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Sample Homemade Diet for Dogs with Early to Moderate Stage Kidney Disease

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Disclaimer: I am not a veterinarian, nor do I have any formal training in any medical field. The information presented here is not meant to replace your vet's advice or prescribed medications, but only to suggest additional options to explore, based on your dog's condition.


Introduction

Getting Started

See Diets for Management of Chronic Renal Disease in Dogs for some quick and easy recipes to help you get started. These recipes are low in protein (a little below the minimum of 1 gram of protein  per pound of body weight daily), and the amount of phosphorus is suitable for dogs with late-stage kidney disease (dogs with early-stage kidney disease can have more). The recipes rely on the addition of a “multiple vitamin mineral tablet” to supply nutrients (make sure it doesn’t have much phosphorus). Some recipes use chicken breast plus chicken fat, but it’s easier to just feed dark meat chicken with skin (amounts fed must be increased a little in that case).

Be sure to add calcium as stated in the recipes. It's also best to add fish oil, which helps dogs with kidney disease. See Supplements Recommended for Dogs with Kidney Disease for more information.

Warning: The recipes on the website above are taken from Dr. Strombeck's book, Home-Prepared Diets For Dogs and Cats. An updated version of this book by Patricia Schenck is available, but it contains a terrible error: it says to use baking soda to provide calcium. Baking soda is not the same as calcium carbonate! If you use the recipes in the new book, be certain to use calcium carbonate, not baking soda.

As a general guideline for dog with early-stage kidney disease, who does not have protein in the urine, you want to feed about half meat and half low phosphorus grains, pasta and veggies, with additional eggs and egg whites, small amounts of liver and kidney, and small amounts of high fat, low phosphorus extras like butter, whole milk yogurt, and heavy whipping cream, as long as your dog has no problems tolerating fat. The percentage of meat should decrease, and the percentage of carbohydrates should increase, for dogs with moderate kidney disease in order to reduce phosphorus levels still further. Dogs with significant amounts of protein in their urine should get less protein (1 gram per pound of body weight daily -- this refers to grams of protein from a nutritional analysis, as shown in the tables below, not grams of meat).

Here is a sample diet for a 40 lb dog. Amounts shown are for about one pound (two cups) of food, plus a couple of extras, which should be about right for an inactive 35 to 40  lb dog, though individual dogs will vary. Note that 8 ounces by weight is approximately 1 cup of food, but this will vary depending on how tightly packed the food is. Compare the mg of phosphorus per 100 kcals (73) to the amount in Hill's k/d (57) and notice that there is very little more phosphorus in this diet while providing much more (and higher quality) protein, which is beneficial for dogs with kidney disease as long as phosphorus is limited.

Note that the meats in this diet are raw. If you prefer to cook the meats, the nutritional values will change somewhat based on how it is cooked and whether you preserve the fat. See Nutrition Data for nutritional details about cooked foods.

There are additional sample recipes for dogs of various sizes in the K9KidneyDiet Files section, but you'll need to join the group in order to access them.

SAMPLE DAILY DIET for Early to Moderate Kidney Disease
Amount Fed Protein
(Grams)
Phos
(Mg)
Calories Phos mg/
100 kcal
Meat 6 ounces (3/4 cup) 28.8 276 355 78
Grains and Veggies  6 ounces (3/4 cup) 4.1 51 153 35
1 Large Egg + 1 Egg White 3 ounces 9.9 101 91 111
Liver/Kidney 1 ounce 4.5 76 32 238
Extras 1 ounce 0.7 19 87 22
Totals 17 ounces 48 523 718 73

Supplements:

YOU MUST ADD 1/2 TEASPOON GROUND EGGSHELL (or 1,000 mg plain calcium) PER POUND OF FOOD FED TO EACH MEAL. This is so the calcium will act as a phosphorus binder, not just to balance out the calcium:phosphorus ratio. Do not add calcium if it is elevated in your dog's blood work (ask your vet about using other calcium binders instead). If you do not want to use ground eggshell, you can use other forms of calcium instead (see Phosphate Binders for more information). Never use bone meal as a source of calcium, as it contains high amounts of phosphorus.

Fish Oil is another important supplement. You should  give 1,000 mg fish oil (body oil, not liver oil) per 10 lbs of your dog's body weight daily. The omega-3 fatty acids in fish oil help protect the kidneys and are one of the best things you can do for a dog with kidney problems.

Other supplements that may be helpful are Vitamin B-Complex, and small amounts of Vitamins C and E. Don't add Vitamin D (or cod liver oil) beyond minimum amounts to dogs with kidney problems unless directed to by your vet. It is also best to avoid supplementing with large amounts of Vitamin A as well unless in the form of beta carotene.

You can also add small amounts of kelp and alfalfa, or something like Berte's Green Blend. These supplements should be used sparingly, as kelp contains sodium and alfalfa can act as a natural diuretic. Using them once or twice a week may be preferable to daily, especially if your dog has moderate to severe kidney disease, or has high blood pressure. Note that a home made diet is naturally low in sodium, unless you add salt or use high sodium prepared foods (including cottage cheese).

Another option

In place of the above, you could use a supplement called Fresh + Oasis Canine, designed to balance out an all-meat diet. This supplement contains a small amount of phosphorus (31.5 mg minimum per 3.5 gram scoop, according to the nutritional analysis they provide). I'd give a little less than they advise in order to keep the amount of phosphorus you're adding low -- for example, they advise adding 3 scoops for dogs weighing 30-39 pounds and 4 scoops for dogs weighing 40-49 pounds, but you should be OK using one scoop less for each of those categories (2/3 to 3/4 the amount shown). This supplement contains plenty of calcium; no need to add more, but I would still add fish oil.

Feeding Instructions

Adjust the amount of food fed as needed for the size of your dog, remembering that smaller dogs generally need more food per pound, while larger dogs on average need less (for example, a 20 lb dog would probably eat a little more than half the amounts shown, while an 80 lb dog would eat a little less than twice the amounts given). 8 ounces is about 1 cup of food. Keep an eye on your dog's weight, and increase or decrease the amounts if you see unwanted weight loss or gain.

This diet can be fed cooked or raw (except for the cereal, rice and sweet potatoes, which should be cooked). If you do cook it, light cooking is better than overcooking. You can break the diet down into two or three meals a day (you can also feed just one meal a day, but it is supposed to be easier on the kidneys to feed multiple smaller meals). You can mix the foods together, or feed them separately, depending on what your dog prefers and what is easiest for you.

Nutritional Analysis

The diet shown here, for a 40 lb dog, would provide 1.2 grams of protein and 13.8 mg of phosphorus per pound of body weight. For comparison purposes to prescription kidney diets, it is about 0.41% phosphorus on a dry matter basis. As fed, this diet contains 9.9% protein, 10.5% fat, 6.7% carbohydrates, 0.5% fiber, 0.7% ash, and 72.6% moisture (based on the USDA Nutrient Database).

You should feed a minimum of 1 gram of protein per pound of body weight daily (more is fine as long as your dog does not have protein in the urine). This measurement is from a nutritional analysis, as shown in the tables above and below, not grams of meat. Phosphorus restriction varies according to the degree of kidney disease. For early stage, 20 mg phosphorus per pound of body weight daily is a good goal. For dogs with elevated phosphorus, or late stage kidney disease (creatinine over about 4.0 mg/dL, or 354 µmol/L), this should be reduced to 11 mg per pound.

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Ingredient Details

Here is more detail on the individual ingredients, and what was used to compute the numbers above:

MEAT

For lowest phosphorus, use high fat meats, such as lamb, pork, and high fat hamburger, but it is also good to include some heart in the diet. Dark meat chicken and turkey are higher fat than light meat, and the skin is where most of the fat resides, so include it if possible when you feed chicken and turkey. Tripe can be used in this category, it is lower in phosphorus than most meats. It is OK to use more eggs and egg whites (use a ratio of one or more egg whites to each whole egg) in place of some of the meat. Small amounts of high fat cottage cheese and canned fish (Jack Mackerel, Pink Salmon or Sardines packed in water -- drain and rinse the fish if sodium is a concern) are also OK, but do not use cottage cheese if your dog has high blood pressure. Feeding a variety of foods is better than feeding just the same thing all the time, both for nutritional purposes, and because your dog will be less likely to tire of the diet, but if there are foods your dog won't eat, it's OK to avoid them.

SAMPLE HIGH FAT MEATS (Raw)
Amount Fed Protein (Grams) Phosphorus (Mg) Calories Phos mg/
100 kcal
Ground Beef (20% Fat) 6 ounces 29.3 269 432 62
Ground Lamb 6 ounces 28.2 267 480 56
Ground Pork 6 ounces 28.7 298 447 67
Ground Turkey 6 ounces 29.8 265 253 105
Chicken (dark meat and skin) 6 ounces 28.4 231 403 57
Beef Heart 6 ounces 30.1 360 182 198
Green Tripe 6 ounces 26.9 238 284 83
Average 6 ounces 28.8 276 355 78

GRAINS and VEGETABLES

Use only low phosphorus grains and vegetables. You may add the extras (butter, heavy whipping cream and yogurt -- see below) to the grains and veggies for added flavor -- you can also try low or no sodium gravy or broth. Winter squashes are the hard bodied ones, such as Acorn Squash, Spaghetti Squash, and Butternut Squash. You may want to alternate between the suggestions below so that your dog doesn't get tired of always eating the same thing, but it is OK to use only the ones your dog likes.

SAMPLE LOW PHOSPHORUS GRAINS AND VEGETABLES (Cooked weights)
Amount Fed Protein (Grams) Phosphorus (Mg) Calories Phos mg/
100 kcal
Cereal (Malt-o-Meal) 6 ounces 2.6 17 87 20
White Rice (short grain) 6 ounces 4.1 56 221 25
Sweet Potatoes (boiled) 6 ounces 2.4 54 129 42
Winter Squash (baked or boiled) 6 ounces 1.5 32 63 51
Macaroni 6 ounces 9.7 97 265 37
Average 6 ounces 4.1 51 153 35

EGGS

Use at least one egg white per each whole egg you feed, for lower phosphorus (most of the phosphorus is in the yolks, but eggs are such nutritious foods that it's good to feed at least some whole eggs).

SAMPLE EGGS (Raw)
Amount Fed Protein (Grams) Phosphorus (Mg) Calories Phos mg/
100 kcal
1 medium egg 1.5 ounces 5.5 84 65 129
1 medium egg white 1 ounce 3.1 4 15 27
1 large egg  1.75 ounces 6.3 96 74 130
1 large egg white 1.2 ounces 3.6 5 17 29
1 extra-large egg  2 ounces 7.3 111 85 131
1 extra-large egg white 1.3 ounces 4.2 6 20 30

ORGAN MEATS (LIVER and KIDNEY)

Although these foods are high in phosphorus, they also have a lot of vitamins and nutrients and are good to feed in small amounts. It is not necessary to feed them every day, but don't feed large amounts at one time, as too much can lead to loose stools. Although liver is easier to find, try to include some kidney in the diet if possible.

SAMPLE ORGAN MEATS (Raw)
Amount Fed Protein (Grams) Phosphorus (Mg) Calories Phos mg/
100 kcal
Beef Liver 1 ounce 5.8 110 38 289
Chicken Liver 1 ounce 4.8 84 34 247
Beef Kidney 1 ounce 4.9 73 28 261
Lamb Kidney 1 ounce 4.5 70 28 250
Abady Kidney (canned) 1 ounce 2.7 44 33 133
Average Liver/Kidney 1 ounce 4.5 76 32 238

EXTRAS

Add low phosphorus, high fat foods for extra flavor and calories without adding much phosphorus. Butter (use real butter, not margarine -- use unsalted if your dog's blood pressure is high) and heavy whipping cream are great for adding flavor to rice, cereal and vegetables, but they're high in fat, so use sparingly. Whole milk yogurt is higher in phosphorus, but is still good for variety in small amounts. Beef fat and bacon grease could also be used, again in very small amounts, to add flavor without too much fat. Be careful when increasing fat in your dog's diet, as too much fat can lead to loose stools and sometimes even pancreatitis, in dogs that are prone to it. Increase amounts gradually, and back off right away if you see signs of problems, such as discomfort after eating, or any vomiting or loose or mucousy stools.

SAMPLE EXTRAS
Amount Fed Protein (Grams) Phosphorus (Mg) Calories Phos mg/
100 kcal
Butter 1/2 ounce 0.1 3 102 3
Heavy Whipping Cream 1 ounce 0.6 18 98 18
Whole Milk Yogurt 1 ounce 1.0 27 17 158
Average Extras 1 ounce 0.7 19 87 22

To reduce phosphorus even further, feed more egg whites and fewer whole eggs, feed less organ meat (liver and kidney), and feed a little more cereal/rice/sweet potatoes and a little less meat. Compare the calories to the amount of phosphorus to look for the lowest phosphorus amounts per calorie -- those marked in green are the best foods for low phosphorus, while those marked in red have the highest amount of phosphorus per calorie. However, they are still important foods to feed for nutritional purposes, unless your dog is in end stage renal failure.

For more recipe suggestions, see Diet for Kidney Needs

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If you have any questions or comments, you can contact me, but I have less time to answer questions than I used to, and it may be several days to a week before I can respond. My name is Mary Straus and you can email me at either or

   


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