Kidney disease is one of the most prevalent conditions found in dogs, and understanding how to manage it naturally can make a significant impact on your dog’s prognosis. While it is more common in older animals, younger pets can also be affected. Early detection and understanding of the causes, symptoms, and treatment options are crucial for effective treatment. In this comprehensive guide, we will delve into the intricacies of kidney disease, its types, prevention strategies, and natural remedies.

The kidneys play a vital role in filtering waste products, conserving water and electrolytes, keeping a balanced pH and production of urine in order to rid the body of waste products. This process is critical for preventing the buildup of toxins that could harm the body. If there is inadequate circulation going through the kidneys or if there are not enough functioning kidney cells (nephrons) to handle the waste load, toxins will build up. Additionally, the kidneys manage blood pressure, red blood cell production, calcium and phosphorus balance, and more.

Regeneration of kidney tissue, specifically the nephrons, is impossible once damaged, making kidney disease incurable. Despite this, there is some reserve capacity in kidneys, allowing them to function reasonably well even with damage caused by the disease. Dogs can often live symptom-free for years with mild kidney disease. While the damaged tissue cannot regenerate, the goal is to impede or slow down the destructive process and preserve the remaining kidney cells. Clinical signs of kidney disease usually appear when at least two-thirds of the kidneys are dysfunctional. The primary focus in treating kidney disease is to optimize and sustain the remaining kidney function as much as possible.

Blood Pressure Regulation

Blood pressure sensors in the kidneys help regulate blood pressure in the body. When these are damaged, hypertension (high blood pressure) can result and can damage the kidney even more. Blood pressure is commonly measured in kidney failure patients

Protein Conservation

There are a lot of important proteins circulating in the bloodstream and it is crucial that they are not lost in the urine. The nephron has a filtration system that keeps the protein in while removing harmful wastes. If this filtration system is damaged then a much more severe form of kidney failure results. Screening for protein loss in the urine is an important aspect of staging kidney failure.

Acute Renal Failure (ARF):

• • Occurs suddenly and presents severe symptoms like vomiting, diarrhea, lethargy, and loss of appetite.
  • Causes can be caused by toxins such as:
    • Antibiotics, excessive vitamin D, antifreeze
    •  Medications such as NSAIDs (such as ibuprofen and naproxen) and diuretics like furosemide. Overdose of diuretics can lead to dehydration, electrolyte imbalances, and kidney malfunction.
    • Toxic foods such as raisins, grapes
    •  Pesticides, heavy metals, and toxic plants 
    • Severe urinary tract infections can ascend to the kidneys, causing pyelonephritis and subsequent acute renal failure (ARF). 
    • Kidney trauma or AKI (acute kidney injury)-such as a kidney contusion caused by blunt force or a direct hit to the lower back, can result in internal bleeding within the kidney. 
    • Glomerular disease, impacting the kidney filtration mechanism in dogs, can be triggered by infections such as Lyme disease, Leptospirosis, e-coli, cancer, and high blood pressure.
  • Acute obstructions of the urinary tract such as urethral stones or tumors can lead to renal damage and failure.

Chronic Renal Failure (CRF):

• • Gradual loss of kidney function is often observed in older pets.  Symptoms are weight loss, muscle wasting, exercise intolerance, and eventually, lack of appetite and vomiting.
  • Contributing factors include over-vaccination, poor diet, infection, high blood pressure, polycystic kidney disease, and chronic bladder & urethral stones. 
  • Genetic causes: renal dysplasia is a developmental disorder of the kidneys characterized by abnormal growth and maturation of the renal tissue. In individuals with renal dysplasia, the normal kidney structures are not formed correctly during fetal development.

• • Increased thirst: A failing kidney cannot make concentrated urine, and the patient must drink excessively to get enough water to get rid of the day’s toxic load. Excess water consumption by your dog could be an early warning sign of kidney disease and is called polydipsia, which is defined as water intake in excess of 100ml/kg/day
  • Increased urination (polyuria). Commonly, urinary accidents will occur.
  • Lethargy, exercise intolerance
  • Oral ulcerations leading to drooling and halitosis
  • Decreasing appetite that may progress to anorexia
  • Weight loss and muscle loss
  • Vomiting- secondary to elevated gastric acid production leading to gastrointestinal ulceration.
  • Diarrhea
  • Clear or bloody urine
  • Late stages can reveal pale gums due to secondary anemia, labored breathing from acidosis and seizures due to high ammonia levels in the blood.

Kidney function testing to detect early disease

• • SDMA test 
  • Testing GFR with Iohexol clearance and scintigraphy

Blood Chemistry Panel

• • Key indicators include Blood Urea Nitrogen (BUN) and Creatinine (CREA) levels.
  • Assess electrolytes (sodium, chloride, potassium).
  • TCO2 (or HCO3)
  • Monitor phosphorus levels, especially in CRF.
  • PTH and iCa++ levels ( the total calcium levels may be high due to an inactive component called complexed calcium).

Blood pressure

• • It is imperative to check and monitor in patients with kidney dysfunction.

Urinalysis

• • Assess urine concentration and protein levels.
  • Confirm protein presence with microalbumin and urine protein creatinine ratio (UPC) tests.

Urine Culture

• • Identify bacterial infections by growing bacteria from a urine sample.

Complete Blood Count (CBC)

• • Reveal changes in red cell count indicative of late-stage kidney disease or elevated white blood cell count indicative of infection.

Diagnostic Ultrasound

• • Provide additional insights into kidney health (size, shape, morphology), chronicity and prognosis. Also evaluates the urinary bladder and urethra to rule out obstructions (stones, tumors).

Kidney fine needle aspirate or biopsy

It is important that your veterinarian individualize a treatment plan that fits the needs of the individual patient and you, the guardian.  Although the underlying lesions in CKD are generally irreversible, there are many therapies that have been proposed for slowing the progression of the disease. There are also numerous symptomatic and supportive strategies that should be considered in these patients.

Treatments can be combinations of fluid therapy, nutrition, medications and healthy supplements. On-going examinations and laboratory tests will be a part of the treatment as your pet is monitored for changes to their condition.

Hydration Status/Fluid Therapy

• Subcutaneous (SC) fluid therapy with an alkalinizing, balanced electrolyte solution may be beneficial for patients with stage 3-4 CKD. SC fluid therapy often improves appetite and activity levels in some patients. However, your dog must be able to tolerate the procedure. If this causes fear, distrust and hiding, then it is not worth doing.
  
  Patients who are clinically dehydrated or have severe symptoms may need IV fluid therapy for at least 48 hours to correct their deficits. Additional options to encourage water consumption include using pet water fountains, adding water or flavoring agents (e.g. bone broth) to food, feeding an appropriate fresh diet, and having fresh water available at all times.

Nutrition

Many veterinarians will recommend a protein-restricted diet in dogs with any stage of kidney disease; however, protein should not be restricted in the early stages of kidney disease. This can result in muscle wasting and energy loss. It is, however, vital that the protein source is of high quality. It is also important to be somewhat restrictive with phosphorous levels in the diet.

It is important to keep the calcium levels up and the phosphorous levels down in these patients. Red meat is high in phosphorous and too low in calcium and should be avoided in later stages kidney disease. Feeding tripe is the closest you can get to maintaining that Ca:P ratio according to Dr. Judy Morgan using nutrition. Sodium restriction is also recommended so be sure to avoid high salt treats, deli meats, etc.

The ideal diet for pets with kidney disease should contain abundant moisture (never dry kibble, even if it is a prescription diet). This can be in the form of a commercial or home-prepared raw or gently cooked diet. I also recommend feeding kidney meat (as in Traditional medicine – treat like with like). Feed organ meat as 10-25 percent of your dog’s diet. The nutrients in kidneys can help support the kidney itself. If you can’t get kidneys easily, feed glandular supplements that contain kidney and other organ meats.

Medications

Phosphate binders – To keep the phosphorus level in a desired range, medications such as phosphate binders can be added to the therapeutic regimen. This is one of the parameters that we recommend checking fairly frequently (typically, every 3–6 months, depending on how stable the other renal values are. Adding tripe to their diet can also help manage phosphorous levels.

Blood pressure meds – Monitoring blood pressure is crucial for tracking the progression of kidney disease. If your dog consistently has high blood pressure, medication might help (Angiotensin-converting enzyme inhibitor (ACEi), calcium channel blocker (CCB) or both).

Darbepoetin is an injectable medication that can be used to treat anemia to stimulate the bone marrow to produce red blood cells.

Antacids such as omeprazole may be necessary to treat stomach or gastrointestinal ulcerations.

Magic MouthWash can be used to reduce pain from ulcerations in the mouth.

Supplements

• Nausea, vomiting or anorexia can be managed with ginger or chamomile tea. For stomach or gastrointestinal ulcerations, medication to reduce acid (such as omeprazole) might be prescribed.
• Free radical scavengers and antioxidants can help keep the body detoxed. I recommend SAM-E (denamarin) at 20mg/kg daily on an empty stomach.
• Omega 3s are very important in supporting kidney health due to their anti-inflammatory and antioxidant properties. Check out my blog on choosing an Omega 3.
• Pre and probiotics to help support the immune system. Check out my blog on choosing a probiotic. Microbiome Restorative Therapy (MBRT) from young, vibrant screened donors with healthy kidney function results in increased vitality while lowering certain kidney-related values.
• A Full Spectrum Hemp Extract CBD for dogs with kidney disease can help with symptom management but will also work to bring the body back into balance (homeostasis) as much as possible. Full Spectrum Hemp CBD for dogs with kidney disease can help elevate their quality of life.
• Medicinal mushrooms are recommended to support the immune system, are liver and kidney protective and have antioxidant, antimicrobial and anti-inflammatory properties. I like MYCODOG Vitality.
• Spirulina is another helpful supplement for its antioxidant effects.

Accupuncture

Acupuncture can be very beneficial to improve appetite, decrease nausea, and slow the progression of the disease.

Chinese Herbs

Certain herbs, like Ba Wei Di Huang Wan (Rehmannia 8), enhance renal blood flow. This promotes the functioning of nephrons even in cases where a significant portion of the kidney is compromised.  Apis Mellifica, Arsenicum Album, Aurum Muriaticum, and Cantharis are some other homeopathic remedies that can help.  It is important to work with a holistic practitioner when starting these herbs.

Medical Ozone and Ultra-Violet Blood Therapy (UVBI)

Ozone and Ultraviolet Light (UBI) Therapy is the combination of removing your pet’s blood, adding ozone, and running the ozone-infused blood via special tubing through UVA, UVB, and UVC rays. Ozone in the blood causes oxidative stress, causing the body to respond and heal. UV light adds energy to the red blood cells, causing a healing cascade to occur. The combination of Ozone and UBI increases the biological activity of the blood cells, thereby increasing immune-modulating effects.  You would have to find a veterinary practitioner who offers this service.

Homeopathic Remedies

Chinese herbal companies offer specific combinations of herbs that successfully support the kidneys. Some combinations work with the Jing (life essence) of the animal. Young animals with a low Jing or weak kidneys need long-term support.  Specific remedies like Arsenicum album, Mercurius, Natrum muriaticum, and Sulphur address various symptoms of CRF.  Chilliness, oral ulcers, preference for cool environments, and sluggishness can be effectively managed.

Prevention, of course, is always preferable to treatment. A poor diet is the main preventable factor for CKD in dogs. Feeding dry, highly processed foods can lead to chronic dehydration and inflammation, directly affecting renal function. To prevent these issues, opt for fresh, moisture-rich foods with minimal synthetic vitamins and minerals. Many excellent brands, including those formulated for kidney issues, are available. Consult a holistic vet or nutritionist for a customized diet.  

Minimizing toxins from vaccines, anesthetics, pesticides and overuse of pharmaceutical drugs.  Kidney damage can result from ingesting toxins, whether it’s a one-time exposure or a continuous intake. Be sure to keep your dog away from renal-toxic foods such as grapes and raisins.  And from other known chemicals and drugs that are renal-toxic, such as antifreeze.  Be cautious around the use of non-steroidal anti-inflammatories and heart medications ( especially diuretics) that can be harsh on the kidneys.  Household items such as scented candles, air fresheners, and cleaning products may contain kidney-damaging chemicals, so minimizing their use is essential for both your health and your pet’s well-being.

Early signs, such as increased drinking and urination, changes in coat, and bad breath, and decreased energy levels, should prompt regular laboratory tests in dogs.

Though kidney disease is a significant challenge, detecting it early and adopting both natural and conventional approaches can make a big difference in your dog’s prognosis and life quality. It’s crucial to include a vet trained in homeopathy or Traditional Chinese Medicine (TCM) for personalized and effective treatment. Keep in mind that starting treatment is never too late, but the sooner you intervene, the more successful the results tend to be.

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