Madeleine Hull
A dog diagnosed with chronic kidney disease (CKD) will require a renal diet to manage the condition and improve their quality of life. The diet should be implemented as soon as a dog is diagnosed with CKD. A dog with CKD will experience a decline in kidney function, leading to a build-up of toxins and waste products in their bloodstream. A renal diet can help slow the progression of the disease and reduce the workload on the kidneys. The diet typically includes restricted phosphorus, protein, and sodium, with increased levels of potassium and omega-3 fatty acids. It is important to ensure that the diet is palatable, as CKD can reduce a dog's appetite, and to provide adequate hydration through both water and food sources.
| Characteristics | Values |
|---|---|
| When to start | As soon as a dog has been diagnosed with CKD |
| Diet type | Prescription kidney diet, or "kidney support" diet |
| Food type | Wet food is better than dry food |
| Diet contents | High-quality protein, phosphorus, potassium, sodium, omega-3 fatty acids, B vitamins, EPA, DHA |
| Diet restrictions | Avoid excess sodium, moderate protein, moderate phosphorus |
| Other | Plenty of water |
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What You'll Learn
The importance of water
Once a dog has been diagnosed with kidney disease, veterinarians typically recommend switching to a prescription kidney diet. This usually involves a reduced or restricted intake of phosphorus, sodium, and protein, with increased levels of potassium and omega-3 fatty acids.
Dogs with kidney disease struggle to maintain hydration. It is therefore critical to provide these dogs with an unlimited supply of fresh, clean water every day. Dogs with CKD have "'dilute'" urine, meaning their kidneys lose the ability to "concentrate" urine. As a result, they compensate by drinking more water to continue removing waste products (toxins) from their bodies.
To encourage more water intake, veterinarians recommend changing the dog's water several times a day and cleaning the water bowl daily. Wet foods are almost always preferable to dry foods for dogs with kidney disease. Canned kidney support food is high in moisture and can help improve water intake. Additionally, adding water, tuna juice, or low-sodium broth to food can enhance its flavour and palatability.
A kidney diet that isn't eaten won't benefit a dog. Thus, it is crucial to ensure the food smells and tastes good, in addition to being calorie- and nutrient-dense.
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Phosphorus and protein restrictions
Once a dog has been diagnosed with kidney disease, veterinarians typically recommend switching to a prescription kidney diet. This should only be done once the dog's condition has stabilised. The most important characteristic of a kidney diet for dogs is that it has to be delicious because metabolic and physical changes associated with kidney disease can lessen a dog's appetite. Kidney diets should also be calorie- and nutrient-dense, so dogs can eat less and still get a lot of nutrition.
Protein restriction is not always necessary, but it helps alleviate clinical signs of a condition called uremia, which occurs when creatinine and blood urea nitrogen build up in the bloodstream. 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 unwell. The goal is to feed just enough protein to meet a dog's needs for muscle maintenance, immune function and other vital jobs.
The amount of protein restriction needed to mitigate renal damage secondary to proteinuria in dogs is unclear. A proteinuric dog on a high-protein diet may have substantial improvement if dietary protein intake is reduced by 25% to 50%.
Moderate protein and phosphorus restriction (35 g and 750 mg per 1000 kcal, respectively) reduced morbidity and mortality in beagles with induced CKD. Limiting dietary phosphorus in dogs with CKD appears to help delay disease progression. 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 that relatively low levels of phosphorus are included in the diet. Plant-based sources of protein tend to be lower in phosphorus than animal-based sources of protein.
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Omega-3 fatty acids
For dogs with chronic kidney disease (CKD), dietary adjustments are crucial for managing the condition and improving their quality of life. One essential component of a therapeutic kidney diet is omega-3 fatty acids, which play a role in reducing inflammation and slowing the progression of CKD.
The inclusion of omega-3 fatty acids in kidney support diets helps to reduce the production of inflammatory compounds, thereby alleviating oxidative stress on diseased kidneys. This, in turn, slows down the progression of CKD. Additionally, omega-3 fatty acids have been found to lower the magnitude of proteinuria and decrease plasma concentrations of creatinine, cholesterol, and triglycerides.
Veterinary input is crucial to determine the optimal omega-3 fatty acid supplementation plan for your dog's unique needs. While supplementation is generally safe when appropriately administered, higher doses may cause adverse effects, including altered platelet function, delayed wound healing, altered immune function, gastrointestinal issues, or weight gain.
It is important to note that dietary adjustments should be made after a dog's condition has stabilised. A veterinarian can recommend specific foods or diets based on the dog's individual case, ensuring that the food is palatable to encourage adequate consumption. Wet foods are generally preferred as they provide additional hydration, which is crucial for dogs with CKD.
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Sodium intake
While sodium intake is not a major concern for healthy dogs, it is important for dogs with chronic kidney disease (CKD) to monitor their sodium levels. Too much sodium can increase the chances of dehydration in dogs with CKD, as it can lead to excessive thirst and urination. This can be particularly problematic for dogs with kidney disease, as they already struggle to maintain hydration.
Small Animal Clinical Nutrition (SACN) suggests that a young adult dog's daily diet should contain about 0.2-0.4% sodium as a "risk factor management" range. This equates to approximately 500-1000 mg of sodium per day for a typical medium-sized dog. It is important to note that the main risk of excessive sodium intake in dogs comes from salty snacks and human food, such as table scraps, pizza crusts, French fries, chips, and pretzels.
Veterinary therapeutic diets designed for dogs with CKD, also known as "'kidney support' or 'kidney-friendly' products", typically include restricted levels of sodium. These diets are formulated to help manage the clinical signs of CKD, such as the build-up of waste products in the blood, fluid and mineral balance issues, and sustaining adequate nutrition. While there is no scientific evidence directly linking modified sodium content in diets to improved outcomes in dogs with CKD, it is believed that mild sodium restriction can reduce the workload on the kidneys and help maintain reasonable blood pressure.
In addition to sodium considerations, it is crucial to provide dogs with CKD an unlimited supply of fresh and clean water. Canned pet food or adding water to dry food can also help improve water intake. It is also important to note that the nutritional needs of dogs with CKD are complex, and a combination of dietary modifications, including protein, phosphorus, potassium, and omega-3 fatty acid adjustments, are typically recommended to manage the condition effectively.
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Potassium levels
Potassium is an essential mineral for dogs with chronic kidney disease (CKD). When kidneys are functioning normally, they retain the amount of potassium needed to maintain health. However, in dogs with CKD, the kidneys lose their filtering capacity, resulting in excessive loss of potassium in the urine. This loss of potassium can exacerbate CKD, hence the importance of including elevated levels of potassium in kidney support diets.
Most therapeutic diets designed for dogs with CKD include moderately elevated concentrations of potassium. These diets are formulated to provide approximately 35 g/1000 kcal of high-quality protein, along with other dietary modifications, to improve and prolong the lives of dogs with CKD. The goal is to sustain adequate nutrition while managing the disease.
However, it is important to monitor potassium levels in dogs with CKD closely. While potassium loss is common, some dogs with CKD may develop hyperkalemia, or high potassium levels in the blood. Hyperkalemia is a potential complication of CKD and can be life-threatening. In such cases, a potassium-reduced, home-prepared diet may be prescribed to correct hyperkalemia.
The decision to increase or decrease potassium levels in the diet should be made in consultation with a veterinarian. They can help determine the appropriate level of medical intervention based on the stage of CKD and the specific needs of the dog. It is crucial to provide dogs with CKD an unlimited supply of fresh, clean water daily, as they tend to drink more water to compensate for their dilute urine.
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Frequently asked questions
The first step is to get a diagnosis from a veterinarian. They will conduct a thorough physical examination and recommend an appropriate treatment plan, which may include dietary changes or restrictions, medication, or both.
A renal diet for dogs with CKD should be calorie- and nutrient-dense, palatable, and high in water content. It should also have restricted levels of phosphorus, protein, and sodium, with increased levels of potassium and omega-3 fatty acids.
Protein restriction helps to alleviate clinical signs of uremia, which occurs when creatinine and blood urea nitrogen build up in the bloodstream. It also reduces the workload on the kidneys by lowering the amount of nitrogenous waste produced during protein metabolism.
Some popular options include Hill's Prescription Diet k/d Kidney Care, Purina Pro Plan Veterinary Diets NF Kidney Function, and Royal Canin Veterinary Diet Adult Renal Support, which are available in wet and dry formulations and different flavors.
A dog with CKD should start a renal diet as soon as they have been diagnosed and their condition has been stabilized. It is important to work with a veterinarian to determine the best food options based on the dog's individual needs and the severity of their case.
