Here is all my research on Chronic kidney disease in dogs, condensed to help you make the best decisions possible for your dog. Kidney disease is extremely individual, I always recommend getting a specifically balanced meal plan for your dog.
Kidney Disease Research
What is canine Chronic Kidney Disease?
What do your dog’s kidney’s do?
How do you know if your dog’s got Kidney Disease?
What causes Kidney Disease?
The protein myth
What stage of kidney disease is my dog?
How do I treat your dog’s kidney disease with diet
What is canine kidney disease?
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, this is the kidneys ability to filter the blood, which leads to a build-up of waste which becomes toxic (1)
The rate of progression 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 particularly the case with diet. (2)
What do your dog’s kidneys do?
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.
All of this gets 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.
- 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
How do you know if your dog’s got kidney disease?
- Anorexia (Common)
- Proteinuria (high protein in urine)
- Hypertension (high blood pressure)
- Hypoalbuminemia (low albumin in blood) (3)
What causes canine kidney disease?
Your dog’s kidneys filter waste, waste which can be harmful or simply too much waste over too long causes the kidneys to degrade faster. 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
The Protein Myth
There is no data at all, to suggest that high protein diets affect the rate of kidney filtration. That means you should not restrict protein, however excess phosphorus is associated with disease progression and phosphorus is higher in lean high protein meats.
As long as there is management of the phosphorus levels, increased dietary protein can be safely fed to dogs with CKD. (7) This is preferable as protein is a vital part of any healthy diet for a dog. (8)
Phosphorus levels can be reduced by using high fat meats and boiling the meat (9)
Low protein diets are recommended only at the end stages of kidney disease when minimal kidney function remains.
What stage of kidney disease is my dog?
The Stages of Canine Kidney disease – International Renal Interest Society Stage for Dogs (10)
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. 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 – 250umol/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 – 440umol/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 stage. (440+ umol/l or 5+ mg/dl). SDMA levels (54+)
This is low protein diet, high fibre, high in probiotics or your dog’s favourite meals.
How to treat your dog’s Kidney disease with diet?
Treatment of Kidney disease should be aimed at eliminating the underlying causes, to make sure to minimize further damage. Apart from congenital and birth defects and medication, the underlying causes can all be treated with diet.
The initial diet that you make for your dog should have a specific balance, this will help control abnormalities in the blood tests, like high urea, phosphorus, calcium or creatinine etc.
I do recommend signing up to a consultation for kidney disease, because it is so individual, it means a diet can be balanced specifically. Some tests will have high calcium and phosphorus, others low calcium etc.
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- Polzin, D.J., 2011. Chronic kidney disease in small animals. Veterinary Clinics: Small Animal Practice, 41(1), pp.15-30.
- Evason, M. and Remillard, R., 2017. Chronic kidney disease staging & nutrition considerations. Clinician’s Brief, 15(3), pp.89-95.
- 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.
- 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.
- 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.
- 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
- Sanderson, S.L., Rethinking Protein Restriction in Aging Dogs and Cats with Chronic Kidney Disease. Premise of Systems Microbiomics in Improving Health and Related Diagnostics for Human and Companion Animals, p.87.
- Leibetseder JL, Neufeld KW. Effects of Medium Protein Diets in Dogs with Chronic Renal Failure. J Nutr. 1991;121: S145-S149
- Jones, W.L., 2001. Demineralization of a wide variety of foods for the renal patient. journal of Renal Nutrition, 11(2), pp.90-96.
- Finco DR, Brown SA, Crowell WA, et al. Effects of Dietary Phosphorus and Protein in Dogs with Chronic Renal Failure. Am J Vet Res. 1992;53:2264-2271.