Nutritional support and follow-up of a puppy with chronic kidney disease

A five months old, Flat-Coated Retriever puppy with poor body condition diagnosed with pyelonephritis and chronic kidney disease (CKD) was referred for a nutritional consult. The conflicting protein and phosphorus requirements for growth and poor body condition versus CKD were scrutinised. To maximise the quality of life (QoL) despite the poor prognosis, several diet plans were advised taking into account the different growth periods of this medium breed puppy. At 15 months of age, body condition was still below target and the creatinine level had increased consistently since the first consult. Despite the progressive decline in kidney function, serum urea concentration decreased compared with seven months before, whereas serum concentrations of total protein, albumin and phosphate remained normal at all times. With the different adjusted diet plans, the QoL of the puppy was improved, allowing for a normal and exceptionally energetic life until the age of nearly three years.