Homemade Diets for Cats and Dogs with Kidney Disease–Most Recipes are Wrong

A new study has been published adding to the evidence, which I have discussed before(see articles listed below), that homemade diets are frequently nutritionally inappropriate and less consistent or reliable than commercial diets.

Larsen, JA. Parks, EM. Heinze, CR. Fascetti, AJ. Evaluation of recipes for home-prepared diets for dogs and cats with chronic kidney disease. Journal of the American Veterinary Medical Association. 2012;240(5):532-8.

The authors looked at 39 recipes from websites and published books for both veterinarians and pet owners (most written by veterinarians) and identified as intended for dogs with kidney disease and 28 such recipes intended for cats. Though the optimal amount and proportion of every possible nutrient is certainly not known for pets with kidney disease, there are some nutrients for which it is fairly clear that animals with kidney disease have different requirements from healthy animals. And the minimal amount of most nutrients needed to avoid deficiency (though not necessarily the optimal amount) is known for most nutrients. The authors systematically compared the nutrient profile of the recipes they examined with known minimal nutrient requirements and with the established special needs of cats and dogs with kidney disease.

Almost all recipes were vague about key ingredients, requiring the owner to guess about exactly what ingredient to use. Similarly, almost all recipes recommended some sort of nutritional supplement but did not offer specific guidance as to type, quantity, or nutrients. Some recipes offered clearly incorrect information, such as suggesting baking soda as a calcium source even though it contains no calcium.

The authors conclusions were:

None of the recipes assessed in the study reported here provided adequate concentrations of all essential nutrients…Furthermore, many recipes did not accommodate currently accepted nutritional strategies for managing [chronic kidney disease].

There is no doubt that homemade diets can be healthy and appropriate for dogs and cats, both those that are well and those with diseases requiring special nutrition. However, the case has not been made that home-prepared diets are superior to commercial diets, as is often claimed. And while commercial diets may not be optimal nutritionally for many individuals, they are at least consistent and monitored for minimal nutritional adequacy. Any benefits home-prepared diets might have won’t matter if they are grossly deficient or inappropriate in terms of essential nutrients.

For my own clients who wish to feed home-prepared diets, I always recommend consulting with a board-certified veterinary nutritionist (try the local veterinary medical school, or PetDiets.com) to ensure the diet is nutritionally appropriate for the individual pet. Recipes have been repeatedly shown not to be reliable, even when created by veterinarians, and relying on them is likely to lead to feeding a nutritionally inappropriate diet.

  1.     Freeman L, Michel K. Nutritional analysis of 5 types of “Raw Food Diets.” Journal of the American Veterinary Medical Association. 2001;218(5):705.
  2.     Lauten SD, Smith TM, Kirk CA, Bartges JW, Adams A, Wynn SG. Computer Analysis of Nutrient Sufficiency of Published Home-Cooked Diets for Dogs and Cats. Proceedings of the American College of Veterinary Internal Medicine Forum 2005.
  3.     Roudebush P, Cowell CS. Results of a hypoallergenic diet survey of veterinarians in North America with a nutritional evaluation of homemade diet prescriptions. Veterinary Dermatology 1992;3:23-28.
  4.     Taylor MB, Geiger DA, Saker KE, Larson MM. Diffuse osteopenia and myelopathy in a puppy fed a diet composed of an organic premix and raw ground beef. Journal of the American Veterinary Medical Association 2009;234(8):1041-8.


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31 Responses to Homemade Diets for Cats and Dogs with Kidney Disease–Most Recipes are Wrong

  1. Art says:

    Those who make their living selling dog food or homemade recipes for dog food need to fess up and tell the public that single source mainance diets are a risk factor for disease. A human kidney doctor does not tell his patients to eat only one bag or can of food or to eat only one homemade recipe. Neither should animal doctors.
    Art Malernee dvm

  2. v.t. says:

    It would be interesting to know which websites and books were evaluated, and what exactly was in the recipes.

    Also, if any of the home-made diets were formulated, written or recommended by the “big three” manufacturers, I believe they always include their standard disclaimer/warnings, such as “not intended for long term feeding”, and other cautions. But, pet owners often do not understand the consequences of long-term (and even short-term) feeding of an insufficient diet.

    Pets with CKD or CRF, are difficult to manage when they are anorexic, and sometimes, the home-prepared foods temporarily can help kickstart their appetite when they are eating nothing else. That said, I would never dream to feed a kidney diseased patient home-prepared food without proper supplementation/direction and medications necessary to manage the disease.

  3. Art says:

    Years ago hills gave the vets homemade recipes of “prescription diets” to hand out to clients. I suspect that’s where a lot of the Internet homemade diets for things like kidney disease come from

    pet food claims insufficiently supported

    Health claims in dog and cat feed]
    Tijdschr Diergeneeskd 128[24]:785-7 2003 Dec 15

    Beynen AC
    The number and diversity of health claims for dog and cat foods have increased markedly over the past few years. There is no explicit legislation as to these claims. Many claims are insufficiently supported by research and are vague and suggestive. In order to inform pet owners and veterinarians properly and to enhance honest competition among pet food producers, rules for the application of claims should be developed. For the time being, the veterinarian will have to take a stand by critical assessment.

  4. v.t. says:

    Art said: “Years ago hills gave the vets homemade recipes of “prescription diets” to hand out to clients. I suspect that’s where a lot of the Internet homemade diets for things like kidney disease come from”

    I suspect you’re right about that (where the internet diets came from). Years ago, we did try them (Hills), and they were suggested to owners of finicky CRF or liver or heart diseased pets, with the strict instruction that it was only to be used temporarily – in some cases, it is better the pet eat something instead of nothing. At least Hills has always stated they are not intended for long-term feeding and of course, they no longer recommend those older homemade prescription diets. Can’t say the same for the holistic, raw, or other concocted recipes with no data, research or reputation behind them.

  5. Art says:

    If the pets were sick they ate the homemade Hills “perscription” formulas using fresh foods a lot quicker than what came in the bag or can. Hills could provide a homemade formula back then because the cans and bags of “perscription” diets were cheaper then than homemade formulas were in the old days.

  6. It is a new thing to know that home-made recipes for dogs and other pets are not sufficient enough to provide the essential nutrients, while the commercial ones have the enough dosage. Thank you for this information, and we’ll be very glad if you keep us posted.

  7. I will Help says:

    Hey There Skeptvet,
    Thanks you for your post, I actually don’t use commercial foods anymore-I create selfmade organic uncooked diet plans for cats and also dog from meats etc . and nutritional vitamins sold for individual usage. Nonetheless I want to make certain they’re having the right levels of nutritional vitamins and also points. If anyone can point me personally the right way that could be fantastic. Many thanks!
    Keep up the good work

  8. skeptvet says:

    If you are formulating a diet for sale and you are not a board-certified veterinary nutritionist with the ability to conduct appropriate research and quality assurance testing to validate the safety, digestibility, and nutritional adequacy of your diets, than honestly I think you are doing a disservice to pet owners and placing animals at risk. Formulating a diet for renal failure is not a simple, straightforward process any intelligent amateur with basic science knowledge can do safely or effectively. Clearly you’ve missed the entire point of my article which is that most such diets, when analyzed carefully, are not nutritionally appropriate. Playing roulette with the health of sick pets, especially as a business, is not helping.

  9. v.t. says:

    “I Will Help”, if you’re asking for help on how to formulate a pet food, you have no business doing it, period, ESPECIALLY if you are pawning it off to unsuspecting pet owners. If you’re doing it for your own pets, the same applies, unless you are trained in a professional capacity in pet nutrition, you’re taking extreme risks with your pets.

    Since you provided your web url in your name, perhaps you could tell us about your marketing affiliation with this so-called “Kidney Diet Secrets!” and other MLM/affiliation marketing schemes. I hope you are not taking advice from people who obviously cannot be bothered to offer their true credentials on their own website, so others can verify them, if they exist at all.

  10. Can I just say what a relief to seek out someone who actually is aware of what theyre talking about on the internet. You positively know the best way to deliver an issue to light and make it important. Extra folks need to read this and perceive this side of the story. I cant believe youre not more well-liked because you undoubtedly have the gift.

  11. Cathib says:

    Um, even prescription dog foods are from China and have been recalled numerous times and killed many animals. Salmonella and melamine are especially harmful to dogs with kidney disease!

  12. skeptvet says:

    The issue here is not that commercial foods are perfect or risk free. Nothing ever is. The issue is that the vast majority of commercial food sold is safe and nutritionally complete. The majority of the recipes available for homemade diets are not nutritionally adequate, and the safety isn’t clear (people do get Salmonella and other serious disease from food they prepare themselves too, you know). On balance, there is not a strong reason to prefer homemade diets in most cases and at least some evidence that they are inferior.

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  14. Me says:

    I ran into the self proclaimed nutrionists Lately when searching for a low allergen kidney food, but ended up having to hire Dr. Remillard. it was ridiculous the dangerous advice people were handing out. I was told to not feed RX diets as they’re not “real” food, and raw (usually prey model raw) will basically cure my dog… A diet VERY high in phosphorous, might I add?

  15. sonya browne says:

    You seem to be calling comments that make sense but don’t agree with you spam. I made a comment that I am in a big group for cats with ckd, and most ckd cats won’t eat the prescription diets for long if at all. How is this spam? Try running an honest blog.

  16. skeptvet says:

    Several points. First of all, the site gets literally hundreds of spam messages every day, and I don’t have time or inclination to filter them all personally, so your message may have been blocked automatically, due to links or some kind of language the filter flagged as suspicious. Secondly, this is a private blog intended to provide information for pet owners, not a public or government site, and I have absolutely no obligation to post any comments of any kind. I allow a wide range of comments, most of which are critical of my articles, in the interest of open debate, but don’t get the idea that you have any “rights” here. I don’t know what you posted or why it was blocked, but only substantive and constructive posts are allowed, so bear that in mind in the future.

    As for your point about CKD diets, the evidence does show that only about half of cats with CKD will eat them, so they are not a perfect solution. That same evidence does show, however, that those who do eat them live longer and have fewer symptoms from their disease, so the composition of the diets does have beneficial effects as claimed. Alternatives for cats who won’t eat commercial renal diets may also have benefits, but this has yet to be properly tested, so such alternatives are still largely guesswork.

  17. Brian says:

    I am sorry but $75 for a 14 lb bag per month is simply not an option in my home or in many homes I would guess. Instead a discussion on what supplements should be considered with these homemade diets would be beneficial. But I would guess the veterinarians are pushing the RX required diets for multiple reasons, claiming that it is nutritionally superior might be fact but I assume profit would also be a consideration as to why it is superior.

  18. skeptvet says:

    For people who can’t afford and Rx diet, I recommend consulting a veterinary nutritionist to formulate a home-cooked diet that is appropriate for their pet. This is more work but pretty cheap. And no, greed doesn’t really have anything to do with the fact that these diets have been demonstrated to be beneficial for patients with kidney disease or that supplements have not. My clients don’t have to buy the food from me, and they often don’t, and I could just as easily sell a bunch of supplements without real evidence for them if I just cared about the money.

  19. Diane Ison says:

    Is there a honest Vet approved recipe (diet) for dogs with kidney disease? My 15 yr old Shih Tzu will not eat the canned or dry Hill’s prescription diet dog food. I do not know what to do. This why I am desperate for a healthy recipe for my dog with kidney disease

  20. skeptvet says:

    Your best option is to have a veterinary nutritionist formulate a diet specifically for your pet. You can consult with the nutrition service at a veterinary college, if you are near one, or there are many who can consult with you online.



  21. Diane says:

    Hi Skeptvet, I’m confused about this statement: “Recipes have been repeatedly shown not to be reliable, even when created by veterinarians, and relying on them is likely to lead to feeding a nutritionally inappropriate diet.” Aren’t commercial foods also formulated from recipes created by veterinarians? Is the difference because commercial foods are created by boarded nutritionists with specialized knowledge?

  22. skeptvet says:

    Right. Most vets have enough training in nutrition to give guidance on general feeding issues and nutritional therapy, but that is a far cry from formulating a complete and balanced diet, which requires specialized expertise. Also, many books written by general practice veterinarians with food recipes are written by advocates for unscientific nutritional philosophies (e.g. TCM, anti-GMO/preservative/etc…), so they ignore basic scientific principles in making their recipes.

  23. Diane says:

    I see, thank you for clarifying!

  24. art malernee says:

    so are we showing clients a rct food trial on cats with kidney disease or are we doing a rct on cats with kidney disease shown to like the taste of the diet we want to sell?

  25. skeptvet says:

    The many studies on diet and kidney disease in cats have involved comparing diets with nutrient levels intended to reduce azotemia and support renal function (e.g. changes in protein, phosphorous, potassium, etc.) to maintenance diets. There have been lab studies and natural disease studies. There is consistent evidence that they improve outcome in cats with CKD. Most of the studies also show a lot of cats don’t like the diets, so we are certainly not choosing cats who like the diets first and then doing studies on them.

  26. art malernee says:

    your post below. love to see a rct that included the other half of the cats remove from the study.

    >>>As for your point about CKD diets, the evidence does show that only about half of cats with CKD will eat them, so they are not a perfect solution. That same evidence does show, however, that those who do eat them live longer

  27. skeptvet says:

    Not sure what you mean. If they won’t eat the diet, we can’t test the effect of diet on their disease. That’s why we often analyze RCTs on an intent-to-treat basis since not all patients comply with the treatment, even though the effect is greater if we analyze them on an as-assigned basis. However, the fact that cats who won’t eat the diets obviously don’t benefit from them doesn’t undermine the evidence that those who do eat them do benefit.

  28. art malernee says:

    wouldn’t a better rct study be offer the kidney cats two diets . Put them in two groups based on which food they ate first. Then follow the two groups out and see which group lives longer. That way you are not excluding fifty percent of the cats in your study from your rct. Its seems like you are selecting for cats that like the taste of the diets we sell by removing fifty percent of the cats from the study who do not prefer to eat it. the best study would be to divide the two groups by a flip of the coin feed half diet A the other half diet B but if someone did that they have not published it and I suspect would get into hot water for the study. But they drill holes in peoples skull as a placebo so maybe the study has been done just not published.

  29. art malernee says:

    That’s why we often analyze RCTs on an intent-to-treat basis since not all patients comply with the treatment>>>> efficacy vs effectiveness trials right?

  30. skeptvet says:

    What do you think of this study? It is close to what you describe in that cats were randomized to renal diet vs maintenance diet and nearly all the cats in the study ate the assigned diet.

  31. art malernee says:

    What do you think of this study? >>>> I love it. If you could find another similar one for dogs also with Carl Osborne’ name on it I would be over the moon.

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