Some changes can be seen quite quickly — for example, improvements in energy levels, stool quality, or appetite may appear within a couple of weeks. Other benefits, such as changes in weight, coat condition, or blood test values, can take several weeks to months, depending on your dog’s health and the reason for the new diet. Every dog is different, so part of the consultation follow-up is monitoring progress and adjusting the plan as needed.

Yes, in theory, you can create a balanced home-prepared dog diet without supplements, but in practice, it’s rarely possible. Meeting every nutrient requirement through food alone would require a wide variety of ingredients, which can be costly, hard to source, or unpalatable to your dog. Carefully chosen supplements fill these nutrient gaps, ensuring your dog eats a healthy and balanced diet.

Yes, one of the many benefits of a homemade diet is that it can be tailored to address several health concerns at the same time. In cases where a dog has multiple health issues with conflicting nutritional needs, the diet is always formulated first for the more immediately serious disease. From there, we adjust as much as possible to support the other condition(s) too. This way your dog still gets a safe, balanced diet that’s designed around their unique health needs.

Yes! Online dog nutrition consultations follow the same structure as face-to-face appointments but offer greater flexibility — no travel, less stress for your dog, and still highly personalised. Research in human healthcare has shown that remote consultations can be just as effective as in-person ones for many conditions. In fact, this is especially true for me, because my diets are formulated using your dog’s medical history and your vet’s diagnostic results, rather than relying on a physical examination.

NRC recommendations are based on a dog’s body weight (kg^0.75), which makes it ideal for tailoring diets to each individual dog. FEDIAF and AAFCO use a more general, energy-based format (per 1,000 kcal). This works well for commercial diets, where a single food needs to suit a wide range of dogs. While FEDIAF is updated more often, its core values still come from NRC. This is why NRC guidelines should always be the standard when formulating personalised homemade dog diets.

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If your dog is prone to calcium oxalate stones, you need to avoid foods high in oxalate, such as spinach, carrots, sweet potatoes, brown rice, organ meats, nuts and tofu.

There isn’t a single, definitive list of oxalate values for foods. Levels can vary depending on where and how a food is grown, the plant variety, and even how it’s prepared - for example, boiling can reduce oxalate content. Different studies also measure oxalate in different ways. Two widely used references are the Harvard Oxalate Food List and the University of California, Irvine Kidney Stone Center tables, both of which provide well-researched guidance.

A diet with normal calcium, reduced salt, moderate protein, and low oxalate tends to work best. Wet or home-prepared diets are generally preferable to dry ones, as they help increase water intake and dilute the urine, which is crucial for reducing stone formation.

Calcium oxalate stones have a high recurrence rate, so feeding the right diet is absolutely key. The aim is to create urine conditions that discourage stone formation by limiting oxalate, avoiding excess calcium absorption, keeping protein and sodium at moderate levels, and maintaining a urine pH that doesn’t favour calcium oxalate. Regular monitoring and sticking with the diet are also essential to minimise the risk of recurrence.

Low oxalate foods can be used as treats for oxalate stone-forming dogs, such as most lean meats, poultry, eggs, cauliflower, apples (peeled), strawberries, blueberries, cucumber and melon (all types).

No. Unlike some other bladder stones, calcium oxalate stones cannot be dissolved with diet alone. They usually require surgical removal or other veterinary procedures. However, diet plays a key role in preventing recurrence.

Yes, absolutely! A homemade diet is often more effective due to its higher water content and the personalised inclusion of minerals it provides. However, it needs to be appropriately balanced and follow the recommended stone-prevention guidelines.

Very high-protein diets may acidify urine, which increases the risk of calcium oxalate stones. Most dogs with a history of stones do better on moderate protein tailored to their health and activity.

No, calcium should not be avoided. Dogs need calcium for healthy bones, muscles, and many other body functions. In fact, providing the right amount of calcium is important because it helps bind oxalate in the gut so it can leave the body in the stool. Too little calcium can actually increase the risk of stones. The key is to feed a diet with a normal, balanced amount of calcium - not too little and not too much.

When urine is too acidic (below pH 6.5), calcium oxalate stones are more likely to form. Keeping the urine closer to neutral, around pH 7, with the right diet and supplements can help lower the risk of stones coming back.

Potassium citrate can help by making urine less acidic, thereby lowering the chance of stone formation. However, it should only be used under professional guidance.

Calcium oxalate stones form when calcium and oxalate in the urine bind together, especially if the urine is too acidic or these compounds are present at high levels. Normally, a natural protein called nephrocalcin helps prevent this by blocking the crystals from forming. In some dogs, nephrocalcin doesn’t work properly, often due to genetics, so stones are more likely to develop.

Yes - peanut butter is high in oxalate, which can increase your dog’s risk of forming kidney stones.

The most common signs of kidney disease in dogs include drinking and urinating more than usual, loss of appetite, weight loss, and reduced energy. Some dogs may also develop vomiting, dehydration, or bad breath. In the early stages of CKD, however, you might not notice any changes at all, and the condition is often picked up by chance during routine blood or urine tests. This is why yearly vet check-ups are so important, especially for senior dogs.

The prognosis for kidney disease is quite variable depending on how early it’s diagnosed and how well it’s managed. My experience says that if diagnosed early and with appropriate management, most dogs will maintain a good quality of life for many years.

The best diet for a dog with kidney disease is one that helps slow the progression of the condition while supporting overall health. This means limited phosphorus, a controlled but adequate amount of high-quality protein, high moisture content, and added omega-3 fatty acids. Veterinary prescription diets are designed with these principles in mind. However, a carefully formulated homemade diet - balanced to NRC nutrient requirements – is often more effective, as it can be tailored to the individual dog’s needs, preferences and disease stage.

For dogs with both kidney disease and pancreatitis, a home-prepared diet is often the best choice, as it can be tailored to manage both conditions. If you rely on commercial food, first clarify whether your dog has chronic pancreatitis, an acute flare-up, or simply a past episode. Some dogs recover fully, while others are repeat offenders who need long-term fat restriction. If pancreatitis recurs, it must take priority, as it can be painful and life-threatening, while kidney disease is progressive but slower to develop.

While no single food is absolutely of the menu, dogs with kidney disease should avoid large amounts of foods high in phosphorus and protein. Some examples include raw bones, canned fish, egg yolks, dairy products and organ meats, all of which can raise phosphorus levels and put extra strain on the kidneys.

Yes, absolutely - but the diet must be carefully formulated to meet nutritional needs and follow the disease protocol. Working with a qualified nutritionist is a must. Starting dietary management early is essential to slow disease progression, so getting it right from the beginning is key.

When the kidneys aren’t working properly, they can’t eliminate excess phosphorus in the urine. This leads to rising phosphorus levels in the blood, which upsets the balance with calcium and triggers a cascade of problems in your dog’s body. It's somewhat complicated, but I've tried to simplify it in this blog. In short, controlling dietary phosphorus helps restore balance and, in turn, slows the progression of kidney disease.

That’s a great question, and one that still sparks plenty of debate. While dogs with kidney disease do need less protein compared to healthy dogs, current research shows that a severely restricted-protein diet isn’t usually necessary, unless your dog is uraemic. The goal is to provide the right amount of high-quality protein - enough to maintain muscle and overall health, but not so much that it produces excess waste the kidneys struggle to clear.

Yes. Dogs with kidney disease often lose more fluid through urine, which can lead to dehydration. Fresh water should always be available. Feeding a high-moisture diet (such as wet or home-prepared food) is also very helpful.

Yes, absolutely! As mentioned earlier, there aren’t any foods that must be completely avoided for dogs with kidney disease; the goal is to reduce phosphorus and control protein intake. I don’t tend to worry too much about treats, since they make up only a small part of the diet and the phosphorus they contain usually doesn’t contribute significantly. That said, it’s best to avoid treats that are notoriously high in phosphorus, such as bully sticks, rawhides, pig ears, and raw bones.

The most important supplement for dogs with kidney disease is fish body oil (not cod liver oil). Fish body oil provides omega-3 fatty acids, which help reduce inflammation and support blood flow in the kidneys. If you’d like to learn more about fish oil, including my go-to brands, you can read more here: How to Choose the Best Fish Oil for Your Dog.

Dogs with CKD often lose their appetite or develop food aversions. Never force-feed, and see your vet if your dog stops eating completely. Small, frequent meals, plenty of water, and flexibility with textures, toppers, or feeding location can all help. If your dog still won’t eat, consider a home-prepared diet. Most dogs find homemade meals more appealing, and recipes can be tailored to tempt picky eaters.