Feline Chronic Kidney Disease
ON THIS PAGE: Risk Factors Home > Related Diseases > Diabetes It is not uncommon for a CKD cat to also have or develop diabetes. The dietary needs of a diabetic cat may seem incompatible with the needs of a CKD cat but the diabetes must take precedence. What is Diabetes Mellitus? Insulin is a hormone which enables the body to process food and to produce energy from it. Diabetes mellitus is a disease in which: not enough insulin is produced by the pancreas; or the cat’s body cells do not properly process insulin which the pancreas has produced. As a result, the cat develops high blood sugar levels (hyperglycaemia), which eventually lead to high sugar levels in the urine (glucosuria). Diabetes may present as: uncomplicated; or diabetes with ketoacidosis (DKA) Cats with the former may only have mild symptoms, at least in the early stages, but cats with ketoacidosis are usually very ill, and may die if not treated promptly. There is another, much rarer form of diabetes called diabetes insipidus which is beyond the scope of this website. Cornell University College of Veterinary Medicine has a good general overview of diabetes in cats. Feline diabetes mellitus: from diagnosis to therapy (2009) is a helpful article by Dr DL Zoran. Feline Diabetes provides detailed answers to frequently asked questions. Risk Factors Increasing age is a factor (as it is for CKD cats). Steroid-induced diabetes in cats (2013) Peterson ME Veterinary Endocrinology says "The average age at diagnosis for feline diabetes is 10 years, with a peak incidence between 9 and 13 years." Obesity in cats, as in humans, is a strong predisposing factor for diabetes. For some reason, male cats and neutered cats are more at risk of diabetes. Burmese cats in the UK and Australasia (but not the USA) appear to be mo Continue reading >>
What Causes High Ketones In A Canine?
A dog with a high level of ketones in his urine suffers from a condition known as ketonuria, usually resulting from a buildup of these substances in the dog's blood. A ketone is a type of acid, which, if allowed to accumulate in the blood, can lead to ketoacidosis, a potentially fatal condition. The main health conditions that can cause high ketone levels in a canine are starvation and diabetes. A dog's body breaks down the food that he eats into sugars, also called glucose, that the cells of the body use for energy. The dog's pancreas then produces the hormone insulin to regulate the amount of glucose that the body will absorb. If the insulin to regulate the glucose is insufficient, typically due to chronic diabetes mellitus, the body breaks down alternate sources of fuel for its cells; a dog's body that is starved of nutrition will do the same. One of these sources is the fat stored in the dog's body. When the body breaks down this fat, it produces as a by-product toxic acids known as a ketones. These ketones then build up in the dog's blood and also his urine, leading to ketoacidosis. Always consult an experienced veterinarian regarding the health and treatment of your pet. A dog suffering from high ketone levels in his blood and urine exhibits symptoms of weight loss, vomiting, increased thirst, decreased appetite, increased urination, lethargy, low body temperature and yellowing of the skin and gums, according to PetMD. The dog's breath may also have a sweet, fruity smell due to the presence of acetone caused by ketoacidosis, says VetInfo. To properly diagnose high ketone levels and ketoacidosis in your dog, a veterinarian will take blood tests and a urinalysis, which will also check your dog's blood glucose levels. Depending on the dog's physical condition, hospit Continue reading >>
Chronic Kidney Disease (ckd)
What is chronic kidney disease? Chronic kidney disease (CKD) refers to a progressive loss of renal function over a period of months or years. In clinical, many kidney related diseases like Polycystic Kidney Disease, Diabetic Nephropathy, Nephrotic Syndrome, Glomerular Nephritis and Hypertensive Nephritis and so on can be regarded as Chronic Kidney Disease. With the progressive loss of renal failure, Chronic Kidney Disease will finally run to kidney failure and cause many fatal complications like heart failure. Chronic Kidney Disease is generally divided into five stages according to Glomerular Filtration Rate (GFR). In the early stage, there is no obvious symptom, so Chronic Kidney Disease is easy to be ignored, which is the reason why many patients are diagnosed with kidney failure when they realize they have kidney problem. Back top What are the tests for Chronic Kidney Disease? Kidney function Test Kidney has function to excretes toxic substances from blood, keep balance of electrolyte and acid-base as well as generate urine. Through kidney function test, we can know clearly whether our kidneys function well. Routine Urine Test Routine urine test is the indispensable test for diagnosing Chronic Kidney Disease. Urinalysis is the most simple of urine tests which are used to screen for kidney problem. A simple dipstick can detect the present of glucose, protein, ketones, or bilirubin in the urine as well as the acidity or alkalinity of the urine, indicators of potential kidney problem. Routine Blood Test With routine blood test, we can get to know whether there is excessive creatinine, urea nitrogen or other harmful substances. In normal cases, these substances should be excreted by our kidneys, so increased levels of creatinine and urea nitrogen may indicate kidney pro Continue reading >>
Lupus And Kidney Disease: What You Should Know About Lupus Nephritis (lupus Kidney Disease)
Adapted from a presentation at the SLE Workshop at Hospital for Special Surgery Introduction At this session of the SLE Workshop at HSS, Dr. Kyriakos Kirou presented his expertise on the diagnosis, symptoms, treatments, and research related to lupus and kidney involvement, including lupus nephritis (LN). Dr. Kirou is an assistant attending physician at HSS and the co-director of the Mary Kirkland Center for Lupus Care. When presenting, Dr. Kirou emphasized that the purpose of his presentation is to educate patients about lupus and its interaction with the kidney and should not be used as therapeutic advice. He stressed that when patients need to make a decision about their own specific care, they should consult their own rheumatologist. It is important to recognize that there’s no “one fits all” therapy. Dr. Kirou discussed how lupus can affect the kidney and cause the disease known as lupus nephritis (LN). He also discussed tests that are used for diagnosis, as well as available therapies. He also spoke about the necessary lifestyle changes that LN patients may have to adopt after their diagnosis of LN to minimize harm in their bodies. First, it is important to understand how the kidney functions, what happens when someone with lupus has problems with their kidneys, and how they can go about dealing with the situation. Background Information Lupus:Lupus is a chronic and autoimmune disease that affects several parts of the body, including joints, blood, skin, and kidneys. The immune system of those with lupus does not function properly. Lupus creates autoantibodies that fight and damage the cells, tissues, and body organs. When they are present, they can likely lead to disease. Kidney: The kidney is a bean-shaped, fist-sized organ that helps cleans the body from a Continue reading >>
Is Kidney Disease Reversible Through Diet In People With Diabetes ?
Anyone with diabetes and chronic kidney disease would gladly accept a treatment that could reverse their kidney disease. That’s why this topic in an article I recently ran across caught my attention. A report from Mount Sinai School of Medicine researchers indicate a ketogenic diet may help people who have kidney disease related to Type 1 and Type 2 diabetes. A ketogenic diet is low in carbohydrate, high in fat and contains a moderate amount of protein. For years this type of diet has been used for seizure control in children with epilepsy. When this type of diet is consumed, the body produces ketones because fat is burned as the primary energy source. Charles Mobbs, PhD, Professor of Neuroscience and Geriatrics and Palliative Care Medicine at Mount Sinai School of Medicine, says “Our study is the first to show that a dietary intervention alone is enough to reverse this serious complication of diabetes. This finding has significant implications for the tens of thousands of Americans diagnosed with diabetic kidney failure, and possibly other complications, each year.” Researchers believe the ketogenic diet works by blocking the toxic effects that high glucose levels have on the kidneys. Future research to find out how the ketogenic diet works to reverse nephropathy may lead to drug therapy to mimic the ketogenic diet effect. The research may also help with treatments for other long-term diabetes complications such as retinopathy and neuropathy. A few considerations are in order before you change your current diet. These findings are from research on mice; human trials are needed before this type of diet could become a part of the treatment plan for people with diabetes. Any changes in your usual intake of carbohydrate will have an impact on glucose levels. Lower gl Continue reading >>
Dr. Charles Mobbs: Diabetic Kidney Damage Can Actually Be Reversed With A High-fat, Low-carb Ketogenic Diet
Exciting news spread throughout the low-carb blogosphere this past week when a brand new study of mice published in the April 20, 2011 issue of the scientific journal Plos One revealed a rather surprising positive health effect of a high-fat, low-carb ketogenic diet for treating diabetic complications. Lead researcher Dr. Charles V. Mobbs, professor and researcher at the Fishberg Center for Neurobiology at the Mount Sinai School of Medicine in New York City, set out with the hypothesis that diabetes is just an accelerated form of aging. And as someone who has studied aging and metabolism throughout his career, he had already made the connection between complications from diabetes being the result of too much glucose metabolism. Along the way of examining aging, though, he noticed that the presence of ketone bodies would actually prevent glucose metabolism from happening which deeply intrigued him to become intently interested in this whole idea of a ketogenic diet as a therapeutic means for treating the various health problems associated with diabetes. Because nephropathy, or kidney disease, is easy to measure by the amount of protein in the urine, he and his fellow researchers focused in on that in conducting their study. Dr. Mobbs acknowledges that the ketogenic diet (defined very specifically as a nutritional intake comprised of 87% fat, 8% protein, and 5% carbohydrate) has already been used for many years as a therapeutic measure for treating epileptic seizures thanks to a fabulous organization named The Charlie Foundation promoting it as an excellent nutritional alternative to medications. I’ve previously interviewed two outstanding experts about using ketogenic diets for epilepsy on my “Livin’ La Vida Low-Carb Show” podcast in the past few years: Dr. Eric Continue reading >>
Ketones, Ketosis, And Ketogenic Diets
An understanding of ketones and ketosis is essential for understanding how some high protein-low carbohydrate diets (also called Ketogenic Diets) such as Atkins diet works. Ketones are mild acids, a sort of reserve fuel released from burned fats for survival under conditions of starvation. When we go without food for even a few days our bodies begin living off our stored fats, and these release ketones. During ketosis, the body switches from using glucose for energy (sufficient dietary carbohydrates are not available) to using fat. Fatty acids are then released into the bloodstream and converted into ketones. The ketones themselves are produced by the metabolism of fat. Ketosis refers to the process of the conversion. The ketones are used by your muscles, your brain, and other organs as an energy source. Excess ketones are then eliminated during urination. Ketosis occurs when the amount of carbohydrate fuel- the fuel that is needed to run the body - drops below a critical level, forcing the body to turn first to protein and then to fat reserves to do the work carbohydrates normally do. When protein is deflected in this manner, it releases nitrogen into the blood stream, placing a burden on the kidneys as they try to excrete excessive urinary water due to sodium loss. When fat is likewise deflected, the breakup releases fatty acids, or ketones, into the bloodstream, further burdening the kidneys. If ketosis continues for long periods of time, serious damage to the liver and kidneys can occur, which is why most low-carbohydrate, or ketogenic diets recommend only short-term use, typically 14 days. Many nutritionists caution their patients-especially women in the early stages of pregnancy-against following them at all. Fasters experience a sensation of improved well-being a Continue reading >>
The Facts The kidneys, each about the size of a fist, play three major roles: removing waste products from the body, keeping toxins from building up in the bloodstream producing hormones that control other body functions, such as regulating blood pressure and producing red blood cells regulating the levels of minerals or electrolytes (e.g., sodium, calcium, and potassium) and fluid in the body After the blood has circulated through the body, it passes into the kidneys. The kidneys filter waste products and excess salt and water out of the blood, and pass these out of the body as urine. The kidneys also make hormones that control blood pressure, as well as maintain bone metabolism and the production of red blood cells. It's a serious problem when the kidneys stop working. Waste products that build up in the body cause imbalances in chemicals needed to keep the body functioning smoothly. There are many different types of kidney diseases. Kidney diseases can lead to end-stage renal disease (ESRD), a condition in which the kidneys fail to work normally. People with kidney failure need to receive dialysis or a kidney transplant. Causes The most common causes of kidney disease include diabetes, high blood pressure, and hardening of the arteries (which damages the blood vessels in the kidney). Some kidney diseases are caused by an inflammation of the kidneys, called nephritis. This may be due to an infection or to an autoimmune reaction where the body's immune or defence system attacks and damages the kidneys. Some kidney diseases, such as polycystic kidney disease are caused by problems with the shape or size of the kidneys (anatomic disorders), while other kidney diseases interfere with the inner workings of the kidneys (metabolic disorders). Most metabolic kidney disorders Continue reading >>
The Effect Of Ketone Bodies On Renal Ammoniogenesis
Infusion of ketone bodies to ammonium chloride-loaded acidotic dogs was found to induce significant reduction in urinary excretion of ammonia. This effect could not be attributed to urinary pH variations. Total ammonia production by the left kidney was measured in 25 animals infused during 90 min with the sodium salt of D,L-β-hydroxybutyric acid adjusted to pH 6.0 or 4.2. Ketonemia averaged 4.5 mM/liter. In all experiments the ammonia content of both urine and renal venous blood fell markedly so that ammoniogenesis was depressed by 60% or more within 60 min after the onset of infusion. Administration of equimolar quantities of sodium acetoacetate adjusted to pH 6.0 resulted in a 50% decrease in renal ammonia production. Infusion of ketone bodies adjusted to pH 6.0 is usually accompanied by a small increase in extracellular bicarbonate (3.7 mM/liter). However infusion of D,L-sodium lactate or sodium bicarbonate in amounts sufficient to induce a similar rise in plasma bicarbonate resulted in only a slight decrement in ammonia production (15%). The continuous infusion of 5% mannitol alone during 90-150 min failed to influence renal ammoniogenesis. Infusion of pure sodium-free β-hydroxybutyric acid prepared by ion exchange (pH 2.2) resulted in a 50% decrease in renal ammoniogenesis in spite of the fact that both urinary pH and plasma bicarbonate fell significantly. During all experiments where ketones were infused, the renal extraction of glutamine became negligible as the renal glutamine arteriovenous difference was abolished. Renal hemodynamics did not vary significantly. Infusion of β-hydroxybutyrate into the left renal artery resulted in a rapid decrease in ammoniogenesis by the perfused kidney. The present study indicates that ketone bodies exert their inhibitory in Continue reading >>
Are Ketogenic Diets Bad For People With Kidney And Liver Issues?
There is an international organization of doctors and other professionals who have clinical experience with ketogenic diets. It's called the International Ketogenic Diet Study Group. They publish guidelines for safe use of ketogenic diets. The guidelines include a list of medical conditions (contraindications) which would make a ketogenic diet unsafe. At least one of the conditions on the list (carnitine deficiency) can cause liver dysfunction. You don't say exactly what sort of liver problem you have in mind. If you personally have a disease that affects the liver, maybe you should look at the list of contraindications carefully. Another condition on the list, beta-oxidation defects, can cause the liver to lack the ability to oxidize fatty acids. Regarding this condition the guidelines say, "An inborn metabolic error at any point along this pathway can lead to a devastating catabolic crisis (i.e., coma, death) in a patient fasted or placed on a [ketogenic diet]." Ketogenic diets increase the risk of kidney stones. Doctors often prescribe potassium citrate to people on medical ketogenic diets as a prophylactic measure against kidney stones. Here is a link to the full text of the guidelines. Contradindications are in Table 2. The title says "children" because virtually all clinical experience with ketogenic diets has been with kids. If you want to read more about the risks of ketogenic diets, click here to see a bibliography on my website (with many links to full text) of articles about risks and prevention. Some people seem to believe that ketogenic diets are harmless, risk-free, totally wonderful things. This isn't true. Ketogenic diets are like medications. They bring benefits but they also bring risks and harmful side effects. They involve tradeoffs. I'm not against Continue reading >>
Diabetes With Ketone Bodies In Cats
Diabetic ketoacidosis is an extreme medical emergency that requires immediate veterinary attention. The condition can result in an accumulation of fluid in the brain and lungs, renal failure or heart failure. Affected animals that are not treated are likely to die. With timely intervention and proper treatment, it is likely that an affected cat can recover with little to no side effects. Diabetes mellitus occurs when the pancreas fails to produce sufficient insulin, creating an inability to efficiently process the sugars, fats, and proteins needed for energy. The resulting build-up of sugar causes extreme thirst and frequent urination. Since sugar levels help to control appetite, affected animals may experience a spike in hunger and lose weight at the same time due to the inability to properly process nutrients. In extreme cases, diabetes may be accompanied by a condition known as ketoacidosis. This is a serious ailment that causes energy crisis and abnormal blood-acid levels in affected pets. Cats affected with diabetic ketoacidosis are likely to present with one or more of the following symptoms: Vomiting Weakness Lethargy Depression Excessive Thirst Refusal to drink water Refusal to eat Sudden weight loss Loss of muscle tone Increased urination Dehydration Rough coat Dandruff Rapid breathing Sweet-smelling breath Jaundice The exact cause of diabetes in cats is unknown, but it is often accompanied by obesity, chronic pancreatitis, hormonal disease, or the use of corticosteroids like Prednisone. Ketoacidosis, the buildup of ketone waste products in the blood that occurs when the body burns fat and protein for energy instead of using glucose, is caused by insulin-dependent diabetes. Diabetic ketoacidosis is commonly preceded by other conditions including: Stress Surgery Continue reading >>
Clearing Up Kidney Confusion: Part Deux
It’s funny how our mental state really affects how we write and what we are interested in. When I wrote the introduction to this piece I was just getting settled into our new place in Santa Fe, NM and was looking at over a month at home to work and write. Then a number of wacky events happened and I’ve been home about 7 days out of the last month and I’ve only made it about 70 pages into Kon-Tiki. Ouch. Now I’m home for 8 days and will then be gone for a project that will take me completely off the grid for nearly 3 weeks. No phone, email…nada. When I sat down to do this kidney piece it was with a mindset that I had a ton of time and could really sink my teeth into it. Now I’m time crunched and anxious that I will get it done at all! Up front here I’d like to thank Mat “The Kraken” Lalonde with his help on some literature for this piece. Any inaccuracies however are my own tomfoolery. If I wanted to cut to the chase I could boil this whole thing down to the following: 1-Dietary protein DOES NOT CAUSE KIDNEY DAMAGE. 2-Chronically elevated BLOOD GLUCOSE levels DO cause kidney damage. 3-Dietary fructose REALLY causes kidney damage. 4-Many kidney issues have either a hyperinsulinemic characteristic, an autoimmune characteristic, and or a combination of autoimmunity or hyperinsulinism. A standard, low-ish carb paleo diet can fix most of these issues. 5-For serious kidney damage a low-protein, ketogenic diet can be remarkably therapeutic. 6-If you get kidney stones that are from oxalates, reduce your green veggie intake (spinach for example) and have other types of veggies. 7-If you get kidney stones that are from urate salts, you are likely NOT following a low-ish carb paleo diet, you likely have insulin resistance and your liver is not processing uric acid Continue reading >>
Are Raspberry Ketones Safe For Someone With Stage 3 Ckd?
I am unaware of any studies of the use of raspberry ketones in patients with Stage 3 chronic kidney disease. According to the Food and Drug Administration (FDA), raspberry ketones are generally recognized as safe (GRAS) but there is no information about use in patients with CKD. The National Kidney Foundation is the leading organization in the U.S. dedicated to the awareness, prevention and treatment of kidney disease for hundreds of thousands of healthcare professionals, millions of patients and their families, and tens of millions of Americans at risk. Continue reading >>
Low Carbohydrate High Fat Ketogenic Diet May Reverse Kidney Failure In People With Diabetes
Share Share Share Health Impact News Editor Comments: Here we have yet another study showing the effectiveness of the ketogenic diet, which is a very strict diet that eliminates almost all carbohydrates and consumes very large amounts of fat, especially saturated fat. This diet has baffled those in the medical community for years, because of their presupposition that saturated fat is bad and leads to cardiovascular disease, and should be avoided in our diet. The ketogenic diet has been effective in preventing seizures in children with epilepsy, often when all other drugs fail. The medical community, while admitting that the diet works, usually state that they don’t know why it works. They are often blinded by their own bias and presuppositions that believe a high saturated fat diet is detrimental to one’s health. So I was surprised when I learned that the ketogenic diet was studied in relation to kidney failure among those with diabetes, and that the funding came from traditional allopathic sources. It suggests that kidney failure due to diabetes has become a serious concern, and that current medical practices and drugs are not all that effective. Unfortunately, as studies like this continue to support the data and research that our bodies need saturated fat, and other studies showing our need for cholesterol, the prevailing belief against the benefits of saturated fat apparently still hold fast. Note the quote by the head of the research team, Dr. Charles Mobbs, at the end of this press release: “Knowing how the ketogenic diet reverses nephropathy will help us identify a drug target and subsequent pharmacological interventions that mimic the effect of the diet,” said Dr. Mobbs. So the motivation in funding such as study was not to change dietary beliefs and pra Continue reading >>
Could A High-fat, Low-carb Diet Someday Replace Dialysis?
MORE A type of low-carb, high-fat diet that's typically used to manage seizures for children with epilepsy could reverse kidney disease in Type 1 and Type 2 diabetics, a new animal study suggests. If successful in humans, the so-called ketogenic diet could have the potential to replace dialysis, which is a procedure that artificially filters blood in place of a damaged or failed kidney, said study researcher Charles Mobbs, professor of neuroscience and geriatrics and palliative care medicine at Mount Sinai School of Medicine in New York City. "I speculate that this may be useful to completely cure diabetic kidney failure , and I hope that it's possible," Mobbs told MyHealthNewsDaily. "If it's possible, we can potentially not require dialysis. That's a big deal." However, a lot more research in mice is needed before any studies can be done in humans, Mobbs said, let alone determine if the diet can reverse advanced kidney disease in humans, he said. "That's the first thing we want to establish in mice: Can we truly reset the clock? Can we completely correct the [kidney] impairments?" Mobbs said. Other experts say the finding is promising for Type 1 and Type 2 diabetics with earlier-stage kidney disease, but more research must be done to provide evidence that the diet can make an impact on end-stage kidney disease , or kidney failure. Type 1 diabetes is a chronic disease that occurs when the pancreas cannot produce enough insulin (needed to move blood sugar into cells for energy) to control blood sugar levels, according to the National Institutes of Health. Type 2 diabetes occurs when the body becomes resistant to insulin, leading to high blood sugar levels. Overweight and obesity, a sedentary lifestyle and poor diet are risk factors for Type 2 diabetes, according to the N Continue reading >>