Courtesy of: © Dr. Liza – https://www.drliza.co.nz/
Link to original post: https://www.drliza.co.nz/2007-2/
In the accompanying videos below, Dr. Liza explains what Kidney Disease is, the signs to look out for and treatments that can help pets with Kidney Disease / Renal Failure:
The kidneys are essential organs that work to remove waste products from the bloodstream, regulate the levels of certain nutrients such as potassium and sodium, conserve water and produce urine.
The kidneys have a large amount of spare capacity to perform their various functions so at least two-thirds (67% to 70%) of the kidneys must be damaged before signs of kidney (renal) disease are easily seen. In many cases, this means that the damage to the kidneys has been occurring over a number of months or even years (chronic) before failure is evident. Chronic renal failure (CRF) is mainly a problem in older cats, but can also affect dogs as they age too.
Occasionally the kidneys can fail very suddenly, especially in younger animals (acute renal failure) following exposure to certain toxins (such as lilies) or severe infections.
Chronic renal failure (CRF) is the end stage of a number of different disease processes, so it can be the result of a genetic defect (Polycystic Kidney Disease), bacterial or viral infection, inflammation and damage to the kidney’s filtration membrane (Glomerulonephritis), cancer, kidney stones, amyloidosis (abnormal protein build-up blocking the kidney function) and others.
Early signs of Kidney Disease are generally weight loss and poor coat quality. Initially the kidneys cope with their inability to efficiently remove waste products by excreting them at a lower concentration in a larger volume (by producing a larger amount of more dilute urine) and many animals are observed drinking more water. This is known as compensated renal failure, when water consumption increases to prevent dehydration. After approximately two-thirds of the kidney tissues have failed, there is a rapid rise in waste products in the bloodstream and severe disease sets in. The symptoms include halitosis (bad breath), decreased appetite, vomiting and lethargy.
Kidney Disease is diagnosed from blood tests and urine samples. If the kidneys are failing, they lose the ability to concentrate the urine and this can be detected. Unfortunately, once the kidneys are damaged, they have a limited ability to recover. However, with careful management and treatment, further deteriorations can be slowed so your pet may have several years of good quality, active life ahead.
For patients who are sick, nauseous and not eating it is necessary to hospitalise them and to provide fluid support to flush out an excess of waste products from the bloodstream, which cause nausea, so that they feel well enough to start eating again. Anti-nausea drugs can also be given to help control vomiting.
Long-term, the most important management tool is to provide good quality nutrition and easy access to fresh water to prevent dehydration. It is important to feed a high-quality protein in the correct amounts as part of a well-balanced diet that is low in phosphorus to help lower the level of waste products in the bloodstream. Phosphate can contribute to the feeling of nausea that affects patients with renal disease and contributes to further damage of the kidneys.
Phosphate binders (a powder) can be given in food to limit the body’s absorption of phosphates and prescription diets may be useful.
Supplementing the diet with water soluble vitamins B and C is important as they are flushed out the body quickly by increased urination. Providing a good quality multi-vitamin and essential fatty acid supplement helps to supply the micronutrients needed alongside essential omega 3 fatty acids that help to reduce inflammation.
Antioxidant supplements such as co-enzyme Q10 and vitamin C are valuable at limiting further cell damage in the kidneys from the disease process. Homeopathic and herbal support for kidney function can also be very effective at maintaining a good quality of life and supporting kidney function.
Sometimes it is helpful to give daily tablets to reduce the blood pressure which helps to support the kidneys as they filter the blood. There are also specific drugs to help stimulate red blood cell production if anaemia (reduced red blood cell numbers) is an additional complication to Kidney Disease. Acupuncture, NIS therapy and hyperbaric oxygen therapy (HBOT) are other useful tools to help improve the health and well-being of your pet.
For most pets with Kidney Disease, their quality of life can be supported and improved for many months and even years following diagnosis.
