Dr. Ruth Roberts: Understanding & Managing Kidney Disease in Dogs | E33

[00:00:00] for dogs that have been eating a kibble diet if they switch to more whole food

[00:00:05] diet where there's plenty of moisture built in. Then we see those kidney values drop

[00:00:10] back down to normal and many cases so that's always step one, it's make sure that the

[00:00:15] dog is well hydrated. The second is that at its basis whether this is an acute process or

[00:00:23] chronic process and the kidneys inflammation is underlying everything and so it's critical

[00:00:29] to make sure that we control inflammation as best as possible.

[00:00:41] Welcome to The Pet Care Report podcast by Pet Summits. Here's your natural dog health care

[00:00:47] host, Alora McKinley. Get out guys welcome back. Now kidney plays such an important role in our

[00:00:53] body and have many roles from filtering out blood to helping regulate out blood pressure and

[00:00:58] many other vital functions. So it's understandable that when something happens to these vital organs,

[00:01:04] such as the diagnosis of kidney disease, it can really be devastating to pet owners and it can

[00:01:10] as it can impact a dog's overall health and longevity. Now kidney disease is quite a complex

[00:01:16] condition and so it helps us understand that a little bit deeper and give us some tips on how

[00:01:21] to manage it and dogs I can't wait to introduce you to Dr. Ruth Roberts, the host of Pet Summits

[00:01:28] Dongsummit. Known as the original pet health coach has 8,000 of pets with conditions

[00:01:34] running from kidney disease to cancer through her natural effective healing methods.

[00:01:39] She developed the original crock pet diet, a balanced homecooked diet for pets,

[00:01:44] emphasizing it as the cornerstone of their health. Excerning her impact she now trained dedicated

[00:01:50] pet parents and professionals to become certified holistic pet health coaches. Thanks so much

[00:01:56] for joining me today, Dr. Ruth. Laura, it is my pleasure and so happy to be here.

[00:02:00] That's great. Now kidney disease can be a really serious concerning dogs. Can you help us

[00:02:05] understand the basics of how kidneys function in dogs and what signs might indicate a problem with

[00:02:10] their renal function? Sure. So the basics are that the kidneys are one of the organs that

[00:02:17] receive something like 30% of the blood flow with each heart rate and it's because they are so

[00:02:24] in filtering out waste products but also they're involved in electrolyte and water balance

[00:02:30] regulation as well as interestingly creating a hormone called a rithropoe, which stimulates

[00:02:38] the bone marrow to produce red blood cells. So they are incredibly vital and I think we're just

[00:02:45] beginning to understand how they interact with the rest of the body. But it's sad because it's one

[00:02:52] of the most common conditions that is diagnosed in dogs and cats. And it's very frustrating to

[00:03:01] me too because we're doing blood work more frequently for pets and what we see with our dogs

[00:03:07] often is we'll see some elevated kidney values, the veterinarian will often say, oh my gosh,

[00:03:13] your dog has kidney disease or kidney failure and then the pet owner is left sort of going,

[00:03:20] oh, what do I do now? Because that is said we'll just put them on this bag of food and just

[00:03:25] wait till it gets worse. Yep. And then what are some problems that might indicate a problem with

[00:03:30] their renal health? So that's the frustrating thing is until the kidney disease is very advanced,

[00:03:36] there may be no signs but the most common are drinking more water, urinating more frequently

[00:03:43] and then things like losing body weight and just sort of lack of energy. And very late

[00:03:50] in the course of the disease we may see nausea, lack of appetite, vomiting and diarrhea.

[00:03:56] So then what are some risk factors for kidney disease in dogs? Is there anything that

[00:04:01] contributes to it? Sure, dry food. I mean we're basically feeding

[00:04:06] a chemical that is incredibly difficult for the dog to digest often they just consume it whole.

[00:04:14] And then it takes a tremendous amount of time for that chemical to resolve enough water to be

[00:04:21] digested and as a result what happens is this food goes through the GI tract and it is sucking

[00:04:30] the water out of the digestive instead of allowing water to go into the body to support for

[00:04:36] their kidney function. And the reason water consumption is so important is that if we drink more

[00:04:43] water then there's more volume in the blood so that the kidneys have an easier time

[00:04:49] of filtering the blood out for toxins. So if the blood is more dilute because we've got where

[00:04:55] well hydrated we've got plenty of fluid on board. The kidneys have a much easier time of doing

[00:05:00] their job versus a dog that's walking around 3 to 5% dehydrate it all the time. Also if there's been

[00:05:08] a significant health challenge that's caused a lot of vomiting or dehydre or dehydration

[00:05:16] then what we can see is an impact on the kidneys secondary to this other illness so that's

[00:05:23] it can be really quite complex as you say. Is there a bit of a difference between maybe just an acute

[00:05:29] kidney injury compared to like a chronic kidney disease? Does that exist? Absolutely so an acute

[00:05:35] situation would be the dog got exposed to something and so that can be aniferies is one of the

[00:05:43] more common ones and that can truly be deadly and then bacterial infections and then as I said earlier

[00:05:50] if the dog gets something that's causing severe vomiting and diarrhea and dehydration

[00:05:57] what would have been pre-renal meaning the renal values go up or the kidney values go up because

[00:06:03] the dog is dehydrated becomes a chronic problem because the kidneys have been damaged because

[00:06:10] the dehydration was sustained for such a long period of time. And then chronic kidney disease

[00:06:17] really comes in to play for pets that are older and they so what's happened is that over time

[00:06:26] they've been dehydrated for quite a while at a low level and the kidneys are not functioning

[00:06:32] well because they've been pushed to the max. The other sort of thing that's in the middle of these

[00:06:37] two is a congenital kidney disease and so this is a dog that is born with kidneys that

[00:06:45] doc function normally and this dog may look completely normal until it hits say 12, 18 months of age

[00:06:53] and then all of a sudden it presents with vomiting diarrhea signs of in-stage kidney disease

[00:07:00] because the body has just surpassed the dogs' ability to filter out the waste products but indeed

[00:07:07] this was likely a condition present at birth but the dog was able to sort of

[00:07:14] deal with it if you will until it reached a certain point if that makes sense.

[00:07:20] Yeah, yep so then once the dog is diagnosed with kidney disease what are the main management

[00:07:26] strategies that you recommend? So first of all I think it's important to understand where

[00:07:32] that dog is so there is something called the International Mental Intersociety and they have

[00:07:38] documents all over the internet about what the different stages of kidney disease are and

[00:07:44] what that involves is looking at the results of lab tests so notably STMA or and then creatinine

[00:07:52] and B-win, what those elevations mean and how to start addressing them and this is all purely

[00:07:59] from a conventional format but what I think is important to note is that they discuss the fact that

[00:08:06] STMA which is sort of the test that veterinarians now hang their hats on is saying yep your dog

[00:08:12] has kidney disease is a good test but it also can be an indicator of inflammation elsewhere in

[00:08:20] the body so if we get an elevated STMA level and the dogs creatinine and B-win are normal

[00:08:27] and the dog really looks fine it's important to know does this dog have inflammatory bowel disease

[00:08:33] does it have a skin infection? Does it have a chronic ear infection? Those are all things that can

[00:08:40] increase STMA values without actual kidney disease being at play and I think this is one thing

[00:08:47] that most veterinarians will say your dog STMA is up at 18 so it probably has early kidney

[00:08:54] disease and stop there not doing further testing or actually look at the rest of the dog to say oh gosh

[00:09:01] but he has this horrific skin infection going on so let's clear that up first and then

[00:09:06] retastency if this is okay or not okay so I think it's critical first to make sure what's

[00:09:13] what the other thing is is that many veterinarians will do STMA be when creatinine and maybe

[00:09:19] the B-win and creatinine are elevated along with the STMA but what they've not done is a urinary

[00:09:27] urinalysis and so urinary tract infection will call us all three of these things to be elevated

[00:09:34] and instead of treating that infection appropriately the veterinarian often says oh your dog has

[00:09:39] Stage 2 kidney disease is put it on the spag of food and we'll see how things are in three weeks

[00:09:44] and then the dog gets sicker and sicker because the infection has not been attended to. So

[00:09:50] this is where you have to be the advocate for your pet and understand what these values mean

[00:09:56] and make sure that all of the testing has actually been done adequately. Now having said all of

[00:10:01] that that was a rather long-winded segue but the deal is is that it's so important to make

[00:10:08] sure that you're getting plenty of moisture into your dog so many times for dogs that have been

[00:10:15] eating a kibble diet if they switch to more whole food started where there's plenty of moisture

[00:10:22] built in then we see those kidney values drop back down to normal in many cases so that's

[00:10:27] always step one. It's make sure that the dog is well hydrated. The second is is that at its basis

[00:10:35] whether this is an acute process or chronic process and the kidneys inflammation is underlying

[00:10:41] everything and so it's critical to make sure that we control inflammation as best as possible

[00:10:47] and we want to do that using supplements so omega-3 fatty acids are the most commonly used

[00:10:55] supplement for this purpose because they'll reduce inflammation and help the body sort of reset

[00:11:01] to a more normal place and then lastly the other thing that's going to be critical is to make

[00:11:08] sure that the microbiome is working as well as it possibly can because that's part of how the

[00:11:14] body gets rid of the waste in the gut so if we do if we've got the gut working well the little

[00:11:20] bacteria that help us be healthy are working well and getting rid of waste products then that

[00:11:27] takes some of the burden off of the kidneys so that's really one of the top three steps I would suggest.

[00:11:34] I know you mentioned nutrition there and like many things nutrition plays a crucial role in

[00:11:40] how we deal with diseases and stuff so what are some considerations and recommendations for dogs

[00:11:46] with regional issues in regards to nutrition? I think again you really have to look at where the dog is

[00:11:52] in the stage of kidney disease if it's at in-stage disease where the creatinine, the B-O-N,

[00:11:59] and the phosphorus levels are astronomically high then this is where I would consider limiting

[00:12:05] protein intake and this is because at this point the kidneys really have minimal ability to do

[00:12:12] their work and so we need to minimize protein intake at this point to help reduce its their workload.

[00:12:20] Before that I think what happens with older dogs is that we end up reducing their muscle mass

[00:12:25] and make them more weak and vulnerable but the more water, the more fluid you can get into your

[00:12:33] dog whether that's through food. Personally I teach cooking foods with the original product pet diet

[00:12:40] so there's a lot of vegetables a lot of meat as well but vegetables grains and legumes if

[00:12:47] that's appropriate for that particular dog all of that fiber helps hold water in the GI tract

[00:12:53] so that again it's more available to the body to help flush things out. Many times dogs as they advance

[00:13:00] through kidney disease may need subcutaneous or intravenous fluids on a regular basis to help flush

[00:13:07] the kidney salt. Unfortunately dialysis in the later stages of kidney diseases really difficult

[00:13:14] to carry off because it does require anesthesia, the pet has to be hooked up to a machine for several

[00:13:20] hours of getting the blood filtered so it's really difficult to do on a regular basis. It's only

[00:13:26] available at select pet and teaching hospitals so often we resort to the poor man's dialysis if you

[00:13:33] will of subcure intravenous fluids. Now it's interesting you mentioned a lower protein diet because

[00:13:39] I know that a lot of people say that your dogs got kidney disease and they just need to go on a

[00:13:44] low-preeting diet full stop so are you saying that it's really only the end of the scale

[00:13:49] that needs a low-protein diet? For me yes and what I found is that because so many of our dogs

[00:13:56] that are diagnosed with kidney disease if we start an eight-year-old dog that has a lifespan of 12 to

[00:14:04] 14 years on a low-protein diet at 8 we're going to limit their ability to maintain muscle significantly

[00:14:13] and so as this dog ages the muscle that would have protected the joints allowed the dog to continue

[00:14:20] to move into a block into exercise isn't there and so we have this debilitated pet. I find that often

[00:14:27] there are many things we can do including adding in supplements like quercitin for instance

[00:14:34] that will hold still those kidney values they won't maybe they will get better maybe they won't

[00:14:40] but in many cases they don't get worse rapidly and so what that means to me is that we've got a pet

[00:14:48] that the piece of paper is saying the dog has kidney disease not because the dog is showing

[00:14:54] a symptoms of drinking more water urinating more frequently that sort of stuff and what we've

[00:15:00] done by not limiting protein at the intake is actually giving the dog the ability to continue to move

[00:15:08] to exercise and that's going to actually improve his kidney health because it's going to allow

[00:15:15] for faster blood flow through the body making fuel better keep him from getting stiff,

[00:15:21] keeping him from developing symptoms of arthritis sooner in life. Does that make sense?

[00:15:26] Yeah yep so does and you'll also mention that sometimes nausea or not having a great appetite

[00:15:35] is another side effect of chronic kidney disease. Do you have any suggestions on how

[00:15:40] pet parents might be able to entice their dogs to eat? Right so there's several things you can do.

[00:15:47] One is to offer different types of food frequently so what tends to happen when we've got a pet

[00:15:55] that's been nauseous and not wanting to eat is finally they eat something so we let them just

[00:16:01] go or join it and what happens is they eat it they're great and then they're like oh my tummy hurts

[00:16:07] I am never going to eat this again and so I find what's important is to rotate what we're offering

[00:16:14] on a regular basis and when they do eat happily don't let them go. So that they don't get an

[00:16:20] upset stomach with it and then this is where you can use things like ginger and mint and other

[00:16:27] things that will help to relieve some of that nausea other products like CBD products and then

[00:16:34] finally to help stimulate appetite there is a point called shun again which is at the junction of where

[00:16:42] the non-haired region of the nose and the herid region of the noses and often by stimulating that

[00:16:49] point with your fingernail you'll see your dog sort of shake and then all of a sudden they'll

[00:16:55] have the desire to eat so that's a benica trick for us too. Well that's a really good treat

[00:17:02] and pet parents often utilize treats for their dogs we know a lot of commercial treats

[00:17:09] and process human foods contain quite a lot of sodium and phosphorus so what do you recommend

[00:17:15] treat eyes are? Peparins are able to give their dogs normal treats? Well I think if you're

[00:17:21] dealing with a dog that is not wanting to eat focus on getting high quality highly digestible

[00:17:28] food in first instead of the treats so it's kind of like I mean and there's a certain point where

[00:17:35] it doesn't matter if we're truly at end stage and this pet's life is drawing towards an end then

[00:17:41] they just you just let them eat what they want to but if we're in a bump in a road and we're

[00:17:46] trying to get through it focus on feeding high quality easily digestible proteins and

[00:17:54] you know you can try them raw my preference would be to use them cooked along with some

[00:17:59] vegetables that are easy for the pet to digest and focus on that rather than treats but yeah

[00:18:06] if you're going to use treats you use pieces of protein, pieces of cheese, you know small bits

[00:18:13] and pieces that are really going to be nutrient dense, certain genes are an awesome option because

[00:18:19] they will also give some omega-3 fatty acids. Yes and you did mention amigas in terms of reducing

[00:18:26] inflammation what kind of supplements do you like to use to help reduce inflammation in a

[00:18:31] dog with chronic kidney disease? Well I think omega-3s is at the top of the list and I think what

[00:18:37] you want to do if your pet is small then you can look at using sargines or something like this

[00:18:43] there is a growing concern that unfortunately they are contaminated with heavy metals and

[00:18:49] strong-chimp for example so I don't think you want to make this a main part but just small amounts

[00:18:55] every day or every few days. Now the other thing that you can use is quair satin and this is a

[00:19:04] bioflavinoid that's generally derived from the white part of the citrus peel and it is fascinating

[00:19:12] we've been using it to help pets and people with allergies because it helps to reduce

[00:19:18] circulating levels of histamine. The other thing quair satin does is it helps to reduce the

[00:19:25] deposition of advanced glycation in products or AGEs at the level of the nephron and this

[00:19:33] I came across this because I was looking for something else we could help our pets with and

[00:19:40] this came out of a human study from people that had organ transplants and one of the drugs they used to

[00:19:47] prevent the organ from being rejected is cyclosporine. Well it's organ of toxicity is the kidney

[00:19:54] and so what they found was that people that had to take now lifetime cyclosporine that took also

[00:20:01] a quair satin the impact on the kidneys was minimized or eliminated and so their

[00:20:09] potential to develop kidney disease became very very low. So I started trying this for my patients

[00:20:16] probably 12 or 15 years ago and what I found over time is that it held the creatinine study and

[00:20:24] I think that's a better marker to use for how well or poorly the kidneys are doing

[00:20:30] held the creatinine study or we actually saw it go down to normal in many cases. So for instance

[00:20:37] one of my own dogs Ollie had a creatinine that was tremendously elevated about three. His

[00:20:45] creatinine was 3.6. He had had an infection, we cleaned that out, it went down to 3.2 which is better

[00:20:52] but still not normal and so we kept feeding Ollie, crock that diet, home-cooked food,

[00:20:59] where satin, omega 3 fatty acids, his creatinine actually went packed down to 1.6 and that's

[00:21:06] not supposed to happen and Ollie died sadly last year at the age of 14 which is amazing. He was an

[00:21:16] American bulltari or American pit bulltari or these big guys 75 pounds so he didn't die of kidney

[00:21:24] disease. He ended up dying of old age essentially. Well that's an amazing result that he got

[00:21:32] just from trying different supplements. Now what would you say to pet professionals that

[00:21:38] a torch that a prescription renal diet is what they need to prescribe to their patients?

[00:21:45] What would you say to them? I will say to you that yes it will make the numbers look better on

[00:21:51] the piece of paper but I think you then need to look at the dog sitting next to the piece of paper

[00:21:57] and are you in this is why I started down this path? Are you contributing to this dog's quality

[00:22:03] of life by limiting its protein intake or taking away from it? And so I'd strongly encourage you

[00:22:10] to make sure that you at least switch first from kibble to either a canned food or cooked food

[00:22:19] so that you can see what does increasing fluid consumption do for these kidney values and if that's

[00:22:25] enough to make a difference then I think that's a home run for your patient.

[00:22:31] All right, so then what's your number one tip that you recommend for pet owners to go away from

[00:22:37] this interview and to think about and maybe implement in their own dogs? One of the biggest things

[00:22:43] I can say to you is that if you're feeding a kibble diet and you don't have time or the energy to

[00:22:50] either look at going raw or of the finances to go raw to go with a full cooked diet start simple

[00:22:58] and go out and buy a bag of frozen vegetables so Normandy Blin has broccoli, cauliflower,

[00:23:04] yellow squash, zucchini. Take a handful, put it in a pot of boiling water, cook the vegetables

[00:23:11] thoroughly and then kind of mash it up pour that over your dog's kibble and see what starts to happen.

[00:23:19] At the very minimum you're going to be adding hot water to the kibble which will help

[00:23:24] to start to break it down and more importantly is you're going to be adding vegetables which will

[00:23:30] provide fight-on nutrients to help the entire body work well. The second thing I would say is

[00:23:38] you can't outpill a bad diet and so do the very best you can in terms of pet food as far as your

[00:23:47] finances will allow you to do because if you don't have the nutrition correct to start with

[00:23:53] adding supplements and supplements and supplements on top of it are not going to get you there.

[00:23:57] Do you find that because I know you mentioned home cooked diets quite a bit,

[00:24:01] do you find that home cooked diets go better with a dog with kidney disease compared to a raw diet?

[00:24:07] I do and so if we think about this so part of my training is in traditional Chinese veterinary medicine

[00:24:14] and one of the principles there is that the spling is considered to be the main digestive organ

[00:24:20] and that's spleen with a capital S meaning it's like well how to that happen but from observation

[00:24:27] they have the Chinese assigned at the spleen many of the functions of the pancreas plus some others

[00:24:33] and so if the spleen appends cold and damp and we're throwing raw food which is cold

[00:24:40] and damp into this gut that's not working well I think if we've gotten to the point of

[00:24:46] diagnosing kidney disease that generally means that there's some level of intestinal permeability

[00:24:53] or leaky gut present along with the kidney disease so if we throw cold and damp into this gut

[00:24:59] that's not functioning well then it's difficult for it to turn around and I will tell you that raw

[00:25:05] food can make a massive difference simply because we're getting away from the kidney if nothing else

[00:25:11] and we're getting on to real food but I've seen a bigger impact with cooked food because

[00:25:17] we are presenting this gut that's not functioning well with a pre-digested diet and so what we tend

[00:25:24] to see is that these dogs are happy to eat again they're feeling good when they eat because

[00:25:30] the food is moving through and being digested easily and the body is getting the nutrients

[00:25:36] as well as the moisture it needs. Interesting and I can imagine something like a probiotic

[00:25:41] would also be helpful when we're talking about overall gut health and improving the dog's health.

[00:25:46] Absolutely and I think as you start out it's important to use a probiotic that does not

[00:25:52] have pre-biotic fibers in it because again if this dog's gut is already sort of not well

[00:25:58] and we had the pre-biotic fibers in or a ton of fiber regardless at one go it's not going to feel

[00:26:05] very comfortable. I think as currently I'm using a spore-related probiotic which means that these are in

[00:26:13] hibernation if you will and so the idea is that they will transit the GI tract more effectively

[00:26:20] and get down into the colon where they need to re-establish the good guys and help do this

[00:26:27] intestinal diurisis which is essentially what we're asking the gut to do is to help get rid of these

[00:26:33] waste products that the kidneys are trying to help us get rid of. Now thank you so much Dr.

[00:26:39] Ruth that's been really informative for our followers that might want to learn more about you

[00:26:44] where can they find you? At drbrithroborid.com super easy. Lovely and to all our listeners

[00:26:50] you can sign up for the holistic dog care summit which is a must for any pet lovers keen to adopt

[00:26:56] a holistic approach for their pet health and enhance their knowledge on a range of topics

[00:27:00] and put all the links below. Thank you so much Dr. Ruth that was really interesting.

[00:27:04] My pleasure Laura very very very fun speaking with you