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Chronic & Acute Kidney Disease in Dogs: Symptoms & Treatment
Chronic kidney disease (CKD), Acute Kidney Disease (AKD)
SUMMARY OF CONTENT
SEVERITY:
- Requires a diagnosis by a veterinarian
- Resolves within days to months, or may be a chronic condition requiring lifelong management
- Treatable by a veterinarian, by the pet parent
- Prevent pets from eating toxins that affect the kidneys. Vaccinate as recommended by your veterinarian
- Transmission may be possible between animals and to humans if caused by a contagious infection like Leptospirosis.
- Diagnosis may require physical exam, blood work, urinalysis, urine culture, infectious disease testing, x-ray, ultrasound
VERY COMMON IN
Symptoms & Signs
Pets with kidney disease can show a variety of physical signs including increased thirst, increased urination, decreased or complete lack of urination, panting and oral pain. Pet parents may also notice blood in the pet’s urine or that their pet only urinates at night. Pets may have a decreased appetite, vomiting, lethargy, diarrhea, dry hair coat or pain.
Although renal disease can develop in pets of any age, chronic kidney disease is more common in older pets and acute kidney disease is more common in younger pets.
Diagnosis
Kidney disease is diagnosed by seeing changes on blood chemistry testing and urinalysis.
A chemistry panel measures blood urea nitrogen (BUN), creatinine and phosphorus. These are waste products that are normally removed from the blood stream. If the kidneys are not working correctly and filtering these waste-products, they build up in the blood.
A urinalysis will also help diagnosis kidney damage. Urine specific gravity is a measurement of the urine’s concentration and will help determine if the kidneys are able to concentrate the urine. Normally the kidneys work to keep protein in the blood, and a urinalysis can be used to see if they are losing protein into the urine.
Your vet may recommend X-rays or ultrasound to determine the size and shape of the kidneys. Small kidneys are more common in chronic kidney disease while large kidneys may indicate an acute problem or cancer.
Causation
Generally, kidney disease is broken down into acute or chronic causes.
In cases of acute kidney disease, the animal usually has severe signs that occurred suddenly. These may include depression, vomiting, fever, loss of appetite and changes in the amount of urination. A good medical history and testing will need to be performed to find the cause. With prompt diagnosis and treatment, some kidney changes as the result of acute kidney injuries can be reversed, but some cases may progress to chronic renal failure.
Chronic renal failure is characterized by irreversible lesions within the kidney. In most cases, improvement of the kidney function should not be expected once the body has compensated as much as possible. If the kidney failure is prerenal (caused by a disease other than actual kidney malfunction that decreases the blood flow to the kidney) or postrenal (caused by a buildup of pressure in the urinary system from an obstruction, for example), these changes may be partially reversible with treatment. Kidney function in chronic cases tends to be relatively stable for weeks to months barring unforeseen changes. Function can progressively deteriorate over weeks to months to years. Many times, owners miss the earliest signs of chronic renal failure. These include a mild to moderate increase in thirst and urination (polydipsia and polyuria) and a need to urinate during the night (nocturia). Other common early clinical findings include variable weight loss, poor hair coat, lethargy and selective appetite. As the condition progresses, more clinical signs appear.
Treatments
AT-HOME CARE
Dietary change is an important treatment for kidney disease. As pets become rehydrated with the fluids, they typically start feeling less nauseous and become more willing to eat. If the pet eats willingly, a high-quality, low-protein diet should be fed. Low-protein diets limit the demands on the kidneys while providing the body with needed nutrition. The pet should always have free access to water. Withholding water at night will not decrease the pet's need to urinate overnight and may cause dehydration. The amount of water and food consumed each day should be monitored so the pet parent knows whether the pet is eating and drinking normal amounts. If not, additional fluids (IV or SQ) will be necessary to maintain hydration.
SUPPORTIVE CARE
Initial treatment of kidney disease involves aggressive intravenous (IV) fluids. This is done in the veterinary clinic so the appropriate amounts can be given and the pet can be monitored for appropriate fluid output (urination).
MEDICATIONS
If your pet is still nauseous, medications like Cerenia may be prescribed to alleviate these symptoms. Phosphate binders may be prescribed to lower the level of phosphorus in your pet’s blood. If your pet has acute renal failure, treatments are aimed at the cause. Fomepizole or ethanol are used to treat antifreeze toxicity. Antibiotics are used to treat leptospirosis.
DEVICES
None
SURGERY
None
SPECIALISTS
Some cases may be referred to a specialist in emergency and critical care or internal medicine.
Cost Of Treatment
Treatment costs will depend on the cause and severity of the renal disease. Hospitalization and treatment costs may reach or exceed $3000 depending on the size of the pet and length of hospitalization. Kidney transplants are performed in dogs, however the cost ($15,000 to $20,000), puts this option out of reach of most pet parents. Management of chronic cases may cost $500 per month for fluids, special diet and medications.
Recovery
Pets with acute kidney damage may recover within several weeks if the cause is identified and treatment is started as soon as possible. If your pet has chronic kidney disease, the condition can be managed but does not resolve. Treatment is targeted at making your pet feel better and providing diet changes that limit additional stress on the kidneys.
Monitoring
Monitor your pets intake of food and water, urination, attitude and energy level.
Prevention
There is no way to prevent chronic kidney disease. Acute renal disease may be prevented by avoiding contact with infectious or toxic agents that could cause kidney damage.
Disclaimer
The information contained on this page is for educational purposes only. Treatment should only be provided under the advice of a veterinarian who has examined your pet under the laws applicable to your state of residence.