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Kidney Failure, the Hows, Whys, the Treatments

Just like us, our pet’s kidneys perform vital functions. They remove toxic wastes the body, help conserve water, regulate blood pressure, and are involved in red blood cell production. Unlike many other organs in the body, kidneys do not have the ability to regenerate well once they have suffered an insult. Because of this, treating kidney disease early in the course or if possible preventing the disease should be the goal for therapy. Kidney disease can be divided into two broad categories, acute or chronic. Acute means that the kidney abruptly stops working. Chronic means this has been a slow ongoing process. Acute disease can lead to  chronic disease, and chronic disease will likely become acute in time.

There are many different diseases and toxins that can send a pet into acute kidney failure. A few of these are NSAID use, antifreeze, lilies in cats, infections that affect the kidney, auto-immune diseases, and cancer. The good news is that if treated early before clinical signs begin, many of these animals can be restored to full or close to full function. The consistent treatment in most forms of acute kidney failure consists of aggressive fluid therapy. The idea is to flush the kidneys of the infection, proteins, or toxin. Depending on the cause of failure, various other treatments will be utilized. If kidney failure can be prevented, many animals go on to have normal lives. If the animal presents already in kidney failure, this means that damage has already been done to the organs. Since kidneys have a set number of filter cells that do not regenerate well, these animals are predisposed to developing chronic kidney failure.

Chronic kidney failure is much harder to treat. It involves a progressive loss of function. CRF can only be detected when 2/3 of the filter cells in the kidney(nephrons) have died. It can be caused by acute kidney failure, toxins, cancer, infectious disease, or autoimmune disease. In many cases, by the time chronic kidney failure is diagnosed, the cause has already resolved and cannot be identified. Fluids are once again utilized, sometimes with subcutaneous fluids every few days for the rest of the pet’s life. These patients are predisposed to anemia, electrolyte imbalances, and trouble maintaining a good appetite as toxins buildup in the blood. With aggressive care and vigilant monitoring, chronic kidney failure patients can live many months to many years.

To diagnose both of these conditions your veterinarian has several tools at their disposal. A biochemistry panel can reveal increasing BUN and creatine. A urinalysis can show protein in the urine and a low specific gravity. Electrolytes should be monitored.  A urine/protein ratio should be considered also. These tests allow your veterinarian to stage the disease and decide the best way to initiate treatment. This is one of the many reasons that veterinarians recommend yearly bloodwork  and visits as patients grow older. If caught early, there is a much greater chance of your pet remaining healthy longer.

The signs of kidney disease can be quite varied. Many pets develop excessive drinking and urination. One of the most common signs is accidents in the house where a pet never had an accident before.  Other signs include vomiting, diarrhea, lethargy, loss of appetite, and even constipation.

Some of the causes of kidney disease can be prevented with education. Do not have lilies in a feline household, clean up spills of antifreeze immediately, and proper storage of hazardous chemicals are just a few. If you want more information contact your veterinarian or read one of my three blogs on household dangers to pets. The other causes may or may not be preventable, but early diagnosis is key to a good outcome. Discuss a long-term health plan with your veterinarian to PREVENT those difficult trips to the emergency veterinarian! They will be able to provide you with a quality plan to keep your pet a loving member of your family.

 

Dr. McKenna

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