Comments on Feeding the Kidney Patient: The Low Protein Diet Myth

Forgot to mention, Rascal from the last comment is 15 years old, turning 16 in May and is approx 28 lbs. He is a rescued terrier mix that we have had since he was a puppy and has aways had a solid loving home and 2 other puppy siblings. He is currently holding the title of ALPHA, with 1 new 2 yr old puppy that he is still able to successfully direct.

My dog Rascal has chronic kidney disease but it is holding steady and at this point, the conditon is not progressing. We have him on a home made diet of beef, turkey, rice, green beans, black beans, carrots, broccoli and peas. The meat is cooked, not raw. We tried raw diet and he stopped eating, cuz he didnt like it. Also it looked and smelled gross, so I dont blame the poor guy for not liking it. He has a good appetite and eats all his food. He eats twice a day and gets about 10-12 oz of food per day. He is also on a homeopathic remedy for kidney disease, 1 dose every other day. He gets weekly infusions and I give him water orally using a syrige when he looks like he is having trouble drinking from his dish. After reading your blog, I am wondering if I should add a few oz of raw hamburger to his food. (?) His numbers are holding steady at this point and our (conventional) vet is amazed, but he doesnt know anything about homeopathy except what we have explained. Also he has a dislocated patella and weak back legs, left worse than right. He is on 2 homeopathic remedies for that as well, but it does not seem to be doing much to help him gain any strength. Wonder if you have any suggestions?

Superlative advice!
Raw food
And lots of it’. It’
And just watch a renal failing dog scarf up that raw food!
It will etch your mind forever!

My 6 year old boxer, Nene was diagnosed with one functioning kidney. After ultrasound we found that one of kidneys looked as if it didn't develop(lots of scarring and small). She was a rescue and I have no history of her first 2 years of life. As soon as I got her we put her on raw lots of immune supplements and at check up she was completely normal. We do blood work every year. This year we had a rise in SDMA and her BUN(we weren't so concerned about BUN at first bc of the raw diet). We ran urine to test(protein ratio) and that was normal. I recently switched her to a home cooked diet(no carbs) and her numbers were bad(CREA was high which was previously normal and her BUN still elevated) but here SDMA was normal. This was a one month difference.
What we did
Ozone, Hyperbarics, home cooked, Standard process renal support, gastriplex, herbs, and acupuncture
Now I switched her back to raw. Took away the Gastriplex looking for a good kidney support probitioc and any other supplement that will help her. I will likely move her acu up to weekly instead of bi-weekly and see if we can get more blood moving.
Can anyone recommend someone to help me with diet and herbs that is the only thing I am missing...
Thank you in advance, Nene thanks you.

I thought the same on raw--put my stage 3 lab on it and his #'s went thru the roof. Got his raw from pet store--used stella's and he got that and goat milk. He got worse in 3 weeks time. Now we are just giving him what he wants to eat within reason. Supplements for his kidneys and lots of love. This disease sucks.

Does anyone have any good sources of raw food? I have a stage 1 kidney kitty that has been on raw for over 6 years (since his diagnosis)... I had been feeding my cats Texas Tripe, (I'm in the Austin area) and they recently had FDA recalls on their food which had tested positive for salmonella and Listeria... I know that usually isn't an issue with cats, but recently mine have been not eating it, or throwing up immediately after eating it or acting sick and lethargic. It happened in a few other cat households who purchased from this company too, so we are looking to change and having trouble finding anything suitable.

My 14yrs old cat is having IBD + HCM + high phosphorus (on normal range high border, while CREA is normal). I would like to try niacinamide, but worry about its possible side effect of abnormal heart beat, fast breathing as well as diarrhea. I read these side effects on human but will it be the same on cats?

Hello Eowyn

I too thank you for your story. I would love to hear how you both are doing since the diet change. Because I have been thinking about that too. My beloved 18 year old kitty has been recently diagnosed to my surprise with CKD. I only discovered it when I was getting her ready for a dental cleaning (and now I have read about the possible contributing factors of that for this disease :( ) In mid march 2018 her creatinine was 2.2 and Phos 3.6 Bun 60. The conventional vet said as I was leaving she should start a kidney diet and to pick up a can. Since, I had been feeding her Rad Cat since 2014, I dismissed his comments. Btw he did not even give me values or reasoning just that she was an incredibly healthy 18 year cat and that she was cleared for a dental cleaning. Which I scheduled the following week. I have been trying to keep her oral health up to par so she could live a long vibrant life. (This would have been her 3rd cleaning. Her first in Oct 2016 creatinine 1.2 at that time...since then they have been slowly rising again with no comment from vets. I have only recently asked for all labs and found the pattern.) I was in a room waiting for the vet for about 30 minutes and there was a dog kennel just out side the room with constant barking. My poor cat was shaking badly and I decided to not have her go under anesthesia in this condition. I told them I would reschedule. I ended up taking her to another vet who specialized only in dental procedures 6 weeks later. I had tried to wait as she was not herself and I was trying to get her back to her normal vital self. Even though she was not her normal self, I attributed it to her accumulation of gingivitis in her mouth and the sooner that was taken care of the better. So May 1st we went to the dental specialist and he suggested another blood test to prior to the procedure. Thank goodness we did that. Her creatinine rose to 2.5, BUN 45 Phos 4.3 and he suggested we get to the bottom of what was going on before proceeding . I followed up with an appointment on May 4 with another local vet and gave her all her labs and she said that it was CKD and that she just needed to start the renal diet and gave me samples and encouraged me that many patients numbers go back to normal once the start the diet. I begged her to do another panel as she just had not been herself and she was drinking and urinating more and constipated. She did another panel and she called the next day and her creatinine had rose to 3.2, BUN 50 SDMA 14 Phos 4.9 I came in for fluids and asked her to take BP and an ultrasound to see if there was a kidney stone. She took xrays as they did not have an ultrasound. BP was high and xrays clear. She is now on amlodepine (sp?) I scheduled and appointment with an ultrasound vet practice and found that her kidneys were normal size, L 3.2cm R3.3 cm. smoothly marginated with decrease in corticomedullary definition. Blunting of the renal papilla, mild renal pelvic dilation, and thickening of the ureteral walls on the left. No ureteral dilation or obstruction was identified. But they did also find a thickening in the small intestine and nodules in the liver and recommended a biopsy. Ugh!!! So, after talking to specialist and the procedures to test for cancer, I have put that off as I attempt to stabilize her.

I have been seeing a holistic vet for 4 weeks now. She has given her acupuncture, VOM, Ozone therapy and renal supplements, omega 3s, (nordic naturals), catnip and aloe vera juice to calm inflammation in small intestine. I also give her fluids every other day. She recommended slightly cooking the rad cat to ease the work of the kidney.

Her vitality is mostly back (she goes through waves of being tired) and her constipation has been relieved quite a bit. She still does not poop every day though. BUT I just did her blood work again and she has increased in creatinine. now to 3.3. BUN 47 Phos 4.9 SDMA 22. I was sure that her numbers were going to be better.

My thoughts are perhaps I could use a moderate level of protein instead of high to see if the creatinine could clear and perhaps be flexible in her daily protein consumption. There is a lot of discussion on the value of high quality protein for cats, which makes sense in their biological makeup. What I have never seen brought up is the natural fasting that occurs in the wild when food is not found. Wild cats have to go for days without food sometimes. Does this help conserve their kidney function? Does anyone have any information on this?

Also, has anyone experience good results with photobiomodulation on the kidneys?

I don't know anything about homeopathic medicine and would like to hear if it could be helpful for my kitty.

Thank you for reading my very long post. I am reaching out for help and encouragement to do the right thing for my kitty. With gratitude...

I agree that protein should not be restricted and that phosphorus is an issue. Blood perfusion is critical, and prescription diets for lack of a better word are crap. By the way, I worked in the veterinary field for 15 years, and the wet food is pushed by vets more often than the dry, if that matters to you.
Claiming that a raw food diet will address kidney needs and other nutritional needs in cats as you have has made it sound all inclusive. I agree that many cats have responded well to such a diet. But this does not take into account that all meats made for pet food have problems. All meat made for humans share the same issues. Yes, all. You can not mass produce that amount of death and not make sacrifices. Proving that every single animal being slaughtered has zero disease factors and has had high quality nutrition all their lives is not viable economically. The customer is being sold the same bill of goods for our pet's foods as we are for ours. We get a lot of promises and good sounding words like "organic: or "free range", but those are not the questions we should be asking. Did each turkey get a full blood screen done before being killed? Of course not. There in lies a big problem that we continue to choose to ignore because why? Our cats are carnivores, as we are doing the best we can? Well, I believe we should do better - much better.
Let's start by addressing blood perfusion. This is markedly increased by the use of omega fatty acid supplementation. I would have liked you to talk about this. A heavy metal tested free fish oil supplement would do wonders for any kidney patient.
Also, B vitamins work best when all are together in the right portions. A superior B Complex created by the top natural nutritional company would be a great addition for kidney patients. Both of these supplements would have to be made for humans with proof of testing for contaminants, bottle contents the same as on label, and absorption backed up by clinical trials published in medical journals. Even the supplements used by holistic veterinarians that are human grade can not offer this kind of proof, because when tested they fail. Shaklee has been the only company that can do this.
I want to say that I appreciate this article and hope it gets more and more notice in the coming years. You answer a lot of questions and point out flaws in what is happening in the veterinary industry. That is needed! Thank you.
Let me end with a personal story. I have lost 2 cats to kidney disease despite being on the most premium holistic diets all their lives. My current cat is 17 and facing the same fate. Last year due to this article and encouragement from an enlightened veterinarian, I switched him to Rad Cat raw. Indeed, I saw an increase in energy for a while. However, it did not last long. Current blood work shows the biggest increase in kidney values yet. That is not what I had hoped would be the results of the diet change. So what now? I figure at this point in the game I have nothing to lose. If I put him on a kidney diet, he will die quickly on horrible nutrition. If I keep him on the raw, he will continue to decline. If I do something else, he may also continue to decline. But what if...
So, going against everything I was taught, I have decided to give him a chance on something that lacks all the scientific data that I usually demand. Like I said, if it doesn't work, we are no worse off. He will be on Evolution canned and Ami Cat dry for treats. Yes, it's vegan. But no diseased or malnourished animal tissue will be infecting him. I don't need to hear about how crazy this is. I used to preach it. He's my child, and I am doing the best I can for him out of love.

My 19 year old cat needs to eat a renal or kidney friendly diet. He has been on a mostly gluten free diet for years. He recently started medication for hyperthyroid. My question, I will be traveling for long periods at a time and need to find canned and dry cat food, cannot ask the pet care giver I am hiring to prepare special food. Problem as I have learned about the brands of prepared food are less than satisfactory, low protein, gluten or wheat and other products. I've been researching to find a brand and I came across your website but. Please, can you recommend a canned and dry food for the renal or k/d diet?

What about the risks of raw meat? Giving raw meat, especially pork can be very dangerous! It can cause the animal to die within a few days because of the Aujeszky virus.

Hi. I have a 9 pound male Bichon Frise who is almost 9 years old and I was told he has a kidney stone. Vet pushed Hill's S/d canned food but he won't eat it. I have been feeding him cooked chicken, rice, veggies, and cottage cheese. His pH is 7 and vet says he needs to be about 6 or 6.5. How should I feed him to get rid of stone (S)?
Thanks!
Heather

The last feedback of Dr. Falconer was more than a year ago - so it seems to me it doesn't make sense to ask questions here.

Dear Dr. Falconer,
Interesting article! My 14 year old Bengal Dalí was diagnosed with kidney failure a year ago. He was in a quite bad condition at the time, so I started to give him infusions - which I believe saved him. And I started feeding low-protein diet, together with Amlodipine and Fortekor/Semintra. Dalí is doing quite well now, he is stable and enjoys a good quality of life. The only thing is that he has lost 1,5 kg the last year: he is skin and bones now, while he is eating much more than ever before in his life....
So for some time, I have this question: is weight loss a inevitable side-effect of the illness, or is it the low-protein diet that is contributing to the weight loss? It is not a brain twister to understand that it is important to feed a kidney patient high-quality protein leading to minimal kidney burden. But most canned kidney diets are low protein, ranging from 6 to 8% - which translates into a daily intake of less than 3 g of protein/day. This troubles me.... His underweight seems to become a more serious problem than the kidney failure.
So I was thinking: what if I supplemented Dalí with small portions of high-quality protein from a source that matches his natural intake? What would be good protein sources which lead to minimum kidney load? If I remember well, poultry and haze are good candidates. What would be your advise?
Many thanks for sharing your insights!
All the best,
Erik Philippus & Dalí

Hi Dr. Falconer-
Does all of this information also pertain to puppies with congenital kidney disease? I have a 5.5 month old Rhodesian Ridgeback who is struggling to put on weight and has developed bad breath and excessive urination - more frequently and lots of it, even occasionally while sleeping. Results of her urinalysis yesterday weren't good - the vet said there was evidence of renal tubules (I think that's what he said) in her urine and that it was highly diluted. We're still waiting on the results of her blood work. She has no other symptoms. She is very active and LOVES to eat. She continues to be VERY motivated by food. Currently, we feed her dry dog food - Nutrisource, grain-free quail. Any advice is much appreciated.
Thank you!

Hello, Dr. Falconer. Thank you for that article and the tip about niacinamide as a phosphorus binder.
My cat of 13.5 years old at the last bloodwork had the serum phosphorus almost at the upper limit of normal and creatinine slightly above normal, but BUN in the middle of normal range. The vet didn.t prescribe renal diet or phosphorus binder but i feel that we need it. Cat had such values after a month of feeding mostly with commercial pet food and immediately after i switched her back to raw turkey breast meat.
The problems is that she has a mammary cancer which i treat with IP-6 and curcumin and it seems to work and keeps cancer in control. But IP-6 is high in phosphorus, as well as turkey breast, so i think i need to give her some phosphorus binder at least to cut phos coming from meat.
Would B3 accelerate cancer growth and metastasis?
Can i use injections of nicotine acid instead of niacinamide?
Thank you

Question for you Dr....I have a 12 year old femail that had major kidney stone blockages in both ureters June 14. She had stents put in both ureters & did great until Jan 15. She ended up with Stones in one ureter again & when they went in for surgery they saw the kidney was so damaged they just removed it. Both my cats are solely on canned food only now (they were on dry their whole lives up til this, I didn't know better!) :( Since her surgery in January she is doing great, but is still on a feeding tube with KD low protein "gruel" 3 times a day. The doctor says it's not only to help her one kidney but because she produces so many stones that the low protein will help that stone production as well. So it's been 6 months now and she still has her feeding tube. She seems very happy, getting alittle wobbly now & then but overall has a great spirit. What do you think about the low protein "way" for kidney stone production? Do you feel it's beneficial? I'd rather her have a happy life on canned food than a not so great life with a tube in her neck if all things are equal, but the stone production/blockage issue has me terrified! We've spent 10's of thousands of dollars on her surgeries so I don't want to put her thru more of them, but also want her quality of life to be good! thank you!

Wondering what Trans Factor to buy from my cat. She has fibrosarcoma a 6 year old stray I saved.
Doing a lot better with the cur cumin, krill & fish oil, but the drug for her pain I hate. Located on her leg they wanted to amputate, she has started to walk on it! Still has quality of life , but I do not know how long she has had this. the 4.5 years I have had her NO VACS from me! I have not vaccinated anything since 1992!!!
Really need a trans Factor at this point.....

I have a 12 yr old English Cocker Spaniel who has Kidney failure and is currently treated with Benazecare. She came to me as a two year old with vaccine history, I put her straight onto a raw diet as she had previously been fed with a low quality Greyhound Kibble. Her coat was stained a shade of orange around her throat area. Over the years I worked out through dowsing that she and her son (who I also have) are very sensitive to chicken or chicken derivatives.
Over the last year her breath has become somewhat less that sweet and her upper Canines have tartar build-up along with a couple of lower teeth on either side. She has been fed bones as part of her diet all these years and as recreational bones. I am assuming that the Vaccines have softened her teeth in some way, I have tried to scrape the tartar off by myself, she is not the most cooperative and I don't push her. My vet won't entertain a scale and polish due to her Kidney failure and wants me to put her on a prescribed Kidney diet. My rational before I read your article was to keep her on protein rich raw diet by way of fish and other high quality sources as she is losing protein in her urine she needs to get it from some where. I have recently discovered she also has a small tumour on her left anal gland, she is not in any pain and still enjoys her walks etc. I recently consulted a 'Zoopharmacognosist' and Teal only chose Incense and Rose in essential oil form, not in the least interested in Arnica and other pain or anti-inflammatory which was good news. I have opted to treat her Palliatively and as long as she still enjoys life and does not appear to be in pain tats the path I shall follow.
Thank you for the article

Thank you SO much for the above article. Fortunately, when my (then) 13yo feline lad was diagnosed with CKD in Sept '14, I was on a good forum which pointed me in the direction of high protein and a phos binder rather than the usual vet advice of low protein. I have had a concern, however, over the ingredients of the phos binder so am very interested in your alternative option of niacinamide. However, finding this in powder form the UK is proving difficult but I have been able to locate Nicotinamide. Doing some searching it would appear that these two names are actually for the same compound - please could you confirm if this is the case.
Additionally, we are also giving an ace inhibitor - Fortekor - and I have just found out that I must give this at least 2 hours apart from the phos binder as the binder prevents proper absorption. Would the Niacinamide / Nicotinamide have the same restriction? I am out at work 9hrs a day so am having a problem with the timing of this. I also give Slippery Elm Bark to minimise his stomach acid and, it too, cannot be given within 2 hours either side of other meds. So, as you can see, timings are tight.
Thank you in advance for your input and advice.