Prescribing a diet for dogs and cats with kidney or renal disease is an area of much debate. Traditionally diets for kidney failure have involved low protein and high carbohydrate models with vets commonly recommending prescription dry foods. However, increasingly there is a shift towards moist, acidifying, raw diets, something I have long been advocating for. Below I discuss what kidney disease is, why I recommend a raw diet, more detail on managing protein levels at different stages of the disease and suggested homemade recipes. Note if your dog or cat has kidney disease then its important to talk to a vet about tailoring a diet specifically for their stage of disease.
What is kidney disease and how to spot it
The kidneys’ main functions are to remove waste products from the blood stream and maintain the water content and pressure. Chronic kidney or renal disease is a condition of irreversible, long term deterioration in the kidney function. The main clue therefore that dogs or cats have kidney disease is in changes to their urination (more or less than usual) and drinking (more than usual). As the kidneys get worse at filtering out waste products dogs and cats are likely to become sick and so exhibit vomiting, loss of appetite, lethargy and other symptoms.
Look out for these signs:
• Loss of appetite
• Increased water consumption
• Increase or decrease in urine production
• Bloody or cloudy urine
• Bad breath with an ammonia smell
Older cats and dogs are more prone to kidney disease as are certain breeds including Samoyeds, Bull Terriers, Cairn Terriers, German Shepherds and English Cocker Spaniels among dogs and Abyssinian, Maine Coon and Persian cats
Helping prevent kidney disease through diet
As with preventing many common ailments in cats and dogs, I always come back to nutrition. A natural, balanced diet high in protein with all the essential vitamins, minerals and nutrients in the right proportions will reduce stress on your pet’s organs and give them everything they need. In particular a moist diet, as with a raw meat-based diet, will help ensure proper hydration and therefore kidney function.
Early detection is the key, so it is important if your pet shows any signs or symptoms to get them checked by a vet. They will be able to perform further blood and urine tests to establish whether they are suffering from kidney disease and the severity. Get a check up with your vet twice a year and if you see changes in urination or water consumption seek their advice as soon as possible.
How to treat kidney or renal failure: nutrition is key
Chronic kidney disease is unfortunately irreversible but treatment can delay the progression of the condition and help control uremia – the build up of waste products in the blood. Your vet may prescribe medication and supplements to address blood pressure, potassium and phosphorous levels and treat various side effects. Its important to control fluids so your vet may prescribe fluid injections also and you should ensure your pet always has access to lots of fresh water.
Traditionally diets for kidney or renal failure have involved low protein and high carbohydrate models with some vets still suggesting a prescription dry food diet for kidney disease. Most recently attention has been give to moisture content, and more vets are now advising wet/moisture rich foods for kidney failure, rather than the more common dry food prescription diets. I absolutely recommend a moist diet as water is essential with dogs, and especially cats, getting a lot of their water intake through their food. Keep multiple sources of fresh water available in several rooms in the house and in the garden.
Protein is also important given most renal failure patients have a harder time metabolising protein and shed it in their urine. Feeding good quality, easily digestible (i.e. fresh) protein is essential therefore for energy and amino acids. I prescribe high protein diets to early stage renal failure patients and have yet to be disappointed with the results.
Water soluble electrolytes and vitamins can also be lost in the urine and so it is important to supplement these, particularly water soluble B and C vitamins.
My recommended diet for kidney disease
Overall, I find a raw meat diet with 60-80% raw meat, and a combination of cereal/vegetable and vitamin/mineral/trace element, low in sodium and phosphate and high in Omega 3 fatty acids forms the perfect diet for managing early to mid-stage renal failure, together with plenty of drinking water on hand. I recommend supplementing this raw diet (our Complete Mix, Raw 76, Health Roll or Balanced Life foods) with our Health Booster powder, which supplements B and C vitamins, trace minerals and antioxidants, as well as our Omega Blend Oil, which helps remove a key waste product (creatinine) and reduce kidney pressure.
Reducing protein for later stages of kidney disease
While high protein levels generally work well for early to mid stage renal disease, it is not necessarily the case with late kidney disease. Monitoring urine protein/creatinine (UPC) levels is a very useful progression tool, as are regular blood tests for BUN (urea levels) and Creatinine and Phosphate. As long as the UPC ratio is less than 3, there is no need to restrict protein. If Phosphate levels begin to rise above the normal range, then phosphate binders like aluminium hydroxide can be used to bind and eliminate excess phosphate. I would recommend blood and urine tests every 3 months with pets that are undergoing any stage of renal failure.
As kidney failure does progress into the chronic, end stage disease, with the UPC ratio greater than 3, then it is time to restrict protein levels in the diet. To achieve this, we need to replace some of the proteins we use with what are described as high biological value proteins (proteins that provide more value per gram). The Moist Diet Formulas can be used to create a restricted protein diet that can be used for end stage renal disease, and for live failure (where low protein diets are also important).
A classic Chinese herbal formula can also be used to support patients in chronic renal failure: Rehmannia 8 (Ba wei di huang), which contains rehmannia, cornus, dioscorea, alisma, moutan and hoelen. This herbal formula can increase local blood pressure at the level of the kidney, and is able to “reactivate” kidney nephrons that are non-functional, but not yet destroyed, thereby improving renal function.
My homemade recipe for renal and liver failure
(1) Fresh meat – preferably raw kangaroo meat, due to its high nutrient profile, and low fat content. It is free range /organic, and affordable. Try and get preservative free. Avoid chicken mince and beef mince if possible.
(2) Biological proteins – these are protein sources of high value and low mass. Fresh liver, eggs, cottage cheese, cooked fish.
(3) Rolled oats – soak an equal weight of dry rolled oats in water overnight. Ie 100g dry rolled oats, soaked in 100ml water = 200g soaked rolled oats.
* To encourage fussy eaters, soak or cook the carbohydrates (rolled oats, rice etc)in beef or chicken stock.
(4) Grated/minced vegetables – carrot, pumpkin, parsley, spinach, silverbeet. Pulp in your food blender or chop grate very finely
(5) Vets All Natural Health Booster – a powdered supplement that provides all the extra vitamins, minerals and trace elements (including calcium) to create a balanced diet. Animals with renal failure have a higher requirement for water soluble vitamins and minerals.
(6) Vets All Natural Omega Blend oil – a balanced oil blend to supply both Omega 3 and Omega 6 fatty acids, as well as vitamins A, D and E.
Formulations (per 1kg mix) :
Cat renal failure Diet ( restricted protein 15%):
500g raw roo meat
100g liver/ egg/ cottage cheese/ cooked fish
270g soaked rolled oats (or rice, pasta, sweet potatoe)
70g grated vegetables
40g Health Booster (2 tablespoons)
20ml Omega Blend Oil (4 teaspoons)
Dog renal failure Diet (restricted protein 10%) :
400g raw meat
100g liver/ egg/ cottage cheese/ cooked fish
300g soaked rolled oats
120g grated vegetables
40g Health Booster (2 tablespoons)
20ml Omega Blend Oil (1 tablespoon)
20ml Olive oil (1 tablespoon)
Note: Alternatively, you can use the pre-prepared Complete Mix to substitute the rolled oats and grated vegetable components . For the cat diet, soak 190g of Cat Complete Mix in 190 mls of water. For the dog diet, soak 230g of Adult Dog Complete Mix in 230mls water.