Proteinuria diet?

Hanna recently had her annual vet checkup and vaccines.  We decided to do a baseline senior blood panel last week since she turned 10 on 1/1/21.

Vet said the test results are consistent with the condition called proteinuria.

The following values came back high:

Creatinine on 4/8/21 was 2.4     on 4/15/21 it was 2.3     in 2018 value was 1.3     in 2016 value was 1.5     (normal range .5-1.8) 

BUN on 4/8/21 was 36     on 4/15/21 it was also 36     in 2018 value was 13     in 2016 value was 15     (normal range 7-27)

An ultrasound was done and came back clear of any tumors. Tests also showed no bacteria or infection issues.

Vet is doing 1 more urinalysis to get a 3rd reading for a reference point to determine medication level.

Hanna has ate Fromm gold for last 8 years, and also has no salt added green beans for last couple of years.

Vet mentioned putting Hanna on a no/low protein no/low salt diet.

Havent received final instructions from vet yet, but wondered if Fromm or any other approved brands have a food for this situation-

Thoughts?

Thanks !!

Marni

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  • There's no such thing as a "no protein diet". :) 
    A dog could not survive without protein. 
    And in fact, with kidney disease you don't want low protein, you want high quality protein that is easier for the body to digest, and produces fewer waste products associated with protein metabolism. If the urinalysis shows protein loss, then you need to make adjustments. Otherwise, you want moderate protein content and high quality, low fat protein sources.

     Reduced sodium is a good idea.


    The real issue with kidney disease is the mineral content in the food, particularly phosphorus. According to Tufts,  "pets with kidney disease should be fed diets reduced in phosphorus and sodium and supplemented with omega-3 fatty acids from fish oil. The most important of these nutrients for most dogs and cats is phosphorus. It is important to feed a low phosphorus diet to keep the pet’s blood phosphorus low, which is thought to slow the progression of kidney disease and improve survival."

    Unfortunately, even if we knew the ideal dietary amounts and ratios for phosphorus, that information isn't available to us for commercial pet foods. This is one reason I don't recommend diets for kidney disease. 

    I do know that the absolute best diet for dogs and cats with kidney disease are wet diets. Canned, home cooked, or the dehydrated raw base mixes like Honest Kitchen to which you add your own meat, poultry, or fish. 
    Hopefully your vet would be able to guide you if you choose to do either of the last two choices. 
    If your vet recommends an Rx diet, I would look at Rayne Nutritionals or Just Food for Dogs.  They are so much better quality than Hills, Purina or Royal Canin. However, if that's not an option, your last choice should be Purina, it contains some really horrible ingredients. 
    Here's a link to the Just Food for Dogs renal diet: https://www.justfoodfordogs.com/vet-support-meals/
    And here's a link to Rayne's veterinary diets: https://raynenutrition.com/

     

    Vet Prescription Dog Food | JustFoodForDogs | JustFoodForDogs
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    • Maybe the vet meant hydrolysed proteins (peptides/amino acids as opposed to whole protein molecules) if easy digestion is one of the goals?  

      Only thing that might make sense to me if they actually said "low/no protein" that they meant a reduction in full proteins that take a lot of "work" digestion-wise.

      • There's been an ongoing debate for years among veterinary researchers about whether diets with low protein percentages (i.e. <20%) are helpful in kidney disease, or harmful. So they really do mean "low" in the sense that the diet contains more carbohydrate and less fat or protein than we would give a healthy dog. Studies have not been conclusive, and have gone both ways. 
        Hydrolyzed protein diets are intended for dogs with allergies and digestive disease. With kidney disease, it's not so much that proteins are hard to digest, it's that the by-products of protein metabolism (nitrogen waste which is converted to urea and eliminated in the urine)  can over-work the kidneys. So it's possible that the vet did mean a hydrolyzed diet, but I doubt it. 

        • That makes sense.  I was just trying to figure out why they may have said "no protein" (which makes no sense) and you mentioned easy digestion.  

          With lower protein that would also reduce the production of acids and ammonia from protein metabolism which require transport work by the kidneys (assuming human/dog kidneys work similarly) so low protein seems to be a good idea.  I wonder why some would say low protein is bad - maybe trying to balance the health of the kidneys vs. the amount the rest of the body needs to maintain good health.

           

          • It's because dogs on low protein diets also lost lean tissue/muscle mass and albumin, and lost weight. When the body isn't getting enough high quality protein to maintain & repair itself, (i.e. essential amino acids) it starts breaking down tissues. That creates more metabolic waste products. According to one article: 
            " Protein restriction as a dietary management strategy for CKD has become increasingly controversial. Some argue that, in an effort to retain muscle mass and increase diet palatability, dogs with kidney disease should not be placed on a low-protein diet. Patricia Schenck, DVM, PhD, of Michigan State University’s Center for Veterinary Medicine wrote, “Reducing dietary protein in older pets may have adverse effects. As pets age, their ability to utilize nutrients decreases. The only time dietary protein restriction is appropriate in renal failure is when the disease has become severe.”


            On a personal note, I've experienced the effects of loss of muscle mass as we age both myself and in my dogs, and I would be very hesitant to reduce a dog's dietary protein intake below 22%. But that's me. 

            • Maybe a good compromise would be a "lower" protein diet then rather than "low".  It's not an easy thing to figure out exactly where that "line" is, probably depends on a specific dog's age and current health/muscle mass status.

              • As I used to tell my clients, muscle mass is the most metabolically active tissue in the body. The primary determinant of any individual person's (or dog's) metabolic rate is their lean mass. That's what burns the most calories, even when you are asleep. And lean mass is the first thing to go when the body isn't getting enough complete protein. It's like throwing the heavy stuff overboard if you are in a boat that's sinking, lol. 
                Muscle mass also determines how easy or difficult it is for you to move around, and everyone starts losing muscle mass at a relatively young age if they aren't doing something to maintain/rebuild it. (Women can start losing muscle and bone in their early 20s!)
                We see dogs developing orthopedic issues as they age, just like people. I experienced that with JD in particular, because  long term steroid use also causes muscle wasting, so the muscle loss was accelerated. By 12 years old, he had difficulty just walking any kind of distance; by the end of a half mile walk, he'd be basically walking on his pasterns. And he needed help standing in one place for any length of time, i.e. on the grooming table. For me, those things may be more important in terms of quality of life for a geriatric dog than elevated kidney values. As always, it's a risk/benefit decision, and it's never easy. 
                I tend to agree with you that a middle of the road approach is probably the best idea. 

  • I'm going to message Allyson and ask her to respond to this discussion. She researched a homemade diet that kept her Chihuahua Taquito alive & thriving for years beyond what the vets predicted after he developed kidney disease from those Chinese sourced chicken jerky treats that caused so much harm years ago. Hopefully she will have some advice. 

  • Thanks Ladies for the info and links!

    I will follow these comments closely, which will definately help me ask more intelligent questions and have a better discussion with my vet-

    : )

     

  • Hello Marni!!!

    My chihuahua, Taquito, became ill at the age of 5 or 6 from the chinese treats/food recalls in 2008ish. He was shortly thereafter diagnosed with kidney disease. We are so lucky to have a vet that takes a holistic approach and provided me with a recipe for home cooking. He lived another 8 years on this food :). Here is the exact recipe. Keep in mind my chihuahua was about 6-7 lbs, and ate 1/4 cup of these at each feeding (2x per day). I would 4x the batch and freeze them in 1/4c portions. 

    Also, we started giving him IV fluids the last two years of his life. The vet taught us how to do it, so we did ourselves from home and didn't have to go to the vet every week. This kept him nice and hydrated. Good luck!!!

    ¼ pound full fat ground beef

    2 ¾ cup cooked rice (brown preferred, white okay)

    2 eggs

    ¼ cup frozen veggies

    2 T olive oil

     

    Brown the beef in 2 T olive oil.  Do not drain fat.

    Add eggs and cook.

    Stir in veggies to heat at the end.

    Mix in the cooked rice.

     

    One feeding per day add:

    1 crushed Tums

    20 mg B-complex

    1 Fish Oil capsule

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