Diet for puppy with kidney failure

[joeykttn]

I have a 16 week old boxer who has been diagnosed with renal failure (most likely congenital). He is now on the Science Hill R/D diet (1 can wet with a 1/2c dry mixed in, 2x daily), pepcid once a day and a phosphorus blocker. We are doing sub-q fluids at home, 300ml every other day. He is now very active, eating well, peeing & pooping well, just not drinking much.
My question is this...I am having a very hard time finding info on how to properly feed a puppy with kidney failure on a home made diet. I want to start cooking for him, because I've not heard good things about the nutritional content of the food he is on, especially for puppies. The vet is most concerned about keeping him alive, and while that is obviously my concern as well I want him to have proper nutrition. I believe I may be able to provide him a good life for a long time, if I can get his nutrition in check. I have done a lot of research, but am overwhelmed a bit, and confused because most of what I'm reading pertains to older dogs, not growing puppies. My vet has admitted he doesn't know much about home cooking, and has suggested I talk to a nutritionist, which I have done, but they are expensive, and our savings are nearly depleted at this point. I have specific questions like should I add calcium to a homemade diet in the form of bone meal, if his calcium levels are already almost high? What supplements are critical for helping kidneys? Can you offer any help, any sources, or any guidance on this, or on any aspect of home feeding a puppy with renal failure? Thank you.

[joeykttn]

Thank you for your reply.
I'm a bit surprised by the resistance in the veterinary's office (or at least mine) to the idea of home cooking for animals. With so much research available for humans on the benefits of less additives, higher quality, less processed, etc food, you'd think they would be more open minded to the idea. :/
After a more then a month of researching & reading anything & everything I could, and talking to several owners of dogs with kidney issues, I decided to go home cooked anyway. I'm currently using a Dr. Strombeck recipe, with a tad additional protein, omega 3, Vit B, calcium & a phosphorus binder. I had come up with a few of my own, also loosely based on the nutritional data available at Hill's website & using nutritiondata.com... My vet is hesitant to approve, since he isn't able to confirm the research I've done (but won't look at the recipes I had concocted either). He gave me a few recipes by Strombeck, and we're trying one right now, mostly to appease the vet. My recipes were almost identical in nutritional values, so that was at least silent confirmation I was on the right track. And the vet is very pleasantly surprised at how well T.J. is doing. He said last night that he doesn't even appear to be the same dog. I couldn't be happier to get such a wonderful report :) Now we'll wait for bloodwork to confirm it at the end of the month :)

[Wist]

I forgot to mention that the phosphorus restriction may be more critical than even the protein restriction depending on the type of kidney disease.  K/D's one size fits all simply does not cut it for different types of disease, different stages of disease and the different needs of a puppy vs an adult or a senior in the same way a specifically tailored home cooked diet can.  

[Wist]

The nutritional information re Hill's K/D is readily available at Hill's online.  My dog with kidney failure is allergic to chicken which is one of the ingredients in K/D and he cannot eat it.  I home cook for him and I make sure the important ingredients: protein, phos., calcium, omega3, vit E, Bvit., fat, calories are all in the same % as Hill's (I use Nutrition Data online) but my ingredients are of a higher quality and his food is prepared daily so there are no preservatives and it is much more palatable.  Also, I have the ability to change it up if he gets picky for any reason by making substitutes within the necessary kidney friendly parameters.  

Even were he not allergic to Hill's K/D, like many other dogs, he refused to eat it.  I believe that many dogs are initially believed to be much more ill than they may be because their doctors and guardians insist on feeding a food that is rejected by many if not most dogs and subsequently become ill more rapidly as their nutritional status tanks because they are so reluctant to eat K/D.

[joeykttn]

Thank you for taking the time to reply. I mis-typed..he is on the K/D, not the R/D.
I was told by the veterinary nutritionist that the Hill's K/D is not good for a puppy because the calcium/phosphorus ratio is not good, and studies have proved it to cause bone malformation. Also, I've seen other sources caution, or even discourage, it's use in puppies. I've also read many stories of people who, with a home cooked diet & careful planning, supplements, vitamins etc have been able to extend their kidney diseased pets lives well beyond the vets expectations. I do understand there are many factors, in both life expectancy & diet balancing, so I appreciate your concern & thoughts. Thank you,
Jenn

[Cliff Redford, DVM]

Hi Joey...you wont like my answer.
Hill's prescription diet is in my mind the best food available. You will not be able to provide your dog with balanced nutrition by cooking at home. Even if your puppy was healthy I would not recommend it but considering their is renal disease, a veterinary approved diet is what is necessary. R/D is a balanced diet, even for a growing puppy. In fact their is a food made from Hill's called K/D that is specifically designed for renal disease. A study was done years ago out of Colorado state university that showed even puppies fed k/d; a protein restricted diet, received all the necessary nutrition for a healthy life. While your puppy will not have the same muscle mass as other dogs, I am confident the renal disease can be best kept in check through K/D.
I am happy to hear that you are so concerned that you would consider taking time out of your schedule to cook for him, but a commercially prepared food is best.