Supplements for Dogs with Kidney Disease

Nutraceuticals to increase antioxidants, reduce inflammation, and improve overall vitality.

To slow the progression of the disease, a low-phosphorus diet is necessary regardless of the stage of the disease. Depending on the stage of the disease, a phosphorus content of between 0.6% to 0.8% is usually acceptable in the early stages, while a lower level of 0.5% and below is recommended for advanced stages.

On top of this, there are nutraceuticals and herbs that can be included in the dog’s diet for additional health support.

These are the following nutraceuticals that I would recommend, and have included them in my dog’s kidney treatment regimen. With my dog, it was a hit-and-miss. She was a very picky eater, and it can be challenge adding these into her food. But we do our best to hide them in her treats and take it as a win everytime she eats it.

It’s best to give these daily but if that’s not possible, don’t beat yourself up. Get creative, hide them in treats, crush them up and mix into food or wet treats (like peanut butter or yogurt), stuff inside a small meatball. Just do the best you can.

Why is it important to reduce inflammation and increase antioxidant in dogs with chronic kidney disease?

Because chronic kidney disease is an inflammatory and oxidative condition.

In CKD, the kidneys progressively lose their ability to filter waste and maintain fluid, electrolyte, and acid–base balance. Toxins that are normally filtered out of the dog’s body, began to build up in the bloodstream, contributing to a state of chronic systemic inflammation which will manifest as symptoms of CKD - nausea, fatigue, and muscle loss.

Within the kidney organ, the high toxin load leads to excessive production of reactive oxygen species (ROS). These unstable ROS molecules continues to damage cell membranes, proteins, and DNA in kidney tissues, potentially progressing the disease further.

On top of this, the damaged kidney cells release inflammatory cytokines like TNF-α, IL-6, and TGF-β. These cytokines attract immune cells that produce more inflammatory mediators, perpetuating a vicious cycle of inflammation and scarring (fibrosis).

Antioxidants and anti-inflammatory polyphenols such as CoQ10, omega-3 fatty acids and curcumin helps to restore the antioxidant-oxidant balance, shift the body’s eicosanoid balance toward less inflammatory prostaglandins and leukotrienes, stabilize the disease and improve the dog’s overall vitality.

What supplements are good for dogs with kidney disease?

Coenzyme Q10 (CoQ10 / ubiquinone / ubiquinol)

CoQ10 is a potent membrane antioxidant. In kidney disease this nutrient can reduce oxidative stress in renal tissue, protect mitochondrial function in tubular cells, help preserve renal cellular energy production and limit progressive injury. CoQ10 is not just an antioxidant. It can also help improve blood flow to the kidneys and support heart and gum health.

In dogs, CoQ10 supplementation has been shown to substantially raise plasma CoQ10 and reduce biomarkers of oxidative stress. Canine toxicity data show very wide safety margins.

Common doses range from ~1 mg per lb (≈2.2 mg/kg) to 2 mg/lb. Many veterinary supplements use 10 mg per 10 lb as a simple rule. Because formulations (ubiquinol vs ubiquinone) and bioavailability vary, dose is often adjusted by bodyweight and product potency. Follow the recommended dose on the product label. If still unsure, consult your dog’s vet.

[Antioxidants (Basel). 2022 Jul 22;11(8):1427. doi: 10.3390/antiox11081427]

Cranberry extract (Vaccinium macrocarpon)

Cranberry’s main renal/urinary benefit is anti-adhesion. Proanthocyanidins in cranberry reduce adherence of uropathogenic E. coli to urinary epithelial cells, lowering UTI risk.

This also means that Cranberry extract works best to prevent UTI. However, if your dog is already suffering from UTI, cranberry extract may not be the best remedy. When there’s an active infection going on, you’ll want to look at other herbs instead, things like horsetail and marshmallow root tend to work better in those situations.

In a randomized controlled trial in client-owned dogs, oral cranberry extract prevented UTIs and reduced E. coli adhesion to Madin-Darby canine kidney (MDCK) cells. Cranberry does not act as an antibiotic but as a preventive anti-adhesion agent and may reduce bacteriuria/UTI-related inflammation that can exacerbate renal disease. Therapeutic dose (dogs in published work / clinical practice): veterinary studies used standardized cranberry extracts given daily (product/mg varies by study); commercial veterinary guidance commonly recommends following the extract manufacturer’s label (typical supplement doses span tens to a few hundred mg/day standardized to PACs). Because formulations differ, use a veterinary-formulated product and consult your vet for dose for that product

[PMID: 27027843 DOI: 10.2460/ajvr.77.4.421]

Omega-3 fatty acids (EPA & DHA from fish oil)

Omega-3 PUFA (EPA and DHA) has been shown to reduce renal inflammation, lower intraglomerular pressure, reduce proteinuria, and slow progression of glomerular damage in experimental and clinical canine CKD. Long-term dietary omega-3 supplementation has been renoprotective in dogs with renal insufficiency.

Commonly cited and used therapeutic dosing is EPA ≈ 40 mg/kg + DHA ≈ 25 mg/kg once daily (equivalently ~300 mg total EPA+DHA per 10 kg bodyweight in some practical recommendations), or about 1 g EPA+DHA per 1000 kcal of diet for therapeutic renal diets. Many renal veterinary diets already include therapeutic fish oil amounts.

Always select high-quality, purified fish oil and be careful of bleeding risk if your dog is concurrently on anticoagulants. It’s best to get advice from your vet if your dog is on a anticoagulant.

[J Lab Clin Med. 1998 May;131(5):447-55. doi: 10.1016/s0022-2143(98)90146-9.]

Probiotics

Probiotics can modulate the gut-kidney axis by altering gut microbiota.

Probiotics reduce generation and intestinal absorption of protein-bound uremic toxins, enhance intestinal excretion of nitrogenous wastes, and reduce systemic inflammation.

In dogs, trials using multispecies probiotic formulations, alongside renal diet have reported improved GFR or reductions in uremic markers and clinical improvement in CKD patients.

Therapeutic dose vary by product. Because probiotic effects are strain-specific, use canine-studied formulations and follow the product’s label and your vet’s advice.

[Can Vet J. 2017 Dec;58(12):1301–1305.]

Curcumin / turmeric (curcuminoids)

Curcumin is an anti-inflammatory and antioxidant polyphenol. Preclinical CKD models (rodent and cell studies) show curcumin reduces renal inflammation (NF-κB, COX-2), fibrosis, oxidative damage, and profibrotic signaling.

Curcumin slows CKD progression and reducing proteinuria and interstitial fibrosis.

Canine CKD trials on curcumin are limited, but studies have shown that curcumin’s anti-inflammatory/antioxidant properties could reduce systemic inflammation and improve appetite and comfort in some patients.

Veterinary sources commonly recommend ~15–20 mg turmeric (curcumin) per lb bodyweight per day (≈33–44 mg/kg/day) in divided doses. Because curcumin can interact with drugs (anticoagulants, certain chemotherapies), always check with the vet before use, and start low.

[Molecules. 2014 Dec 2;19(12):20139–20156. doi: 10.3390/molecules191220139]

Safety!

Before you add any supplements to your dog’s routine, run it by your vet first. This is especially important for CKD pups or any pups with a diagnosed medical condition. Dosing isn’t one-size-fits-all. It depends on factors like the specific formula/product you’re using, your dog’s size, what other meds they’re taking, how advanced their kidney disease is, and whether their renal diet already has certain nutraceuticals built in.