Kidney disease, or kidney failure in dogs and cats requires comprehensive attention to multiple aspects of their health. The primary objective of renal therapy—whether dietary or otherwise—is to prevent or delay the onset of advanced uremia (poisoning by toxins that the kidneys can no longer adequately remove) and to enhance both life expectancy and quality of life. Diet plays a crucial role in achieving these goals, and fortunately, there are commercially available diets specifically designed for renal patients.
Why Use Diet as Therapy for Renal Failure in Dogs and Cats?
The concept of using diet to manage renal failure, also known as kidney disease, involves modifying the pet’s diet to correct or mitigate the toxic metabolic state induced by kidney failure. By adjusting the diet, we can correct imbalances, slow the progression of the disease, and maintain healthy muscle mass and body condition.
One notable study tracked 38 dogs with kidney failure over two years and found that dietary therapy reduced the risk of death by 69% compared to dogs that continued eating regular dog food. Another study showed that starting a renal diet when the creatinine levels were between 2.0 and 3.1 delayed the onset of uremic crisis by five months.
Similarly, a study of 50 cats with stable, naturally occurring renal failure found that those on a renal diet survived more than twice as long as those on regular food.
These studies highlight the significant survival and quality of life benefits for renal patients on specialized renal diets compared to those on regular maintenance diets.
Renal Diet vs. Regular Diet
A renal diet is tailored to reduce uremic toxins, control high blood pressure, balance calcium and phosphorus levels, maintain proper potassium levels, and reduce inflammation. There are some key features of a renal diet and their importance:
Phosphorus restriction
Potassium supplementation
Omega-3 fatty acids
Protein restriction
Phosphorus Restriction in Food for Dogs and Cats
Phosphorus balance is crucial in renal food for dogs and cats. Excess phosphorus can exacerbate kidney damage in dogs and cats with CKD. Phosphorus is absorbed through the diet and excreted via the kidneys. In cases of poor kidney function, phosphorus is not adequately removed, leading to an imbalance. Reducing dietary phosphorus can help maintain normal blood phosphorus levels. Sometimes, medications like phosphate binders are needed to further reduce intake. Restricting dietary phosphorus has been shown to slow the progression of renal disease.
Potassium Supplementation
In chronic kidney disease, potassium is not conserved properly and can become depleted. Severe potassium depletion affects the pet’s muscle strength, energy, and overall quality of life. Potassium supplements, in the form of oral gels or powders, may be necessary, though ideally, potassium should be supplemented through the diet to minimize medication.
Omega-3 Fatty Acids
Studies suggest that omega-3 fatty acids can extend the life of kidney failure patients. As a result, most renal diets now include fish oils. The full benefits of fatty acid supplementation are still being researched.
Other dietary features include B vitamin supplementation (to replace the excess lost by damaged kidneys) and non-acidifying features to help control acidosis.
Protein Restriction
Renal toxins are often byproducts of protein metabolism. Thus, reducing dietary protein can lessen the kidneys' workload. The extent of protein restriction depends on the severity of the kidney disease, as there is a minimum protein requirement for maintaining body condition. Balancing protein restriction is complex, requiring a balance between reducing protein intake and maintaining palatability and necessary amino acids.
When to Start a Renal Diet for Dogs and Cats?
This has been a controversial topic. Changing to a less palatable diet too soon can reduce a pet’s quality of life, but waiting too long can make the pet less willing to accept the change. The International Renal Interest Society (IRIS) now recommends starting a renal diet by IRIS Stage II (creatinine test between 1.6 mg/ml and 2.8 mg/ml with an SDMA test between 18 & 25 in cats; creatinine test between 1.4 mg/ml and 2.8 mg/ml with SDMA test of 18 & 35 for dogs).
This early intervention allows pets to acclimate to the new diet and benefit from its preventive advantages.
Can I Feed My Other Healthy Cat or Dog the Renal Diet?
Diet Sharing: It’s generally safe for a healthy cat or dog to eat renal food, but it’s best to provide a balanced diet suitable for their needs. While occasional consumption of renal food by a healthy cat is not harmful, they should primarily eat food formulated for their health requirements to ensure they receive all necessary nutrients.
What if My Dog or Cat Will Not Eat the Renal Diet?
Pets with insufficient kidney function often feel unwell and may resist bland food. Here are some tips to increase acceptance of a renal diet:
Ensure the Pet Feels Well: Use medical treatments to improve the pet's overall health before changing diets.
Make Food Accessible: Place the food where the pet can easily reach it.
Offer a Variety of Renal Diets: There are many renal diets available in different textures and flavors. Your veterinarian can help you find an acceptable option.
Use Appetite Stimulants: Medications like capromorelin, mirtazapine, or cyproheptadine can enhance hunger and encourage eating.
How Long Does It Take to See Benefits from a Renal Diet?
Some pet owners notice improvements within a few weeks, but this can vary. Regular check-ups with your vet are crucial to track your pet’s response to the diet and make any necessary adjustments.
Managing chronic kidney disease in pets through diet is a well-researched and effective approach. Early intervention and adherence to a renal diet can significantly improve the quality of life and longevity of pets with kidney disease.
Cat Treats for Kidney Disease
Low Protein Cat Food
Treats for cats with kidney disease should also follow the low-protein and low-phosphorus guidelines. Many renal diet brands offer treats specifically formulated for cats with CKD. Ensure that any additional treats given do not counteract the benefits of the renal diet.
Bone Broth for Cats
Bone broth can be a nutritious and hydrating treat for cats with kidney disease. It provides additional fluids and can be a source of minerals and collagen. However, ensure the bone broth is free from added salts, onions, and garlic, which can be harmful to cats.
Not Sure If Your Fur Baby Needs Renal Diet? We Can Help!
If your beloved fur baby has CKD, or you are unsure of when to start a renal diet, Dr. Terry White at EverPal can give expert guidance, available after regular clinic hours. We can help provide the care your fur baby needs when you need most.
Schedule a same-day virtual visit with Dr. Terry White at EverPal.
Consultations are currently available only for residents and pets living in California.
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