Feeding horses with renal disease
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Author: Dr Nerida McGilchrist | PhD Equine Nutritionist and Founder of My Happy Horse
Horses with chronic or acute kidney disease can benefit from careful nutritional management. Feeding these horses appropriate rations can take the load off their kidneys to allow them time to heal or to prolong the time the kidneys are able to function effectively for the horse.
The key aspects of managing a horse with renal disease are:
1. Feed enough, but not too much protein
Excess protein in a horse’s diet creates excess nitrogen waste which needs to be handled and excreted by the kidneys. In normal horse’s with healthy kidneys, this isn’t an issue, but in horses with kidney disease, it puts more pressure than is necessary on the kidneys to function.
Diets need to be carefully formulated to meet protein, and more specifically to meet essential amino acid requirements without exceeding protein intake requirements.
This means, the higher the quality of protein used (with high quality proteins containing the highest concentrations of amino acids in the correct proportions), the less total protein you will need to meet essential amino acid requirements.
2. Meet but don’t exceed calcium requirements
Excess calcium in horses is excreted through the kidneys. Meaning high calcium diets create more work than necessary for the kidneys.
It is therefore important to meet calcium requirements but not exceed them, making careful diet formulation essential.
3. Be careful with salt
Ordinary table salt contains sodium and chloride, two of the most important electrolyte minerals that horses need. You absolutely must meet sodium and chloride requirements, but, like with protein and calcium, too much salt for a horse with renal disease can put extra pressure on the kidneys. So you must meet but not exceed their requirements.
The best and safest way to do this is to avoid adding salt to the feed, but always allow free access to loose rock salt. That way the horse can seek out and consume enough salt to meet requirements without exceeding requirements.
4. Meet vitamin and mineral requirements
Requirements for all vitamins and minerals should be met in order to maintain general health and welfare. Use high quality supplements (which are not necessarily the most expensive or well-known brands!) that won’t exceed calcium requirements.
Balancer pellets are often best avoided as the calcium content may be too high for horses with renal disease.
5. Maintain body condition
Horses with kidney disease can be difficult to feed and will sometimes have a poor appetite and lose weight.
To help maintain body condition:
feed ample amounts of low protein (10% or less crude protein) grass forage
feed a variety of grass forages to maintain hindgut microbe health and diversity (which will help make sure they are digesting forages efficiently)
feed small amounts of lucerne/alfalfa where possible to increase overall palatability of the forage and to add a small amount of high quality protein to the diet; and
use high energy fibres like low protein soybean hulls or lupin hulls, high omega 3 oils like flaxseed oil and cooked cereal grains and/or oats where safe and appropriate to increase a horses calorie intake to help them maintain weight.
Accurate diet formulation is crucial
With so many specific needs and very little leeway for ‘error’ in diets for horses with kidney disease, it is important to carefully design the diets using scientific methods.
Some rules to follow when balancing the diet are:
Base the diet on low protein forages like mature grass hays containing 10% or less crude protein.
Where possible, feed a variety of grass hays to maintain some degree of fibre variety in the horse’s diet that will support microbiome diversity.
Avoid diets high in legume forages like lucerne/alfafa or clover to control protein and calcium intake.
Avoid feeds that are formulated for broodmares, growing horses or seniors as these are typically high in protein and calcium.
Avoid sugarbeet pulp in significant quantities as it is high in calcium.
Use high omega 3 oils to the diet to meet omega 3 requirements and to increase calorie intake where additional energy is needed to maintain body condition.
Use digestible/cooked cereal grains and/or oats, where safe and appropriate to add additional energy when required to maintain body condition. Avoid for any horses who also have insulin dysregulation.
Balancing diets for renal disease patents is not a simple task. You should use a qualified equine nutritionist or the MyHappy.Horse Virtual Nutritionist to create balanced diets that meet but don’t exceed requirements for protein (and essential amino acids), calcium and all other vitamins and minerals.
About the Author
Dr Nerida McGilchrist
Dr Nerida McGilchrist is an Australian equine nutritionist with a PhD and over two decades of experience. As the founder of Equilize Horse Nutrition, and advisor to some of the world's largest nutrition companies, she’s built an international reputation for blending science with practical solutions. Now, she’s bringing her expertise to My Happy Horse to make advanced nutrition accessible to all.
