you will love the idea of holistic treatments. Others will be extremely sceptical about them.
I'm more of an allopathic (conventional) medicine
person myself, but some of the
methods discussed below worked for Thomas and for many other cats on
Tanya's CKD Support Group
so I think it is important to discuss them.
Even if you try nothing else, I strongly
recommend the herbal remedy, Slippery Elm Bark (for excess stomach acid and
constipation), if appropriate.
Unfortunately holistic medicine is
an area which can attract charlatans and others aiming to make money from the
stressed and the vulnerable. I know you want to help your
cat, but there is no miracle cure for CKD (if there were, I
wouldn't need to run this site), so please don't fall for
the hype (or the testimonials).
Even if you are a devotee of holistic medicine, please be
prepared to use allopathic medicine as well when appropriate. I am not
aware of any holistic treatments that could substitute for phosphorus
binders, for example.
Holistic medicine aims to treat the whole cat rather
than just symptoms. Holistic medicine consists of a variety of modalities,
including homeopathy, herbal medicine, acupuncture and Traditional Chinese
The American Holistic Veterinary Medical Association has a good
overview of holistic medicine and how homeopathic treatment forms a part of
If at all possible, please try to visit an holistic vet.
Alt Vet Med
- lots of information and links but being remodelled as at April 2012.
works on the principle of treating like with like, but unlike allopathic
treatments, homeopathic remedies are extremely diluted (though in
homeopathic terms, this is thought to make them more effective). There are two types of homeopathy,
classical and complex. Classical homeopathy only uses one treatment at a time.
In contrast, complex homeopathy uses several treatments at a time.
Homeopathic remedies do not work
the way regular medication does - you cannot take a remedy when you feel
sick and expect it to work like an aspirin would. Usually you give a
homeopathic remedy once, then maybe not again for days, weeks or even a
Ideally you should seek advice from a homeopathic vet, though these are
not always easy to find.
If you are using herbal medicine, it is important not to overdose. Herbal
remedies are just like any other drug and may have side effects. Too high
can actually end up causing the very thing you are trying to treat - for
example if you give too much of a treatment for diarrhoea, it can actually
make the diarrhoea worse. So only give the suggested dose and remember
that, as with all medicines, more is not always better.
Herbal remedies can be very potent, so I would not recommend giving herbs
other than slippery elm bark without input from a qualified professional;
and do ask your vet about slippery elm bark or any other products you plan
Health library has information on herbs and supplements and possible interactions with
- links to summaries of research papers, including benefits, harmful
effects and safety testing of herbal medications (primarily relates to
The natural remedy most commonly
used in the treatment of CKD is slippery elm bark powder (ulmus rubra or
ulmus fulva). Slippery elm
bark is a herbal remedy used for most kinds of digestive or intestinal problems - it can
be used for nausea, vomiting, diarrhoea or constipation. As a side effect
it can also improve coat dryness and dandruff.
Slippery elm bark is a demulcent, which means it soothes the stomach lining and
intestinal walls and reduces irritation. This can be particularly useful in
combating the nausea and stomach acid which many CKD cats experience. You
will usually see an improvement within a day or two of starting slippery elm
A potential nutritional prophylactic for the reduction
of feline hairball symptoms (2004) Dann JR, Adler MA, Duffy KL and
Giffard CJ The Journal of Nutrition 134(8) pp2124S-2125S found
that it also appears to help with hairballs.
You can use slippery elm bark in addition to
famotidine (Pepcid AC) if necessary (though
with luck the slippery elm bark alone will suffice), but do not give these
treatments at the same time (see
Ideally, you want organic or wild-crafted slippery elm bark powder from most
good health food shops. See below for sources.
If you cannot find loose slippery elm bark, you can usually find capsules
in a 350-400mg size, but try to make sure the capsules contain only pure
slippery elm bark, no fillers.
It is hard to find capsules that don't contain magnesium stearate because it
is a glidant used in the manufacturing process (it helps the powder flow when
the capsules are being filled). Magnesium stearate is not a problem, but I
would try to avoid capsules containing other ingredients. You cannot always
syrup recipe from
capsules containing anything other than slippery elm bark.
I would avoid tinctures because they often contain other ingredients,
Slippery Elm Bark Dosage
The usual dosage is:
1/8 to 1/4 (0.125 - 0.25) of a teaspoon of the organic or
wild-crafted slippery elm bark powder once or twice a day; or
one 350-400mg capsule a day. You can give these whole or open them and
sprinkle on the cat's food once or twice a day.
I open the capsules and sprinkle the slippery elm bark into my cat's food and mix it up, but
slippery elm bark has a
bittersweet flavour which some cats do not like. In that case, try giving
it in a capsule, either the one it came in or, if you are using loose slippery
elm bark, purchase
separately for this purpose.
Some people have found their cat will eat slippery elm bark if it is mixed in
baby food (make sure the baby food does not contain any onion).
You can also
make slippery elm bark into a syrup that is used for digestive problems or
for mouth sores or ulcers. It has the same soothing and healing effects in
the mouth - try dabbing in your cat's mouth ulcers if required. The syrup
is weaker than the straight powder, so you can give a little more of it.
Some people have told me they find it hard to place the syrup on their cat's
mouth ulcers if they are in hard-to-reach areas of the mouth. In such cases,
you may wish to use a syringe to aim the syrup at the ulcers.
Here is the
recipe for the syrup:
Sprinkle 1 to 1.5 tsp of
slippery elm bark powder onto one cup of cold water.
If you are using slippery elm bark from capsules, you need pure slippery elm
bark with no fillers, otherwise the syrup will usually not thicken properly.
Let it sit until the powder is damp, then bring to the boil stirring
constantly. Use a stainless steel or heat-proof glass pan, not an aluminium or
non-stick one. Reduce the heat and simmer, still stirring constantly, until it
thickens, about 3 minutes or so. It will be the consistency of watery egg
Allow to cool and give ¼ - ½ (0.25 to 0.5) teaspoon up to 4 times a day. This will
keep at room temperature for a day or in the fridge for up to five days.
For the non-cooks among us, one of my support group members came up with this
Take a glass container which holds two cups. Put one cup of water in the cup.
Add 1 to 1.5 tsp of slippery elm bark powder.
Heat in the microwave on high for about 1.5 minutes. Remove from the microwave
and stir, then put it back in for about another 30 seconds. Keep an eye on it
because you do not want it to boil over. Remove from the microwave and stir
Allow to cool and give
¼ - ½ (0.25 to 0.5) teaspoon up to 4 times a day. This will keep at room
temperature for a day or in the fridge for up to five days.
Where to Buy Slippery Elm Bark
San Francisco Herb Co
sells loose slippery elm bark powder at the best price I've found, US$16.10
per pound plus exact shipping cost, but their minimum order is for US$30. They
will waive this on request and charge a US$7 small order fee instead;
alternatively you could stock up on other products such as catnip.
sells its own brand 400mg slippery elm bark capsules for US$3.49 for
Unfortunately, as part of the new EU regulations for herbal products, slippery
elm bark was banned in Europe from 1 May 2011. From that date herbal
medicines can only be sold in Europe if they have either a traditional herbal
registration (which slippery elm bark does not) or a product licence.
UK suppliers (including those mentioned below) will be allowed to sell
slippery elm bark until their stocks are exhausted. Thereafter
slippery elm bark products will only be available in Europe if they are
licensed, but since obtaining a licence can cost as much as £300,000 per
product, not every manufacturer will continue to sell slippery elm bark,
though apparently Holland and Barrett hopes to do so, as does Neal's Yard.
However, there is no guarantee that pure slippery elm bark products will be
available; it is entirely possible that manufacturers will instead produce products containing
slippery elm bark mixed with other ingredients which may not necessarily be suitable
Some manufacturers are arguing that slippery elm bark is a foodstuff,
which would make it exempt from these regulations. I am waiting to see how
this argument pans out. However, if you live in Europe, I recommend stocking up on
bark with as long a shelf life as possible. If you visit the USA, I would also
stock up there.
Holland and Barrett sells 100 370mg capsules
for £6.99. These are the ones I use (and have stocked up on myself).
Body Energy Club sells 100 capsules (400g
each) of slippery elm bark for CAN$7.35 plus tax. Shipping is included in the
Slippery Elm Bark Cautions
Do not give slippery elm bark at the same time as any other
medications or supplements - as
University of Maryland Medical Center
explains, it can inhibit the absorption of the
medications. It is therefore best to give it 1-2 hours before or after any other
medications (especially antibiotics), and ideally on an empty stomach,
although it is safe to sprinkle it on food if you wish.
Slippery elm bark also contains calcium, so it is probably safer not to use it
if your cat has
Flower essences or remedies are made by boiling flowers. The best known
flower essences are
the Bach Flower Remedies (details of this and other makes are
below). These are thirty-eight individual essences which are designed to
address a specific state of mind or personality trait. These remedies can be
mixed together; in fact, the best known remedy, Rescue Remedy, is a
combination of five different essences.
Many people are sceptical about flower essences, failing to see how they
work or believing that using them simply results in the placebo effect.
Although I was sceptical, my own experiences of using
such essences with my cats have been favourable, and since they are
reasonably priced and are unlikely to do any harm, you may wish to give them a
try as appropriate.
In order to help your cat,
you need to identify which is the most appropriate remedy. Some
essences are for personality traits, and others are for moods or
emotions. It is best to try to find the remedy suitable for the animal's
personality type as well as for its current mood. Thomas, for example,
who was a stoical, low-key kind of cat, responded well to Oak as his
personality type essence.
These are the remedies which
I think may help a CKD cat, although others may be helpful
Crab apple the cleansing essence
Gorse hopelessness, pessimism
terror, panic (perhaps for vet visits)
Rescue Remedy for emergencies and crisis
are two main ways to give your cat the remedies, and you can give more than one
remedy at a time. However, do not use more than six or
seven remedies in one go or results may be disappointing, because mixing
too many remedies together can make some of the essences ineffective.
Although flower remedies contain alcohol, this is not normally a problem since
they are diluted so much before using.
There is a new pastille form of Rescue Remedy but this should not be used for
cats according to the
manufacturer because it contains xylitol.
Although this is toxic to dogs, there is currently no
evidence that it is toxic to cats. However, some people prefer to avoid
products containing it.
Add two to
four drops of each remedy to a 30ml bottle of bottled spring water (do not
use tap water for flower essences). Take four drops at a time from this bottle at least four times a
day, and use a dropper to place the remedies in your cat's mouth. Make
sure you thoroughly rinse the dropper before putting it back into the
Alternatively, place two
to eight drops of each remedy in
your cat's bowl of drinking water. As long as your cat drinks four times a
day - and most CKD cats do, of course - he/she will be receiving the
correct dose. Incidentally, it does not matter if you have other cats who
share the water bowl, they will not be affected by the remedies.
I have also heard from one reader who at times of crisis has put a couple of
drops of the remedies on her fingers, and then rubbed the drops into her cat's
Where to Buy Flower Essences
sells Bach essences online in the USA at US$17.55 for 20ml.
My Vitanet sells Bach essences online for US$9.69 - US$10.19.
based on the idea that the body has channels along which energy passes.
Imbalances or blockages may arise in these channels, leading to health
problems, but acupuncture can clear the blockages so that the energy can
To the Western
mind, this can sound strange. However, acupuncture for humans is covered
by many private health care schemes in the UK, because of its proven
benefits. I admit that I myself am a big fan
of acupuncture. It has
worked wonders for me personally, finally getting rid of pain that nothing
else could shift, and had astonishing results on
State University College of Veterinary Medicine mentions that acupuncture may be of use for
pain management and diseases of the kidneys and the liver, and some people
have had very good results using acupuncture for CKD cats, either by
improving the cat's wellbeing (less vomiting, generally perkier) or
occasionally even through an improvement in bloodwork. It can also help
with appetite. Of course, I have
also heard of a couple of people whose cats did not react particularly
well to acupuncture; but when it is performed by a trained professional
with sterile needles, acupuncture is unlikely to have bad side effects even if
you don't notice an actual improvement, so you may wish to try it and see
how you get on.
Heel is a German company that produces a number of homeopathic remedies.
Members of the German Feline CKD list,
Nierenkranke Katze, have used these products for many years and speak
highly of them, in many cases finding that BUN and creatinine reduce after
Normally a combination of three remedies is used:
Ubichinon compositum (CoQ10)
Using the remedies in this way is complex homeopathy rather than classical homeopathy, which would
require that a treatment plan be tailored to the individual's needs and
symptoms. However, it can be
hard to find a classically trained homeopathic vet.
The words "ad
us.vet" mean it is a special
veterinary formula but this is only available in German-speaking countries
at the moment. If you live elsewhere, you will have to use the human
products, which were used by the German support group before the
veterinary products became available.
Luca's Story tells
(in German) the
story of Luca, who had borderline high kidney values before he was even
one year old. By the time he was three, his creatinine level was 7.4
mg/dl. He was treated with Heel Complex, and his creatinine level fell to
3.3 mg/dl. Luca lived to the age of seven despite having CKD, and died of
cancer, not of CKD.
The usual starting dose is 1 ml of each, three times a week (they can be
mixed together in a syringe). After a few weeks, if the cat seems to be
improving, dosage can be reduced to twice or occasionally once a week.
Where to Buy
sells two of the Heel products in
liquid form as follows:
Bank's Chiropractic in the USA sells Heel
products online, with orders over US$100 shipping for free within the USA.
It will ship internationally for a flat fee of US$29.95 (less for Canada).
Heel USA is the American website.
It contains links to retailers - I believe many of these only sell
commercial human remedies but they may be able to order the remedies you
is the Canadian website. It contains links to retailers - I believe many
of these only sell commercial human remedies but they may be able to order
the remedies you require.
is the UK supplier. They will only supply to fully qualified practitioners
but may be able to put you in touch with such a person in your area.
Ergebnisse zur chronischen Niereninsuffizienz der Katze bei biologischer
Behandlung (Results of treating CKD in cats with biological means) (2006) Eichentopf A, Eichentopf F Biologische Tiermedizin2 pp31-34
discusses the results of a study which used the above remedies plus
another one called Hepar compositum to treat 24 CKD cats aged from 7-17
for eight weeks. On the first two days, the cats were given the basic
three remedies subcutaneously, along with sodium chloride fluids. On days
3-7 the cats were only given the Heel remedies once daily, with dosage
thereafter reducing to once every other day and eventually to once or
twice a week. After the first week the treatments were given orally or
sub-cutaneously, as preferred by the cat's owners. The Hepar compositum
was given once a week between the third and eighth weeks. The study found
that all the cats improved in terms of behaviour (appetite etc.) and most
of the cats had measurably better bloodwork within the first 1-2 weeks,
although results were much less dramatic for those cats in end stage renal
disease. 80% of the owners involved in the
study were very satisfied with
Biologische Behandlung bei Katzen mit chronischer
Niereninsuffizienz (CNI) (Biological treatment of cats with
CKD) (2002) Ulf U Wissenschaftliches Veterinär-Symposionder
Firma Heel involved giving the Heel Complex to fifty cats with medium
stage to advanced CKD. Forty cats showed improvement within one week. Ten
cats did not respond so their treatment was discontinued. Five of the
treated cats died but 75% were still alive after 3-6 months, and 50% were
still alive after 7-12 months, often with much improved bloodwork results.
Some of the cats were treated for three years in all.
The Heel Veterinary Guide has information
about these remedies on pages 82 (Coenzyme compositum), 115 (Solidago
compositum) and 121 (Ubichinon compositum).
Rehmannia 8 is a traditional Chinese medicine treatment which is supposed
to strengthen kidney function. Some sites also recommend it for helping
with infection or inflammation. A few members of
Tanya's CKD Support Group
use it and find it helpful. It is unlikely to do any harm and may be
helpful, but do check with your vet before using.
Herbs 2000 mentions that Rehmannia may have a diuretic effect, which is
not good for a CKD cat. It also states that Rehmannia should not be used
in cats with acute infections.
I first heard about Rubenal in April 2008 from a lady who was participating in
trials of a new CKD treatment made by Vetoquinol at Kansas State University. Rubenal was launched in Europe in
2008, in the UK in January 2009, and in the USA in July 2009. The trial
results were published in 2011 (see below).
Rubenal is made from
Rheum officinale (Chinese rhubarb extract) and produced by Vetoquinol, who
also make Ipakitine (Epakitin) and Azodyl. In TCM (traditional Chinese
medicine), Chinese rhubarb extract has been used to treat kidney problems in
humans for many years. Rhubarb leaves are toxic for cats but the root is
In TCM rheum is commonly used in combination with other herbs. Vetoquinol
appear to have produced a product that only contains Rheum.
available in two sizes, 300mg and 75mg. The recommended dose is 25mg per kg
(2.2lbs) of body weight twice a day, so a 3kg (6.6lb) cat would need two 75mg
tablets a day. In the UK they cost around £9-10 for 60 tablets.
Vet UK is a UK online supplier which sells 60
75mg Rubenal tablets for 9.81. Rubenal is also available in the UK
from vets or Amazon.
I have heard from a number of
people in German-speaking countries who have used Rubenal. The majority of
them seem to think it has helped their cats, although one person said the capsules are too
big for a cat to swallow easily, a problem which commonly arises with another Vetoquinol product,
Rhubarb extract may affect
electrolytes. In particular, it may lower potassium levels, so I would
recommend monitoring your cat's potassium levels and other electrolytes
if you use Rubenal.
In early 2011 Rubenal became the subject of a label review by the FDA in the
USA. Whilst this is going on, the manufacturer is not allowed to produce or
within the USA, so most US suppliers no longer have any stock and it is not
known when or if the FDA will permit it to be sold again. You might be able to
obtain it from UK suppliers on eBay or at
Clinical effects of rheum and captopril on preventing
progression of chronic renal failure (1990) Zhang JH, Li LS, Zhang
M Chinese Medical Journal103(10) pp788-93 investigated the
effects of rhubarb extract and captopril (an ACE inhibitor) on people with CKD.
The three groups tested received either rheum, captopril or both together. The
people who received both together did best but it was concluded that
"long-term low-dose Rheum E taken orally is beneficial to CKD. Its effect is
better than that of Captopril."
Effects of rhubarb tannins on uraemic toxins
(1991) Yokozawa T, Fujioka K, Oura H, Nonaka G & Nishioka I Nephron58(2) pp155-60 found that certain components of rhubarb reduced BUN
and creatinine levels in the rats in the study, though another tannin
found in rhubarb actually increased BUN levels.
A human study at the Washington University in St Louis School of
Establishment of a persistent Escherichia coli
reservoir during the acute phase of a bladder infection
(2001) Mulvey MA, Schilling JD & Hultgren SJ Infection and Immunity69(7) pp 4572-9, found that in some cases the bacteria that cause
urinary tract infections can burrow so deep into the bladder lining that
they cannot be detected in the usual tests.
If your CKD cat is prone to persistent, ongoing or repeated UTIs, speak to your vet about using D-mannose,
which is supposed to be very helpful when dealing
with infections where the bacteria have burrowed into the bladder wall.
D-Mannose is a simple sugar, in fact it is actually the active ingredient in
cranberry but without the downsides associated with
It does not kill the bacteria as an antibiotic does; rather, it works by attracting the bacteria to
bind with itself rather than with the bladder wall; the bacteria can then
be passed out with urination. D-Mannose will only work for
urinary tract infections caused by E coli, but this accounts for 90% of all
urinary tract infections in humans, and is commonly the cause of
feline urinary tract infections too.
I have heard from a number of people who have tried this treatment on
their cat, and all of them thought it was effective. A commonly used dose
is 250-500mg twice a day. With most (but not all) brands, a ¼ of a
teaspoon of the powder is 500mg, so this would mean giving ⅛-¼ teaspoon
twice a day, but check with your vet. Some people find it works better if
they divide the total amount over 3-4 doses a day. Keep giving it for a
week after the symptoms have disappeared. Since it is a type of sugar,
D-Mannose has a pleasant taste. It can be easily mixed with wet food or
mixed with water and syringed into the cat's mouth.
Since D-Mannose does not get absorbed by the digestive tract, it should be
safe for diabetic cats, but check with your vet before using if your cat
D-Mannose appears to be effective, it seems to work best for cats with a
recurring UTI. If your vet prescribes
antibiotics, you must use them, because untreated urinary tract infections
can rise into the kidneys and cause permanent damage, which is the last
thing a CKD cat needs.
D-Mannose is widely available from health food shops (it is often in the
women's health section). You want pure D-Mannose. It can also be bought
The word "holistic" can be strangely reassuring, but it must not be
"natural" does not necessarily mean something is safe, in fact some of the most dangerous things in
the world are "natural", such as belladonna. Below are some of the
unsuitable products I have seen recommended for CKD cats, and an explanation as
to why they may be inappropriate.
cats usually benefit from Vitamin B supplements, but many other Vitamins,
such as Vitamins A and D, can be a problem for CKD cats. Please see
Nutritional Requirements for more information.
is often promoted as possessing many health benefits. Whilst this appears
to be true for humans, garlic belongs to the same family as onion, and
onion can cause a particular type of anaemia in cats called Heinz body
anaemia. I would therefore not recommend risking garlic supplements,
particularly in CKD cats, who are already sick. The
Which Foods to Feed
page has more information.
should avoid giving cranberry or food containing cranberry to CKD cats -
it is too acidic for CKD cats, who tend towards
Cranberries also contain benzoic acid, which cats lack the pathways to metabolise. The
active ingredient in cranberries is
D-Mannose, so you could consider giving
D-Mannose to a cat who is prone to
urinary tract infections.
The International Programme on Chemical Safety
reports on a case from 1971 when 28 cats were fed meat containing 2.39%
benzoic acid. Seventeen of the cats died. Toxicity may develop with quantities
greater than 0.45 g/kg given in single doses or 0.2 g/kg when the item is fed
on an ongoing basis.
The Boston Globe reports on the recent trend
of adding cranberries to cat food, and has a comment from a vet at Tuft's
University School of Veterinary Medicine that there is no evidence that
cranberries have the same benefits for cats as they appear to have for humans.
product has high levels of potassium, which can be dangerous for cats in
end stage renal failure. It is not appropriate to use as a potassium
supplement, because it is not possible to tailor an accurate dose.
I sometimes hear from people who want to use dandelion root or nettles on their
because they have read that it is good for kidney function. However, these are actually diuretics, so
are not usually suitable for CKD cats, who are usually urinating excessively.
There is one study I am aware of,
Urtica semen reduces serum creatinine levels
(2003) Treasure J Journal of the American Herbalists Guild
4(2) pp22-25, where nettle seed extract appeared to
lower creatinine levels in two human patients. However, one of these
two patients had cancer, and the other had lupus and a crisis as a kidney
transplant recipient. Obviously these scenarios do not apply to your typical
says that stinging nettles may lower blood pressure and blood sugar levels, so
I would be reluctant to use these in a cat with diabetes or a cat on blood
Dandelion is occasionally used
in CKD cats who are also suffering from heart problems, but this should only
be done with your vet's input. The
Heart Problems page has more information on diuretics as used for heart disease.
Some people use colloidal silver as a type of natural antibiotics. However,
National Center for Complementary and Alternative Medicine
states that side effects "may include neurologic problems (such as
seizures), kidney damage, stomach distress, headaches, fatigue, and skin
irritation." Since CKD cats are prone to many of these problems anyway, I
would not use colloidal silver in a CKD cat.
It never ceases to amaze me how many feline products contain essential oils.
Cats lack the metabolic pathways to process essential oils, so these oils can
be extremely toxic for them, but unfortunately even some vets are not aware of
Essentially, essential oils should never be used on
cats, and some sources also question whether hydrosols are
pourri hazards in cats is an ASPCA article by a vet about pot
pourri, which also discusses essential oils (which are commonly used in pot
Flax Seed Oil (Linseed Oil) and Other Omega 6 Oils
Flax seed oil is commonly used in cat foods, and may also be recommended as an
essential fatty acid supplement. I don't object to flaxseed oil per se, I use it myself. The problem
is it is of limited value to cats whose bodies cannot metabolise it properly.
There are two
Omega 6 essential fatty acids for cats, linoleic and arachidonic. These fatty acids are essential in the sense that a cat cannot
produce them within the body, so must obtain them through diet.
Flax seed oil
contains around 13% linoleic acid but no arachidonic acid. Cats do not have
the pathways to convert linoleic acid into arachidonic acid, so another source
of arachidonic acid is necessary. Cats can only obtain arachidonic acid from
animal products, so if you want to give your cat an essential fatty acids oil,
consider a fish-based oil instead.
Skin and coat in cats (1999) is an article from the Waltham Course
on Dog and Cat Nutrition which states that "cats require a dietary source of
both linoleic and arachidonic acids."
Unfortunately, excessive amounts of Omega 6 fatty
acids may cause inflammation of the kidneys and therefore may not be a good
thing for CKD cats. See
Requirements for more information on essential fatty acids for
CKD cats. Astro's CRF Oil can be found
Kidney Support Gold (Tripsy)
I used to receive regular enquiries about a product called Tripsy. Reading the
seller's description of kidney disease was enough to set alarm bells ringing
for me - they could not even seem to differentiate between CKD and Feline Lower
Urinary Tract Disease, which are not the same condition.
In 2012 Tripsy changed both its name (to Kidney Support Gold) and its
formulation. Tripsy used to contain diuretics such as parsley, but Kidney
Support Gold contains astralagus root, cordyceps sinesis, rehmannia and Dong
astralagus is thought to be an antioxidant but
Holisticat states that astralagus should only be used short term in
cordyceps is a fungus which appears to help boost the immune system. It has
been used in human kidney transplant patients and appears to help reduce the
risks of complications in these patients when used in conjunction with
cyclosporine, an anti-rejection medication commonly used following kidney
transplants. It is a natural blood thinner. It may increase the effectiveness
corticosteroids, so I would not use it in a cat who is on steroids.
dong quai (Angelica sinesis) is a herb which appears to help manage female
hormonal imbalances, e.g. around the time of the menopause. Some Chinese
studies indicate that using dong quai and astralagus may help kidney function
in rats with surgically induced kidney disease. It may slow blood clotting.
The US National Library of Medicine says that
taking dong quai in large amounts for a long period of time may be unsafe
because it contains carcinogens (chemicals thought to cause cancer).
Some people do like Kidney Support Gold. I think the new formulation is better than
the old one, but I still don't think I would use it when more proven
treatments are available. I would not use it without talking to your vet first, and
ideally to an holistic vet.
I am pretty open to the idea of holistic treatments such as those I mention above.
However, over the years I have become increasingly worried - and not a
little sceptical - to see some of the treatments that are recommended
in the holistic world.
So many of these practitioners do not seem to understand the first thing
about kidney problems in cats! They offer products with diuretic properties (a real strain on sick
kidneys), or offer products which are intended for the lower urinary tract
when in fact the kidneys are the upper urinary tract - many products labelled "for urinary
tract health" are intended to treat feline lower urinary tract disease
(FLUTD), and are often contraindicated for kidney problems. Of course, some of
these sellers get around this problem by not even stating what their product contains!
I would never give such a product to my cats, you need to know what you are
Even if these practitioners understand about kidney problems, they
offer blanket treatments for cats and dogs, clearly not understanding that cats
have unique physiological needs.
So please, always consider your sources. If something
sounds too good to be true, it probably is. If that great miracle cure
were such a miracle, we would all be using it, they would be millionaires and
this website would be redundant. There is no such miracle cure, so please
don't fall for the hype (or for testimonials).
behind these products is that giving kidney glandulars (extracted from
cows' kidneys) is supposed to strengthen the cat's own kidneys. Renatrophin is pure
kidney extract, while the other two products contain other ingredients.
The process by which these extracts (known as protomorphogen or PMG
extracts) are obtained is patented by Standard Process.
I am concerned to note
that the products contain some or all of phosphorus, calcium and Vitamin
A, which can be a problem for CKD cats. They also contain
flax seed oil, and alfalfa,
which is toxic to cats. Some
Tanya's CKD Support Groupmembers
do like these products. Personally,
though, I'd save my money. If you do decide
to use them, Renatrophin contains magnesium citrate, so should be
given apart from phosphorus binders containing aluminium.
launched in the USA in summer 2011 and contains something called Avastamine
(AB070597). Avastamine is said to consist of "naturally occurring
biomolecules", which apparently means it is a proprietary mix of six specific
amino acids and one peptide. I suspected one of them would be
l-arginine, but they did not state which ones until August 2013, when it
was announced that RenAvast contained a "Proprietary blend of amino acids and
peptides 300mg: L-Aspartic, L-Carnosine, L-Glutamic Acid, L-Glutamine,
Glycine, L-Arginine, L-Histadine."
Amino acids are the components of protein. Peptides are the molecules formed
when two or more amino acids are joined together. There are 23 amino acids
which cats need, and they can manufacture twelve of these themselves, but the
other eleven must be obtained from food.
is one example of an amino acid which cats must obtain from food.
Virginia-Maryland Regional College of Veterinary
Medicine explains more about cats and
RenAvast is marketed as a dietary supplement. Dietary supplements do not need
US Food and Drug Administration approval but the manufacturers make the bold
claims that RenAvast "can halt the progression of chronic renal failure in
cats" and that "unlike other products and drugs, RenAvast does not treat the
symptoms of renal failure, it treats the cause." The
FDA states that
"a product sold as a dietary supplement and promoted on its label or in
labeling as a treatment, prevention or cure for a specific disease or
condition would be considered an unapproved - and thus illegal - drug."
On 1 August 2012, the
FDA issued a warning letter to the
manufacturer of RenAvast about this.
RenAvast is being widely promoted online. The marketing literature for RenAvast focuses heavily on a study published online by the manufacturers
(rather than in a veterinary journal),
AB070597 and its effect on declining renal function in
felines (2007) Archer J, published online. This reports on 19 cats
who were given RenAvast over a two year period. Cats joined and left the study
during this period so it is not known over how long a period the results for
individual cats were measured. No cats in the trial were on sub-Q fluids or a
prescription diet, but it is not known if they were receiving other treatments
such as phosphorus binders or Azodyl. Many of the cats were in early stage CKD
(Stage 2 of IRIS), and it is not uncommon for cats in this stage to survive
An unrelated study,
Plasma amino acid profiles in cats with naturally
acquired chronic renal failure (1999)
Goldstein RE, Marks SL, Cowgill LD, Kass PH & Rogers QR American Journal of
Veterinary Research60(1) pp109-13, found that CKD cats in all
stages of the disease had lower levels of amino acids than healthy cats.
However, they concluded "the magnitude of these changes is mild and of little
clinical relevance." This is an older study, and it might eventually be shown
that supplementary amino acids are in fact helpful to CKD cats, but currently
there is no evidence that RenAvast is the miracle cure it claims to be.
Still, some members of my support group have tried RenAvast and like it,
whereas others think it has either not helped or in a couple of cases has even
made their cats worse.
What do I think? My feeling is that RenAvast might be a good product, it might
not, but it is unlikely to be as effective as its manufacturers claim, and it
is certainly not cheap at over US$30 a month. Personally, I would save my
money and put it towards more proven treatments than RenAvast.