Managing kidney disease in dogs requires careful attention to their diet. While prescription diets are often recommended by veterinarians, some owners explore non-prescription commercial options, especially in the early stages of the disease. Two key dietary adjustments that can significantly slow the progression of kidney disease and improve a dog’s lifespan are reducing dietary phosphorus and supplementing with omega-3 fatty acids from fish oil (EPA and DHA). It’s crucial to note that phosphorus reduction is only beneficial once kidney disease has progressed to a certain point, typically when creatinine levels exceed 2.0 mg/dL or fasting blood phosphorus is above 4.5 mg/dL. The recommended daily intake of EPA and DHA from fish oil has recently been updated to a maximum of 50 mg per pound of body weight.
Some commercial dog foods, particularly those formulated for adult or senior dogs, may contain sufficiently low phosphorus levels for dogs in the early stages of renal disease. However, it is essential to verify phosphorus content directly with the manufacturer, as formulations can change. Combining lower-phosphorus commercial foods with prescription diets may also be an option as the disease progresses. Once a dog’s fasting blood phosphorus levels surpass 5.0 mg/dL, a prescription kidney diet becomes necessary, as the required phosphorus intake falls below AAFCO recommendations.
When comparing wet and dry foods, it’s important to use “dry matter” percentages for accurate comparisons. Feeding a low-protein diet is generally not advised unless the dog is uremic. However, a moderate protein reduction might be necessary if the dog exhibits proteinuria (significant protein in the urine). Canned food can be beneficial due to its higher moisture content, aiding hydration, though adding water to dry food can achieve the same effect. For reference, most regular commercial diets contain around 1-2% phosphorus on a dry matter basis. Dogs with early-stage kidney disease should ideally consume no more than 0.6% phosphorus on a dry matter basis. An alternative guideline is to limit phosphorus intake to no more than 30 mg per pound of body weight daily for early-stage kidney disease, with lower amounts being preferable for more advanced stages.
Incorporating Fresh Foods into a Kidney-Friendly Diet
For dogs who dislike prescription kidney diets, a strategy involves feeding a lower-phosphorus, non-prescription commercial food and supplementing it with low-phosphorus fresh foods to lower the overall dietary phosphorus content. If the commercial food is high in protein, adding low-phosphorus carbohydrates like white rice, pasta, or potatoes can be beneficial. For low to average protein commercial diets, incorporating fatty meats low in phosphorus is recommended. A combination of both fatty meats and carbohydrates can be added to any diet, prescription or otherwise.
For dogs in the early stages of kidney disease, fresh foods with less than 100 mg of phosphorus per 100 kcals are ideal. The aim is to achieve an overall dietary phosphorus level of approximately 100 mg per 100 kcals. Dogs with moderate to late-stage kidney disease require even lower phosphorus levels, and non-prescription diets are unsuitable for them. Crucially, calcium supplementation is necessary to bind phosphorus. Adding calcium at a rate of 1,000 mg per pound of added fresh food (e.g., 1/2 teaspoon of ground eggshell) is recommended. Calcium not only binds phosphorus but also fulfills dietary requirements, and dogs with kidney disease should consume two to three times more calcium than phosphorus.
When incorporating a significant amount of fresh foods, long-term dietary balance becomes critical, especially for younger dogs. If fresh foods constitute half the diet, a simple mix of fatty meat and grains may not provide all essential nutrients. In such cases, a multi-vitamin and mineral supplement that excludes phosphorus should be added to compensate.
Utilizing Dog Food Mixes for Kidney Support
A convenient method for creating a balanced diet is by using specialized mixes like Balance IT Canine K Plus, which lacks added phosphorus, unlike its regular counterpart. Veterinary approval is required to generate recipes and purchase this supplement. While these recipes can be helpful, they may sometimes be lower in protein than necessary for many dogs with kidney disease, unless significant proteinuria is present. Additionally, the omega-6 fatty acid content might be higher than advisable, particularly with poultry-based recipes. The recommended fish oil supplement, Welactin for Dogs, provides EPA and DHA, but owners may consider increasing the dosage for kidney disease patients.
When generating recipes through platforms like Balance IT, it’s possible to customize protein and fat percentages. For instance, a Beef & White Rice recipe for early-stage kidney disease might have a certain percentage of calories from protein and fat. Adjusting these parameters can help achieve a more suitable nutritional profile. It’s important to note that some generated recipes, while balanced, may have phosphorus levels more appropriate for later stages of kidney disease.
Currently, there are limited reliable dog food base mixes specifically designed for early-stage kidney disease that don’t require significant modification. These mixes are intended to be combined with fresh foods. Using higher-fat meats, tripe, whole milk ricotta cheese, and a combination of whole and egg whites can help maintain reasonable phosphorus levels, provided the dog tolerates a high-fat diet. Varying the fresh food sources is key for comprehensive nutrition. Consulting a Table of Nutritional Values is essential to determine phosphorus content per 100 kcals in various foods. When adding fresh foods to these mixes, calcium should still be supplemented at a rate of 500 mg per pound of added fresh food to aid in phosphorus binding.
Understanding the Nutritional Table for Kidney Disease Diets
The provided table offers a comparison of calories, protein, and phosphorus in various commercial diets. The most critical column to focus on is “Phosphorus mg per 100 kcals.” For dogs with early-stage kidney disease, the goal is to find foods or food combinations that provide 150 mg of phosphorus or less per 100 kcals. Similarly, when adding fresh foods, refer to the Table of Nutritional Values for their phosphorus content. The “Phosphorus (dry matter)” column is also important; for early-stage kidney disease, a target of 0.60% or less is recommended. Combining foods with higher and lower phosphorus levels can help achieve an average that meets these targets.
For dogs experiencing significant proteinuria, a diet moderately reduced in protein may be necessary to manage urinary protein levels, best assessed by the urine protein:creatinine (UPC) ratio. While specific protein reduction levels aren’t definitively established, UPC ratios of 0.5-0.9 are questionable, 1.0 is abnormal, and glomerulonephritis is typically diagnosed with UPC ratios of 3.0 or higher.
If a dog is uremic (BUN over 80, creatinine over 4.0, with symptoms like vomiting, nausea, poor appetite, and lethargy), protein intake needs to be reduced. However, other than for managing proteinuria, protein restriction doesn’t harm the kidneys directly; it primarily affects symptoms.
It’s important to be aware that some foods listed in red in the table previously had lower phosphorus values but have since shown higher amounts. This discrepancy could be due to formulation changes or inaccurate data. The reliability of analyses for non-prescription foods can be a challenge. Always request an actual nutritional analysis from the manufacturer, not just a guaranteed minimum. If a company cannot provide this information, their product may not be suitable for a specialized diet.
Regularly verify phosphorus content with manufacturers, and report any discrepancies or newly discovered low-phosphorus foods to help maintain the accuracy of such resources.
For instance, as of February 2018, several brands including Acana, California Natural, EVO, First Mate, Grandma Lucy’s Artisan (excluding Valor), Lotus (canned), Orijen, The Honest Kitchen, Sojo’s, Tiki Dog, and most Wellness and Wysong products were found to have phosphorus levels too high for dogs with creatinine greater than 2.0 or fasting blood phosphorus greater than 4.5.
Comparing Commercial Diets for Kidney Health
The table provides detailed nutritional information, including calories, protein, and phosphorus content, for a range of commercial dog foods. This allows for comparison between dry, canned, dehydrated, frozen, and cooked food options. For example, SquarePet VFS Low Phosphorus Formula Dry Dog Food shows a notably low phosphorus level of 70 mg per 100 kcal, making it a potentially suitable option. Similarly, several Weruva canned varieties like Weruva Dogs in the Kitchen Wok the Dog and Weruva Dogs in the Kitchen That’s My Jam! exhibit low phosphorus levels within the desired range. Frozen options from My Perfect Pet Kidney Support Blend and JustFoodForDogs Lamb and Brown Rice also demonstrate favorable phosphorus content.
Special considerations apply to food mixes and dehydrated options. For example, Grandma Lucy’s Artisan Pre-Mix and The Honest Kitchen Preference require the addition of fresh foods, and their phosphorus calculations reflect the mix alone, not the final prepared meal. Warnings are issued for products like Grandma Lucy’s Artisan Dog Food and The Honest Kitchen Keen, Love, and Zeal due to high phosphorus content.
For cooked foods, varieties from Caru Daily Dish, such as Caru Daily Dish Turkey Stew, show phosphorus levels around 150 mg per 100 kcals, which might be acceptable depending on the dog’s specific stage of kidney disease.
It is essential to consult with a veterinarian to determine the most appropriate diet for a dog with kidney disease, considering their individual health status and the stage of the disease.
