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Hi, my dog Lottie is 16 and has had kidney disease so we have to be careful with her diet. We have two wet foods and one dry biscuit specially formulated for dogs with kidney disease but unfortunately she's very picky. She constantly wants variety and regularly will turn her nose up to it to go on the hunt elsewhere, she can't find any so she goes hungry. We even put a little bit of home cooked meat and veg in the meals, but she still gets bored extremely quickly.
This is what we have tried so far to flavour the meals: chicken, beef, liver, fish, egg, rice, pasta, potato, cucumber, carrot.

Does anyone have similar experience and tips on how to keep food new and interesting for a little dog with kidney problems? Any good recipes? Any meat, veg etc that really works well?
 

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Annie, my older dachshund, has kidney disease, and like your dog, doesn't care much for the rx kidney diets, and is pickier in general these days vs her younger "garbage disposal" years.

She had slightly elevated BUN (46?) and Cre (1.7 maybe?) on bloodwork done in spring of '14, at that point I continued her normal diet (ground wet food only), but added more water to it to increase her fluid intake. I also started her on a supplement called Renal Essentials. She didn't like the taste of the pills or treats, so she got them whenever I could convince her to eat them, probably several times a week. She also got fish oil, and coQ10 because her heart isn't in the best shape. Her BUN had crept up to 64 by May '15, but her creatinine had actually dropped a hair back down to 1.6. She had HGE (bloody vomit and diarrhea, not associated with kidney dz, but definitely not a good thing for them to get) later that month, and refused to eat her normal food after that, so I got her some of the "stew" types (multiple brands from petsmart, she had lost weight and had already been thin, so eating anything was important) and she liked them well enough. During this time I had stopped all her supplements, as she was already reluctant to eat for a while, and I didn't want to stress her digestive tract any more. A few weeks later she had a possible seizure (still unknown cause), and bloodwork done at that time showed her BUN up to 74, Cre up to 2.5, phos. still within normal range but starting to creep up as well. I still had some fluids left from her HGE, and the vet said it was ok to do those a couple times a week, so she had those 3x weekly for probably 2 weeks. I also put her on Hill's k/d stew at that point, though she quickly tired of it, and I now use it in rotation with several other stew foods. Started her back on the supplements at that time as well- I figured out that she will eat them in gravy, so I froze gravy into ice cube trays, and now she gets one warmed cube every evening with all her supplements in it.

I try to pick OTC foods which have lower protein (though I have read the phosphorous is what's really important, most don't list that), but there are some foods she really likes that are higher protein, and she still gets those here and there. I haven't had bloodwork rechecked for her recently, though I talk to her vet regularly (work for them), as she gets super stressed going there and it's difficult to take her anywhere in the car by myself. She occasionally skips a meal here or there (usually the k/d, and will eat if offered something different), and I do have an appetite stimulant that I can give her (mirtazapine), but I've used only 6 of the 8 pieces I got back in June, most of which were used following her HGE, when she was still reluctant to eat anything. It's frequently used in dogs with kidney disease, but I feel like if she's consistently not wanting to eat, that's a QOL issue, and it makes her pace looking for (more) food for several hours after getting it. This table has a list of nutritional info (including phos) for a variety of people food we might use as treats/food add ins/homemade diet, so it's helpful
DogAware.com Health: Nutritional Information on Selected Foods

I was looking for ways to put a little more weight on Annie and now am giving her some additional stuff from that list to add calories without further compromising her kidneys.

There are a number of rxs/supplements available for dogs with kidney disease, Azodyl (helps lower BUN) and Epakatin (phosphorous binder) are 2 that are frequently rx by vets, but there are others available OTC as well, though how well they work is up for debate. I had used the one Annie is on for a previous dog, and started her on it before the vet had recommended the others, but as she is difficult to medicate, haven't tried either of them yet. I don't know that it's made a difference, but she's still around almost 2 years after elevations were first noticed, without much other treatment, so I keep her on it ;)

I would talk to your vet and let them know her resistance to eating. My vet has told me that it's more important for Annie to eat anything vs going hungry over a long period due to not eating the rx food. If she's eating the regular foods well, it may be just a matter of adding a supplement to neutralize some of the waste products incurred by the higher protein/phos. I would guess that's not ideal, but better than not eating at all. They should also be able to provide you with a homemade kidney diet sheet (it's common for dogs not to like the rx kidney foods), or there are others online that you could print and show to them to see if it's ok. Have you tried heating the food up? Mixing the kidney diet with a spoonful or two of a food she's crazy for? Annie really likes Merrick or Organix brand food with the whole chicken wings in them, so if she's reluctant to eat other stuff, we'll offer her that or mix some of it into the other food. My vet said often dogs refusing to eat with kidney dz are nauseous, and there are medications that can help with that. Some dogs who've felt sick after eating a certain food are reluctant to eat it again, so if she's eating one type, but consistently turning away another, that could be contributing. If this is a new development, it may be worth repeating bloodwork to see if her kidney function is deteriorating further. In any case, it would be a good idea to let the vet know, as this is a common problem and they have a variety of things to try, plus knowing her medical history makes them the best person to advise you :)
 
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