This article was published in Westie's and Bestie's magazine in March 2020.
What causes kidney disease in dogs?
There are many possible causes which include:
- congenital abnormalities (e.g. cysts and other anatomical defects)
- infections by bacteria and viruses
- damage caused by poisons (such as antifreeze)
- toxins (in spoiled food, grapes and raisins, for example)
- the side effects of certain prescribed drugs (e.g. NSAID’s)
- autoimmune diseases
- formation of urinary stones
- other, less common conditions such as amyloidosis
It is important to determine the specific cause of kidney disease whenever possible, so that the most effective treatment can be provided.
Does diet play a big part?
Nutrition can be a factor in both the development and management of kidney disease.
Providing a complete, healthy, balanced diet, rich in the nutrients the body needs for optimum health, helps to maintain normal kidney function for as long as possible.
This is central because many vitamins, minerals, trace elements, fatty acids and other micronutrients can’t be made or stored by the body, and so need to be supplied by food every day.
This is best achieved by feeding high quality raw (meat, bone and offal) or home-cooked food, and adding selected natural supplements to whichever option is chosen. Tailoring this to meet a dog’s own, unique nutritional needs is even better. If there is no alternative but to feed kibble or wet processed pet food (eg tinned), it is best that meat content is high, and it is free of non-organic grains, fruit, vegetables, and chemical additives.
Fresh water should always be freely available to maintain good hydration, so that the kidneys can clear excessive salt, other minerals, toxins, and waste products from the body. This is especially important if dry food is fed.
Is there anything dog owners can do to help prevent kidney disease occurring?
A two-pronged approach to kidney care can reduce (not eliminate) the risk of kidney disease developing.
The first step is to avoid unnecessary exposure to substances which can damage renal tissue, by:
- minimising the use of potentially toxic chemicals in and around the home
- avoiding grains, fruits and vegetables in the diet which contain pesticide residues
- using effective, natural alternatives to nephrotoxic medications whenever possible (antibiotics and NSAID’s, for example)
The second step is to provide a nutritional support to the kidneys, by means of highly nutritious fresh food, combined with clinically proven natural supplements and remedies.
What should dog owners be looking for in their dog’s blood test results?
The earliest indicator of renal dysfunction is an increase in blood SDMA. This begins to rise when as little as 25% of kidney function has been lost. Creatinine and BUN (blood urea nitrogen) - both waste products of protein metabolism in the body - tend to increase only after 75% of renal tissue has been irreversibly damaged.
As SDMA is the most sensitive test currently available for monitoring kidney health, there is a good argument for performing this test annually, to pick up dogs with subclinical kidney disease, when they can be helped the most.
The debate of raw versus kibble – which is best for dogs with kidney disease and why?
Commercial renal foods are based on the principle that lowering protein, phosphorus and sodium levels in the diet, relieves the strain on failing kidneys and supports continued renal function. And there is some evidence that such a diet results in a slower rate of progression of CKD (chronic kidney disease). A challenge often faced however, is that many dogs find renal foods unappetising, and so there is a risk of reduced food intake at a time when body condition needs to be maintained as much as possible.
A carefully formulated raw diet can be highly effective at supporting quality of life in CKD dogs. Care must be taken however, to take into account the specific nutritional needs dictated by each stage of the disease, and the individual requirements of each pet. Adjusting the amount of phosphorus in the diet for example, is just one piece of the jigsaw to consider. Increasing levels of B vitamins, essential fatty acids and ensuring only the highest quality protein is fed, is equally important, if not more so. And giving supplements and remedies known to aid and protect renal health, adds another dimension of support which is important for the best possible outcome. Such an approach requires significantly more work compared to feeding ‘ready made’ renal foods, but the individualisation and ability to adjust the diet in response to how CKD affects a particular dog, frequently offers the greatest rewards.
What do dog owners need to look out for when it comes to protein and phosphorus levels? And should dogs with this disease be fed one protein?
For the first part of this question, see the previous answer above.
Feeding a consistent diet is best, as this makes it easier to assess the impact of nutrition on a pet. Adjustments can then be made to achieve the best possible results.
A single protein is the simplest way to do this, but different sources can be combined (meat and eggs, for example), as long as they are all high quality, and the proportions are kept fairly constant.
Are fruit and vegetables a good idea for dogs with kidney disease?
A small amount of organic vegetables added as a topping or given as a treat is fine. Large quantities however, risks lowering nutrient content to a level which adversely affects kidney function and body condition.
It’s also important to be aware that most fruit and vegetables used in commercial pet foods (processed and some raw) are not organic. Consequently, many of these contain chemicals which can be harmful to the kidneys. This was highlighted recently in a report by the Pesticide Action Network called ‘Food For Thought’ which found 123 different pesticide residues in a wide range of produce. Feeding non-organic fruit and vegetables therefore (or pet foods including these in their ingredients) risks causing further damage to already compromised kidneys.
What can dog owners do to help stop weight loss?
Appetite is often suppressed when kidney disease is present. It is important therefore to feed energy rich, highly nutritious, easy to digest food, which delivers the maximum amount of nourishment in every mouthful. For those choosing a raw or home-cooked diet, this means placing an emphasis on lean meats, eggs, high quality fish oil, nutrient dense natural supplements and non-protein sources of extra calories, such as organic, cold-pressed, virgin coconut oil.
What are the main differences in the various stages of kidney disease?
Kidney disease is often characterised as acute or chronic.
Acute is where there is sudden and often severe impairment of renal function. Ingestion of a poison, a blockage in the urinary tract, a blow to the kidneys or an infection for example, can all cause this. Here treatment should address the underlying cause as quickly as possible, to limit the extent of any damage and reduce the risk of CKD occurring subsequently.
Chronic kidney disease on the other hand, typically occurs over a much longer time frame (which can be many years). Here there is a progressive loss of healthy renal tissue, to the point where the kidneys are unable to filter blood effectively. This typically results in a build up of waste products in the body, which cause many of the signs associated with kidney failure, such as:
- raised blood levels of SDMD, creatinine and BUN
- an increased thirst
- more frequent urination
- loss of appetite
- weight loss
- deterioration in body condition
- a sore mouth
- bad breath
- a tendency to vomit or regurgitate food
- fluid and / or electrolyte disturbances
Treatment for CKD is focused on supporting continued renal function and alleviating the toxic effects of increased nitrogenous waste in the body.
How big a part does dental hygiene play in kidney disease in dogs?
Huge. Over 75% of dogs suffer from naturally occurring periodontal disease, which is associated with the development of chronic renal failure. Maintaining healthy teeth and gums therefore, significantly reduces the risk of kidney damage being caused by bacteria and toxins entering the bloodstream through inflamed gums, particularly at mealtimes.
Regular brushing with a natural toothpaste (made from Vince the Vet Immunity and organic coconut oil) and the provision of natural chews (e.g. air dried strips of meat), help to keep teeth and gums healthy.
Vince the Vet can provide an individually tailored, kidney support regime upon request.