A Search for Food for Dogs with Renal/Kidney Disease

Trail of research

When my thirteen year old mini schnauzer was diagnosed with renal disease and was headed toward stage 3 kidney failure, I was prepared to only have her with me for six more months or less. The most disheartening part was the pain that she was in every time she ate. So I started researching the disease and found out that  the process of food digestion (in dogs in renal failure) causes toxins to build up in the body, making mealtime painful.

When I started my research, I discovered that there was a lot of information; but that information was all over the place. I had to piece things together and discuss with my veterinarian to compile an exhaustive plan for making my sweet furbaby comfortable in her final days. So, I’m hoping my research (and this article) can help someone else who is going through the same thing. Just remember, I am not a vet and have no training in this area whatsoever. I did however, work closely with my vet to come up with the right combination for my dog. Your circumstances may be different, and your dog may require a totally different plan.

My vet and supplement dieticians that I worked with said to do a low phosphorus and medium protein diet. Unlike in healthy dogs, phosphorus makes digestion painful for them (for lack of a better way to describe it). Georgia (my mini) actually quit eating because she was in so much pain. Originally, my vet prescribed a prescription dog food specifically formulated for renal disease. However, because of my research, I found that even the dry food meant for aiding kidney disease is highly processed and difficult for the system to break down. At this point I decided I wanted to feed fresh food.

The problem with fresh food is that most commercially sold fresh food options are not made for renal disease. They have ingredients in them that are higher in phosphorus and the protein balance isn’t optimal. So I decided I would find a recipe that I could cook for her myself.

That led to a new problem. Cooking a properly balanced meal is very complicated and it’s almost impossible to include all of the necessary nutrients. They don’t get everything they need unless you stick to a strict diet that has a balance of things like bone marrow, organ meats, egg shell powder, omegas, and other stuff. So you need to add nutrients with a supplement.

Of course, this led to an entirely new rabbit trail of research. How was I supposed to find the right recipe with the right type and amount of nutrients and supplements? There are actually a few resources out there to help formulate this for you. Keep reading to see what I found.

Some Answers

Balance IT is a supplement and dietary service to help people formulate special diets. They have professional dieticians that work with your vet to create an exact recipe in combination with the proper supplements. I went through the process and ordered the supplement. They sent me a couple of recipes to use with it. It is a high quality product and I’m very impressed with the service.

One problem. She didn’t like it! It has a pretty strong smell and I assume the taste is strong as well. She just wasn’t going for it. So back to the drawing board!

It wasn’t a total loss. Although I had to resign myself to the fact that the next solution would be a little less precise, I felt like I was beginning to get a pretty good grip on the ratios of proteins, carbs, and fats that needed to be included in her diet. I was able to find another supplement created just for homemade fresh food diets. I modified their recipes to fit with the low phosphorus-moderate protein plan created by my vet and Balance IT. Georgia loved Azestfor, and she began eating enthusiastically! She even began to anticipate mealtime again and began to gain a little weight. She no longer had pain after meals and her urea and creatine levels began to slow and level out.

My sweet little furbaby outlived her predicted six months and had a fun, full, and comfortable life for three more years! As time-consuming and inconvenient as it was to cook for her every week, I would not trade the experience to provide this for her! What I thought was making her comfortable in her last days, was actually saving her life. This experience has also caused me to rethink my own food intake and the effects it has on my body.

Breakdown the Information

Foods

So now let’s talk about specific foods. Not only should you consider meals, you need to remember what you are giving as treats and snacks. Most treats contain ingredients that are not desirable in a restricted diet. And if you use too many meat treats, you’ll be adding too much protein to the overall diet. So be mindful of everything you allow your dog to eat. I found this article to be a very good (although not exhaustive) resource: The Dog Kidney Diet.

Proteins

You will find several different schools of thought on the amount of protein to use for renal disease diets. This is a discussion you should have with your vet and dietician. We decided to go with the moderate-protein diet.  At first, I would purée the protein with the other ingredients and serve the entire meal as mush (helps with digestion). Later, I found that it was easier and allowed for more variety to begin with the vegetable and starch base as the purée and then sprinkle the protein over the top of each serving.

Proteins I included the most in Georgia’s diet:

• Ground beef (80/20)
• Dark chicken meat
• Egg whites

Proteins to avoid (or use in small amounts)

• Turkey
• Egg yokes
• Cheese
• Raw bones
• Fish with bones (like sardines)
• Canned fish
• Salmon, Cod, Tuna

I mostly used chicken because it was the easiest and most economical way. My husband would grill all of our protein for the week and cook hers at the same time without the seasoning. That made weekly food prep much easier for me.

Carbohydrates and Fruits/Veggies

There are a lot of naysayers about giving vegetables as a consistent form of carbs for dogs. But pets with kidney disease still need the extra calories and nutrients, and the right veggies can help fill that gap. Dogs don’t digest veggies the same way people do, so I pureed them to help that break-down process.

Starches and veggies I included the most in Georgia’s recipes

• White rice or sticky rice (the longer the grain the better)
• Barley flour
• Buckwheat flour (I use this in treat recipes)
• Pumpkin
• White potatoes
• Green beans
• Carrots
• Parsley
• Squash/Zucchini
• Apples
• Bananas
• Berries

Starches to Avoid (higher phosphorus)

• Whole wheat
• Oatmeal
• Brown rice
• Quinoa
• Chia
• Nuts (including peanut butter!)
• Seeds
• Chickpea

Fats

Fats also add calories and are a good source of energy. I gave Georgia a fish oil supplement (suggested by my vet) and added oil to the meal recipe. I chose walnut because that was in the recipes that the dietician prescribed. But you could also use coconut oil or butter.

Fats I used

• Walnut oil
• Coconut oil
• Butter
• Vetoquinol Triglyceride Omega

Fats to Avoid

• Vegetable oils (corn, canola, flax seed, sunflower)
• Cod liver oil

The Recipes

Meals

Although I did different variations depending on what I had on hand (and what was available during the pandemic), this is the basic recipe I landed on. I went through several versions before I figured out what worked best for my schedule and Georgia’s eating preferences. This recipe lasted 5 to 6 days. I gave her 1 cup of “mush” twice a day and sprinkled 1 to 2 tablespoons of the meat on it at each meal.

• 1 lb ground beef or grilled chicken thighs
• 16 oz. egg whites
• 1 lb white potatoes
• 1 lb green beans (I used frozen for convenience)
• 1 large apple
• 1/2 cup fresh parsley
• 2 cups white rice (long grain or sticky rice)
• 1 15 oz. can pure pumpkin (not pie filling)
• 3 tablespoons Walnut oil
• 1/2 cup Azestfor supplement for home-cooked meals (or you can try other supplements if you like and follow the recommended amounts)
• 1 capsule per day Vetoquinol Triglyceride Omega (with one meal, not mixed into the recipe)
• Add water for desired consistency

This process can be very time consuming, so I’ll walk through my process for you.

1. Cook the rice following package instructions using a little extra water. You want to overcook it so it’s extra mushy.
2. In a large pot, begin boiling the water for the vegetables.
3. Wash potatoes, parsley, apple.
4. Quarter the potatoes and put them in the boiling water with the green beans. Cook until somewhat soft and strain/set aside to cool. Don’t use the water from the veggies. Although we would normally want the nutrients in the “broth” of the veggies, it also contains any phosphorus from them. So always strain the veggies and discard the broth.
5. Remove stems from parsley. I usually do an entire bunch at one time and separate 1 cup servings in snack baggies to freeze and use for the upcoming weeks’ recipes. Dry the leaves, put one cup in each baggie and squeeze as much air out of the bag as possible. Seal and freeze until ready to use.
6. This is a good time to start cooking the beef if you plan to purée it with the rest of the food. Otherwise, you can cook it when you are ready to feed. I cooked it and put it in a plastic container so it was handy for mealtimes. When I used chicken, I would cut it up into tiny bite-size pieces so it was ready when I needed it.
7. Set the beef aside and in the same pan, cook the egg whites.
8. Core and slice the apple. You can leave the skin on it.
9. Use a blender (I use the Ninja blender) to purée all the veggies and the apple. Go ahead and add the pumpkin, eggs, and rice to make sure it is all well blended. You’ll need to do it in stages since it won’t all fit in the blender at once. Do not blend or cook the powder supplement. Heat and over-processing will diminish the potency of it.
10. Pour mixture into the big pot you used for boiling.
11. After everything has cooled, add the powder supplement and mix well.
12. Store in the refrigerator in an airtight container. It will be fine for up to a week.

Georgia weighed about 13 pounds and she ate 1 cup of mush plus about 2 tablespoons of protein every meal. I gave her the fish oil supplement during the morning meal.

Treats/Snacks

Before I began cooking for Georgia, I had already been making my own dog treats for years. I like giving them treats with no preservatives using natural ingredients. I have a great recipe for healthy dogs, but it uses whole wheat and natural peanut butter. Two big “no-nos” for dogs with kidney issues. So I had to come up with something different for Georgia.

Crunchy Snack Bites

• About 1 cup buckwheat flour or barley flour
• 2 tbsp egg whites
• 1/4 cup chicken broth
• about 1/4 cup water (use your judgment for consistency)
• 1/2 cup pureed green beans, parsley and carrots (altogether)

Preheat oven to 350 °F. Use a non-stick baking sheet or line one with parchment paper.

Mix all ingredients together and form into a ball (add extra water and/or buckwheat flour as necessary to get a consistency for light kneading).

Knead on a floured (buckwheat flour) surface one or two times then spread dough onto the baking sheet to create a thin layer.

Score the dough with a pizza cutter or knife.

Bake in oven 25 to 30 minutes.

Turn off the oven with the pan still in it and allow it to cool before removing.

Break into pieces and store in the freezer in an airtight container.

Serve straight from the freezer for a cool summertime treat, or remove small portions at a time to have room temperature treats ready at any time. Since there are no preservatives, I recommend storing them in the freezer.