Up close shot of dog food bowl

Q. Our older dog is having kidney problems. The veterinarian recommended an expensive diet formulated for kidney disease. Will it really help manage the problem? Are there alternatives?

A. Yes, a special therapeutic diet really does help. And, yes, there are alternatives, but I am hesitant to recommend them for a couple of reasons based on my clinical experience of more 30 years as a practicing veterinarian.

Therapeutic diets, available only on the order of a veterinarian, have been formulated to target specific metabolic processes to help prevent, reverse or manage an illness. One example, Hill’s Prescription Diet y/d Feline Thyroid Health, was featured in our piece Groundbreaking Veterinary Discoveries That Revolutionized 2011 for its use in managing feline hyperthyroidism.

Why Veterinarians Recommend Therapeutic Diets

The reason I prescribe these therapeutic diets and have used them on my own pets in the past (my daughter, Vetstreet training expert Mikkel Becker, feeds one to her Pugs for skin problems now) is because they’re clinically proven to work. That’s not the same as a neighbor telling you that something worked for her dog or a testimonial from a pet owner on a website about what he says worked for his cats. Clinical trials are the gold standard for how we chose products to carry and prescribe in a veterinary practice. Not only can we review the clinical trials and ask questions of experts at veterinary conferences and in online discussions among veterinarians, we see actual data from our own patients.

If these diets didn’t work, we wouldn’t carry them.

Alternatives to Therapeutic Diets

Now, are there alternatives? Yes, you can work with a veterinary nutritionist to get a special diet you can make at home, but it can be more expensive and is undoubtedly an inconvenient and time-consuming endeavor. My experience has been that despite their best intentions, most pet owners are unwilling or unable to maintain the work and dedication required to provide such a diet prepared at home. If you wish to try, however, you must work with your veterinarian to ensure that the therapeutic benefits of a special diet are being met for your dog.

Some final thoughts: The biggest problem I see in practice is that someone starts her pet on a therapeutic diet on her veterinarian’s recommendation. As a result, the pet seems to gets better or the condition stabilizes, and then it’s back to the old food, typically without talking to the pet’s veterinarian. Bad idea. People would never dream of stopping thyroid medication or injections for a diabetic pet, but they tend to forget that these foods are treatment all the same.

As for the expense, it’s important to realize that high-quality ingredients with specific, metabolically targeted effects cannot be manufactured, distributed and monitored cheaply. In my experience, these diets are worth every penny.