Early Kidney Disease - Difficulty Getting Her to Eat

My Cosmo is 14 yrs. old and recently diagnosed with early stage kidney disease. I have always done the full senior blood panel the past few years in her annual and all was okay. Until this June. The creatinine level is 1.8 (last year was 1.1), BUN is 35 (last year was 20), urinalysis had no red flags though she's drinking a lot more water.

For the past few years, I've been feeding her Merrick's Grain Free Real Chicken Dry mixed with the Merrick's Canned (there are 7 recipes of the canned that I rotate and she really loves them). Last year, I switched to Orijen Senior Dry (and kept rotating the 7 flavors) and she loves this, too. So far at this point, all seems fine.

Then last month, because of the bloodwork results in her annual check-up, I switched her food to Purina NF canned - she ate it for about 3 weeks then just outright refuse to eat it now. So I tried mixing it with the Merrick canned. For about 2-3 days, she ate some then just a little and now she doesn't want to touch it.

So then I tried the Purina NF Dry kibble with the Merrick canned. I can't believe she actually pick every dry kibble and removed it from the bowl! But only ate a little of the canned then walked away.

This week, I asked my Vet for a medication and she prescribed Azodyl (she said it will bring down the metabolites in the blood but this won't slow progression). I started giving it to Cosmo yesterday but I don't know when I'll see any improvement.

The Vet also suggested JustFoodForDogs and BalanceIt food. So I gave her some JustFoodForDogs (Beef and Potato). She seems to like for a day but now she's only eating a little bit of it. It actually tastes good (and definitely tons more flavor than the Purina NF). I'm also waiting for the prescription for the JustFoodForDogs "Renal Support Medium Protein" so I can get it and see if my senior pup will eat it. I may boil a whole chicken with carrots (with the fat removed) for soup/liquid.

I used to feed her twice daily but am now trying to get her to eat litte amounts 4-5 times daily. She's 14 so I feel I just need for her to eat. Other than eating less, she acts normal and is not lethargic. We walk every morning and we both enjoy it. She jumps on the highest part of the couch. She does her zoomies once in a while (though a little shorter time). She is alert and still full of life.

I don't think she's lost appetite because she seems to want some food - maybe just not the ones I've been giving her (she eats the treats).

Not sure if her health is deteriorating faster (even if she's just in the early stages of the kidney disease). Or did I just change/switch her food too quickly?

Does anyone have a similar experience and have some ideas or insights to share?

I'm really worried and it's just stressing me out. She's definitely eating less. Not sure what I can do to get her to eat more and enjoy the food.

last edited by imbj

I have had similar experience when trying to switch to a recommended food for kidney issues. Sometimes you just have to feed them what they are willing to eat! A food that is "better for them" isn't better if it results in diminished appetite or outright refusal to eat. And yes, sometimes it is difficult to tell whether the lack of appetite is due to the food or progression of the disease.

If you think your Cosmo would be willing to eat some "home cooking", I have a recipe from Hill's Pet Products. Naturally, check with your Vet first.

Canine Restricted Protein Diet
1/4#(pound) ground beef (not lean)
2C white rice, cooked (no salt)
1 egg, hard boiled
3 slices white bread, crumbled

Saute beef, stirring until lightly browned. Stir remaining ingredients in, mixing well. Add a little water, not milk, if mixture is too dry. Store covered in the refrigerator. Yields 1.25#.

Add daily
1 Tums® (aka calcium carbonate), and
1 canine multivitamin

Nutritional Values
6.9% Protein
5.5% Fat
21.1% Carbs
65.5% Moisture
750 Calories/#

Recommended Feeding Guide
~1/4# for every 5# of body weight

Thanks for the feedback and ideas! This morning, I just decided to give her a small amount of the regular canned and she ate it (all of it). I'll slowly introduce any new food and see if that works. @elbrant - I enjoy cooking so home-cooked meals is an easy thing for me to do. I'll check with my Vet on the recipe you kindly shared! We're doing another blood panel/urinalysis next week to check the values so keeping my fingers crossed.

last edited by imbj

@imbj - The food recommended by Vets for things like kidney failure are typically "nasty" and most all dogs will not touch it... as noted, many are filled with grain and many times the first ingredient is corn. You can look on line for some recipes for home made. Remember that Vets do not get much training in food sources (during training) and go by what these company reps are "pushing", so most likely you will get pushback. You might be better off talking to a holistic Vet about feeding.... I have used Azodyl in the past, it takes about 30 days to make a difference.

last edited by tanza

@tanza Yeah, Cosmo sniffs the kidney diet food first and whatever smell it is, she just walks away (and then looks at me with disappointment). Any suggestions on holistic Vets?

@imbj - Go on line for your area and see who is available... talk to them.. and then make a decision... been a while that I have used a holistic Vet... You might want to try and catch up with Tayda_Lenny as she has been dealing with Kidney issues and she have been doing home made

last edited by tanza

@tanza Thanks! When searching, I think those paid ADs are skewing the correct results when googling for holistic vets. So I dug in a little deeper and found the American Holistic Veterinary Medical Association and they have a VetFinder (yeahhh!). It turns out there's a Vet (in the same clinic as my Vet, but in a different location). This Vet has a "Whole Food Formulator" certification. I think I'll contact that Vet but hoping it won't be awkward. And will catch up with Tayda_Lenny and check on the posts.

@imbj - Great to hear, shouldn't be awkward, not like you need a referral.... Hope it goes well, keep in touch!

Sorry you are having difficulties. I have taken in several fosters with CKD. I've had a couple who were at Stage 3 for 5+ years - and I didn't put them on special KD food. KD food is often not appropriate. One wouldn't touch food that was high (or 'normal') in fat. He started out here extremely anorexic and gained 50% of his original body weight on low fat weight management food (and still looked lean - he was so thin!). I did always feed wet food (though I had to be a bit flexible with the seriously anorexic boy, sometimes starting a meal out with a couple of bites of desiccated food).
Do you have a copy of lab results? What was the phosphorus level? Have you considered a second opinion or a visit with an internal med specialist? They should have more familiarity with CKD and, hopefully, more successful experience.

Our Wendy, 15, had her liver enzymes get pretty high. Her medication, it seemed, was killing her appetite. She looked at food, but walked away without eating. She now gets a 1/2 Prilosec morning and evening. In the am she also gets 1/2 dose of Entyce and that kick starts her appetite quite well. After a week of the appetite stimulant she is now eating regularly-3 small meals a day. It so hard to watch them not eat, knowing that they are hungry too. Prayers for you and your b.

Hello IMBJ,

My heart hurts for you as I went through this. I won’t relive my story but maybe I can give some advice. There are a few things I would do differently if I could go back.

Know this, you need to take care of the caretaker- yourself. The peace you impart on your pup on this journey is everything - no matter how long or short. They pick up your fear and worry.
Keep in mind there is quality of time and there is quantity of time. They are not the same.

So, you need a plan.

  1. Ditch the kibble stuff as the ingredients and protein levels will spike their blood counts and they feel so sick afterwards. Home cooking is best and definitely contact an animal nutritionist. Univ of PA has a veterinary school that does this as do a few others. Money well spent. They will give you a few recipes.

  2. QT— learn how to give a QT yourself- fluids IV in loose skin a top of neck if you are comfortable doing this. A vet can show you how and you will save a lot. This journey is an expensive one. If you are not comfortable with this or your pup gets aggressive then don’t do it. It is far better to keep things calm as long as possible but it will mean a shorter journey. If you do give fluids whether from a vet or yourself you will definitely see them perk up and maybe get playful. Enjoy this time.

  3. CBD —-know that pups never show the level of pain they are in. Watch the signs- hiding, sleeping a lot, less eye contact or more, and the obvious signs of pain. If I could go back, I would have given my pup CBD in addition to pain medications. Check w your vet if perhaps you can try a medication that will make him less groggy and/or see double. CBD is amazing but it can’t do everything. There is still pain and discomfort so please still treat w meds.

  4. Listen, You could have another year or so making it the best you can is worth making a plan. We all will pass but having a plan in place helps you from having to make emergency arrangements and getting even more upset in front of you pup. Have stronger pain meds at the ready as per a vets guidance in case a pain spike. And arrange that whenever the day comes, how and when you will go about alleviating their pain once and for all. Whether a vet that will come to your home (now w shelter in place - maybe your backyard or a park). I had a lovely on call vet arranged in advance. All I had to do was call and give my name and they came as soon as they could. At that point it is never soon enough. Everyone I have talked to says they wish they had made this final action sooner - days or weeks sooner. I also feel this way. We do the best we can and they know we love them and that is the most important thing.

These are all ideas for a plan but do make one, it will empower you.

Every day is a wonderful gift with your pup. I hope this helps. - Your fellow Basenji pup mother

Hello,
Make sure you give the Azodyl as a whole pill. It is supposed to be in a special capsule which does not dissolve in the stomach.
I recommend you read the trend in 'Basenji Feeding' about Lenny's kidney disease. I like the info from DogAware.com. Wet food is usually the way to go. It can help with water intake and the protein has better bioavailability. Avoid kibble and avoid cooking at high temperature.
Elevated liver enzyme require a bit more research for proper feeding. A half teaspoon of green tripe (stinks to humans, my Basenji looooves it) can help appetite... but nothing compares to it afterwards (and I am not sure about green tripe and elevated liver enzymes).
You need a canine nutritionist how is not 20 years behind in their knowledge. You need someone who is acquainted with: Mythology of Protein Restriction for Dogs with Reduced Renal Function by Kenneth Bovee DVM (1999).
Good luck!

last edited by coldsenji

Thank you all for your support, help and sharing your knowledge and experiences! It's feels better to know there are options that I can explore. Her quality of life is of utmost priority for me and want her to be comfortable and happy. She's curled up beside me right now on the sofa and snoring as I'm writing this.
(oh, her phosphorus level is 5.7 and last year, it was 5.0)

Hi,
For the phosphorus, do compare from year to year, but your need the 'normal' range for a proper assessment. It is important to balance the calcium-phosphorus in the diet using eggshells or calcium carbonate. It is easy to do with a homemade diet. Most regular dog foods use bonemeal for balancing which is the way to go for healthy dogs (it contains both calcium and some phosphate).
If phosphates go way to high, your vet might recommend phosphate binders. BTW, calcium carbonate is a phosphate binder but there are others. Reducing the total phosphate in the diet is important, but not necessarily the solution.

My Firbi started apparent kidney problems just as I was setting off for Australia - the vet put him on Hill's to hold him until I got back 17 days later and could discuss it further. Marvin was dog-sitting (obviously he wasn't left alone or kennelled).

I took him in for further blood tests the day I got back - and the diagnosis was confirmed. Deterioration was rapid and he was starving himself rather than eat Hill's. The vet said there was nothing to be done anyway and so give him whatever he fancied to eat.

What he wanted was his normal diet with additional zuccini, marrow - any form of squash. Back eating with the rest of the pack, we were down to four at that time, Firbi even gained a tiny bit of weight. I think he hadn't liked being singled out for a special diet. Wanted to feel he was part of his pack. The end came some 6 months after I got back from OZ. He was only 13.

On a happier note, Debradownsouth is back !

One of my Basenjis is also diagnosed with early kidney disease. The vet prescribed Enalapril Maleate (generic for Vasotec). My vet allowed me to choose whatever prescription food I wanted to use. After some research I chose Blue Buffalo BLUE Natural Veterinary Diet KS Kidney Support. I looked into and tried a more holistic food, Dr. Harvey's - a dehydrated food, but Kushika couldn't manage to eat it without getting it all over the walls, kitchen floor, and herself so we went back to the kibble. I liked the Dr. Harvey food AND you can call to talk to Dr. Harvey, who asked me to send Kushika's lab results to him so he could make specific recommendations dependent on those results. Kushika came to live with us at almost 10 years old and was immediately diagnosed with kidney disease. At age 12+ she is still with us, going strong and looking better than when she arrived.

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