Supplements Recommended for Dogs with Kidney Disease
See Also:
- Kidney Disease in Dogs
- Tests used to Diagnose Kidney Disease
- Diet for Dogs with Kidney Disease
- Overview of Dietary Goals for Dogs with Kidney Disease
- Is a Low Protein Diet Necessary or Desirable?
- Table of Nutritional Values of selected foods
- Sample Homemade Diet for early to moderate stage kidney disease
- Nattie's Story
- Prescription Renal Diets
- Non-Prescription Commercial Diets
- Supplements
- Medical Treatment for Dogs with Kidney Disease
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.
Recommended Supplements
- Fish Oil (body oil, such as salmon oil or EPA oil, not cod liver oil) has been shown to help with kidney disease. Use an amount that provides 300 mg combined EPA and DHA per 10 pounds of body weight daily, preferably split into two doses. Pay attention to the amount that the analysis applies to -- some supplements will show a combined 600 mg EPA and DHA for two gelcaps rather than just one, for example.
- Renal Essentials from Vetri-Science, which contains EPA and DPA (see Fish Oil above), Rehmannia (see below), several of the B vitamins, potassium, plus other beneficial ingredients. Recommended by Dr. Susan Wynn, a veterinary nutritionist I trust. Available from Only Natural Pet Store, Entirely Pets, Holistic Pet Info (see my Shopping page for coupons) and Amazon. Note this product is the same as Kidney Assist for Dogs from Mountain Naturals (available from Amazon) and Kidney Strength for Dogs from US Animal Nutritionals.
- Rx Renal Canine from Rx Vitamins contains a number of whole food supplements, including Rehmannia (see below) and milk thistle, which it says has been shown to protect the kidneys as well as the liver. This brand is often recommended by holistic vets. Available from vets or may be able to find elsewhere, such as Amazon.
- Vitamin E -- excellent for renal dogs and recommended whenever you supplement oils (such as salmon oil). See Vitamin E for my current recommendations on vitamin E supplementation.
- Coenzyme Q10 -- A recent human study indicates that CoQ10 may be helpful for renal disease. It is an antioxidant and should be quite safe. The ubiquinol form appears to be absorbed better than ubiquinone, or you could mix the powder with oil (such as fish oil or coconut oil) yourself.. Give up to 1.5 mg (or possibly a little more) per pound of body weight daily, preferably split into two doses. Give with food that contains fat for best absorption. More info on the Feline CRF site. Also see their information on Astro's Oil, which combines fish oil, vitamin E and CoQ10 (ubiquinone).
- Vitamin B-complex -- Most dogs can take a B-50 supplement. Vitamin B does not help the kidneys specifically, but it is a water soluble vitamin that is flushed from the body more quickly by dogs with kidney disease, due to their drinking and urinating more than normal.
- Vitamin C -- normally, the Ascorbic Acid form is recommended, so you are not adding additional calcium, sodium or magnesium that you will find in the Ascorbate forms. You can give about 100 mg twice a day to a small dog (10-25 lb.), 250 mg twice a day to a medium dog (25-50 lb.), or 500 mg twice a day to a large dog (50-100 lb.). Vitamin C can sometimes cause stomach upset of diarrhea, so you may need to discontinue it if this occurs. Vitamin C does not help the kidneys specifically, but it is a water soluble vitamin that is flushed from the body more quickly by dogs with kidney disease, due to their drinking and urinating more than normal.
- You may need to supplement iron (or feed iron rich foods) for anemia. Pet-tinic has been suggested as supplement, if needed. Iron won't help with non-regenerative anemia, and too much iron can be toxic, so talk to your vet before adding iron.
- Some people have had success using the Chinese herbal combination Rehmannia 6 or 8. This supplement as well as another Chinese herbal supplement called Marrow Plus may be particularly helpful for dogs with anemia related to kidney disease. Rehmannia is included in the Vetri-Science Renal Essentials for Dogs (this is a company I like). Talk to your holistic vet or join the K9KidneyDiet list for more information on using these herbs.
- Some studies have suggested that supplementing with Taurine may be helpful for dogs with kidney disease, due to its antioxidant properties. See the following for more info:
- See Holistic Treatments on the Feline Chronic Renal Failure site for more information about supplements, particularly the Cautions section. While this information is written for cats, most of it also applies to dogs (though essential oils and garlic are not as toxic to dogs as they are to cats). Note this site has a great deal of information about where to find supplements (and everything else related to kidney disease), including sources in the UK. See their Treatments page for more links.
- There is very limited information that nettle seed tincture may help with chronic kidney disease and glomerulonephritis. It is an ingredient in Vetri-Science Renal Essentials (see above). See the following for more information (note I could not find any additional supportive information, everything else just references these or are unreliable anecdotal reports)
- Herb of the Season: Stinging Nettle (also see his Kidney Support Compound)
- Urtica semen reduces serum creatinine levels (this is the "study," actually two case reports, that Winston references in his newsletter above)
- Stinging Nettle (Urtica dioica)
- I do not recommend the supplements or diet guidelines from Five Leaf Pharmacy, for a variety of reasons. These products are also not recommended by the moderators of the K9KidneyDiet list.
Dogs with kidney disease may require a special form of vitamin D, see Calcitriol below. Caution should be used in supplementing with vitamin A, which can build up in cases of chronic renal failure. The beta carotene form of vitamin A is safest, as it will not be converted unless the body needs it. If you're feeding a homemade diet, it's OK to provide minimum daily requirements of vitamins A and D, but don't add them to a commercial diet. Since cod liver oil is high in both vitamins A and D, it should not be given to dogs with kidney problems except in small amounts when feeding a homemade diet. I would give no more than 400 IUs vitamin D and 4,000 IUs vitamin A to a large dog, half that much to a medium-sized dog, and 1/4 that amount to a small dog (even less for tiny dogs).
See Vitamin and Mineral Concerns in Dialysis for a little more information, although it is human oriented and geared to patients on dialysis.
Be very careful about using multi-vitamins, as they may contain phosphorus. Very small amounts are OK, but you don't want to be adding phosphorus if you can help it. Thorne Canine Geriatric Nutrients might be a good choice, as it contain appropriate amounts of vitamins B-complex and E, plus about half the amount of CoQ10 you should add for a dog with kidney problems, and only 12.5 mg phosphorus per capsule (0.5 mg per lb when given at the suggested dosage of one capsuleĀ per 25 lbs -- note that the analysis shown for this supplement is per 2 capsules). Other possibilities include:
- Animal Essentials Herbal Multi-Vitamin Powder contains approximately 24 mg phosphorus per teaspoon (from 131 mg dicalcium phosphate). Dosage is 1 tsp per 30 lbs of body weight, so that's 0.8 mg/lb of body weight. This supplement has limited amounts of vitamins, as is common in whole food supplements. Available from K9RawDiet.
- (Canada) OptiPet Multi Liquid Multivitamin lists no phosphorus on its label.
- Canine Geriatric Basics from Thorne Veterinary lists no phosphorus on its label. Good amount of vitamins, not much in the way of minerals.
- Theragran-M Advanced has 31 mg phosphorus per caplet. Give around 1/2 to 1 caplet per 20 pounds of body weight daily.
- Centrum Adults Under 50 has 20 mg phosphorus per capsule. Give 1 caplet per 40 to 50 pounds of body weight daily if feeding a homemade diet. This type of supplement is not appropriate for dogs who are fed a commercial diet.
There are also glandular supplements that can support the kidneys as well, including Renatrophin PMG, Renafood and Canine Renal Support from Standard Process, available at Spinelife.
The herb Hawthorn may be useful for dogs with kidney disease, according to Gregory Tilford, author of Herbs for Pets. He says "When combined with ginkgo biloba (for small capillary circulation) and herbs that improve urinary function, hawthorn may be useful for getting more blood and oxygen into renal arteries and smaller vessels of the kidneys. This, in theory, is thought to slow degeneration of whatever healthy tissue remains in the diseased organs." When supplementing with herbs, I prefer to use tinctures that are made specifically for dogs, so that the dosage will be correct, such as Animal's Apawthecary's Hawthorn Berry, Heart Health and Senior Support.
In general, diuretics are not recommended for dogs with renal failure. However, if your dog is having problems urinating, they could be helpful (it's very important: to check with your vet first in this situation). Marshmallow (the herb) would fall into this category, as well as being soothing to the urinary tract. Watermelon is also a natural diuretic, a good source of potassium, and low in sodium. Parsley, celery and dandelion greens are also natural diuretics. Watermelon tea can also be used.
Note that Essiac is not recommended for renal dogs. See http://essiac-info.org/herbs2.html for more info.
Giving Pills
If your dog doesn't like to take pills, there are many things you can use to wrap the pills in and make them go down easily. The best I've found are Pill Pockets -- the smell is very enticing, and you can pinch off just enough to cover the pill, making each one last a long time (I used to think they were too expensive because I thought you had to use a whole pill pocket each time you gave pills). Note that Pill Pockets are now available in a Duck and Pea Allergy Formula for dogs with food allergies.
Before I knew about Pill Pockets, I started with soft cream cheese, then braunschweiger sausage (similar to liverwurst), then peanut butter. When those stopped working (when she went through a period of inappetence, she often didn't want the same foods again), I found that a number of leftovers work great -- Nattie was particularly fond of crab cakes, shrimp or crab dumplings (dim sum), and potstickers. I've also used mashed potatoes and gravy, peanut sauce (Thai satay), string cheese, and fast food (potato wedges from KFC went over very well). Many of these foods are high in salt, which is not ideal for dogs with kidney disease and so should only be used as a last resort. Meat doesn't work as well, since she tries to bite it and sometimes bites the pill, I find softer food works better. Mini marshmallows are another option. I've also found that first offering a bite with no pill, followed by the bites with pills, and ending with a no-pill bite, works well for us. Note I use as little of the extras as possible, I'm not talking about giving one pill with a whole pot sticker, for example, but making that pot sticker last for several days and a large number of pills. For updated information, see the section on giving pills in my article on Inappetence.
You can also get medications compounded into easy to give, palatable liquids or chewable pills, or even ones that can be absorbed thru the skin, if needed. See these sites for more information:
Pilling Cats: There IS Another Way
Compounding Pharmacies
Compounding Pharmacies -- United States (see bottom of page for Australia and Canada)
Animal Pharmacy
In addition to Pill Pockets described above, another treat designed to hide pills is Medi-Crunch, but these have a hard exterior so you couldn't pinch off pieces to get multiple uses per treat as you can with Pill Pockets.
Another option would be to put bad-tasting pills into capsules for easier consumption. See Spaniel Antics blog post for details.
You can find other helpful tools such as the Pill Crusher/Splitter at Amazon, PetRx and DiscountPetMeds
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