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Managing Chronic Kidney Disease Holistically (Part 3)

shutterstock653789644.jpgBy Sarah Griffiths, DCH

June 4, 2018

We’ve been talking about chronic kidney disease (CKD) - how it can be prevented and some new research that’s come to light on the nutrition front. If you missed the first two parts in our kidney disease series, you can find them here:

Help Us Stop the Kidney Disease Epidemic (One Meal at a Time)

Why Kidney Diets Don’t Work

We often get asked: What do I feed my pet if he/she is diagnosed with chronic kidney disease?

Now it’s time to talk about what your options are when your pet is diagnosed with kidney disease and how you can manage it with holistic strategies. Often, it takes time to find a balance and a treatment plan that works for your pet. This should always be done with the knowledge and assistance of your veterinarian.

Let’s look at some simple and effective options in terms of nutrition.

Hydration, Hydration, Hydration

We sometimes forget that water is an essential nutrient. Animals that eat a fresh food diet will naturally consume large amounts of moisture with their food. This keeps them fully hydrated throughout the digestive process. As discussed in Part 1 of this series on kidney disease, dry food diets leave the animal temporarily dehydrated making them thirsty. Pets with kidney disease do best with high-moisture foods such as raw or canned food. Your veterinarian may also recommend regular fluid therapy, depending on the severity of your pet’s disease.

Understand How to Properly Feed Your Pet Protein

Conventionally, a high-protein diet is considered to be a negative course of action when it comes to feeding pets with kidney disease. Protein waste products are processed by the kidneys. The idea behind reducing dietary protein is to decrease the workload of the kidneys. Fresh meat/carnivore diets contain a much higher protein level than conventional processed diets and this precipitates the myth that they are harmful for pets with kidney disease. However, protein content is only one of the many factors that you need to consider for pets with chronic kidney disease.  Dogs and cats need protein to survive and limiting protein in their diet will mean that their body will begin to consume protein in the muscles, leading to other health complications.

There are 3 things to consider when it comes to protein in your pet’s diet:

Protein Quality

Protein quality will greatly affect how it’s processed in the body. If you’re feeding fresh forms of protein that are biologically appropriate (e.g. meat), this will help to reduce the workload of the kidneys. This is because there will be less protein waste products circulating in the body which will be reflected in your pet’s blood urea nitrogen and creatinine levels.

Protein Quantity

The stage (1-4) of kidney disease of your pet’s diagnosis will determine how much protein to feed. You can adjust a raw diet to suit any stage of kidney disease by adjusting the protein/ veggie ratio and by adding a variety of appropriate foods to the diet.

Moisture Level

The more hydrated an animal is, the easier it is for the kidneys to excrete protein wastes. It’s imperative that your pet stays hydrated at all times to maintain the most efficient level of kidney function possible.

In conclusion, while raw diets may have a higher protein content, the quality of that protein and its natural water content is actually more effective for kidney disease diets than heavily processed, low-protein diets.

Calcium and Phosphorus Levels in the Diet  

It’s important to ensure that phosphorus levels are kept to a minimum for pets with chronic kidney disease. The kidneys are responsible for removing excess phosphorus in the body and this function is reduced when the kidneys are not working correctly. 

It’s also important to keep an eye on dietary calcium levels since these two minerals interact closely and too much dietary calcium or phosphorus can cause high levels in the blood which can result in serious health complications. Blood tests can be used to help establish dietary guidelines for your pet. If you’re not sure how to achieve a raw diet, we can help.

Sodium and Potassium in the Diet

Dietary sodium is often restricted for animals with renal disease since it can dehydrate the body, cause imbalance of electrolytes, and contributes to pulmonary hypertension - a complication of kidney dysfunction. Potassium levels can become depleted in CKD patients due to an increased urine output and a reduced intake of food. Potassium supplementation may be recommended.  These foods are naturally high in potassium and we recommend feeding them in rotation:

  • Wild-Caught Salmon (canned salmon can perk up the hunger of pets who’ve lost their appetite)
  • Acorn and Butternut Squash
  • Spinach
  • Sweet Potato
  • Swiss Chard

Chronic Kidney Disease Supportive Foods and Supplements

Omega 3 Fats

Omega 3 fatty acids are essential for reducing kidney damage by reducing the inflammation of kidney tissues.

It’s crucial to include a balanced ratio of omega 3 and 6 fatty acids in order to reduce kidney stress. Foods that are high in both omega 3 and 6 fatty acids include:

  • Whole Fish (raw herring, salmon, canned sardines - no salt)
  • Freshly Cold-Pressed Fish Oils
  • Flax Oil and/or Ground Flax Seed
  • Krill Oil

Vitamin B Complex

When pets have kidney disease, their urine output is often higher which depletes B vitamins. It’s important to ensure that your pet is getting enough B complex vitamins. There are several whole food options that can help, along with natural-source B-vitamin supplements that might be useful.

The following whole foods provide B vitamins in a naturally occuring form for your pet:

  • Liver
  • Fish
  • Poultry
  • Red Meats
  • Eggs
  • Raw Goat’s Milk

We recommend feeding a variety of these foods in rotation. Your veterinarian may also recommend vitamin B injections in specific cases.

VITAMINS C and E

Vitamins C and E act as antioxidants that help to reduce inflammation and therefore slow down the damage caused by kidney disease. Supplements can be used to increase concentration of these nutrients in the body to reduce or slow down oxidation (damage) of kidney tissue... and here is a list of foods that contain high levels of them:

Vitamin C

This is a water-soluble vitamin, meaning the body will use what it needs and the rest will be excreted from the body via the urine.  

  • Raw Liver
  • Broccoli
  • Kale
  • Parsley
  • Strawberries
  • Blueberries
  • Sweet Potatoes

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Vitamin C Supplementation

Vitamin C can be used in high doses as a therapy, on top of adding natural sources of it. Check with your vet to see if this might be a good option. Your vet can help you to determine how to gradually increase the vitamin C in your pet’s diet and how much your pet should get.

Vitamin E

This is a fat-soluble vitamin that can be overused if given as a supplement. Fat soluble vitamins are stored in body fat and can reach toxic levels if fed in very high amounts. It is uncommon to see vitamin E toxicity if you are just using food to provide vitamin E.

  • Ground Seeds and Seed Oils: sunflower, hemp, pumpkin and sesame.
  • Coconut Oil
  • Almonds (best given in a ground format to pets)
  • Swiss Chard
  • Mustard Greens
  • Spinach
  • Turnip Greens
  • Kale
  • Broccoli
  • Parsley

Vitamin E Supplementation

Vitamin E can be useful to add in concentrated forms, but this should always be done with the assistance of a veterinarian and/or animal nutritionist. Ask your holistic vet about how vitamin E supplementation might work for your pet.

There are many roads to Rome when it comes to feeding a pet with chronic kidney disease. It’s important to have all of the facts and to discuss things thoroughly with your holistic vet to ensure that you’re on the right track with your diet planning. Most pets with CKD will need regular blood testing to check kidney function and blood mineral content. Lab work will help you to track your pet’s progress and to give a clear guideline on how to manage the disease. For more specific dietary planning, please visit our website to request a detailed feeding guide. We’re always here to help.