March is National Kidney Awareness month; this includes kidney health of our beloved furry friends. The kidney is a very important organ that helps the body maintain overall health. The main job of the kidneys is to remove waste and produce urine. However the kidneys do much more than that including maintaining a normal blood pressure, balancing minerals and electrolytes in the blood, managing hydration, and producing red blood cells. The kidney is made up of nephrons which can become diseased and die off over time or due to toxins which causes renal insufficiency.
Renal insufficiency can be short or long term, but in most cases is a long-term concern. The very few cases in which renal insufficiency is short-term is when it is caused by a toxic ingestion and is caught/treated very quickly. Early detection of a renal insufficiency is important and can increase the lifespan of the pet. The best way to detect an insufficiency early is having bloodwork done yearly on older pets and bringing a pet to your veterinarian as soon as any symptoms begin to show. The most common symptoms for kidney disease are increased water intake, increased urination, and loss of appetite. Other symptoms that occur later in the disease are bad breath, weight loss, weakness, lethargy, vomiting and diarrhea. Unfortunately, clinical symptoms and lab work will not show until two-thirds of the kidneys normal cells are already diseased. There is a new test called SDMA that can detect kidney disease earlier which is why it is important to have your senior pets seen by your veterinarian yearly and have preventative panels of bloodwork done whenever possible.
Kidney disease occurs in four stages. The stages are best explained with a guide called IRIS stages of chronic kidney disease. The IRIS guide also has treatment recommendations for each stage. The stages are categorized based on the results of lab work and are different for canine vs feline. ( http://www.iris-kidney.com/education/guidelines/index.html)
The most common question to be asked when a pet is in kidney failure is “what can be done for treatment?” The type of treatment varies based on the severity(stage) of the disease and the results of the lab work. In severe cases the pet will need to be placed on IV fluids to flush the kidneys and remove built up toxins in the body and monitored closely for several days. If the pet does not eat for several days a feeding tube maybe necessary. Sometimes this is successful, and the pet will go home on prescription diet and medications, but sometimes the kidneys do not get better. In the scenario of the pet getting better after hospitalization, the pet will need to be on a strict prescription diet that is restricted in protein and phosphorous and high in fat. Diet is one of the most important treatments for kidney disease. No treats can be given unless they follow the guideline of the prescription diet. It will also be important to recheck the kidney values periodically to make sure they are not getting worse. In mild cases, such as stage 1, a diet change could be enough to make the pet feel better and slow the progression of the kidney failure. The unfortunate part of kidney disease is that it is chronic, there is no cure, and the only way to treat the pet is to slow the progression. It is necessary to continue all treatment lifelong and be proactive in consulting with the veterinarian to ensure the best care for your pet. In addition to the strict diet, a dog or cat with kidney disease needs to have plenty of water intake. Some ways to help increase hydration is adding an extra water bowl in the house, getting a fountain water bowl, adding water to food, and feeding canned food. In cases that the pet is not getting enough hydration it may be recommended to give subcutaneous fluids at home as well.
Many medications may become necessary to maintain health when a pet has been diagnosed with chronic kidney disease. Blood pressure can be affected by kidney disease as well and should be closely monitored. In the case that hypertension arises a medication may be needed to decrease blood pressure. Electrolytes can become off balance as well and medication could be needed to manage electrolyte balance. In the later stages, anemia may need to be treated as well due to the kidneys not producing red blood cells. Nausea and vomiting may occur in the later stages as well and will need to be addressed. Although it sounds like a lot of medications and special care, a dog or cat in kidney failure can still live a happy life. The lifespan varies from case to case and is longer in cats than in dogs. The lifespan also varies on what stage the kidneys were in at the time of diagnosis. The earlier detection of insufficiency the better the prognosis.
Kidney disease overall is very serious in all species and must be medically managed in order to maintain a good quality of life. The best way to catch a renal insufficiency is to have annual bloodwork done especially on pets over seven years of age, that way the insufficiency is found before any symptoms arise. If you have any question on annual bloodwork, kidney disease or overall health for your pet please contact your veterinarian.