kidney problems dog medicine
A rugged rascal since puppyhood, Cowboy had weathered many scuffs, but in spring 2012 his owner, Jay Phillips, noticed something very wrong. Though he had been fine the previous day, suddenly the Boston terrier was reluctant to move or eat and began crying late one night. He seemed limp and in the morning he was paralyzed from the neck down.
It was terrifying, said Phillips. I raced him to Cornell University Hospital for Animals and they took samples for a bunch of tests.
The doctors suspected Lyme disease, and proteinuria and hypoalbuminemia seen on blood work raised concern about the possibility of Lyme nephritis, a condition in which Lyme disease attacks the kidneys.
Test results told us that Cowboy's kidneys were being damaged at two different locations, both at the glomerulus (or filtering apparatus) and the renal tubules (concentrating apparatus), said Dr. Catherine Cortright, who oversaw the case. The glomerular damage was causing protein to leak into Cowboy's urine. The tubular damage resulted in glucose remaining in the urine rather than being pumped back into the body and saved. It caused cells to be sloughed into the renal tubules and appear in the urine.
Testing at the Animal Health Diagnostic Center revealed that Cowboy had chronic Lyme disease and was experiencing an acute flare up. Lyme disease can present two different clinical scenarios; an acute infection, or chronic disease. The acute form usually attacks the joints, causing an intermittent lameness that may move from one joint to another. The more chronic disease is the result of antibodies against the bacteria building up in the blood and blocking the filters of the kidney, causing extensive kidney damage that can be fatal.
Most dogs that are Lyme positive in this area have no clinical signs, and just being exposed and testing positive is not a reason to treat, said Cortright. But Cowboy had developed severe clinical signs. Its possible he had Lyme nephritis, a serious and life-threatening condition that is poorly researched in the dog. Many of the treatment options are in their infancy and there is not yet strong scientific support for any recommended treatments. Cowboy's kidneys had experienced extensive damage. Kidneys in general are not able to regenerate function. This means that every insult that they experience is irreversible, so waiting to treat aggressively could mean the loss of adequate kidney function in the future.
The prognosis was grave, but Cortright prescribed a combination of medications that helped ease Cowboy back to functional kidney levels. Recent tests have revealed a more complex picture, suggesting that autoimmune disease, which can be sparked by Lyme disease, might also have played a role in Cowboys symptoms. Nevertheless, Cowboys symptoms have been managed through medication since he came to CUHA, and frequent rechecks show he continues to maintain the good health he restored.
Initially they had estimated he had two months to live, but I took him home and had a serious talk with him, and years later hes still thriving thanks to the care he gets at CUHA, said Phillips. He looks like a million and still has his spunky personality. I took him on a three mile walk yesterday and he came home and found a rope to play with. I owe Dr. Cortright everything, she was a rock star. She called me from her honeymoon to check in on him. It has been a very long road, but Cowboy has gotten better and better."
Arthritis with kidney failure
I have a 14-year-old spaniel that suffers from very bad arthritis. He has also just been diagnosed with chronic kidney failure so can no longer take his normal pain medication. I am so worried we wont be able to control his painful joints. Is there anything we can give him that wont cause further damage to his kidneys?
Paul Manktelow advises
Firstly, I am sorry to hear about your dogs recent diagnosis. Sadly, issues with the function of the internal organs can be common in dogs as they reach old age, as can the development of muscle loss and stiff painful joints. I imagine your dog was on a nonsteroidal anti-inflammatory drug (NSAID), which are very effective at controlling the inflammation and pain associated with arthritis. However, they arent recommended if there are health issues, particularly with the kidneys and the stomach.
There are, however, some other treatment options that it would be worth chatting through with your vet. Certain drugs that dont have an effect on the kidneys could be substituted for the NSAIDs, and while they might not be as effective, they might at least take the pain from the inflamed joints down to a manageable level. These drugs can be used together, so you might want to try different combinations to see what works the best.
Im also a great fan of joint supplements, particularly those containing green-lipped mussel extract and hyaluronic acid, which Ive seen work wonders in older dogs. Most of these joint supplements have ingredients such as glucosamine and chondroitin so you might want to look for a product that has a combination of all these ingredients. These supplements work by helping to reduce inflammation, promote healing and increase water retention in the joint, which in turn, provides more cushioning.
As well as drugs and supplements, there are various lifestyle adjustments you can make to ensure optimum health. You will want to balance the diet so that its suitable for both renal and joint issues, and its best to speak to your vet about this so you know what to put in and what to keep out of your dogs food to ensure the organs are working well and optimum weight is maintained. Finally, you might want to consider other therapies, such as passive physiotherapy, acupuncture or cold-laser therapy as other forms of additional treatment.
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...
