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Manuela Seeber, Switzerland

 

Kidney disease and PONS

 
Kidney disease is often discussed among PON owners particularly as their PONS grow older. While a number of factors can contribute to kidney disease, the symptoms tend to be nonspecific. Early diagnosis and intervention may help curb progressive kidney damage in acute cases. However, especially in chronic cases, one or both kidneys usually are severely and irreparably damaged by the time observable signs appear.
These symptoms of kidney disease result from the body’s attempt to compensate for the kidneys decreased ability to flush toxins out of circulation. Some symptoms of kidney disease include:
  • Increased thirst and water consumption 
  • Increased urine output
  • Inappropriate urination (in the house, car, elsewhere
  • Loss of appetite 
  • Weight loss
  • Vomiting
  • Diarrhea
  • Dehydration
  • Lethargy
  • Disinterest in normal activities (apathy)
  • Bad breath (halitosis; ammonia-like smell)
  • Oral ulceration
  • Tooth discoloration
  • Brownish discoloration of the tongue
  • Loose teeth
  • Abdominal discomfort and pain
  • Swollen extremities
  • Pot-bellied appearance of the abdomen
  • Seizures 
  • Poor hair coat and skin condition (dry; flaky)

The list of symptoms is extensive. Please request blood tests from your local veterinarian.

As the kidneys deteriorate, urine becomes less concentrated and lighter in color. Dogs with end-stage kidney failure develop high blood pressure, stop eating, make few if any attempts to urinate and produce little or no urine. They ultimately collapse, go into a coma and die. Unfortunately, owners usually cannot detect chronic kidney disease until the damage has become irreversible.

 

Diets for Management of Chronic Renal Disease in Dogs   

The following diets supply nutrients for a medium-size adult dog, and provide about 10 percent protein (135 percent of needs). Chicken fat improves palatability. Increasing dietary chicken fat decreases the protein percent, however. The diets are all low phosphorus and provide 50 to 75 percent of vitamin D requirements. Some diets contain minimum amounts of sodium and some are low in sodium. Some animals loose excess sodium with chronic renal disease and in such cases iodized salt is used for flavor (one-tenth teaspoon iodized salt can be added). Depending on needs diets contain normal, low or high amounts of potassium. Potassium depleted animals can be fed a low potassium diet if one-fourth teaspoon potassium chloride is added. Magnesium is available to meet required levels. Some diets are low in vitamin B12 which is probably unimportant unless they are fed for many months. Substituting chicken or ground beef for eggs enhances flavor and provides more B complex and B12 vitamins. A vitamin B12 supplement can be given occasionally. The diets are balanced with respect to all other nutrients.

Feeding a diet matched to needs can restore phosphorus, potassium and sodium to normal. Blood chemistry panels are done to monitor plasma concentrations. With normal blood levels dietary mineral levels can be modified. It may not be necessary to continue feeding a very low phosphorus diet; doing so may result in deficiency. To increase dietary phosphorus substitute bone meal powder or tablets for calcium carbonate tablets. For example, to one of these diets providing 45 percent of the phosphorus needs, adding bone meal powder in place of 1 1/2 calcium carbonate tablets increases dietary phosphate to meet NRC requirements. Normal calcium levels are maintained. At the end of each recipe directions are given for restoring normal phosphorus levels.

Eggs and Potato
Low Protein, Low phosphorus, High Potassium, Normal Sodium

1 cooked whole egg, chicken
3 cups potatoes boiled in skin (369 grams)
1 tablespoon chicken fat (14 grams)
1 1/2 calcium carbonate tablets (600 mg calcium)
1/2 multiple vitamin-mineral tablet

provides 600 kcalories, 15.1 g protein, 18.5 g fat
supports caloric needs of 18 pound dog
provides phosphorus 53%, potassium 322%, sodium 114% of a dog's daily needs.
To feed this diet with a normal amount of phosphorus substitute  2.5 grams bone meal powder for the 1 1/2 calcium carbonate tablets

Chicken and Potato
Low Protein, Low phosphorus, High Potassium, Low Sodium

1/4 cup cooked chicken breast (72 grams)
3 cups potatoes boiled in skin (369 grams)
2 tablespoons chicken fat (28 grams)
1 1/2 calcium carbonate tablets (600 mg calcium)
1/2 multiple vitamin mineral tablet

provides 689 kcalories, 18.9 g protein, 26.8 g fat
supports caloric needs of 21 to 22 pound dog
provides phosphorus 45%, potassium 301%, sodium 54% of a dog's daily needs.
To feed this diet with a normal amount of phosphorus substitute  3 grams bone meal powder for the 1 1/2 calcium carbonate tablets

Beef and Potato
Low Protein, Low phosphorus, High Potassium, Low Sodium

2 ounces (raw weight) lean ground beef, cooked (57 grams)
3 cups potatoes boiled in skin (369 grams)
2 tablespoons chicken fat (28 grams)
1 1/2 calcium carbonate tablets (600 mg calcium)
1/2 multiple vitamin-mineral tablet

provides 737 kcalories, 18.6 g protein, 32.5 g fat
supports caloric needs of 23 to 24 pound dog
provides phosphorus 43%, potassium 293%, sodium 54% of a dog's daily needs.
To feed this diet with a normal amount of phosphorus substitute 3 grams bone meal powder for the 1 1/2 calcium carbonate tablets

Eggs and Tapioca
Low Protein, Low phosphorus, Low Potassium, Normal Sodium

3 cooked whole eggs, chicken
2 cups tapioca, cooked, (125 g dry before cooking)
1 tablespoon chicken fat (14 grams)
1 1/2 calcium carbonate tablets (600 mg calcium)
1/2 multiple vitamin-mineral tablet

provides 779 kcalories, 19.3 g protein, 28.9 g fat
supports caloric needs of 25 pound dog
provides phosphorus 40%, potassium 30%, sodium 216% of a dog's daily needs.
To feed this diet with a normal amount of phosphorus substitute 3 grams bone meal powder for the 1 1/2 calcium carbonate tablets

Beef and Tapioca
Low Protein, Low phosphorus, Low Potassium, Low Sodium

4 ounces (raw weight) lean ground beef, cooked (114 grams)
2 cups tapioca, cooked, (125 g dry before cooking)
2 tablespoons chicken fat (28 grams)
1 1/2 calcium carbonate tablets (600 mg calcium)
1/2 multiple vitamin-mineral tablet

provides 845 kcalories, 19.9 g protein, 37.2 g fat
supports caloric needs of 28 pound dog

provides phosphorus 18%, potassium 29%, sodium 55% of a dog's daily needs.
To feed this diet with a normal amount of phosphorus substitute 4 to 5 grams bone meal powder for the 1 1/2 calcium carbonate tablets

Egg White and Tapioca
Low Protein, Low phosphorus, Low Potassium, Normal Sodium

3 whites from whole chicken eggs, cooked
2 cups tapioca, cooked, (125 g dry before cooking)
1 tablespoon chicken fat (14 grams)
1 1/2 calcium carbonate tablets (600 mg calcium)
1/2 multiple vitamin-mineral tablet

provides 610 kcalories, 14.1 g protein, 13 g fat
supports caloric needs of 18 pound dog
provides phosphorus 6%, potassium 33%, sodium 269% of a dog's daily needs.
To feed this diet with a normal amount of phosphorus substitute 5 grams bone meal powder for the 1 1/2 calcium carbonate tablets

Chicken and Tapioca
Low Protein, Low phosphorus, Low Potassium, Low Sodium

1/2 cup cooked chicken breast (143 grams)
2 cups tapioca, cooked, (125 g dry before cooking)
2 tablespoons chicken fat (28 grams)
1 1/2 calcium carbonate tablets (600 mg calcium)
1/2 multiple vitamin-mineral tablet

provides 763 kcalories, 20.8 g protein, 27.3 g fat
supports caloric needs of 24 to 25 pound dog
provides phosphorus 20%, potassium 22%, sodium 55% of a dog's daily needs.
To feed this diet with a normal amount of phosphorus substitute 5 grams bone meal powder for the 1 1/2 calcium carbonate tablets

Eggs and Rice
Low Protein, Low phosphorus, Low Potassium, Normal Sodium

1 cooked whole egg, chicken
2 cups cooked rice, white polished, long-grain (320grams)
1 tablespoon chicken fat (14 grams)
1 1/2 calcium carbonate tablets (600 mg calcium)
1/2 multiple vitamin-mineral tablet

provides 721 kcalories, 15.2 g protein, 31.4 g fat
supports caloric needs of 23 pound dog
provides phosphorus 40%, potassium 30%, sodium 90% of a dog's daily needs.
To feed this diet with a normal amount of phosphorus substitute 3 grams bone meal powder for the 1 1/2 calcium carbonate tablets

Egg White and Rice
Low Protein, Low phosphorus, Low Potassium, Normal Sodium

3 whites from whole chicken eggs, cooked
2 cups cooked rice, white polished, long-grain (320 grams)
2 tablespoons chicken fat (28 grams)
1 1/2 calcium carbonate tablets (600 mg calcium)
1/2 multiple vitamin-mineral tablet

provides 693 kcalories, 18.8 g protein, 26.8 g fat
supports caloric needs of 21 to 22 pound dog
provides phosphorus 27%, potassium 43%, sodium 208% of a dog's daily needs.
To feed this diet with a normal amount of phosphorus substitute 4 grams bone meal powder for the 1 1/2 calcium carbonate tablets


 

Please consult your family veterinarian.

 

References

1. Brown, Scott A. 1994. Canine Renal Disease. In The Waltham Book of Clinical Nutrition of the Dog and Cat. Edited by J. M. Wills and K. W. Simpson, 313-334. Oxford: Pergamon Press.

2. Moraillon, Robert and Roger Wolter. 1994. Feline Renal Disease. In The Waltham Book of Clinical Nutrition of the Dog and Cat. Edited by J. M. Wills and K. W. Simpson,277-291. Oxford: Pergamon Press.

3. Grauer, Gregory F. and India F. Lane. 1994. Acute Renal Failure: Strategies for its Prevention. In Nephrology and Urology. Waltham Symposium Number 16. Edited by C. Tony Buffington and James H. Sokolowski, 23-30. Vernon: Kal Kan Foods.

4. Kopple, Joel D. 1991. Role of Diet in the Progression of Chronic Renal Failure: Experience With Human Studies and Proposed Mechanisms by Which Nutrients May Retard Progression. Journal of Nutrition 121(11S):S124.

5. Polzin, David J., Carl A. Osborne and Larry G. Adams. 1991. Effect of Modified Protein Diets in Dogs and Cats with Chronic Renal Failure: Current Status. Journal of Nutrition 121(11S):S140-S144.

6. Leibetseder, J and K. Neufeld. 1991. Effects of Dietary Protein and Phosphorus Levels in Dogs with Chronic Renal Failure.

Purina International Nutrition Symposium in Association with the Eastern States Veterinary Conference. 15 January. 35-38.

7. Polzin, David J. 1991. Can Diet Modify Progression of Chronic Renal Failure? Purina International Nutrition Symposium in Association with the Eastern States Veterinary Conference. 15 January. 29-33.

8. Lewis, Lon D., Mark L. Morris and Michael S. Hand. 1987. Small Animal Clinical Nutrition III. 3d ed. Topeka: Mark Morris Associates. 1-15.