# Protein in Diets



## Benjismom (May 19, 2013)

Last night on the 11 o'clock news they had a segmant on "Health Watch" which can pertain to various subjects. At any rate last night it was on the added protein in diet which totally pertained to adults. How everything today is geared towards protein as in energy bars, with added "high protein" and even drinks etc. A nutrionalist came on and gave her comments and stated it is all marketing tools for the consumer and that in reality a person needs only so many grams (58?) I think a day and she then added that to much protein in a diet can take its toll on the kidneys. It is not necessary she said to use so much protein. My thoughts went to our dogs. Is all this protein good for them in the dog foods? Annamaet the one I am slowly introducing my dog to at the present time is 30% protein 5% fat as it is a lean fat loss diet. He only gets a few tsp. a day. I home feed otherwise. It was just a concern I have since the nutrionalist are saying humans kidneys can be overworked on high protein how about dogs? Any thoughts?


----------



## Willowy (Dec 10, 2007)

Humans are omnivores, and dogs are carnivores. So our nutritional needs are totally different.


----------



## domika (Jul 1, 2012)

I am not a super healthy eater by any means, and if I went throughout my day eating, I would not reach my daily protein levels unless I specifically buy foods that are high in protein. I know that I'm supposed to try and get my protein from natural sources instead of protein shakes and bars, etc. but some days I just don't make it with normal food so I'll make a protein shake. 

Also, I agree with what has been said above, we are different species all together, so our nutritional requirements are different. I don't think 30% protein is too high, there are diets with much higher. However, feed a food that you feel comfortable feeding.


----------



## Benjismom (May 19, 2013)

Thanks yes dogs diets are different that ours--makes sense to me. I was just thinking about it last night. Domika a small piece of chicken has a lot of protein in it--you would be surprised. You might get more than you think--


----------



## ItalianDogz (May 16, 2013)

Benjismom said:


> Last night on the 11 o'clock news they had a segmant on "Health Watch" which can pertain to various subjects. At any rate last night it was on the added protein in diet which totally pertained to adults. How everything today is geared towards protein as in energy bars, with added "high protein" and even drinks etc. A nutrionalist came on and gave her comments and stated it is all marketing tools for the consumer and that in reality a person needs only so many grams (58?) I think a day and she then added that to much protein in a diet can take its toll on the kidneys. It is not necessary she said to use so much protein. My thoughts went to our dogs. Is all this protein good for them in the dog foods? Annamaet the one I am slowly introducing my dog to at the present time is 30% protein 5% fat as it is a lean fat loss diet. He only gets a few tsp. a day. I home feed otherwise. It was just a concern I have since the nutrionalist are saying humans kidneys can be overworked on high protein how about dogs? Any thoughts?


This is what you use? Looks like excellent food for a chubby dog. Safe numbers.

Guaranteed Analysis:



Crude Protein, min 30.0% 
Crude Fat, min 7.0% 
Crude Fat, max 9.0% 
Crude Fiber, max 3.5% 
Moisture, max 10.0% 
Ash, max 6.8% 


Average Lab Analysis:

Calcium - 1.15%
Phosphorus - 0.945%


----------



## Benjismom (May 19, 2013)

Yes this it--we are just trying it I got a sample bag. He is a bichon--he was 20.7 now he is 18.4. I am giving him some each a.m. along with his egg whites.


----------



## Kathyy (Jun 15, 2008)

Dogaware has an article on protein and kidneys with links to further reading.
http://www.dogaware.com/health/kidneyprotein.html


----------



## Amaryllis (Dec 28, 2011)

The risk of high protein diets to the kidneys of humans is highly overstated- unless you have a kidney problem. If your kidneys aren't functioning properly, they will have trouble filtering out the additional urea from digesting protein. 

The thing is, you can get down to 25% kidney function between both kidneys without realizing anything is wrong. You'll feel a bit tired and flu-ish, but nothing dramatic. So what will end up happening is, you start eating high protein, your kidneys are already in big trouble, you add a little stress with all the urea and bam! in the hospital learning you have kidney disease.

People will place the blame in that situation on the high protein diet, but that was never the problem.


----------



## ItalianDogz (May 16, 2013)

Amaryllis said:


> The risk of high protein diets to the kidneys of humans is highly overstated- unless you have a kidney problem. If your kidneys aren't functioning properly, they will have trouble filtering out the additional urea from digesting protein.
> 
> The thing is, you can get down to 25% kidney function between both kidneys without realizing anything is wrong. You'll feel a bit tired and flu-ish, but nothing dramatic. So what will end up happening is, you start eating high protein, your kidneys are already in big trouble, you add a little stress with all the urea and bam! in the hospital learning you have kidney disease.
> 
> People will place the blame in that situation on the high protein diet, but that was never the problem.


High protein is ok if the mineral content of the food is safe. High protein from bad sources of protein that has much bone is very unsafe.


----------



## Benjismom (May 19, 2013)

Amaryllis,

What the nutrionalist was saying who by the way was an educated nutrionalist is that the need for protein in our diet as if we are not getting enough is what is overly stated--we are speaking in humans. From yogurt, to energy bars to drinks etc the push is for protein which is all marketing tools which people buy into.


----------



## georgiapeach (Mar 17, 2012)

Benjismom said:


> Yes this it--we are just trying it I got a sample bag. He is a bichon--he was 20.7 now he is 18.4. I am giving him some each a.m. along with his egg whites.


Feeding just the egg whites can cause a biotin deficiency. You need to feed the whole egg to balance it out. Here's an article about feeding eggs to dogs: http://www.dogsnaturallymagazine.com/feeding-your-dog-raw-eggs-good-or-bad/


----------



## Benjismom (May 19, 2013)

georgiapeach, well I do cook it I do not feed raw, I thought I would cut down on his fat content by just giving whites. I will scamble it from now on the entire egg. Thanks.


----------



## ItalianDogz (May 16, 2013)

Benjismom said:


> georgiapeach, well I do cook it I do not feed raw, I thought I would cut down on his fat content by just giving whites. I will scamble it from now on the entire egg. Thanks.


Your dog seems like a normal companion, 30% protein of that high quality is more than enough for your dog, you don't need to add eggs. That food is specifically designed for overweight dogs so why mess up the balance of things.


----------



## Benjismom (May 19, 2013)

I home feed my dog I do not rely on dog food he has been totally home fed for the past 2 months. I am just covering the bases for calcium, vitamins etc. I only give him a TBSP. in the a.m. no more. I am just seeing how he does as they recommend gradually--I doubt he would eat just kibble alone at this point in time. I make him salmon etc. all high quality home cooked foods.


----------



## Amaryllis (Dec 28, 2011)

Benjismom said:


> Amaryllis,
> 
> What the nutrionalist was saying who by the way was an educated nutrionalist is that the need for protein in our diet as if we are not getting enough is what is overly stated--we are speaking in humans. From yogurt, to energy bars to drinks etc the push is for protein which is all marketing tools which people buy into.


Except that nobody's really sure what humans need. The whole "base your diet on carbs" thing isn't rooted entirely in science. A great many people, myself included, feel significantly better eating high protein/high fat, very little carbs. Despite my (former) nutritionist's dire predictions, my kidneys are fine and my liver is doing much better and my cholesterol went down 100 points. (Back to within normal!)

And, as a vegetarian, I really appreciate all the new protein offerings. It's easier than rice and beans.


----------



## Fade (Feb 24, 2012)

I am curious what made you decide to do cooked meals instead of raw meals?


----------



## Benjismom (May 19, 2013)

Fade, my dog is a certified Therapy dog. They prohibit raw feeding.


----------



## Fade (Feb 24, 2012)

interesting I never knew that! thats so strange  I was just curious I know quite a few people that home cook their own meals I did for years


----------



## Tuco (Jun 16, 2013)

We are very different from our canine companions. And even with us the source of the proteins changes things completely. The bio availability of the protien and the quality are the biggest things, if a dog is on science diet pretty much every gram of protein he is getting is from plant protein like corn or soy or peas (worse off in many foods its animal feed regulated and Genetically modified) that protein is going to be hard as hell on a dogs or even a persons kidneys. If a dog with kidney failure went on these diets it could very well kill them. When they consume meat it's a high quality, significantly more bio available, protien with complete amino acid profiles and even when feeding very high protien (as they should be) it puts practically no stress on the kidneys. On the raw forum there is about a dozen members who's dogs were prescribed a kidney support food for either kidney damage brought on by certain diseases or even genetic kidney diseases but instead modified the calcium to phosphorus ratio to go with their needs. These dogs have serious kidney issues, yet are thriving on diets that are sometimes higher in protein than Orijen or evo, Because the quality of the proteins.


Sent from Petguide.com Free App


----------



## Tuco (Jun 16, 2013)

Oh yea and if the ash is too high, it can be harder on the kidneys (keep the number at 12 or lower, or 8 or lower with preexisting kidney issues)


Sent from Petguide.com Free App


----------



## Benjismom (May 19, 2013)

So in essence dog digestive systems are so totally different than ours but still and all it is all about the "type" of protein they are getting. 

Fade I am with TDI, Therapy dog international and that is there requirement. That is not to say that all dog therapy groups support that idea. I don't know--?


----------



## Tuco (Jun 16, 2013)

I don't know if any of you are into body building but its like the whey protien concentrates vs the whey protien isolates vs hemp protien. They
All give you protien but the reason people Say whey is better is because your body digests more of it faster. Same with why isolates are better post workout shakes than whey, it's used faster


Sent from Petguide.com Free App


----------



## Mr. V (Jan 28, 2010)

Tuco said:


> is from plant protein like corn or soy or peas (worse off in many foods its animal feed regulated and Genetically modified) that protein is going to be hard as hell on a dogs or even a persons kidneys. If a dog with kidney failure went on these diets it could very well kill them. When they consume meat it's a high quality, significantly more bio available, protien with complete amino acid profiles and even when feeding very high protien (as they should be) it puts practically no stress on the kidneys.
> Sent from Petguide.com Free App


Ive never heard that dogs with renal disease do better with animal based protein vs plant based protein. How exactly does a plant based protein stress the kidneys more than the other protein?


----------



## zhaor (Jul 2, 2009)

Benjismom said:


> So in essence dog digestive systems are so totally different than ours but still and all it is all about the "type" of protein they are getting.


A dog's digestive system isn't drastically different from ours. More like it's just different enough.

With protein, "quality" tends to refer to the amino acid profile along with how digestible a protein is. Absorption speed of different proteins has certain impacts too but is something that's more for body building than general health. The most digestible proteins are pretty much animal proteins. They also provide a complete balance of amino acids. Things like pea and soy protein have a good amino acid profile (which is why they tend to be the protein of choice for vegetarians) but are not as digestible as animal protein. Lower quality things like gluten are both difficult to digest and have poor amino acid variety.

When it comes to kidney health, a concern is solubility of minerals in the urine which is affected by pH and concentration. Protein digestion creates certain by products. These can affect pH which is how protein consumption can impact kidney health. With out going into too much detail, lets just say these by products are not handled quite the same way in humans and dogs.


----------



## Tuco (Jun 16, 2013)

Well first of all lets just establish that dogs ARE facultative carnivores, not obligate ones like cats, however that is simply the definition for survival not to THRIVE. Dogs will thrive better on a properly balanced 100% meat diet, then a 100% plant based diet, because their recent evolutionary adaptations from wolves now allow them to secrete amylase and other digestive enzymes to aid in carbohydrate and starch digestion, HOWEVER the ammount of these enzymes they release are not even remotely comparable to humans and are only suitable to digest tiny ammounts of starch. The amount isn't even enough to fully digest the starch content in foods that have practically none beyond its use as a binder like evo or Orijen.

So yea C. lupus familiaris has adapted some of its biology to plant digestion further from its co-subspecies the wolf. But the changes are minimal in many digestive aspects, one of the largest being the kidneys. 

The kidneys are crucial in protein metabolism. They help break down proteins into their base amino acids, by assisting the liver, and they also filter proteins to prevent them from ending up in the urine. 

When they break down the proteins they release nitrates. The harder the protein is to break down the more nitrates, hence high nitrates means your kidneys are having a hard time digesting.

When a protein has a lower BV more has to be filtered by the kidney and puts more stress on the kidneys.

For dogs, the plant proteins are harder to digest and result in higher release of nitrates. The significantly less complete amino acid profiles and lower BV also result in much more needing to be filtered. Hence more stress on the kidneys

I can't copy+paste on my horrid excuse of a phone, so if anybody doesn't trust my credibility and are too lazy to search on google I can post some studies and articles when I get home.


Sent from Petguide.com Free App


----------



## Tuco (Jun 16, 2013)

I didn't really go into urine mineral content because this post would end up being 6 pages long but it also plays a big role


Sent from Petguide.com Free App


----------



## Mr. V (Jan 28, 2010)

Tuco said:


> I can't copy+paste on my horrid excuse of a phone, so if anybody doesn't trust my credibility and are too lazy to search on google I can post some studies and articles
> 
> 
> Sent from Petguide.com Free App


Yes - please post these.


----------



## Tuco (Jun 16, 2013)

K im home and on my ipad now woth the ability to copy and paste, halelujah! While I look for online info beyond that of my textbooks this is a good article that gives some good basic info to back up the base of my points, although I'm not a fan of DNM for Afew reasons this article isn't on vaccination and that's where they usually line the page with bs.

http://www.dogsnaturallymagazine.com/canine-diets-for-kidney-failure/



Sent from Petguide.com Free App


----------



## Tuco (Jun 16, 2013)

It's turns out there isn't really much online beyond paid scholarly articles and e-textbooks that actually go into the details of canine kidney function, however here are a couple articles, they do have Afew things involving BV wrong but they get the jist of it

http://www.dogfoodproject.com/index.php?page=protein_myth


I despise dog food analysis as well as dog food advisor for alot of reasons, but this particular article is one if the better ones for those with less knowledge of canine biology and biochemistry 

http://www.dogfoodadvisor.com/choosing-dog-food/judging-protein-quality/


Sent from Petguide.com Free App


----------



## Kathyy (Jun 15, 2008)

Have you never seen this book on home prepared dog and cat foods by Dr. Donald Strombeck? If you haven't heard of him here is an interview.
http://thebark.com/content/donald-r-strombeck-talks-dog-nutrition-and-pet-food-recalls

http://www.dogcathomeprepareddiet.com/diet_and_chronic_renal_disease.html#dog
"The optimal value of a restricted protein diet is most importantly determined by feeding proteins with high biological value. Little of these proteins are catabolized to products (urea, phosphate and sulfate) the kidneys must excrete. Egg protein has the highest biological value (set at 100) and so is ideal for dietary management of chronic renal disease. For comparison, biological value for milk protein is 92, chicken or beef 78, soybean protein (tofu) 73, oat protein 65, rice protein 64, and corn protein 45.8 Egg protein is high in sulfur-containing amino acids, however, but unless acidosis is marked (usually only in severe or terminal cases) eggs are the ideal protein to feed. On the other hand, sulfur-containing amino acids are the first limiting amino acids in milk and soybean proteins. This means that relative to the other essential amino acids they provide the smallest percentage of an animal's requirement. Diets with proteins from vegetables rather than animals are low in sulfur-containing amino acids and produce less acid. However, because biological value for vegetable protein is much lower than that for animal protein, more protein must be consumed and that increases waste for renal excretion. Thus, with the possible exception of tofu, protein in these diets is from animals.

Affected dogs require 2.0 to 3.5 grams protein per kilogram of body weight per day. The lower amount can be used when feeding a protein with a high biological value and the higher amount when feeding a protein with low biological value. Feeding low biological value protein requires more work for kidneys with reduced function. Feeding a diet containing a high quality protein such as casein maintains an adult dog at a protein level of 6.5 percent of the diet's dry matter. In general, feeding high quality protein diets containing eight to 10 percent protein maintains adult dogs."


----------



## Mr. V (Jan 28, 2010)

Tuco said:


> It's turns out there isn't really much online beyond paid scholarly articles and e-textbooks that actually go into the details of canine kidney function, however here are a couple articles, they do have Afew things involving BV wrong but they get the jist of it
> 
> http://www.dogfoodproject.com/index.php?page=protein_myth
> 
> ...


I have access to nearly every online journal in existance. So if you have the articles please post them. Hopefully they'll be better than opinion pieces from the dog food websites.


----------



## ItalianDogz (May 16, 2013)

Kathyy said:


> Have you never seen this book on home prepared dog and cat foods by Dr. Donald Strombeck? If you haven't heard of him here is an interview.
> http://thebark.com/content/donald-r-strombeck-talks-dog-nutrition-and-pet-food-recalls
> 
> http://www.dogcathomeprepareddiet.com/diet_and_chronic_renal_disease.html#dog
> ...



Stop using the term "biologic value" like it actually means something. That is a very old concept for humans, not dogs, that judges completeness of the amino acids, not digestibility. It doesn't mean one protein is better than another.

No dry dog food in the world uses just one protein, so picking out one ingredient means zero. In the end a good food gets protein from various sources so it reaches the egg reference.

As for quality protein, numbers don't lie...that is why some very poor foods don't list total ash and the good ones do. Foods with low ash because of vegetable protein are no better than foods with high ash using cheap animal sources. But I would use Pro Plan over Earthborn or Nature's Variety if I had to pick.

Dogs require 2 -3 % mineral, so given that kidney disease is such a serious problem, there is no reason to feed 12%, as there is only downside.

Who in the world would take that chance? You have no way of knowing if your dog is one of the unlucky ones until its too late. There are other issues with high ash including skin and coat problems and zinc deficiency, since calcium binds with zinc.


----------



## Kathyy (Jun 15, 2008)

I did not use the term biological value, a highly respected vet that is a professor at a respected university did. I understand that combining different protein sources will complete the protein fed but it also muddies the food by providing a lot of unnecessary things that can create trouble. I wanted exactly what Sassy needed when she was fighting her kidney disease. Extra poor quality protein meant I was wasting phosphorus mg. I didn't even give her veggies or use egg shell for calcium as the 8mg of phosphorus per 1/2 tsp of shell were better coming from low phosphorus stewed chicken so I bought human grade calcium carbonate instead.

When I make up my dog's raw recipe that includes all the minerals he needs at 100-110% of his 2006 NRC values it comes to 5.2% ash and when I add up the actual mineral content listed it comes to 3.44 grams of minerals or 3.2% of his particular diet. 2% is a bit low unless your dog needs twice the calories my dog needs per day, a possibility of course. 

I was horrified when I worked through what is in the kibbles my dogs got before they went on fresh food in 2007 and although the companies seem to be improving lately continue to be concerned about the poor iron-zinc-copper ratios and high calcium and phosphorus levels in most commercial products . Rather than 300% of calcium it is 180% now. And my dogs got fed at least 25% less than the labels indicate.

Not sure high mineral content causes kidney disease, have you found any research indicating this? I know high phosphorus is a problem when feeding a dog with kidney disease but that is not the same thing at all. I am not willing to risk my dog's health to feeding food with the overabundance of ash and mineral content of commercial foods any longer but haven't seen information showing it really does cause trouble.


----------



## Mr. V (Jan 28, 2010)

Kathyy said:


> I did not use the term biological value, a highly respected vet that is a professor at a respected university did. .


Yea that was coming on a little strong. Where does it say who wrote that or where they are located? I didn't see it and was curious.


----------



## Tuco (Jun 16, 2013)

Mr. V said:


> I have access to nearly every online journal in existance. So if you have the articles please post them. Hopefully they'll be better than opinion pieces from the dog food websites.


Do you have millers anatomy of the dog textbook? It would be alot easier if I could just send you to specific pages. 


Sent from Petguide.com Free App


----------



## Tuco (Jun 16, 2013)

Mr. V said:


> Yea that was coming on a little strong. Where does it say who wrote that or where they are located? I didn't see it and was curious.


It was Dr. Ronald Strombeck that wrote that I believe. 


Sent from Petguide.com Free App


----------



## Tuco (Jun 16, 2013)

The term biological value is a term that is also used for dogs in the veterinary profession and is quite widely used however I do agree BV ITSELF doesn't affect stress on kidneys, HOWEVER there is a general pattern that if you have a lower BV you get less complete amino acid profiles which do contribute to kidney disease. But yes, if you are completely eliminating beef and replacing it with egg or chicken or whatever because of Afew points lower BV you are looking at it wrong because although the proteins are used slightly less they are still very complete proteins with lots of other benefits coming from the food itself. 

It's when you are comparing the
BV between things like corn gluten and wheat when you want to take it into account very much 


Sent from Petguide.com Free App


----------



## ItalianDogz (May 16, 2013)

Tuco said:


> The term biological value is a term that is also used for dogs in the veterinary profession and is quite widely used however I do agree BV ITSELF doesn't affect stress on kidneys, HOWEVER there is a general pattern that if you have a lower BV you get less complete amino acid profiles which do contribute to kidney disease. But yes, if you are completely eliminating beef and replacing it with egg or chicken or whatever because of Afew points lower BV you are looking at it wrong because although the proteins are used slightly less they are still very complete proteins with lots of other benefits coming from the food itself.
> 
> It's when you are comparing the
> BV between things like corn gluten and wheat when you want to take it into account very much
> ...


Dogs require 10 amino acids that is all. The term "biologic value" is not used at all in science. It is pop science that gets around the internet like it is gospel. 

What a nutritionist might look for is the level to which an amino acid can be assimilated but this has nothing to do with the concept of "biological value".

A good formulator will mix proteins until the level of the required amino acids is perfect. Of course, other amino are present as well but just 10 are required.

Did you know that at some point egg has a biological value of zero? Yes zero.

If you apply the concept of biological value rigidly, then spelt would have a higher rating than beef or fish.

Biological value does not measure digestibility and it does not take into account preparation, such as cooking


----------



## Mr. V (Jan 28, 2010)

Tuco said:


> Do you have millers anatomy of the dog textbook? It would be alot easier if I could just send you to specific pages.
> 
> 
> Sent from Petguide.com Free App


Yes I do have it. There is nothing in that anatomy book that will answer my question. You said you had specific articles and studies. Where are they?


----------



## Mr. V (Jan 28, 2010)

Anything on those studies?


----------



## aussiegirl6 (Mar 16, 2013)

Benjismom said:


> Last night on the 11 o'clock news they had a segmant on "Health Watch" which can pertain to various subjects. At any rate last night it was on the added protein in diet which totally pertained to adults. How everything today is geared towards protein as in energy bars, with added "high protein" and even drinks etc. A nutrionalist came on and gave her comments and stated it is all marketing tools for the consumer and that in reality a person needs only so many grams (58?) I think a day and she then added that to much protein in a diet can take its toll on the kidneys. It is not necessary she said to use so much protein. My thoughts went to our dogs. Is all this protein good for them in the dog foods? Annamaet the one I am slowly introducing my dog to at the present time is 30% protein 5% fat as it is a lean fat loss diet. He only gets a few tsp. a day. I home feed otherwise. It was just a concern I have since the nutrionalist are saying humans kidneys can be overworked on high protein how about dogs? Any thoughts?


I wish I had seen this post last year, I just lost my 2 gals from kidney disease and looking back on their lab work last year they both showed high alk phos on thier blood work and 3 different vets, did not acknowledge any importance. Had I done my homework and 2nd guessed these vets, I would have seen that it is a sign they are getting too much protein that over works the kidneys, They died within 7 weeks of each other. My katie passed 2 days ago, and I am so angry, and hurt. They left her in a cage with an IV to diuresis her and no documentation of urination during the night, she was "found" lateral in the cage 7 hours after leaving her there.


----------



## sassafras (Jun 22, 2010)

Protein in the diet does not "overwork" the kidneys or cause kidney failure, nor does it have anything to do with Alk Phos.


----------



## Milo's mom (Oct 25, 2009)

I don't think I really understand kidney disease but I know that my old dog was losing "massive amounts of protein" (words of her vet) through her kidneys and had elevated alk phos and other liver values and cancer (!) after years on a low protein, low fat kibble diet (Wellness Weight Management). Years earlier she had had pancreatitis and that had made me really scared of fat and too much protein in her diet. Her new and holistic vet to my surprise suggested a raw, grass fed meat and organic vegetable diet (I decided on "Darwin's pet food") which is NOT low in fat to protein at all. I asked him about all the things I read about fat and protein and kidney disease and he explained that the QUALITY of protein and fat make the difference. It matters if you feed grass fed or not for example. A year and a half later my almost 15 year old dog is dramatically better and my other two dogs are as well. Even her kidneys are better in spite of the common conception that once damaged they can't recover. My other dog had bad arthritis that completely went away on this diet. Like I said, I'm confused about all the things I read and heard about this issue but I'm glad I listened to my holistic vet.


----------



## aussiegirl6 (Mar 16, 2013)

The management of chronic kidney disease-mineral bone disorder (CKD-MBD) is central to the care of patients with kidney disease. Key to these efforts is the availability of clinically accessible biomarkers that can help distinguish between a wide variety of bone and mineral disturbances related to kidney failure. Two such markers, parathyroid hormone (PTH) and alkaline phosphatase, are already well-established in current guidelines for managing CKD-MBD and are familiar to most clinical practitioners.
The measurement of alkaline phosphatase has been advocated as an adjunct test for non-invasively assessing bone turnover in CKD patients, particularly in clinical scenarios in which elevated PTH levels may be challenging to interpret.2 These recommendations were based upon studies that showed that elevated bone alkaline phosphatase levels have some predictive value in diagnosing high-turnover bone disease in both pre-dialysis and end-stage kidney disease populations.2,16-18 As such, although the KDOQI guidelines do not address alkaline phosphatase in the management of CKD-MBD, the more recent KDIGO guidelines recommend that the measurement of alkaline phosphatase levels should commence in stage 3 CKD, and that in patients with stage 4 -5 CKD, alkaline phosphatase should be measured at least every 12 months, and more frequently when monitoring response to therapy

Orlando M. Gutiérrez, MD

Post Script:
Kidney Disease: Changing Your Diet

When you have kidney disease, your kidneys are no longer working as well as they need to. Changing your diet can help protect your kidneys. It can also help you control other diseases, such as diabetes and high blood pressure, that can make kidney disease worse.

This topic can give you some general ideas about how to follow the diet your doctor or dietitian recommends.

Note: These diet tips are not for you if you are on dialysis or have had a kidney transplant. Follow the special diet your doctor gave you.

Key points

Most people who have kidney disease need to limit salt (sodium), fluids, and protein. Some also have to limit potassium and phosphorus.
There is no one diet that is right for everyone who has kidney disease. Your doctor or dietitian can tailor a diet for you based on how well your kidneys are working.


----------



## aussiegirl6 (Mar 16, 2013)

Milo's mom said:


> I don't think I really understand kidney disease but I know that my old dog was losing "massive amounts of protein" (words of her vet) through her kidneys and had elevated alk phos and other liver values and cancer (!) after years on a low protein, low fat kibble diet (Wellness Weight Management). Years earlier she had had pancreatitis and that had made me really scared of fat and too much protein in her diet. Her new and holistic vet to my surprise suggested a raw, grass fed meat and organic vegetable diet (I decided on "Darwin's pet food") which is NOT low in fat to protein at all. I asked him about all the things I read about fat and protein and kidney disease and he explained that the QUALITY of protein and fat make the difference. It matters if you feed grass fed or not for example. A year and a half later my almost 15 year old dog is dramatically better and my other two dogs are as well. Even her kidneys are better in spite of the common conception that once damaged they can't recover. My other dog had bad arthritis that completely went away on this diet. Like I said, I'm confused about all the things I read and heard about this issue but I'm glad I listened to my holistic vet.


I had researched and found the same thing about it must be "organic" as that is a grass fed animal, NOT shot up with hormones and antibiotics which is what is killing our pets because THEY have to filter the chemicals they eat from these animals, so therefore THEIR little organs are impaired even though the pet itself was not injected with a chemical it still ingested it. So I am on board with you, thanks for the information about Darwins.


----------



## sassafras (Jun 22, 2010)

That study is for people? Also, they are also talking about people with known/diagnosed kidney disease, not an increased ALP by itself with no evidence of previous ckd.

In dogs and cats, there is evidence that decreasing phosphorus and to a lesser extent protein can help slow the progression of kidney disease _once it is already there_. There is no evidence that a higher protein diet _causes_ damage to the kidneys. (That I'm aware of, anyway, enlighten me if I'm wrong).


ETA: Don't get me wrong, I don't think high protein diets are necessary for dogs and in a lot of cases are a waste of money. But it's a myth that they cause kidney damage.


----------



## aussiegirl6 (Mar 16, 2013)

I feel the vets should have warned me about the elevated alk phos, being possibly caused by non-grain foods could hurt an old dogs kidneys maybe I could have not aggravated the disease along.


----------



## sassafras (Jun 22, 2010)

aussiegirl6 said:


> I feel the vets should have warned me about the elevated alk phos, being possibly caused by non-grain foods could hurt an old dogs kidneys maybe I could have not aggravated the disease along.


I'm unclear what your assertion is, that the ALP caused kidney damage or that it was a marker for kidney damage? Or that the diet caused the elevated ALP? There is no evidence that I'm aware of that elevated ALP is a marker for kidney disease in dogs, and if there was no other evidence of kidney disease on bloodwork (eg elevated BUN and/or creatinine, low urine specific gravity) it doesn't even make sense that it would be. I think you are misinterpreting the study you posted. 

It is actually extremely common for middle aged to senior dogs to have slight elevations in ALP with no other changes for a variety of reasons that are not immediately life threatening and certainly have nothing to do with the kidneys: Periodontal disease and benign nodular aging changes in the liver are two common examples.


----------

