Chronic Kidney Disease (CKD) in Dogs

At the mention of kidney disease, most people would immediately think of restricting their dog’s protein intake. Many still believe that a low protein diet is the answer to managing dog kidney disease.

Latest evidence suggests that phosphorus restriction plays a larger role in preserving kidney function and extending survival, while severe protein restriction can risk loss of lean body mass and quality of life. Today, many veterinarians will agree that a low protein diet is not necessarily the best nutrition plan at an early stage kidney disease. High-quality, highly digestible protein is preferred, rather than simply minimizing total protein.

All dogs with CKD must be closely monitored with regular vet visits. I bring my dog to the vet every 6 months for follow-up health checks and blood works. It is highly recommended to see the vet every 4 to 6 months.

Depending on the progression of the disease, and should signs of uremic is observed, then protein restriction becomes necessary. Moderate reduction of protein intake can decrease production of nitrogenous waste products, lowering the risk of uremic symptoms and some clinical signs.

On the other hand, phosphorus level must be carefully controlled even at an early stage.

Role of Phosphorus Restriction

Studies have shown that lowering dietary phosphorus is directly associated with a longer period of stable kidney function and improved clinical outcomes.​ Limiting phosphorus intake helps maintain stable glomerular filtration rate (GFR) and prolongs the survival of dogs with CKD.​

Also, elevated phosphorus leads to hyperparathyroidism and renal damage, accelerating kidney disease progression.​

Prescription renal diets for dogs often focus on phosphorus reduction as a central feature.

Why I Choose to Homecook My Dog’s Renal Diet

Firstly, the Prescription Renal Diet recommended to us was a dry kibble diet. As a nutritionist, I wasn’t comfortable feeding my pup a dry diet, knowing that moisture is critically important for dogs with kidney disease. Adequate hydration helps flush toxins from the body. Dogs with CKD are prone to dehydration, which can worsen kidney function and accelerate disease progression, making water intake a key part of management.

I prefer a wet diet.

On top of that, my dog won’t eat the prescription renal diet. She has always been on a fresh, cooked diet and she wanted her fresh cooked food.

So, I decided to formulate a complete and balanced (according to AAFCO nutrition guidelines) diet that is also lower in phosphorus content (around 0.6%), and has a therapeutic omega-6 to omega-3 ratio of not more than 3:1. The omega ratio is important to ensure that the overall diet is non-inflammatory.

Kidney patients (both people and pets) tend to be inflammatory due to a combination of factors including accumulation of toxins, oxidative stress, and impaired immune response. This chronic, low-grade inflammation is linked to complications such as cardiovascular disease, muscle atrophy, and other morbidities.

The Recipe

IMPORTANT: Please know that this recipe is suitable only for adult and senior dogs, with early stage kidney diseaase (stage 1 - 2), with no signs of uremia, and have no history of recurring pancreatitis.

This is a beef recipe, so if your pup is allergic or sensitive to beef or any of the ingredients used here, please do not feed this recipe.

And, if your pup is in a more advanced stage of the diseases or are experiencing multiple conditions, it is best to consult a Veterinary Nutritionist or a Pet Nutritionist for a customized diet.

If you require any assistance, you are welcome to contact me on my about.me page.

Recipe and the macronutrient analysis below.

On how much to feed, this recipe is 1498 kCal per kg. You can use this formula below to calculate your dog’s caloric requirements to determine how much food to feed.

First, calculate the Resting Energy Requirement (RER) by using the formula:

RER = 70 X [(body weight in kg) ^ (0.75)]

Then, multiply your dog's RER by a factor based on their specific needs to get the MER (Maintenance Energy Requirement). Commonly used multipliers:

• Neutered adult: 1.6

• Intact adult: 1.8

• Active/working dog: 2.0 to 2.5

• Weight loss: 1.0

• Weight gain: 1.7

• Growth (under 4 months): 3.0

• Growth (over 4 months): 2.0

Example, if I have a 10kg neutered dog, the calculation would be:

Step 1: Calculate RER
RER = 70 x [10 ^ 0.75]
RER = 393.64 kCal per day

Step 2: Calculate MER
MER = 393.64 X 1.6
MER = 629.82 kCal per day
So, my dog will need 629.82 kCal per day

Step 3: Calculate the amount of food to feed
1 kg (1000 gram) of this dog food = 1498 kCal
My dog only needs 629.82 kCal per day. This means I need to feed about 420 grams of food daily. This amount can be divided into several smaller portions.

You are welcome to give this recipe a try, and feel free to contact me on my about.me page if you need any clarification.