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Treating Kidney Disease in Our Pets

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Every now and then we get an email asking if our protocol and supplements can help our furry four-legged friends. The short answer is yes.

Being an animal lover I have advised and treated many patient’s beloved pets with kidney disease with great success. So let’s dive into how kidney disease affects the furrier members of our families, what symptoms to look out for and how to support them to live their best lives.

CKD and Your Pet

Chronic kidney disease (CKD) affects an estimated 1% to 3% of all cats and 0.5% to 1.5% of all dogs. In fact, it is one of the leading causes of death in cats.

In dogs, the Samoyed, German Shepherd, English cocker spaniels, and bull terriers are more prone to the disease. In cats, it is more commonly found in Abyssinian and Persian breeds of cats. But any breed, if the conditions are right, may end up with diminished kidney function.

By definition, chronic renal failure (CRF), or chronic kidney disease (CKD) is the inability of the kidneys to efficiently filter the blood of waste products, not the inability to produce urine. Ironically, most dogs and cats in kidney failure produce large quantities of urine, but the body’s toxic wastes are not being effectively eliminated.

Because renal replacement therapy (dialysis and transplantation) is not widely available in veterinary medicine, management of CKD in dogs and cats focuses on:

  • Early detection
  • Renoprotective treatments designed to slow the progressive loss of nephrons. 

Symptoms of CKD in Animals

Symptoms may not be seen until the later stages of the disease. It is for this reason that I advocate that pet parents have an annual check-up with their pets to run basic blood work that can pick up changes in kidney function well before symptoms appear. With my elderly Dobermann Ruby, we ran annual health checks for her every year as she got older. I have started this with my young 7-month-old puppy Apollo as well. 

Dogs and cats can be quite stoic and very often we miss symptoms or write off changes in behavior as not being important. A simple blood test can reveal biochemical changes well before the kidneys are beyond the point of no return and thus give you a much better chance of helping your pet make a full recovery. 

One of the earliest clinical signs of kidney failure is increased water consumption and urination and is called compensated renal failure. After approximately 2/3 of the kidney tissue is destroyed, there is a rapid rise in waste products in the bloodstream and an apparent sudden onset of severe disease. 

The clinical signs of more advanced kidney failure include:

  • Loss of appetite 
  • Depression
  • Vomiting
  • Diarrhea and/or constipation
  • Bad breath
  • Weight Loss
  • Loss of Muscle Mass
  • Blindness
  • Blood in their urine
  • Oral bruising
  • Mouth ulcers
  • Weakness
  • Bone Fractures
  • Itchy Skin

Your vet will use the IRIS (The International Renal Interest Society) staging system. IRIS staging is based on serum creatinine levels, with sub-staging based on the presence of protein in the urine (as determined by a urine protein: creatinine ratio [UPC]) and measuring your pet’s blood pressure. 

Kidney function in Pets

http://www.iris-kidney.com/pdf/IRIS_Staging_of_CKD_modified_2019.pdf

Causes of CKD in Pets

There are many potential causes of kidney decline in our pets. One common cause that often gets overlooked is the impact of diet. Dried commercial pet foods filled with fillers, binders, and chemicals all pass through the kidneys. If you feed your pet a diet of dried kibble this adds strain to the kidneys as they have to drink more water due to the dried food. In the wild, our pets ate a very moisture dense diet of about 70% moisture, which dried commercial kibble does not offer. Every ingested chemical that our pets eat gets processed through the kidneys, meaning that a lifetime of dead, processed, chemical-filled foods will, whether we like it or not, have a negative impact on our pet’s kidneys. To make matters worse there are no regulations around the labeling of commercial pet foods, which means that what is on the bag might not actually be what your pet is eating. It is for that reason that I advocate a raw, natural whole food, moisture-rich diet as much as possible when it comes to optimizing the health of our pets, but more about that in a moment. 

If you want to know more about the hidden toxins in our pets’ foods and brands that are better to feed your furry children, then I recommend watching this great video from Vet Dr. Karen Becker

Other Causes of Kidney Disease in Cats & Dogs

Other causes of kidney disease include:

  • Bacterial infections
  • High Blood pressure
  • Poisoning
  • Urinary blockage
  • Lymphoma
  • Diabetes
  • Certain medications including NSAIDS, Cardiac medications, and some antibiotics
  • Idiopathic
  • Familial renal disease
  • Inflammation
  • Chronic low levels of vitamin D can contribute to the onset of diabetes in pets which in turn can set off kidney disease, so this is something else to be mindful of. 

Blood Tests

If you want to see what your pet’s kidney function is doing then there are a few specific blood tests that you will want to have run. These include:

  1. A complete blood count. As a healthy kidney function is required for the production of erythropoietin, changes in kidney function may lead to a decrease in the production of this substance which in turn leads to a decrease in the number of red blood cells produced by the bone marrow. This may show up on a test as anemia. 
  2. Serum biochemistry profile is another test that can pick up changes in your pet’s kidney function. This test will show your pet’s blood urea nitrogen (BUN) levels as well as creatinine levels. Both of these two substances are normally cleared from the bloodstream by the kidneys and therefore are indicators of how well the kidneys are functioning. An increase in either BUN or creatinine may be seen in kidney disease, as well as things like dehydration and anything that reduces the flow of blood to the kidneys. 
  3. A complete urinalysis is also essential to determine the health and function of the kidneys. A urinalysis might help your vet to determine the actual contributing factors that have led to altered kidney function. A simple urinalysis can detect
  4. Occasionally ultrasound examination and/or kidney biopsy may be recommended to evaluate the kidneys if any of the above tests warrant it or if your vet requires more information. 

Treatment

Treatment will depend upon the cause and severity of the disease. The table below shows the typical diagnostic and treatment focuses that your veterinarian might take once they have the required information from pathology testing. 

Diagnostic treatment of CKD in Dogs and cats

https://todaysveterinarypractice.com/wp-content/uploads/sites/4/2016/12/T1701F01Table04-1.jpg

As always the standard model of care for pets deemed necessary from your veterinarian often neglects to take into account dietary and lifestyle changes that are often just as effective and have far fewer side effects than many traditional pharmaceutical medications.

So let’s explore some of the other ways we can support our pets’ wellbeing and possibly even enhance their kidney function. 

Note – If you are new to this page and have been told that once the nephrons (the cells of the kidneys typically damaged in kidney disease) are lost or damaged, that they cannot regenerate and that kidney disease is not curable, then you are in for a reorientation. That information is simply not true. The cells of the kidneys can be regenerated if given the right environment to do so. The earlier you catch the disease and the less damage that has occurred, obviously the easier it is to get improvements, but even in the later stages of the disease, we have seen kidney function improve. It is my personal belief that if we support the vitality of the body and create a healing environment, then the body, including the bodies of our pets, will do what they were created to do, heal!

Diet

 

Dogs

First and foremost if you have a dog with diagnosed kidney disease please take them off dried kibble. As I mentioned earlier this just adds strain to the kidneys due to the lack of moisture content in their food. Dried food requires them to drink more water which in turn adds undue strain on already strained kidneys. 

A healthy kidney-friendly diet for pets should aim at providing much-needed micronutrients to boost your pet’s overall health as well as reducing protein, sodium (salt), and phosphorous and increasing potassium (unless blood tests show elevated potassium levels) to prevent heart arrhythmias and muscle weakness. 

If you can provide your pet with organic food that is even better, the fewer chemicals their kidneys have to process the more available energy they will have to heal. 

The main foods to remove from their diet include:

  • Wheat gluten (dry foods, store-bought dog treats, bread, pasta, dental bone type gunk)
  • Dairy
  • Processed meats (Salami etc)
  • Pet store treats including dental sticks, rawhide chews, etc.
  • Dried, highly-processed grain containing kibble

As it is with us humans, a diet high in gluten and wheat has been shown to cause damage to the kidneys, dried kibble is full of grains that our dogs are not genetically designed to eat. Grains are highly inflammatory and inflammation further damages the cells of the kidneys. Dairy, like gluten, is also highly inflammatory and high in phosphorus so also needs to be avoided in our pets’ diets.

A meal example for a dog might include the following:

Protein restricted to 10%

  • 400g raw organic meat

The best meat choices include organic beef, unbleached green tripe (full of healthy probiotics), dark chicken meat (avoid chicken breast), kangaroo, lamb, and duck. These meats are all lower in phosphorus than other meats.

  • 100g liver
  • 30gms of kidney – this is called organotherapy, where you feed the organ meat of the affected organ to provide the micronutrients to support the healthy function of that organ. Make sure you choose organic if possible.
  • 150g of grated low phosphorus vegetables and berries. This might include sweet potato (good for balancing blood sugar levels if your pet also has diabetes), squash, zucchini, carrots, cabbage, cauliflower, and blueberries.

Note – I love adding blueberries to Apollos food as they are high in antioxidants and support immune function. Berries have also been shown to have a beneficial action on the kidneys. Read more about that here – https://www.kidneycoach.com/food/berries-super-food-for-the-kidneys/

  • 1 -2 tablespoons of alkalizing greens powder – as with humans it is important to support an alkaline diet. Alkalising green blends can be really useful here. I personally like this brand 
  • 20ml Fish oil  (1 tablespoon) Make sure you choose good quality here.
  • 20ml Olive oil (1 tablespoon)
Cats

Just like their canine cousins, cats that have been fed a diet predominantly of dry food are also more prone to developing kidney disease due to the lack of moisture content in their foods. As with dogs I highly recommend that you avoid feeding your cat the following foods:

  • Wheat gluten (dry foods, store-bought dog treats, bread, pasta, dental bone type gunk)
  • Dairy
  • Processed meats (like salami)
  • Pet store treats including dental sticks, rawhide chews, etc.
  • Dried, highly-processed grain containing kibble

Low protein diets are most commonly prescribed for kidney failure in cats. The reason for this is because most meats are high in phosphorus, and it is thought that phosphorus and its ability to combine with calcium is the culprit in kidney damage. However, the scientific support for this treatment is much stronger for dogs than for cats. It is also important to remember that high protein diets (that cats require) do not cause kidney disease.

A meal example for a Cat might include the following:

  • 50 grams liver  
  • 50 grams kidney – Just like with dogs, adding a kidney to their meal is called organotherapy, where you feed the organ meat of the affected organ to provide the micronutrients to support the healthy function of that organ. Make sure you choose organic if possible.
  • 2 cups water more as needed to puree – to ensure they are getting enough hydration
  • 1 whole raw egg
  • 100 grams heart
  • 700 grams ground lamb, kangaroo, or beef
  • 100 grams raw salmon with the  bones removed (this keep the phosphorus levels down)
  • 15g good quality fish oil
Recipe Notes 

This works best to puree all the organ meats (heart, kidney, etc) into the water, and then pulse this mixture into the ground beef.  If you have a  blender or something like a Vitamix this should work just fine.  If you have a regular blender, I would mix the water/organ mixture and the ground beef by hand or with a stand mixer instead. 

Divide out into containers and thaw 2-3 days’ worth at a time. 

For more information about this recipe please visit  – https://healthhomeandhappiness.com/raw-kidney-care-cat-food.html

Water

Your pet needs access to good quality water throughout the day and night. I filter Apollos water, but if he had kidney disease I would probably think about giving him access to alkaline water as well as filtered water. 

Herbal Medicine

Now we get to the exciting part. If you’re committed to helping your pet live their best lives then the addition of specific herbal medicines might really help to support their kidney function. 

The best news is that the herbs that we use in humans to support kidney function are the same herbs that we can use for our furry family members. I have waded through all the research that I can find, and the most common herbs we use in humans are the same herbs that are also safe to use to treat our pets with kidney disease.

The top four herbs I would consider for any pet with Kidney disease include:

Rehmannia

Rehmannia has been shown to be capable of slowing down or even halting the progression of kidney disease. This herb targets the kidneys directly, so it is considered very useful, especially for improving the strength of the still working aspects of the kidney. 

The actions of Rehmannia include:
  •     Kidney protection
  •     Stops problematic bleeding
  •     Anti-inflammatory
  •     Lowers fever
  •     Balances immune system
  •     Energy tonic
  •     Adrenal gland tonic
  •     Anti-anaemic
  •     Adaptogen (helps the body adapt to stress)
Kidney Health

Research shows that Rehmannia has a kidney protective effect, which it does via a few different mechanisms. Firstly, Rehmannia has antioxidant and anti-inflammatory effects. Reactive oxygen species are highly reactive and unstable molecules that may cause damage to cells and organs and can contribute to kidney damage and kidney disease, as does inflammation. 

Rehmannia increases the activity of the body’s major antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) and raises glutathione levels, which is one of the key antioxidants within the body so can reduce damage to the kidneys (and other organs). 

Secondly, Rehmannia also protects the kidneys from damage by inhibiting the expression of angiotensin II. Angiotensin II is involved in the accumulation of specific proteins which contribute to kidney inflammation and scarring (glomerulosclerosis).

Studies have shown that by inhibiting angiotensin II and other proteins, Rehmannia was able to stop the progression of scarring and deposits in the kidneys, slowing or preventing the decline in kidney function. By doing this it can reduce creatinine levels, reduce protein loss in urine and improve kidney function.

Finally, Rehmannia also increases blood flow to the kidneys. Kidney damage can be caused by a lack of blood flow and oxygen. Lack of oxygen itself stimulates further scarring of the kidneys so maintaining blood flow is incredibly important to maintaining healthy functioning of the kidneys. 

Read the full story about Rehmannia by heading to our article on this amazing herb – https://www.kidneycoach.com/causes-of-kidney-disease/rehmannia-angiotensin-ii-diabetes-stem-cells-and-more/

Astragalus

This ancient herb has long been used in animals to balance immune function, support energy levels, and for pets prone to stress. When it comes to kidney function there are many things that this fantastic herb can help with:

  • Reduces protein loss in urine
  • Improved albumin levels
  • Lowers blood pressure
  • Prevents hypertensive kidney damage
  • Astragalus can increase red blood cell and hemoglobin levels which makes it useful in the treatment of anemia. 
  • Astragalus has been prescribed for centuries for general debility and chronic illness and to increase one’s overall vitality. This makes it a useful treatment for fatigue.
  • Astragalus contains beneficial plant compounds that may enhance your pet’s immune system, reducing the risk of infections and illness. It is particularly beneficial for chronic immune weakness.
  • Astragalus is also classified as an adaptogen which means it helps the body deal with and adapt to stress.

Numerous studies have been conducted in both animals and humans that demonstrate that astragalus is a promising complementary medication in the management of diabetic kidney disease. 

A meta-analysis of 25 studies that included 945 patients with diabetic kidney disease and 859 control subjects found that astragalus treatment resulted in significantly improved creatinine clearance levels, lower blood urea nitrogen (BUN), lower creatinine levels, reduced urinary protein loss.

All very useful actions for any pet diagnosed with CKD. For more information about this herb head over to our website 

Cordyceps

This fungus has a long history of use in the treatment of chronic kidney disease. Studies show it has the ability to significantly decrease serum creatinine levels, increase creatinine clearance and reduce the loss of protein in the urine (proteinuria). It also increases hemoglobin levels and improves fat metabolism. Great actions if your pet is showing signs of fatigue and depression. 

Cordyceps has the following actions that all greatly impact kidney function and health:

  • Antioxidant
  • Anti-inflammatory
  • Anti fibrotic
  • Regulates blood sugar levels 
  • Supports healthy immune function

If you want to read more about this amazing herb then head over to this blog post.

Dan Shen

Dan Shen is not a herb commonly seen in pre-made formulas for pets. Which made me wonder if it had any toxic effects on our furry friends. The good news is that id does not, and is completely safe to give to our pets as long as we stick to the safe therapeutic dosage range.

There are a number of different therapeutic actions that make Dan Shen an excellent choice of herb to use in supporting our pets with kidney disease. Some of these actions include:

  • Kidney tonic
  • Protects kidneys
  • Helps heal scarring
  • Lowers blood pressure
  • Heart tonic
  • Prevents heart attacks
  • Anti-coagulant
  • Cardiovascular tonic
  • Anti-bacterial
  • Anti-inflammatory
  • Antioxidant
  • Improves blood flow
  • Anticancer

The main reason I love Dan Shen so much when it comes to supporting both four-legged and two-legged humans is the ability of Dan Shen to protect the kidney’s tissues. A number of studies have demonstrated that Dan Shen can protect against kidney damage from a number of different causes. Animal studies have shown that it prevents kidney injury from everything from contrast dyes to lead to gentamicin (an antibiotic well known to cause kidney damage) to iron overload to high uric acid levels. 

But it doesn’t just protect from damage caused by exogenous sources but also from damage caused by high blood pressure and diabetes, the two primary causes of kidney disease. 

Acute kidney injury (AKI) is another potential cause of CKD and it can also contribute to the progression of CKD. Dan Shen has been shown to prevent the progression of CKD after AKI in animal models by directly protecting against renal tubular damage and by reducing inflammation. That means that if your pet acquired kidney damage due to poisoning or an infection Dan Shen should be one of your first choices of treatments to support the health and function of your pet’s kidneys. 

Dan Shen is probably one of my most used and favorite herbs when it comes to preserving and supporting kidney function. To read more about this herb head to – https://www.kidneycoach.com/clinical-studies/dan-shen-kidney-tonic/

Herbal combinations

There are many pre-made herbal combinations on the market made for pets that contain some of the herbs mentioned above. 

But you can also use our Kidney Prime formula which is safe for both cats and dogs. Just make sure you adjust the dosage. We recommend taking 3 caps a day for an adult human. So if you have a dog that weighs 55 pounds / 25Kg I would give 1 capsule a day. If you have a cat that weighs 11 pounds / 5kg then I would break open a capsule and empty out ¼ of a capsule and mix it with their food. 

References for the safety of herbs in pets – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151902/

Nutrients

 

Co-Enzyme Q10

Co-Enzyme Q10 (CoQ10) has been a popular vitamin used to safely treat animals with cardiovascular-related diseases. However, CoQ10 also has many benefits when it comes to kidney health and kidney function. CoQ10 is capable of the following actions on the body:

  • Antioxidant capacity- oxidative stress is a key contributor to CKD development and progression.
  • Energy production- its ability to increase energy levels which doesn’t just mean that it reduces fatigue but also provides energy for improved immune function and healing of the kidneys.
  • Anti-inflammatory actions- inflammation contributes to the development of most chronic health conditions including kidney disease.
  • Cardiovascular effects- CoQ10 plays a role in both preventing and treating cardiovascular disease and has blood pressure lowering effects. 
  • Improves glucose metabolism and helps to regulate blood sugar levels.

In a small study of people with CKD, half the patients received CoQ10 while the other half were given a placebo. After four weeks, the patients receiving CoQ10 showed a significant reduction in blood creatinine and urea levels. The CoQ10 trial also lowered the number of patients who ended up needing dialysis; only 36.2% of CoQ10 patients were receiving dialysis compared to 90% in the placebo group. This research also applies to our furry friends and is one of the reasons it is popularly prescribed in the veterinarian world.

Dosage 

For kidney disease, I would aim to get 90 mg daily for cats divided into 3 doses 

Dogs 100 – 300mg daily depending on size. For Apollo who is a 30kg 7-month-old Doberman, if he had kidney disease I would have him on at least 200mg of Coenzyme Q10 a day. 

If you want more information about CoQ10 then head over to this link.

Omega-3 Fatty Acids

If you have been researching online about what supplements to give your pet diagnosed with CKD then you have definitely come across all the research and websites touting the benefits of Omega-3’s.

Fish oil or Omega 3’s are probably one of the best-studied alternative therapies to support our furry friends diagnosed with any type of kidney disease and for good reason. Dogs lack the ability to synthesize Omega 3 and Omega 6 and therefore Omega-3’s are considered dietary essential fatty acids. Meaning that is an essential addition to what our dogs eat.

Plant sources won’t cut the mustard when it comes to supplementing your dog’s diet with omega 3’s. Dogs cannot convert plant-based sources of omega 3’s such as flaxseed oil, linseeds, or canola oil into the needed active forms of EPA and DHA. 

EPA, a component of Omega 3 fatty acids, provides anti-inflammatory and prostaglandin effects while DHA, the other main component of Omega 3 is critical in nervous system health. Both of these Omega-3 fatty acids are used in the management of kidney disease, cardiovascular disease, idiopathic hyperlipidemia, inflammatory and immune diseases, and osteoarthritis.

When nephrons are destroyed in CKD, the remaining viable nephrons enlarge in an attempt to compensate for their diminishing numbers, this results in a maladaptive increase in glomerular capillary pressure (GCP). This increase in capillary pressure can further damage the tissues in the kidneys. 

Fish oil supplementation can reduce this increased GCP and this protects the kidneys from further damage.

A study done in dogs with reduced kidney function who were fed a diet rich in Omega-3 from fish oil showed a normalized GCP to a level consistent with dogs with normal kidney function. 

Another study found that dogs fed a combination of antioxidants and omega-3 fatty acids, who had CKD, slowed the progression of CKD better than those dogs who were treated with diet alone. 

In a study of 146 cats with kidney disease, cats fed diets supplemented with omega 3 fatty acids lived a median of 17 months compared to 7 months for those who were not supplemented.

Other benefits of Omega-3’s include:

  • Protects heart function – Reduces the vulnerability to developing atrial fibrillation, it also acts as an anticoagulant and prevents blood clot formation in cats with heart disease
  • Anti-inflammatory – great for pets with dry itchy skin, allergies and arthritis all caused by inflammation. 
  • Slows the progression of kidney disease as described above. 
  • Improves neurological development and supports cognitive function. This is great for our aging pets to prevent cognitive decline. Studies show it decreased pattern-pacing behavior in aging pets.
  • Omega-3’s also decreased harmful triglyceride levels. This is especially critical in pets suffering from heart disease, pancreatitis, and inflammatory bowel disease.

https://pubmed.ncbi.nlm.nih.gov/9605110/

Therapeutic Dosage in Dogs

In dogs, the recommended doses of EPA and DHA supplements for therapeutic purposes ranging from 50 to 220 mg/kg body weight. The highest dose is recommended for osteoarthritis and kidney disease. 

Therapeutic Dosage in Cats

The recommended dosing for cats is approximately 112 or 120 mg of combined EPA + DHA per kilogram of body weight for cats with chronic kidney disease or osteoarthritis.

https://todaysveterinarypractice.com/fish-oil-dosing-in-pet-diets-and-supplements/

So there you have it! Hopefully, if you are a pet parent and have a beloved pet diagnosed with kidney disease you now have a little more direction and more importantly, hope that there are things that you can do to make your pet’s life happier and healthier.

Don’t forget that there are no magic bullets, it is the combination of diet and herbal and nutritional support that can make the difference. I would also highly recommend that you find a good holistic vet to work with as you navigate your way through supporting your pet with kidney disease.

To all our furry family members out there I wish you good health and lots of belly rubs! If you have any questions about this article please head over to our Facebook page and leave us a comment, I look forward to seeing you there.

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