What is Chronic Kidney Disease?

Chronic kidney disease is an extremely common ailment in our pets. Unfortunately, once the clinical signs of renal disease are detected by owners and veterinarians the damage to the kidney is irreversible. Over 75% of the kidney has to be compromised before the body can no longer compensate for the build up of metabolic waste in the body. Our cats and dogs can slowly adapt over time to the build up of these wastes before they begin to show the clinical signs such as lethargy, decreased appetite, weight loss, vomiting, and increased urination and water consumption.

Chronic kidney disease (CKD) is an irreversible process, but medical intervention with the help of veterinarians and things you do at home can help maintain the high quality of life for some period of time. The goal of treatment is to keep your dog or cat feeling well, maintaining his/her hydration status to help maintain the blood flow to the kidney, decrease the secondary effects of the metabolic waste build up, and to slow the progression of disease.

 Stages of Chronic Kidney Disease

 

Loss of Renal Reserve - Early signs of PU/PD

Renal Insufficiency - Early warning signs, such as increased thirst, may begin to appear

Renal Failure (Azotemia) - Kidneys cannot eliminate waste efficiently, causing signs of illness

 

Advanced Kidney Failure (Uremia) - Severe signs of illness appear; eventually, collapse and death result

Management of CKD

 The mainstay of the management of CKD is maintaining your dog or cat’s hydration status. The kidney is responsible for concentrating the urine and with fewer nephrons, the functional unit of the kidney; he/she is going to urinating a much greater quantity and therefore drinking a lot more water than before. When you couple this with the propensity of animals in CKD to vomit due to an upset stomach, he/she can become quickly dehydrated. It is critical for your dog or cat to have unlimited access to fresh water at all times. However, this may not always be enough to help him maintain its hydration status. A very simple procedure that you can do at home, or if necessary at your veterinarian’s office, is to administer fluids beneath the skin, otherwise known as subcutaneously (SQ). Animals tolerate this very well and most owners report their animals feeling better afterwards. We can easily teach you how to do this if warranted in the future. If he/she becomes fluid dependent and will not tolerate SQ fluids, we can consider placing a feeding tube in the future (E-tube, PEG tube).

 

New Prescription Diet

Animals with CKD require a change in diet to help their kidneys work more efficiently and to help with some of the changes in electrolytes that they face. Prescription diets, such as Hill's Prescription Diet K/D, are specially formulated with a lower amount of Phosphorus. It's important to maintain your dog or cat's caloric intake. There may come a time when her/she will no longer eat any of these prescription diets. If that's the case, the intake of food becomes more important than the intake of a particular diet. Down the line we may get to the point where we're offering him/her anything to eat.

Effects and Treatments of CKD

 The two main metabolic byproducts that the kidneys are responsible for excreting are blood urea nitrogen (BUN) and creatinine. One of the side effects of these building up is stomach and eventually oral ulcerations. This can lead to the nauseous feeling that many people describe in renal failure and a decrease in appetite. There are many different medicines that we can give to help protect and make the animal feel better.  Since urinary tract infections can be seen in animals with CKD, we would evaluate your dog or cat.

Often animals with CKD can develop high blood pressure which can increase the decompensation of the kidney. Monitoring of your dog or cat’s blood pressure every time you visit us can help us determine when we need to intervene with pharmaceuticals to halt the progression of nephron loss and the secondary effects of elevated blood pressure

A Common Problem in Our Dogs and Cats

 

Based on a survey conducted in 2005 among 109 U.S. veterinarians, chronic kidney disease affects, on average, 10.8% of cats and 5.2% of dogs brought in for consultation.

 

• The term “renal failure” refers to persistent azotemia accompanied by an inability to concentrate urine, usually resulting from a 75% loss of nephron function in both kidneys.

 

• Kidney disease is a leading cause of death in dogs and cats.

 

 

 

 Even though many animals can be managed for a long period of time with a high quality of life, there will come a time when your dog or cat will go down hill, stop eating, and slowly deteriorate. Try to remember him/her now and make a mental list of things that he/she enjoys doing. This list can be used as a marker or a gauge to help you decipher when his/her quality of life isn’t where it used to be. At that time we can help to re-evaluate his/her health and see if there are any changes we can do to help stabilize him/ her again. Sometimes hospitalization for a day or two with intense fluid therapy can help bring his/her overall attitude back. Even though this is a very common ailment of animals, it’s still a complicated one.

We are here to help, so please do not hesitate to contact us with any questions you may have about your dog or cat's health.