best diet for a dog with kidney failure

By Isabella Storyclaire

last updated September 16, 2024

Contributions sourced from

Dietary Guidelines for Dogs with Chronic Kidney Disease (CKD)

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What To Feed a Dog With Kidney Disease

Nutrition plays a big role in the management of dogs with kidney disease. Because dogs with kidney disease usually arent feeling well, the first step is often to merely get your dog to eat anything.

Kidney disease can make dogs nauseated, and they can also develop ulcers in their mouth or stomach, which makes eating painful. A feeding tube may be necessary to get dogs with severe kidney disease the nutrition they need.

Once your dogs condition is more stable, you can turn your attention to providing more optimized nutrition. Kidney diets for dogs have to tick a lot of boxes. Heres a guide that explains nutritional needs and what to feed a dog with kidney disease.

What To Look For in a Kidney Diet for Dogs

Kidney diets for dogs are significantly different from regular dog foods. However, no single kidney diet is going to be best for every dog throughout the rest of their life.

For example, a dog in the early stages of kidney disease could thrive on a kidney diet with more protein, but as their disease progresses, a diet lower in protein and phosphorus might better control their symptoms.

As a rule of thumb, good kidney diets for dogs tend to have anutrient profilethat looks like this:

Nutrient	Grams/1000 kcal
Protein	31-41
Phosphorus	0.5-0.8
Sodium	0.4-1.2
EPA and DHA	0.4-1.2

Unfortunately, it can be hard tofind this information on dog food labelsor on pet food manufacturers websites. If you are having trouble getting the numbers, your veterinarian can help you pick a good kidney diet based on your dogs needs.

Here are several important elements to look for in kidney diets for dogs:

Taste

The most important characteristic of a kidney diet for dogs can be the hardest to achieve: It has to be delicious! Thats because the metabolic and physical changes associated with kidney disease can lessen a dogs appetite.

To counteract this effect, kidney diets need to smell and taste great. After all, a kidney diet that isnt eaten isnt going to do a dog any good. Kidney diets should also be calorie- and nutrient-dense, so dogs can eat less and still get a lot of nutrition.

Hydration and Water Content

Kidney diets should also contain a lot of water. Dogs with kidney disease struggle to maintain their hydration. All dogs always need to have access to bowls of fresh clean water, but a diet that has high water content is a great way to boost a pets water intake when they have kidney disease.

Wet foods are almost always a better option for dogs with kidney disease than dry foods. If you are feeding your dog kibble, ask your veterinarian about adding water to the dry food or other ways you can supplement their water intake.

It's also important to keep an eye on the sodium levels in kidney diets for dogs. Too much sodium increases the chances that your dog will becomedehydrated.

The Right Amount of the Right Protein

Next comes the balancing act that is protein. Dogs with kidney disease need protein, but not too much. The breakdown products of protein digestion are responsible, in large part, for making dogs with kidney disease feel yucky.

The goal is to feed just enough protein to meet a dogs needs for muscle maintenance, immune function, and the other vital jobs proteins have in the bodybut not to feed too much more. Extra protein will only be turned into calories that can be more safely provided by carbohydrates and fats.

Protein quality is also important. Proteins should be highly digestible and supply all the essential amino acids dogs need.

Low Phosphorus Levels

Theres a close relationship between protein intake and blood phosphorus levels. Dogs with kidney disease gradually lose the ability to excrete phosphorus in their urine, so it backs up in the bloodstream. Reducing phosphorus intake has been shown to slow the progression of kidney disease in dogs and increase their lifespan.

An important way to reduce phosphorus levels in the diets of dogs with kidney disease is to not overfeed protein and to ensure thatproteins relatively low in phosphorusare included in the diet. Plant-based sources of protein tend to be lower in phosphorus than animal-based sources of protein.

Supplements

Nutritional supplements can also help dogs with kidney disease. Supplements often included in kidney diets for dogs include:

Omega-3fatty acids:eicosapentaenoicacid (EPA) and docosahexaenoic acid (DHA), which can reduce inflammation in the bodyincluding in the kidneysand possibly improve kidney function
Antioxidants,which neutralize free radicals that can further damage the kidneys
Fermentable fiber,which helps get rid of protein digestion waste products in poop. This allows dogs to eat more protein than they might be able to otherwise.

Prescription Kidney Diets vs. Homemade Kidney Diets for Dogs

What abouthomemade kidney diets for dogs? Astudypublished in 2012 showed how hard it is to find nutritionally complete and balanced kidney diet recipes in books and online. Of the 39 recipes evaluated, none met all the National Research Councils recommended nutrient allowances for adult dogs.

In contrast, prescription kidney diets produced by reputable dog food manufacturers undergo testing to ensure they are safe for long-term feeding and have a positive effect on a dogs health.

How To Cook for Dogs With Kidney Disease

One big benefit of homemade kidney diets, however, is taste. If your dog simply wont eat anything else, a homemade kidney diet is worth considering. To avoid nutrient deficiencies or excesses, make sure a veterinary nutritionist or a service likeBalanceIT, which requires veterinarian approval, is involved in formulating recipes for your dog.

Common Prescription Kidney Diets for Dogs

After a dog has been diagnosed with kidney disease and their condition is stabilized, veterinarians typically recommend switching over to a prescription kidney diet. Your veterinarian may have recommended a particular food based on the details of your dogs case. Here are three popular options:

Hill's Prescription Diet k/d Kidney Careis available in wet and dry formulations and different flavors:

How To Transition Your Dog to a Kidney Diet

special attention to how you make the transition. Do notchange your dogs foodwhile they are still nauseated or feeling bad. They may associate their symptoms with their new food and refuse to eat it.

Once your dog has a good appetite, start making the switch very slowly. Give them lots of time to get used to the new flavors, textures, and ingredients. This reduces the chance of food refusal and lets your dogs digestive system adapt.

Here is a timetable for taking two weeks to switch your dog to a new diet:

Days 1 and 2:Mix 5% of the new food in with 95% of the old food
Days 3 and 4:Mix 10% of the new food in with 90% of the old food
Days 5 and 6:Mix 20% of the new food in with 80% of the old food
Days 7 and 8:Mix 40% of the new food in with 60% of the old food
Days 9 and 10:Mix 60% of the new food in with 40% of the old food
Days 11 and 12:Mix 80% of the new food in with 20% of the old food
Days 13 and 14:Mix 90% of the new food in with 10% of the old food
Day 15:Try 100% of the new food

If at any point your dog turns their nose up at their food or develops signs of digestive upset, move back a step in the timetable and proceed more slowly.

Signs to Watch for After Starting Your Dog on a Kidney Diet

Dont give up if you initially have trouble switching your dog to a kidney diet. Call your veterinarian if your dog wont eat the recommended food. They can help by:

Recommending an appropriate food topper to make the food more appealing. Avoid products that are high in phosphorus and salt.
Prescribing medications to reduce nausea, stomach inflammation, ulcers, or other symptoms that may be reducing your dogs appetite
Recommending a different prescription kidney diet or, if necessary, a suitable over-the-counter food
Referring you to a veterinary nutritionist to get recipes for homemade kidney diets
Talking to you about the benefits of a feeding tube

Many dogs with kidney disease live happily for quite a long time, particularly if they get the right kind of nutrition. Onestudyshowed that on average, dogs who were fed a kidney diet lived 13 months longer than those who ate regular dog food. Thats certainly a goal worth striving for!

Featured image: iStock.com/RichLegg

WRITTEN BY

Jennifer Coates, DVM

Veterinarian

Dr. Jennifer Coates is an accomplished veterinarian, writer, editor, and consultant with years of experience in the fields of veterinary...

My pet has kidney disease what kind of diet should I feed?

While kidney disease can be a scary diagnosis, many dogs and cats can live comfortably for years with kidney disease if it is caught early enough and treated appropriately. While most drugs used to treat pets with kidney disease are only meant to reduce symptoms, feeding the right diet can have dramatic effects on survival studies have shown that pets that eat diets designed for kidney disease can live twice as long as those who eat more typical diets.

The nutritional changes that need to be made depend on the severity of the kidney disease, but in general, pets with kidney disease should be fed diets reduced in phosphorus, protein, and sodium and supplemented with omega-3 fatty acids from fish oil. The most important of these nutrients for most dogs and cats is phosphorus. It is important to feed a low phosphorus diet to keep the pets blood phosphorus low, which is thought to slow the progression of kidney disease and improve survival.

As the kidneys are responsible for getting rid of the waste products from protein in the diet, diets for pets with kidney disease have lower amounts of protein to minimize the buildup of waste products in the blood as the kidneys fail, which can make your pet feel quite sick. If your dog or cat has protein loss in his or her urine, then a low protein diet is particularly important because lower protein diets reduce the protein loss, which can improve survival time. In addition to feeding a lower protein diet, you also need to avoid giving high protein treats such as meat, jerky treats, cheese, rawhides, pig ears, etc.

High salt (sodium) diets may increase blood pressure and may worsen kidney damage, so diets designed for pets with kidney disease are low in sodium. You should also avoid feeding high salt treats such as cheese, bread, deli meat, and many commercial dog and cat treats. Keeping to foods and treats that have less than 1 mg sodium per Calorie (kcal) is generally a good start. Low sodium treats include fruits and vegetables (but be sure to avoid grapes, raisins, onions, and garlic!)

There is some evidence that omega-3 fatty acids from fish oil may have benefits for cats and dogs with kidney disease, so many diets for pets with kidney disease contain added fish oil, or fish oil is added as a supplement if the diet doesnt already have it. Talk to your veterinarian about whether fish oil is right for your pet and, if so, about optimal dose and a brand that has high quality control.

Diets designed for kidney disease are also designed to be non-acidifying whereas many dog foods and most cat foods are designed to be acidifying. Pets with kidney disease often become too acidic, so it is important that the diet be designed to help counteract this issue.

All of these modifications can be found in therapeutic diets that your veterinarian can provide to you or give you a prescription to purchase elsewhere. Unfortunately, diets that you can buy at the pet store are going to be too high in phosphorus and protein for pets with anything other than the mildest kidney disease and also are likely to be acidifying, so this is a time when you really do need to get a diet from your veterinarian if you want your pet to have the best nutrition!

Posts authored by the Clinical Nutrition Service team are by Dr. Lisa M. Freeman, DVM, PhD, DACVN, Dr. Deborah E. Linder, DVM, MS, DACVN, and Dr. Cailin R. Heinze, VMD, MS, DACVN