Interesting read. She recommends that cats with kidney disease (which would include HCM cats that have high levels of diuretics which have begun to affect their SDMA, BUN, and creatinine) have 40% of calories from protein and not just the 20% that is found in CKD special diet foods. Cats need protein for health. Any more than 40% and you run the risk of creating a load of BUN-blood urea nitrogen-on the kidneys to filter and remove. If the cat has CKD or low performing kidneys, you need to reduce the load of BUN on the kidneys. Of course, if the cat's kidneys continue to decline, you'd want to reduce the protein level to the 20%. But she argues that a cat on a low protein diet may not eat it (because it's not that tasty); and will lose weight. The cat would need to eat 2-3x the amount of the diet to make up the protein and caloric needs. So, feed a CKD diet along with some of a regular diet and continue to monitor the CKD with regular checks at the vet's.
I've always recommended HCM cats take iron and other vitamins and supplements to help the kidneys (see Med tab at blog or here in Notes.) Actual kidney disease can be caused by other health issues-thyroid disease, hyperaldosteronism (what Baby apparently has), etc. So, finding the cause of CKD and treating the cause as well as the CKD requires more than just a careful diet.
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