stage 3 kidney disease diet for dogs

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.

7-Day Meal Plans for Stage 3 Chronic Kidney Disease

Chronic kidney disease (CKD) is a progressive condition where the kidneys lose their ability to filter waste and excess fluids from the body. There are five stages of CKD, and noticeable symptoms dont generally start to show until stage 3.

In stage 3, adjusting your diet becomes essential to slow further kidney function decline and help manage symptoms. Your doctor may or may not suggest restricting certain foods or nutrients during this stage, and you will likely have many questions about which foods are ok to eat, in what amounts, and in what combinations.

Knowing what to eat during each stage of chronic kidney disease is one of the biggest challenges to people living with the condition. While your renal dietitian can help you craft customized meal plans for your tastes and needs, here are some general ideas for kidney-friendly meal plans for people with stage 3 CKD.

An eGFR between 30 and 59 defines stage 3 CKD. Some experts further divide stage 3 into subsets: 3a (45-59) and 3b (30-44), with eGFR numbers indicating your percentage of remaining kidney function. Mild symptoms may appear in stage 3a, and this is often when many people with CKD receive their diagnosis. In fact, this is the first stage at which a diagnosis can be confirmed with a blood test alone.

Discuss the best nutrition options for your specific case and stage with your renal dietician. Image from Shutterstock.

In stage 3, the kidneys still remove a moderate amount of excess fluid, potassium, and metabolic waste. The treatment goals during stage 3 are to slow the progression of CKD and preserve remaining kidney function. These goals can largely be achieved by managing:

• Blood pressure,
• Glucose, and
• Weight.

Your doctor may or may not recommend limiting certain foods or nutrients at this point, but they will likely:

• Monitor your calories. Adequate calories can either prevent weight loss if youre at a desirable weight or provide extra calories if you are underweight.
• Suggest certain types of fats. If you have heart disease or high cholesterol, you should avoid saturated and trans-fats, which are abundant in fast and highly processed foods.
• Watch for fluid retention. If you develop high blood pressure, swelling in your hands or feet, sudden weight gain or shortness of breath, you may be retaining excess fluid that your kidneys are unable to flush. Your doctor may suggest restricting fluid intake.
• Monitor your sodium, phosphorus, potassium, and protein intake. Depending on your eGFR, you may need to start limiting your phosphorus, potassium, and protein intake, as your kidneys may not be able to process and eliminate excess, which can then build up in your blood. Too much sodium can also cause fluid retention, raise your blood pressure, and interfere with blood pressure medications. This is more likely to be the case in stage 3b.

Its helpful to work with a registered renal dietitian, because as the stages of CKD change, so will your diet.

To help get you started, here are some generalized meal plan options for people with mild CKD, designed by registered dietitians. Your own doctor and dietitian can help you individualize your meal plans going forward.

Day 1

• Breakfast. Oatmeal with cinnamon, milk, raspberries, and a tablespoon (Tbsp) of sliced almonds.
• Lunch. Tortilla wrap with tinned salmon (rinsed). Season with lemon juice, black pepper, fresh dill, and green onion.
• Dinner. BBQ shrimp over rice, and frozen mixed vegetables with olive oil drizzle.
• Snacks. Fresh veggies with hummus or apple slices with plain (no sugar or salt) peanut butter.

Day 2

• Breakfast. Chia seed pudding made with almond or soy milk, berries, cinnamon, and vanilla extract.
• Lunch. Egg salad sandwich with a fresh green salad, simple olive oil and red wine vinegar dressing, and fresh mint.
• Dinner. Small portion of grilled steak with white rice and baked cauliflower, corn, carrots, and garlic.
• Snacks. Fresh veggies with hummus, or 5 ounces (oz) of Greek yogurt with fresh berries and cinnamon.

Day 3

• Breakfast. Oatmeal with milk, berries, and a dash of maple syrup. Add a boiled egg on the side for protein.
• Lunch. Leftover steak in a lettuce wrap with tomato and 1 Tbsp of shredded cheese. Fresh honeydew melon on the side.
• Dinner. Kidney bean burgers and a fresh green salad. Use condiments like ketchup, mustard, and mayo sparingly, as they are often high in salt, sugar, and potassium.
• Snacks. Fresh veggies with hummus, or fresh plums with a handful of cashews.

Day 4

• Breakfast. Egg omelet with bell peppers, broccoli, 1 Tbsp of shredded mozzarella, pinch of parsley, and 1 slice of rye bread.
• Lunch. Chickpea (garbanzo bean) soup with celery, red cabbage, carrot, onion, garlic, rosemary, and olive oil drizzle.
• Dinner. Pasta with extra lean ground beef, fresh tomatoes, garlic, onion, and parsley.
• Snacks. Fresh veggies with hummus, or clementines with a handful of cashews.

Day 5

• Breakfast. Sourdough toast, avocado (mashed), lemon juice, sliced hard-boiled egg, fresh tomato, and basil leaves.
• Lunch. Shredded kale, Brussels sprouts, almonds, raspberries, chicken breast, with olive oil and balsamic vinegar dressing. Garnish with fresh mint.
• Dinner. Air-fried salmon with a side of couscous and a salad of fresh greens.
• Snacks. Fresh veggies with hummus, or apple slices with natural plain peanut butter.

Day 6

• Breakfast. Egg omelet with asparagus, bell peppers, parsley, and 1 slice of rye toast.
• Lunch. Tuna salad with celery, olive oil, onions, and whole wheat English muffin.
• Dinner. Lentil stew with carrots, shredded cabbage, onion, fresh dill, and cherry tomatoes. Serve over rice (optional).
• Snacks. Grapes and walnuts, or 5 oz of plain Greek yogurt with blueberries.

Day 7

• Breakfast. Smoothie made with kale, plain almond butter, strawberries, and soy milk.
• Lunch. Curried chicken lettuce wraps with fresh cilantro and lemon, and a side of fruit.
• Dinner. Stir-fried shrimp with carrots, peas, and cauliflower. Serve over white rice and dress with sesame oil, grated ginger, and garlic.
• Snacks. Fresh veggies with hummus, or fresh pear slices with plain peanut butter.

Most people in stage 3 CKD can still eat a moderate amount of lean animal protein, though plant-based options are encouraged by many experts and supported by mounting research. Whole foods that are unprocessed or minimally-processed are important, particularly fresh fruits and vegetables. Check with your doctor and renal dietitian, however, to determine which ones are safest for you, and in what amounts. Check out alternative sample meal plans here, and more targeted meal plans here.