A client that was recently referred to me by her veterinarian wanted me to formulate homemade dog food that would help manage her dog’s advanced kidney disease. In preparation for her consultation appointment, I gathered the necessary information over the phone that I needed in order to have some recipes ready for her dog.

Patients with kidney disease need a protein restricted diet to minimize blood ammonia levels. When protein is broken down by the body it produces ammonia that is changed to a less toxic chemical in the liver called urea. In normal patients, the blood urea is eliminated from the body by the kidneys. Pets with kidney disease cannot eliminate urea effectively and urea levels increase in the blood. This increase results in decreased appetite and activity, vomiting and even painful sores in the mouth that causes drooling and refusal to eat altogether.

By restricting protein levels in the diet, the blood urea can be maintained at more tolerable levels so the pet acts and eats normally. The decreased protein also reduces phosphorus levels in the blood and slows the deterioration of the kidneys. Low protein diets are high in fat and carbohydrates which provide taste and calories without creating any ammonia. It was these types of homemade recipes that I presented to my new client at her consultation. As I explained the rationale of the recipe to the owner, she interrupted to tell me that she forgot to tell me her dog also had frequent bouts of pancreatitis. My jaw dropped and I fell silent for a short period. She had just rendered my recipes worthless for her dog.

Pancreatitis is a mysterious inflammation of the pancreas that it often associated with the consumption of high levels of fat. It causes severe abdominal pain and vomiting. Pets require hospitalization with fluid therapy until the episode slowly resolves. Food is generally withheld for 2-3 days. The condition is managed by commercial or homemade diets that have minimal fat in them.

My challenge now was to design homemade food that had minimal protein and fat, conflicting needs. The bulk of the calories needed to come from carbohydrates- the ingredient that dogs least prefer. Carbohydrates contain less than half the calories of fat for the same quantity. That means diets low in fat must contain lots of carbohydrates. Like us, dogs quickly tire of carbohydrates as the major portion of their diet. Protein and fats taste better. “Food fatigue” is common with dogs on carbohydrate rich diets. It is not uncommon for these pets to need frequent changes made to recipes to keep them interested in food.

Although these diets are challenging, the abundance of foods available for designing homemade diets makes it possible. Commercial special diets are much more limited in ingredient selection and the main reason owners of pets with special medical needs seek homemade diets. Their dogs simply don’t like the limited commercial choices. And few commercial diets are available for pets with conflicting medical needs.

I re-worked the recipes for my client’s dog. Now, I only await future calls from her for recipes with different ingredients.