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Maggie asked me to summarize a post I did recently regarding kidney disease.

My previous Maltese, Austin, was diagnosed with chronic kidney disease at the age of 10. We later learned that it was not *chronic* kidney disease but rather acute kidney injury due to an adverse reaction to NSAIDs, specifically Metacam (Meloxicam). I joined a yahoo group called K9KidneyDiet and learned how to homecook for him. My dog eventually recovered from the acute kidney injury and lived another 8 years eventually dying at the age of 18 from natural causes. I would encourage you to learn as much as you can about kidney disease so you can be a better advocate for your dog.

The Hill's K/D and the other prescription kidney diets are VERY high fat and low in protein. A lot of dogs in that Yahoo group, especially the smaller dogs had trouble with the prescription food and some developed pancreatitis due to the high fat levels. Newer research over the past 10 years, has revealed that phosphorus restriction is the most important consideration for kidney disease; not protein restriction. I have found www.Dogaware.com to be very useful and comprehensive.

DogAware.com Health: Kidney Disease in Dogs

Here is an excerpt from the section on dietary guidelines:

Based on research done in the last ten years (see s a Low Protein Diet Necessary or Desirable?), that the only time it is necessary to feed a low protein diet is when your dog is uremic, which generally means BUN is over 80 mg/dL (equivalent to 28.6 mmol/L), creatinine is over 4.0 mg/dL (equivalent to 354 µmol/L), and the dog is showing symptoms such as vomiting, nausea,inappetence, ulcers and lethargy, which are caused by the build-up of nitrogen in the blood. Even then, feeding low protein will not extend life, but it will help the dog feel better. Subcutaneous fluids can also help at this time (and before).

This is one of the most important papers on low protein diets in the treatment of canine kidney disease.
http://www.dogaware.com/files/bovee.pdf

This page summarizes the health tests. DogAware.com Health: Tests used to Diagnose Kidney Disease in Dogs

A 12 hour or longer fast is generally recommended prior to a blood draw to make sure that the test results are not influenced by feeding. Based on my experience with my dog, I found that BUN can vary widely and his was high for a very long time. BUN may be influenced by eating and dogs that are fed higher protein diets have a higher than normal BUN. High BUN alone should not be the basis for a diagnosis of kidney disease.

A complete urinalysis is important in the diagnosis of kidney disease, including looking for signs of infection, protein in the urine and the urine specific gravity (tests for the kidney’s ability to concentrate urine). The urine for USG does not have to be sterile so you can catch the first urine of the day and take it with you to your appointment for bloodwork. I found that a long handled soup ladle worked well for collecting the urine midstream. The rest of the urinalysis is best done by cystocentesis (needle collection directly from the bladder).

I would encourage anyone whose dog has been diagnosed with Kidney disease to join one of the Yahoo K9Kidney groups, especially the K9KidneyDiet as well as thoroughly reviewing the Dogaware website section on kidney disease (Dogaware is Mary Straus' website - she is a frequent contributor to Whole Dog Journal). The K9KidneyDiet moderators stay very up to date kidney disease and have all lived with dogs with kidney disease. They will look at your dog's bloodwork, urinalysis and history and based upon their experience, they will help you determine guidelines for homefeeding your dog. They will also help you if you decide to feed one of the veterinary prescription foods. As the disease progresses, dogs with kidney disease become very fussy about food and often will not eat the same thing day in, day out. This is why it helps to get an early start on homefeeding when your dog is still in the early stages. They will also help with supplements and other things they have found helpful in their own experience. They have files with recipes but the focus is not on *recipes* but rather helping you learn how to work with the nutritional guidelines for your own dog’s stage of health.

I am not a veterinary professional and I would encourage you to find a veterinarian who will collaborate with you on the best approach for your dog. The best advice I was given was to become proactive and learn how to be an advocate for my dog. I was told by someone I respect very much who has lived with multiple kidney dogs to “hit the deck running, get out in front of the disease and don't look back. The disease will someday catch up with us, and it will eventually overtake us, but the more we know, and the more on top of things we stay, the longer we can hold that lead.” There may not be a cure, but there is hope.

Terre
 

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Good Post

:goodpost:This is interesting & Thank you for posting it!

I will read the links when I have more time. I'm interested in finding out the best diet for my Baby. He has healthy kidneys as far as I know {knock on wood!}. Although his last vet visit resulted in our being told Baby has 'alkaline urine' . For about a year I had been feeding a home cooked diet from {justfoodfordogs.com a California company, I made their d.I.Y. meals using their nutrition packets which they shipped to me & then I mixed them into their home made recipes which I made in my own kitchen myself} I stopped making this home made food for Baby when we got the diagnosis of 'alkaline urine'. My vet seemed to think it was his home made JFFD food that was causing it.

I have switched Baby to Stella & Chewy's freeze dried raw & plan to have Baby's urine tested again to see if it has become normal. I am always unsure if I am doing the right thing regarding his food & want to research so thanks for this info . I want to prevent Baby :heart: developing any Kidney problems in the future. I am afraid about the alkaline urine & if anyone knows what is causing it and what it could indicate is wrong I'd welcome any info, thanks in advance! --Sandy
 

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Good info to have on hand. Tink had high BUN numbers this spring when he got his teeth cleaned. The vet told me to lower his protein....which I have don.

His eyesight and hearing are diminishing also, would this be at all related to the kidneys? ....or just old age? not sure how old he is exactly, he was an adult when I rescued him 10 years ago.
 
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