We receive several emails weekly regarding kidney disease in dogs and  always feel so bad because we know that the dog owner feels helpless.

Most often the emails mention that the vet wants to place the older dog on Hills K/D food and the owner is struggling with this decision.

Diet should and must be your top priority if your dog has been diagnosed with Kidney failure.

Your dog will need a highly nutritious diet made up of whole foods.  The diet must include a high quality protein and remain low in phosphorus.

Since diet is critical for this disease in dogs; the dog owner is forced to make a decision on how to proceed nutritionally and this can be very overwhelming.

What is Kidney Disease?

There are two types of kidney disease:

  • Acute comes on suddenly and is often caused by a bacterial infection, kidney stones, an injury, shock, heart failure or poisoning.
  • Chronic kidney failure happens when kidney function simply deteriorates with time. This can be the result of the dog never fully recovering from his battle with acute kidney failure problems such as infections never fully healing, unknown heart problems, injury or shock, and/or poisoning (which can come from long term use of chemical flea and tick products, vaccinations, etc.).

How those bean shaped organs work and what they do….

using the herb bee balm for dogsYour dog’s kidneys are responsible for making sure that his body tissues receives enough water, while disposing of waste and excess water from the blood.

It does this by turning the waste and excess water into urine and moving it through the ureter tubes to the bladder, to store until your dog finally urinates.

Waste is derived from what your dog eats as well as the breakdown of active muscle tissue.  After the body has taken any nutrients it needs from the food, the waste is moved to the blood and then filtered through the kidneys as urine.

But, if your dog’s kidneys can’t remove the waste for whatever reason, that waste continues to back up up into the blood at dangerous amounts.

What the Urine Sample Shows….

By providing your dog’s vet with a urine sample, he or she can determine if there is blood, protein, white blood cells or glucose in the urine. If any of these are present, this can indicate that your dog may have an infection, an injury is present, the kidneys are inflamed or your dog is a diabetic.

What To Do?

It used to be that once a dog was diagnosed with kidney failure; the dog would be placed on a low protein diet. However, that theory has changed quite a bit over the past decade, although most traditional veterinary websites still claim that this is necessary.

It is now believed that dogs in the early stages of kidney disease do better with a moderate amount of high quality protein in their diet. Once the disease progresses and renal failure is in the severe or final stages (dog becomes uremic), then protein restriction does become very important.

Relax and Take Note……

relax with dog

Eliminate feeding kibble, and focus on feeding a diet consisting of high quality protein in moderate amounts, either a raw or home cooked diet, or a combination of both.  Provide ONLY fresh filtered or bottled water, a few supplements AND herbs, and avoid pesticides and vaccinations.

It’s also critical that you completely understand what stage of kidney disease your dog is in.  Ask your dog’s vet so that you know!


Traditional vets treat kidney disease with Hills K/D diets or other prescription diets, which are not only disgusting with regards to ingredients, they completely lack nutrition.

Home Cooking for Sick Dogs is a cookbook consisting of recipes for dogs with different diseases/illnesses.  It’s an option for those that want to home cook for their dog with ailing kidneys.

SOME of what you’ll find inside the cookbook:

  • Four specific recipes for kidney disease.
  • Non phosphorus binders that are natural to eliminate toxins in the stool vs building up in your dog’s blood.
  • Best Chinese herb(s) for renal issues.
  • Recommended herbal blends and supplements for kidney disease and others.
  • Specific diet advice on what can help.

You can learn more about the book here.


  1. When home cooking, it’s important that you add calcium to the diet. However, for dogs with kidney disease, you really want the calcium to bind with the phosphorus.  If your dog’s calcium levels are elevated (according to his or her blood test – again ask your dog’s vet); avoid adding calcium to the meal.  Instead, look to a natural phosphorus binder such as Bentonite Clay to eliminate toxins in the stool vs building up in your dog’s blood. Bentonite clay is recommended to help with the symptoms associated with the disease as well as prevention.  You can read more about it here.
  2. You should feed QUALITY sources of protein (organic meats and high grade fish).  You should feed in small quantities frequently.


  • Epakitan Binder is a antioxidant formula and a phosphorus binder. GIVE WITH FOODIf you use this, then don’t use the Natural Seaweed Calcium that we mentioned above. 
  • Supplementing the Diet is Critical: Your dog needs a HIGH QUALITY form of omega 3 such as Flaxseed Oil or GUARANTEED TOXIN FREE Fish Oil.  You can also include coconut oil (in addition to the omega 3 oils mentioned above.  A shout out goes to Nicky for sharing with me that Vetriscience makes a great kidney support product.  Typically, I would recommend some of the ingredients individually for dogs with kidney issues, but this product includes them all.
  • Azodyl is a supplement that is really just a probiotic that slows down toxins in the blood stream.  Some say it works well for dogs with kidney problems, but there are much better probiotics out there.  It is often used together with Epakitan.
  • Multivitamin with Kidney Glandular is a multi wholefood nutritional supplement for dogs and cats.  It DOES NOT contain calcium.  Glandulars are used a lot in holistic medicine. It is based on the theory that when an animal has a problem with a kidney or the liver, you include some of that organ into the diet.  I wouldn’t recommend buying organ meat and adding it due to the fact that you don’t know how toxic the organ meat is that your including. This is a pure, whole food supplement that includes a number of foods, probiotics and enzymes to help with digestive issues that often accompany the disease.
  • Drinking Water: Either filtered or distilled water is recommended for dogs with kidney disease.
  • Avoid chemical flea and tick products as well as vaccinations.

Different Stages of Kidney Disease

There are four stages of kidney disease that determine how advanced the disease is.  Your dog’s protein, blood pressure and creatinine level in the blood are the determining factors of the stage of the disease.  According to wikivet.com, the following levels of creatinine explain the stage of renal failure your pet may be in:

Stage 1: Creatinine 125
Stage 2: Creatinine 125-250
Stage 3: Creatinine 181-440
Stage 4: Creatinine 440 and above with or without symptoms of uraemia (blood toxins)


References: DogAware.com, Wikivet.com

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Showing 39 comments
  • Nicky

    I looked up the Only Natural Pet supplement you referenced and was disappointed to see the cost for dogs ($39.99) as opposed to cats ($10.99).

    For any of your readers out there who, like me, have become quickly overwhelmed by the cost of necessary supplements to give you more, precious, quality time with your best friend, VetriSCIENCE makes a supplement with the same active ingredients for a 90 capsule bottle (same size). I purchased mine on Amazon for $27.84 with free Amazon Prime shipping. Here’s a link.

    I also purchased Azodyl, Epakitin, Renafood, and omega 3 from Amazon at much lower prices than I was getting from my vet.

    I’m administering subcutaneous fluids twice a week (every 3-4 days). I found an online store that sells these slightly cheaper than my vet, and if I order in advance enough to utilize the free shipping it saves me a little bit of money, that is Drs. Foster & Smith website.

    Also doing a homemade diet, which is all my baby will even eat at this point, other than the pill pockets, thank goodness (greenies pill pockets also significantly discounted on Amazon from what you’d pay at Petsmart, under $10 for a 60 count package). I’m giving him Pepcid acid reducer, a Coq10 supplement, some vitamin C (ascorbate is best), and diffusing lavender and peppermint oil which helps tremendously with his appetite and anxiety (and mine!).

    I’m also running a humidifier in my room to help any way I can with hydration. For anyone who, like me, has looked to essential oils to help, PLEASE do not use the DoTerra Zendocrine blend. You will find pamphlets saying it is safe for dogs; however 2 of the 4 oils in the mixture are harmful to dogs – grapefruit (any citrus oil is bad for dogs) and clove.

    Best of luck to everyone out there going through this devastating time like I am right now.

  • Nicky

    Here is a better price option for the VetriSCIENCE renal supplement (select the capsules for the listed price, the chews are a little more expensive for less quantity): http://www.amazon.com/gp/aw/d/B00076NTBE/ref=mp_s_a_1_2?qid=1453668852&sr=8-2&pi=SY200_QL40&keywords=vetri+science+renal+essentials+for+dogs&dpPl=1&dpID=41CITiryReL&ref=plSrch&th=1&psc=1

  • Connie

    OTHER THAN PILL POCKETS? I have been asked by my vet to give low-protein food, which I had no trouble finding. But, she also asked me to administer medications in pill pockets or food because my dog displays evidence of laryngeal paralysis along with his kidney failure. I have been using a variety of protein foods up until now. No go! When I checked the price of pill pockets, a bag which would last me 3 days cost approximately $10.00, which would be cost prohibitive on top of the meds and vet bills. I have not had good luck with most herbal remedies. Can anyone give me some examples of low-protein foods that dogs would readily eat other than meat, nut butter, eggs, milk products or fish? He is a big boy, and so takes several pills at a time.

    • yourolddog

      Hi Connie:

      Is your dog in end stage renal failure? Why can’t he have meat, eggs or fish?

      You have to be consistent with herbal remedies in order for them to work. You also have to combine and eliminate all the other things that may be harming the body (chemical flea and tick products). Vaccinations must be avoided. Talk to your vet. A holistic vet is best in my opinion.


    • Mike

      egg whites are great as they are high in protein but low in phosphorus

  • Nikki Sagliani

    I purchased the book for kidney diets, just waiting for it to arrive. Can I get some suggestions in the meantime for a home cooked diet? My 8 year old weim was just diagnosed with chronic kidney disease stage two. He has been raw fed since I adopted him when he was four. Thanks! Nikki

    • yourolddog

      Hi Nikki:

      I sent you a private email earlier.


  • Jennifer

    I have been making our 16-1/2 year old Cocker Spaniel’s food for the past couple of months. His KD is acute, after a nasty bout with a bacterial infection & urinary tract infection (at the same time) one year prior. He also has 2 blown discs in his lower lumbar region. I’ve been making a quality protein cooked diet, which he scarfs down, and I feed him several times a day. I’ve also been supplementing his meals with Co q10, B50 complex, Pepcid, boswallia, hemp protein and glucosamine (for his spine). However, he was thin to begin with & now he is just plain scary looking. What can I do to increase his weight? I am pretty positive that if I can get some muscle mass on him, his joints will hurt less. He has the energy of an 8yr old dog, & is incredibly stubborn!!!????????????

  • Mike

    My 12 year old is in stage 3. He is doing well on Just Food For Dogs renal diet but it is incredibly expensive and I want to start cooking myself. Does anyone have any recipe ideas preferably with lamb as that is what he has been eating. It is mostly sushi rice, lamb, carrots, cauliflower, blueberries, spinach and fish oil. Trying to find something similar I can cook and add the above vitamins and supplements. [email protected] if you want to private message. Thanks

  • xiomi

    FYI the costco (at least in los angles sells 12 -1 liter bags) if you are member and register your pet. We paid 39 dollars at their pharmacy. i don’t know if all the costcos have this.

  • Kelly Meyer

    My young puppy has KD. We found Dr Harveys Canine Miracle to help with preparing fresh food. So far she loves it. It also makes preparing the home cooked food a little easier. You just add the high quality protien to it. A 5lb bag would give us about 20 days worth of meals. Of course you add the protien still. Lucy is 43 pounds and it is costing about 60.00 for the 20 days of meals. Not sure how that compares to the prescription food. We just ordered the supplements for her and will start those this week. Any advice of othe ways to keep the dog hydrated besides drinking water or IV’s?

    • janie

      Hi Kelly:

      It breaks my heart when I hear about any dog with KD, but it’s especially troubling to hear about a puppy with KD.

      Any kind of mellon is very hydrating. I would get your pup used to eating watermelon and cantaloupe. NOT A LOT. Give a chunk (use common sense with how big) maybe twice daily; you don’t want to cause loose stool.

      Hope this helps.


  • kim

    My dog won’t drink any water, but will drink bone broth (made with organic chicken bones). Is this ok? He has pancreatitis and kidney disease. creatinine is 4.2 and BUN is 70. Does anyone know which stage this is? Is this diet ok for him? I was told to do a low fat diet for the pancreas and low protein for the kidneys. I’m wondering if I can give him fish oil and coconut oil, but mainly wonder about the bone broth.

    • janie

      Hi Kim:

      Creatinine levels of 4.2 is considered stage 4 of kidney disease. The bone broth is good for Pancreatitis and as long as it’s low sodium (or your not adding additional sodium, it should be okay. What else are you feeding him? He definitely needs more than just bone broth (which is excellent to any diet). You might want to consider our cookbook which may be of some help with recipes and helpful herbs and supplements for the disease.

      Any fish oil you use MUST BE GUARANTEED TOXIN FREE We recommend Bonnie & Clyde only. Coconut oil should also be fine.

      Hope this helps.


  • Jenna

    Hello, would you recommend giving your dog ALL of those things recommended? Or how should we go about choosing?

    • janie

      Hi Jenna:

      You don’t need all of the supplements listed. Can I ask what stage of kidney failure your dog is in, and what you’re feeding including supplements at this point? How is she feeling and what are her symptoms?



    Howdy! Can someone tell me which is the right Salt Substitute to use for dogs? I have a Yorkie with acute renal injury and I will now be making him home cooked meals. On the recipe it says to use salt substitute (potassium chloride), any good ones please? My dog also has pancreatitis but mild.

    Much appreciated. Thank you.

    • janie

      Hi Tanya:

      I’m not sure why you’re using a salt substitute? If interested, our own cookbook offers recipes and recommended supplements for both of these conditions. You can learn more here if you like.


  • Jeanette

    I notice a few postings about pill pockets. Are these the greenies pill pockets? I have been looking for information to see if greenies re safe for dogs with renal disease. Does anyone have info? Thanks.

  • Michelle Sines

    Came to this post tonight are doing a search for phosphates in canine diet. I’m so glad I did. Kenzie is almost 19 months old. Was given the DX of kidney disease 2 days after Christmas 2016. Breaks my heart. The are good days, bad days. Days when I know she is hiring and the is nothing I can do. I recently have contacted a vet, not the one who diagnosed her, seeking low cost options to give her the best life possible. We don’t know what caused her KD, I expect that she had a virus that caused her to go into sick, as that is the stage she was in when we brought her in, initially. I would appreciate any and all information I can get to help her… Kenzie, red nose pitbull, 60#. I currently prepare all of her dog food. And she loves coconut oil. 😉

    • janie

      Hi Michelle:

      I’m really sorry to hear about Kenzie.

      I’m not sure if you checked out our cookbook or not, but it also includes the best supplement ideas and recommendations for dogs with kidney disease. You can learn more about it here if you like.

      I hope this helps. That’s great that you’re preparing all her food.


  • Melinda Mele

    Hello, thank you so much for the website. I came across it this morning looking for low-phosphate food ideas.

    My 12-year-old pug is diagnosed with kidney insufficiency, liver disease and a tumor on his spleen. Obviously the tumor is the most pressing problem (and I am working on that separately), but the one I can control best myself is his diet to help his kidneys and liver. I just wanted maybe get some advice, and add my 2-cents on homemade dog food.

    Advice first please: I am looking for low-phosphate, appetizing snack foods that I can make myself. I feed my dogs four times a day: two meals, two mini-meals. The mini-meals are the problem. I’m looking for a little variety, something I can hand over like treats, so not in a dish, and something I make myself, because I only feed my dogs food – not “dog food.” Nothing processed. I do make egg white heavy omelettes often. But I am having a hard time finding easy snack foods that I can entrust other people to give when I am not around.

    I’ve been making my own dog food for many years. I’ve had up to five dogs at a time, but now have three. When the kidney and liver diagnosis came in for my pug, I immediately researched what changes I needed to make. I had been making a stew of beef, carrots, acorn squash, potato, sweet potato and apple(seeds removed!), flavored with herbs and salt to taste. I use salmon oil as a supplement.

    The major change I made was to lower the ratio of meat to veg and to change the way I cook the food: 25% meat (stewed in a pot with water, apples and herbs) and 75% veg (steamed, except the potatoes, which I boil and throw away the water to rid it of phosphates). I puree the veg in a food processor, then mix it with the stewed meat. I added green beans and stopped using sweet potatoes. So the ingredients are: Stewed meat, steamed carrots, apples, green beans, acorn squash, and a boiled potato with the water discarded.

    I add ground egg shells from high quality eggs to the food dish (I just collect them for a day or two from normal use, dry them and grind in a grinder), a healthy squirt of salmon oil, and a seaweed based powder supplement. I serve the food warm. And before I feed him, I give him an herbal tincture supplement (from the same source as the seaweed powder), which my vet approves of. Here is a link for the herbal tinctures: http://caninekidneyhealth.com; you can decide for yourself. I’ve seen tremendous improvement in my pug (his tail is up a lot more, he trots around at meal time, his appetite is healthy again, he has greater strength in his hind quarters, he is much less mucus-y. He still sleeps a lot, but he’s in a better mood. He also gets one 10 mg Pepcid ac a day.

    I also do hydrotherapy on him daily, as recommended on the website I linked above. I don’t know if it’s the hydrotherapy, the supplements, the changes in the cooking method, or all of those combined, but I have seen great improvement.

    Of course, I’m going to buy your cookbook. I’m always looking for variety. So thank you for that.

    Anyway, it is a lot to figure out alone, so I appreciate any advice or comments that will help.

    Thanks, Melinda

    • janie

      Hi Melinda:

      I’m sorry for the delay in getting back to you. We get a bit swamped here at times. 🙂

      It sounds like you’re doing an outstanding job with your little guy! Congratulations…….

      I'm not sure what herbs you're adding, but I recommend adding burdock root to the mix if you're not already doing so. You can read more about it here. Very good for both the liver and the kidneys.

      I appreciate you considering buying our cookbook Melinda. If nothing else, it will give you lots of ideas for some of the best supplements, etc for many different diseases and illnesses.

      With regards to a low phosphorus treat, we’ve been recommending Matties treats which are low protein and low phosphorus. You could also consider replacing Pepcid ac with apple cider vinegar.

      I hope this helps and again, thanks so much for sharing your details with us Melinda. Keep up the excellent work. P.S. I assume you are avoiding all chemical flea and tick products and vaccinations now? If not, you should so that his little organs aren’t unnecessarily taxed any more. 🙂


  • Lisa Arbour

    Hi Janie…first of all, thank you for sharing your knowledge and experience. I have a 14 yr. old chihuahua/rat terrier mix (Rudy) who was just diagnosed with KD after bloodwork was done because of a bout with pancreatitis. After doing research online, we have decided to try a holistic approach. I ordered your ebook and also Epakitan, Azodyl, the Vetriscience kidney support chews, the multivitamin with kidney glandular, and Rehmannia 8. Do you think we should use all of these supplements, or might I being using too many products that offer the same benefits? Thanks for your help.

  • Susan Bird


    I was just told by my vet that my dog may have Cushing and that they found protein in her urine. I am picking up some medication that she wants me to give her today. I downloaded your cook book. I have been feeding her Primal Raw food for several years. I noticed your food was cooked, is that better? I don’t even know where to start to help her. Is protein in the blood a kidney disease? Or kidney failure? I would appreciate any help you can offer.

    thank you

    • janie

      Hi Susan:

      I’m so sorry to hear about your dog. Thank you Susan for purchasing the cook book. We appreciate your support.

      Vets can confirm that there are several causes for high protein levels to show up in a dog’s urine and they are most often related to kidney failure, infection, inflammation and/or trauma.

      Can you share some details about your girl for me Susan?
      How old is she?

        What breed is she?
        How much does she weigh?
        Have you done any vaccinating and if so, when?
        Do you use chemical flea and tick products on her?
        What did you feed her before Primal raw food and how long ago was that?
        Has your dog had any type of stones?
        What about infections in the urinary tract?
        Did the vet mention kidney disease to you? Symptoms such as drinking a lot of water and urinating a lot are symptoms of Cushings Disease, but other diseases such as kidney disease.
        Does your girl have any skin issues?

      You asked if cooking the food is better. It can be better when your dog has kidney disease since raw meat is naturally higher in phosphorus.

      Once I hear back from you, I’ll try to help you get started on a program for her Susan.


  • Christin L. Goff

    Hi there,
    My dog is almost 12 and has kidney disease. I need to know what to do, food-wise. She is losing so much weight and I believe I should begin to make her food rather than buy it. She seems to want to eat, but only certain foods, at certain times. Then it changes to other foods, at other times. She is very inconsistent. I give her Epakitin and Pepcid. Also, if I were to change to apple cider vinegar, how much should I give her to replace the Pepcid? Any advice would be helpful. (She is a terrier mix, a bit blind and deaf, but has bounced back a little from her initial diagnosis, which was at the end of February, 2017

    • janie

      Hi Cristin:

      I’m not trying to push our cookbook on you, but I think it might help. Besides recipes, it also includes supplements and other valuable information that can help with the effects of kidney disease. The recipes are for the crock pot and there are 4 in the book (it includes recipes for many diseases).

      We created this book because we receive so many questions on kidney disease and others on a daily basis. The book was put together to offer the very best options we know of for this disease and others.

      If you want, you can check into it here.

      The diet change and the right supplements (bentonite clay) can help tremendously with the acid build up. I hope this helps.


  • Jessica

    I just found out that my 8 month old female puppy has polycystic renal disease (a genetic disorder). So far she has no symptoms, except being a picky eater and tiring out a little easier than she used to. Her creatinine is 4.2 mg/dl, stage 4. Her Calcium levels are elevated just slightly above the normal range.

    How long does she have to live? The vet is hesitant to give me a clue. I realize that it can vary, but even just a clue would be great.

    What are better alternatives to Azodyl?

    I used to do a raw foods diet. My vet has recommended a diet that is almost entirely boiled potatoes plus about 1 ounce of chicken/day. I have been adding carrots and cabbage as well as a little extra chicken (for a total of 1.5 ounces/day). Is this acceptable?

    What else can I do? What are some important guidelines I should follow? Is it ok to give her little bits of fish etc every now and then?

    I give her fish oil, epakitin, azodyl, rehmannia 8 combination, denosyl, some vitamins and aluminum hydroxide.

    Thank you so much!

  • mel

    Thank you for this informative website/ article. I had blood word done on my 6 year old lab and everything was normal expect the SDMA which was 16. She’s had no other signs of KD- eating and drinking normal, no increased urination etc. Her vet also did an urinalysis and everything was normal- no protein in her urine. My question is should I switch her food? She’s on a high quality diet but it is kibble with phosphorus level of .8%. I also add canned 100% pumpkin and high quality fish oil supplement. The vet didn’t say we should change her diet yet. Also, should she still get her heartworm medication? Appreciate your help

    • janie

      Hi Mel:

      You’re welcome and I’m sorry for the delay.

      I would definitely change the food and move to a good food (not canned). I would switch her to a food like The Honest Kitchen or Dr. Harveys where you simply add HOT FILTERED water to it and your dog has a meal. However, I always recommend adding additional protein. I would still add meat and/or egg to her meal as well. Depending on the severity of her kidney disease, I would 1/3 QUALITY meat as part of her daily meal. I would place her on a good multivitamin (and ours are very good). I would eliminate the pumpkin. I would include a little fresh alfalfa sprouts 3-4 times a week.

      I would also include Rehmannia 8 for her kidneys. You can read about it here if you like.

      I definitely would NOT include any chemicals in her body whatsoever Mel.

      I hope this helps.


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