Home-made renal diet

RE: Home-made renal diet

Chris Milligan — Tue, 15 May 2018 17:08:59 GMT

It's very, very difficult - especially considering the nutritional content of home prepared diets is inconsistent and, in effect, it gives owners a license to feed "other things they think are the same".

There's a reason why so much science and investment has gone into preparing the renal diets, and they are indisputably effective. There simply isn't enough knowledge about the nutritional content of even well understand foodstuffs to know that some compound in the pumpkin you're feeding doesn't inactivate the phosphate binder you added.

That said Penny Watson at Cambridge vet school or Marge Chandler at Glasgow vet school can give you better advice than most :D

RE: Home-made renal diet

Martin Atkinson — Tue, 15 May 2018 10:26:44 GMT

[quote user="GrooveJet"]I just don't understand why people think they can do things better than the researchers and scientists at RC or Hills.... or how they find the time![/quote]Don't you know nuffink - its because we're all in the pay of big pharma and pet food companies.

RE: Home-made renal diet

Miriam Lodewyks — Tue, 15 May 2018 09:51:32 GMT

My own dog developed CRI somewhat unexpectedly and for no obvious reason, found myself topping up waterbowls more and more often... then the penny dropped.

Switched her to RC Renal and within 3 days her drinking returned to normal. She survived another 28 months, and was really well for 26 of those, but did succumb to it in the end...

I just don't understand why people think they can do things better than the researchers and scientists at RC or Hills.... or how they find the time!

RE: Home-made renal diet

Martin Atkinson — Tue, 15 May 2018 09:27:11 GMT

[quote user="Kate Richardson"] I remain to be convinced that the renal diets are essential (for cats anyway, can't comment on dogs)- are they beneficial or do they actually make little difference or do they actually potentially do harm. I'm certainly not happy having a cat on it unless it eats it happily and maintains its weight.[/quote]I often say to clients who are struggling to get their CKD cats to eat renal food to at least mix as much as they can with food the cat will eat. Up to 50% it will still be having some benefit but the cat will die of starvation quicker than it will die of renal disease if it doesn't eat. The problem with phosphate binders is that they are often unpalatable so adding to the food is not an option.

OK this thread started with a dog but the number of dogs I see with kidney disease is vanishingly low so it is an apt tangent.

RE: Home-made renal diet

Evelyn Barbour-Hill — Mon, 14 May 2018 22:06:05 GMT

[quote user="Beats"] use proteins such as soy that have a low phosphorous content.[/quote]

But are of low biological quality.

RE: Home-made renal diet

Jenny Harris — Mon, 14 May 2018 20:43:29 GMT

I agree with Kate though that quality of life and the cat enjoying the food is important. Luckily I find that’s not often a problem!

RE: Home-made renal diet

Jenny Harris — Mon, 14 May 2018 20:42:47 GMT

If phosphate already high a binder on its own won’t be enough to counteract the amount of phosphate in the food

RE: Home-made renal diet

Beats — Mon, 14 May 2018 20:39:46 GMT

[quote user="Jenny Boyd"]Survival times of dogs and cats with spontaneous renal failure show a significant benefit for those on a phosphate restricted diet-[/quote]

The argument then is why not just add a phosphate binder (and possibly some omegas) to the food the dog actually likes eating already etc., rather than insisting on a protein-restricted diet when it is questionable what benefit restricting the protein does? Or another argument angle is to use proteins such as soy that have a low phosphorous content.

There's lots of differing opinions.

Here's two recent (easily accessible), yet somewhat contrasting, ones for dogs with CKD:

http://www.vetfolio.com/2016-navc-proceedings/rethinking-nutritional-management-of-chronic-kidney-disease-in-dogs (2016)

https://www.cliniciansbrief.com/article/chronic-kidney-disease-staging-nutrition-considerations (2017)

The best dietary advice for a dog diagnosed with CKD and used to a kibbled food may differ from one used to having a meal cooked at home every day.

RE: Home-made renal diet

Jenny Harris — Mon, 14 May 2018 20:08:54 GMT

Survival times of dogs and cats with spontaneous renal failure show a significant benefit for those on a phosphate restricted diet-

Elliott et al JSAP 2000, survival of cats with naturally occurring chronic renal failure: effect of dietary management

Ross et al 2006, clinical evaluation of dietary modification for treatment of spontaneous chronic kidney disease in cats, JAVMA

jacob et al 2002, clinical evaluation of dietary modification for treatment of spontaneous renal failure in dogs, JAVMA

Plantinga et al 2005, retrospective study of the survival of cats with acquired chronic renal insufficiency offered different commercial diets, vet record

roudebush et al 2010 an evidence based review of therapies for canine CKD JSAP

dogs = median survival 3xlongwr with a 70% decrease in uraemic crises, cats survival 2.4 x longer with a decreased risk of uraemic crises and renal related death

also this paper may be of interest- Larsen at al 2012, evaluation of recipes for home prepared diets for dogs and cats with CKD, JAVMA

RE: Home-made renal diet

Kate Richardson — Mon, 14 May 2018 20:04:57 GMT

[quote user="Beats"]

[quote user="Kate Richardson"]Sorry Niall, slight tangent as your post is about a dog![/quote]

whoops. me too.

However, optimal nutrition for "renal insufficiency" in a dog that "seems relatively well" is perhaps an even more demanding question than the incorrectly-assumed cat one!

If you have (and are happy to share) full case details could make an interesting discussion?

[/quote]

No specific case, just a general interest and desire to do the best for my patients. read Lisa's website- she discusses it and explains it in a really rational manor (unlike the Roger Meacocks and Tom Lonsdales of this world)

RE: Home-made renal diet

Beats — Mon, 14 May 2018 20:01:22 GMT

[quote user="Kate Richardson"]Sorry Niall, slight tangent as your post is about a dog![/quote]

whoops. me too.

However, optimal nutrition for "renal insufficiency" in a dog that "seems relatively well" is perhaps an even more demanding question than the incorrectly-assumed cat one!

If you have (and are happy to share) full case details could make an interesting discussion?

RE: Home-made renal diet

Kate Richardson — Mon, 14 May 2018 19:48:49 GMT

Thanks Beats- this is an area I have been doing some research on recently as I remain to be convinced that the renal diets are essential (for cats anyway, can't comment on dogs)- are they beneficial or do they actually make little difference or do they actually potentially do harm. I'm certainly not happy having a cat on it unless it eats it happily and maintains its weight. I will read these links and digest and report back with my opinions- Sorry Niall, slight tangent as your post is about a dog! But maybe we should look into this further in dogs as well, or maybe someone already has? As far as I am aware there is very little peer reviewed evidence for the 'prescription' diets. But I will read the above first before making my mind up.

Another link you may be interested in reading

https://catinfo.org/

Really interested in peoples thoughts/views.

RE: Home-made renal diet

Rob Loxley — Mon, 14 May 2018 19:34:51 GMT

[quote user="Niall Taylor"]Does anyone know of a sensible recipe for home-made renal diet?[/quote]

balanceIT.com is a useful resource, though many ingredients are US-centric

RE: Home-made renal diet

Beats — Mon, 14 May 2018 19:13:55 GMT

https://secure.balanceit.com/info/acvnecvcn.php

PS - I thought the Vet Clinics articles few years back gave a nice balance to opinions and dogma regarding optimal nutrition of the cat with CKD:

https://www.sciencedirect.com/journal/veterinary-clinics-of-north-america-small-animal-practice/vol/46/issue/6

Read:

Controversies in Veterinary Nephrology: Renal Diets Are Indicated for Cats with International Renal Interest Society Chronic Kidney Disease Stages 2 to 4: The Pro View

Review articlePages 1049-1065

David J. Polzin, Julie A. Churchill

Controversies in Veterinary Nephrology: Renal Diets Are Indicated for Cats with International Renal Interest Society Chronic Kidney Disease Stages 2 to 4: The Con View

: Review article; Pages 1067-1094; Margie A. Scherk, Dottie P. Laflamme

Controversies in Veterinary Nephrology: Differing Viewpoints: Role of Dietary Protein in the Management of Feline Chronic Kidney Disease

Review articlePages 1095-1098
Jennifer A. Larsen

RE: Home-made renal diet

Niall Taylor — Mon, 14 May 2018 18:09:40 GMT

[quote user="Martin Atkinson"]I'm a bit surprised at the question given you know views on BARF diets[/quote]

Good point, she seemed keen to try and wouldn't be convinced about how difficult it is to get right.

[quote user="Martin Atkinson"]Surely red meat is the first thing to avoid given the protein and phosphate levels[/quote]

Yup, that's what I said, I think she believed me but she is looking for a cheap/easy fix at the moment. I hope if I tell her it's not a practical option after having spoken to a few folks she might be convinced.

[quote user="Anthony Dennison"]Very difficult to get right. Just feed them RC Renal or Hills k/d[/quote]

Quite - but she seems convinced she'll be fine. I'm sure there was a recipe I used to recommend occasionally in the dim and distant, but even if I could find it, it was fiendishly complicated IIRC.

[quote user="Kate Richardson"]If you contact Marge Chandler, thinks she’s Glasgow, she is a vet who specialises in nutrition...[/quote]

That's great, Kate, thanks.

Niall

P.S. - This group's great btw

RE: Home-made renal diet

Kate Richardson — Mon, 14 May 2018 17:45:30 GMT

If you contact Marge Chandler, thinks she’s Glasgow, she is a vet who specialises in nutrition and she can formulate bespoke homemade diets for clients for a fee. Google her. She’s very helpful

RE: Home-made renal diet

Anthony Dennison — Mon, 14 May 2018 17:24:48 GMT

[quote user="Niall Taylor"]

Does anyone know of a sensible recipe for home-made renal diet? I have a client whose dog has just been diagnosed with renal insufficiency, seems relatively well at the moment and the owner is keen to home prepare. She has already bought a supposed renal diet from a pet shop and read something online about red meat and pumpkins and I'd like to point her in the right direction.

Thanks in advance,

Niall

[/quote]

There was a study a couple of years ago looking in to the use of home prepared/raw diets, think it was quoted by a vet times article. Basically said that of the entire study population that were put on a correctly balanced and calculated diet, less than 2% of the people were still following it exactly, and only 10% or so were even using home prepared diets still.

Very difficult to get right. Just feed them RC Renal or Hills k/d

RE: Home-made renal diet

Martin Atkinson — Mon, 14 May 2018 17:11:03 GMT

[quote user="Niall Taylor"]

She has already bought a supposed renal diet from a pet shop and read something online about red meat and pumpkins and I'd like to point her in the right direction.

Thanks in advance,[/quote]I'm a bit surprised at the question given you know views on BARF diets unless of course it is rhetorical!

Surely red meat is the first thing to avoid given the protein and phosphate levels.

I'd say the right direction is to another vet!

Home-made renal diet

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Controversies in Veterinary Nephrology: Renal Diets Are Indicated for Cats with International Renal Interest Society Chronic Kidney Disease Stages 2 to 4: The Pro View

Controversies in Veterinary Nephrology: Renal Diets Are Indicated for Cats with International Renal Interest Society Chronic Kidney Disease Stages 2 to 4: The Con View

Controversies in Veterinary Nephrology: Differing Viewpoints: Role of Dietary Protein in the Management of Feline Chronic Kidney Disease

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