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Non-Prescription Commercial Diets for Dogs with Kidney Disease

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Introduction

Some senior and light diets contain less phosphorus than regular dog food, and may be usable as part of the diet for dogs with early stage renal disease (creatinine no higher than about 2.2). A few have been included below, but there is a chart of many more included in the article Phosphorus Content in Dog Food -- this chart is listed in order of mg phosphorus per hundred calories, which is the best way to look at the data. Note that the numbers provided below are extracted from a number of sources and are not guaranteed to be current; it is always best to contact the manufacturer and ask for a nutritional analysis (not the guaranteed minimum) to be sure.

Not all of the foods listed below are appropriate for dogs with kidney disease, but I've tried to find some with lower than average amounts of phosphorus, which you might be able to use as a base with added low-phosphorus fresh foods, as described below, or combined with a prescription kidney diet to improve the overall quality of the diet..

In the table below, use the "dry matter" percentages for comparing brands, and canned vs. dry. Use the "as fed" values for computing how much you are feeding. In particular, do not use the amount per can or per cup for comparison purposes, as the size of the can/cup varies quite a bit between brands. See Know the Difference: “As Fed” vs. “Dry Matter” Percentages for more information.

Remember that low protein is unnecessary and even harmful unless your dog is uremic, but low phosphorus is advisable. Moderate protein reduction may be required if your dog has proteinuria (significant protein in the urine). Canned food may be preferable to dry, as the extra moisture can help your dog stay hydrated, though you can add water to dry food to accomplish the same purpose.

For comparison purposes, most regular commercial diets have around 1-2% phosphorus on a dry matter basis. A dog with early stage kidney disease should be limited to no more than 0.6% phosphorus on a dry matter basis. Another way to figure it is that you want to feed no more than 30 mg phosphorus per pound of your dog's body weight daily if your dog has early stage kidney disease (less is better). These numbers must be reduced further for dogs with moderate stage kidney disease.

In addition to the high-quality foods listed in the table below, the following foods have less than 0.6% phosphorus minimum on a dry matter basis, according to a chart I saw in a book. They're not high-quality foods but may be better choices than lower-protein diets for dogs with early-stage disease:

Hill's Science Diet Adult Advanced Fitness Gourmet Beef Entree (canned)
Hill's Science Diet Adult Light dry, canned, and Small Bites dry)
Hill's Science Diet Mature Adult Active Longevity (dry) and Gourmet Beef and Savory Chicken (canned)
Hill's Science Diet Mature Adult Large Breed and Small Bites (dry)
Nutro Natural Choice Large Breed Weight Management (0.5-1.0% phosphorus, 152-305 mg/100 kcal)
Natural Choice Large Breed Adult Lamb & Rice, Chicken & Rice, Beef & Rice, and Senior Chicken & Rice Formulas (canned)

The following foods have phosphorus amounts between 0.6% and 0.7% minimum on a dry matter basis:

Hill's Science Diet Adult Advanced Fitness Beef & Chicken, Savory Chicken, and Gourmet Turkey (canned)
Hill's Science Diet Adult Advanced Fitness Original Dry
Hill's Science Diet Adult Light Large Breed (dry)
Hill's Science Diet Mature Adult Active Longevity Gourmet Turkey (canned)
Nutro Natural Choice Lite and Natural Choice Herring Meal, Rice & Potato Formula
Royal Canin LA23, Maxi, Medium and Mini Adult 2 (dry)
Superior Brands Dr. Ballard Oven Bake Senior (dry).

Add water If you feed dry food, it's best to add water to help your dog stay hydrated. Remember that dry food will spoil once water is added, so you shouldn't leave it out all day.

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Adding fresh foods

One option to consider, particularly if your dog does not like any of the prescription kidney diets, is to feed a lower-phosphorus regular (non-prescription) commercial food such as those listed below, and then add some low-phosphorus fresh foods to reduce the overall percentage of phosphorus in the diet.

If you're feeding a high-protein commercial diet, you can add some low-phosphorus carbohydrates such as white rice, pasta, potatoes and sweet potatoes. If you are feeding a low or average protein commercial diet, you could add fatty meats that are low in phosphorus. You can add a combination of both low-phosphorus fatty meats and carbs to any kind of diet, prescription or otherwise.

For dogs with early stage kidney disease, look for foods to add in the Table of Nutritional Values with less than 100 mg of phosphorus per 100 kcals. The goal is to reduce the amount of phosphorus in the overall diet to around 100 mg per 100 kcals. Dogs with moderate or late-stage kidney disease will need foods with even less phosphorus. You cannot use non-prescription diets at all for these dogs.

Be sure to add calcium, which acts as a phosphorus binder, at the rate of 1,000 mg (1/2 teaspoon ground eggshell, or any other form of plain calcium) per pound of added fresh food.

EXAMPLE: You might provide half the dog's daily calories from a relatively low-phosphorus commercial food (less then 200 mg phosphorus per 100 kcal). The other half of the calories would come from a mixture of half fatty meat, such as 80% lean ground beef or dark meat chicken with skin, plus half low-phosphorus starchy carbs, such as white rice or sweet potatoes (the latter are more nutritious). The mixture would be based on weight, not volume; e.g., 4 oz ground beef plus 4 oz sweet potato, not half a cup of each.

Those mixtures will provide in the neighborhood of 50 calories per ounce, to help you compute how much to give. You'll have to figure out how many calories their dog needs, which you should be able to do based on whatever you've been feeding before. Such a mixture will provide in the neighborhood of 50 mg phosphorus per 100 kcal.

You must add calcium at the rate of around 500 mg per pound of added food. You can use ground eggshell (1/4 tsp provides 500 mg calcium), or any other form of plain calcium. Calcium helps to bind phosphorus, as well as meeting dietary needs.

The more fresh foods that are added to the diet, the more important it becomes to balance the diet in the long term (short term, a few weeks to maybe a few months, it's OK to feed an incomplete diet). This is especially true for younger dogs, who may be on the diet for years. So if half the diet is fresh foods, just fatty meat plus starchy grains won't provide all the nutrition your dog needs. Add a multi-vitamin and mineral supplement that does not include phosphorus to help make up the difference.

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Dog Food Mixes

There are a few dog food mixes on the market that can be used to create a diet for dogs with early stage kidney disease. These mixes are designed to be combined with fresh foods to create a complete diet. Use higher-fat meats, tripe, whole milk ricotta cheese and combinations of whole eggs and egg whites to keep phosphorus levels reasonable, as long as your dog can tolerate a high-fat diet. Be sure to use a variety of fresh foods, not just one kind, and it's OK to feed very small amounts of foods that are higher in phosphorus, such as liver, for variety and better nutrition. Use the Table of Nutritional Values to see the amount of phosphorus per 100 kcals in various foods (far right column). Although these foods are designed to have fresh foods added, I would still add calcium at the rate of 500 mg (1/4 teaspoon ground eggshell, or any other form of plain calcium) per pound of added fresh food to help bind phosphorus.

Sojo's Original and Grain-Free (formerly European Style and Europa) -- Warning! Sojo's has replaced calcium with tricalcium phosphate in their foods. This increased the amount of phosphorus to 246 mg per 100 calories for the Original, and 260 mg per 100 calories for their Grain-Free mix, too high for dogs with kidney disease. Their complete diets are similar.
Grandma Lucy's Artisan Pre-Mix Shows a maximum of 0.37% phosphorus as fed (0.41% dry matter) on their web site, which works out to 105 mg phosphorus per 100 calories. The pre-mix is not a complete diet and is designed to add your own protein to, although they do not say how much. Add fresh foods that are lower than 100 mg phosphorus per 100 kcals to reduce the overall amount of phosphorus in the diet.
Essex Cottage Farms Kidney Diet -- ECF Kidney Diet (item 9) has approximately 0.25% phosphorus on a dry matter basis when fed as directed with just one pound of meat, according to the analysis on their web site.
The Honest Kitchen Preference -- Preference is 0.71% phosphorus on a dry matter basis (185 mg phosphorus per 100 kcals). It is designed to be fed with added meat, eggs, and dairy at a 1:1 to 2:1 ratio of meat and other foods to Preference (dry measure, before being rehydrated with water). Use the higher ratio (2 parts meat and other foods to 1 part dry Preference), and add fresh foods that are lower than 100 mg phosphorus per 100 kcals, to reduce the overall amount of phosphorus in the diet. For example, 20% fat raw ground beef has only 62 mg phosphorus per 100 kcals, so it would be a good choice (but be sure to use a variety of fresh foods, not just one kind).
Wendy Volhard's NDF -- I have heard one direct report of a dog with kidney failure that gained weight, lost foul breath and water consumption went back to normal on this diet (dog was fed less meat than normally called for). See K9KidneyDiet message #2103. They could not provide me with the amount of phosphorus in NDF, only figures that included added protein (80/20 raw beef, lamb or cooked chicken with skin on), which are (dry matter basis): Protein 34.7%, Phosphorus 1.3%, Calories per pound 2,172. That translates to 272 mg phosphorus per 100 kcals, which is too high for dogs with kidney disease.

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Using the Table

To use the table below, pay most attention to the column on the far right, Phosphorus mg per 100 kcals. For dogs with early stage kidney disease, try to find a food (or combination of foods) with 150 mg of phosphorus or less per 100 kcals. The same is true of fresh foods you add to the diet, from the Table of Nutritional Values.
Also pay attention to the next column to the left, Phosphorus (dry matter). For dogs with early stage kidney disease, you would want to feed a diet that is 0.60% or less phosphorus (dry matter). Again, you may be able to combine two different foods, one with higher phosphorus and one with lower, to get them to average out to the numbers you're looking for. You can also add fresh foods to help reduce the overall percentage of phosphorus in the diet (see above).

Note that dogs with significant proteinuria need a diet moderately reduced in protein in order to control the amount of protein in the urine, most accurately measured by urine protein:creatinine (UPC) ratio. I have not been able to determine exactly what level requires a dietary adjustment. UPC of 0.5 -0.9 is considered questionable and 1.0 is considered definitely abnormal, but glomerulonephritis is not usually diagnosed unless the UPC is 3.0 or above.

If your dog is uremic, with BUN over 80, creatinine over 4.0, and symptoms such as vomiting, nausea, inappetence and lethargy, you will have to reduce the amount of protein, but not otherwise (as long as there is not significant proteinuria), as protein only affects symptoms, it doesn't harm the kidneys (other than increasing inflammation when protein is being lost in the urine).

**Comparison of Calories, Protein and Phosphorus in Selected Commercial Diets with Relatively Low Phosphorus**
Food	Calories (as fed)	Protein (as fed)	Phos (as fed)	Protein (DM)	Phos (DM)	Phos mg/100 kcal
Dry Foods
Blue Buffalo Senior	3398/kg (35.3 oz) 456/cup (4.75 oz)	24 g/cup	1,073 mg/cup	20.0%	0.89%	235
Canine Caviar Special Needs	3518/kg (35.3 oz) 399/cup (4 oz)	20 g/cup	567 mg/cup	19.6%	0.54%	142
Burns Fish & Brown Rice (UK, Europe, Hong Kong)	3,273/kg (35.3 oz)			20.1%	0.52%	147
Dr E's Rx Formula Duck Dog Food (made by Great Life)	3,717/kg 433/cup (4 oz)	20 g/cup	747 mg/cup	20.0%	0.73%	177
First Mate Pacific Ocean Fish	3,226/kg (35.3 oz) 500/cup (5.5 oz)	36 g/cup	775 mg/cup	25.6%	0.56%	155
First Mate Pacific Ocean Fish Large Breed	3,600/kg (35.3 oz) 510/cup (5.5 oz)	39 g/cup	930 mg/cup	27.8%	0.67%	167
First Mate Ocean Fish Senior	3,032/kg (35.3 oz) 470/cup (5.5 oz)	28 g/cup	775 mg/cup	20.0%	0.56%	165
Great Life Dog Food -- Chicken	3,643/kg 414/cup (4 oz)	27 g/cup	987 mg/cup	26.9%	0.97%	202
Great Life Grain Free Dog Food -- Open Range Chicken	3,991/kg 453/cup (4 oz)	37 g/cup	907 mg/cup	36.7%	0.89%	200
Holistic Blend Lamb & Rice (Canadian)	3,390/kg			25.0%	0.75%	204
Holistic Select Senior Health	368/cup (3.6 oz)	26.5 g/cup	715 mg/cup	28.9%	0.78%	216
Innova Senior	374/cup (4 oz)	21/cup	728/cup	20.5%	0.72%	195
Innova Senior Plus	391/cup (4 oz)	27 g/cup	885 mg/cup	26.8%	0.88%	226
Karma Organic	400/cup (4 oz)	24/cup	686 mg/cup	22.5%	0.64%	172
Merrick Campfire Trout	3988/kg (35.3 oz) 399/cup (3.5 oz)	34.9 g/cup	740 mg/cup	37.1%	0.79%	197
Royal Canin (formerly IVD) Vet Diet Mature	318/cup (3 oz)	15.8 g/cup	541 mg/cup	20.0%	0.68%	170
Royal Canin Mini/Maxi Mature	373(maxi)-399(mini) /cup (3.3 oz)	25.3 g/cup	515-608 mg/cup	30.0%	Mini:.55-.65% Maxi:0.5-0.6%	Mini: 131-154 Maxi: 121-145
Wysong Nephreon (freeze-dried)*	287/cup (3.6 oz)	47.1 g/cup	970 mg/cup	48.6%	1.0%	355
Wysong Synorgen*	413/cup (4.6 oz)	31.2 g/cup	686 mg/cup	27.3%	0.60%	189
Wysong Maintenance*	410/cup (4.6 oz)	31.3 g/cup	801 mg/cup	27.4%	0.70%	222
Wysong Senior*	400/cup (4.6 oz)	23.5 g/cup	801 mg/cup	20.5%	0.70%	228
Wysong Optimal Performance*	385/100 g (3.5 oz)	26.7 g/100g	704 mg/100g	41.6%	0.80%	183
Canned Foods
Castor & Pollux Organix Turkey & Vegetable Formula	440/can (12.7 oz)	27 g/can	684 mg/can	34.1%	0.86%	155
Castor & Pollux Organix Chicken & Potato Formula	448/can (12.7 oz)	27 g/can	648 mg/can	34.1%	0.82%	145
Innova Senior WARNINGToo Much Phosphorus!	396/can (13.2 oz)	32 g/can	1,422 mg/can	36.5%	1.62%	358
Royal Canin (formerly IVD) Vet Diet Mature	421/can (13.5 oz)	30.8 g/can	462 mg/can	36.4%	0.60%	120
Wysong Gourmet*	184-220/can (5.5 oz)	18.1-21.2 g/can	243 mg/can	44.7-52.4%	0.60%	110-132
Dehydrated Foods **
Essex Cottage Farms Kidney Diet**				9.4-15%	0.25%
Essex Cottage Farms Hypoallergenic **	419/100 grams			21%	0.49%	117
Grandma Lucy's Artisan Dog Food Chicken/Lamb (dehydrated)	330-341/ cup (3 oz)	22 g/cup	374-400 mg/cup	28.2-28.6%	0.48-0.51%	114-117
Honest Kitchen Keen	470/dry cup	22.7 g/dry cup	909 mg/ dry cup	21.9%	0.87%	193
Honest Kitchen Love	514/dry cup	37 g/dry cup	1012 mg/ dry cup	34.9%	0.95%	197
Honest Kitchen Preference**	398/dry cup	13.6 g/dry cup	737 mg/ dry cup	13.2%	0.71%	185
Honest Kitchen Zeal	437/dry cup	41.7 g/dry cup	897 mg/ dry cup	39.5%	0.85%	205
Frozen Foods
My Perfect Pet Snuggles Blend (Reduced Mineral)	1,447/kg (328/8-oz bar)	20.4 g per 8-oz bar	388 mg per 8-oz bar	28%	0.53%	118
My Perfect Pet Boomer's Blend	1,517/kg (344/8-oz bar)	27.2 g per 8-oz bar	439 mg per 8-oz bar	37.1%	0.60%	128
My Perfect Pet Roxy's Blend	1,681/kg (382/8-oz bar)	20.4 g per 8-oz bar	378 mg per 8-oz bar	26.3%	0.55%	99
Nature's Logic Raw Frozen Beef Formula	2,701/kg (245/3.2 oz patty)	10.9 g per 3.2-oz patty	236 mg per 3.2-oz patty	37.5%	0.8%	96

* Wysong makes high quality foods, but their Nephreon prescription kidney diet is higher in phosphorus than other prescription kidney diets, so it would only be appropriate for dogs with very early stage kidney disease whose phosphorus levels are normal (and it's questionable even then). According to the manufacturer, Nephreon is essentially Archetype with added nutraceuticals to support the kidneys. Most of Wysong's other foods are actually lower in phosphorus than either Nephreon or Archetype. See their table with dry matter percentages of all their regular foods (does not include prescription diets). Note that the canned "Au Jus" foods are just meat and organs, they are not complete diets. Of the three canned Gourmet foods, Liver is the best (lowest) and Seafood is the worst (highest) in terms of phosphorus per 100 kcals.

** You can't compare the figures for the various mixes directly to each other, as ECF figures are as fed (with water and meat added), while the rest are dry (before adding water, meat and other foods):

Essex Cottage Farm figures are as fed (mixed with meat, fish, eggs and veggies per instructions). Amounts are approximations, as they will vary depending on the fresh foods mixed in. The Kidney Diet numbers shown are for the mix combined with 1 lb of meat, 1/4 lb fish and 2 eggs to 5 cups ECF, but may not be reliable. This diet is low in protein. I would use 2 lbs meat unless your dog is uremic (BUN over 80). Note the instructions that come with the mix may be different from what is shown on the web site; do not increase the amount of fish that is added above 1/4 cup per 5 cups ECF, and do not use canned fish with bones, which are high in phosphorus. Also, do not add sunflower oil, which is high in omega-6 fatty acids that are not advisable for dogs with kidney disease. If you include poultry in the diet, there should be no need to add oils to the mix.
Honest Kitchen Preference figures are for the mix only, and do not count the meat and other foods that must be added to make this a complete diet. Keen, Love, and Zeal are complete diets that do not require other foods to be added.

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