This is a conversation that took place between Dr Susanna and website visitor called Nicola.
Hi Susanna - I asked yesterday in a comment on this website, if PET Plus would be OK for my dog with kidney disease. You replied that it would so I have ordered and I am hoping the PET Plus will arrive today. However I was wondering if you have any advice in terms of diet as my vet is no help at all
My dog Darla who is 15 years old, was diagnosed at Christmas with stage 4 kidney disease. I was told she only had a few weeks so feed her whatever but I didn’t listen. I started giving her bottled water with cranberry juice and home cooked food. I fed her low protein food with veg and pasta, raw goat's milk, Kidney Support Gold, and as recommended by a support group a phosphorus binder.
I took her to another vet beginning of February and she did another blood test. The vet said it was bad and that if I feed her Hills or Royal Canin I may have her a few more months. My dog is also anaemic but the vet wouldn’t prescribe anything for it because the urea is killing red blood cells, (whatever that means). I returned home so upset that I didn’t know what to do, but started giving her raw paleo ridge special kidney diet which she was eating. But I was scared because the support group were saying it’s not good to give that to her at her stage so I moved her on to Royal Canin these past couple of weeks, She has been eating that like she couldn’t get enough but then stopped and throughout it all she is losing weight and muscle. I started her on Nutriment Raw Low Purine and Phosphorus yesterday which she is eating but I am so scared I’m going to make her worse and what if she stops eating this as well?
Nicola - thanks for your enquiry both on the comments section of the website and here. You've given some more details, so I'm able to give some more suggestions. But first, here is what I wrote on your comment originally.
I'm so glad she has the sense to refuse the Royal Canin! Crafty advertising, branding and pricing leads one to believe it's good! It's the same rubbish as all the other processed foods. Raw is the way to go. Raw protein is unlikely to give her kidneys any problem. Can she deal with fats OK? If she can, then raw fatty meat would be excellent, like chicken with the skin and lamb.
That's the quickest way to gain weight. 50:50 with blended greens and PET Plus. About 400g raw meat should be fine, but if she wants more, give her more, divided between 2 or more meals. Each meal with blended greens and PET Plus.
Between meals, like an hour before her meaty meals, give her lots of dried fruit, like dates, cranberries, non-sulphured apricots, and prunes ... but NOT any of the grape family (raisins, sultanas, currants) as they have been associated with renal failure, exactly not what you want.
As with everything, introduce the dried fruits gently. I find dates to be the best, especially medjool dates. Then give her a stalk of broccoli or a carrot or something veggie and tough and fibrous to alkalize her mouth and saliva and clean her teeth. Or you could brush her teeth.
First, relax. She's amazing to have reached 15, nearly 16. Good for you! That shows you've been giving her all the best things in every aspect. Enjoy every moment, because we have to face the fact that they don't usually outlive us humans. It's sad but true, so don't feel that you could have done more than you have.
You have given her a fantastic life. Give yourself a pat on the back for that! And have a cup of tea and a chocolate biscuit! And some dried fruit you can share with her (see below).
Definitely raw is best. It is the most easily digested protein, hasn't been damaged by heating and processing, so is the easiest form of protein for digestion and absorption, and for the liver and kidneys to deal with. Raw goat milk is an excellent idea. Raw egg also is really easy to digest and the yolk is full of nutrients. So give her the yolk specifically. Maybe you have friends who like meringues (you could use the egg whites that way!)
For the anaemia specifically, there is an amazing superfood plant called Moringa. You can buy Moringa powder online. It is incredibly green! You might have to disguise it in a blob of jam or something as it is not often the favourite flavour for our four legged friends. If you can get it as tablets that state they have not been heated, that would be easier. My cat loves chlorella! He pesters me for them! You could use Chlorella as well. There's chlorella in Pet Plus, but there is absolutely no risk at all of overdosing it.
Thank you so much for your reply. I also spoke with Connor Brady the author of Feeding Dogs and he said exactly the same thing ... that vets know nothing about nutrition and just push the rubbish prescription food.
Since I haven’t been through this before I knew nothing about it or what to do so everything so far has been trial and error and me trying to gain as much info as I can. My vet isn’t helpful at all and to be honest I don’t really like her that much for that reason. She charged me £150 pounds just for a blood test and did no urinalysis and just told me my dog is dying there is nothing I can do except feed a kidney diet to try and get a few more months.
The first vet at Christmas did do urinalysis and said it’s so diluted so her kidneys aren’t doing much. Also I said previously the vet said she’s anaemic as well but won’t prescribe anything, only that if my dog starts panting and pacing and her gums go white to bring her straight in. I have been told that only a particular iron injection can help this and nothing from food can help - is this true? It is scrambling my brain because when I originally took her to see the vet at Christmas she was really unwell, literally drinking like she couldn’t get enough then weeing it straight out, not wanting to eat and having seizures. She's not doing this now. Apart from low appetite sometimes and low energy, she is a lot better.
It is also a nightmare trying to find another vet as I wanted an holistic one but none near me are taking new patients as they’re so busy. I have been giving her Nutriment Low Purine and phosphorus (500 grams) is this OK? It also contains bone which I read is no good for kidneys? If this is OK I will continue.
Also the vet never advised phosphate binder. However, I posted copies of the blood results to the kidney support group and her levels were elevated from the first blood test in December so they recommended it but on her second blood test beginning of February it had started to come down so not sure whether to continue with it once I start PET Plus. I know from an holistic perspective it’s only recommended to use pre and probiotics for this.
In a nutshell should I continue with the Nutriment Low Purine which is 12.7% protein at 500 grams per day with phosphorus binder or give the Nutriment Low Purine and some home cooked low protein and PET Plus with her being at end stage 4, to break the protein level down? Also she hasn’t ever had any problems with pancreatitis although her liver enzymes were a little elevated on her last blood test and someone said that could be indicative of pancreatitis but I’m not sure again the vet said nothing about this.
Thank you so very much for all your help Dr Susanna and I will be sure to let you know how she gets on.
Just a quick answer ... Yes, keep going with Nutriment Low Purine raw. Raw bone is also great! Don't cook anything. Egg yolk is great. Blended greens too. And PET Plus. And moringa. You can get everything from food if taken with enzymes. That is the point. Give her PET Plus. Iron injections are inorganic and close to useless! I hope that helps.
Does she also have access to water without additives?
Darla's drinking is good, pure organic cranberry juice in her water daily to help flush toxins and added vitamin C. She drinks close to half a litre daily. The Moringa that I ordered arrived today and was wondering how much and how often to give it her. I ordered in an organic powdered form because it was the best quality I could find. I plan to mix with water and syringe feed as I don’t want to associate it with food in case it puts her off eating. I also noticed it is quite high in potassium and also calcium, do you think this could be a problem seeing as her phosphorus binder (Ipakitine) is calcium based? I just don’t want to cause her calcium levels to be going off the charts.
Other than that since she has been on the raw and PET Plus she has a lot more energy and I feel she may have even more if she wasn’t anaemic. I think this is getting bad now as she has dark purple bruising around her lower abdomen
As it's a natural plant, the body will deal with all the ingredients in a gentle, natural way. Does the one you bought give a recommended amount for a human? I used to give my 30 kg son a couple of teaspoonfuls 3 times a day and that reversed his anaemia in a few weeks. I was amazed!
I'd suggest start with 1/2 tsp a day for a few days and watch what happens, then increase it to 1 tsp a day. I'd spread it out too. She might find it delicious, so you could try just making it into a paste for her to lick up. Don't assume she's going to hate it! They say there's no increase in serum calcium using Ipakitine so maybe there's no need to reduce that. How often do you get her blood tested? It's probably a stressful event for her, so best avoided as stress is very detrimental. Hope that's helpful.
Regarding Moringa - it says a dessert spoonful for humans. I did read about The benefits of Moringa online and it said it’s great for kidney disease but not everyone should have it due to calcium, potassium etc. She’s been doing better on the Nutriment with PET Plus, lots more energy and not so weak on her legs which is nice to see but she yawns a lot and still has some lethargy (probably due to anemia and kidney issues).
I just don’t want to make her feel like rubbish again. She had a blood test in December and again at the start of February but I’d like to take her to another vet which is hard since a lot aren’t taking on new patients due to COVID.