The confidence your clients need. The life your kidney patients deserve.

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1 The confidence your clients need. The life your kidney patients deserve. Extending quality of life for 60 YEARS Lisa MacConnell, pet owner Cheri Rhodes, DVM, with Dudley Clinical Nutrition to Improve Quality of Life

2 Diagnosing kidney disease Affecting more than one million pets each year 1, kidney disease occurs when the kidneys fail to function properly, resulting in the accumulation of waste substances in the blood. Kidney disease is called a silent killer because signs do not appear until a pet has lost nearly 75% of kidney function. By closely evaluating and monitoring the progression of the disease, you can help to provide optimal management and care for the best chance at prolonging and improving quality of life. Signs include: Ñ Increased urine production Ñ Increased thirst Ñ Weakness Ñ Weight loss Ñ Lack of energy Ñ Bad breath Ñ Sore mouth Ñ Vomiting and diarrhea Ñ Decreased appetite You can give them a better, longer life When a patient is diagnosed with kidney disease, the right nutrition can make all the difference in slowing the progression of the disease and improving quality of life. And the earlier the diagnosis and treatment begins, the better. Hill s Prescription Diet k/d Canine and Feline pet foods prolong life and meet the specific needs of patients living with kidney disease. Hill s Prescription Diet k/d pet foods are backed by extensive clinical studies and the highest-grade evidence Giving pets more time 2 Dramatically reducing clinical signs % 22% Typical grocery cat food The four stages of kidney disease Diagnosing kidney disease using the IRIS (International Renal Interest Society) CKD Staging System * Kidney function remaining NUMBER OF DAYS FED DAYS Hill s Prescription Diet k/d Canine 188 DAYS Typical grocery dog food 20% 15% 10% 5% 0 SURVIVAL TIME 0% 0% Hill s Prescription Diet k/d Feline CATS WITH UREMIC EPISODES Azotemia Stage I: 100% Stage II: 33% Stage III: 25% Stage IV: 10% Plasma creatinine (mg/dl) Effects None Mild renal Moderate renal Severe renal Hyperphosphatemia unlikely Hyperphosphatemia possible Hyperphosphatemia probable Levels apply to average size dogs and cats Measured when patient is well-hydrated * IRIS was created to advance the scientific understanding of kidney disease in small animals at the 8 th Annual Congress of the European Society of Veterinary Internal Medicine, convened in Vienna, Austria, in The organization is led by a board of 16 independent veterinary experts from ten different countries. The mission of IRIS is to help veterinary practitioners better diagnose, understand and treat kidney disease in dogs and cats Hyperphosphatemia probable Delayed onset of clinical signs Feeding Hill s Prescription Diet k/d Canine to dogs with a lesser degree of azotemia (serum creatinine concentration mg/dl) delayed onset of uremic crisis by approximately five months Longer survival time Dogs with chronic kidney disease live more than twice as long with the support of k/d Improved quality of life Dogs fed k/d were 50% less likely to suffer clinical signs associated with renal failure than dogs in the control group Delayed progression Dogs fed k/d saw a 72% reduction in the rate of disease progression Improved quality of life Feeding Hill s Prescription Diet k/d Feline to cats with stages 2 and 3 CKD (serum creatinine concentration mg/dl) resulted in no uremic episodes during the two-year study period, while 22% of cats fed a typical adult grocery food experienced uremic crises Lower mortality There were no deaths among the cats fed k/d during the two-year duration of the study, compared with a 17% renal-related mortality rate in the control group during the same time Fewer clinical signs Cats fed k/d were 22% less likely to suffer clinical signs associated with kidney disease, showing significantly lower concentrations of serum urea nitrogen and higher blood bicarbonate concentrations than cats in the control group

3 The nutrition they need to feel better, longer Hill s Prescription Diet k/d Canine and Feline pet food helps to: Control clinical signs (e.g., ascites/edema, hypertension, etc.) associated with low/reduced sodium 6 tips on transitioning to a new food Changing to a therapeutic food can be difficult for pet owners and their pets. To make it easier and to ensure your patients receive the full benefits of their new food, try offering these tips to your clients: Slow the progression of kidney disease, with low/ reduced phosphorus Meet the nutritional needs of patients while minimizing signs of uremia, with reduced protein levels Improve blood flow to the kidneys, with high omega-3 fatty acids Counteract the tendency for metabolic acidosis, with increased dietary buffering capacity Defend cells from free radicals, promoting a healthy immune system, with added antioxidants Encourage sick pets to eat with improved taste, texture and variety 1 The single most important step is to gradually transition to new foods.this may require 3 to 4 weeks, or longer for some pets, especially cats. 4 Offer foods with different textures, or canned formulas such as Hill s Prescription Diet k/d with Chicken Feline. A pet s lifelong texture preference may reverse with the onset of kidney disease. Although nothing could have stopped the progression of Murphy s kidney disease, feeding Hill s Prescription Diet k/d has helped to extend her life much longer than I ever would have anticipated. 2 Emphasize the importance of beginning nutritional management sooner rather than later. Pets are more likely to accept a new food earlier in the disease progression, and they ll benefit longer. 5 Use fresh food at room temperature. Some pets will only eat food that comes from a newly opened container, or food that s been refrigerated in a plastic container and then warmed. Theresa Bednar, DVM Murphy s veterinarian Rock Road Animal Hospital St. Louis, MO The birth of therapeutic pet nutrition Veterinarian Mark Morris was developing a food for dogs with kidney problems Buddy, a guide dog in renal failure, tried the new food and his condition improved within a week In 1948, based on this special food, Hill s Prescription Diet k/d pet food was introduced 3 Avoid offering new foods during periods of illness or hospitalization. A food aversion may develop causing decreased acceptance of the food when the pet is feeling better. 6 Add flavor enhancers, such as low-sodium chicken or beef broth, tuna water, or oregano. Use in small amounts to avoid diluting the beneficial effects of nutritional management.

4 When not to start a new food Dogs and cats experience so much of the world through their senses of smell and taste. Pets sometimes associate food they eat at the hospital with fear, discomfort or other bad feelings, causing an aversion to that food later. It may be very difficult to overcome even after the pet is feeling better. Given the challenge of persuading many kidney patients to eat due to decreased appetite, it s very important to wait to transition to the new food until they are well enough to return home. When I met Dudley and learned he had a pre-existing kidney condition, I immediately switched him to Hill s Prescription Diet k/d. His quality of life and blood work have actually improved. It is a joy to see him doing so well. Cheri Rhodes, DVM Dudley s veterinarian Osage Beach Animal Hospital Osage Beach, MO Hill s Prescription Diet k/d saved Dudley s life, halting his kidney failure and turning him back into a healthy, happy dog. Lisa MacConnell Dudley s owner Osage Beach, MO Recommend Hill s Prescription Diet k/d Canine and Feline pet food to help extend and improve quality of life Hill s Prescription Diet k/d Canine: 13-oz. cans in cases of 12 Hill s Prescription Diet k/d Canine: 10-lb. bag 20-lb. bag 40-lb. bag SKU Hill s Prescription Diet k/d with Chicken Feline: 5.5-oz. cans in cases of Hill s Prescription Diet k/d Feline: 4-lb. bag 10-lb. bag Pictured: Jay Kirkpatrick, DVM Cheri Rhodes, DVM Heather Brettschneider, DVM

5 It s not a miracle, It s the power of precise nutrition. The therapeutic nutrition in Hill s Prescription Diet pet foods makes an incredible difference in your patients quality of life. Recommend Hill s Prescription Diet and see the difference for yourself. Share your success stories at FeedingIsBelieving.com today. Hill s Veterinary Consultation Service VETS (8387) HillsVet.com 1 Morris Animal Health Foundation, 1998 Animal Health Survey. 2 Jacob F, Polzin DJ, Osborne CA, et al. Clinical evaluation of dietary modification for treatment of spontaneous chronic renal failure in dogs. JAVMA 2002;220: Ross SJ, Osborne CA, Kirk CA, et al. Clinical evaluation of dietary modification for treatment of spontaneous chronic kidney disease in cats. JAVMA 2006;229: / Trademarks owned by Hill s Pet Nutrition, Inc Hill s Pet Nutrition, Inc. P-9488

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