Potassium

As I was putting together a supply order this morning, Alison and I both remarked at how many potassium supplements we seem to go through. We sell that stuff like candy most of the time - so many patients are on it, and I have a cat at home that gets it, too (Boochi).

So I thought it would be worth a quick discussion here - a sort of review of when and why and how.

Older cats often develop low serum potassium levels - in most cases this is linked to a decline in kidney function, but not always. And it can precede detection of kidney problems in lab testing by a few years, so I often look at it as an early warning sign. And as if that's not bad enough, low potassium in and of itself can cause kidney function problems. So the two are very closely linked. Low potassium levels can be extremely dangerous because it is vital in electrical conductivity of heart muscle and if it gets too low the heart can literally STOP.

When your cat has low potassium, most of the time it needs to be on long-term (generally permanent) supplements to avoid serious medical consequences such as muscle wasting and pain, anemia, and kidney failure. We have three main ways of providing that extra dose of this vital mineral: gel, granules, and tablets.

The potassium gel is administered orally by dosing syringe - we will show you how to do this and how much to give when we prescribe it. If you are unsure how to do it after instruction, you can bring your cat in for a demo.

Potassium granules for mixing into canned food are available and this is often the best solution. The taste is disguised by both the flavor added to the granules in the factory and the flavor of the canned food. A measuring scoop comes with the product.

Potassium tablets are another alternative. You need to be able to administer pills to your cat successfully and consistently. We recommend a water chaser after pilling and can provide a syringe for this if you want to do it.

Follow-up lab testing is essential to determine the right dose of potassium for your cat. You will need to continue giving the supplement as directed and come back for testing in a timely manner or treatment may fail to help your cat. We virtually never tell a client to merely give the first bottle of supplements and simply stop and go on your merry way!

Take-home message for cats with hypokalemia: consistent administration of supplements and timely follow-up lab testing, probably for the life of the cat to avoid dangerous complications.

New Product for Managing Feline Hyperthyroidism

Exciting news! Hills Pet Nutrition has just introduced a new Prescription Diet product specifically for managing feline hyperthyroidism.

Y/D is available in both canned and dry. Along with limiting the amount of iodine so as to reduce thyroid hormone production, the food is formulated to ease the work load on the kidneys. As many of you are aware, treatment of overactive thyroid gland in the cat can in some cases lead to diminished kidney function - a classic Catch 22 because untreated hyperthyroidism is itself fatal.

It is hoped that this new dietary means of managing thyroid disease will make use of methimazole less necessary as a temporary measure in cats that go on to receive I131 therapy (curative) and as long-term management for thyroid cats with kidney disease and those who cannot tolerate methimazole's potential side effects.

If your hyperthyroid cat is on methimazole, please ask us about Y/D the next time you are in, or feel free to call.

A Particularly Important Reason to Never Feed Your Cat Raw Meat

If NDM-1-containing Salmonella ever gets established in poultry farms in the US, it's game-set-match in the battle against this particular food-borne bacterial infection. If you don't care about your own life, I can't make you. But I care about mine and that of my staff and patients and clients. I have seen presumed Salmonella infection in several cats that were fed raw poultry, and it can make kitties (and humans who associate with them) extremely ill. If we have no antibiotics to fight it, cats will have to be euthanized and humans will simply die if they catch it.

NO RAW MEATS. USE GOOD FOOD HANDLING SAFETY TECHNIQUES IN YOUR KITCHEN. BE INFORMED - READ ABOUT NDM-1 IN SALMONELLA HERE.

Nestle Purina Recall

The Nestle Purina dry cat food recall does NOT involve food sold in California, but stay tuned just in case it expands.

ETA: Many people don't realize that half the concern about Salmonella contamination of dry pet food is due to the risk of it spreading to humans. Salmonellosis is a zoonosis (a disease spread from animals to humans) - in this case, the food is the device by which such spread is accomplished.

CDC has an excellent page that discusses how to minimize the risk of catching Salmonella from pet food.

Wellness Canned Cat Food Recall

http://www.wellnesspetfood.com/letter.aspx

Wellness has announced a voluntary recall of some canned cat food due to inadequate thiamine levels (which can cause neurologic disease). The full text of their letter follows:

February 28, 2011
Dear Pet Parents,
My name is Tim Callahan and I'm the CEO of WellPet, makers of Wellness® natural pet food. Over the years, we at WellPet have worked hard to earn the reputation of being a company that does everything possible for the pets that depend on us.
WellPet is committed to delivering the very best in pet food nutrition, as nothing is more important than the well-being of our dogs and cats. So when we found through product quality testing that specific product runs of our Wellness canned cat food might contain less than adequate levels of thiamine (also known as Vitamin B1), we decided to voluntarily recall them.
Please know, the vast majority of products tested had the appropriate levels of thiamine; however, with the number of recipes we offer, we did not want to make this more confusing. Therefore to avoid confusion and in an abundance of caution, we have decided to recall all canned cat products with the specific date codes noted below. Cats fed only product with inadequate levels of thiamine for several weeks may be at risk for developing a thiamine deficiency. If treated promptly, thiamine deficiency is typically reversible.
Though the chance of developing this deficiency is remote, withdrawing these products is the right thing to do and we are removing it from retailers' shelves.
The lots involved in this voluntary recall are:
Wellness Canned Cat (all flavors and sizes) with best by dates from 14APR 13 through 30SEP13;
Wellness Canned Cat Chicken & Herring (all sizes) with best by date of 10NOV13 and 17NOV13.
If you have cat food from these lots, you should stop feeding it to your cats. You may call WellPet at 1-877-227-9587 to arrange for return of the product and reimbursement.
No other Wellness products that your pets currently enjoy are impacted, so you can continue to feed your pets Wellness with full confidence. This is an isolated situation, as we have had only one reported issue. We are taking all the necessary steps to ensure it does not happen again.
Speaking on behalf of our entire Company, I apologize for any concerns this may have caused you. As a parent of a yellow lab named Hope, I understand the sense of responsibility we all share for our dogs and cats. Rest assured, product quality and safety will always be our top priority.

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Some of you may feed Wellness and be perfectly happy with it, but it's not on my "Doctor Gayle-Approved List" because it is not tested to document nutritional adequacy but rather merely formulated to meet written criteria. Nutrient bioavailability is very much an issue when that's the case, completely apart from failing to add necessary ingredients in the first place.

I still don't recommend the company. I still see lots of urinary problems associated with their products, too.

Online Resources: Part 3 - Nutrition and Parasite Prevention

Today I'm finally getting around to wrapping up my series on web resources for cat owners with this piece on diet, nutrition, and parasite prevention.

Your Cat's Nutritional Needs - A Science-Based Guide for Pet Owners - this informational brochure is produced by the National Academy of Sciences, so you can take it to the bank.

Companion Animal Parasite Council: Information for cat owners - I agree with virtually everything they recommend provided it's tailored to local risk realities. Adult housecats eating commercial cat food and living completely indoors in my region of Southern California are essentially NOT a factor in toxocaral larva migrans problems in children, particularly when compared to puppies living outdoors in the American Southeast. And IMHO, CAPC overrates the value of fecal microscopic testing in asymptomatic animals because of the unacceptably high incidence of false negatives.

American Heartworm Society - we are not in an endemic heartworm area here in the San Fernando Valley (yet), but it is a disease of potential importance in cats from other areas where it IS endemic: Northern California, the American Southeast, and any areas with significant ongoing mosquito issues (Marina del Rey is a local pocket of trouble).

Feline’s Pride Issues Nationwide Recall of its Natural Chicken Formula Cat Food Due to Salmonella Contamination

The FDA issued this press release on July 1:

Contact:
Shelby Gomas,
Tel: 1-716-580-3096

FOR IMMEDIATE RELEASE - July 1, 2010 - Buffalo, NY – Feline’s Pride is announcing a voluntary recall of Feline’s Pride Raw food with ground bone for cats and kittens, Natural Chicken Formula, Net Wt. 2.5 lbs. (1.13 kg., 40 oz.) produced on 6/10/10, because it may be contaminated with Salmonella. People handling raw pet food can become infected with Salmonella, especially if they have not thoroughly washed their hands after having contact with the raw pet food or any surfaces exposed to the product.

When consumed by humans, Salmonella can cause an infection, salmonellosis. The symptoms of salmonellosis include nausea, vomiting, abdominal cramps, minimal diarrhea, fever, and headache. Certain vulnerable populations, such as children, the elderly, and individuals with compromised immune systems, are particularly susceptible to acquiring salmonellosis from such pet food products and may experience more severe symptoms.

Pets with Salmonella infections may be lethargic and have diarrhea or bloody diarrhea, fever, and vomiting. Some pets will have only decreased appetite, fever and abdominal pain. Infected but otherwise healthy pets can be carriers and infect other animals or humans. If your pet has consumed the recalled product and has these symptoms, please contact your veterinarian.

The product is packaged in uncoded plastic containers and sold frozen to private consumers nationwide. Once thawed, the pet food has a shelf life of about 1 week. The firm manufactures the pet food by an as-ordered basis. This recall affects only those orders placed and shipped from June 10 through June 17, 2010.

The firm and FDA are investigating this matter to determine the source of this problem, and will take any additional steps necessary to protect the public health.

To date, both the firm and the FDA have received no reports of Salmonella infection relating to this product.

This product should not be fed to pets but should instead be disposed of in a safe manner (e.g., in a securely covered trash receptacle). People who are experiencing the symptoms of Salmonella infection after having handled the pet food product should seek medical attention, and report their use of the product and illness to the nearest FDA office.

People should thoroughly wash their hands after handling the pet food – especially those made from raw animal protein such as meat or fish -- to help prevent infection. People may risk bacterial infection not only by handling pet foods, but by contact with pets or surfaces exposed to these foods, so it is important that they thoroughly wash their hands with hot water and soap.

Since certain vulnerable populations, such as children, the elderly, and individuals with compromised immune systems, are particularly at risk from exposure they should avoid handling this product.

Consumers with questions should contact the company at (716) 580-3096, Monday –Friday from 10 am - 4 pm EDT.

###

In a nutshell, Salmonella-contaminated cat food like this can make your cat ill and then you can catch the disease from your cat, but ALSO you can catch it directly from the food just by handling it (if any of it contacts your mouth). This is one of the main reasons I NEVER recommend raw meat or foods containing raw meat for cats. I occasionally have to treat suspected Salmonella in cats because the owner won't listen to my advice or never even thought to discuss cat food with a veterinarian.

RECALL: Iams ProActive Health Canned Cat and Kitten Food

P&G Recalls Specific Canned Cat Foods Due to Low Levels of Thiamine (Vitamin B1)

CINCINNATI, June 9, 2010 - The Procter & Gamble Company (P&G) (NYSE:PG) is voluntarily recalling specific lots of its Iams canned cat food in North America as a precautionary measure. Diagnostic testing indicated that the product may contain insufficient levels of thiamine (Vitamin B1), which is essential for cats. Cats that were fed these canned products as their only food are at greater risk for developing signs of thiamine deficiency.

The following Iams canned cat foods are included:

Product Name: Iams ProActive Health canned Cat and Kitten Food - all varieties of 3 oz & 5.5 oz cans

Date on Bottom of Can: 09/2011 to 06/2012

This recall is limited to only Iams canned cat food distributed in North America. No other Iams pet food is involved.

Early signs of thiamine deficiency may include loss of appetite, salivation, vomiting and weight loss. In advanced cases, signs may include ventroflexion (downward curving) of the neck, wobbly gait, falling, circling and seizures. Contact your veterinarian immediately if your cat is displaying any of these signs. If treated promptly, thiamine deficiency is typically reversible.

Consumers who have purchased canned cat food with these codes should discard it. For further information or a product refund call P&G toll-free at 877-340-8826 (Monday - Friday, 9:00 AM to 7:00 PM EST).

Media Contact: Jason Taylor 513-622-3205

~~~~~~~~~~~~~~~~~~~~~~~~~

That's NINE MONTHS' output of product. Shame on P&G for not detecting this MUCH sooner.

On the up side, if your cat is eating primarily a high quality kibble food, and you rotate brands/flavors/styles of canned food, a deficiency leading to illness is unlikely.

Like the press release says, if you have been feeding a significant amount of the food listed and your cat has any of the listed symptoms, be sure to get it looked at sooner rather than later.

A Garden For Your Cat?

Spring is officially here, and the internet is full of articles about gardening. Los Angeles Times had this piece about square foot gardening (a technique well suited for small city lots), and First Lady Michelle Obama has started planting in the White House garden again.

I know, I know, this sounds like it has NOTHING whatsoever to do with cats, but bear with me for a moment.

There is at least one thing you can plant in your garden for your cat that I can enthusiastically recommend: catnip. I have grown fresh catnip in the past for my own cats, and it was a BIG hit. This perfectly safe plant is a mild euphoric, but the effects last only about 15 minutes. Some cats don't react to it at all (it's genetic), but most really enjoy it. The dried organic catnip available at the pet store is fine, but fresh is a real treat. I have heard that transplanted catnip seedlings have a lot more of what cats like than plants grown from seed, so buy the young plants at a nursery.

One word of caution - if your cat goes outside, you may find that it rolls all over the catnip plant and eventually kills it with love (ask me how I know this), so a wire protective cage might be warranted. You can also grow it in a pot or planter.

Now on to something that you should NOT plant for your cat: "cat grass". This is a very coarse grass that can be highly irritating to the gastrointestinal tract and cause unnecessary vomiting and diarrhea. I also have seen at least one cat choking on the grass, and there are published reports of the grass blades being inhaled and causing very dangerous (and costly to treat) complications.

If you have a weird cat like my Eddie was, you may find it likes raw spinach. Bloomsdale Longstanding is a savoy or curly-leaf heirloom variety that is almost crunchy when fresh. Eddie would always try to steal a leaf or two when I picked it so I would let him chew on it (he was mostly playing and not eating). He never vomited any of it, so I consider it safe in small amounts.

Happy gardening! And if you wind up with too many tomatoes this summer, I am always available to take your oversupply.

Raw Diet "Research"

Worms & Germs Blog's Scott Weese has another excellent post, this time about some recent "research" done by the folks at Nature's Variety.

~~~~~~~~~~
(snip)
Apparently, the study, commissioned by Nature's Variety, involved the feeding of 6 adult dogs variations of different diets over a 4.5 month period. They looked at stool quality, volume and odor, blood chemistry, quality of their skin and coat and body weight.

•In research, we worry about sample size. You need to have enough animals to detect any real differences. With 6 dogs, 4.5 months of feeding and different diets, you don't have much of a chance to detect a problem. You could have a diet that kills 10% of the dogs that eat it every year and not detect that in study of that size!
•The number of dogs and time don't even fulfill AAFCO feeding trial requirements, so this doesn't provide any information that would be accepted using standard requirements.
Nature's Variety director of research stated “It’s kind of a sigh of relief.”

•It's pretty concerning that the head of research would be relieved that there were no obvious health problems in such a small study. If they don't have real confidence in the quality of the food, why are they selling it? If you have confidence in your diet, you say "Of course, as expected, our diet was shown to be nutritious and safe..." not "Wow, we're really happy no dogs died!". Research to indicate safety and nutritional value should be done before you sell, not well after.
Duclos said she expects the study to be published in a peer-reviewed journal in about one year.

•Not likely. For one thing, from what they are releasing, it's very weak and not defendable scientifically. For another, they've already released the results. It's inappropriate for people to release results before they've undergone peer review, and releasing data in a press release will probably prevent any reasonable journal from even considering the study.

(snip)
~~~~~~~~~~

Nature's Variety recently had a large recall of their pet food due to massive Salmonella contamination. This "research" doesn't exactly inspire any confidence on my part in the company, but then I think feeding raw meat to pets is just plain foolishness.

Nature's Variety Expands Nationwide Voluntary Recall to Include All Raw Frozen Chicken Diets with Any "Best If Used By" Date On or Before 2/5/11

Well, the raw meat diet people have done it again: massive Salmonella contamination. This comes as no surprise. Raw poultry is pretty much always contaminated with Salmonella bacteria these days, and often Campylobacter, too. This is why you will never hear me recommending the feeding of raw meat to cats. And don't think beef is magically exempt from the problem - it's not. It just tends to have different bacteria doing the contamination.

Of course nobody should expect that raw meat, or produce, or even milk are sterile - they are NOT. But the contamination with disease-causing organisms is an ongoing problem, and one that requires far greater regulatory oversight than it has received in recent years.

For information on foodborne diseases, which can affect humans who handle raw meat just as easily as the pets that eat it, go to the FDA's Animal & Veterinary page, Food Safety page, and for the truly adventurous, their Bad Bug Book.

As always, if you stick with my advice to feed only a high quality commercial kibble cat food (or in some cases canned), both of which are COOKED, you avoid the risk of this sort of problem.

Pet Health and Safety Widget

It's brand new today so I don't think they have any "Tips" loaded on there yet, but the "Updates" button has lots of good info.

One more handy time-saver so I don't have to think and type and reinvent the wheel quite so much. Thank you, FDA!

Another Pet Food Recall

This time the problem is with Premium Edge, produced by Diamond Pet Foods.

-----------------------------------------------------------------------------
Diamond Pet Foods has withdrawn from distribution the following date codes of Premium Edge Finicky Adult Cat and Premium Edge Hairball cat: RAF0501A22X 18lb., RAF0501A2X 6 lb., RAH0501A22X 18 lb., RAH0501A2X 6lb. The calls from pet owners or veterinarians regarding this issue have been centered in the Rochester, NY area. All retail outlets shipped the above lots were contacted, asking them to pull the product from the store shelves. The retailers were also asked to contact their customers via email or telephone requesting them to check the date code of the food. However, if you or anyone you know has these date codes of Premium Edge cat food, please return them to your retailer.

Symptoms displayed by an affected cat will be neurological in nature. Any cats fed these date codes that display these symptoms should be immediately taken to a veterinarian.

Product testing proved no contaminants were discovered in the cat food; however the cat foods were deficient in thiamine. Diamond tracked the vitamin premix lot number that was utilized in these particular cat foods and have performed testing on another lot of Premium Edge cat food that used the same vitamin premix, and it was not deficient in thiamine. No other neurological signs have been reported on any other product manufactured by Diamond Pet Foods.

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I thought it was interesting that a few weeks ago, some veterinarians in the Northeast started asking questions about how to handle a rash of ataxic (uncoordinated) kitties. Several of them put their heads together, and one found an article online about a similar problem in the Netherlands a while back that involved thiamine-deficient food, and then they reported it to the FDA, and voila! A recall. This would have been greatly delayed if caring cat owners had not gone the extra mile with diagnosis and treatment of these puzzling cases. Eventually we private practice veterinarians, as a group, figured it out. Yay us!

Diamond has had several recalls in the past, some involving contamination with mold toxins. They need to clean up their act.

The Doctor's Pick - Cat Treats

I know, I know - I am always harping about not feeding junk to your cats. But it IS possible to indulge them in their wishes without getting into trouble.

First of all, avoid feeding your cat your own personal treats - human food is not a wise choice for kitties. That said, a tiny (and I mean TINY) bite of boiled or roast turkey or chicken once in a while is not going to cause problems. Just be sure that it has not been seasoned with garlic or onions, which are poisonous to cat and dog red blood cells. And NO, lunch meat turkey and chicken is NOT ok due to the garlic usually used for flavoring.

My favorite cat treats are Temptations brand made by Mars. Their chicken and turkey flavors are safe and appropriate, and their new All Natural chicken flavor is a HUGE hit with my own cats. They can be found at Target, most larger pet stores, Ralph's, and some drug stores.

My next favorite is Hill's Prescription Diet Hypoallergenic Cat Treats, which are particularly nice for cats with food allergies and sensitive tummies. They don't come in a "flavor" - they are just food flavored, I guess. My cats haven't told me the particulars. We carry them at Cat's Meow Veterinary Clinic, though we are out of them at the moment (they have been backordered for a while). These treats are larger and harder than the Temptations, so they may not be appropriate for cats with dental issues or elderly cats with poor muscle tone (though Dusty loves them and she's 18).

When choosing a treat for your cat, I recommend avoiding those with ANY fish in them, and I also don't care for any with wheat gluten, though for occasional feeding this should not be a problem. Also, you should never feed your cat any freeze-dried meat treats because these have a long and sorry track record of Salmonella contamination, and freeze-drying is the preferred method for keeping bacterial cultures alive forever in microbiology labs.

Kitten Care Basics: General Husbandry and Nutrition

Having a new kitten is an exciting experience, but it carries great responsibility. Your new kitten will need a lot of attention and care, so it's a good idea to learn some basics about these wonderful creatures. Your relationship with kitty will benefit tremendously.

First vet visit: Schedule your new kitten's first visit with us for 3-7 days after you obtain it (sooner if it is still not on solid food). The first visit for vaccinations/parasite treatment is normally at 8 weeks of age, but kittens younger than that still need to be seen to make sure they do not have any immediate medical concerns. Obviously if kitty has vomiting, diarrhea, visible parasites, or is not eating enthusiastically, it needs to be seen promptly.

Naming: Keep it short and simple so it's easy for kitty to learn. Teach the name by using it consistently.

Feeding: You should place the food and water bowls together, preferably in the kitchen. Special mats are available to help control spills. Use ceramic or stainless steel dishes - plastic can contribute to chin acne and is impossible to clean thoroughly. Provide fresh food and water daily, and clean dishes frequently.
Avoid the following foods: human foods as a general rule, chocolate, garlic/onions, dairy products, bones, fats, and all seafood. Stick with a proven high-quality commercial food to prevent potentially serious medical problems.

Sleep: Provide soft, washable bedding for kitty, and try placing it in a basket or cozy box near your own bed or in a sunny spot in the home. Give your kitten a soft or plush toy to cuddle with in bed to ease the transition away from littermates. We discourage shutting kittens out of your bedroom at night because cats hate closed doors and the resulting fuss will probably prove more disruptive to your sleep than nighttime roughhousing. Play with kitty for a while right before bedtime to encourage sleep patterns similar to your own.

Litter Box: The rule of thumb for litter boxes is one per cat, plus one - if you have the available space. The best location for the box is in the bathroom or a laundry/mudroom, well away from the feeding station for sanitary reasons. Clumping litter is best, but kittens need to be at least 8 weeks before using it so they do not eat it mistakenly. Scoop out the feces and urine clumps daily, and add more litter as the level drops. Wash the box itself on a regular basis (to get those near-miss marks off the sides). We advise against boxes with lids and the automatic cleaning type - they are gimmicky and can backfire badly. Kittens have a strong instinct to use litter and bury their own waste so they usually just need to be shown where to go.

Collars/ID: Get kitty a breakaway collar and adjust it so it just barely slips over the head. Don't forget to adjust it frequently as the kitten grows. Attach an ID tag with your current phone number. Consider having a microchip implanted at the time of spaying/neutering - we recently reunited an injured stray cat with its owners because it had a microchip - they were delighted.

Basic Safety: Never allow your cat or kitten to play with any potential linear foreign bodies such as string, thread, yarn, ribbon, rubber bands, sisal rope, or newspaper ties as these can cause fatal intestinal injury. Never give your cat or kitten any human medicines (including OTCs), vitamins, or cat grass unless your own veterinarian specifically instructs you to do so. Catnip IS safe, and kittens may safely partake of its mild euphoric effect, though some do not respond to it (and never will). Do not allow access to houseplants as many are toxic.

How to Feed Your Cat - Part 2 - Canned Food vs. Dry

I am frequently asked whether or not cats should be fed dry food (kibble) only, or canned food in addition to kibble. My answer in the case of normal, healthy cats is dry food only, with the caveat that it be a top quality dry food.

Poorly formulated dry food often contains fish meal of various types, always a no-no unless it's medically unavoidable, and also can have too much plant protein in proportion to animal protein. Fish sets the cat up for skin, urinary, and gastrointestinal problems (which can be dangerous and not merely annoying), and too much plant protein makes for urine that is too alkaline (can set up more urinary problems).

Canned food has its own inherent problems. It can lead to far too many vomiting and diarrhea complaints, leads to excessive dental problems (if you eat mush you get "mush mouth"), is a very expensive way to get calories into your cat, and has been linked to risk of hyperthyroidism.

There may be circumstances in your cat's life that call for canned food as part of a medical management plan, but for everyday feeding a well-chosen and top quality kibble is just fine. And in the majority of cases, free-feeding is acceptable.

How to Feed Your Cat - Part 1

Few people appreciate just how critical proper nutrition is to our feline friends. A significant number of my patients present with medical problems that have their roots in an incorrect diet.

Domestic cats are the direct descendants of Felis libyca, the desert wildcat of North Africa, the Negev, and Arabia. In this environment, the primary food sources for the cat were birds, reptiles, small rodents, and insects. You may note that fish are not on the list - nor should they be. Water is genuinely scarce in the Sahara, as are fish.

So as one might suspect, the healthiest protein source for cats is poultry (analogous to small birds and reptiles), with beef (analogous to mice/rats) a close second. Lamb and other novel proteins are not the best first choice, and fish is completely inappropriate from a biological standpoint.

My first bottom line recommendation for a maintenance diet in cats is that it NOT contain fish. Fish oil itself is a valuable nutrient, but fish flesh or fish meal is problematic. While healthy for us humans to eat, fish is implicated in (and I believe it to be directly causative of) a large percentage of the lower urinary tract disease, skin disease, and gastrointestinal disease I see at Cat's Meow Veterinary Clinic.

The second bottom line recommendation I make for a cat food is that it be tested for nutritional adequacy. Anybody can throw together a cat food that looks perfectly acceptable on paper according to the guaranteed analysis and other numerical data, but that diet could have serious problems with nutrient bioavailability. Because of this, we only recommend maintenance foods that have the following statement of nutritional adequacy on the label (known as the AAFCO Statement):

"Animal feeding tests using AAFCO procedures substantiate that (name of food) provides complete and balanced nutrition for maintenance of adult cats."

The best kitten foods have a similar statement pertaining to growth of kittens and maintenance of pregnant and lactating females.

There may be times in a cat's life when we need to feed it a diet that violates these two guidelines in the interest of special needs during illness. And if a cat has been happily enjoying a food which contains fish without adverse consequences (that is otherwise an excellent food) for years there may not be any need to switch. But in general you can't go wrong by following this basic advice.

Several kibble foods which as of this writing meet these criteria are:

*Science Diet - any flavor/variety kibble not containing fish on ingredient list
*Nutro Natural Choice Complete Care Indoor - any flavor not containing fish
*Max Cat Adult Roasted Chicken
*Purina One Special Care Sensitive Systems
*Costco Kirkland

Next time I'll address the dry food vs canned food issue and my recommendations about that.