[Vicky T]

Our 15 year old Chihuahua was recently diagnosed with mid stage kidney failure. Obviously he’s an old dog but he’s still eating and happy. As long as his quality of life is good we will treat him. Its been 2 weeks since his diagnosis and he has perked after being on antibiotics (incase he had an infection) and we have been giving him 350 ml saline solution sub q daily, now cut back to every other day which we will have to give him indefinitely. We are also giving him a natural supplement product for dogs with kidney failure. If anybody here has been through this with your dog any advise appreciated.

[anonymously]

The sub q fluids every day or every other day treatments are similar to dialysis, regarding what they accomplish. What does that tell you. Keep him comfortable for as long as you can, but be realistic. I would not give him supplements or make any diet changes to the prescription food, unless a vet that has examined him approves.

[C4D]

Hi Vicky T,

I have been through this with one of my older dogs a few years ago. I strongly recommend you ask your vet about the BalanceIt website. They can create a homemade recipe for you based on your dog’s kidney (bun/creatinine) levels. There are also a couple of very good sites which I found very helpful in dealing with CRF. One is dogaware which has a ton of information regarding diet and supplements. Here’s the link:

http://www.dogaware.com/health/kidneydiet.html

Another helpful site is a bit older but still loaded with information. It’s on Facebook and is called CRF Dogs. It’s exact name on FB is: CRF Dogs (Chronic Renal / Kidney Failure). for some reason, disqus never links the FB pages. Both sites are loaded with homemade diets that worked well for my dog. He was in CRF for almost a year and was not the ulitmate reason we had to put him down.

Wet food is the best thing you can do and the key is not necessarily to restrict protein, but to bind the phosphorus. You would do this with calcium and do this in various ways. Epakitin is a nutritional supplement that helps to bind the phosphorus. You can check with your vet on dosage. My vet gave me some to try. There are also many foods listed on those sites that are moderate in phosphorus levels. Green Tripe (without added minerals and vitamins) and cooked egg white are 2 proteins that are kidney friendly.

The subQ’s are essential to keep the kidney flushed from toxins. You may also need to use famotidine (generic Pepcid AC) to help with the acid that occurs and causes nausea as the disease progresses. Again, your vet should be able to help you with all of this information. Shawna is a frequent poster that has a lot more experience in dealing with Kidney Failure in a young dog, but has a wealth of information.

Good Luck!

[Shawna]

Hi Vicky T,

My Chihuahua mix had kidney disease from birth and lived to just shy of nine years of age. The most important thing I can say about kidney disease is DON’T feed a kibble diet — even prescription kibble. If you want to stick with prescription, Science Diet has some nice canned products that they recently came out with. One is beef based and the other is chicken based. If you are interested in feeding homemade, Veterinary Nutritionist Dr. Meg Smart has a nice recipe on her blog page. Dr. Smart gives a recipe for “early to moderate” and for “late stage” kidney disease. http://petnutritionbysmart.blogspot.com/2013/02/home-made-diets-and-renal-disese-in.html

Many, if not most, vets have not yet heard about (or understand if they did hear) the importance of probiotics and certain prebiotics (aka fermentable fibers) for kidney patients. These two supplements help to re-route BUN from the dog’s blood to the colon. This helps pup feel better and allows for a bit higher protein diet. The Merck Vet Manual has a nice blurb about it if your or your vet might be interested. They write “In addition, feeding moderately fermentable fiber can facilitate enteric dialysis and provide a nonrenal route of urea excretion.” http://www.merckvetmanual.com/mvm/management_and_nutrition/nutrition_small_animals/nutrition_in_disease_management_in_small_animals.html

The fermentable fiber I found to be the most helpful with my Audrey was a human product called “Fiber35 Sprinkle Fiber”. It is no longer made but the fiber used, acacia fiber, is also sold by NOW brand. The probiotic I used is also a human product called “Garden of Life Primal Defense”. I gave the products together with Audrey’s meal whenever she seemed depressed, down or not feeling well. Audrey at a HIGH protein diet her whole except the last couple months and then I added some canned KD to her diet.

If Audrey had symptoms of nausea (which was rare until the very end) I would add a drop or two of peppermint essential oil (therapeutic grade only) or ginger extract (from health food store). Now vet Dr. Melissa Shelton has a line of essential oils for animals that are wonderful. I tried her GI Goe product when I had eaten something that wasn’t agreeing with me and it helped TREMENDOUSLY.. I put a dot of the oil on my finger and rubbed it on my tongue. Helped almost immediately.

Having a purified source of high quality drinking water always available is a great idea. Also giving Evian (or another high calcium, lower sodium mineral water) has been shown to help kd patients too.

The one supplement that I gave my Audrey from the day of diagnosis to the day she passed was Standard Process Canine Renal Support. It is a whole food supplement that can help prevent damage to the kidneys from inflammation. I HIGHLY recommend it.

I also really really like Answer’s Raw Goat Milk for kd dogs. It can often be found in pet boutique stores.

I found my local vets (two regular vets and one holistic vet (that I otherwise LOVE)) to be almost useless when it came to diet (or anything else natural that could be helpful with kidney disease).. I hope your vet is much more helpful!!!

Do take a look at the link that C4D posted (dogaware). That site was HUGELY helpful to me when I was trying to figure out what to do with Audrey right after diagnosis.

Good luck to you and thanks to C4D for the kind words!!!!

[Vicky T]

WOW THANK YOU for all this information!
I’m late in responding to this because reply notification went in my junk mail.
I will look into all this great information you kindly took the time to share.
Very grateful!

[Vicky T]

P.S. He is not on any prescription food and wouldn’t eat it if he was
The vet did not recommend anything other than the sub q saline treatments.
When I asked him if there was any meds he could prescribe he said yes but that none would help that much, so we’re kind of on our own helping our little guy feel comfortable.

Prior to being diagnosed he was on a high quality grain free kibble (wetted with water) mixed with a grain free canned dog food but he started refusing to eat that so I’ve been feeding him people food like eggs, cottage cheese, canned salmon and mackerel, chicken and venison. He also likes cooked and raw carrots.
I have some dog probiotics I’ve been giving him and the supplement he’s on is:
Pet Wellbeing Kidney Support Gold…just something I found on the internet.

I will have to look into the homemade kidney disease diet ASAP.

[Vicky T]

I think I read somewhere it was recommended (for kidney failure in dogs) to feed liver and kidney a few times a week.
Does anybody know anything about this?

[C4D]

Hi Vicky T,

I’m sorry that you’re vet didn’t sound very helpful. Mine was adamant about using the Sub-Q’s and giving famotadine (Pepcid AC) to help with the metabolic acidosis that is a part of kidney disease. That’s the reason he doesn’t want to eat. Imagine trying to eat when you have terrible acid indigestion. It’s generally given 1/2 hour before feeding. You also need to bind the phosphorus with the meal. That’s the reason for the calcium, whether is a natural source (ground eggshell) or premade (i.e. epakitin).

http://www.dogaware.com/health/kidneymedical.html

Here’s the link, from the dogaware site I linked above, that contains the table of phosphorus content of various proteins. Since she is in moderate kidney failure, I would stay with muscle meat. Canned Salmon and Mackerel are very high in phosphorus compared to many other protein sources. The kidney and liver are as well. By comparison raw green tripe (you can find these in some dog stores as frozen). Do not use the bleached white tripe found in the grocery store for people.

http://www.dogaware.com/health/kidneytable.html

[Shawna]

Hi C4D,

“Mine was adamant about using the Sub-Q’s and giving famotadine (Pepcid AC) to help with the metabolic acidosis that is a part of kidney disease. That’s the reason he doesn’t want to eat.”

You’ve mentioned this a few times and I was hoping you would allow me to give a different point of view? First though, I DEFINITELY agree with the Sub-Q fluids. Fluids are started when BUN and creatinin get to a certain level usually. This is, in part, to help flush toxins from the blood (hence why they wait for a build up of those toxins). Flushing those toxins out helps pup feel better and is often the only cause of inappetence.

I wanted to talk more about Pepcid AC. I think the first thing is that these types of drugs don’t actually help with “systemic” acidosis. They are designed to control the amount of acid in the gut only – not in the whole body. However, the doctors that I follow feel that indigestion etc is caused by too little acid production. This makes sense to me when you think about how food is digested. When we eat protein our gut makes hydrochloric acid in response to the amount of protein in that food. It does this because it then activates the enzyme pepsin in the stomach that helps to digest protein. Not enough acid and the protein sits in the tummy not getting digested — this causes symptoms. YES, antacids do work but they don’t resolve the issue but rather hide the symptoms. You are still not digesting your proteins and NOW, due to the antacid, you are digesting even less protein (while potentially on an already low protein diet). It’s no wonder our dogs and cats don’t live long with KD. 🙁

Yes, when ulcers are present there are definitely considerations that need to be made. That said, ulcers are caused by Helicobacter pylori bacteria. Newer thinking believes that dietary sensitivities (which we now know can be activated by bacteria) strip the lining of our gastrointestinal tract and set the gut up FOR the bacterial infection and symptoms – aka ulcer. Avoiding the trigger, when possible, is a far better way of dealing with a symptom than simply medicating the symptom.

You had mentioned Dogaware as a reference for the use of pepcid with inappetence but Mary actually states that it was the pepcid that was “causing” her Shar Pei to have inappetence. She writes “WARNING: I had my dog on Pepcid for over a year when I discovered it was contributing to her inappetence. Once I stopped giving it, her appetite improved immediately.”

A few times a year, the last few years at least, I could tell that my Audrey was having some gut issues after eating. I resolved her discomfort by mixing apple cider vinegar 50/50 with water and forcing it down via syringe. With in a few to five minutes she would belch and then be fine. Other great options for inappetence that don’t have protein digesting side effects would be peppermint essential oil and ginger extract. Actually, just yesterday I watched a video on Dr. Melissa Shelton’s Facebook page — she’s treating a kitten that was failing to thrive. She offered kitty food and kitty sniffed but wouldn’t take it. She picked kitty up and dropped 5 to 6 drops of Kitty Boost (an essential oil she formulated specifically for cats) on his back and then rubbed it in. While rubbing it in she said that it had the oils from GI Goe (her blend for tummy issues) in it. She spent a minute or two rubbing the oil in the kitties fur, set the kitten down and continued talking. The kitten immediately went over to the food bowl and started eating. It was pretty amazing how quickly it worked.

Anyway, sorry this was soooo long. Hope there was some food for thought there. 🙂

[C4D]

Hi Shawna,

Yes, you did give me some food for thought and more research! 🙂

I did go back and read that portion of the article again. She did say that it didn’t work for her dog. I did find articles stating that famotidine can cause inappetance in some. In my case it seemed to help and I used it on an “as needed” basis. We are going back over 4+ years when I was doing the initial research. My vet recommended the famotidine (when we were in the later stage) and I found it on many sites as well the dogaware site. I was using almost every natural supplement recommended on the dogaware site as well as both mirtazapine and b complex vitamins, alternately, to help increase appetite in the later stage. They did seem to work. This is another one of the dogaware links that include the use of famotidine:

http://dogaware.com/health/kidneynattie.html

I understand your point that it might only be masking the sypmtoms, but in the case of CKD in an older dog, I think it might be helpful, particularly if there would be nothing done otherwise. I’m aware of the peppermint oil and ginger extracts and agree that this is quite helpful. I did find that apple cider vinegar can be used, but it seems to have mixed results, depending on the problem, on some sites such as livestrong. I found that sodium bicarbonate could be added to the Sub-Q fluids to combat the acidosis, but this was on a more traditional kidney site (the merck manual).

http://www.merckvetmanual.com/mvm/urinary_system/noninfectious_diseases_of_the_urinary_system_in_small_animals/renal_dysfunction_in_small_animals.html

Since in the traditional sites they are mentioning the metabolic acidosis as part of the kidney problem, are they the holistic vets disagreeing with this? I understand your point that indigestion, not necessarily related to kidney disease, can be related to insufficient acid production.

On another note, what do you think of the OP’s recent question regarding giving liver and kidney a few times a week?

[Shawna]

I do agree, at some points in the progression of an illness (especially a chronic one) we simply have to do what we have to do to keep the pup / person comfortable and symptoms manageable… 🙂

I forgot about the liver and kidney questions but did mean to respond to that. Thanks for the reminder…. I ABSOLUTELY WOULD recommend giving both liver and kidney but not as a whole food, especially not in later stages of kidney disease. Instead I would (and did) use therapeutic amounts of whole food supplemental liver and kidney — specifically Standard Process Canine Kidney Support and Standard Process Canine Hepatic Support. Both of these supplements will have a far greater overall impact than just feeding liver or kidneys. Both will act much more readily as an “oral tolerant” than the organ itself due to how the product is made (specifically the protomorphogens). 🙂 The supplements also have less phosphorus than the whole organ.

[Vicky T]

Sorry I keep responding so late but these messages alerts are going into my junk mail even though I check them as not junk mail.

How much pepcide and how often would you give a 6 lb. dog?
I’m very much into essential oil and will try the peppermint.
I have been rubbing a bit of Frankincense onto his lower spine over his kidneys when I remember. Its very healing in general.

THANK YOU SO MUCH for all the details!
Much reading and digesting to do.
Your advise is very much appreciated!

He is doing quite well.

[Riley L]

Shawna,

I started my dog on the Standard Process Canine Liver Support after reading these old threads. I was hoping you’d be able to help me.

Should I discontinue my dog’s prescription denamarin since I started the Standard Process?

Thanks for your help,
Riley

[Riley L]

I mean Standard Process Canine RENAL Support.

[InkedMarie]

Shawna doesn’t post her any more. Ask your veterinarian.

[Author]

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