Bernese Mountain Dogs
Health and Information Pages
Diets for Special Needs
Diets for Dogs with Kidney Problems
Lew Olson, PhD
Natural Health, LMSW-ACP
Diets for Dogs with Kidney Problems This article addresses how to prepare home made diets for dogs with renal issues. Most kidney problems are diagnosed through routine blood work and urinalysis tests. While the basic information will be outlined in this article, a more detailed account can be found at the following website: http://www.dogaware.com/kidney.html
This is a website written by Mary Straus, and it has a wealth of information in it, including, sources, charts and definitions of various kidney problems.
There is also a wonderful list on yahoogroups.com called K9KidneyDiet, which has extremely helpful members to answer questions and it contains kidney information and different diets for dogs with renal issues in their files. You can click on this link to find out more. http://groups.yahoo.com/group/K9KidneyDiet/
The signs that an owner will first see that may point to kidney disease include weight loss, drinking more water, more frequent urination, vomiting, diarrhea, anemia (light colored gums can be one sign) and the dog being less active.
The blood work will usually show elevated BUN and creatinine, and you may see high phosphorus, low red blood count, and possibly problems with calcium, sodium, potassium, amylase and lipase.
At this point a urinalysis and urine culture is recommended. Signs of kidney disease in the urinalysis can show low specific gravity, which is the inability to concentrate the urine, and sometimes protein in the urine. The urine culture is needed to rule out and check for a urinary tract infection.
Other kidney problems that can show some of these symptoms include glomerulonephritis (protein losing nephropathy), urinary tract infection, and diabetes insipidus, to mention a few. It is important to understand which cause is in play, to determine if the kidney problem is acute (short term) or chronic (long term, on going). It is also important to rule out other problems that can affect kidney function, such as Cushings disease, Addison's disease, leptospirosis and pyleonephritis (bacteria infection).
Once the tests are done, the information will be interpreted by your veterinarian for a diagnosis and to determine the extent of the kidney disease and hopefully the cause.
Acute kidney problems are often seen to be reversible and the kidneys will resume normal functioning with any needed treatment for this condition. Acute kidney problems can be caused by poisoning, leptospirosis or other insults to the kidneys. With proper treatment and supportive care, the kidneys can return to normal function.
Chronic kidney problems are not seen as reversible, but can be managed with special care.
An example would be my Rottweiler, the Bean. He was diagnosed early with pyleonephritis (kidney infection) which was determined through a urine culture. At that point I also had his kidneys checked with a sonogram, and we discovered that while his kidneys were of normal shape, they had congenital problems. His creatinine and BUN were in acceptable levels, so no diet changes were needed at that time. However, with this information in hand, I was able to have periodic blood tests to check his kidney levels. I was also armed with good information that let me know he needed IV therapy when given anesthesia and that I only use medications on him that were renal friendly. I also gave supplements that help support the kidneys, which include high doses of salmon oil, along with vitamin B-complex, vitamin E, and CoQ10.
Then, last fall, the Bean became ill and his blood levels showed alarmingly high creatinine levels (at over 5) and BUN (over 80). Our assumption was that his kidneys were shutting down, but I was determined to check all other causes. After a series of tests including tick borne diseases and urine cultures we decided to do a leptospirosis test (spread from urine from infected animals). He came up positive and we were easily able to treat this with IV fluid therapy (recommended for high creatinine and BUN to support the kidneys) and penicillin which can kill the lepto bacteria. While his levels were still elevated, I fed him a diet low in phosphorus and sodium. When his blood levels became normal, I was able to feed him his regular raw diet.
It is through this article I will share the diets I fed the Bean, and also how I decided to change the diet as needed.
Bean is normally on a raw diet, and I tend to feed him meatier bones. Bones are higher in phosphorus, so I try and limit these. His diet is 50% of these, with the other half being muscle meat, organ meat, eggs and occasional dairy. I use this diet when his creatinine, BUN and phosphorus are in the normal range. I tend to check his kidney functions through blood work every 4-6 weeks. This may not be necessary for all dogs, but Beans kidney problems are congenital, and since he is young (21 months) I know this could change at any time.
Most veterinarians may suggest to lower protein at any sign of renal problems, but it has been discovered that this can do more harm than good:
Dogs with kidney problems by Dr. Lucy Pinkston, D.V.M.
"Because by-products of protein digestion are the main toxins that need to be excreted by the kidneys, an obvious assumption might be that all one needs to do is to cut out the protein and the kidneys wouldn't have any more hard work to do. . . . There is significant evidence, however, that the daily protein requirements actually increase slightly for dogs in chronic renal failure. Therefore, severely restricting the protein for such a dog is likely to result in protein malnutrition, in spite of the fact that the levels of blood urea nitrogen, or BUN (the primary by-product of protein metabolism) would be correspondingly lower." This article contains a great deal more useful information in easy to read format.
Feeding the Older Dog from the SpeedyVet Clinical Nutrition Library"
The assumption was that low-protein diets retarded the progression of renal degeneration. This assumption was disproved, using partially nephrectomised dogs, which showed no uraemic signs and had reduced but stable renal function for 48 months. These dogs did better on moderate protein diets than on low-protein diets. There is no direct evidence that high protein intake damages canine kidneys or that reducing protein intake in dogs with renal dysfunction results in preservation of either renal structure or function."
Kidney Failure from the Iams nutrition symposium
'For years, physicians and veterinarians have treated renal failure by reducing protein levels in diets,' said Gregory Reinhart PhD, an Iams researcher. After working with leading universities, we have now found that restricting protein in a dog's diet may do more harm than good by potentially putting the companion animal at risk of protein malnutrition.' It would appear restricting protein may do more harm than good, and when it may be beneficial (end stage renal disease) the dog may well be too ill to eat well. With this in mind, I do lower phosphorus levels at certain times. Mary has a great list of low phosphorus foods on her site, at http://www.bowchow.com/kidney.html and further references on protein needs of dogs with kidney disease.
When the Beans creatinine level goes over 3, and his BUN is greater than 60, I move to feed him lower phosphorus foods (not lower protein) and restrict his sodium. Fortunately, most home cooked and raw diets are already low in sodium. Commercial dog foods tend to add sodium for preservatives. Additionally note that if your dogs creatinine goes above 3 and BUN goes higher than 80, fluid IV therapy may be needed. This helps to bring these levels down and may well prolong your dogs life. This can also be done at home with subcutaneous fluids, which means fluids given under the skin. For more information on treatment, medications, and a wealth of links and education on kidney disease, see Mary Strauss website at: http://www.bowchow.com/kidney.html
Serve food twice daily, and feed at approximately 2% to3% of the dogs body weight daily in food. For example, a 100 pound dog would get two to three pounds of food (one cup is approximately 8 ounces, or ½ pound). A 50 pound dog would get one to one and a half pounds of food daily. A 25 pound dog would get eight to twelve ounces daily. A ten pound dog would get three to seven ounces daily. Dogs can vary on these amounts, depending on their metabolism and activity levels.
Mix 1/2 cooked sticky rice (sushi rice) cooked in unsalted butter with 1/2 HIGH fat hamburger or dark meat chicken (lower in phosphorus than white meat). Add two cooked egg whites (no yolk) per cup. You can make as large a batch as needed and freeze for daily portions. Save the egg shells, and add back one teaspoon of egg shell (dry overnight, grind in a coffee bean grinder) per two pounds of food. The egg shell is good for calcium and also acts as a phosphorus binder.
Cook Malt o Meal and add one tablespoon of unsalted butter per cup. Cool, and add two tablespoons of heavy whipping cream (don't need to whip it!). You may add a bit of meat (hamburger, ground chicken) and some gravy for flavor. I have also added chicken skin or beef fat for variety.
Cook sticky rice (sushi rice) and add unsalted butter. Mix at 1/3 sticky rice, to 1/3 boiled sweet potatoes, and add 1/3 either ground pork, lamb or fatty hamburger. Add one egg white per cup. (You can substitute boiled potatoes for sweet potatoes).
Green tripe is also a pretty good food lower in phosphorus than other foods. You can buy this frozen at outlets that sell frozen raw diets for dogs, or buy it in cans called Tripett.
It is also good to occasionally add beef kidney, a bit of liver and egg yolks. While these are high in phosphorus, they do provide needed nutrients. . You can also mix either the rice or the vegetable mix with drained mackerel or salmon for variety and the fish already has bone steamed with it, so it is balanced properly for calcium. Because of the bone, fish is high in phosphorus and so should be used in very limited amounts. Do not feed tuna, as it is high in mercury.
Again, save your eggshells, and dry them overnight. Then grind them in a coffee bean grinder and add to the food served at 1/2 teaspoon per pound.
It is important to select fatty meat. So pork and lamb are also good choices to mix with the rice and they add a nice variety. Fat offers calories for energy and weight gain, and fattier cuts of meat are lower in phosphorus. Do offer a variety to keep your dogs interest and appetite hearty. More severe kidney problems can lend to loss of appetite and at these times, offering almost any type of food may be necessary.
Fish or salmon oil (NOT COD LIVER OIL!) needs to be 1,000 mg per ten pounds of body weight to be renal protective. Brown, S. A., C. A. Brown, W. A. Crowell, J. A. Barsanti, T. Allen, C. Cowell, and D. R. Finco. "Beneficial effects of chronic administration of dietary omega-3 polyunsaturated fatty acids in dogs with renal insufficiency." J Clin Lab Med 131:447-455 (1998).
In two studies, one from 2000 and the other from 1998, dogs with induced kidney disease showed improvement when they were fed omega-3-rich fish oil supplements, compared to omega-6-rich safflower oil supplements. Results from this model of renal insufficiency in dogs suggest a beneficial effect of fish oil in protecting the kidney, whereas safflower oil hastened the decline of kidney function.
I would also give one milligram of COQ10 daily per pound of body weight. There is good research behind this that shows it can help bring down the creatinine levels.
CoQ10 was studied in a small pilot study involving 21 patients with chronic renal failure. Researchers administered CoQ10 to 11 of the subjects while 10 received a placebo capsule. To be included in the study patients had to have a creatinine level of 5 mg/dl or above. After 4 weeks, the subjects receiving CoQ10 had significant decreases in serum creatinine and urea while creatinine clearance significantly increased. At the end of the 4 week study the number of patients on dialysis was significantly less in the CoQ10 group. 36.2% of the patients in the CoQ10 group were on dialysis at the end of the study while 90.0% of the placebo group was on dialysis at the end of the study.
Conclusions: Treatment with coenzyme Q10 reduces serum creatinine and blood urea nitrogen and increases creatinine clearance and urine output in patients with chronic renal failure.
I would also include a B vitamin in the dogs diet, as well as vitamin E. Both of these are helpful for support of the kidneys.
I hope you find this information and these recipes helpful, please email me if you have further questions.
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