You're Shopping
Nature's Select Carolinas
Change Location
toggle menu
You're Shopping
Nature's Select Carolinas
Change Location


Managing Renal/Kidney Failure in Dogs

A year ago this month, I lost one of my best friends, Raleigh, to Renal Failure. Even writing this blog article makes me tear up. I still have her photo as the wallpaper on my computer.

Today, I emailed a new customer recommendations of supplements and medications for managing Stage III through Stage IV renal failure. I thought it would be a great topic for this week’s blog post, for those pet parents looking for answers.

Raleigh was a rescue. A beautiful German Shepherd/Husky mix with the most soulful eyes I’ve ever seen. She could see right through me. We adopted her when she was four. We don’t know much about her history, other than she suffered some abuse and had a litter of puppies before being captured and fixed at the shelter. Raleigh was diagnosed with Stage III Renal Failure at age 6.

Raleigh Hiking – Age 7

I could spend my life wondering what caused it, but without knowing anything regarding her genetics or history, the cause remains unknown. What I do know, is that we were blessed with 5 years with this angel, and I’m thankful for that time.

When I found out the diagnosis, I battled it with everything I had. I researched everything online, from hydrotherapy, to natural herbal cleanses (over $200), to even considering kidney transplants. I had her blood work done often, hoping her numbers would be lower with each new treatment I tested at home. For me, nothing seemed to work. When I finally accepted the diagnosis and decided to manage her treatment and care the best I could, I went to the experts.

I consulted with an animal nutrition expert, and decided against using a prescription diet for my girl, choosing instead a low-protein (16%) natural dry food to help manage her disease. The food contained no by-products, no chemicals, no artificial ingredients, and no corn, wheat or soy.

Between recommendations I received from the nutritionist, and working closely with my vet, we co-created a special plan just for Raleigh, that helped her live three happy, healthy years after her Stage III diagnosis. Unfortunately, the low-protein food I used has been discontinued (Nature’s Select Ultra Lite), but the supplements I used can still be found.

(NOTE: The topic of low-protein diets for managing kidney failure in dogs is a subject of debate. You can learn more about the pros/cons and research various other opinions, by browsing through the works cited of this article from

For those pet parents looking for options, please consider mentioning these to your vet at your pet’s next check up, as I believe they helped tremendously extend the life span, and more importantly, the quality of life, for Raleigh. Everyone who saw her would tell you, that she didn’t look sick at all. 

Supplements and Medications: Azodyl (Kidney Specific/Renal Probiotic): You can find this online. Consider pricing around. This supplement needs to be kept chilled or refrigerated, even during shipping.

1800PetMeds offers it here:

TIP: Order more in the winter months when it is cooler and stock up. Some distributors allow you to avoid the freezer pack needed to keep the medicine cool, plus the expedited shipping costs, in the winter months, lowering the cost to ship the medicine significantly. 

Aluminum Hydroxide (Phosphorus binder): This helps bind the phosphorus content in foods to help reduce phosphorus intake. You will need to speak with your vet to get dosage suggestions.

NOTE: 1-lb jar is most cost effective. I would scoop Raleigh’s food into a Ziploc bag, squirt 3 pumps of Salmon Oil onto the food, add the Aluminum Hydroxide powder, seal the bag, and shake the bag to cover the kibble. The powder is supposed to be tasteless, but does give the food a chalky texture if you administer it the way I did. So, I would sometimes add 1-2 tablespoons of a natural, healthy canned food (lowest protein possible) and mix it in, to help encourage Raleigh to eat. 

Famotidine (Pepcid): At later stages (III through V), this can help prevent nausea and upset tummy. Talk to your vet about dosage requirements.

Salmon Oil: I used Grizzly Salmon Oil with Raleigh. You can read about the benefits of Salmon Oil from an article on here. Raleigh weighed between 50-53 pounds. I used three pumps in the morning with breakfast and three in the evening with dinner. Each pump is 2ml or about 1/2 teaspoon. We carry the Grizzly Salmon Oil on our website here:

Additional Supplements: I also liked to use digestive enzymes and probiotics to break down the food as much as possible to reduce stress on her kidneys. I like this one that we carry from NaturVet:

I hope these suggestions help you in your search.

Hugs and Paws, 

Dee and Raleigh

Raleigh working the crowd at an event

“If there are no dogs in Heaven, then when I die I want to go where they went.” -Will Rogers