diet for dogs with kidney failure
Kidney Disease in Dogs: Signs, Symptoms, and Treatment
Your dogs kidneys are essential organs that filter waste products from the bloodstream. When the kidneys are weakened, either by acute or chronic kidney disease, your dogs health could suffer. Because kidney disease progresses over time, its important to learn the common symptoms so tha you can recognize them. If you catch kidney disease in dogs early on, treatment can slow down the progression and allow your dog to live longer.
What Is Kidney Disease in Dogs?
Kidney disease in dogs is sometimes called renal or kidney insufficiency because it occurs when a dogs kidneys stop doing their job as efficiently as they should. The main job of the kidneys is to help clear and excrete waste products from the blood and convert them to urine, says Dr. Jerry Klein, Chief Veterinary Officer for the AKC. If the kidneys are not working properly, these waste products can build up in the blood, causing detrimental effects.
Dogs can get either acute kidney disease, which develops suddenly, or chronic kidney disease (CKD), which develops slowly and worsens over an extended period. Both involve loss of kidney function, but they result from different circumstances. Acute kidney disease is a sudden attack or injury to the kidney, whereas chronic kidney disease is a slow, degenerative loss of kidney function, Dr. Klein explains.
What Causes Kidney Disease in Dogs?
Dr. Klein warns that kidney disease could be caused by a lot of things, including infection (such as with the bacteria that causes leptospirosis), trauma, genetics, drugs, toxins, cancer, mechanical obstructions (like kidney stones), and degenerative diseases (where the job and form of the affected body part get worse over time). Anything that decreases blood flow to the kidneys, such as dehydration or heatstroke, can cause the kidneys to fail.
Acute kidney disease in dogs can be caused by exposure to hazardous materials, including toxic plants such as lilies, certain drugs, harmful foods such as grapes or raisins, or antifreeze. Puppy-proofing your home and yard can keep your dog away from potentially harmful items or foods that could be toxic.
Chronic kidney disease in dogs is also associated with growing older. Because kidney tissue cant regenerate once its damaged, the kidneys can wear out over time. As small-breed dogs often live longer than large-breed dogs, they tend to show early signs of kidney disease at an older age10 years old or more, compared to as young as 7 for the large breeds.
What Are the Symptoms of Kidney Disease in Dogs?
The earliest signs of kidney disease in dogs are increased urination and therefore increased thirst. Other symptoms dont usually become apparent until about two-thirds of the kidney tissue is destroyed. So, in the case of CKD, the damage may have begun months or even years before the owner notices. Because of this, its common for the signs of kidney disease in dogs to seem like they came out of the blue when in fact, the kidneys have been struggling for a long time.
Other signs of chronic kidney disease in dogs to watch for include:
Dr. Klein says there are some rarer symptoms of kidney disease in dogs to be aware of, as well. On occasion, there can be abdominal painurinary obstructions or stonesand in certain instances, one can see ulcers in the oral or gastric cavity. In extreme cases, little or no urine is produced at all.
What Are the Stages of Chronic Kidney Disease in Dogs?
Kidney disease in dogs is measured in stages. Many veterinarians use the IRIS scale, which has four stages. Blood work measurements like creatinine and SDMA (biomarkers for kidney function) allow your vet to assign your dog to a particular stage which will determine the exact treatment.
Dr. Klein explains, The stages determine how well the kidneys can filter waste and extra fluid from the blood. As the stages go up, the kidney function worsens. In the early stages of CKD, the kidneys are still able to filter out waste from the blood. In the latter stages, the kidneys must work harder to filter the blood and in late stages may stop working altogether.
How Is Kidney Disease in Dogs Treated?
Dialysis (a medical procedure that removes waste products and extra fluid from the blood) is far more common in humans than in dogs, although peritoneal (kidney) dialysis can be performed in some cases. On rare occasions, surgical kidney transplant is possible in dogs.
But Dr. Klein specifies that depending on the type and stage of kidney disease, the main treatments for CKD are diet changes and administration of fluids, either directly into the veins (intravenous) or under the skin (subcutaneous). The balancing and correction of electrolytes are extremely important in the management of kidney patients, he explains.
Proper nutrition is needed, and there are many available diets formulated for cats and dogs with kidney issues, some by prescription only. Your veterinarian can help guide you to the most appropriate diet for your pet.
Because kidney disease, particularly in the late stages, can cause a dog to lose their appetite, it can be difficult to encourage your dog to eat enough. Dr. Klein advises, There are medications used as appetite stimulators available, such as the prescription drug mirtazapine. Capromorelin has recently been FDA-approved for dogs to address appetite in chronic kidney disease.
When Do You Need to Call Your Vet?
The prognosis and expected life span for a dog with kidney disease depend on the type of disease, the speed of progression, and underlying conditions present in the dog. However, the more serious the disease, the poorer the outcome. Thats why its so crucial to catch the illness early on.
According to Dr. Klein, In chronic kidney disease, there are methods, such as diets and medications, that can be used to lessen the burden of work the kidneys need to do and may help slow down the progression from one stage to the next. In acute kidney disease, there is less time and fewer choices available to prevent further damage to the kidneys and to try to jump-start the kidneys to get them to function normally.
Regular veterinary exams, including bloodwork, are an excellent way to spot kidney problems before the outward symptoms become apparent. And if you notice any of the above signs, dont hesitate to get your dog to the vet for further testing. It can make a huge difference in preserving kidney function and your dogs well-being for as long as possible.
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, DVMVeterinarian
Dr. Jennifer Coates is an accomplished veterinarian, writer, editor, and consultant with years of experience in the fields of veterinary...
