Dear Kara: Renal health (Sponsored by Hill's Pet Nutrition)

PHOTO: GETTY IMAGES

Senior wellness testing on Goldie, a 12-year-old golden retriever, revealed early kidney disease. She has no clinical signs and eats Hills® Prescription Diet® w/d® Canine pet food. Would it be a good idea to switch her to Hills® Prescription Diet® k/d® Canine pet food?

I am glad to know you are performing wellness tests on your senior patients. If Goldie's results show early kidney disease, I would recommend gradually transitioning to Hill's® Prescription Diet® k/d® Canine pet food. Even in dogs with a lesser degree of azotemia, clinical studies have found that k/d Canine pet food delayed onset of a uremic crisis by approximately five months. It has also been shown that dogs eating k/d were 50% less likely to suffer clinical signs and experienced a 72% reduction in the rate of kidney disease progression. Proper nutrition can give our patients a better, longer life! Remember, as Goldie has a tendency to gain weight, healthcare team members should calculate the amount to feed, divide this and recommend twice-a-day feedings, and review this with the owner.

Food for Thought

I get confused when discussing the importance of therapeutic foods for cats with kidney diseases with their owners. I thought the main purpose of a therapeutic food for cats with kidney disease is to reduce protein, thus diminishing the workload on the kidneys. I explained this to an owner who refused to believe that reducing the dietary protein for carnivorous animals, like cats, could be good. I had no idea how to answer. Help!

Nutritional management is the cornerstone of treatment for dogs and cats with chronic kidney disease; it is one of the most effective treatments the veterinarian can implement for prolonging the life span in these patients. Therapeutic foods are not focused simply on one nutrient, but are an entire nutritional package for those patients suffering from kidney disease. Healthcare team members should educate owners that therapeutic foods can help patients with kidney disease by: avoiding excess protein, phosphorus, and sodium chloride. These foods also have increased levels of potassium (for cats), omega-3 fatty acids, antioxidants, soluble fiber, B-complex vitamins, and increased buffering capacity against metabolic acidosis. The benefits associated with feeding these foods include reduced kidney workload, reduced stress on the kidneys, and reduced renal cellular oxidation, all leading to a slowing of the progression of kidney disease.

We have clients that decline wellness testing on their mature and senior pets. We try to explain the need for senior wellness testing, but they say their pet looks fine and is slowing down due to old age. What else can we tell them to raise awareness of the need for senior wellness testing?

I believe that one of our major roles as technicians is to educate our clients as to the importance of wellness testing and the results that may be uncovered. The pet may look fine, but kidney disease is called the "silent killer" because signs may not appear until the pet has lost nearly 75% of its kidney function. This kidney function loss is irreversible. Kidney disease affects more than one million pets each year, and is one of the leading causes of death in dogs and cats. Healthcare team members should be asking clients about their pet's activity at home. Open-ended questions exploring the drinking and urinating habits of their pet; energy and appetite of the pet; breath odor and gastrointestinal function of the pet. These questions will help owners think about their pets' behavior and maybe the subtle differences they are in fact seeing may uncover a more serious condition.

As kidney disease is common in older cats, do you recommend feeding Hill's® Prescription Diet® g/d® Feline or k/d® Feline pet food as a preventive food? It seems that canned k/d or g/d may be a good idea, especially as canned foods increase total water intake.

Frequent screening for kidney disease is very important as early kidney disease is difficult to detect. If the results indicate early kidney disease, Hill's® Prescription Diet® k/d® Feline pet food would be recommended. If the screening results do not uncover any level of kidney disease, Hill's® Prescription Diet® g/d® Feline pet food would be appropriate for geriatric cats. Reducing sodium helps to control clinical signs associated with ascites or edema and minimizes systemic and renal hypertension. Soluble fiber is added to help decrease urinary nitrogen excretion and lower serum urea nitrogen. Canned formulas are a great way to increase water intake and high levels of omega-3 fatty acids in the canned formula help improve blood flow to the kidneys.

What treats do you recommend giving dogs on Hill's® Prescription Diet® k/d® Canine or g/d® Canine pet food?

This is a great question. Because we know that dog owners are going to treat, healthcare team members should be proactive in recommending the appropriate treat.

Dogs that are eating Hill's® Prescription Diet® k/d® Canine or g/d® Canine pet food need to be given a treat with the same nutritional factors in mind. One suggestion is to treat the pet with the dry kibble of the food—it typically is the attention you are giving to the pet, not the food reward—that treats the dog. Another option would be to slice the k/d Canine or g/d Canine canned pet food, bake in the oven at 350 f, and make treats out of the canned food. An additional recommendation would be to complement the therapeutic food with Hill's® Prescription Diet® Canine treats. These treats have the important benefit of being low in sodium to help maintain kidney health.

Remember with all of these options, the calories of the treats must be incorporated into the daily caloric intake of the dog, not in addition to their food. If the treats are added and the calories are not accounted for, the dog potentially will gain weight.

Kara M. Burns, MS, MEd, LVT Veterinary Technician Specialist Hill's Pet Nutrition

Kara M. Burns, MS, MEd, LVT

© 2008 Hill's Pet Nutrition, Inc. All rights reserved. ®/TM Trademarks owned by Hill's Pet Nutrition, Inc. To view this and other issues of Dear Kara, visit www.dvm360.com/dearkara