The dreaded kidney disease. It seems that every dog owner has experienced this at some point. Is this an inevitable disease of aging in dogs? Is there nothing we can do about it?
What is CKD and what causes it?
Canine Kidney Disease or “CKD” is also known as Chronic Canine Kidney Disease, Canine Renal Disease, Kidney or Renal Insufficiency or Chronic Kidney Failure. It affects 1 in 10 dogs, with some studies indicating the number of affected dogs to be much higher – up to 25% (1,2).
CKD refers to a chronic (degenerative) disease, rather than acute kidney failure, which results from a sudden injury to the kidneys. While dogs of any age may experience acute renal failure; chronic CKD is generally thought to be a disease of aging pets; as the kidneys age, functions degenerate. Diet can also influence the progression of CKD, and studies suggest that dietary factors can trigger the onset of renal failure, which may cause initiation of the disease in non-seniors, especially in predisposed dogs (3).
Historically, high protein levels in canine diets were blamed for both onset and progression of the disease and the prescribed dietary management of CKD and its prevention consisted of feeding a low protein diet to senior canines, often leading to increased lean muscle loss. More recent research suggests that the Phosphorus content of the diet is the main contributor to both development and progression of CKD, with sodium possibly having a worsening effect (4) and that protein reduction should only be prescribed in the late stages of CKD to help alleviate symptoms.
How do I know if my dog has CKD?
Previously, CKD was usually not diagnosed until clinical signs appeared, or when kidneys have lost most of their function. Today, early detection - as early as IRIS stage 1 (5) - is possible with improved laboratory analysis.
Can I prevent my dog from developing CKD?
A dog’s kidney function will naturally decline with age, but this doesn’t mean there is nothing to be done! Dietary intervention for early-stage CKD (IRIS stage 1-2) can prevent the progression of the disease. Even dogs in later stages will benefit; diet changes can improve quality of life and survival. My own belief is that we can avoid or at least forestall the disease by protecting the kidneys. This means not overproviding phosphorus to adult dogs and ensuring omega 3 and antioxidants in the diet are optimized from the beginning.
What types of diet changes are indicated for a dog with CKD?
Early stages:
Reduce dietary phosphorus and sodium - avoid diets formulated for “All Life Stages”; avoid commercial treats (high in sodium); avoid excess raw meaty bones (RMB’s)
Increase omega 3 fatty acids and antioxidants to protect the kidneys.
Feed a diet for adult maintenance and feed within the feeding guidelines on the package for your dog's weight (do not feed in excess). Or, feed a properly formulated homemade diet with correct levels of nutrients specific to your dog.
Late stages:
Further restriction in dietary phosphorus and sodium
Reduce protein.
Decrease Omega 6:3 ratio to around 1:1 and add appropriate antioxidant support.
Feed a prescription renal diet or properly formulated homemade diet specific to stage of disease and individual dog (not a free internet recipe).
Conclusion.
Proper dietary intervention is important in the avoidance or delay of clinical disease and can contribute to quality of life and survival for your CKD dog. A well formulated homemade diet can help overcome inappetence and provide precise nutrient delivery for a CKD dog at any state of the disease – this service is provided at Food for Fen.
Want a deeper dive into CKD? Head on over to the Clients-only site for a nerdier post on the subject. Not yet a client? Book any service, even a 30-minute phone consultation for unlimited access to the site that never expires.
References:
1.Littman, M. P. (2017) Genetic basis for urinary tract diseases. In BSAVA Manual of Canine and Feline Nephrology and Urology, 3rd ed, BSAVA (eds Elliott, J. et al.) 172–184.
2.O’Neill, D. G. et al. (2013) Chronic kidney disease in dogs in UK veterinary practices: Prevalence, risk factors, and survival. J. Vet. Intern. Med. 27, 814–821.
3., 4. Robertson, F. (2022) Development and Progression of Renal Disease – Minimizing Risk: Phosphorus in Commercial Dry Food Labeled for Senior Dogs. Unpublished. CASI (2022). Available in the Files section of the Clients Only Site.
5. IRIS Kidney - Guidelines - IRIS Staging of CKD. (n.d.). http://www.iris-kidney.com