[sheila23]

Hi all!

I was hoping for some feedback on a kidney disease diet for my pup Alvin. I have been doing research for the past few days, on here, DogAware, and a few other sites. My brain is starting to hurt! 🙂

Right now, I am leaning towards Honest Kitchen Preference, supplementing with Rotating Tripe and Beef.

Do you guys think the phosphorous would be low enough?
(I can provide all the numbers if needed!) I am also starting him on the Standard Process Renal Supplement.

A little background on Alvin:
He’s 4, currently eating Zignature Turkey.
He was diagnosed a little over a week ago, his Bun was 52 and his Creatinine is 3.5.

Thanks in advance for any help.

[InkedMarie]

A poster here, Shawna, has alot of info on this. I will let her know to come here.

[C4D]

InkedMarie is right, Shawna is very knowledgable on this situation. I’ve only had experience with CRF in an older dog. A few things I can share are that when in renal failure, a wet diet instead of dry is much more beneficial since your giving the kidneys more moisture to work with. You might want to check out Grandma Lucy’s website. I believe their food is made with low phosphorus. Tripe and egg white are low in phosphorus, while organ meats tend to be high in phosphorus so you might want to avoid foods that contain liver, etc. I also found a FB page called CRF Dogs that has a lot of helpful advice, although it isn’t as active as it was a few years ago. Good luck with Alvin!

[aimee]

Hi sheila23,

I’m so sorry to learn about your dog. You are right to be very concerned about nutrition for Alvin. Since he is so young looking for any conditions that are treatable is also very important.

This site is technical but may be of help to you or your vet as you decide upon treatment. Foods that are intended for normal dogs will have phosphorus levels too high for a dog with kidney insufficiency.

http://iris-kidney.com/

Preference could be an option but I’ve found that The Honest Kitchen knows precious little about dog nutrition and personally I wouldn’t trust the company’s products in this situation. Grandma Lucy’s used to market their diet as a low phosphorus diet appropriate for kidney patients. I repeatedly asked them what the phosphorus level was in the food and they said they didn’t know. It was only after I reported them to the state feed control official that they tested the food and changed their labels. The diets are too high in phosphorus to be considered a low phosphorus diet for a kidney patient and contain garlic which is something I’d avoid in this situation.

A homemade diet may be the best option if you are not comfortable with any of the commercial diets designed for dogs with kidney compromise. Or a combination of homemade and commercial. Nutrition of a kidney patient is very important, so much so that this is a situation that I personally would consult a vet nutritionist. Or you may want to check out the “balance it” site as they have for kidney friendly homemade recipes balanced by a vet nutritionist.

Best of luck to you and Alvin

[Shawna]

Hi Sheila23,

Although a homemade diet is absolutely doable I would do a LOT more research before you decide on any one brand. Example — Tripe is a great food for kd dogs but it is supposedly already balanced in calcium to phosphorus. Adding a premix like Preference, that is designed to balance higher phosphorus meat, could be problematic. Although phosphorus needs to be watched, you can go too low too early in the disease.

Balance IT could be an option but I personally wouldn’t have fed my KD girl such a low protein diet (ESPECIALLY in the early stages). Based on the nutrient profile of their beef and rice early stage kd diet the protein amount is only 15.3%. That’s ridiculously low for early stage kd without any complicating issues like proteinuria. Not even enough to meet the minimum protein amounts required for an a complete and balanced diet. They also use corn oil — EEEEKK. The chicken & rice recipe is even worse at 14.9% protein.

If you can afford it, I would highly recommend looking at Darwin’s prescription KD diet formulated by vet Dr. Barbara Royal. The ingredient list is
“Human-Grade Meat: Beef Meat, Beef Tripe, Beef Pancreas, Beef Lungs, Beef Kidneys, Beef Liver, Beef Heart, Beef Spleen.

Vegetables: Cabbage, Celery, Squash, Sweet Potato, Beets, Romaine Lettuce.

Special Nutrient Mix: Filtered Water (for processing), Sardine oil (source of EPA, DPA and DHA), Egg Shell Powder, Parsley, Apple Cider Vinegar, Inulin, Cornsilk, Dandelion Root, Cinnamon, Cranberry, Linden Flowers, , Chitosan, Zinc Amino Acid Chelate, Vitamin E, Manganese Amino Acid Chelate, Potassium Iodide, Vitamin D3, Aloe Vera.” http://www.darwinspet.com/our-raw-foods/our-raw-dog-food/intelligent-design-ks/

I LOVE that you are starting Alvin on Standard Process Renal Support. It is the one supplement that my Audrey NEVER did without since diagnosis. She had KD from birth (symptoms showed at just 6 weeks of age) but she wasn’t diagnosed till she was 13 months old. She was given one year to live after that. She lived to almost her ninth birthday and it was an infection that took her life not the normal progression of kidney disease.

Some other things to look at for Alvin — purified water (as much as he wants), extra water soluble vitamins if he urinates large volumes of water. A high quality probiotic and a prebiotic made with acacia fiber helps to clear BUN etc from the blood allowing for higher protein to be fed or simply helps clear BUN when necessary. This is called “nitrogen trapping”. Giving Evian (or another higher calcium, lower sodium mineral water) has been shown to be beneficial for kidney disease. I did give my Audrey fresh, raw garlic most of her life. I still believe that if I hadn’t gotten lazy and quit giving it to her near the end of her life she wouldn’t have developed the severe infection that ended up damaging her kidneys and taking her life. Enzymes to help with the digestion of his food. Certain supplements and herbs can be helpful — spirulina provides many nutrients, food grade activated charcoal given off an on in small amounts can help clear toxins, organic turmeric helps with inflammation and also helps prevent scar tissue (works best when combined with pepper or the enzyme bromelain from pineapple). Chlorella is a wonderful detoxer and it helps build red blood cells due to the high amounts of chlorphyll in it. Apple cider vinegar can help with indigestion (fed with food in small amounts or given via syringe but must be diluted first). Ginger extract and therapeutic grade peppermint oil can help with nausea (later in the illness). I also recently read that there is other therapeutic grade essential oils that can help the kidneys but I don’t remember the particulars of the article. Vet Dr. Melissa Shelton would be the person to seek out if wanting to incorporate essential oils.

I was lucky with Audrey, she was able to eat commercial raw products clear up to a few months before she passed. I’m not sure if that was because of the supplements, being fed raw from weaning or what but she did quite well. Possibly look at lower phosphorus commercial foods and then add small amounts of low phosphorus toppers (lightly cooked egg whites and coconut oil as an example) to keep the calories up while lowering the overall phosphorus even more. There are some great nutritionists out there as well that could be quite beneficial to you and Alvin.

Hoping Alvin does as well as, or better than, my Audrey!!!

Thank you Marie!

[C4D]

Shawna, all I can say is well done, as always! 🙂

[Shawna]

Thanks C4D!! MUCH appreciated!!

I just reread and noticed all the grammatical and spelling errors. YIKES I really shouldn’t post when I don’t have time to proofread. 🙂 Oh well

[aimee]

Hi Shawna,
In regards to balance it I hand calculated out the protein requirements for a 50 lb dog and then looked at several recipes and they all met or exceeded NRC recommendation. Not sure why you’d say the diet isn’t complete and balanced.

The strength of Balance is it is a good place to start if you can’t afford an individual consult and it looks that you can customize the recipes for a small fee. But if you wanted to say up the protein you could run the calculations yourself since all the nutritional information is given.

I do agree that in early stages higher protein can be fed and of great importance to me is to calculate protein needs and make sure they are being met independent of the percent of protein in the diet.

Darwin’s “kidney” diet is quite the mystery to me as phos. is not restricted. As you know phos. restriction is the most important key to slowing down progression of renal disease. The Phos level is nearly twice the NRC recommended amount for a normal dog.

I’m glad to see they require vet approval as it looks like this diet would only be appropriate for a dog that doesn’t yet need any modifications from AAFCO maintenance requirements. In that case there are OTC diets that are a lot less expensive that could be used

[sheila23]

Thanks all for the replies! There is a lot of info to consider and some I hadn’t even thought of (filtered water!) we are actually considering going to a veterinary nutritionist to have them help create a diet for us, has anyone ever used one of those?

Shawna- so much info!! You rock! So, so helpful. And gives me a lot of hope for my boy! Initially it was a very scary diagnosis for us, but I feel there’s a lot I can help him with now. I hadn’t heard of Darwin’s yet, looking into that right after this post.
-Regarding the mineral water, is it ok for other (not kd) dogs to drink this? That could be a dumb question, I am not sure.

[Shawna]

Aimee,

I’m sure you are more than aware that I was discussing AAFCO nutrient profiles (which are set at 18% as a minimum) versus NRC? You have such a way of spinning things…..

“Balance IT could be an option but I personally wouldn’t have fed my KD girl such a low protein diet.” I gave my opinion about BalanceIT. The OP can take it or leave it.

Could you point me in the direction of OTC foods that have kidney friendly herbs etc? I missed those when I was planning out Audrey’s diet. In case you missed, I have stated that the Darwin’s diet is not suitable for all stages of KD (however not this time as I think it very likely could be quite appropriate — could being the operative word).

[Shawna]

Hi sheila23,

Yes, don’t lose hope. Your boy is young and in early stages. There’s lots of reason for hope.

Absolutely, the mineral waters will be just as beneficial for your other dogs as well. I was at a lecture once and they discussed ionizable calcium (calcium bicarbonate) which is found in good quality mineral waters. Calcium bicarbonate is found in the blood (about 1% of the total body calcium) and helps the immune system to fight invaders like bacteria. The calcium traps the bacteria etc (referred to as the calcium wave) until the immune systems white blood cells can get there to eat the bacteria (called phagocytosis). In fact, the medical professionals that I follow suggest fevers are actually beneficial as the muscle heats up to pull ionizable calcium from the bones when needed to fight an infection. That’s why you shouldn’t treat a fever unless it gets too high. By consuming ionizable calcium your body (and that of your dogs) is better able to fight off the infection without needing to generate a fever. More info than you asked for, hope it is useful info. 🙂

[C4D]

Shawna,

You do rock. When my old boy was diagnosed with CRF, my vet suggested the Balanceit website, along with some homemade recipes, when I said K/D was not an option. I did my own research and found dogaware and the CRF FB page. I never realized that Balanceit’s protein was so low! When I was referring to tripe, I meant frozen raw, not the vitamin enhanced version.

Also, for Sheila23, you can’t use the bleached human version found in grocery stores.

LOL on the typos and grammatical errors. If I’m ever accused of editing my comments, that would be the reason why! 😉

[aimee]

Hi Shawna,

When you wrote “Not even enough to meet the minimum protein amounts required for an a complete and balanced diet.” it could leave a reader with the impression that the diet would cause protein deficiency in the patient. Yet it will not when appropriately used.

AAFCO is an interpretation of NRC to account for the usual and common ingredients used in commercial pet food. Protein digestibility in commercial foods is usually decreased compared to fresh because of the type of protein used and the processing it underwent. AAFCO built a “cushion” into the profile to account for this. Also remember that AAFCO min is really what should be considered a recommended daily amount not the min to sustain life.

I don’t understand the choice of herbs, some of which sure seem contraindicated for a kidney patient. Can you cite the papers where they have been shown to be beneficial?

[Carol W]

Hi all,
My sweet Yorkie, Nellie, is almost 13 and is in kidney failure. The vet has her on Azodyl and an appetite stimulant, but I can’t get her to eat. She’s been on Science Diet KD (dry) most of her life due to a liver shunt when she was about 3. She stopped eating that a few months ago, and he switched her to canned, but she only ate that a few weeks before turning her nose up at it. For the last few weeks, I haven’t been able to get her to eat hardly anything. The vet said give her whatever she wants, just to get her to eat, but she doesn’t seem to want anything. I’ve tried various dog foods, plus all different “people” food – chicken, beef, eggs, rice, peanut butter, bread, veggies (some of which she used to love), but she won’t eat any of them. She might eat chicken, for example, one day, but then won’t touch it again. She’s down to 9 lbs (from 12), and I don’t know how to get her to eat! Other than the eating issue, she seems pretty ok for her age – still loves her long walks, barking at everyone out the window, and snuggling with me. She’s all I have – no family – and I want to keep her around as long as possible. But I’m afraid she’s wasting away and I just want to get her eating again. All she’s had in the last 24 hours is 2 pill pockets with her meds. Any suggestions on getting her to eat again?

[anonymously]

Have you tried chicken baby food, the small jars that look like a creamy pate? I had a dog that would lick it off my fingers, I think they like the salty taste. How about a little chopped up broiled chicken liver? I know dogs like a bite or two of rotisserie chicken?
I know those chickens are terrible, msg, and all. But, desperate times call for desperate measures.
Make sure you take care of yourself, I know how hard this is.
PS: She probably feels nauseous after she eats, then associates it with the food she’s eaten, then she won’t eat it again, thinking it will make her sick. See if she will at least drink water or chicken broth.

[Carol W]

Thanks, I never thought of baby food. I’ll give it a try. She used to love baked or boiled chicken – would come running as soon as she smelled it – but now won’t eat it. I can get her to drink water pretty well, haven’t tried broth other than adding it to food. I appreciate the help!

[sheila23]

Hi all,

I originally got some feedback for starting a homemade kidney diet. So far so good for my little boy, Alvin. My only question is about the poo (ew, I know). It’s never “solidified” on his new diet. I expected an adjustment period but it’s been over 3 months now and he still has loose stools, and I am afraid his stomach is constantly upset.

I am following the diet plan from Dogaware, and he is on probiotics as well as prilosec at suggestion from his vet. Does anyone have any ideas? Also, his ground beef is 80/20, if that information is useful. Thanks all!

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