Dietary Nutrient Evaluations in a Cohort of Dogs with Aminoaciduric Canine Hypoaminoacidemic Hepatopathy Syndrome Inform Dietary Targets for Protein, Fat, Sodium, and Calcium

Aminoaciduric canine hypoaminoacidemic hepatopathy syndrome (ACHES) is a rare syndrome affecting dogs. Nutritional management is a pillar of optimal treatment. Currently, there are no specific published data to inform dietary nutrient composition selections for treating affected dogs. Thus, our goal was to establish nutrient targets for the dietary management of ACHES by comparing nutrient profiles of commercial and home-cooked diets fed to dogs after diagnosis and determine if different nutrient inclusions were associated with survival. This retrospective cohort study evaluated nutrient profiles of commercial diets (n = 10) and home-cooked diets (n = 8) fed to dogs with ACHES. Associations between dietary nutrient inclusions and survival duration were determined using Cox proportional hazard analysis. Home-cooked diets were significantly (p < 0.001) higher in dietary protein and several amino acids than commercial diets. Risks of death were significantly (p < 0.05) lower with increasing dietary protein (hazard ratio 0.92 [CI 0.82–1.0]) and sodium (hazard ratio 0.02 [CI < 0.01–0.38]) and higher for dietary fat (hazard ratios 1.15 [CI 1.02–1.37]). An increased risk of death with increasing dietary calcium did not achieve significance (p = 0.067, hazard ratio 9.92 [CI 1.02–201.0]). These results were used to recommend target dietary nutrient ranges, in g/1000 kcal, of 90–130 for protein, 20–40 for fat, 0.7–1.8 for sodium, and 1.0–2.8 for calcium for dietary ACHES management.