Homemade dog food diets for dogs with Cystine Stones

Here's all the latest research on canine cystine stones, I've condensed into this article so you can get the best understanding of what cystine stones are, how they form, why they form and how to use nutrition to help treat them. The great news is, you don't only have to use a processed low quality veterinary diet. What are cystine stones?Canine cystinuria is caused by a malfunctioning within the tubes or transporter channels in the kidneys, (part of the urinary tract) specifically when it comes absorption of cystine and other types of amino acids.This leads to the formation of rock-like formations of minerals that form in the urinary tract, specifically bladder.To understand a little more about how and why they form, you need to understand the urinary tract. What does the urinary tract do?The urinary tract is a waste removal system. When your dog eats, the body takes nutrients from the food and they go into the blood through the digestive process. Not everything taken into the blood is needed or in fact healthy, and some of what the body has used needs removing from the body, the waste. The kidneys and urinary system help the body to eliminate the waste.Sometimes there’s too much waste or not enough of the right stuff, or the kidneys struggle to absorb and nutrient and it causes an imbalance. This makes the urinary tract more susceptible to encountering issues, like infections or types of stones or both. What are the symptoms of a cystine stones in dogs?

• Bloody and/or cloudy urine
• Straining or whimpering during urination
• Accidents in the house
• Needing to be let outside more frequently
• Licking around the urinary opening
• Fever

 What causes Cystine Stones? (Too much cystine)

• Altered intestinal transport of cystine (1)
• A high urine specific gravity suggests an increase in concentration of urolithic precursors. (1)
• Certain mutations in genes predispose dogs for cysteine stones. A classification model developed in 2013 indicates four types of genetic defects that can lead to cystine urolithiasis, from which one type is sex-linked to intact male dogs (2)
• Cystine uroliths form typically in acidic urine, however the solubility of cystine is about 250 mg/ L at 6.5pH, meaning they do dissolve in acidic urine. This solubility increases as the urine becomes more alkaline. For example, 500 mg of cystine will dissolve in a litre of urine at a pH of 7.5. But this increased pH this brings an increased risk of other health issues. (3)

 If stones are present, an initial high alkaline diet with the inclusion of potassium citrate is recommended to increase the speed in which the stones dissolve (4) , however this is not recommended or necessary for the maintenance cystine stones, as long term high alkaline diets will present other issues.Dietary management of cystine stones is designed around maintaining a urine pH 6.5 - 6.75. This is done by having a slightly more alkaline diet than is normally prescribed for a dog.Also decreasing the urine specific gravity (promoting urine dilution) this is best achieved by feeding high-moisture diets (5). Raw food diets have a moisture content of around 70%.There is little evidence to support dietary restriction of protein, however the restriction of methionine contain foods like broccoli, mushrooms, cauliflower, potato’s is recommended. Also the vegetables used should have a high in organic anion content (6)You need to restrict salt intake. No more snacking on leftovers that have human levels of salt.The inclusion of Alpha Lipoic Acid is a safe and well tolerated food supplement that has been remarkably effective in a mouse model of cystinuria. (7)Selenium supplementation has also been shown to reduce cystine volume (8) Get Cam's help:If you'd like a bespoke Urinary Recipe Plan, please click here.If you'd like to organise a Consultation, please click here. References

1. Bartges, J.W. and Callens, A.J., 2015. Urolithiasis. Veterinary Clinics: Small Animal Practice, 45(4), pp.747-768.
2. Burggraaf, N.D., Westgeest, D.B. and Corbee, R.J., 2021. Analysis of 7866 feline and canine uroliths submitted between 2014 and 2020 in the Netherlands. Research in Veterinary Science, 137, pp.86-93.
3. Leslie, S.W., Sajjad, H. and Nazzal, L., 2020. Cystinuria. In StatPearls [Internet]. StatPearls Publishing.
4. Lulich, J.P., Berent, A.C., Adams, L.G., Westropp, J.L., Bartges, J.W. and Osborne, C.A., 2016. ACVIM small animal consensus recommendations on the treatment and prevention of uroliths in dogs and cats. Journal of veterinary internal medicine, 30(5), pp.1564-1574.
5. Queau, Y., 2019. Nutritional management of urolithiasis. Veterinary Clinics: Small Animal Practice, 49(2), pp.175-186.

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Homemade dog food diets for dogs with Struvite Stones or Crystals

Here's all the latest research on diet and struvite stones/ crystals for dogs, condensed into an easy to read article to help you make the best decision possible for your dog. What are struvite stones or crystals?Struvite is the name given to the crystal/ stone that forms in the urinary tract.Struvite crystals can be present in normal urine and alone, they do not require treatment. However when you combine them with certain bacteria and urine which is too alkaline, this leads to the formation of rock-like formation of minerals that form in the bladder (part of the urinary tract. (1)As they make their way through the urinary tract, the can cause dog’s serious discomfort and pain.To understand a little more about how and why they form, you need to understand the urinary tract. What are the symptoms of a struvite stones in dogs?

• Bloody and/or cloudy urine
• Straining or whimpering during urination
• Accidents in the house
• Needing to be let outside more frequently
• Licking around the urinary opening
• Fever

 What does the urinary tract do?The urinary tract is a waste removal system. When your dog eats, the body takes nutrients from the food and they go into the blood through the digestive process. Not everything taken into the blood is needed or in fact healthy, and some of what the body has used needs removing from the body, the waste. The kidneys and urinary system help the body to eliminate the waste.Sometimes there’s too much waste or not enough of the right stuff, this creates an environment susceptible to encountering issues, like infections or types of stones or both. What causes Struvite stones in dogs?Struvite stones are formed when there are increased levels of bacteria in the urinary tract. Struvite stones are form when there is an overgrowth of bacteria, like Staphylococci and Proteus species, signalling an infection (bacterial imbalance). The bacteria produce the enzyme urease. This enzyme then reacts with urine that’s too alkaline, causing a stone to form. (1) What are the causes of infection in the Urinary Tract?Urine Microbiome Imbalance – Incorrect Diet/ Overuse of antibiotics The urine microbiome is a community of microorganisms (such as bacteria, fungi, and viruses) in the urine, healthy dogs has a diverse bacterial and fungal species. (2)We used to think that urine was sterile! In fact it contains its own ecosystem of bacteria that comes from the foods that you feed your dog. Improper functioning of the Lower Urinary Tract – Incorrect diet (mainly) or inheritedThe Lower Urinary Tract has several mechanisms for the defence against bacterial overgrowth and imbalance, this includes releasing anti-microbial peptides and releasing neutrophils, immune cells. (3) Alkaline UrineA healthy dog produces slightly acidic urine between 6.0-6.5 pH. There is a correlation between bacterial overgrowth with more neutral urine, around pH 7. (4)Fresh meat is acidic, diets lacking in fresh ingredients, in particular meat and fresh food ingredients become unnaturally alkaline for dogs. How to treat?Treatment of your dog’s struvite stones with diet will mean eliminating the underlying causes, to make sure to minimize further damage.The most important part of ensuring there’s no recurrence, is going to be a move to a fresh food diet. A diverse, balanced bacteria, creating a healthy microbiome, both in the gut and the urine, comes from having a diet with a range of natural fresh foods in the diet.This will have secondary effects of improving the lower urinary tracts ability to deal with bacterial overgrowth and ensure the urine pH is within the correct range. The use of more acidic ingredients like cranberries or pomegranate can also decrease urine pH effectively. (5)By using a range of anti-inflammatory ingredients, in combination with a complete diet, your dog will likely not have any recurring issues. Specific Diet for Struvite Crystals  ProteinA high protein diet is recommended, high in meat to help acidify the urine. FatsA standard medium fat diet is recommended. CarbohydratesThis should be lowered to help balance the gut bacteria and to aid lowering urine pH. Vitamins and MineralsA standard complete diet is recommended. Which supplements are recommended for dogs with Struvite stones or crystals?Cranberry (6)D-Mannose (7)Probiotics (7) If you'd like more help with your dog's diet:For specific Urinary Recipes, click here.For a consultation call with Cam, click here. 

1. Lulich, J.P., Berent, A.C., Adams, L.G., Westropp, J.L., Bartges, J.W. and Osborne, C.A., 2019. ACVIM Small Animal Consensus Recommendations on the Treatment and Prevention of Uroliths in Dogs and Cats. 日本獣医腎泌尿器学会誌, 11(1), pp.30-40.
2. Melgarejo, T., Oakley, B.B., Krumbeck, J.A., Tang, S., Krantz, A. and Linde, A., 2021. Assessment of bacterial and fungal populations in urine from clinically healthy dogs using next‐generation sequencing. Journal of veterinary internal medicine, 35(3), pp.1416-1426.
3. Byron, J.K., 2019. Urinary tract infection. Veterinary Clinics: Small Animal Practice, 49(2), pp.211-221.
4. Robin R. Shields-Cutler, Jan R. Crowley, Chia S. Hung, Ann E. Stapleton, Courtney C. Aldrich, Jonas Marschall, Jeffrey P. Henderson. Human Urinary Composition Controls Siderocalin's Antibacterial Activity. Journal of Biological Chemistry, 2015; jbc.M115.645812 DOI: 1074/jbc.M115.645812
5. Chou, H.I., Chen, K.S., Wang, H.C. and Lee, W.M., 2016. Effects of cranberry extract on prevention of urinary tract infection in dogs and on adhesion of Escherichia coli to Madin-Darby canine kidney cells. American journal of veterinary research, 77(4), pp.421-427.
6. Chou, H.I., Chen, K.S., Wang, H.C. and Lee, W.M., 2016. Effects of cranberry extract on prevention of urinary tract infection in dogs and on adhesion of Escherichia coli to Madin-Darby canine kidney cells. American journal of veterinary research, 77(4), pp.421-427.
7. Gerber, B., 2018. Current tips on the management of canine urinary tract infections.

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Homemade dog food diets for dogs with Calcium Oxalate Stones

Here’s all the latest research on canine calcium oxalate stones, I’ve condensed into this article so you can get the best understanding of what calcium oxalate stones are, how they form, why they form and how to use nutrition to help treat them. What are Calcium Oxalate Stones?Calcium oxalate stones are the most common type of kidney stone. Kidney stones are solid masses of calcium and oxalate that form in the kidney. During their journey out of the urinary tract, they can cause significant pain and discomfort to your dog.They are not simply caused by too much calcium in the diet, it’s a little more complete. What does the urinary tract do?The urinary tract is a waste removal system. When your dog eats, the body takes nutrients from the food and it goes into the blood. Not everything taken into the blood is needed or in fact healthy, it’s waste. The kidneys and urinary system help the body to eliminate the waste.Sometimes there’s too much waste or not enough of a key component of health, which is when the urinary tract will begin to encounter issues, like infections or types of stones. What are the symptoms of a Calcium Oxalate Stones in dogs?

• Bloody and/or cloudy urine
• Straining or whimpering during urination
• Accidents in the house
• Needing to be let outside more frequently
• Licking around the urinary opening
• Fever

 What causes Calcium Oxalate Stones? (Too much calcium in the urine)There are factors that increase the probability, like disease factors (diet, body condition score (BCS), urine pH, and urine specific gravity). Certain breeds are more predisposed, Crain Terrier, Jack Russell’s Terrier, Lhasa Apso, Maltese, Papillon, Pomeranian, Shih Tzu, and Yorkshire Terriers.However, the following are the causes of Calcium oxalate stones in dogs.

• Urine microbiome imbalance – Incorrect diet
• Calcium homeostasis - Incorrect balance of calcium, can be too high or too low
• Insufficient or unbalanced phosphorus and Vitamin D
• Urine supersaturation – too many minerals in urine causing crystallisation
• Hypoparathyroidism – too little parathyroid hormone
• Kidney disease

(1,2,3,4) How to treat?Treatment of calcium oxalate stone should be aimed at eliminating the underlying causes, to make sure to minimize further damage.The most important part of ensuring there’s no recurrence, is going to be a move to a fresh food diet. A diverse, balanced and healthy microbiome, both in the gut and the urine, comes from having a range of natural fresh foods in the diet (1).The bacterial urinary microbiome in healthy has a greater taxonomic richness, meaning it’s a clear indicator of health. (6)Secondly, you’ll need to review the balance of the current diet, what are the calcium, phosphorus and vitamin D levels, are they sufficient? Too much or too little can contribute to calcium oxalate stones. (2)Try to increase fluid intake with bone broth and watermelon.A study on increasing salt levels to help alleviate calcium oxalate stones, found that by adding 2-3g per 1kg of food, it increased water intake by around 50%. (5) This should be a short term solution, only do this in the first week when your dog is clearly experiencing pain. Prolonged salt intake would not be healthy. Get Cam’s help:If you’d like a bespoke Urinary Recipe Plan, please click here.If you’d like to organise a Consultation, please click here. References:

1. Rodríguez, F.M., Rubio, L.S., Nanne, I.G., Martín, F.S., Emiliani, E. and Feu, O.A., 2020. The relationship between calcium oxalate lithiasis and chronic proinflammatory intestinal dysbiosis pattern: a prospective study. Urolithiasis, 48(4), pp.321-328.
2. Hunprasit, V., 2017. Epidemiologic Evaluation of Risk Factors for Calcium Oxalate Urolith Formation and Recurrence in Dogs
3. Stevenson, A.E., Blackburn, J.M., Markwell, P.J. and Robertson, W.G., 2004. Nutrient intake and urine composition in calcium oxalate stone-forming dogs: comparison with healthy dogs and impact of dietary modification. Veterinary therapeutics: research in applied veterinary medicine, 5(3), pp.218-231.
4. Luskin, A.C., Lulich, J.P., Gresch, S.C. and Furrow, E., 2019. Bone resorption in dogs with calcium oxalate urolithiasis and idiopathic hypercalciuria. Research in veterinary science, 123, pp.129-134.
5. Queau, Y., Bijsmans, E.S., Feugier, A. and Biourge, V.C., 2020. Increasing dietary sodium chloride promotes urine dilution and decreases struvite and calcium oxalate relative supersaturation in healthy dogs and cats. Journal of animal physiology and animal nutrition, 104(5), pp.1524-1530.
6. Melgarejo, T., Oakley, B.B., Krumbeck, J.A., Tang, S., Krantz, A. and Linde, A., 2021. Assessment of bacterial and fungal populations in urine from clinically healthy dogs using next‐generation sequencing. Journal of veterinary internal medicine, 35(3), pp.1416-1426.

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Homemade dog food diets for dogs with Pancreatitis.

Here is the latest research on canine pancreatitis, condensed into an article so you can make the most informed decisions about caring for your dog. What does the pancreas do? The pancreas produces enzymes that help with the digestion of fats, carbohydrates and proteins. It also releases hormones that control blood sugar, insulin and glucagon which goes into the blood.The enzymes help digest food, and inadequate enzyme release can lead to the pancreas failing to get enzymes out of the pancreas, causing inflammation and having secondary effects like the dog not being able to digest their food properly.The pancreas also makes sure not too much sugar, which is digested from the food, is present in the blood through the release of hormones. Improper production of hormones causes and inability to control blood sugar, which is what diabetic dogs suffer from. What is pancreatitis?Pancreatitis is inflammation of the pancreas causing a reduced ability to carry out the functions it needs to. The pancreas is an organ rooted in the digestive process, and making sure you manage it correctly begins with the diet.Acute or a “one off” bout of pancreatitis is considered a completely reversible condition. (1) Chronic pancreatitis or a recurring bout/s can become a lot more problematic due to the potential for bile duct obstruction. This is when activated enzymes get stuck in the pancreas, which then effectively digest parts of the pancreas (necrosis), causing further inflammation and potential loss of function.Secondary effects can be diabetes or malnutrition from an reduced ability to digest food. What are the symptoms of Pancreatitis in dogs?

• Vomiting
• Fever
• Lethargy
• Abdominal pain
• Diarrhoea
• Decreased appetite.
• Frequently adopting the bow/ prayer position

 The causes your dog’s pancreas to become inflamed (pancreatitis)

• Wrong diet which is an incorrect balance of protein/ fats/ carbs
• Hyperlipoproteinemia is a reduced ability to break down lipids or fats.
• Hypercalcemia Calcium builds up in the pancreas
• Bile duct obstruction Enzymes can’t be released
• Drugs g. Azathioprine, chlorthiazide, hydrochlorthiazide, zinc, potassium bromide, vinblastine, sulfonamides, cisplatin, organophosphates, L-asparaginase, and 5-aminosalicylat.
• Toxin Ingestion
• Pancreatic trauma Physical damage

(2,3,4) How to treat?Treatment of your dog’s pancreatitis with diet will mean eliminating the underlying causes, to make sure to minimize further damage.The most important part of ensuring there’s no recurrence, is going to be a move to a fresh food diet that’s balanced with the correct macronutrients. Ensuring that your dog is digesting the right food, in the right balance, will be the most effective way to safeguard against improper enzymes release.The first stage, after any type of pancreatic issue no matter how severe, is a 24hr fast period. This allows for a clear-out and will decrease the levels of inflammation.Depending on the severity of the issue will depend on the continued diet, but it’s recommended that all dogs start on a really low fat diet of around 5%. Initially use cooked sweet potato, a low-glycaemic carbohydrates which is high in soluble fibres (anti-inflammatory) as well as digestive enzymes to aid with digestion. Natural supplements like quercetin can be used to inhibit inflammatory mediators. (5,6)If it’s just a one off flare up, after a few weeks on a 5% fat diet, move to a more balanced recipe with a slightly higher fat % and you can gradually increase the fats back to around the 10% range after a month.If it’s not just a flare (seek Veterinary advice) it can be that some cases of pancreatitis have damaged the pancreas leading to recurring episodes and a strict diet will need to be maintained on an ongoing basis.For all dogs who’ve had pancreatitis, it’s important to avoid high fat treats. ProteinA moderate protein diet is recommended. FatWhilst in early stages of recovery (first two weeks), the diet should be max. 5%. For dogs with one off bouts, you can gradually increase this up over the period of 1 month back to normal healthy range. 10-15% fat.For dogs with recurring pancreatic issues, it’s recommended the dog stays on a diet of 5% fat. Carbohydrates and FibreAn increase of carbohydrates in the diet to account for the reduced fat. Cooked sweet potato and brown rice will help provide the energy your dog’s need without increasing the fat levels over 5%. These carbs should be max. 20% of the total meal.For dogs who need a long term low fat diet, keep the carb content at 15%. For dogs suffering from diabetes, the carbohydrate consumption needs to be managed carefully. Vitamins and MineralsNiacin is a vitamin that has been used successfully for the treatment of hyperlipidemia, in dogs, niacin treatment reduced serum triglyceride concentrations for several months without causing any side effects (7)Niacin is usually administered at the dose of 25–100 mg/day and is prevalent in liver, low fat poultry meats and salmon (8)For those with chronic pancreatitis, reduced mineral intake need to be accounted for with a multi-vitamin supplement. Supplementation for dogs with PancreatitisResveratrol supplementation is recommended because of its anti-inflammatory and anti-oxidant mechanisms, studies show it to be really effective and natural therapeutic component for the treatment of pancreatitis. (9)A large number of clinical studies have shown that rhubarb enema can reduce serum inflammatory cytokines, high sensory C-reactive protein (CRP) and endotoxin levels, and relieve the systemic inflammatory stress response and restore intestinal mucosal barrier function in SAP patients (10)Supplementing with Omega-3 fatty acids from fish oil has been shown to lower serum lipoprotein concentrations in humans with primary hypertriglyceridemia, normal humans, and experimental animals (11)However, not all Omega-3 fish oil is the same. Low quality options, which tend to be higher in toxins will have the opposite effect. Either use a fish source or a high quality organic option. (12) Get Cam's help:For specific recipes for pancreatic support, click here.For a consultation with Cam, click here. References:

1. Lindsay, S., Entenman, C. and Chaikoff, I.L., 1948. Pancreatitis accompanying hepatic disease in dogs fed a high fat, low protein diet.  Pathol., 45, pp.635-638.
2. Charles M.G. Maxie (Ed.), Jubb, Kennedy, and Palmer's Pathology of Domestic Animals (5th ed.), Saunders Elsevier, Edinburgh (2007), pp. 389-423
3. Johnson, M.C., 2005. Hyperlipidemia disorders in dogs. Compendium, 27, pp.361-370.
4. Wilkinson, A.R., DeMonaco, S.M., Panciera, D.L., Otoni, C.C., Leib, M.S. and Larson, M.M., 2020. Bile duct obstruction associated with pancreatitis in 46 dogs. Journal of Veterinary Internal Medicine, 34(5), pp.1794-1800.
5. Hamalainen, M. et al. Effects of flavonoids on prostaglandin E2 production and on COX-2 and mPGES-1 expressions in activated macrophages. Planta Med. 77, 1504–1511. https://doi.org/10.1055/s-0030-1270762(2011).
6. Palozza, P. et al. beta-Carotene downregulates the steady-state and heregulin-alpha-induced COX-2 pathways in colon cancer cells. J. Nutr. 135, 129–136. https://doi.org/10.1093/jn/135.1.129(2005).
7. Johnson, M.C., 2005. Hyperlipidemia disorders in dogs. Compendium, 27, pp.361-370.
8. Bauer, J.E., 1995. Evaluation and dietary considerations in idiopathic hyperlipidemia in dogs. Journal of the American Veterinary Medical Association (USA).
9. Ma, Q., Zhang, M., Wang, Z., Ma, Z. and Sha, H., 2011. The beneficial effect of resveratrol on severe acute pancreatitis. Annals of the New York Academy of Sciences, 1215(1), pp.96-102.
10. Yao, P., Cui, M., Li, Y., Deng, Y. and Wu, H., 2015. Effects of rhubarb on intestinal flora and toll-like receptors of intestinal mucosa in rats with severe acute pancreatitis. Pancreas, 44(5), pp.799-804.
11. Xenoulis, P.G. and Steiner, J.M., 2010. Lipid metabolism and hyperlipidemia in dogs. The Veterinary Journal, 183(1), pp.12-21.
12. Hong, M.Y., Hoh, E., Kang, B., DeHamer, R., Kim, J.Y. and Lumibao, J., 2017. Fish oil contaminated with persistent organic pollutants induces colonic aberrant crypt foci formation and reduces antioxidant enzyme gene expression in rats. The Journal of nutrition, 147(8), pp.1524-1530.

 

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Liver disease in dogs, homemade diets and nutrition.

Here's the latest research on liver disease in dogs and nutrition. I've condensed it into an easy to read article, to help you make the best decisions possible when caring for your dog. 

How Does a Dog’s Liver Function?

The liver is an integral part of your dog’s digestive system. A healthy liver processes all blood that leaves the stomach and intestines in order to support digestion, break down toxins, metabolise proteins, fats and carbohydrates, store essential vitamins, minerals, and nutrients, and eliminate waste from your dog’s body. Your dog’s liver also metabolizes drugs and removes all waste from their digestive system by excreting a fluid called bile.  

Liver Diseases and Illnesses

All liver diseases and liver-related health issues will reduce the functioning ability of your dog’s liver. Below is a list of such illnesses (1): 

• Acute or Chronic Hepatitis (Inflammation)
• Hepatic Cirrhosis (Scarring)
• Portal Hypertension (High blood pressure)
• Shunts (Deformation)
• Bile duct obstruction (Obstructing enzymes from leaving the liver)
• Storage diseases (Can’t remove waste)
• Cancer

  

What are the Symptoms of Liver-Related Illnesses in Dogs?

• Loss of appetite
• Weight loss
• Vomiting
• Stomach ulceration
• Diarrhoea
• Seizures or other neurologic problems
• Fever
• Blood clotting problems
• Jaundice (a yellow tinge noticeable in the skin, mucous membranes, and eyes)
• Fluid collection in the abdomen
• Excessive urination and thirst
• Gastrointestinal bleeding can be seen in animals with liver disease due to ulcers or problems with blood clotting (2)

  

What are the Causes of Liver-Related Illnesses in Dogs?

• Bacterial or viral inflammation
• Obesity (causes overuse of liver)
• Gut Microbiome Dysbiosis (causes bacterial inflammation)
• Inability to remove copper (causes a build up of copper that damages the liver)
• Cancer of the liver
• Reduced ability to digest fats (Hyperlipidaemia)
• Cysts or gallstones (impedes liver function)
• Endocrine diseases (causes inadequate enzyme secretion)
• Ingestion of a toxic substance
• Congenital defects
• Autoimmune disorders

(3,4)  

How Can I Treat My Dog’s Liver Disease?

Primarily, an accurate diagnosis of your dog’s specific illness will be vital to your success in treating their liver disease, as you’ll be able to remove the primary cause of their reduced function.The second goal of hepatic therapy is to provide nutritional support. The premise of all diets that remedy liver disease is the same, as you’ll need to avoid overwhelming the functioning capacities your dog’s liver has, while providing sufficient nutrients for liver regeneration and other bodily functions.Lastly, your dog may require specific therapies, such as anti-inflammatories, antifibrotics, or copper chelation, as well as liver support therapy, such as antioxidants and additional vitamins (5,6).  

Diet Breakdown

Protein

Protein is needed to support your dog’s hepatic regeneration and prevent negative nitrogen balance, which is why your dog’s protein intake should be increased to the highest level.Protein restriction should only be implemented if your dog is showing signs of hepatic encephalopathy. 

Fat

An increase in fat content will increase caloric density and palatability. This means the dog is consuming less quantity digesting less, while intaking an equal amount of calories. Fat is tolerated by dogs with liver disease unless they are suffering with severe cholestasis, which results in fat maldigestion. 

Carbohydrates and Fibre

If your dog has liver disease, they may see a decrease in hepatic glycogen storage, which potentially increases the risk of low blood sugar levels and increases the use of protein catabolism for energy. Therefore, feeding your dog high-glycaemic treats (carbohydrate treats that break down quickly) between meals will prevent low blood sugar.The inclusion of some fibre, especially soluble fibre, will increase the speed that food is transported through your dog’s gut, which gives toxins less time to be absorbed. 

Vitamins and Minerals

Any disorder that decreases the amount of bile acids entering the intestine, enterohepatic bile acid circulation, or intestinal fat absorption requires the reduction in fat-soluble vitamins A, D, E, and K. Vitamin K and E deficiencies are particularly common.It has been demonstrated that copper accumulation is often controlled using a low-copper diet. Dietary zinc can also block intestinal copper absorption, and zinc supplementation in a low-copper diet may also be beneficial following chelation therapy. 

Recommended Supplements

Silibinin (Milk Thistle Extract): Antioxidant that suppresses fibrinogenesis, promotes fibrinolysis, and helps protect against hepatotoxins (6).

 References

1. Prins, M., Schellens, C.J.M.M., Van Leeuwen, M.W., Rothuizen, J. and Teske, E., 2010. Coagulation disorders in dogs with hepatic disease. The Veterinary Journal, 185(2), pp.163-168.
2. https://www.msdvetmanual.com/dog-owners/digestive-disorders-of-dogs/disorders-of-the-liver-and-gallbladder-in-dogs
3. Cullen, J.M., 2009. Summary of the World Small Animal Veterinary Association standardization committee guide to classification of liver disease in dogs and cats. The Veterinary Clinics of North America. Small Animal Practice, 39(3), p.395.
4. Xenoulis, P.G. and Steiner, J.M., 2010. Lipid metabolism and hyperlipidemia in dogs. The Veterinary Journal, 183(1), pp.12-21.
5. Norton, R.D., Lenox, C.E., Manino, P. and Vulgamott, J.C., 2016. Nutritional considerations for dogs and cats with liver disease. Journal of the American Animal Hospital Association, 52(1), pp.1-7.
6. Twedt, D. C., Chandler, M. 2014. Clinical Nutrition for Common Liver Diseases. World Small Animal Veterinary Association World Congress Proceedings

 

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A diet for dog with liver shunts (portosystemic shunts)

A diet for a dog with liver shunts (portosystemic shunts)This is my full research on liver shunts and what any diet, homemade or prescription diet should be for a dog with liver shunts. Unfortunately, you will not find a veterinary diet suitable for liver shunts. 

What are Liver Shunts?

Liver shunts, also known as congenital portosystemic shunts, refers to an abnormality in the transport tubes of the liver, which is a key organ in your dog’s digestive system. A healthy liver processes all blood that leaves the stomach and intestines in order to support digestion, break down toxins, metabolise proteins, fats and carbohydrates, store essential vitamins, minerals and nutrients, and eliminate waste from your dog’s body.If, however, your dog has liver shunts, the abnormality in their liver will allow blood to bypass your dog’s liver and enter their blood circulation, enabling toxic substances such as ammonia to accumulate in the blood. This can lead to hepatic encephalopathy, which is a reduction in brain function and brain damage due to toxic build up. 

How Do You Know If Your Dog has Liver Shunts?

The following symptoms are indicators of liver shunts:

• Loss of appetite and weight loss
• Vomiting
• Diarrhoea
• Seizures or other neurologic problems
• Jaundice (a yellow tinge noticeable in the skin, mucous membranes, and eyes)
• Excessive urination and thirst
• Blood clotting
• Gastrointestinal bleeding can be seen in animals with liver disease due to ulcers or problems with blood clotting

 Current Treatment for Liver ShuntsGenerally, surgery is recommended for animals with liver shunts because surgical intervention leads to higher survival rates and a better quality of life when compared to non-surgical treatment (3). This is because non-surgical interventions aren’t able to affect your dog’s blood flow.However, studies have also shown that non-surgical treatments can improve the quality of life of dogs with liver shunts (1).

 

How Can I Treat My Dog's Liver Shunts with Nutrition?

Changing elements of your dog’s diet can control their symptoms of live shunts, including hepatic encephalopathy, vomiting, diarrhoea, and ammonium-urate urolithiasis.You can improve ammonium-urate urolithiasis by feeding your dog a diet that has lower levels of protein (approximately 40g per 1000 calories) and a high branched-chain amino acids to aromatic amino acids ratio (4).Furthermore, sources of soluble fibre such as lactulose help to reduce ammonia intake from the gastrointestinal tract; it transforms ammonia into ammonium that is not absorbed, and its laxative effect ensures the rapid expulsion of bacteria and ammonia (5). An antimicrobial treatment may also have a similar effect (2,6).

Diet Breakdown

Protein

A low protein diet of 40g per 1000 calories is recommended.In a study exploring the life expectancy of dogs with an Eck fistula, a model for liver shunting and hepatic encephalopathy, it was found that the life expectancy of dogs who were fed fish or milk-based proteins was almost twice as long as that of dogs fed a meat-based diet (7).

Fat

An increase in fat content will increase caloric density and palatability. This means the dog is consuming less quantity digesting less, but equal in calories. As well as being much tastier for the dog. Fat is tolerated by dogs with liver disease unless they are suffering with severe cholestasis, which results in fat maldigestion.

Carbohydrates and Fibres

If your dog has liver disease, they may see a decrease in hepatic glycogen storage, which potentially increases the risk of low blood sugar levels and increases the use of protein catabolism for energy. Therefore, feeding your dog high-glycaemic treats (carbohydrate treats that break down quickly) between meals will prevent low blood sugar.The inclusion of some fibre, especially soluble fibre, will increase the speed that food is transported through your dog’s gut, which gives toxins less time to be absorbed.

Vitamins and Minerals

Any disorder that decreases the amount of bile acids entering the intestine, enterohepatic bile acid circulation, or intestinal fat absorption requires the reduction in fat-soluble vitamins A, D, E, and K. Vitamin K and E deficiencies are common in dogs with liver shunts.It has been demonstrated that copper accumulation is often controlled using a low-copper diet. Dietary zinc can also block intestinal copper absorption, and zinc supplementation in a low-copper diet may also be beneficial following chelation therapy.

Recommended Supplements

Silibinin (Milk Thistle Extract): Antioxidant that suppresses fibrinogenesis, promotes fibrinolysis, and helps protect against hepatotoxins (8). References

1. Favier, R.P., de Graaf, E., Corbee, R.J. and Kummeling, A., 2020. Outcome of non-surgical dietary treatment with or without lactulose in dogs with congenital portosystemic shunts. Veterinary Quarterly, 40(1), pp.108-114.
2. Berent, A.C. and Tobias, K.M., 2009. Portosystemic vascular anomalies. Veterinary Clinics: Small Animal Practice, 39(3), pp.513-541.
3. Tivers, M.S., Lipscomb, V.J. and Brockman, D.J., 2017. Treatment of intrahepatic congenital portosystemic shunts in dogs: a systematic review. Journal of Small Animal Practice, 58(9), pp.485-494.
4. Proot, S., Biourge, V., Teske, E. and Rothuizen, J., 2009. Soy protein isolate versus meat‐based low‐protein diet for dogs with congenital portosystemic shunts. Journal of veterinary internal medicine, 23(4), pp.794-800.
5. Bajaj, J.S., 2008. Management options for minimal hepatic encephalopathy. Expert review of gastroenterology & hepatology, 2(6), pp.785-790.
6. Mankin, K.M.T., 2015. Current concepts in congenital portosystemic shunts. Veterinary Clinics: Small Animal Practice, 45(3), pp.477-487.
7. Condon, R.E., 1971. Effect of dietary protein on symptoms and survival in dogs with an Eck fistula. The American Journal of Surgery, 121(2), pp.107-114.
8. Twedt, D. C., Chandler, M. 2014. Clinical Nutrition for Common Liver Diseases. World Small Animal Veterinary Association World Congress Proceedings

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What causes kidney disease in dogs?

A diet for a dog with kidney diseaseThis is my full research on canine kidney disease and diet. It's important to remember that kidney disease is extremely individual to the dog and their stage. I recommend signing up to a bespoke recipe plan or a consultation to get specifically balanced recipes. What causes canine kidney disease?To understand the causes of kidney disease in dogs, you need to understand the role of the kidneys and what canine kidney disease really is.Chronic Kidney disease (CKD) is a progressive disease that is caused by structural or functional abnormalities in one or both of the kidneys. The reduction in the functional capabilities of the organs means a reduction in Globular filtration. Globular filtration is the kidneys ability to filter the blood. The reduction in the ability to filter the blood leads to a build-up of waste which becomes toxic, causing damage and further decline. (1)The rate of progression of kidney disease in dogs is extremely variable, for example an early diagnosis of CKD can slow disease progression, and with the correct management, it will ensure your dog’s quality and length of life remains unaffected.Depending on the stage of the disease, will depend on what management/ therapy your dog should receive, this is especially the case with diet. (2) What do your dog’s kidneys do?To understand how to care for a dog with kidney disease, you need to understand what the kidney’s dog.Just like us humans, blood flows through the kidneys every single minute. Your dog’s kidneys filter out waste products that are in the blood (globular filtration) from the breakdown of food, old cells, toxins, metabolic by products, and drugs. They also balance minerals like phosphorus, potassium, sodium and calcium.All of these get into the blood via the digestive process, then the kidneys filter the blood and remove all waste in the form of urine. They also trap good substances, like proteins and supply them back to the body.By controlling what your dog is digesting, you can control the waste. Kidney Functions

• Remove waste material from the bloodstream
• Help regulate blood pressure
• Regulate levels of certain essential minerals such as calcium, phosphorus, potassium and sodium
• Produce a variety of hormones
• Regulate the amount of water in the blood and produce urine
• Stimulate red blood cells formation
• Help regulate vitamin D levels

By not overloading the functions of the kidneys, you will extend longevity. How do you know if your dog’s got kidney disease?

• Anorexia (Common)
• Lethargy
• Vomiting
• Diarrhoea
• Anaemia
• Weight-loss
• Proteinuria (high protein in urine)
• Hypertension (high blood pressure)
• Hypoalbuminemia (low albumin in blood) (3)

  What causes canine kidney disease?A significant proportion of the treatment of a dog with kidney disease is addressing the underlying causes.All of these causes either increase the workload of the kidneys, eventually causing it to deteriorate, or directly cause reduced function of the kidneys.

• Low grade long term inflammation
• Increased waste in the food
• Gut Microbiome dysbiosis (wrong diet)
• Chronic bacterial infection
• High blood pressure
• Urinary blockage
• Certain drugs
• Congenital or at birth malformation of the kidneys
• Vitamin D deficiency
• Prolonged periodontal disease

(3,4,5,6) Get Cam’s help:If you’d like a bespoke Kidney Recipe Plan, please click here.If you’d like to organise a Consultation, please click here. References:

1. Polzin, D.J., 2011. Chronic kidney disease in small animals. Veterinary Clinics: Small Animal Practice, 41(1), pp.15-30.
2. Evason, M. and Remillard, R., 2017. Chronic kidney disease staging & nutrition considerations. Clinician’s Brief, 15(3), pp.89-95.
3. Dunaevich, A., Chen, H., Musseri, D., Kuzi, S., Mazaki‐Tovi, M., Aroch, I. and Segev, G., 2020. Acute on chronic kidney disease in dogs: Etiology, clinical and clinicopathologic findings, prognostic markers, and survival. Journal of Veterinary Internal Medicine, 34(6), pp.2507-2515.
4. Brown, S.A., Crowell, W.A., Barsanti, J.A., White, J.V. and Finco, D.R., 1991. Beneficial effects of dietary mineral restriction in dogs with marked reduction of functional renal mass. Journal of the American Society of Nephrology, 1(10), pp.1169-1179.
5. Finco, D.R., Brown, S.A., Crowell, W.A., Duncan, R.J., Barsanti, J.A. and Bennett, S.E., 1992. Effects of dietary phosphorus and protein in dogs with chronic renal failure. American journal of veterinary research, 53(12), pp.2264-2271.
6. Simona Mihai, Elena Codrici, Ionela Daniela Popescu, Ana-Maria Enciu, Lucian Albulescu, Laura Georgiana Necula, Cristina Mambet, Gabriela Anton, Cristiana Tanase, "Inflammation-Related Mechanisms in Chronic Kidney Disease Prediction, Progression, and Outcome", Journal of Immunology Research, vol. 2018, Article ID 2180373, 16 pages, 2018. https://doi.org/10.1155/2018/2180373

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How much food and how many meals for a dog with Kidney disease?

How much food should I feed a dog with kidney disease?The simplest answer to this question is that your dog should eat between 2–3.5% of their body weight every day, although smaller and more active dogs will need around 4%.If your dog is losing or gaining weight, this means you’re feeding them the wrong amount of food. Simply adjust the quantities of their meals slightly until you’ve hit the sweet spot.Remember the ideal figure for a dog with kidney disease is lean, as this limits the number of jobs their kidneys perform and ensures they’re not digesting more than they need. How many meals should I feed a dog with kidney disease?If your dog has Stages 1–3 kidney disease, they should either eat one meal a day or two meals a day within a five-hour window. You can feed your dog treats outside of this window, but only if they’re small, training treats.This gap between meals will allow your dog’s digestive system time to rest; constant digestion is unnatural and stressful and can cause further aggravation to any digestive issue. Therefore, a reduction in time spent digesting will be a major part of ensuring your dog’s long-term health.If your dog has Stages 4-5 kidney disease, you should reduce your dog’s daily food intake by 20% and feed them three meals a day. Supplement Quantity RecommendationsIf the supplements you’re using are specific to dogs, the packaging should provide you with information about the correct quantity your dog should be given. If they’re human grade, the amount your dog will need should be based on their weight. Follow the guidelines below to determine how much of each supplement you should give your dog.

• If your dog weighs 5–10kg: 1/4 of recommended dosage
• If your dog weighs 10–20kg: 1/3 of recommended dosage
• If your dog weighs 20–30kg: 1/2 of recommended dosage
• If your dog weighs 30–45kg: 2/3 of recommended dosage
• If your dog weighs over 45kg: Recommended dosage

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What are the stages of canine kidney disease?

The Stages of Canine Kidney disease - International Renal Interest Society Stage for Dogs  The severity of your dog’s kidney disease and the loss of ability to filter the blood (globular filtration) is classed in Stages, which you can work out from a blood test.The nutrition therapy that you provide your dog is very much dependent on what stage of kidney disease they have and the balance of their blood work results. Stages 1 and 2 are treated the same. Stage 3 is treated different and Stage 4 even more so. Stage 1 - Normal blood creatinine (less than 125 umol/l or slightly less than 1.4mg/dl) or normal or mild increase blood SDMA (18 or lower), proteinuria (protein in urine), abnormal renal biopsy results, increasing blood creatinine or SDMA concentrations.Persistently elevated blood SDMA concentration (>14 µg/dl) may be used to diagnose early CKD.Stage 1 is extremely manageable. Stage 2 – Normal or mildly increased creatinine (125 - 250 umol/l or 1.4 - 2.8 mg/dl).Mildly increased SDMA (18 – 35 ug/dl). Clinical signs usually mild or absent.Stage 2 is very much manageable. Stage 3 – Creatinine levels higher (250 - 440 umol/l or 2.8 - 5 mg/dl).SDMA levels (36-54)Stage 3 the long term outlook is dependent on the total loss of kidney function. Reduce protein levels of diet.  Stage 4 – The last of management. (440+ umol/l or 5+ mg/dl).SDMA levels (54+) Stage 5 - This is low protein diet, high fibre, high in probiotics or your dog’s favourite meals. Get Cam’s help:If you’d like a bespoke Kidney Recipe Plan, please click here.If you’d like to organise a Consultation, please click here.

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