Caring for a Cat with Kidney Disease: Hopeful News from the Front Lines
This is an interview with Karil Kaylor about how her cat, Boomer, has had significant improvement since his initial sobering kidney failure diagnosis.
Ever on the lookout for encouraging cat health stories we might learn from, and painfully aware of how common kidney failure is in cats, I was eager to let Karil share her story here.
LIZ:
Can you give me some background on your cat’s health story — when and what was the diagnosis + what were his/her symptoms?
KARIL:
Boomer, a domestic long hair male, was diagnosed with early stage renal failure in November 2013, at age 10 1/2.
He had a full wellness check up with blood work in April 2013, and everything was fine. He weighed 11 pounds at that time.
I took him to the vet in November for a weight check because he seemed thin. He is normally a picky eater, but his appetite, litter box habits and behavior were the same as usual. It turned out that he had lost 2 pounds in 6 1/2 months. Blood work and urinalysis revealed early stage renal failure.
The vet said the goal was to prevent further weight loss, and maintain current kidney values. There was no reasonable expectation for improvement, just stability before the disease gradually progressed with age.
LIZ:
What did the vet recommend?
KARIL:
Dr. Meekins recommended a prescription kidney diet, so we tried Hill’s k/d. Boomer absolutely refused to eat. He because so adverse to the attempts to make him consume k/d that he began hiding from me, and would tremble when I found him.
After a few days of this, Dr. Meekins suggested trying another brand of food. I obtained a prescription for Royal Canin Renal LP, and bought it at another vet’s office.
He would not eat the modified (shredded variety in small cans) or the pate type. But I found that I could blend the pate type with warm water and feed him with a 5 ml syringe. I had to cut the tip off, and could insert the tube in the wet food, pull back the plunger and have a ready mouthful of food for Boomer.
Initially he gagged and cowered, but gradually I was able to force feed him several times daily, getting about 15 – 20 ml per feeding. He was completely averse to food at that point.
LIZ:
So what did you do then?
KARIL:
During online research, I found Pet WellBeing Kidney Support Gold. I ordered a bottle, and took it and a list of ingredients to our vet. She said there were no ingredients that she believed would harm Boomer, and that it was worth trying.
So about 3 weeks after his diagnosis, I tried administering a few undiluted drops of Kidney Support Gold, but he couldn’t tolerate them directly. He gagged and foamed at the mouth, and shook violently. So I mixed a few drops with his food, and fed him with the syringe.
LIZ:
He was able to get his supplement drops down that way?
KARIL:
Yes, and his appetite began to improve. He began nibbling on the other cat’s canned and dry food. He will not voluntarily consume Royal Canin k/d or the Kidney Support Gold, but tolerates 2 or 3 daily feedings of 40 – 50ml with the syringe. He nibbles throughout the day on whatever he chooses.
LIZ:
That is good news – a real improvement over being completely averse to any food. Are any other treatments helping him?
KARIL:
The other significant treatment for Boomer is the administration of subcutaneous fluids every other day. I started the subQ fluids immediately at his diagnosis.
The vet taught me how to administer regular fluids at home. Fortunately, Boomer is a very docile and loving cat, and tolerates this well. Many times he purrs throughout the procedure.
LIZ:
What is Boomer’s condition like now?
KARIL:
Astonishingly, Boomer’s kidney values have improved. He has gained 1 pound, and seems to feel great. He is active, playful, loving and very forgiving of the indignity of force feeding and fluid administration.
He chooses to eat the food he likes, but I still feed him at least twice daily with the syringe so that I know he is receiving the Kidney Support Gold and the prescription cat food he requires.
Boomer’s regimen of care is high maintenance, but he is well worth the effort, and I am glad to take the extra time and effort needed to keep him healthy. He gets along with the other pets in the household, greets every guest, and is a wonderful, loving and again healthy cat!
LIZ:
That is so good to hear! Thank you very much for sharing your story.
MORE: Be sure to check out Dr. Hofve on what to feed a cat with kidney disease.
My 13 year old Siamese has stage 2 kidney disease. She will only eat the dry prescription food. She was eating some wet food with FortiFlora. I would like to know what the top quality food you recommend. I feel I need to do something better for her before she gets any sicker. Thank you, Helen
Can kidney gold be added to food? Using the syringe is not an option for my cat
yes– we did— assume you are talking about Kidney gold from Pet wellbeing.. however, with one of our cats, we found great success with products from http://www.askariel.com esp their Renelix (one bottle will last a long time)–depending on size of cat– you may only need 4 drops.. and they can let you know how often.. perhaps only a couple times a week.. depends on what stage…and Kidney health–a specific digestive enzyme in their food….. Kidney gold works great for some cats though.. it depends on what type of kidney disease they have.. Everyone is diff in the way their respond. We always hid ours in a very tiny amt of baby food.. Same thing wit Renelix.. only a small amt of food or broth.. and then no food for 2 hrs before or after the dose.. so, that it will work real well in their little bodies… ..wishing your baby well.. debbie
Thank you for the advice , I’ll look into your suggestions. I’m also treating him for hyperthyroidism, I’m trying a gel that goes on the underside of his ear. If I can sneak up on him it goes well enough but if senses me coming its a bit of a struggle. His official name is Smokey the Bear but I call him Kittley. Again thanks!
I also meant to mention that Kittley looks like Boomer.
Beautiful…ps…we had luck with thyroid soothe and pet calm ..both Pet alive products…for our cat with Thyroid issues…but again everyone is diff. Just crushed & hid in food…never could pill them…too much stress. BACH RESCUE REMEDY…a liitle on inner ear lobes
.helped all our boys..when stressed.
I Also agree Ingredients of the supplement, Rehmannia has some beneficial effects in some cases of kidney disease, but can be harmful in the wrong situation.
yes– this is what I was referring to as well… deb
it causes inflammation in animals and HUMANS actually
one thing i am seeing is the adverse affects of carrageenan (a seaweed additive that helps to make food creamy) in the the food. Apparently, although fda approved, it causes inflammation in cats and animals. Dr. Pierson even suggested that this ingredient may be the cause of some animal’s vomiting. I am wondering if this is what has brought on my cats sicknesses in the first place. I am switching them to a food without carrageenan immediately.
Although I don’t know for certain how carrageenan affects cats, or how much is needed to be detrimental, I have had my own human experience, with a large quantity. Along with my cat, I have kidney disease and lost a great deal of weight. My doctor suggested that I drink Boost Plus, every day. I didn’t like the ingredients of lousy fats and sugars, in addition to the carrageenan, but I really needed to gain weight and have no appetite. After some weeks of drinking it (not solely), I began to vomit, seriously, several times a week. At that time, I was, coincidentally, researching the algae extraction, and wondered if it played a role. I stopped drinking it, and, voila!, no more vomiting. Coincidence?! I decided not–so no more Boost Plus (Asure is the same), no more vomiting. Unfortunately, it is a common ingredient in many cat foods and human foods. I still, feed my cat some food with carrageenan because it is lower P, but mix it with others and try to purchase the ones where the ingredient is low on the list. I am not happy about any of this, but there other many other issues to contend with in cat foods, along with palatability, especially, one with inappetence problems, needing a stimulant–fillers, preservatives, poor quality protein, 4-D poisons, microtoxins, bacteria, heavy metals, (and P for CKD cats), etc. I like Hounds & Gatos, and Radcat, both of which add high phosphorus. He will eat the lamb/duck H & G, sadly, not the chicken, haven’t tried the rabbit. Of the Radcat, the lamb is the lowest phosphorus, but a lot of fat, some of which I have to pick out. He seems to like the chicken the best. I give him all three offerings (includes turkey). He will eat some Weruva, (they are low in fat, though) only If I grind them up–he’s a pate guy. Dental problems make it more necessary, but too sick, now, to consider scaling. I am now going to have to add phosphorus binders, the P is high. don’t trust many commercial cat foods and am too ill to make my own, so I do what I can.
Good thing for Boomer. Best wishes Liz. Water therapy sounds basic but I think it’ll help even by little.
Hi:
I have had several cats die from Renal(Kidney) Failure. I believe that the reason for the
anorexia is directly related to the fact that there is concomitant Gastritis from which
the cat suffers. I have given 1/4 tablet of Priloec(20mg) along with Nutrical gel. and
Nutri vitamins also a gel.
I guarantee that this will improve kitty’s appetite so that he can eat alone.
My vet agrees with me and I also am a physician.
My last kitty Laura succumb to Renal Failure after 3+ years at 22 years old.
This is absolutely great content. Our cat at home doesn’t suffer kidney problem ever since though. It’s because we trained him to drink water after every meal. I strongly suggest cat owners also do what I do. I think this’ll help even a bit.
I’m so glad Boomer is doing well! 🙂 I also had a cat diagnosed with kidney disease and we tried to give her the subq treatments but she was too thin by this point and we had trouble getting the needle in. I think that the disease may have been too far advanced since she passed shortly after. I wonder if a special would have helped…
Hi Liz,
Thanks for this post. Thanks also to Karil and Boomer for sharing their story, and Dr. Hovre for her advice.
Just before this post came out I found out my kitty that’s only about 7 years old has a creatinine level at the max. of the normal range when I was doing pre-op blood work for dental work. It’s quite surprising and upsetting news since she never ate dry food, eats organic grass, drinks filtered water, gets fish oil, probiotics, digestive enzymes, DMG (immune support), and a lot of love (o: I also only vaccinated her only once for FVRCP with modified live vaccine.
I recently changed her to Primal raw food but I noticed that you detail that the formula’s with ground bones aren’t good for kitties with kidney issues. I’m just curious why that is? Unfortunately she doesn’t like Rad Cat)o: I think I’ll try the Feline Instinct Kidney formula and mix it with meat and make my own. (Not easy for a vegetarian, but I love my cat so I’ll do it.) I already started giving her Azodyl and Standard Process Feline Renal Support, and adding extra water to her food.
Thanks also for the best foods guide. It was very helpful for finding good canned foods when my kitty started having allergies to chicken and turkey, and then again when I changed to raw.
Congratulations on your book being part of the gift set. I enjoyed your book a lot, and it was very helpful after losing my other kitty last year from lymphoma.
think we all — gain so much.. Liz has provided a wonderful site for all of us. another site I found helpful is http://www.askariel.com some wonderful products for kidney health. I ordered an entire box of HOunds and gatos rabbit…but, mine are not liking the “duck liver: they use .so for those of you –that have cats that don’t like duck….just a heads-up
Hi Deborah,
Thanks for sharing the site. I agree; I’m very grateful for the time and effort that Liz and other sites take to help spread awareness to feline health.
I’m sorry your kitty/kitties didn’t like the new food. It’s very tricky. I know with my kitty she may like a certain protein source from one brand and not eat the same protein source from another brand. She had no interest in Addiction venison, but Primal raw venison is a favorite. She loved Hounds and Gato’s rabbit but isn’t too crazy about Primal raw rabbit.
Addiction canned cat food uses the same animal source for the liver as the type of main meat. For example, the Black Forest Rabbit has rabbit liver in case that brand is of any interest to you.
Thanks so much. I’m always trying to find better canned food choices. I have an adopted/rescued feral kitten– now 18 that can be picky. I used to home cook more–but, have to be careful now– due to renal insufficiency and making sure everything is balanced. He loves white chicken…but, too high in phosphorous.. plus, he has developed a bit of allergy to chicken as well.. warming food…so, we try to stay with cooling ones.– esp more like venison or rabbit for allergies etc. He sometimes likes the Addiction rabbit..but, others not.. Lately we have been battling constipation issues.. even with all the natural pumpkin and green beans added. Any food suggestions are always welcomed. Glad your babies love the Hounds and gatos– I was impressed with the ingredients. I also use Nature’s variety a lot and find that their “immune boosters” are a perfect powder to sprinkle on top-for an enhancer. 🙂 I also raise Rocky’s plates now and tilt a little– that seems to help with acid reflux in the morning..as well as the slippery elm tea. Wish mine liked raw—- have tried many types.. they will do freeze dried raw some. Some of my adopted ones– have 2– 18, 14 and 10 also have stomatitis issues..so, we do many homeopathic formulas to assist.
Michele, thanks for you kind words! I’m so sorry to hear about your kitty’s creatinine levels. I know it’s frustrating when we are trying to do everything right… my understanding is that sometimes cats are born susceptible to kidney disease (perhaps due to mother’s health) or were exposed to a substance that damaged their kidneys before you even adopted them. I think your cat is very lucky to be in your care because she could have been much worse off by now.
Regarding ground bones – some experts have indicated that ground bones make the phosphorous levels less than ideal and high phosphorous levels can make kidney disease progress more quickly (once a cat has the disease – not before). Also, many cats with kidney trouble have constipation and cats with constipation often have trouble digesting the ground bones.
Regarding phosphorous – I’m not an expert, but in the book Your Cat by Dr. Elizabeth Hodgkins she talks about using phosphorous binders in food as a possible solution.
Liz; thanks so much for your reply. I really appreciate it. I know you’re very busy.
Thanks for your kind words as well. Once I have her urinalysis I’ll do a consultation with a holistic practitioner to see what else I can do.
Thanks for the info on the ground bones and the book recommendation. I’ll check it out.
Dr. Jean,
One thing I do not understand, is your saying that if you don’t give a CKD cat the prescription food, exclusively, it negates the benefit, totally. Yet, you suggest using foods that are lower in phosphorus and protein. If you mix the RC, for example,( which my cat won’t eat) in with another food, you will still be reducing the total phos., prot., sod., so how is that completely negating the benefits. I have been mixing Dave’s restricted diet (that has low phosphorus–lower than RC and low protein–about the same as RC) with other foods, just to reduce the total phos. (mainly) and prot. consumed. He does not like it as with the prescription diets, which is why I have to mix it, otherwise I would have to force-feed him it–not the way I want him to have to live, at least, every day, indefinitely. It appears to be a better quality food than the regular prescription diets, incl. RC. I also, don’t believe that the prescription foods are so miraculous, besides being poor quality, or are that sophisticatedly developed to do anything special. I have pretty bad kidney disease, myself, and I have not been given a prescription diet–just lower the protein, consume mostly lower phosphorus, potassium and sodium foods, and keep hydrated. Unlike cats, though, eventually, I will have to reduce my fluid intake and keep a record of it. Why are cats given the complete opposite treatment–increasing subQ’s? Since I have been giving subq fluids to my cat, I see no improvement. In fact, the days that I give him the treatments, he will not eat anything, and he is more lethargic than normally–I spoon-feed and assist-feed, as necessary. I thought the fluids were supposed to make him feel better. I am only giving him small amounts, 50 ml, because he is not dehydrated, I feed him canned food, and add approx 350-420 ml of water to his food (3-4 tsps. each meal) each week, and he won’t sit still for longer than a couple of minutes, even while eating treats the entire time! I thought the main purpose of the fluids was to keep the cat hydrated. If he is hydrated, what good are they doing? My vet says they flush out toxins. I don’t see how. He just absorbs a small bolus of water, over a few minutes, which is eventually absorbed, as needed–not flushed throughout the system out of the body. In the hospital, using continuous IV fluids, that would make sense, but not with slow-infusing acute subq treatments–at least, not to me, and many others on Tanya’s CKD group. They indicate the purpose is to keep the cat hydrated.
I really hope you can read and respond to some of this. There are only 2 main issues, despite all my verbosity.
Hi Pat,
Thanks for the idea to add extra water to the food. My kitty rarely drinks water.
Very useful information. Thank you for sharing it. By the way, am I doing right by giving my so far young and healthy cats predominantly canned dios instead of dry in order to prevent kidney dese?
I agree.. wet food always best… more similar to the wild… 🙂 They say raw is good too… like INstinct Variety–but, mine just do high quality canned or home cooked— their favorites are rabbit with Instinct, rabbit and lamb with Ziwi Peak and Venison and apples with Addiction. I always lessen the protein load a little by adding in some all natural canned pumpkin or baby food all natural squash. ps– on my previous post– I DON’T GIVE THEM TUNA– JUST A SMALL AMOUNT OF THE juice in the “very:” low sodium bumble bee tuna– added to just their Weruva pounch pumkin lickin chicken juice/gravy.. — this keeps them extra hydrated.. and they lick it right up– I add their supplements to the mixture.. happy campers. 🙂
I agree with Jo on the fluids likely being the most important factor in Boomer’s improvement. There is nothing more important than hydration!
Of the ingredients of the supplement, Rehmannia has some beneficial effects in some cases of kidney disease, but can be harmful in the wrong situation. The supplements of most value in feline CKD (supported by published scientific research) are Omega-3 fatty acids and Azodyl, (a probiotic product).
Also, to clarify on the use of kidney diets, they must be used *exclusively* to have any benefit at all. If you feed ANY other foods, you completely negate the kidney diet. I agree that the ingredients of all the kidney diets are truly awful. If you want to use lower phosphorus foods, Dr. Lisa Pierson has done a monumental and masterful job of researching commercial foods and lists them by phosphorus content here: http://www.catinfo.org/docs/FoodChartPhosphorus9-22-12.pdf
My kitty Inge has been in CRF for 4.5 years, getting 100mls of subQ fluids every day, a life saver for CRF kitties. He’s losing weight tho over the past 2 years and won’t eat the prescription stuff (don’t like it myself). Still trying new things. He’s my 4th CRF kitty over 30 years, all rescues (have 10 others at home). He’s normal in every other way.
I seriously doubt Kidney Support Gold had anything to do with Boomer’s improvement. I do not care for the ingredients and wouldn’t give anything to my cats that was so vile it caused any cat to gag! It was likely the addition of the regular subQ fluids that hydrated his kidneys and body, thus making him feel much better and aiding his kidneys in helping to rid the body of toxins which make a cat feel very bad. Fluids are THE single best thing that can be done for a cat with CKD. It truly extends their life and gives them great comfort!
Be sure to always warm the bag, however! And always test the temp of the fluids on the inside of your wrist before administering to your kitty. Cold fluids are very uncomfortable to a cat! The cold will make your cat shiver and develop an aversion to fluid sessions.
Liz–thanks for sharing all the tips and stories.. they certainly help all of us. Ps– I would highly recommend http://www.askariel.com and a consultation with Susan Davis. I do like Kidney Gold & can actually hide ours in some ham baby food.–make sure all natural… I add a little taurine and some other supplements with a little RO water and Rocky (17+) eats it all up.. I also raise and tilt his little plate… seems to help … as well. HOwever, we saw huge results when we added Ask ariel’s– Renelix.. the king of all kidney detox. I only use 4 drops every other day or sometimes every 3rd day. I do boil some water and add a tsp to the 4 drops to get the alcohol content out..(some cats are not sensitive to the amount–but, Rocks was) I know this really helps our baby. I skip the Kidney gold on those nights.. Plus.. we use Instinct variety and add some all natural pumpkin to lessen the protein load as well as help with motility issues.—- hope these help. I agree with other article about “quality protein” to preven muscle wasting..when they can tolerate it. Toppers like Nature’s variety immune boost powders also seem to “bribe” them to eat a little more. (not too much-tiny sprinkle) I also use the juice only from the Pumpkin lickin Weruva pouches.. I mix in a little Beta Plex from Orthomolecular specialties.. gives them some extra B-complex and other good nutrients…. You can even put a tiny bit of very low sodium tuna water–bumble bee makes one– with no broth—so, no onions-etc…but, go gingerly on this.. the key is hydration. (make sure “very” low sodium– not the low sodium–still too much salt in that one.. By doing this, we have prevented having to do sub-q yet.. and Rocky being “feral”– it takes a lot of added stress out of the equation for him.. he looks at all the “extras” as special attention and treats–just for him.. makes him feel extra special.. and tons of love and brushing– .. 🙂 A strip of two of nutri-cal out in a little saucer helps too.. sometimes they will eat ..others not..but, sometimes give that extra energy needed to then want more food. 🙂 He has maintained about 10 lbs– which is a healthy weight for him… still runs faster than our 10 or 14 yr old. 🙂
ps– please don’t give the Tuna.. just a tiny bit of the “very” low sodium tuna water– added to the broth bowls.– You can eat the tuna.. and mix some spring water or RO water with the other tuna water for them… It will last in frig for 3-4 days…so, just a little bit to add flavor to the Weruva pumpkin lickin pouch broth.. to make a nice soupy mixture for them. I put a little saucer out and in no time–it is all gone. I keep this available. If they ever get that dehydrated feeling–they won’t eat.. makes them feel awful…so, keeping them hydrated is the key.– This has helped our little boy–now almost 18 do quite well. We don’t do any dry food.. only “quality” canned and home cooked. Their favorite canned: INstinct variety rabbit– 2 diff textures– original and new ritzy rabbit; (lesser protein load); Ziwi Peak Lamb and rabbit; and Addiction venison and apples are their favorites. They will sometimes go for Merrick thanksgiving turkey and Wellness Turkey–but, we try to limit the poultry due to inflammation. Raw is great–but, ours never liked..so no experience much with those. OUrs developed a little allergy to the canned chicken after so many years—but, if we do every now and then.. they seem to like the variety. We also add the all natural pumpkin (not pie filling) and/or baby food squash to lessen the protein load –at the same time adding a little fiber for motility issues as they age. We do love the Kidney Health (digestive enzyme–special kind), Power Probiotic and Renelix from http://www.askariel.com These work well for our babies. Thanks for all the other comments and suggestions. We all learn from each other. Each cat just like humans is individual, so what works for one — may not work for the others. Kidney Gold helps one of ours, but we have to use Urinary Gold for another—–so, checking with your vet to see exactly what is going on is always the best first line.– Then evaluate your options… I recommend this for people too,… over 25 yrs in our “sick” healthcare system.. -stay well –for you and your feline friends.. best the natural way —when you can!! debbie
My feral cat Ese lost so much weight in a one to two week period that his hip bones were sticking out. The vet diagnosed kidney disease and taught me how to give 100ml of subcutaneous fluids a day, every day. HELPFUL HINT: Many vets charge anywhere from $8 to $12 a container, which is a bit more than a weeks worth. Too expensive for me on top of vet bills. My vet wrote me a prescription and I took it to the pharmacy at Costco’s (you can buy or order them at most drug stores) It cost me slightly over TWO DOLLARS for each one, instead of $8 to $12 for each one. I tried the K-D canned food and the K-D dry food. He didn’t like the canned K-D, so I went to Whole Foods and I got a container of those dried chicken or salmon pieces. I take the smallest piece of one and I crumble it in my hands and I sprinkle it over the K-D canned food as if it were a seasoning. Just a tiny bit and Esé gobbles the K-D up … and the teeny bit of chicken/salmon, is not even close to being enough to mess up his diet. Two weeks later I took Esé back to the vet and he shouted when he saw him ” What the **** have you been feeding that cat ? He is back to his old fighting weight. Don’t know if this will work for everyone but its been over two years and he has maintained his old weight and he is an active, playful, cat who could set a new indoor land speed world record for racing around the apartment. My best guess estimate is that he is 8 to 10 years old. * I don’t know if this contributed to his kidney troubles but as a young feral, I would sit out a plate of food and a bowl of water in the parking lot. He would eat the food, look me dead in the eye and take his paw and tip the water bowl over, spilling all of it. Then he would walk over the swimming pool at the hotel and drink water from the pool. For the last 7.5 years since I turned him into a house cat he has only gotten bottled water in a bottle.
Subcutaneous fluids are amazing – we have been doing it for our 18.5 year old Birman for 3 years since she was diagnosed with CKD. She is now in Stage 3 of CKD. We would have had to say good-bye to her a long time ago if we didn’t administer the SQ fluids consistently. There is also a new drug out called Semintra and it has made a great difference in our cat over the past few weeks. She no longer needs a drug for nausea and her blood pressure is no longer elevated. It is a once a day liquid and we are so thankful that our little Coco is now enjoying the summer…just a month ago we were shedding tears thinking that she would be too unwell to stay around.
Thanks for this very encouraging and informative story, Liz. Karil, all I can say to you is…wow… that level of dedication and love is so inspiring. I really admire you. And Boomer is one lucky cat! (My cat has cancer and I thought our daily routine was intense – but you’re taking things to another level – how wonderful – I actually find it quite humbling and meaningful to help an animal that needs me, and I bet you do too!). Thank you for sharing. 🙂
I think it’s incredibly cruel to feed your cat 50 cc’s of food twice a day with a dropper. My holistic vet says, Animals should like their food. I mean duh, why would you forced we’d by dropper for extended lengths of time. That’s meant for short term. How would you like it if you were force fed food you hated every day with a huge syringe.????
Feed high quality protein low phosphorous food.
Think about what you are doing in the big picture.
Plus there’s a lot of new research out there debunking the benefits of the k/d types foods FOR CATS. You wanna watch them get emaciated slowly on those low protein diets? They are not humans or dogs. They need high quality meat and fish. Do the research, don’t keep weight on them by treating them like a pate goose
I’ve spent many a day feeding sick cats with droppers, but wouldn’t subject them to it permanently
Wow I am glad Boomer is doing better but the foods Karil tried are two of the worst foods ever. Royal Canin, Eukaneuba, Iams, Science Diet are horrible and are the ones the vets all push, including my own vet. I wonder if she had tried some of the top quality food on your list if the results would have been better. I use your list all the time to buy the best for my two cats.
Regular cat food isn’t formulated to treat kidney disease. The foods for crf are lower in protein, phosphorus and sodium and higher in b vitamins and potassium. Some people use a regular food and add a phosphorus binder powder but some cats don’t like the taste. To each his own, I say if it’s working, that’s great. My cat ate the foods made for kidney disease and she lived to 16.