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Diamond CARE

Diamond Care Renal RX for Dogs

Easily Digestible Eggs

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DIAMOND CARE Rx Renal Formula for Adult Dogs is indicated for the management of acute or chronic kidney disease in adult dogs.

Formulated for dogs diagnosed with acute or chronic kidney disease

High-quality, easily digestible protein

Carefully regulated levels of phosphorus and sodium

Guaranteed levels of antioxidants for immune support

Complete and balanced for everyday, long-term feeding

Complete nutrition, unique formulation

Diamond CARE Rx Renal Formula is a limited-ingredient diet that delivers complete nutrition and may be fed long-term as part of a complete renal disease management plan. High-quality egg protein in controlled levels provides adequate amounts of essential amino acids, while guaranteed levels of antioxidants help support the immune system. A guaranteed amount of live, active cultures of canine-specific probiotics also helps support the digestive and immune systems.

A smooth transition

Dogs with renal disease often experience appetite loss or may associate their current diet with feeling sick. Furthermore, many renal formulas lack palatability compared to adult maintenance diets. Our nutritionists paid special attention to the palatability of our renal formula. Working closely with pet owners to correctly transition their dog to Diamond CARE Rx Renal Formula will further help avoid food aversion. The transition should take place gradually, over a period of 7 to 14 days.

Controlled phosphorus and sodium levels

Phosphorus retention by the kidneys is one of the first changes in mineral status with renal disease. The resulting hyperphosphatemia can lead to vitamin D deficiency as well as interfere with normal calcium regulation. Evidence shows that controlling serum phosphorus levels may help slow the progression of renal disease.1,2 That’s why one goal of canine kidney disease management is to normalize serum phosphorus concentration. Diamond CARE Rx Renal Formula is guaranteed to contain no more than 0.5% phosphorus.

Hypertension is a common clinical finding in dogs with kidney disease. Activation of the renin-angiotensin-aldosterone system in response to hyperfiltration of sodium in the early stages of kidney disease promotes retention of sodium. Over time, the RAAS actually causes further injury to the kidneys. In combination with pharmacological intervention, controlling sodium intake is an important feature of the management of renal disease. Diamond CARE Rx Renal Formula is guaranteed to contain no more than 0.25% sodium.

1. Jacob F, Polzin D, Osborne C, Allen TA, Kirk CA, Neaton JD, Lekcharoensuk C, Swanson LL. Clinical evaluation of dietary modification for treatment of spontaneous chronic renal failure in dogs. J Am Vet Med Assoc 2002;220:1163–1170. Unchanged: 1. Jacob F, Polzin D, Osborne C, Allen TA, Kirk CA, Neaton JD, Lekcharoensuk C, Swanson LL. Clinical evaluation of dietary modification for treatment of spontaneous chronic renal failure in dogs. J Am Vet Med Assoc 2002;220:1163–1170.
2. Finco DR, Brown SA, Crowell WA, Groves CA, Duncan JR, Barsanti JA. Effects of phosphorus/calcium-restricted and phosphorus/calcium-replete 32% protein diets in dogs with chronic renal failure. Am J Vet Res 1992;53(1):157–163. Unchanged: 2. Finco DR, Brown SA, Crowell WA, Groves CA, Duncan JR, Barsanti JA. Effects of phosphorus/calcium-restricted and phosphorus/calcium-replete 32% protein diets in dogs with chronic renal failure. Am J Vet Res 1992;53(1):157–163.

Animal feeding tests using Association of American Feed Control Officials procedures substantiate that Diamond CARE RX Renal Formula for Adult Dogs provides complete and balanced nutrition for maintenance.

RESEARCH

Key Research Findings and Supporting Studies –

Diamond CARE pet foods are designed based on proven research and carefully curated studies. This document is a synopsis of the key findings that guided the formulation of Diamond CARE Rx Renal Formula for Adult Dogs.

Restricted sodium content can have beneficial effects for managing hypertension in patients with chronic kidney disease.

Reduction in protein intake reduces proteinuria and slows progression of chronic kidney disease.4
Diets with reduced salt content enhance the antihypertensive effects of antihypertensive agents in dogs and cats.4

Restricting protein and phosphorus intake for dogs with chronic renal failure can delay onset of uremic crises and enhance survivability.

Higher protein levels in the diet led to elevations in BUN without concurrent increases in creatinine. Clinical symptoms of uremia include anorexia, vomiting and oral ulcers.1

Dogs fed a renal formula dog food with 14% protein and 19% fat had fewer incidences of uremic crisis and delayed mortality compared to dogs fed a maintenance formula dog food containing 25% protein and 12% fat. Calcium, phosphorus, sodium and potassium were restricted in the renal formula as compared to the maintenance formula. The renal formula had an n-6:n-3 of 2:1 compared to 15:1 in the maintenance formula.9

Uremic crisis occurred in 65% of dogs in the maintenance formula group compared to 33% of the dogs in the renal formula group.9

A median of 188 days elapsed before deaths occurred in the maintenance formula group compared to a median of 594 days before deaths occurred in the renal formula group.9

At the end of the study, 65% of the dogs in the maintenance formula group had died from renal causes while 33% of the dogs in the renal formula group had died from renal causes.9

In this study, 42.9% of the dogs fed medium-protein diets showed declining renal function while 12.5% of the dogs fed low-protein diets showed declining renal function.11

Dogs with chronic renal failure consuming a restricted-protein diet had no mortality associated with uremic complications over a 40-week period compared to 6 of 11 dogs consuming a maintenance diet.12

Several researchers (Polzin, Finco and Barsanti) favor a diet with a moderate protein level for management of chronic renal failure (14-18% dry matter protein). This range was found to provide adequate nutrition without aggravating the uremic status of the dogs with chronic renal failure. Renal function appears to remain most stable in groups of dogs fed this level of protein.13

Restricted protein and phosphorus intake for dogs with chronic renal failure (CRF) has several clinical benefits, including increased activity levels, weight gain and a healthy hair coat.

Dogs with CRF gained weight when switched from a phosphorus-replete diet containing 31% protein to a phosphorus-restricted diet containing 16% protein.8

Diets containing 8.2% protein and 17.2% protein on a dry matter basis were associated with increased physical activity and reduction in serum urea nitrogen concentrations when compared to a diet containing 44.4% protein on a dry matter basis.10

Dogs with chronic renal failure consuming a restricted-protein diet were more active and had a better-quality hair coat than dogs consuming a maintenance diet.12

Diets with restricted calcium and/or phosphorus can have beneficial effects on survivability and progression of renal disease.

Restriction of dietary phosphorus had significant impact on survival of dogs with experimentally induced renal failure, independent of protein levels in the diet.6

Over a two-year period, dogs with experimentally induced kidney failure fed a diet replete with calcium and phosphorus had significant unfavorable alterations in numerous biochemical parameters such as calcium, phosphorus, potassium, sodium, chloride, total CO2, anion gap and parathyroid hormone concentration. Dogs fed the calcium/phosphorus-replete diet also had significant reductions in GFR over the course of the study.7

Supplementation with omega-3 fatty acids from fish oil has numerous beneficial effects on dogs with chronic kidney disease.

Supplementation with fish oil is renoprotective through enhanced glomerular filtration rate and decrease of renal interstitial fibrosis.2

Supplementation with fish oil enhances creatinine clearance.2 Supplementation with fish oil results in diminished glomerular injury.2

Supplementation with fish oil in early renal insufficiency led to lower serum cholesterol concentrations and lower urinary prostaglandin E2 and thromboxane A2 excretion.3

Dietary supplementation with fish oil lowered glomerular pressure, decreased renal eicosanoid series-2 excretion and provided renoprotection.3,4

Diets containing an altered ratio of n-6:n-3 fatty acids of 5:1 led to lowered glomerular capillary pressure, altered urinary excretion of eicosanoids and delayed progression of chronic kidney disease.4

Supplementation with menhaden fish oil as a source of n-3 PUFA prevented deterioration of glomerular filtration rate, lessened the magnitude of proteinuria and preserved renal structure.5

Diets with restricted protein and phosphorus without n-3 PUFA supplementation fed to dogs with chronic kidney disease showed decreases in GFR and progression to end-stage renal failure.5

REFERENCES
1. Bovée KC. Influence of Dietary Protein on Renal Function in Dogs. J Nutr. 1991;121:S128–S139.
2. Brown SA, Brown CA, Crowell WA, Barsanti JA, Allen T, Cowell C, Finco, DR. Beneficial effects of chronic administration of dietary μ-3 polyunsaturated fatty acids in dogs with renal insufficiency. J Clin Lab Med. 1998;131:447–455.
3. Brown SA, Brown CA, Crowell WA, Barsanti JA, Kang CW, Allen T, Cowell C, Finco DR. Effects of dietary polyunsaturated fatty acid supplementation in early renal insufficiency in dogs. J Lab Clin Med. 2000 Mar;135(3): 275–286.
4. Brown, S, Elliott J, Francey T, Polzin D, Vaden S. Consensus Recommendations for Standard Therapy of Glomerular Disease in Dogs. J Vet Intern Med. 2013;27:S27–S43.
5. Brown SA, Finco DR, Brown CA. Is There a Role for Dietary Polyunsaturated Fatty Acid Supplementation in Canine Renal Disease? J Nutr. 1998;128:2765S–2767S.
6. Finco DR, Brown SA, Crowell WA, Duncan RJ, Barsanti JA, Bennett SE. Effects of dietary phosphorus and protein in dogs with chronic renal failure. Am J Vet Res. 1992 Dec;53(12):2264–71.
7. Finco DR, Brown SA, Crowell WA, Groves CA, Duncan JR, Barsanti JA. Effects of phosphorus/calcium-restricted and phosphorus/calcium-replete 32% protein diets in dogs with chronic renal failure. Am J Vet Res. 1992 Jan;53(1): 157–63.
8. Hansen B, DiBartola SP, Chew DJ, Brownie C, Nagode L. Clinical and metabolic findings in dogs with chronic renal failure fed two diets. Am J Vet Res. 1992 Mar;53(3):326–34.
9. Jacob F, Polzin DJ, Osborne CA, Allen TA, Kirk CA, Neaton JD, Lekcharoensuk C, Swanson LL. Clinical evaluation of dietary modification for treatment of spontaneous chronic renal failure in dogs. J Am Vet Med Assoc. 2002;220: 1163–1170.
10. Polzin DJ, Osborne CA, Adams LG. Effect of Modified Protein Diets in Dogs and Cats with Chronic Renal Failure: Current Status. J Nutr. 1991;121:S140–S144.
11. Polzin DJ, Osborne CA, Hayden DW, Stevens JB. Effects of modified protein diets in dogs with chronic renal failure. J Am Vet Med Assoc. 1983 Nov 1;183(9):980–986.
12. Polzin DJ, Osborne CA, Hayden DW, Stevens JB. Influence of reduced protein diets on morbidity, mortality, and renal function in dogs with induced chronic renal failure. Am J Vet Res. 1983;45:506.
13. Schlichting JL, Tyler JW. The Use of Reduced Protein Diets in the Management of Canine Renal Failure. Iowa State University Veterinarian. 1986;48(2):120–125.

INGREDIENTS

Brown rice, chicken fat (preserved with mixed tocopherols), egg product, potato protein, tomato pomace, flaxseed, natural flavor, menhaden fish oil (a source of EPA, preserved with mixed tocopherols), calcium carbonate, potassium citrate, DL-Methionine, choline chloride, taurine, dried chicory root, dried Lactobacillus plantarum fermentation product, dried Bacillus subtilis fermentation product, dried Lactobacillus acidophilus fermentation product, dried Enterococcus faecium fermentation product, dried Bifidobacterium animalis fermentation product, vitamin E supplement, iron proteinate, zinc proteinate, copper proteinate, ferrous sulfate, zinc sulfate, copper sulfate, potassium iodide, thiamine mononitrate, manganese proteinate, manganous oxide, ascorbic acid, vitamin A supplement, biotin, niacin, calcium pantothenate, manganese sulfate, sodium selenite, pyridoxine hydrochloride, vitamin B12 supplement, riboflavin, vitamin D3 supplement, folic acid.

Contains a source of live (viable), naturally occurring microorganisms.

GUARANTEED ANALYSIS

Crude Protein 13.0% Minimum
Crude Fat 18.0% Minimum
Crude Fiber 2.0% Maximum
Moisture 10.0% Maximum
EPA (Eicosapentaenoic acid) 0.05% Minimum
Phosphorus 0.2% Minimum
Phosphorus 0.5% Maximum
Sodium 0.25% Maximum
Zinc 150 mg/kg Minimum
Selenium 0.35 mg/kg Minimum
Vitamin E 300 IU/kg Minimum
Taurine* 0.12% Minimum
Omega-6 Fatty Acids* 3.0% Minimum
Omega-3 Fatty Acids* 0.8% Minimum
Total Microorganisms*
(Lactobacillus plantarum, Bacillus subtilis, Lactobacillus acidophilus, Enterococcus faecium, Bifidobacterium animalis in descending amounts)
not less than 36,363,636 CFU/kg

*Not recognized as an essential nutrient by the AAFCO Dog Food Nutrient Profiles.

4,038 kcal/kg (378 kcal/cup) Calculated Metabolizable Energy

PRICE PER FEED

*Based on a 11.3kg bag priced at $124.95 = $11.06 per kg

Size Amount Cost
2.27 kg 93.8 g $1.04
4.54 kg 156.3 g $1.73
9.07 kg 218.8 g $2.42
13.61 kg 291.7 g $3.23
18.14 kg 343.8 g $3.80
27.22 kg 468.8 g $5.18
36.29 kg 593.8 g $6.57
45.36 kg 708.3 g $7.83
56.70 kg 843.8 g $9.33
68.04 kg 968.8 g $10.71
79.39 kg 1083.3 g $11.98

FEEDING GUIDE

A standard measuring cup equates to 114g

Pet Size Amount
2.27kg – 4.54kg ¾ – 1
4.54kg – 9.09kg 1 – 1½
9.09kg – 13.6kg 1½ – 2¼
13.6kg – 18.18kg 2¼ – 2½
18.18kg – 27.27kg 2½ – 3½
27.27kg – 36.36kg 3½ – 4⅓
36.36kg – 45.45kg 3½ – 4⅓
45.45kg – 56.81kg 5¼ – 6¼
56.81kg – 68.18kg 6¼ – 7
68.18kg – 79.54kg 7 – 7¾

TRANSITIONAL FEEDING
A gradual incorporation of new food helps prevent any stomach upsets. Adding the new diet in 25% increments can make the transition to a new diet smooth and comfortable.

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