Renal problems

[sivi]

Hi, I am new to this site but thought I would ask if anyone had any advice for me.   My 9 year old English Pointer has just been diagnosed with renal failure and the vet has told me that he must be fed special renal dog food from now on.   The problem is that he doesn't seem to like any of the ones I have tried so far, although he can be rather crafty and fussy!   This site seems to have some really good dog food on it but I really don't know where to start!  Help.

[Dottie]

Hello sivi.  I am sorry to hear of  your dog's kidney problem.  I don't have much experience of this in dogs although one of mine had renal failure towards the end of her life.  She was older than your dog and had other problems so I took the view that as it was terminal, she should have what she wanted.  However, diet is important in controlling the disease process and in helping the dog to feel better so I understand why you want to get it right.

The problem is that kidney disease can cause diminished appetite and this may be why your dog is not interested in the special renal diet.  BTW which one have you tried?  Is it the Royal Canin Renal dog food? 

Regarding his lack of interest in the commercial food, have you tried pouring a little bit of warm water on it?  Sometimes the aroma encourages them to eat and warm water can help with this.  Alternatively, I am wondering if you might be better off making your own.  You need to be looking at restricting protein but what you do give should be of good quality.  There should be no added salt. The key features of a suitable renal diet are outlined in this document which is produced by Royal Canin.  In making your own food for your dog you cannot hope to achieve the exact quantities and nutrition that is given in commercial food but it may be more palatable. Obviously you would need to discuss it with your vet but the type of diet may include things such as chicken and white fish for the protein,  brown rice or oatmeal (both well cooked in water) and suitable vegetables.   Omega oils can be given as a supplement - again, check this with your vet.

If you check the ingredient list of the RC renal you will see that it is bulked up with a lot of carbohydrate in the form of rice, maize and beet pulp.  You could do a similar thing but with different types.  Manufacturers use rice, oatmeal, potato and sweet potato as carb sources.  Of course some of these also contain protein so it would be best to check with the vet which of these would be best, especially as it would form the bulk of the diet because of the lower protein. You may need to do your own research regarding suitable ingredients, bearing in mind what you want to achieve.  In the aforementioned document they speak of restricting phosphorous but there is one thing that they don't mention but which needs to be restricted in human renal failure and that is potassium.  TBH I do not know whether this is an issue in canines. 

If this seems too complex, the only thing I can suggest is that you ask the vet to put you in touch with a nutrition specialist vet or veterinary nurse who could perhaps advise you over the telephone or Internet.

[Tinyplanets]

Hello and welcome Sivi, I am sorry to hear your dog has this problem. I don't have any experience of renal problems myself but Dottie has given some sound advice and hopefully someone may come along who has had some personal experience with this issue.

[Schnauday]

Hi Sivi
My boy was diagnosed with chronic kidney failure after a kidney infection nearly took him away from us at a very young age. The vet didn't expect him to survive the weekend. He also hated the prescription tinned after being used to being fed raw. The vet suggested a home cooked diet with dietary supplements.

This site has some great information as a starting point for home feeding. I was used to home preparing raw it now takes even longer to prepare his food. The plus sides are he loves his food and it is way, way cheaper than any other previous way of feeding him.

 http://www.dogaware.com/health/kidney.html#

If you have any other questions please ask it really is a lot to get your head around and it helps a great deal if your vet is supportive of home cooked diet. As Dottie says its controlling the phosphorus level that is the main thing. I work on a level 1.1mg of phosphorous per 1lb of dog weight.

The only prepared dog food I've fed him is natures diet senior/lite

 http://www.naturediet.co.uk/naturediet/wp-content/uploads/2013/04/ND_FACT_Kidney-Failure.pdf.

Burns hypoallergenic mixer also has very low phosphorus level. He has this occasionally mixed with small amount of minced beef. These are my standby fast foods in case I haven't had time to prepare his normal food.

[sivi]

Hi, thank you all for your very good advice.   I did look on the 'dogaware' website which had a lot of very good suggestions.   The trouble is that when we go on holiday we have to put our dog in kennels who are very good.  However it would be very difficult if I had to provide them with home made dog food for two weeks.   They are happy to feed him anything I provide but it is just finding the correct one.   At the moment he is eating Royal Canin renal wet and just about eats 3/4 of a tin plus a little Hills I/D dry.   Not sure if this dry food is Ok but it is what the vet sent him home with.   We are seeing the vet in 2 weeks for a blood test so will find out then.   He hated the Hills wet food though, I am waiting for a few tins of Purina wet to try now!!!   I may contact Naturediet and see if they could sell me a couple of tins to try as I like the look of this product.  I have tried all the tricks, heating the food and adding warm water but it makes no difference.   I think that the fact that he is not too well is affecting his appetite - although he still manages to scrounge for the odd biscuit!
Before he was taken ill he always used to have Royal Canin Maxi Adult 5+.   Any further suggestions would be welcome.  Thanks again.

[Dottie]

I can see your point about home cooked food. It might help in that perhaps he would be more interested but it is problematical when you go away and in any case you can't really tell how much protein you are feeding. I noticed that with the RC dry renal diet it is 14%.  This made me wonder if you were to prepare your own, would it equate to 14g of chicken, fish or whatever meat source you use in 100g?  That would mean you would need to bulk it up with 86% of carbohydrate and vegetable.  TBH I just don't know how it would work out so I can see how commercial diets are a lot more straightforward.

It does rather sound as if the diminished appetite might be a result of the disease but you will know more when you have seen the vet. Sometimes a short course of steroids improves the appetite and well being so that might be worth discussing with the vet.   Looking at the Naturediet it is quite high in protein but as you say, have a word with their customer services.  The only thing I can think of is to try it at a lower amount and bulk it up with carbohydrate.  IIRC the product itself only has 10% white rice so there is a fair bit of leeway there.  I think you are right in using wet rather than dry food.  It is usually more palatable for dogs with poor appetite.

I have just looked on the Dog Food Directory with the filters of wet and 20% protein - there are none.  At 25% protein it comes up with Advanced Nutrition Light and Sensitive, Burns Penlan Farm, Chappie Adult Tins and Denes Senior Tins. 

BTW scrounging odd biscuits and enjoying them is not unusual - I have often found that when mine are not so well they still seem to manage a Gravy Bone biscuit.  It sounds like he might feel equal to frequent  nibbles rather than meals. 

Edit: I have just been thinking of my elderly dog who had renal disease. I used to give her Metoclopramide, which is an anti emetic. I don't know if your dog's lack of appetite is due to feeling a bit nauseous but it is not an expensive drug and might be worth thinking about.  My vet gives the oldies a Vitamin B12 injection every now and again to boost them up.  Not sure if other vets do this but it is another thing to consider when seeing your vet. 

[Eden Holistic Pet Foods]

Protein restriction for kidney disease is a myth, and may actually cause more problems that higher protein

As far as the phosphorous content, its actually more about the right balance of calcium and phosphorous, since calcium binds to the phosphorous and it then passes through the intestines without being absorbed.

It is important to feed as natural a food as possible as the kidneys have to work harder to remove toxins and toxic by-products.

I'm not sure if we can post links on here to some useful information, i think it got blocked last time I did. google "Myths of high protein.pdf" and also Orijen White Paper (they have other documents on their website too) a large part of the myth comes from flawed studies done on rats that have a very different digestive system to a dog.

The nutritionist at Eden would be more than happy to discuss things with you in detail on the phone to help you work out what is best, contact details on their website

Hope some of this information can help you find the best answer.

[Dottie]

It may be useful for sivi to discuss this with the nutritionist but we have to bear in mind that her dog is under the care of the veterinary surgeon.  If the offer is taken up I think that any advice should be discussed with the vet before proceeding with dietary changes. 

As with humans, renal failure is usually handled with restricted protein. However, there are certain forms of kidney disease in which protein is lost via the urine and that particular type may be treated differently.  The advice has to be to discuss these issues with the veterinary surgeon.

[Schnauday]

I'd forgotten when replying before. I don't know how you feel about feeding raw but Nutriment do a low purine / low phosphorus food. My vet would have been happy with this as a diet for my dog but he didn't like this either. Its main protein source is green tripe which is low in phosphorus and my dog has never been keen on green tripe.

The site has the full analysis that you could print off and take to your vet.

http://www.nutriment.co/low-purine-phosphorus-formula/

David is right about the calcium and phosphorus ratio. The vet prescribed ipakitine which is a phosphorus binder. This has now been replaced with a natural phosphorus binder, powdered eggshells, loads of calcium.

Dottie - with regards to knowing how much protein you are giving. I use a website to enter all the recipes I make which gives the full nutritional breakdown of each meal. So I know exactly how much protein, calcium, phosphorous, nutrients, vitamins, calories, are being given. As I said before its a lot of work to do a home prepared renal diet.

As others have said make sure you discuss any new diet with your vet.

[Dottie]

Thank you for the information.  Please could you let me know which website you use? It sounds as if it is very useful.

[sivi]

Hi, Thank you everyone, all that information has given me a lot of food for thought.   I have looked on several website regarding food but of course I will speak with our Vet regarding which food to use.  Also a very kind lady from Collards was very helpful and is sending me a sample plus information which I can show our vet.  I will keep you all posted as to what we decide and what our vet has to say.

[Schnauday]

Thank you for the information.  Please could you let me know which website you use? It sounds as if it is very useful.

Sorry Dottie not been online for a few days. This is the website. It is American so some foods have different names eg what we know as minced meat is ground beef, courgettes are zucchini, swede is rutabaga. What I also do is make sure I change quantities to grams to be more accurate as things are measured in teaspoons and cups.
I also added my own foods such as green tripe.
http://nutritiondata.self.com/

[Dottie]

Thank you - have bookmarked it and will have a good look at it later.

[Dottie]

Robbie's Cuisine Brown Rice and Egg - Low Phosphorus (Kidney Support) is a dehydrated food formulated for renal disease by Land of Holistic Pets. It is low in protein and fat so could be useful for pancreatitis and liver problems.