Greenbriar Animal Hospital
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Canine and Feline Kidney Disease

Greenbriar Animal Hospital Canine and Feline Kidney Disease Handout

Canine Kidney Disease

Kidney disease may have many different causes, including inherited defects, infections, toxic substance exposure and nutritional factors.  Kidney disease is common in old age.

Normal kidneys filter and remove from the blood stream waste materials that are the by-products of normal body processes.  They regulate the amount of fluid retained or released by the body and also play a role in maintaining the hemoglobin levels (anemia status).  Kidneys also produce the hormone that controls blood pressure.

SYMPTOMS OF KIDNEY DISEASE

When the kidneys cease to function correctly waste material builds up the bloodstream.
    1. Loss of appetite and weight
    2. Increased water drinking
    3. Increased frequency of urination (the kidneys cannot control the water retention)
    4. Poor hair coat
    5. Depression
    7. Vomiting

There are FOUR criteria used to measure kidney disease- Creatinine (on bloodwork) tells us the stage of the kidney disease, SDMA (from bloodwork) will also help with staging, blood pressure and the amount of protein in and concentration of the urine. Protein in the urine may be the very first sign of kidney disease.

Sick kidneys may cause high blood pressure, which in turn causes the kidneys to decline faster. Treatment consists of treating any underlying disease, maintaining hydration in the face of constant water loss, counteracting the build-up of toxins with medication and potentially stimulating red blood cell production.  This is a disease that can be managed and slowed, not "fixed".  Common medications to control high blood pressure and improve blood flow through the kidney, thereby reducing protein spillage in the urine, include benazapril, amlodipine and telmisartan.

Fluids are crucial, even though the dog appears to be already drinking a lot.  Changing to canned food and adding in  low sodium "chicken ice cubes" may help boost hydration levels.  Additionally, adding a fresh water fountain may help.

We often recommend changing to canned food and changing to a Science Diet K/D food.  Although, if the appetite is poor we may feed whatever the dog likes that is low in protein (meat).  We also can add in medications for nausea (Cerenia) or for appetite stimulation (mirtazipine).

As the disease progresses, electrolyte changes are common - dogs may be started on a potassium supplementation or phosphorus blocker.  We also have to carefully monitor the blood pressure - any increase in blood pressure needs to be medically managed to protect the kidneys.  Many medications are in a pill form, but can be compounded (depending on the medication) into a chewable treat, a liquid, or even a trans-dermal (absorbed though the skin) form.  If your dog is resisting medicating, please let us know and we can alter the form, discuss changing, or decide if it is still worth the hardship of medicating.

This is typically a slowly progressive disease that with proper management can be slowed significantly.

We will recommend monitoring of the progression of the kidney disease every six to twelve months.
    
 


Feline Kidney Disease

Kidney disease may have many different causes, including inherited defects, infections, toxic substance exposure and nutritional factors.  Kidney disease is common in old age, and is the primary cause of death in cats that live a long life. 

Normal kidneys filter and remove from the blood stream waste materials that are the by-products of normal body processes.  They regulate the amount of fluid retained or released by the body and also play a role in maintaining the hemoglobin levels (anemia status). Kidneys also produce the hormone that controls blood pressure.

SYMPTOMS OF KIDNEY DISEASE

When the kidneys cease to function correctly waste material builds up the bloodstream.
    1. Loss of appetite and weight
    2. Increased thirst
    3. Increased frequency of urination (the kidneys cannot control the water retention)
    4. Poor hair coat/grooming
    5. Depression
    7. Vomiting

There are FOUR criteria used to measure kidney disease- Creatinine (on bloodwork) tells us the stage of the kidney disease, SDMA (from bloodwork) will also help with staging, blood pressure, the amount of protein in and concentration of the urine.

In the very early stages, we try to slow the syndrome as much as possible.  Early on, we can increase the blood flow through the kidneys with a medicine called benazepril (ACE inhibitor) and help manage appetite with calcitriol (vitamin D).  These meds will delay the need for fluid therapy.

Sick kidneys may cause high blood pressure, which in turn causes the kidneys to decline faster.Treatment consists of treating any underlying disease (ie thyroid disease), maintaining hydration in the face of constant water loss, counteracting the build-up of toxins with medication and potentially stimulating red blood cell production.  This is a disease that can be managed and slowed, not "fixed".

We recommend  Science Diet Metabolic food, a high protein food, in the early stages of kidney disease. In the late stages we'll recommend a protein-restricted diet. Often the cat will determine what it is willing to eat.

As the disease progresses, electrolyte changes are common -we may need to supplement Potassium (low potassium causes decreased appetite and muscle weakness) and block phosphorus (high phosphorous causes nausea).  We also have to carefully monitor the blood pressure - any high blood pressure needs to be medically managed to protect the kidneys.  Many medications are in a pill form, but can be compounded (depending on the medication) into a chewable treat, a liquid, or even a transdermal (absorbed though the skin) form.  If your cat is resisting medicating, please let us know and we can alter the form, discuss changing, or decide if it is still worth the struggle of this medication.

Fluids are crucial in the later stages. Due to the kidneys being able to hold on to less and less water, your cat will be drinking to keep up with its losses. If they are spending all their time drinking they will not be able to eat as much. At that point we can teach you how to give subcutaneous (SQ) fluids (under the skin) at home to support hydration.  If the appetite is poor or we suspect nausea, there is medicine for each of those.

We will recommend monitoring of the progression of the kidney disease every six to twelve months.