Wednesday, January 22, 2014

Chronic Renal Failure in Dogs and Cats by Dr. Mary Gardner

 “Cali” was a sweet brown dog I met in 2009 when I was working at a clinic. Her mom Grace brought her to see me because she was vomiting for a few days and her appetite had decreased. After a few tests, I diagnosed “Cali” with Chronic Renal Failure (CRF). “Cali” turned out to be my first in-home hospice patient and Grace turned into one of the best care givers I have met.

What is CRF?

CRF – also known as Kidney Failure - is the gradual loss of kidney function. Some functions of the kidneys are to excrete naturally occurring waste products, concentrate urine and produce a hormone known as erythropoietin which assists in the production of new red blood cells.

When the kidneys begin to fail, those waste products begin to build up in the bloodstream. These waste products, such as blood urea nitrogen (BUN), creatinine, and phosphorus is what causes the animal to feel ill and can even cause oral and gastric ulcers, making the animal feel even worse while decreasing their desire to eat.

Even though animals in CRF will drink more frequently, they will become dehydrated because the kidneys stop concentrating urine sufficiently and they begin to urinate large volumes of very dilute urine.

In some cases, the dog or cat can also become anemic because the kidneys are not producing enough erythropoietin to help make red blood cells.

How is it diagnosed?

CRF can be diagnosed with blood work, urine samples and imaging (x-rays or ultrasound). However, it is important to know that studies show almost 80% of kidney tissue is irreversibly damaged before clinical signs present and the disease is found in blood workups.

How is it treated?

The goals of treatment are to support the kidneys and medically assist them to complete the jobs that they are meant to do.

We usually start by putting the animal on a prescription diet – one with low-quantity/ high-quality protein and low phosphorus in order to reduce the amount of BUN and phosphorus build-up in the body.

Administration of fluids under the skin (subcutaneous/sub-q fluids) can be done at home or intra-venous fluid therapy in the hospital. This is done to flush out the build-up of toxins and to keep the animal hydrated.

Oral phosphate binders are sometimes used to help remove excess phosphorus.

What is the prognosis for renal failure?

Managed appropriately, many animals that are diagnosed with CRF go on to live many more great years. However, with any disease there are some animals that do not respond positively to treatment and remain ill and their condition quickly worsens. It is important to have your animals checked regularly by a veterinarian so that renal function can be assessed and any changes in the kidneys can be addressed immediately.

“Cali’s” mom spent 9 months caring for her with special diet, sub-q fluids at home and a lot of TLC. “Cali” passed at home, in the comfort of her personal chaise lounge and her mom close by.

Written by Dr. Mary Gardner

Dr. Mary Gardner
Lap of Love Veterinary Hospice
San Diego County

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