated “ten fifteen”) or 1.020 (“ten twenty”) and a concentrated urine would be more in the >1.040 range.  A USG between these ranges should be monitored to see if it continues to go lower or starts to rise.

The USG of dry food-fed cats is higher (the urine is more concentrated) than it is for canned food-fed cats.

 

Robbie

Prescription Diets

Please review what I wrote about diet issues at the top of this page in the grey box and also keep in mind what was discussed above regarding the fact that urine crystals are often erroneously diagnosed and the fact that they are NOT necessarily an abnormal finding that needs to be ‘treated’ with a prescription diet.

If you need help beyond the scope of this webpage I am available for phone consultations but please note that many people write to me asking questions that are already addressed on this webpage.

That said, there is a lot of content here and it can be quite confusing.  Therefore, if you want to address it verbally in more detail and also as it pertains to your own cat, you can contact me for a consultation appointment.

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I do not use use ‘prescription’ diets except in rare cases as noted below.  They are expensive and contain low quality, species-inappropriate ingredients, and are not necessary in most cases of feline urinary tract disease.

I only consider the temporary use of Hill’s canned s/d if I know that the patient has urinary tract stones (“uroliths”), or a large amount of crystals – with a high index of suspicion for them being struvite versus calcium oxalate (CaO).

I tend to reach for canned s/d more readily in a male cat than a female. This is because males are much more prone to a urethral obstruction than females due to their long, narrow urethra.

In these cases, I will consider the use of canned s/d (the most acidifying diet on the market) for a short period of time until the patient shows radiographic or ultrasound evidence of stone dissolution/crystal clearance.  This can take as little time as a few days but may take 1-2 months for large stones.

If the stones are not showing any signs of dissolution once the patient has been on the acidifying diet for 2 – 3 weeks, there is a very good chance that the stones are CaO and keeping them on this diet is only going to make matters worse. This  is why it is so important to monitor the patient with radiographs or ultrasound and urinalyses and to not just leave them on s/d.

Remember, CaO will not dissolve with diet manipulation and Hill’s s/d will actually promote the formation of CaO – creating a dangerous situation.  Surgery is the only way to remove CaO stones and if they form in the kidney (more common than the easier-to-access bladder), they cannot be removed without significant risk to the patient.

‘Sludge’ (cellular debris, mucus, proteinacious material, etc.), can be addressed with simply a water-rich diet (canned or homemade diet with added water) to flush it out but it is possible to have small stones hiding in this mixture that could be missed on radiographs or ultrasound and which could result in urethral blockage.

If your cat has a large amount of sludge in his bladder that you are now addressing with diet (s/d or simply canned/homemade food with added water), be sure to watch him carefully for any signs of a urethral blockage. I would not want to leave a cat like this unattended for more than ~12 hours in case he blocked.

Also note that meat-based diets promote an acidic urine (but not overly acidic like Hill’s s/d) and that carbohydrate-based diets promote an alkaline urine.  Keep in mind that carbohydrates have no logical place in the feline diet.

Other prescription diets such as Hill’s c/d, Royal Canin SO, and Purina UR are diets that do not aggressively acidify the urine like Hill’s s/d does.

Therefore, c/d, SO, and UR can be fed for life but I would not recommend it due to their cost and unhealthy ingredients and species-inappropriate composition.

Hill’s s/d, on the other hand, is NOT safe for long-term feeding and should only be used temporarily.

When urinary tract prescription diets were first formulated, they mainly focused on urinary pH manipulation and magnesium restriction.  In recent years, some of the manufacturers such as Purina and Royal Canin have added salt to their diets to encourage higher water consumption in order to dilute the minerals (crystals).  There is controversy surrounding this practice.

Prescription urinary tract diets come in dry and canned forms but after reading this webpage, hopefully the reader will understand just how illogical it is to add salt to a dry food diet to get the cat to drink more water when the cat should be eating a water-rich diet of canned food in the first place.

For dry food addicts, please see Tips for Transitioning Dry Food Addicts to Canned Food. 

As stated in the first section of this webpage, manipulating the pH of urine is not the most important factor in preventing feline urinary tract diseases yet it is so heavily focused on.

I am finding it increasingly frustrating to watch the veterinary community continue to be fixated on the pH of cat urine and the presence of urinary crystals instead of focusing on the much more important issue of dietary water content.

Veterinarians are exhibiting a serious lack critical thought when prescribing a water-depleted diet to any cat but especially one with urinary tract issues, including kidney disease which is very common in cats. 

Instead of reflexively reaching for the prescription diets when patients present with urinary tract issues, I would like to see the emphasis switch to getting the patient off of all dry food and onto a meat-based canned food with added water.

This diet will help maintain a species-appropriate urine pH and will keep the bladder flushed out.

When I say it is illogical to feed “any” cat a diet of dry food, think about practicing preventative nutrition. Do you really want to wait until your cat develops urinary tract problems before you implement the feeding of a water-rich diet to a species with a naturally low thirst drive?

Think about closing the barn door before the horse is running down the roadway.

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Updated: December 2016
Lisa A. Pierson, DVM

Lisa A. Pierson, DVM

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Hyperthyroidism is a very common endocrine disorder of older (usually >10 years of age) cats.  In fact, it is said to be the most common endocrine disorder in cats but judging by the large volume of emails I receive asking for help with feline diabetes management, I would say that it is a toss-up as to which disease is more common.

The catalyst for the writing of this webpage is the recent introduction to the veterinarian-prescribed diet market of Hill’s y/d which is an iodine-deficient diet targeted at feline hyperthyroid patients. 

Please note that Hill’s has made false and misleading statements about this diet that will be addressed below.

What is hyperthyroidism?

What are the signs of hyperthyroidism?

What are the causes of hyperthyroidism?

How is hyperthyroidism diagnosed?

What are the treatment choices of hyperthyroidism?

• radioactive iodine (I-131)

• anti-thyroid medication (methimazole, carbimazole)

• Surgery

• Hill’s y/d – an iodine-deficient canned and dry food

• What does it mean to be an obligate carnivore?

• Would I use y/d?

• Is Hill’s being truthful in their marketing claims?

Comments on hyperthyroidism and chronic kidney disease (CKD)

 

What is hyperthyroidism?

Hyperthyroidism results from an overproduction of thyroid hormones (mainly T4) from a tumor in the thyroid gland.  This tumor, in over 97% of all cases, is a benign (non-cancerous) adenoma.

To repeat, hyperthyroid patients do not have cancer except in very rare (2-3%) cases where a thyroid carcinoma is the cause of the disease.

An elevation in thyroid hormones increases the metabolic rate of the body which puts stress on the heart, kidneys, nervous system, gastrointestinal tract, liver, as well as all other organs of the body.

Think of how hard your car’s engine has to work and how much fuel it uses if you rev up the motor (increase its rpms) by stepping on the gas pedal while in neutral.

This is what is happening inside your hyperthyroid cat’s body.  Every organ system is under the negative influence of an abnormal increase in the body’s metabolism.

In the analogy above, food is your cat’s fuel and it is being used at a faster rate than normal which results in an increased hunger and weight loss.

Hyperthyroidism is eventually fatal if left untreated.

What are the signs of hyperthyroidism?

Since elevated thyroid hormones negatively affect every organ system in the body, the clinical signs are extremely varied but include some or all of the following – with an increased appetite and weight loss being the two most common:

• increased appetite (but sometimes decreased)
• weight loss (fat and muscle) in the face of a good appetite
• increased activity (“acting like a kitten again”)
• increased drinking and urination
• vomiting
• diarrhea
• heart disease – increased heart rate/’pounding’ heartbeat
• increased respiration rate
• hair coat/skin/nail abnormalities
• nighttime yowling/restlessness/confusion/behavior changes
• high blood pressure (hypertension) – Please note that if your cat’s eyes look like big black pools (dilated pupils), this is a sign of possible retinal detachment which can occur secondary to high blood pressure and will result in partial or total blindness.  Not all hyperthyroid cats become hypertensive but is a good idea to have  your veterinarian monitor your cat’s blood pressure.

What are the causes of hyperthyroidism?

I wish we knew the definitive answer to that question.

Possible causes of hyperthyroidism include:

• Iodine levels in cat food – either too low or too high.  Note that this is a very poorly regulated nutrient in cat food with levels varying over a 30-fold range.

• PBDEs – PBDEs are fire retardant chemicals that can be found in high concentrations in some fish and also in house dust.  Since PBDEs are known to affect thyroid function, and cat foods tend to be high in fish, there may be a causal link between hyperthyroidism and fish consumption.  This is one of several reasons why I recommend against feeding fish-based diets to cats.

• Soy in cat food – Soy is a known disruptor of thyroid gland function.  If you have read my Feeding Your Cat:  Know the Basics of Feline Nutrition which outlines what it means to be an obligate carnivore, you will understand that soy has no logical place in cat food.  However, soy will increase the profit margin for pet food companies.  Therefore, it is present in many cat foods – especially those made by Purina.

According to one study, soy was identified in 60% of all tested cat foods at a level high enough to interfere with thyroid function.

• BPA (bisphenol A) – BPA is a known endocrine disrupter that may play a role in the cause of hyperthyroidism.  BPA is found in the coating of the inside of some cans of pet food.  Generally speaking, the smaller (3 ounces and 5.5 ounces) cans will be less apt to contain BPA than the larger (12-13 ounce) cans.

How is hyperthyroidism diagnosed?

Your veterinarian will perform a thorough physical exam including palpating (feeling) both lobes of the thyroid gland which sit in the throat area near the Adam’s Apple.  A normal thyroid gland should not be large enough to feel whereas an adenomatous thyroid gland will usually be large enough to palpate.

Next, a full blood panel, cbc (complete blood cell count), and urinalysis will be performed to look for any disease process(es) that could explain any of the clinical signs that your cat is exhibiting.

It is important that the blood panel include a total T4 level since this is the most important value to look at when assessing thyroid gland health.  The panel that your vet chooses may also include a free T4 which is also useful in diagnosing some hyperthyroid patients but is not as clearly interpreted as total T4.  Free T4 can be falsely elevated for various reasons.

The panel that I choose to use for my patients includes both total T4 and free T4 but panels vary from lab to lab.

Thyroid scintigraphy (thyroid scan) is considered the ‘gold standard’ for diagnosing mild hyperthyroidism but it is not readily available to most people.  However, as noted below, the best treatment for hyperthyroidism is radioactive iodine and, if available, you should choose a facility that performs thyroid scintigraphy to characterize the size, shape, and location of the abnormal tissue in order to gain more knowledge of the disease severity and to also aid in selecting the proper dosage of I-131.

What are the treatment options for hyperthyroidism?

In the sections below, you will see links to Insights into Veterinary Endocrinologywritten by Dr. Mark Peterson, DVM, DACVIM.  Dr. Peterson is a world renowned expert in feline hyperthyroidism and was the first veterinarian to recognize this condition in the early 1970s.  He has treated over 10,000 hyperthyroid cats in the past 30 + years and has lectured countless times to veterinarians from all over the world regarding topics in endocrinology.

Dr. Peterson and I have collaborated recently regarding the new Hill’s diet, y/d, and on other general nutrition issues.  In combining our individual strengths (Dr. Peterson’s background in endocrinology and mine in nutrition), Dr. Peterson has written several very informative blog entries.

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There are 4 treatment options for hyperthyroidism:

• radioactive iodine (I-131) – the ‘gold standard‘
• anti-thyroid medication (e.g. methimazole)
• surgery
• Hill’s y/d (a diet deficient in iodine – canned and dry)

Note that only radioactive iodine and surgery address the underlying cause of the disease which is a tumor.

Anti-thyroid medication and an iodine-deficient diet do not address the tumor which will continue to grow. 

Therefore, representatives from Hill’s are making a false statement when they claim that y/d “restores thyroid health.”

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Radioactive iodine – 131 (I-131)

Radioactive iodine is the treatment of choice for hyperthyroidism in nearly all cases. This treatment involves an injection of a very small dose of radioactive iodine that is placed just under the skin.  Because the thyroid gland heavily concentrates iodine, the thyroid tumor will be selectively destroyed.

In addition to the thyroid tumor being targeted, any other ectopic (found somewhere other than its normal location) overactive thyroid tissue will also be destroyed. This ectopic tissue is often located in the chest cavity but will show up on a thyroid scan as discussed below.

A small risk (~5%) of hypothyroidism (the opposite of hyperthyroidism) exists if too much normal tissue is also destroyed.  These cats will need to receive thyroxine supplementation temporarily or for life.

On the flip side, a small number of cats (~5%) remain hyperthyroid (and require a second treatment) if not enough of the adenoma is destroyed or if the patient actually has a carcinoma (cancer) instead of a benign adenoma.  In the case of a carcinoma, a much higher dosage of I-131 is needed to effectively treat the disease.

As noted above, a thyroid scan (scintigraphy) helps the clinician determine the size, shape, and location of the abnormal tissue which helps determine the proper dosage of I-131 to ensure the best possible outcome.

Without a scan, the dosage will only be a guess.

Other treatments are discussed below but I can say without hesitation that if any of my own deeply-loved cats ever ended up with hyperthyroidism, this would be the only treatment that I would consider.

Update:  6 months after I wrote the statement above, my Andy had a slight-to-moderate rise in his T4 and was showing clinical signs of hyperthyroidism – weight loss and agitation/restlessness – especially at night.  I took him to our local imaging clinic and had him scanned. Right arrow = normal; Left arrow = thyroid adenoma.

Andy was admitted to the clinic on Sunday.  He was scanned that day and received his I-131 injection on Monday.  He was able to come home on Thursday.

Was he miserable? Yep. Was I stressed and anxious?  You bet.  But now I have my Andy back.  He has gained 1.5 lbs and, at 16 years of age, is doing great.

Many people worry about the hospital stay and the stress that it will cause for the cat.  Yes, it is stressful but the benefits far outweigh the difficult few days and it sure beats having to give a pill (methimazole) twice daily, for the rest of the cat’s life, which is a medication that can have significant side effects and does not address the tumor.  More on this drug below.

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Anti-thyroid medication:

methimazole (Tapazole and Felimazole)

carbimazole is a newer drug that is rarely used and not readily available in the United States.

These drugs are known as ‘anti-thyroid’ medications since they interfere with the thyroid gland’s production of  thyroid hormones.

I will say at the outset of this section on anti-thyroid drugs that I am not a fan of putting any chemical into my own body, or that of my own cats or patients.  For every positive action that a drug exerts on a living being, there are plenty of side effects that are very often overlooked by the doctors prescribing the medications.

There are many cats that do well on these drugs but side effects are not uncommon and include nausea, vomiting, and severe allergic/itchy facial skin reactions and, less frequently, life-threatening liver dysfunction, bone marrow disease, and bleeding problems.

While these drugs effectively lower the thyroid hormones and ameliorate the clinical signs of hyperthyroidism, they do not address the underlying tumor and, therefore, the tumor will continue to grow with the risk that it will become a malignant cancer over time.

As the tumor continues to grow, the dosage will often need to be raised which means that the patient must be monitored with periodic blood tests for life.  The frequency will depend on the patient but as we all know, trips to the veterinarian are expensive and very stressful for the patient.

Other health factors may necessitate lowering the dosage.  Therefore, lab monitoring is very important for these patients.

If methimazole is chosen over I-131, I strongly prefer the transdermal preparation which is a cream that is applied to the ear.  This formulation results in less gastrointestinal (vomiting/diarrhea) side effects when compared to the pill form.

Plus, it is a much more humane and less stressful way to administer the medication.

If the pill form is used, please see my Pilling Cats article and never, ever ‘dry pill’ any medication for any cat or dog. All pills or capsules need to be ‘chased’ with food or at least 4 mls of water via a syringe.

Or, better yet, use Pill Pockets as discussed on the Pilling Cats page.

At first glance, I-131 may appear to be a more expensive treatment but in many cases it turns out to be less expensive when compared to lifelong treatment with methimazole when the cost of the medication and the continued monitoring are considered.

Also, the hassle of twice-daily medication must be considered.

In the end, however, I-131 is closer to being a true cure for this disease than methimazole since it addresses the underlying tumor.

Note that if your cat has been on methimazole and you now want to have him treated with I-131, you may have to withdraw the methimazole for ~1-2 weeks prior to I-131 treatment.

For more information on these drugs, please see Dr. Mark Peterson’s discussion here.

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Surgery

Surgery to remove the thyroid adenoma has fallen out of favor since I-131 became available.  This is true for several reasons:

1)  It is impossible to differentiate normal tissue from tumor tissue.  If both lobes of the gland are involved and removed, this will result in hypothyroidism necessitating lifelong treatment with thyroxine.

2) The parathyroid gland which sits right next to the thyroid gland can be damaged or accidentally removed. The parathyroid gland is critical for calcium balance in the body and if damaged or removed, serious complications, including death, can result.

3)  General anesthesia is necessary which is always a risk but even more so in an older patient with hyperthyroidism considering how many organs are negatively affected by this disease.  Severe heart disease can be present in these patients especially if they have been hyperthyroid for a long time.  Any level of heart disease will increase the risk associated with anesthesia.  For this reason, if surgery is the treatment of choice, it is recommended to stabilize the patient with anti-thyroid medication prior to the surgery.

4) Some hyperthyroid cats have ectopic (not in the normal location) thyroid adenoma or carcinoma tissue located in the chest cavity which the surgeon will not be able to remove.  Plus, the surgeon will not even be aware of its presence unless a thyroid scan was performed.

See here for a more comprehensive chart comparing the pros and cons of each of the 3 treatments discussed above.

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Hill’s y/d

This iodine-deficient diet is the newest addition to the Hill’s ‘alphabet prescription diet’ product line and it is targeted at the feline hyperthyroid patient.  As stated above, representatives of the Hill’s company have made false and misleading statements about this diet that will be addressed below.

y/d is formulated to be deficient in iodine with the simple goal of providing less ‘building material’ for the patient’s thyroid tumor and normal glandular tissue to make thyroid hormones (T3 and T4). Iodine is an important component of these hormones withT3 needing 3 iodine atoms and T4 containing 4 iodine atoms.

The premise of this diet is simply to starve the thyroid gland of iodine but here is where the issue of ‘tunnel vision’ nutrition comes into play.

While starving the thyroid gland of iodine, the entire body – including the thyroid gland itself – is also negatively affected by this deficiency.

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If anybody reading this has not read at least the first part of my Feeding Your Cat: Know the Basics of Feline Nutrition article, I will briefly summarize it here because, before reading my comments about y/d, it is important to understand what constitutes a healthy diet for a cat.

In a nutshell, the cat is an obligate carnivore which means:

• They are designed by nature to get their protein from other animals (meat), not plants (grains/potatoes/other vegetables).

• They lack the enzymes necessary to efficiently process carbohydrates.

• They have a low thirst drive and are designed to get their water with their food.  This means that there is no dry food that is suitable to feed to a cat. 

Their normal prey is ~70% water and in times of drought, they could actually survive on the moisture in their prey.  Canned foods are ~78% water and dry foods are only ~8-10% water.

Several studies have shown that the water intake and urine output of cats fed canned food are double that of dry food-fed cats. This is taking into consideration all sources of water from the food and the water bowl.

Please understand that a cat on a dry food diet will drink much more water from a bowl than a canned food-fed cat but he will not make up the deficit caused by the feeding of a water-depleted diet of dry food.

Considering that water is one of the most important nutrients for every living creature, it is easy to understand why it is much more physiologically sound to feed canned food diets to cats rather than dry food.

See Urinary Tract Health for some graphic pictures of what happens to cats like Opie when fed a water-depleted diet.

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Summary statement regarding y/d:

I would only use this diet if:

• I-131 was not available or the client could not afford the treatment, or
• the patient was not a good candidate for surgery, or
• the patient had shown an intolerance to transdermal methimazole.

In other words, I see y/d as a last resort and certainly not a first-line treatment.

Why?

Because:

• y/d leaves the whole body in a state of iodine deficiency.  This is an excellent example of tunnel vision nutrition – i.e.- only paying attention to the thyroid gland, in this case, and not the rest of the body.  Safety studies have not been conducted to assess the long-term damage to the body when left in an iodine-deficient state.

Most of our knowledge of iodine centers around the thyroid gland but there is strong evidence pointing to iodine as playing an important role in immune health, adrenal function, breast health, and also having antioxidant properties.

• y/d does not address the disease process (tumor) that is causing the hyperthyroidism and the tumor will continue to grow.  Therefore, it does not “restore thyroid health” as claimed by Hill’s.

The longer the tumor is allowed to grow, the higher the chance of it becoming a malignant carcinoma.

• y/d is too low in protein for many cats especially considering the muscle-wasting state that hyperthyroid cats are already in. (See Dr. Peterson’s article here.)

• y/d is too high in carbohydrates. (See Diabetes)  Note that many hyperthyroid cats have sub-clinical diabetes.  Feeding them a high carbohydrate diet could very well tip them over the edge into overt diabetes.

canned y/d: 24% carbohydrate calories

dry y/d: 23% carbohydrate calories

mouse: 1-2% carbohydrate calories

• dry y/d has an extremely unhealthy ingredient list for an obligate carnivore and it is water-depleted. (See Urinary Tract Health.)

Corn Gluten Meal, Animal Fat (preserved with mixed tocopherols and citric acid), Whole Grain Corn, Soybean Mill Run, Dried Egg Product, L-Lysine, Chicken Liver Flavor,…..

Please read the above ingredient list with your cat’s obligate carnivore status in mind.  Also understand that your hyperthyroid cat needs a high amount of high quality protein since the disease is causing his body to ‘eat’ (catabolize) his own muscle mass.

Corn is not a “high quality” protein for a carnivore.

I would never feed a diet like dry y/d to any cat in my care.  It is a more appropriate diet for a horse or a cow to be eating.  Please note that there is no meat in this food.  The only animal-based protein is the dried egg product which is lower on the list than even the fiber source so there is next-to-nothing in the way of animal protein in this diet.

• y/d canned has a better ingredient list than the dry and is at least a properly hydrated diet but note that liver is the first ingredient after water.  Liver is high in vitamin A and a diet of predominantly liver does not represent a species-appropriate balance of nutrients. However, note that liver is cheap and provides a higher profit margin for the company.

Water, Liver, Meat by-products, Chicken, Whole Grain Corn, Rice Flour, Chicken Fat (preserved with mixed tocopherols and citric acid), Chicken Liver Flavor, Powdered Cellulose,…..

See Dr. Peterson’s article: Is Hill’s y/d a Nutritious Diet for Hyperthyroid Cats?

If you choose to feed this diet, please feed the canned version and not the dry.

• The patient cannot be allowed to eat any other food which means no treats of any kind.  He must eat only y/d which can pose a problem in multiple-cat households or if he suddenly stops eating the food.

• This diet cannot be fed to non-hyperthyroid cats.  Hill’s states that it can be fed to normal cats if these cats are also fed some regular food.  However, I would not subject your healthy cat to this diet with the hope that you feed enough food from another source to meet his iodine needs – especially in light of the fact that there are diets on the market that are very low in iodine – too low to furnish enough iodine to make up for the bulk of the diet being iodine-deficient.

In my strong opinion, Hill’s is being very irresponsible when making the recommendation to:  “supplement (y/d) with 1 tablespoon of regular cat food (dry or canned) each day to provide additional iodine”.  Given the wide range of iodine in commercial cat food, this recommendation will not ensure adequate iodine in every healthy cat that may be subjected to y/d as the bulk of their diet.

• There is compelling scientific evidence to show that feeding an iodine-deficient diet can actually make the hyperthyroid patient worse over time.

When there is not enough iodine in the body, thyroid hormones decrease. This signals the pituitary gland to secrete TSH (thyroid stimulating hormone).  TSH’s action on the thyroid gland causes it to grow larger (hypertrophy/goiter).

Thyroid Response to Low Intake of Iodine:

• Deficient dietary iodine intake causes the thyroid gland to make less T4
• Plasma T4 levels drop
• This results in increased TSH release from the pituitary gland
• leading to increased iodide trapping in the thyroid gland to maintain T3 secretion
• resulting in thyroid hypertrophy due to increased TSH release = GOITER

If you are interested in learning more about the biochemistry of iodine deficiency and thyroid disease, see Dr. Peterson’s article:  Does Iodine Deficiency Cause Thyroid Disease in Cats?

Reminder: y/d is an iodine-deficient diet.

Here is an excerpt from Dr. Peterson’s article:

So, based on the trend to lower iodine levels in cat food over the last two decades, could iodine deficiency be contributing to the explosion in hyperthyroid cases that we are seeing today?

In support of that reasoning, a recent case-control study reported that cats consuming commercial foods which were relatively deficient in iodine were more than 4 times as likely to develop hyperthyroidism compared with cats that ate iodine-supplemented foods.”

…and another excerpt from Dr. Peterson’s article under the heading:

 Could y/d make this situation worse?

…..will lowering T4 and T3 secretion in these hyperthyroid cats lead to increases in circulating TSH and continued stimulation of thyroid growth and proliferation in some cats? Will this TSH stimulation cause transformation of benign adenomatous thyroid tissue to carcinoma, as has been documented to occur in some hyperthyroid cats?

The short answer is this: we simply do not know. The long-term safety studies needed to answer this question have not yet been done.

Because Hill’s y/d is not a drug (although it’s certainly being marketed as a replacement for methimazole), the company is not required to do the these safety studies, and it’s fairly clear that they have no intension of paying to have them done.”

Also note this excerpt from an article that appeared in the Journal of Feline Medicine and Surgery (2010) entitled Feline Hyperthyroidism: Potential relationship with iodine supplement requirements of commercial cat foods:

Feline hyperthyroidism resembles toxic nodular goiter (TNG) of humans with discrete foci of benign adenomatous hyperplasia.  The etiology of TNG includes iodine deficiency and consumption of or exposure to goitrogens in food, water, and the environment.”

The article goes on to discuss evidence that the current NRC dietary minimum iodine requirement of 1.4 ppm may be too low and may be contributing to feline hyperthyroidism.

Note that y/d is a very iodine-deficient diet at 0.2 ppm (range 0.1 – 0.3 ppm) and we know that iodine-deficient diets cause goiter.

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Is Hill’s being truthful in their marketing claims?  Are they considering what is best for your hyperthyroid cat?

You be the judge.

• Hill’s states that this diet “restores thyroid health”.  After reading the information above, I hope that you can see that this is a blatantly false statement.

Hyperthyroidism is caused by a benign thyroid gland tumor.  Feeding a diet that is deficient in iodine is not halting the growth of the tumor. 

In addition, it has been common knowledge for many years that diets deficient in iodine cause goiter (thyroid gland enlargement).

The tumor will keep growing unless addressed with I-131 or surgery. This continued growth will only enhance the chances of the benign tumor becoming cancerous.

Therefore, it should be very clear that this diet does not “restore thyroid health.”

• Hill’s is calling this an “iodine-restricted” diet and claiming that it is “not iodine-deficient” which is in direct contradiction to their own study as well as studies of other researchers who have investigated the dietary iodine needs of the cat.

To illustrate why their statement is false:

There are studies showing that the minimum iodine requirement in cat food should be 1.4 ppm. In fact, the current NRC requirement states a minimum of 1.4 ppm.

A Hill’s study using a corn-based diet stated that the minimum iodine requirement was 0.46 ppm.

y/d is 0.2 ppm (range 0.1 – 0.3 ppm)

How can Hill’s perform a study coming up with 0.46 ppm as a minimum requirement and then state that a diet with less than half that amount is “not iodine-deficient”?

Here is what Dr. Mark Peterson has to say about this issue in his blog entry entitled Treating Hyperthyroid Cats with an Iodine Deficient Diet (Hill’s y/d): Does It Really Work?

“Hill’s y/d is clearly an iodine deficient diet, containing levels of approximately 0.2 mg/kg (0.2 ppm) on a dry matter basis, well below the minimum daily requirement for adult cats (0.46 mg/kg or 0.46 ppm) of food. It’s important to note that the study that established this minimum daily requirement for cats was done by investigators funded by Hill’s Pet Nutrition. So, claims that this is just a low iodine diet, but not one deficient in iodine is nonsense, unless one does not believe the results of that study.”

An important issue regarding the Hill’s iodine study is that they fed the test cats a corn-based diet.  No nutrient is an island unto itself.  All nutrients are influenced by other nutrients in the diet.  Therefore, it only makes sense to feed a cat a species-appropriate diet (which corn is not) when trying to figure out the optimal level of any nutrient in the diet.

Since Hill’s is known for manufacturing feline diets with high levels of species-inappropriate ingredients to enhance their profit margin, it was not the least bit surprising to learn that their iodine study involved feeding cats a corn-based diet.

Did this skew the results?  We have no way of knowing but, again, if you are going to conduct any nutrient study, common sense dictates that you at least feed the test subjects a species-appropriate diet which, in this case, would be meat – not corn.

• This statement is appearing in our veterinary journals:

“Managing hyperthyroidism is now as easy as feeding your cat,” says Dru Forrester, DVM, MS, Dipl. ACVIM, director of Scientific & Technical Communication for Hill’s Pet Nutrition.

This irresponsible and misleading marketing is going result in far fewer cats receiving the gold standard treatment of I-131.

It is natural for all of us to want to take the easy (and cheaper) way out and this inherent desire is exactly what the Hill’s marketing team is focusing on as is evident by Dr. Forrester’s statement above.  However, ‘easy’ is not always ‘healthy.’

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Comments on treating hyperthyroid patients that also have CKD (chronic kidney disease):

Since hyperthyroidism and kidney disease are common problems in older cats, it should come as no surprise that many hyperthyroid patients also have concurrent kidney disease.  It is estimated that 30-35% of all hyperthyroid cats also have some level of kidney disease.

However, the increased metabolic rate of the hyperthyroid patient can make the kidneys looking better ‘on paper.’  This is because  an elevated metabolic rate causes an increase in blood flow/increase in pressure through the kidney which makes it filter out waste products (e.g., BUN and creatinine) more efficiently.

When the patient’s T4 level is returned to normal – regardless of treatment choice – underlying kidney disease may be unmasked.

It is very important to understand that treating the hyperthyroid state did not cause kidney disease.

In addition to the increased blood flow making the patient’s lab values look better than they might end up being post-treatment for hyperthyroidism, hyperthyroid cats have less muscle mass than healthy cats and since creatinine comes from internal muscle breakdown (a normal daily occurrence), a skinny kitty is going to generate less creatinine – making his kidneys look better than they really are.

Once the treated hyperthyroid cat starts to regain his muscle mass, the creatinine value may rise – leading the clinician to erroneously assume that the kidneys have worsened.

Again, the underlying kidney disease is being masked by the hyperthyroidism but it is critical to understand that treating a cat for hyperthyroidism does not actually cause kidney disease.

Quite the contrary.

Recent research has shown that the negative effects (including the increase in blood pressure at the kidney level) of an increased metabolic rate may very well contribute to the development and progression of kidney disease in the untreated hyperthyroid cat.

While it may be tempting to leave a hyperthyroid cat either untreated or undertreated with very low levels of anti-thyroid medication, this can have a negative effect on kidney health, as well as heart health.

Many veterinarians shy away from I-131 or surgery versus anti-thyroid medication and Hill’s y/d because the first two are permanent and the last two are temporary. Their argument is that the medication dosage can be lowered or discontinued and the diet can be changed if they don’t like how the kidney values look once the T4 is lowered to the normal range.

But the idea of lowering the dosage of an anti-thyroid medication or altering the diet to let the patient ‘run hot’ so that the kidneys look better is not without its very unhealthy consequences.

Remember that hyperthyroidism is revving up your cat’s ‘engine’ (metabolic rate) damaging the entire body, including the kidneys.

The heart is another vital organ that suffers with this disease since it is basically wearing itself out by its increased rate of pumping.

I try very hard not to fall into the trap of ‘tunnel vision’ medicine.  I focus on the whole body and, for that reason, I will repeat this statement:

I-131 is the only choice I will consider for my own cats.

If the I-131 unmasked kidney disease that was not apparent when their metabolic engine was in high gear, I would just deal with the CKD as needed.

Some readers may be familiar with a ‘methimazole (Tapazole) trial’ whereby the patient is put on this anti-thyroid medication to return the patient’s T4 level back to normal which often happens within 2-4 weeks.  Once the T4 level is back to normal, the kidney values (BUN, creatinine, etc.) are assessed.

This trial is basically showing us what the kidney values will most likely be after effective I-131 treatment but in a reversible manner.

Even though this is definitely not the protocol that I would follow for my own cats – since I am going to treat their hyperthyroidism with I-131 no matter what their kidney values are – I do offer it as an option for my clients so that there are no surprises regarding kidney function after the I-131 treatment.

It is important for some clients to know what the kidney values may be after the T4 returns to a normal level but most of them forego the methimazole trial and go right to I-131 when hearing that this is how I treat my own cats.

I have never heard any client express regret for skipping the trial.

Note that the experts in this field who I have spoken with have recently tended toward slightly lower doses of I-131 for cats with significant kidney disease so that the T4 is more likely to end up in the upper part of the desired range versus the lower part. Therefore, please discuss the issue of dosage with the doctor administering the I-131 to your cat.

It must be understood that it is impossible to know the exact dosage that will result in your cat’s T4 ending up in the higher end of the desired range versus the lower end.  Therefore, there is always a chance that a lower dosage of I-131 may not be enough to cure the hyperthyroidism and your cat’s T4 will still be too high.  In these cases, the treatment will need to be repeated at additional expense.

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September 2012
Updated October 2014
Updated November 2016
Lisa A. Pierson, DVM

Lisa A. Pierson, DVM

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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

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September 2011
Reviewed November 2016
 Lisa A. Pierson, DVM

Lisa A. Pierson, DVM

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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

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French translation

To the best of my knowledge, this webpage is the only source of information for striking a balance between cooked and raw homemade cat/kitten food.  Every other source focuses on either 100% cooked or 100% raw with individual proponents vehemently arguing which is better/safer.

(A short note regarding dogs can be found at the bottom of this webpage.  Also, please consider purchasing Feeding Miss Lilly by my colleague, Dr. Christine King.  Dr. King is a fabulous writer and her book is a very enjoyable and easy-to-read essay discussing how she feeds her own beloved dog and why.)

As this webpage explains (see Safety), there is a logical way to compromise between the two which will result in a diet that is safer and healthier than any dry food, and is safer than some sources of raw ingredients – especially those that come from a supermarket and have spent time in a refrigerator versus a freezer.

It is my strong preference to feed a diet that is a safe balance between raw and cooked as described below.  This is why I ask my clients/readers to use the word “homemade” as opposed to “raw” when discussing the diet described on this  page.

Note that dry kibble is very often contaminated with bacteria, fungal mycotoxins, insects and their feces, as well as being high in carbohydrates and plant-based (vs animal-based) proteins.

And, more importantly, all dry foods are dangerously low in water which wreaks havoc on your cat’s urinary tract and puts him at great risk for life-threatening and excruciatingly painful urethral obstructions and possibly cystitis.  (See Urinary Tract Diseases – Opie’s Story.)

If you are firmly opposed to feeding any part of the diet in a raw form – even after reading the Safety section below – you can contact me to set up an appointment for a phone consultation to discuss formulating and preparing a diet that uses cooked ingredients.

For a comment about feeding cats with chronic kidney disease (CKD), please see this note below.

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Table of Contents

You will notice that several statements are repeated in various sections linked below.  This is because I am assuming that many people will not read the entire webpage.

UPDATE:  Sadly, as of April 2017, wholefoods4pets.com is no longer selling rabbit.  Please disregard any recommendation below to source rabbit from this producer.  Hare Today, Gone Tomorrow on the east coast is the only recommendation that I have at this time but the shipping costs will be extremely high for people on the west coast.

Important comments

Introduction

Raw versus cooked

Cost

Poultry

Rabbit

Grinder

Before you dive in

Making cat food – quick summary

With bones or without bones; how much bone

Constipation

Meat types and sources

Ingredients

Recipe

Making the food – VIDEO

Canning the food

Dental Health

Safety issues

Commercial pet food contamination – especially dry food

Pet food recalls

Dogs

Conclusion

Important Comments

I frequently see people jump into making cat food without doing their homework and without any thought as to using a balanced recipe.  This is what gives veterinarians – including myself – a very good reason for recommending against homemade diets.

I recently came across a post within an internet group stating how “wonderful” my Making Cat Food page is – including the recipe provided below.  However, the poster then went on to outline what she was feeding to her cat which was not even close to the recipe discussed on this webpage!  This poor cat was being fed a terribly UNbalanced diet because his owner was using her own ‘creation’ based very loosely on the recipe below.

She had completely missed the boat on this very critical issue and was harming her cat.

If you are not going to follow a balanced recipe, then please feed a balanced, commercial canned food diet.  Please see Feeding Your Cat:  Know the Basics of Feline Nutrition for reasons why dry food is not a healthy diet for any cat.

Making cat food:  Do it and do it right, or don’t do it at all.  It is not difficult to make cat food but do your homework first and do not get ‘creative’ and start adding/omitting ingredients to/from a balanced recipe.

Introduction

After spending a great deal of time reading and learning about the way commercial pet foods are processed, and the ingredients that go into many of these foods, I decided to start making my own cat food.  I found that I was getting more and more frustrated with the species-inappropriate and low quality ingredients found in most commercial foods so this was a very easy decision for me to make.

Also, the 2007 Menu pet food tragedy that resulted in the deaths and severely compromised health of many cats and dogs left me with an even deeper desire to have as much control as possible over what goes into my cats’ food bowls.  I don’t ever want to go through what those people went through when they lost their beloved pets due to human greed and deception.  I remember feeling a great sense of relief knowing that my cats were eating a diet that I had personally sourced and prepared for them – and that feeling continues.  I don’t see myself ever going back to feeding commercial cat food after having fed a 100% homemade diet since 2003.

My cats are very special to me and I feel it is important for them to eat a diet that is equal in nutritional quality to what I would put on my own dinner plate.  I spend a few hours in the kitchen every ~ 12 – 16 weeks making a batch of food that is then frozen. This is a small amount of time out of my schedule given the rewards.

I have been using the recipe below since early 2003 and I could not be happier with my cats’ health and energy level and – again – my control over their diet.

If you decide that making cat food is not for you, then please at least feed canned food and no dry food.

Raw vs Cooked

This subject is one of considerable debate among two – usually strongly divided – mindsets.

The anti-raw folks are afraid of bacteria and parasites.

The pro-raw feeders are afraid of nutrient loss from cooking/processing.

However, it is not necessary to have such an ‘all or nothing’ viewpoint and our cats will benefit if people approach this issue with more critical thought and compromise.

Unfortunately, often neither group considers how the meat is sourced and prepared and they fail to see that one can strike a balance between the two issues.

Our goal is to feed a diet that nature intended for our carnivores – staying as close as possible to the form and nutritional composition that our cats would eat in a natural setting – while implementing safety strategies as discussed below.

I am not as smart as nature.  No human is – even board-certified veterinary nutritionists.  None of us know exactly which nutrients and in what amounts are destroyed/damaged with the cooking process.

Because of this fact, I choose to ‘split the difference’ between semi-cooked and 100% raw depending on the source of the meat.

I feed meat from two sources:

• rabbit obtained directly from a rabbit producer (wholefoods4pets.com) – fed 100% raw – April 2017 UPDATE – Rabbit is no longer available from this company.  Hare Today, Gone Tomorrow on the east coast is an option.

• chicken and turkey whole thighs (never pre-ground) from the supermarket – fed partially baked to kill surface bacteria

With regard to parasites, commercially raised meat (either from the grocery store or producer) is much less apt to be infected with parasites when compared to wild game.

However, meat from a grocery store can be higher in bacteria than meat from a fresh kill in the wild or meat purchased directly from the producer.

But having said that, when considering the issue of bacteria, I am reminded of the mountain lion that ate off of a deer carcass in my brother’s backyard for one week in northern California (not a very cold location…therefore, more bacterial growth).  The mountain lion was dining on meat that was a week old in the ambient temperature (not refrigerated) and did just fine.

For the first ~7 years of feeding a homemade diet, I purchased chicken or turkey thighs and simply rinsed them very well with water before grinding them.  However, I have since decided to increase the safety of the diet and I now partially baking whole thighs to kill the surface bacteria.

This partial baking makes the diet much safer than dry food.

The main reasons for the switch were:

• I wanted to be able to leave the food out longer.

• I was tired of calling my butcher to see when the poultry thighs were going to be delivered so that I could source them as fresh as possible.  Now, I just purchase the thighs when it is convenient for me.

The chicken or turkey cat food that I make usually ends up being ~25 – 50% cooked and ~50 – 75% raw but you should aim for at least a 10-20% surface cook.

The rabbit that I source directly from the producer is fed raw because it is frozen as soon as it is processed and arrives on my doorstep frozen.  It is never in a refrigerated state.  Refrigeration slows bacterial growth but does not halt it.

For more details, please see my safety section below.

It is up to the reader to work within their comfort zone when deciding whether to go forward with this type of diet, or not.  Most things in life do have some risk associated with them but most people think that commercial diets are completely without risk and this could not be further from the truth.

With the critical thought that I put into my cats’ diet with regard to sourcing and preparation, I would confidently submit their diet to a ‘safety contest’ with any dry food on the market.

Dry food (aka “kibble”), in addition to containing potentially deadly fungal toxins, contains a great deal of bacteria.

If you would like to read more comments regarding pet food recalls and the issues with commercial pet food contamination – especially dry food – see below.

Fortunately, our cats’ intestinal tract is designed to handle a much higher bacteria load than that of a human, but if one is worried about the bacteria in raw meat, then the bacteria in dry food also needs to be taken into consideration because dry food is very far from bacteria-free.

Cost

The cost of a homemade diet is extremely variable and takes into consideration:

• the type of meat being used (chicken is a lot cheaper than rabbit),

• where it is sourced (Whole Foods Market is going to be more expensive than a local farm), and

• their cat’s appetite/caloric needs.

The cost of the supplements may seem high when first purchasing them but when averaged over time, the expense is minimal.

A reader of this webpage contacted me regarding a coupon program at iherb.com (which is where I buy my supplements) that allows for $5 off your first purchase if you enter the following code:  LIS675 or just click on this link which will take you to the main webpage where the discount will be automatically applied.

See the Recipe section below for links to specific ingredients that I order from iherb.com.

The links are affiliate links which sends a bit of money my way when they are used.  I then pass the funds on to charity – specifically, cat rescue efforts focusing on spaying and neutering to help prevent the suffering of homeless cats and kittens.

It would not take much time for the reader to do their individual cost analysis based on the meat they choose to use and their source.  For the calculation, I would consider the cost of approximately 5 ounces (weighed raw) of poultry or rabbit (including the bones) + 0.25 ounces (weighed raw) of poultry liver per cat, per day.

Example (consider that there are 16 ounces/lb):

If you can buy chicken thighs at $2.00/lb => 5/16 x $2.00 = $0.63 (63 cents)

If the liver costs $2.00/lb => 0.25/16 x $2.00 = $0.03 (3 cents)

Total = $0.66 (66 cents) per day for one cat

The supplements will add in a bit more but, again, when the cost is averaged over time, it is not that significant.

A discussion regarding the cost of good nutrition would not be complete without considering the cost of not feeding a species-appropriate, nutritious diet. The saying “pay me now or pay me later” really applies here. You can feed your cats well – either with a homemade diet or canned food – or you can pay the veterinarian later. I have often said that if people would feed their cats and dogs better, more vets would be out playing golf.

One must also consider the cost of time involved when dealing with a sick pet.

For instance, diabetes can be a time-consuming and expensive nightmare to deal with. Inflammatory bowel disease is not much fun either, nor are skin allergies to inappropriate ingredients found in most commercial pet food. I would rather spend time making cat food than giving my cat insulin or cleaning up vomit or diarrhea from intestinal woes or dealing with any number of other diet-related problems that keep veterinarians’ waiting rooms full of sick pets.

This is not to say that all feline diseases are necessarily linked to diet but many of them are. “We are what we eat” is not just a useless cliché.

Back to the cost of the food…..

As noted above, I feed meat from two different sources:

• chicken or turkey thighs from Whole Foods Market or another local grocery store; some people get poultry thighs from Costco

• rabbit from wholefoods4pets.com – April 2017 UPDATE – Rabbit is no longer available from this company. Hare Today, Gone Tomorrow on the east coast is an option.

Poultry thighs:

I buy free-range (whatever that really means given that this issue is poorly regulated), antibiotic-free (as required by law) chicken or turkey thighs (with skin and bone).  Some cats like turkey better than chicken.  Turkey seems to have a stronger smell than chicken which entices some cats.

As much as I would love to buy organic, it is just too expensive when feeding multiple cats.

Rabbit: 

The second type of meat that I feed is rabbit and it is shipped to me from Washington – wholefoods4pets.com. (This company is no longer selling rabbit as of April 2017.)  I buy 51 lbs at a time of the Extra Fine Double Ground (the most expensive choice) in the 3 lbs packages.

I purchase the Extra Fine Double Ground because my cats were having problems with the bones in the more coarsely ground product.  On rare occasions (a few times a year) they would paw violently at their mouths as if a bone was stuck in their gum tissue.

That said, many people feed coarse ground food without any problems.  In fact, I have never received a single email from any of my readers saying that their cat had problems with the coarser grind which is much less expensive.

Another option is to buy the less expensive coarse-ground and re-grind it yourself using the 4 mm plate that I show under the Safety section below.  Or, just feed it as is.

Grinder:

For the first 10 years of making cat food, I used a Tasin TS-108 meat grinder (a #12 grinder, ~$160) but it finally died in July of 2012 after years of faithful service grinding approximately 45 lbs of meat and bones each month. What a truly impressive workhorse it was! I never expected it to last as long at it did given the amount of food that I grind.

So, what did I decide to replace it with? As much as I loved my Tasin, I had been dreaming of upgrading to a faster and quieter grinder so I went with the Weston #12 Meat Grinder (~$460).  I figured that after spending 10 years making cat food, I deserved an upgrade and I have been thrilled with my decision. Yes it is more expensive than the Tasin but, for me, it has been worth every penny.

April 2017 update:  I have been using the Weston #12 for 5 years and am still extremely pleased with the it.  I will note that in 2016, the Weston #12 was upgraded with 30% more power and it now carries a 5 year warranty.

That said, the purchaser must know that the Weston #12 is not warranted for use with bones – only the #22 and #32 are technically warranted for grinding bones.  However, many people, including myself have been using the older (‘weaker’) version to grind chicken thigh bones (and turkey thigh bones, on occasion) without any problems so I assume that the newer (as of 2016), more powerful, version will be even better.

All of the above said about the Weston #12…. I want to make it clear that the Tasin TS-108 will be just fine for the average household.

Anne (catnutrition.org ) has been using hers for ~13 years to make food for 2 cats. However, if you are interested in a faster and quieter grinder, I suggest that you consider the Weston #12. Honestly, I am kicking myself for not upgrading sooner.

If you are interested in the smaller Weston #8, understand that it has a smaller feed tube and it is going to be slower than either the Tasin TS-108 (which is a #12 size) or the Weston #12.

April 2017 update: I just consulted with a client who bought a Kitchner Heavy Duty grinder and said that it worked great with chicken thigh bones so that is another option but keep in mind that this is only one report from one person (other than the current 8 positive reviews on Amazon who did *not* mentions grinding bones).

The Tasin has been around longer and has a good track record of happy customers.  However, maybe the Kitchner Heavy Duty grinder will turn out to be as good.

Here are two grinders that I would *not* recommend:

1) Kitchner #12 Electric Meat Grinder – 1/2 HP.

2) STX Turbo Force 3000   This grinder has received some good reviews on Amazon.com but I have heard from three people who are very upset with this grinder stating that it does not grind bones well and does not even grind meat efficiently unless it is frozen. Therefore, I cannot recommend purchasing this product.

Here are some comments regarding the Weston #12, along with comparisons to the Tasin meat grinder:

Positives:

• It is very quiet! The Tasin is quite noisy and frankly, it was getting on my nerves. (Now that I have the Weston, Robbie stays in the kitchen with me. Before, he would leave the room when he sensed that I was going to turn the grinder on.)

It is faster – maybe twice as fast as the Tasin TS-108. Making cat food is definitely not my favorite pastime and the sooner I can get out of the kitchen, the happier I am.

It has a larger feeding tube (2.5″ vs 2.0″) which easily takes a whole chicken thigh but will also accommodate a whole turkey thigh so that means less prep time cutting up meat.  The Tasin TS-108 can handle whole pieces of chicken but sometimes a larger thigh needs to be cut down into smaller pieces to fit down the tube. This is not a big deal but is an extra step.

• The Weston’s auger is larger – with a wider ‘bite’ which quickly takes a chicken or turkey thigh bone. This is a significant improvement over the Tasin which sometimes has trouble ‘biting’ the big end (knee joint) of a chicken thigh bone. (It is always best to put the hip joint end in first because it is smaller.)

When I used my Tasin to grind turkey thigh bones (which I do *not* recommend doing), it really labored even when putting the smaller hip joint in first.  In an effort to not tax the motor, I did not allow the knee joint to go through the grinder. I would stop the grinder and then back it up to remove the knee joint. This is hard on the motor and probably contributed to my Tasin’s final demise.

While my grinder did process ~100 pounds of turkey thighs, I honestly think that this is expecting a lot from a grinder at this price point. If you must use your Tasin meat grinder for turkey thighs, I would recommend chopping or smashing the bones into smaller pieces to take some of the strain off the motor.  For me, this would have been far too much trouble and I would have just stuck with chicken.

• The pan is significantly larger and deeper.

• I can use all of my old grinding plates on the Weston #12.  I use the 4 mm plate that came with the Tasin.  The Weston comes with a 4.5 mm plate which is close enough.

Negatives:

• The Weston is larger and heavier than the Tasin but I do not have a problem with lifting it onto my sink.

Weston #12 (body only – OLD style, not the new 2016 model): 33.0 lbs (the website states that the new one weighs 45 lbs but I assume that includes the body, the pan, the augar, etc…which you don’t have to lift all at once.)
Dimensions: 14 1/8″ long x 6 1/2″ wide x 11 7/8″ tall

Tasin TS-108 (body only): 8.75 lbs
Dimensions: 12 7/8″ long x 6 1/5″ wide x 9 5/8″ tall

• The Weston does not have a reverse switch which does worry me in case it gets jammed.  I used the reverse function on my Tasin (rarely) but my hope is that the Weston’s power will prevent it from jamming so that I will not miss this feature.  If it does jam, it won’t be the end of the world; I will just have to take it apart and clean it out.  (April 2017 update:  I have not experienced any need for the reverse switch.)

Do not get caught up in looking at just the wattage rating since more wattage does not always mean a better or faster grinder. For instance the Tasin TS-108 is listed as a 1,200 watt grinder and the Weston #12 is listed at ¾ HP (2016 now 1 HP) or 560 watts (2016 now 750watts). The motor type and gear construction are significant factors in the performance of the grinder and its power rating.

Please note that the Tasin and Weston grinder parts (as well as the Turbo Force brand mentioned below) are NOT meant to go into the dishwasher.  I don’t have a problem with this since I prefer to wash them by hand anyway.  The grinding plates are not stainless steel but I have never had any problems with rust forming.   I simply wash them off with soap and hot water (using a nail to clean out any clogged holes) and then dry them and wrap them in a paper towel to wick away any moisture. I have never needed to add any oil to them.

However, some people spray the grinding plates with food grade silicone spray before storing them.  This will help prevent rusting.

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Before you dive into making cat food….

…..I want to mention that there are few things more frustrating than slaving away in the kitchen carefully preparing a wonderful meal for your carnivore…..only to have them end up sniffing it and then walking away.

I don’t like to see people get discouraged so I strongly suggest that you just take it slowly.

When I decided to start making cat food, I did not buy a grinder and all of the supplements right away.  I just simply bought a chicken thigh, thoroughly rinsed the meat with water, and cut it up into small pieces (the size of a pea or a bit larger) to see if my cats would eat raw meat.  A couple of cats went for it right away and a couple of them just walked away.

Ok….that was a start.

(Most cats will like thigh meat better than breast meat because thigh meat has a higher fat content and fat increases palatability.)

I then mixed in a few of these small pieces with their canned food to get them used to the taste and texture of just plain meat.  I also cooked some of the pieces to see how that went over.  If your cat likes it cooked, you can then cook it less and less to get them used to eating raw or semi-cooked meat.

Other tips:  Coat the meat pieces in parmesan cheese or FortiFlora.  FortiFlora is a probiotic that I use to entice cats to eat.  I do not use it as the label states since I am not using it for its probiotic properties.  Instead, I am using it as I would if I wanted to season my own food with salt and pepper.  As little as 1/10th or 1/20th of a package sprinkled on top of food can go a long way to entice a cat to eat something new.  This is because  FortiFlora is formulated using animal digest which is the same substance that pet food manufacturers coat dry food with to make it very palatable for cats and dogs.

FortiFlora has an expiration date on it which I don’t pay any attention to since I am not using it for its probiotic properties.  Therefore, I don’t care if the ‘good’ bacteria in the product are dead or not. I am only using the product because most cats really like the taste of it.  I think that all cat owners should have it in their cupboard in the event that you want your cat to try something new or they are ill and not wanting to eat anything.  A box of it may very well last you a lifetime.

If you have been feeding your cat dry food, try crushing the dry food in a baggie and then rolling the meat pieces in it.  You can also use crushed Temptations treats, etc. Temptations treats are easier to source and are cheaper than a box of FortiFlora and may work just as well.

I experimented in various ways as stated above for a couple of weeks before I bought a grinder and the supplements.  Much to my surprise, several of my cats actually immediately preferred what I made for them over the commercial canned food that they were eating. To this day, several of my cats will not even eat canned food anymore – they will only eat their homemade diet.  I have created little obligate carnivore monsters who hold out for their species-appropriate diet.

Another option before purchasing the grinder and supplements is to try a commercially prepared raw food.  That said, I do not favor the use of commercial raw diets long-term (more than a couple of weeks to see if the cat will eat this type of diet) mainly because many of them have too much bone material relative to the meat.  Please see my comments regarding commercial raw diets at the bottom of my Commercial Food page.

A second option is to purchase one of the TCfeline premix powders from the Raw Meat Cat Food Company (formerly Feline Future). Note that there are different pre-mixes depending on if you want to add fresh liver along with the fresh meat (preferable) in which case you would use the TCfeline Original powder or, if you do not want to use fresh liver, you can use the TCfeline Plus with chicken liver.

Please note that I prefer chicken liver over beef liver. I do not recommend the use of their “Special” formulation. I prefer to formulate diets for my kidney disease-patients on an individual basis. Keep in mind that it was a very sad day when humans deemed that protein is an enemy of the cat – including patients with chronic kidney disease. It is not necessary to add vegetables (or grains) to a cat’s diet to lower the protein.

The TCfeline pre-mix powder is to be mixed with water, ground meat and skin (no bones), and liver unless using the Plus version.

Please be aware, however, that I am not advising to use pre-ground meat in the raw form due to safety issues so you will still have to find a way to grind up whole, boneless cuts of meat.  Food processors work well for meat but not bones, or skin.  That said, I find them much harder to clean than a meat grinder and would never use one for making cat food.

Please see the Safety Issues below for more information on pre-ground meat.  If you want to use the TCfeline pre-mix powder, then I would suggest buying chicken or turkey thighs (with the bone and skin) and baking as discussed in the Safety section below.  After removing the thighs from the oven, debone them.  After deboning the thighs, run the meat and skin through a food processor or grinder.  I discuss how much skin to use in the Ingredient section below.

I would also like to mention that the recipe on this page is adapted from earlier work done by Natascha Wille of Feline Future Raw Meat Cat Food Company. I am very grateful to Natascha for her pioneering work in this area.

However, I did notice one statement on the Feline Future (now Raw Meat Cat Food Company) webpage that I need to address.  I would not let a cat go without food for 48 hours when trying to get them to switch to a new diet.  There is no reason to be that extreme.  Time and patience is the key – not starvation.  I will let a healthy cat go without food for about 18 hours and then offer them some of their regular food if they will not eat the new food that you are introducing.  See Tips for Transitioning.

Please keep in mind that many cats are not going to dive into any new food right away!  It takes time, patience, and some tricks to transition cats onto a new diet.  (It took me 3 months to get my cats off of dry food and eating canned food but it took less time to move them from canned to homemade.)

Also note that I have seen cats go from dry food to a raw or semi-cooked diet – and still refuse to eat canned food.

If your cat does not take to a new food immediately, don’t get discouraged.  Try mixing the new food with their existing diet of canned food at a ratio of 10% new to 90% old and then gradually increase the new diet from there.

Your cat may make it easy for you and show enthusiasm for the new food right away….but many (most?) will not.  It took one of my cats (Toby) many months before he would start eating this diet with any consistency and when he finally did start eating it, I noticed that he was picking out the pieces that got a bit cooked when I was warming the food.  Toby still is not terribly keen on strictly raw meat so he gets his semi-cooked.  See below for a picture of how he likes his homemade diet half cooked and half raw.  I often cook it even more than is shown in the picture below.  Interestingly, Toby is one of my cats that does not like canned food.

Some people feed a bit of canned mixed with the homemade for the rest of the cat’s life.  I don’t have a problem with this if that is what it takes to get them to eat a predominantly homemade diet.

My mom’s cat, Tyke, has drawn his ‘line in the sand’ and will only eat his homemade diet when it is 2/3 homemade and 1/3 Sheba.  He is 19.5 years old so….we compromise.

Making Cat Food – Quick Summary

Making cat food is not difficult.  I am a walking disaster in the kitchen and it is my least favorite room in the house.  If I can make cat food, anybody can.  I won’t lie – it can be a bit time-consuming – but it is definitely not difficult or complicated.  If you can follow a simple recipe, you can make cat food.  I usually prepare enough food for 8 – 12 weeks at a time but I have also used food that has been in my freezer for up to 1 year.

I was afraid that the 1 year old food would be freezer burned but I rinsed the top ice crystals off and my cats were fine with it.  And…they are normally very picky cats.

All that said, aim for no more than 3 months in the freezer since nutrients do degrade over time – even when in the freezer.

The time that I spend making cat food is much less time than is involved in caring for cats that become ill from poor nutrition.

In a nutshell – before I go into more detail below – I grind up meat, bones, skin, and liver.  I then make a supplement slurry by adding vitamin B-complex, vitamin E, fish oil, taurine, and iodized lite salt (if using poultry thighs) to water.

After I am sure that all of the supplements are thoroughly dissolved in the water, I mix the slurry into the ground up meat/skin/liver and then portion it into containers and put it in the freezer.

Very simple.

If I was not so lazy, I would use the eggs that are listed in the recipe below.  Truth be told, I have not added eggs to the recipe for many years so I will leave that open as an option.  If you can swing it – add them.  They are very nutritious – especially the yolks.

I also cut some of the meat into chunks for dental health – when I am not being lazy.

Of course your cat has to have a healthy mouth to start off with when pushing the chewing issue.  No cat will want to chew on any type of food if he has a painful mouth!

See the Dental Health section below.

The picture of the ground thighs shown below was taken when I was just rinsing the thighs off in water – versus baking as mentioned above.  Therefore, the meat below appears to be a deeper color of red that it will if you partially bake the meat.

Please also see a very helpful pictorial section on Anne Jablonski’s website at catnutrition.org.

In addition to the great pictures that Anne has on her website, she also has a frequently-asked-questions list that address many of the issues that come up when people are new to making cat food.

Also, if you are interested in learning more about feline nutrition, please read Michelle Bernard’s book Raising Cats Naturally.

I tend to be a bit lazier than Anne so the information here will differ from her way of doing things just a bit.  I will point out where I deviate from her methods and then you can decide for yourself how you would like to proceed.

With Bones….or Without Bones…and How Much Bone to Use?

One of the most important issues to address when feeding a homemade diet is the calcium-to-phosphorus ratio.  Keep in mind:  Bones = calcium (etc.)…..Meat = phosphorus.

When a cat eats a bird or a mouse, he is getting a naturally balanced diet since he is eating both meat and bones.

Always remember that calcium is not an optional ‘supplement’ but a very critical component of the diet.

The bones must be ground with the meat (preferable), or another source of calcium + additional supplements must be added to the recipe if only meat is used.  A cat cannot live on meat alone with no source of calcium.

Meat is high in phosphorus but does not contain much calcium. Therefore, a calcium source must be supplied and it must be done in the proper ratio considering the phosphorus in the meat.  The most obvious – and best – way to add calcium to the recipe is to grind the bones with the meat.

I am a stickler for using fresh bone versus bone meal or calcium carbonate.  You will not find a substitute source of calcium (bone meal, egg shells, etc.) that has all of the elements that are contained in fresh bone.  Bone meal is heavily processed and the nutrients in the marrow will not survive the processing intact.

Plus, it is so easy to just grind the meat and bones together.  And….deboning meat is not much fun and I do not advocate the feeding of pre-ground supermarket meat fed in the raw form.  The bacterial load can put your cat at risk for severe illness.

September, 2011 update:  For people who are unwilling or unable to purchase a grinder, I have finally ‘given in’ and added to the recipe section below the amount of bone meal needed to balance a boneless diet.  However, you will still need a food processor to grind up the meat, skin, liver, and eggs since, again, I do not advocate using pre-ground supermarket meat.  You will also have to debone whole cuts of meat such as chicken or turkey thighs.  (In the long run, most people come to realize that it is much easier to just use a grinder.)

Back to bone…..how much to use…..

When the typical prey of wild cats is analyzed, we see that there is a fairly wide range in the calcium-to-phosphorus ratio in these prey animals so we do have some leeway when dealing with this issue.

Note that when small wild cats eat mice and small rabbits they usually eat the entire carcass – including the entire boney skeleton of their prey – whereas the larger cats (lions, etc.) strip the meat off of the bones leaving much of the skeletal structure of their prey behind.  This fact illustrates that there is a wide variation in how much bone material wild cats consume.

Taking a logical look at the calcium-to-phosphorus ratio (bone-to-meat ratio), it would seem that the easiest way to ensure having a proper ratio is to use a whole carcass of whatever animal you are choosing as a food source.  However, after witnessing constipation in many raw-fed cats, as well as life-threatening urethral obstructions (see Anne’s Sidney Beans’ story here and Opie’s story here), and watching lions strip the meat from the bones – leaving most of the bones behind – I am not comfortable feeding as much bone as that found in whole chickens, turkeys, or rabbits.

Therefore, I use poultry thighs, which have a lot of meat relative to the bone.  I dilute the bone even further by removing ~30% of the thigh bones.  If I am grinding 10 thighs, I remove 3 bones.

I also add boneless poultry meat (including some of the fat and skin) to the whole carcass ground rabbit for the following reasons:

• Rabbit has a high bone-to-meat ratio and I want to dilute out that bone with some poultry meat/skin.

• Rabbit is a very low-fat meat.  Plus, it is skinned prior to grinding which reduces the fat content even further. Fat is an important component of a carnivore’s diet.  Therefore, I want to add some fat/skin to the rabbit diet and using poultry is the easiest way to do this.

• I can cut part – or all – of the poultry meat into chunks to help promote dental health.

• Adding in some poultry lowers the price of the food since poultry is cheaper than rabbit.

If you choose to grind up an entire carcass and not dilute the bone with added boneless meat, then I would suggest at least leaving out the back and neck since these are the parts of the chicken/turkey with the highest bone-to-meat ratio.

On a good note, if you do choose to grind up whole poultry carcasses, in considering the bone-to-meat ratio, our commercially raised chickens and turkeys will most likely have a lower bone-to-meat (higher meat-to-bone) ratio than a wild chicken/turkey given that poultry producers do whatever they can to promote ‘meaty’ birds for human consumption.

But all that said, unless you are trying to save money by using whole carcasses, I suggest just using poultry thighs which will lower the bone content of the food since the thigh is the meatiest part of a bird’s body that contains a bone. Also, cutting up carcasses is not only an unpleasant task but it is also very time-consuming.

Constipation

Updated 6/1/14 with added poop pictures for your viewing pleasure.

If you are tempted to write to me about your cat’s constipation (or diarrhea) issues, please understand that no advice will ever be offered via email.

A consultation (via phone or Skype) can be scheduled but only after medical records – including lab work and your veterinarian’s physical exam/diagnosis/recommendations/treatment notes – are provided for my review.

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Many people write to me stating that their cat is “constipated” simply because they are not passing feces every day.  However, this is not necessarily a sign of constipation.  Cats on a low residue (low fiber/low waste/highly digestible) diet will often not pass stool every day.

There is very little non-digestible matter contained in this diet.  Therefore, the volume of feces will often be much less when compared to cats on high fiber or poorly digestible diets.

Signs of constipation can include:

• straining without production of feces,

• crying in the litter box and acting distressed,

• diarrhea – yes, you read that correctly – sometimes diarrhea feces will leak around a hard piece of stool,

• excessive licking of the anal area, and

• defecating outside of the litter box can also be a sign of constipation but it can also be due to other (behavioral and/or medical) issues.  These cats either associate the litter box with pain and develop a litter box aversion or they simply get discouraged and impatient when trying to defecate in the litter box and end up going elsewhere.

Make sure that you are not confusing constipation with urethral obstruction! A cat with a blocked urethra – which blocks urination – is in a tremendous amount of pain and their bladder can rupture, resulting in death within 24 hours.  Seek immediate veterinary attention if your cat is not able to pass urine.

Note:  Some cats – especially long-haired cats – end up with ‘hang on’ poop meaning that the bulk of the feces was passed but a long thread of hair is mixed in with the feces with one end still in the rectum resulting in the feces hanging from the anus.  In these cases you may see poop outside of the litter box – wherever the poor cat managed to get the ‘hang’er on’er’ off – but this is not an issue of constipation.  In these cases, look for a stringy tapered end to the fecal ‘log.’

If your cat is exhibiting any of the signs of constipation noted above, it is important to determine if he has any other medical problem(s) that may be causing or contributing to the constipation. For instance, kidney disease can cause dehydration which, in turn, can lead to constipation.

Intestinal disease is also common in cats and constipation can be a sign of an unhealthy intestinal tract.

The two treatments that will be discussed in this section are Miralax (or its generic equivalent) and soluble fiber (e.g., guar gum, pumpkin, and psyllium).

• Miralax increases fecal water content without increasing bulk/diameter.  It is a laxative (made for humans) that can be found at pharmacies and some grocery stores.

• Soluble fiber increases fecal water content but also increases bulk.  Soluble fiber (versus insoluble fiber) may also play a beneficial role in intestinal health since it is fermented to short chain fatty acids which nourish the cells of the colon and also promote healthy bacteria.

Both treatments can be used at the same time but I normally just start with Miralax.  The dosage of each is determined on a case-by-case basis but I will discuss general starting doses below.

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What is the normal consistency of feline feces when eating a species-appropriate diet?

With regard to the diet discussed on this webpage, as well as some low residue commercial canned and commercial raw diets, it is important to note that the feces of a cat eating a species-appropriate diet are often dry and crumbly which is not necessarily abnormal, or a problem, for most cats.

Cats eating a natural, species-appropriate diet do not produce soft, voluminous, stinky feces like so many people are used to seeing from their cats eating commercial diets.

This is a picture of feces from 2 separate bowel movements from my cats.  In other words, an average bowel movement from my cats is half this volume – or even less.  I crushed 2 of the fecal pieces to show how dry and crumbly it is.  The feces from my cats also has very little odor.

That said, some cats do experience constipation when started on a species-appropriate diet (homemade, commercial raw, or canned) and it needs to be addressed.

The reason(s) for the constipation may be different for each cat but one cause may be the addition of too much bone to the diet.

Note that when I use chicken thighs, I remove ~30% of the bones.

Wings, necks and backs are all parts of the chicken with a very high bone-to-meat ratio.  These parts of the chicken should never be used as the sole component of the diet.  I suspect that these body parts make up a large percentage of some of the commercial raw diets since they are cheap and are part of the ‘discards’ from the human-targeted market.

Another reason that cats may experience constipation from this type of diet is because the fecal ‘logs’ are smaller in diameter than those produced from higher residue commercial diets and the cat’s gut tract is not accustomed to dealing with the difference in bulk.

Notice the larger diameter of the feces on the right.

The normal body is stimulated to defecate when the colon is distended/full.  While the feces on the left is not abnormal and is very easily passed by most cats, some cats’ colon may not be ‘triggered’ with only mild distension after spending years exposed to diets that produce bulkier feces.

The longer the feces sit in the colon, the more water is pulled from it (since the colon’s job is to save water for the body) and the drier the feces become, leading to constipation in some cats.

There are two main issues to consider:

• fecal water content – is it too dry – for the specific patient?  Take a paper towel and squeeze the poop.  Is it firm? Soft? Dry and crumbly?

• fecal diameter – is it too skinny, possibly not triggering defecation in some cats?

It is important to determine the answers to the above questions because constipation is not a ‘one treatment fits all‘ situation.

Treating constipation involves trial and error and the condition often benefits from a combination of treatments as discussed further below.

Generally speaking, all constipated cats will benefit from an increase in fecal water content but the main question is:  Do we want to increase fecal bulk (increase in diameter) with a soluble fiber?

In most cases, we don’t want to do that – at least not significantly.  However, as noted above, there is evidence to show that soluble fiber (a bulking agent) has other beneficial effects on the colon.

Therefore, I occasionally add a small amount of soluble fiber into the diet, in addition to using Miralax for some constipated patients.

In the ‘old days,’ megacolon cats (cats with abnormally large colons with compromised motility) were routinely treated with high fiber diets.  Unfortunately, many of these cats had their constipation worsen because their compromised colon could not handle the bulky stool.

But as the saying goes, “the devil is in the details” or, in this case, the dosage.  While too much fiber (or the wrong type of fiber –  INsoluble vs soluble) may be detrimental, a lower dosage of the correct type of fiber (soluble) may be beneficial.  This is true for megacolon cases as well as the average cat with a reasonably healthy gut tract experiencing a bout of constipation.

When treating constipation in cats, monitor the diameter of the feces, as well as the moisture content to determine which treatment – and dosage – works best for your cat.

To repeat:  We are not looking to create a large, soft, stinky poop by using too much fiber!

Visual example:

I recently added a bit of guar gum (soluble fiber) to my cats’ food.  Note that the first part of the stool (the dark part) is fiber-free and is firm and dry – just like what would be found coming out of a wild cat eating a natural diet.

The firm stool is followed by the guar gum stool which is ~3/4″ – 7/8″ in diameter and is very soft.  This is not what we want for the average cat.

Starting dosages for Miralax and soluble fiber:

• Miralax (or its generic equivalent):  Again, it increases fecal water content without adding bulk to the stool.  Most feline veterinary practitioners like using Miralax much better than lactulose which also adds water but not bulk.  Miralax is tasteless and can be mixed with the food.   This is much better than trying to get sweet, sticky lactulose into a cat!

Start with 1/8 tsp once or twice-daily mixed into the food and increase from there to get the desired fecal consistency.  Most cats do well on no more than 1/4 tsp twice-daily but it is safe to go higher.  If your cat’s stools are too loose, lower the dosage.

• Soluble fiber such as guar gum:  Start with 1/16 tsp once or twice-daily (use one half of a 1/8 tsp measuring spoon) – add extra water (1-2 tablespoons) to the meal or an amount just short of your cat refusing to eat the food.  Fiber absorbs water like a sponge and then swells thereby adding bulk to the feces.  Therefore, we want to add extra water to the food.

You can purchase guar gum from Whole Foods Market or online here.

Many people use pumpkin (canned – plain….not pumpkin pie filling with added sugar and spices) but some cats do not like it.  I prefer guar gum because it is more convenient and is not an unnecessary source of carbohydrates for our carnivores.  It lasts forever (it is not perishable) and most cats readily eat it when mixed into their food.  If you want to try pumpkin, use 1/2 – 1 teaspoon 2-3 times per day mixed into their food.  Some people freeze the pumpkin in ice cube trays for convenience.

Psyllium husk powder is also an option.  Start with 1/4 tsp once or twice daily and increase or decrease from there as needed.

All of the above treatments are ‘dosed to desired effect.’

To repeat: The “effects” being monitored are:

• relief from clinical signs of constipation

• fecal water content

• fecal diameter

Keep in mind that cats are not designed to handle a lot of fiber in their intestinal tract.  The diet of a wild cat is very low in fiber.  Horses and cows, on the other hand, are designed to eat very high fiber diets.

It is ok to add a little fiber to your cat’s food but we don’t want his poop looking like it came out of a St. Bernard!

There is one drawback to using fiber….you will no longer be able to brag that your cat’s poop does not have any odor.  The feces of a cat fed the recipe discussed on this webpage (without fiber) has very little odor but soluble fiber is fermented into some pretty stinky gases by the bacteria in the colon.

Meat Types and Sources

As discussed above, I use chicken, turkey, and rabbit.

• The poultry is purchased from Whole Foods Market and is antibiotic-free (as per the law) but is not organic due to the cost.  I use chicken or turkey thighs with bone and skin.

I also purchase chicken livers at WFM or another local grocery store.

• The rabbit is sourced from wholefoods4pets.com and I purchase the extra fine double ground product.  This product, which includes the meat, bones and organs (skin/hair/stomach/intestines are removed), arrives frozen in 3 lbs flat bags which are easy to store in the freezer.  (UPDATE:  wholefoods4pets is no longer selling rabbit.)

This product does not have to be re-ground.

Note that each rabbit comes with its own liver (and other organs) so no extra liver needs to be purchased.

For people on the east coast, a rabbit supplier is  www.hare-today.com (814) 587-2178.  I have no idea how finely this company grinds their food but it is not as fine as the product mentioned above.  That said, I have never received any complaints from readers stating that their cats have had problems with any of Hare-Today’s products.

Side note: Of course there are other issues involved with commercially-raised meat besides antibiotics such as the diet they are fed, how humanely they are raised, etc., but that is outside the scope of this webpage.

I stick to poultry and rabbit and do not feed beef or fish because poultry and rabbit are closer in composition to what a small cat would eat in the wild.  Also, beef and fish have been shown to be hyperallergenic in some cats and if you used beef, you would have to use bone meal and I greatly prefer using fresh bone.

Raw fish should never be fed in large amounts because it contains thiaminase which will lead to a thiamine deficiency in the cat but I don’t feed any fish (cooked or raw) to my cats for many reasons, some of which are:

• possible link to hyperthyroidism,

• hyperallergenic properties for some cats,

• phosphorus content

• possible heavy metal contamination….but

• mostly because cats get so fixated on the taste and smell so that they won’t eat anything else which can be a significant problem.

Regarding poultry:  I find that it is easiest – and results in a favorable bone-to-meat ratio – to just use chicken thighs.  However, some people want to use chicken carcasses but I would suggest leaving out the backbone/neck/wings.

At the beginning of my cat food-making days, I bought whole rabbit carcasses (because they were cheaper than the ground carcasses) but soon tired of the work involved.  Plus, I am dangerous with a knife….I ended up bleeding too frequently.  So I now purchase pre-ground rabbit instead of whole rabbit.

As noted above, I only buy poultry thighs and never whole carcasses. The extra savings is just not worth the hassle of having to cut them up and I like to use less bone for my cats’ diet as discussed under the bone section above.

Note that chicken legs = thighs + drumsticks.  Thighs are easier to work with but legs are fine to use also.

I love using turkey thighs but if you are using a Tasin grinder versus a Weston (discussed above in the Cost section) there is a good chance that a these large bones will kill your Tasin.

That said, when I was using a Tasin, I did grind turkey thigh bones with it but I sent all bones through it with the hip joint (asymmetrical end/ball joint) first – never the knee joint (symmetrical end) – in order to save the motor.  This is because the auger of the grinder will grab the ball of the hip joint easier than it will grab the bigger, symmetrical knee joint.

Also, when I used the Tasin to grind turkey thighs, I stopped the grinder before the knee joint advanced to the auger.  I then back up the grinder and remove the knee joint end of the thigh bone and discard it.

That said, my Tasin eventually died in the middle of grinding a turkey thigh bone.  That size of bone is a lot to ask of a grinder at this price point ($150) and power.

The Ingredients

Many opinions exist regarding the ingredients that should be included in an optimal homemade feline diet.  Everyone is free to do their own research and come to their own conclusions.

The diet that I choose to feed is very basic.  Some of the elaborate and complicated recipes found on the internet are enough to cause anyone to abandon the idea of making their own cat food and that is a shame.  It does not have to be that complicated and involved.

The diet of a wild cat is pretty basic – they eat other small animals, often leaving the stomach, intestines, and some bone behind.  They do not consume a large amount of grains, vegetables, or fruits – ingredients often present in large quantities in some recipes and in many commercial raw pet food diets.

I always use a recipe that includes finely ground bones.

I get fish oil, taurine, vitamin E, and vitamin B-complex from iherb.com or Whole Foods Market but there are numerous sources for these items.

If you order from iherb.com, the code for 5 off of your first order is LIS675 but you should not have to enter it if you just use the link above.

If your cat is thin and needs the extra calories, leave all of the skin on the meat.  If your cat is chubby or has had pancreatitis, remove ~80% of the skin.  (Some cats that have had pancreatitis do better on a low fat diet.)  If he is just right, remove ~50% of the skin.

When I first started making cat food, I removed all of the skin – figuring that my cats are indoor-only and are not burning off as many calories as an outdoor cat would be.  That said, when I started feeding them a better diet, they became much more active.

My cats did lose weight (a good thing) on the skinless chicken diet but then I worried about the fact that in the wild they would be consuming the skin of their prey so now I use ~20% of the skin on the chicken thighs.  As mentioned above, I also add in some chicken/turkey meat with skin/fat to the rabbit meat and bones since the rabbits are skinned prior to processing and because rabbits are very low in fat.

Cats need a reasonable amount of animal fat in their diet so don’t remove the fat from the meat.

One suggestion for very picky cats is to add a bit of bacon fat to individual meals to see if that helps them eat it.

I baked 18 ounces of the fattiest nitrite-free bacon I could find and it yielded 16 TBS of fat.  I used a broiling pan to catch the drippings.  Cook it slowly until the bacon is dry and crispy. That way, you will collect the most fat from the bacon.  The dried bacon makes nice bacon bits for non-vegetarians.  Or you can feed them to your cats as treats. Nitrites in cured meats is a controversial subject so I opted to purchase nitrite-free bacon from Whole Foods Market.

1 teaspoon of bacon fat is 38 calories.  I would not feed more than 1 tsp/day and you may be able to use less since a little bit will go a long way to adding a bit of flavor to the food for a picky cat.

If you are not using whole carcasses of chickens or rabbits but are using chicken parts instead, use all or mostly dark meat (thighs) since dark meat has a more appropriate amount of fat than white meat.

Breast meat does not contain enough fat if it were to make up the whole diet but it is fine to use some breast meat as long as it is not over ~25% of the total weight.  That said, I never use breast meat because it is too expensive.

You will note that I do not include any vegetables, fruits, or grains in my cats’ diet.  There seems to be a strong anthropomorphic drive for the addition of vegetables to a carnivore’s diet – some people just can’t get past the idea that while vegetables may be good for humans, they are not a dietary necessity for a carnivore and will often cause problems in the digestive tract of the cat if fed in large amounts.

Cats lack the digestive enzymes necessary to efficiently process these ingredients – especially in the raw form –  into a usable form.  Many people insist on adding large amounts of species-inappropriate vegetables to a carnivore’s diet arguing that they would eat them along with the stomach and intestines of their prey.  However, these arguments do not  take into account the fact that this vegetable matter is pre-digested by the prey’s own enzymes – enzymes that are lacking in the cat.

In addition to this very important fact, the amount of vegetable matter in the average bird or mouse is extremely small and often the stomach and the intestines are not even consumed by the cat.

That said, some people do use a small amount of vegetables and I don’t have a problem with that as long as the amount is minimal (~5% by weight).  If you choose to use a small amount of vegetable matter in this diet, do not feed them raw.  Steam the vegetables first to help break them down to a more usable form for a carnivore.

Regarding grains – please disregard recipes that add grains to an obligate carnivore’s diet.  We want to refrain from feeding cats as if they were horses or cows.

The Recipe

Please check back to this webpage periodically for any updates to the recipe.

Also see below the recipe for links to products that I purchase from iherb.com.

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Please note that I do not recommend this recipe for cats with CKD (chronic kidney disease) – formerly known as CRF.

Also, I definitely do not recommend the many recipes on the internet that use potatoes, pumpkin, squash, rice, etc., for CKD patients.  Not only is the feeding of these species-inappropriate ingredients unnecessary, but they can be detrimental to the health of the patient.  See below.

It was a very sad day for our cats when humans got it in their mind that protein is a cat’s enemy.  Quite frankly, I am getting very tired of watching cats end up protein malnourished on low protein diets including the so-called “prescription” diets – none of which would ever be fed to any cat in my care.

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September, 2011 update:  Since writing this page many years ago, I have pushed heavily for the use of fresh bone (versus bone meal) as a calcium source.  This requires buying a grinder.

However, many people are either unwilling or unable to purchase a grinder so I am finally ‘giving in’ and will state that if you are going to use 3 pounds of boneless meat and skin, then the amount of bone meal (NOW brand linked below) to use is 2 1/3 tablespoons.  That is 2 tablespoons + 1 teaspoon….or….7 level teaspoons.  (1 tablespoon = 3 teaspoons)

Keep in mind that when you feed bone meal, your cat is missing out on the benefits of ingesting fresh bone marrow.  Since humans are not as smart as nature, we cannot exactly define these “benefits” but our goal is to always stick as close to nature as possible and in nature, cats consume fresh bone marrow.

A commonly asked question:  “What do I do with the bones left behind in the grinder?”

Answer:  Discard them.

I use the following ingredients – in amounts listed – per

3 pounds of poultry thigh meat/bones/skin

or

2 – 2.25 lbs of whole carcass ground rabbit + 0.75 – 1 lbs of boneless chicken or turkey meat/skin/fat (see reasons above):

• 1 cup water or, preferably, more if your cat will eat it with more water – increased dietary water helps keep the urinary tract healthy and unobstructed with debris (crystals, mucus, protein, white blood cells, red blood cells, etc.)

• 2 eggs – (optional) use the yolk raw but lightly cook the white (soft boiling them for ~3-4 minutes works well) – remove all or at least most of the shell

• 5000 – 10,000 mg fish oil (5-10 capsules of the average 1,000 mg capsule) – I use 10 capsules for my cats.  Fish oil is a good source of essential fatty acids – note that this is increased from the original amount of 2,000 mg – if your cat does not like fish, it is ok to use only 2,000 mg.  Do NOT use cod liver oil!  There is already plenty of vitamin A and D in the liver we are using.

• Vitamin E – 400 IU (268 mg) (powdered E in capsules is the easiest to use)

• Vitamin B-complex 50 – 1 capsule or tablet but if you have a picky cat, you should start with only 1/2 capsule or tablet for a total of 25 mg; you can try to increase from there for the next batch but if you determine that your cat is turned off from the food with more than 25 mg, then just leave it at 25 mg.

• 2,000 mg taurine (use powdered – either in capsules or loose)

• 1 tsp Morton Lite (or Windsor Half and Half for Canadian residents) salt with iodine when using chicken but use 1/2 tsp when using rabbit + chicken (contains potassium and sodium – make sure that it contains iodine – see below for further explanation.)

For people who cannot source Morton Lite Salt with iodine, use 3/4 tsp of regular salt (sodium chloride) with iodine + 14 tablets of potassium gluconate (99mg each) OR 14 capsules of potassium citrate (99 mg each).

If you absolutely cannot source potassium gluconate or citrate, the meat and liver have enough potassium in it for health cats. In that case, use 1 tsp of regular salt (sodium chloride) with iodine.

• Liver – If using ground rabbit (which includes liver) from wholefoods4pets.com, do not add additional liver.  If using chicken legs, thighs or a whole chicken carcass minus the organs, add 3-4 ounces of chicken livers per 3 lb of meat/bones/skin.

• Fiber –  6/1/14 update:

For the past 11 years, I have not added any fiber to my cats’ diet and they have done well.  

Keep in mind that a cat’s natural diet is extremely low in fiber.  Contrary to popular belief, the hair and feathers of their prey is not a source of fiber.  Fiber only comes from plant material – not animals.  The only source of fiber for a cat in the wild is the miniscule amount in the gut tract of their herbivorous/omnivorous prey or the plants that they may eat.  Since cats don’t generally chow down on much plant material, this is also a negligible source of fiber.

Please see the Constipation section above for a more detailed discussion of fiber.  Cats that have been on high residue commercial food with a colon used to a bulky stool may benefit from a small amount of fiber in their diet.

At the request of several readers, here are links to specific products that I purchase from iherb.com but please note that I cannot keep up with iherb’s website if they change links. If a link is dead, you will have to find another option on your own.

Fish oil – This is a link to Nature Made 300 capsules for people who make a lot of food.

Fish oil – This is a link to Nature Made 100 capsules for those with fewer cats.

Both of these fish oil products have 300 mg of EPA + DHA per capsule.  There are other fish oils with a higher level (called “super,” etc.) but they are more expensive per gram of EPA + DHA.

Note that I strongly prefer using fish oil capsules – not bottled oil.  Capsules stay fresh longer than bottled oil which can become rancid.  Make sure that whatever you buy is not lemon flavored!

Do not use cod liver oil.

Vitamin E – Use the d-tocopherol (natural) form not the dl-tocopherol (synthetic) form of vitamin E.  The d- form is better absorbed and utilized than the dl- form.  Some people use the phrase “does little” to help them remember to stay away from the dl form.

You can also use liquid vitamin E in gel capsules but you will need to either dissolve them in the water or poke them with a pin and squirt the oil into the water.  I find dry vitamin E capsules easier to work with.

B-Complex 50

B-Complex 100 (for people making larger batches)

I prefer purchasing B-Complex tablets instead of capsules since the powder inside the capsules often gets ‘gummy’ and will not pour out.  The tablets are more stable and last longer.  I have thrown out a lot of gummy B-Complex capsules which is wasteful.

Note that these B-Complex products do not contain vitamin C.

Taurine – loose powder

Lite salt with iodine – sample link to show picture – can be purchased at most local grocery stores (not available at iherb.com)

Salmon vs fish oil: I prefer to use fish oil from smaller fish such as anchovies and sardines.  Oil from fish that are lower on the food chain are less contaminated with heavy metals and other impurities.

If you prefer to use salmon oil, here is a link to a product that I used for many years before switching to oil from smaller fish:

Wild salmon oil

Bone meal powder – for use if you are not going to buy a grinder.

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Random notes:

Most cats eat approximately 4-6 ounces/day but it depends on how much water you add to the recipe and how fatty the end result is.  Fat has more calories than protein so it is more calorically dense.

This recipe yields enough food for one cat for approximately 10-14 days.

If using capsules with dry ingredients, open them and add the powder to the water.  If using tablets, dissolve them in the water after crushing in a baggie with a hammer or using a mortar and pestle to expedite the dissolution.

You can either poke the fish oil capsules with a pin or cut the tip off with scissors and squirt the oil into the water….or you can do what I do and just dissolve the fish oil capsules in the water for ~15 minutes and then, once they are somewhat dissolved, make sure that all of the oil is liberated from the capsule by squeezing the capsules with your fingers within the water.  Using warm/hot water helps dissolve them faster. I use this method because I make so much cat food at one time that it would take forever to poke each capsule with a pin.

It is fine to leave the capsules in the water. They are gelatin (a protein) and most cats readily eat them. However, make sure that none of the vitamin supplements get stuck in a blob of the capsules. The last thing you want your cat to do is bite into a highly concentrated area of bad tasting vitamins.

Some people run the fish oil capsules through their grinder but be sure to put your hand over the outflow of the grinder because sometimes the oil splatters as it is coming out and that can get messy.

It does not matter how you deal with the fish oil capsules…just make sure that all supplements are evenly dispersed throughout the food.  Again, you don’t want your cat biting into an area of concentrated vitamins or fish oil.

For the boneless poultry meat and skin that you are adding to the pre-ground rabbit carcass, you can either use a grinder or a food processor for the meat that you don’t chunk for dental health.  However, meat grinders are much easier to clean than some food processors.

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Notes on why I omit/alter certain ingredients that you may see in other recipes:

• Kelp – You will see recipes on the internet that use kelp.  Kelp varies in its iodine content but usually contains very high levels of this mineral.  The thyroid gland is very sensitive to iodine levels that are either too low or too high.  Given the fact that hyperthyroidism is very common in the cat, I do not want to add too much, or too little, iodine to the diet and I don’t know how much iodine is in each supplement.

The thyroid gland of a cat’s natural prey is a good source of iodine but when using chicken or turkey thighs – and, therefore, no thyroid gland – we need to add Morton’s iodized Lite salt as a source of iodine.  I use Lite salt instead of regular table salt because Lite salt is a mixture of sodium and potassium versus table salt which is all sodium.

The iodized Lite salt (or, for non-US residents, regular iodized salt) is not an optional ingredient.  It is a definite requirement when using only chicken or turkey parts – or any whole carcass that does not include a thyroid gland.

Also keep in mind that when we use poultry, we are missing the blood and its sodium and potassium.  The Lite salt adds in some sodium and potassium 

If using ground rabbit, I would assume that the thyroid gland is included.  However, you may want to call your supplier and ask if this is the case.

Be sure to use all of the blood that comes with any ground food since blood contains valuable nutrients – including sodium and potassium. Note that the ground rabbit from wholefoods4pets.com comes with a lot of blood included (and the thyroid gland) which is why I use less Lite salt when making rabbit + chicken recipe.

• Multi-glandular supplement – I initially added this item but when Mad Cow disease surfaced, I discontinued using it.  If you wish to use this supplement, here is a link to the product that Anne uses.  Unfortunately, that webpage does not list the iodine content so I have no idea how to work that in with the iodized salt that I have in the recipe for use with chicken parts.

• Dulse – This is an optional trace mineral supplement.  I have never added it to my cats’ food.  Many people feel that the mineral content of our soil is not what it used to be so this is one reason why some people choose to add it to the recipe.

• Hearts – Hearts are a good source of taurine but chicken hearts are not as high in taurine as mouse hearts.  Therefore, I consider hearts to just be pretty much the same as muscle meat so I still add powdered taurine.  (I have never used heart meat in my cats’ food since I do not have a readily available source for them.)

• Egg whites – Raw feeding sites often discuss the fact that raw egg whites contain avidin which binds to biotin in the intestinal tract and prevents it from being absorbed.  However, I don’t see this as a significant issue because there is biotin in the egg yolk and there is plenty in the B-complex so I doubt that the avidin in the raw egg whites would cause a problem.

But, that said, in light of the possible contamination of eggs with salmonella, I would lightly cook the egg whites anyway.  If you want to be extra safe, then lightly cook the entire egg (white and yolk).  I find that soft boiling them (~3-4 minutes) works very well but some people like to scramble them in a bit of butter.  Be be sure to run them through the grinder or food processor in order to break them up so that you can mix them into the food uniformly.

For cats with gastrointestinal issues or any signs of allergies, I would suggest omitting the eggs when first introducing this diet.  They can always be added in later as a single change to the diet.  That way, any negative reaction can be monitored.  If your cat does not like the diet, try omitting the eggs.  Some cats just do not like eggs.  I consider the eggs to be an optional ingredient.

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Note: I do not recommend this recipe for CKD (Chronic Kidney Disease) cats.

(CKD is also known as CRF – Chronic Renal Failure – but we are trying to move away from the word “failure” because it is such a negative term.)

There are other recipes that are more suited to feeding cats with this condition.  However, the nutritional needs of these cats must be discussed on an individual patient basis.  The reader can request a phone (or Skype) consultation if they wish to discuss an appropriate diet for a CKD patient.

All consultations are conducted via the phone or Skype only after the patient’s medical records, including lab work and your veterinarian’s physical exam/recommendations/treatments notes, have been provided for my review.  General CKD medical management to prolong the length and quality of life, in addition to appropriate dietary issues, is discussed during the consultation.

Homemade diets, as well as commercial options, are covered.  My CKD consultations take up approximately 2 hours of phone time since there is a lot to discuss if optimal CKD medical and nutritional management is desired.

Again, as noted above, diets that are loaded up with potatoes, pumpkin, squash, rice, etc., as not healthy diets for any cat – including CKD patients – since they often result in protein malnutrition and can contribute to the development of diabetes.

Putting the Recipe Together

Here is a video that my friend, Anne Jablonski of catnutrition.org fame, put together.  Please note that Anne uses a plate that creates a very coarse grind whereas I prefer a more finely ground product.  Anne has never had any problems with her cats eating larger bone pieces but I have.  You will see that her grinding process goes much faster with the plate that she uses.

See Anne’s Pictorial here.

I prepare food for my cats in two basic ways – depending on if I am using pre-ground rabbit or chicken/turkey thighs from Whole Foods Market:

1) Ground rabbit (meat, bones, and liver): The ground rabbit is shipped to me in a frozen state in 3 lb packages.  I thaw it and mix in the ground and chunked chicken/turkey thigh meat and skin as discussed above.

The supplements are added to the water and, once they are all dissolved, this supplement slurry is added to the meat/bones/skin/liver/eggs.  Since I make so much food at one time (30 – 50 lbs), I find it easiest to use my hands to thoroughly mix the food.  After the food is mixed well, it is portioned into containers and put into the freezer.

Note that for this preparation, either a grinder or a food processor is needed to grind the boneless poultry meat and skin.

2) Chicken/turkey thighs:  The second way that I make food is to:

• Remove the pre-determined amount of skin.

• Bake (at 350 degrees) the chicken/turkey thighs leaving ~50% of the thigh meat raw.  (The time needed varies depending on how thick the thighs are but is usually ~15 – 20 minutes, give or take.)  I add all of the fat drippings to the ground meat/bones/skin/liver/eggs.

• The liver is cooked for about 20 minutes.  ~10 minutes into the time, I stir/break up the liver to ensure even cooking throughout.  I cook the liver more than the thighs because bacteria does not reside in the depths of the thigh meat but, instead, lives on the surface. The liver, on the other hand, has a higher chance of having bacterial contamination throughout.  Plus, one of my own cats because extremely ill (horrible vomiting and diarrhea) after eating raw liver that was fed within 1 hour of being purchased….with current/fresh dating.

• Remove some of the raw meat from the bone for chunking.

• Cut the meat into chunks for dental health…. as much as you have the patience for.  (I hate chunking meat but since switching from using a knife to using a pair of sharp scissors, this task is not as annoying.)  Truth be told, I often skip this step.  There is just only so much time I am willing to spend making cat food!

When I say “chunks” I mean pieces of meat about the size of a die (~1/2 inch cubes) or a bit smaller at first and then larger (size of your thumb) once your cat gets the hang of chewing on them.  The bigger, the better.  Keep in mind that raw meat is more tenacious (and better for teeth) than cooked meat.

I would prefer it if the chunks were raw like the ones in the middle of this picture.  Raw meat is harder to chew than cooked meat and will, hopefully, exert more cleaning action on the teeth.  That said, nothing is as beneficial for dental health as daily brushing.

• Run the meaty bones, non-chunked meat, skin, liver, and eggs through the grinder using this plate with 4 mm holes:

Since I really hate chunking meat by hand, I tried the plates below which were a waste of money.  Even the one with three large holes ground the meat too finely to allow for any dental health benefits.

 

• The ground meat/bones/skin/liver/eggs plus the fat drippings from the baking pan and the chunks of meat are then placed in the refrigerator while the supplements are mixed up.

Mixing up the supplement slurry:

• Whether you are using pre-ground rabbit with additional ground boneless poultry meat and skin, or chicken/turkey thighs that you have ground yourself, it is now time to combine the water, vitamin E, vitamin B-complex, taurine, iodized lite salt, and fish oil (if you have not already run the fish oil capsules through the grinder) with a whisk.

• Pour the supplement slurry into the meat/bones/skin/liver/egg mixture.  Mix very well then portion into containers and freeze.  Leave at least 3/4″ of head space to allow for expansion.

Ideally, the food should only be in the refrigerator (in a completely thawed state) for 48 – 72 hours so keep that in mind when choosing your container size.  The average cat eats about 4-6 ounces (by weight not volume) per day.  When I was first starting to feed a homemade diet, I used baby food jars so there would be no waste during the transition.  I then quickly graduated to pint canning jars with reusable lids and rings.  These jars hold 15 ounces of food.  People with just one or two cats need to pick the container size that works for them.

Freezing the food in ice cube containers works well for nicely-sized portions.  Store the food cubes in a ziplock bag.

You will note on Anne’s site that she prefers not to warm the food in the microwave.  Instead, she heats it in hot tap water.  This method would never work for me since it takes forever to get hot water at my sink and I hate wasting water.  Plus both my cats and I are impatient so all of my cat food-warming is done in the microwave.  Depending on the level of thawing, I may heat it for 5-10 seconds then stir.  I repeat this several times so that the food is not cooked but is just warmed to ‘mouse body temperature.’

Exception to the above:  I found that one of my cats, Toby, is very stubborn about eating meat if it is completely raw but I noticed that he would eat the accidentally-cooked pieces if I left it in the microwave too long.  I have tried to cook it less and less over time but he is really stubborn about eating the completely raw rabbit so I humor him and feed it to him half cooked and half raw – or sometimes it is cooked even more than is shown in this picture.

I do not worry about cooking the ground bones.  I grind them so finely that this is not even a remote concern for me.

Canning the Food

There is a very helpful page on the Raw Meat Cat Food Company website.  It provides information on canning cat food.  My Robbie does not do well on any commercial canned food (he gets severe diarrhea) so this is a great alternative for me in an emergency situation so I don’t have to use commercial canned foods.

I purchased this pressure canner and now have homemade canned chicken, turkey, and rabbit cat food available for periodic feedings and for emergencies.  This canned food also comes in handy if I have to be gone for 12 hours on a hot day.  I leave this food out instead of the raw/semi-cooked diet.  This canned food is also safe for human consumption so it doubles as an emergency supply for both two-legged and four-legged members of the house.  Of course, this will not be an option for vegetarians.

Please note that I said for “periodic feedings.”  I have no idea what nutrients and in what amounts are destroyed in the canning process so I would not want to feed this diet as a sole diet for more than a few weeks during an emergency situation.

Dental Health

To readers who have navigated here from the side bar, this is a section that I quickly added to my Making Cat Food page.  One of these days I will write a separate Dental Health webpage but, in the meantime, here are some comments on the subject which start off with a discussion about getting cats to chew on chunks of meat to help promote a healthy oral cavity.

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Of course your cat has to have a healthy mouth to start off with when pushing the chewing-on-chunks-of-meat or tooth brushing issue.  No cat will want to chew on any type of food or have his teeth brushed if he has a painful mouth!

If in doubt, please be sure to have your veterinarian examine your cat’s mouth.  Poor dental health is the most commonly overlooked health problem in our cats and dogs!

Unfortunately, people (including myself….) do not take their cats in for dental cleanings/exams as often as they should.  We need to stop over-vaccinating cats and pay more attention to their dental needs.  (Please see my Vaccine page for more information on the rampant over-vaccination that occurs among our cats and dogs.)

I would encourage you to have your cat’s teeth properly cleaned and examined (under general anesthesia – *not* anesthesia-free) if you have not already done so.  You want to know that your cat’s oral cavity is in a healthy state before you push the issue of chewing on chunks of meat and/or tooth brushing.  If you start your cat off with clean teeth, you can then go forward and be proactive in keeping them clean.

It is important to note that chewing on meat and tooth brushing will not remove the plaque that is already on the teeth.

Only professional scaling under general anesthesia can do this in an effective and safe manner.

Unfortunately, like most cat and dog owners, I have been ignoring my cats’ dental health when using finely ground meat and bones and they are paying for it with unhealthy mouths.

Hopefully you will do better for your cat.

The reasons why my cats’ dental health is not being addressed are:

1)  I am being lazy.  De-boning and cutting up meat by hand is time-consuming.

2)  My cats are also lazy (Robbie has a perpetual ‘Mommy, please cut my meat for me‘ look on his face….) and will often just eat around the chunks.  Not only is this frustrating because the meat is wasted, it can also lead to an unbalanced diet.

If a large percentage of the meat in the diet is chunked….and the cat eats around the chunks….they will be eating too much ground bone/liver and supplements.

Therefore, watch your cat to make sure that he is consuming both the chunks and the ground-up portion.  Otherwise, he will be eating an unbalanced diet.

And….if you have a kitten, train him to eat chunks of meat early in life!

One trick that you might try is to serve a full meal of 100% chunks – when your cat is ~12 – 18 hours hungry in order to get him used to chewing on meat chunks. Hunger goes a long way when trying to get a cat to embrace any new food but, again, make sure that your cat has a healthy, non-painful mouth.

As mentioned above, you can also try coating the chunks of meat in parmesan cheese or FortiFlora or crushed Temptations treats.  My cats LOVE FortiFlora and would probably eat cardboard if I sprinkled it with FF.  That said, some cats (~10-15%) do not like FF.

See Anne’s pictorial here where she shows the size of the meat chunks that her cats are chewing on.  You may have to start smaller – like the size of a pea – just to get them used to the texture of meat.  Unfortunately, most cats are not used to doing what nature intended for them and they may take some time to get used to gnawing on chunks of meat.

Another good dietary option to promote dental health for your cat is to feed them gizzards.  Gizzards are very fibrous and tough to chew and If your cat will eat them alone, they can be used as a great dental snack.

If your cats like gizzards, you can incorporate them into the batch of food since they are easier to cut up when compared to muscle meat. Just count the gizzards’ weight as part of the 3 lbs of meat/bone/skin in the recipe above.

In order to promote dental health, many proponents of a raw diet use meaty bones.  However, this is not within my comfort zone due to the risk of broken teeth, or swallowing sharp bone fragments.  Plus, I don’t want raw bones drug around my house.

When first starting to feed a homemade diet, you may not want to do much chunking if your cat will not readily eat the chunks.  First things first….ie….get them to embrace the finely ground up meat and bones diet first….then see if you can get them to chew on chunks of meat.

Brushing your cat’s teeth is the best way to keep his teeth clean if he will not chew on chunks of meat but, honestly, even if they do chew on meat?  I would still suggest brushing their teeth as an added insurance policy.  Please see this video that explains how to do this.

This toothbrush is the only product that is suitable for cats and is the one shown in the video.

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, all you will end up with is 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.

In January, 2010, I started brushing Robbie’s teeth after a dental cleaning under anesthesia and am kicking myself for not doing it sooner.  Robbie builds up tartar faster than any cat I have ever dealt with and he really could use dental cleanings 2 times per year.  Plus, his breath smelled awful!  It actually smelled worse than his feces.

July, 2011 update:  Robbie’s teeth would have been a mess by now since his last dental was in December, 2009.  However, since I have been brushing his teeth daily (or at least 6 times/week) for the past 18 months, his breath is still great and his teeth are very clean. I should have started doing this years ago!

Here is a video that I took in December, 2010.  It is not a very good video but it shows that he tolerates it very well….and the kisses on the head are mandatory.  :>)

February, 2012 update:  It has been more than 2 years since Robbie’s last dental and his teeth are still very clean and his breath has no odor.  I am still brushing his teeth every night.

November 2013 update:  It has been 4 years since Robbie’s last dental cleaning under general anesthesia and I am happy to report that his breath is still great and his teeth look good but I can see some tartar build up.  I rarely miss a day of brushing his teeth.

Understand that you will not be able to get to the inside of any teeth.  I just focus the brushing on the outside surface of the upper and lower molars which is where the bulk of a cat’s teeth problems lie.  At first, Robbie was not as cooperative with the lower molars as he was with the uppers but now he willingly lets me brush both areas.  He is also very good about having his canine teeth (‘fangs’) brushed.

Note that you brushing back and forth like you would on your own teeth will annoy most cats.  With Robbie, I swipe the tooth brush in one direction over and over again.  Front to back, front to back, front to back….trying for ~8-10 swipes.  Then the other side is back to front, back to front, back to front….

When first starting to train your cat, only swipe a couple of times then feed him a treat and let him go.  Concentrate on the canine teeth and upper molars. Leave the lower molars until your cat has accepted the other areas.

It may take a month or more to get your cat used to this process.

Go slowly and be very patient!

Note that you do not have to use any toothpaste.  A moistened (with water) toothbrush is all you need.  In fact, I only use the CET toothpaste that I bought for Robbie as a treat after I brush his teeth.  He likes the taste of it so I put a bit on my finger for him to lick off when we are done.

You can try using toothpaste but some cats start licking and chewing and that will make it hard to brush his teeth.  You actually want the cat to keep their mouth closed and still.

One final comment….when I brush the upper molars, I pull up/back the lip/corner of the mouth so that I can actually see them.  However, with the lower molars, I keep my finger under his chin so that he keeps his mouth closed.  I then slip the bristles between his lips and just ‘feel’ the lower molars and listen for the sound of the bristles against the teeth but I don’t actually see them.  Sometimes the same is true for the uppers.

It is easier to get the uppers brushed than the lowers.

When I find the time, I will write a Dental Health webpage which will address this issue in more detail.

Safety Issues

• Pre-ground supermarket meat:  I hear you asking “But I don’t want to buy a grinder….so why can’t I just buy ground meat at the supermarket and add a calcium source?”  I would never do this for reasons stated below.  This method is definitely outside of my comfort zone and is not one that I can recommend.

I buy only whole meats from the market for the following reasons:

1) The surface of whole meats is where the bacteria resides – not in the depths of the meat.  Therefore, cooking the thighs until there is at least a 20% surface cook will result in the destruction of the surface bacteria.  I bake the thighs at 350 degrees until they are ~50% cooked.

There will be a loss of weight from the original 3 lbs of meat/skin/bones but by the time you add the drippings back in and add more than 1 cup of water to account for the moisture loss, you will be back at roughly 3 lbs.

I definitely suggest partial cooking of whole cuts of meat for any animal that may be immunocompromised due to illness, advanced age, or if they are receiving any immunosuppressive medications, or antacids.

Note: Boiling is one of the worst ways to cook meat in terms of nutrient loss. Baking is much better for nutrient retention. I used to boil the thighs because it was easier given the large batches that I make but I now bake them so that there is less nutrient loss and so I can save the fat drippings to put back into the food.

2) Once whole cuts of meat are ground, it needs to be cooked all the way. This is because the surface bacteria has been ground into the meat. Once the meat is ground, the surface area increases, which makes a great breeding ground for bacteria. This meat then sits in the refrigerated section of the meat department. It is not immediately frozen which would halt any further bacterial growth.

When packaging for the freezer, use a container size that will be used up with within 2 – 3 days of being in a completely thawed state in the refrigerator.

You may be wondering what the difference is between the ground meat at the supermarket and the ground rabbit that I buy from wholefoods4pets.com.  Wholefoods4pets process the rabbits and then they immediately freeze the final product versus refrigerating it.  It arrives on my doorstep frozen.

This meat comes to me in such a clean state so that it would probably be fine if left in the refrigerator for 4 days but I still package it in containers to be used up within 3 days of being completely thawed in the refrigerator.

3) I want to use fresh bone versus bone meal and it is very easy to grind the meat with the bones.  With regard to adding a basic calcium source (like calcium carbonate) – instead of using bone –  you run the risk of feeding an unbalanced diet because these calcium supplements are just that – calcium only.  Bone is a source of more than just calcium.

• Source fresh meat:  Check with the butcher who you are purchasing from and see what his delivery schedule is so that you may purchase the freshest meat possible.  Sometimes I will ask my butcher if he has anything fresher in the back – versus what is in the display case.

However, having said this, one of the reasons why I started partially baking the poultry thighs is because I did not want to have to worry about shipment dates.  I wanted the convenience of buying meat on my schedule – not my butcher’s.

• Safe food handling principles:  Basic hygiene practices should be followed when preparing meat for yourself or your carnivore.  My kitchen counters and cat feeding areas are kept very clean with a 1:22 bleach/water (1 part bleach to 22 parts water) solution.

• Bone size:  Many people, including Anne, chunk a portion of the meat and then send the rest of the meat and bones through this coarse grinding plate.

However, I am not comfortable with the size of bone pieces that result from the use of this plate.  In fact, my cats have gotten bones the size shown below stuck in their mouths causing them great distress.  I have a 4 minute video of my Robbie violently pawing at his mouth because of a bone fragment that had gotten stuck.  He was not happy and neither was I!

I often get asked about acceptable bone size.  This is where I differ from many raw feeders.  I tend to err on the side of caution and grind the bones very finely.

This picture illustrates a bone size that I am not comfortable with.

These bone pieces were taken from a single ground rabbit product obtained from wholefoods4pets.com.  At my request, Mary (at WF4P) now offers an Extra Fine Double Ground product using what she jokingly refers to as “Dr. Pierson’s microplate” to appeal to my paranoia about bone size.  (The regular double ground still yields the bone size as shown in the picture above.)

If you want to save money, order the single ground (this will yield the bone sizes shown above) and then it will be your choice to feed as is or send it through your grinder using a fine plate.

The Dangers of Commercial Pet Food – Especially Dry Food

With regard to the safety of raw meat diets, you will no doubt hear varying opinions on this issue.  Many of my colleagues are adamantly opposed to the feeding of raw meat yet they think nothing of supporting the common practice of leaving bowls of dry food sitting out for pets to free-feed from which can be contaminated with fungal mycotoxins, bacteria, chemicals, or storage mites.  It is very frustrating to witness this narrow-mindedness and lack of acknowledgement as it pertains to the contamination issues regarding dry food and treats – many of which have been recalled as noted below.

I would like to see my colleagues stop reflexively telling their clients that all raw meat diets are dangerous and understand that there are ways to source and prepare this diet that will actually make it safer than the commercial foods that they continue to recommend without any thought as to feline illnesses that these foods contribute to due to their species-inappropriate composition/ingredients, as well as the contamination issues. 

I don’t think that a single cat or dog caregiver in the US is not aware of the thousands of cats and dogs that suffered tremendously and died – or have been left with failing kidneys and a shortened lifespan/diminished quality of life – due to the contamination of commercial foods processed by Menu Foods in the summer of 2007.

While the Menu Foods recall was the largest pet food recall in the history of commercial pet food, make no mistake in thinking that this was the first time that cats and dogs have died after consuming commercial pet foods that have been contaminated with chemicals, bacteria, and bacterial or mold toxins.

However, keep in mind that the vast majority of these contamination disasters (outside of the Menu Foods tragedy) have involved dry food or treats – not canned food. Therefore, if you decide that you don’t want to make your cat’s food, please feed canned food and keep the dry food out of your cat’s food bowl.

Dry food is simply not a very healthy or completely safe diet to be feeding to any cat.

See Urinary Tract Health and take a look at Opie’s pictures.  If humans would stop feeding dry food to cats, cats like Opie would not have to suffer from excruciatingly painful – and life-threatening – urethral blockages.

There have been many instances of mold toxin-related deaths of pets after eating contaminated commercial dry food.  I have listed a few below but these tragedies are too numerous to list all of them.

The regulatory body for the commercial pet food industry does allow a certain level of mold toxins (found in grains) to be present in your pets’ food.  For me, this is unacceptable – especially when feeding cats – since grains have no business in their diet to begin with.

With regard to the extremely dangerous and life-threatening fungal toxins found in commercial dry food, this issue will never be a worry when feeding a grain-free diet – either in the form of canned food or the diet discussed on this page.

And if mold toxins and bacteria in dry food are not enough to cause us worry, please consider the fact that the fats contained in dry food become rancid over time – even with the preservatives that are added to the food.  Heat, oxygen and light are all factors involved in fats becoming rancid.  Keeping dry food in the refrigerator will help with the issue of heat but that still leaves the oxidation issue unaddressed.

Dry foods sit in warm warehouses and pet food stores before they even reach our pets’ bowls – promoting rancidity of fats, bacterial growth, mold growth, and toxin formation, and proliferation of storage mites.

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.

See this link for an abstract that discusses the issue of storage mites that were found in 9 out of 10 bags of tested dry food.

There is absolutely no doubt in my mind that many cats and dogs have died as a result of consuming commercial pet foods yet the cause goes unrecognized.

These deaths include the various illnesses that manifest themselves due to the species-inappropriate composition (composition = percentage of calories coming from proteins/fats/carbohydrates and the water content) of the diet, as well as out-and-out contamination issues as discussed above and below in the Pet Food Recalls section.

Unfortunately, humans just don’t recognize these illogical and unsafe diets as the cause of the pet’s illness.  Humans – including veterinarians – often fail to put 2 + 2 together in many instances of ill health or death.  Food is often the last thing to even be considered as a cause or contributing factor in the event of an illness or death.

As stated above, we all must work within our comfort zone.  If you find that you are not comfortable feeding a raw meat – or semi-cooked – diet even when implementing the tips in my safety section, then please feed canned food and remove all dry kibble from your cat’s diet.

Pet Food Recalls/Warnings

Throughout the history of the commercial pet food industry, there have been numerous recalls of dry kibble pet food and treats due to contamination issues involving bacteria (salmonella, etc.) fungal mycotoxins, deadly chemicals, and storage mites. And to be fair, there have also been recalls of commercial raw meat diets.

The list below by no means includes all reported contamination issues. If it did, this webpage would be a mile long.

For a list of current recalls, please see truthaboutpetfood.com.  This website lists pet food recalls and is much more current than the information below. I cannot keep up with the task of posting all recalls/warnings/dry pet food-related animal deaths and human illnesses/deaths on this page.

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January, 2011:  200 cows recently died after consuming feed contaminated with moldy sweet potatoes.  The mycotoxins produced by the mold was the cause of  death.

February/March 2010:  Nature’s Variety raw chicken products – possible salmonella contamination.  This company has recently implemented a pasteurization process to help ensure the safety of its future products.

January, 2010:  Merrick Beef Filet Squares for dogs – FDA warning issued due to salmonella contamination of these treats.

October, 2009: Wysong recalls dry food with mold contamination.

October, 2009: Diamond Pet Food company recalls Premium Edge dry food due to thiamine deficiency which causes severe neurological damage and death in cats.

June 12, 2009: The U.S. Food and Drug Administration announced today it was suspending the temporary Emergency Permit issued to Evanger’s Dog & Cat Food Co., Inc.  The deviations in their processes and documentation could result in under-processed pet foods, which can allow the survival and growth of Clostridium botulinum (C. botulinum), a bacterium that causes botulism in some animals as well as in humans.

January 9, 2009:  Chicken jerky treats for dogs.  Here is an excerpt from VIN (Veterinary Information Network):

The U.S. Food and Drug Administration has received 153 complaints during the past 16 months about illness in dogs that have eaten chicken jerky treats and continues to take reports “at a steady clip,” an agency spokeswoman said Friday.

November 25, 2008:  Mars Petcare US extended its October 28, 2008 voluntary pet food recall of dry food that affected 15 states, adding more product carriers and brands affected by possible salmonella contamination.

October 28, 2008:  Mars Petcare US is yet again recalling another salmonella-contaminated dry food manufactured at one of their facilities.  This time it is Special Kitty Gourmet which is sold at Wal-Mart locations in 15 states.

October 20, 2008:  Hartz Mountain Corporation is recalling rawhide chips due to salmonella contamination.

September, 12 2008:  Mars Petcare US, once again, is recalling salmonella-contaminated dry pet food.  This company makes many different brands of pet food.  There were many human cases of salmonella infection possibly linked to this food.

August, 2008:  The California Public Health department reported salmonella contamination of Pedigree dry dog food.  Pedigree is made by Mars Petcare US.

August, 2007: The FDA recalled several dry foods under the Natural Balance Eatables product line due to botulism toxin contamination.

January 2006 – September 2007:  See this link for a CDC report on a multi-state (19 states) outbreak of salmonella in humans during 2006 and 2007.  The source was dry pet food made at Mars Petcare US.

December, 2005:  Some of you may also remember the deaths of many cats and dogs after they ate Diamond pet food in 2005.  These animals became very ill – and many died – secondary to liver failure from mold toxins (aflatoxin) that were contained in the grains of a commercial dry kibble.  Many cats and dogs died as a result of this contaminated food.  The surviving animals will have permanent liver damage.

Dogs

I frequently receive emails from readers asking for recommendations for websites like mine that discuss optimal canine nutrition.  There may be some out there but I don’t know of any specific ones to send readers to.

That said, I recommend purchasing Feeding Miss Lilly – a easy-to-read, common-sense-based book written by my colleague, Dr. Christine King.

I will say that if I had a dog, she would be fed the same diet that my cats are fed.  However, if someone wants to incorporate some vegetables and grains into their dog’s diet, appropriate balanced recipes can be formulated.  Please refer to Dr. King’s book linked above.

Dogs differ from cats in that they are not true obligate carnivores.  Therefore, they can utilize plant proteins in a more efficient manner when compared to cats.  Dogs also have a higher thirst drive to make up for the water deficit in dry kibble.

But, all that said, I would still feed my (hypothetical) dog a fresh, water-rich, minimally cooked, meat-based diet and refrain from feeding her a water-depleted, cooked-to-death, high carbohydrate, plant-based protein, and often highly-contaminated dry food.

Conclusion

If you would like more information regarding the obligate carnivore status of the cat, please see Feeding Your Cat: Know the Basics of Feline Nutrition.  If you would like to read a more in-depth discussion of this topic, please see Dr. Zoran’s wonderful paper entitled The Carnivore Connection to Nutrition in Cats.

As stated above, if you decide that you are not comfortable preparing your own cat food, please feed canned food and get the dry food out of your cat’s food bowl.

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Partially updated: December 2016
Lisa A. Pierson, DVM