Kidney disease or renal failure in dogs (also referred to in medical terminology as renal disease) is a common finding in pets like cats and dogs, especially those who are reaching their senior years.
In acute disease, such as a toxicity, the signs occur suddenly and can be very severe.
In chronic kidney disease, the onset may be very slow and the signs fairly nonspecific, i.e., the animal is “just not doing well.” Whether the disease is acute or chronic is typically related to the cause.
Causes of renal failure in dogs
There are many causes of renal disease, and they may include:
Signs and symptoms of renal failure in dogs:
- Viral, fungal, or bacterial infections
- Recurrent renal stones.
- Amyloidosis (caused by abnormal deposits of a certain type of protein in the kidney)
- Autoimmune diseases
- Toxic reaction to poisons or medications
- Congenital and inherited disorders
Pets with kidney disease can show a variety of physical signs. Some of the signs are non-specific and may be seen in other disorders such as liver or pancreatic diseases, or urinary tract disorders not involving the kidneys. Signs may include:
- Increased water consumption (polydipsia)
- Increased urination volume (polyuria)
- Decreased urination (oliguria)
- Lack of urination (anuria)
- Voiding urine during the night (nocturia)
- Blood in urine (hematuria)
- Decreased appetite (anorexia)
- Weight loss
- Hunched over posture or reluctance to move
- Poor or unkempt hair coat
During the physical examination for renal failure in dogs, a vet may find the following signs:
Investigations for renal failure in dogs
- Pale mucous membranes (e.g., gums) from a decrease in red blood cell production resulting in anemia
- Enlarged and/or painful kidneys or small, irregular kidneys
- Ulcers in the mouth, most commonly on the tongue, gum, or inside of the cheek
- Bad breath (halitosis) due to toxic substances building up in the blood stream
- Swelling of the limbs due to accumulation of fluid (subcutaneous edema)
- Enlarged abdomen due to accumulation of fluid (ascites)
- High blood pressure
- Changes in the retina due to high blood pressure
- Softening of the bones (rubber jaw) in young dogs with hereditary kidney disease (fibrous osteodystrophy) can also be seen.
Various blood tests can be performed to determine if kidney disease is present, how severe it may be, and what may be causing it. In addition, a urinalysis and imaging techniques may also help to determine the cause and severity.
- Urinalysis: Multiple tests are performed on a urine sample. Several of them are especially important in determining if kidney disease is present.
Urine specific gravity:- This test is a measurement of concentration of urine.
- Complete Blood Count: A complete blood count (CBC) is useful to check for anemia and indications of infection. Anemia in renal failure is common and results from a decrease in the production of a erythropoietin by the diseased kidney. Erythropoietin is a hormone that tells the body to produce more red cells. The red blood cells also have a shorter life span in uremic patients.
- Imaging techniques
Radiological Test:– X- ray are taken to determine the size and shape of the kidneys. Mostly in chronic kidney diseases we can find the small kidney while large kidneys may indicate an acute problem or malignancies(cancer).
Excretory urography such as an intravenous pyelography (IVP) is a specialized type of x-ray. A dye (positive contrast media) is injected into the pet’s vein and monitored via x-rays as it is filtered out by the kidneys. This is used for anatomic evaluation of the urinary tract and to determine the size, shape, and location of the kidneys. It gives a crude assessment of renal function also.
Ultrasonography: Ultrasound looks for changes in the density of the kidney. A biopsy taken during ultrasonography may help determine the cause of kidney disease in some cases.
Treatment of (ARF) acute renal failure in dogs
In cases of acute kidney disease, the dog usually has severe signs that occurred suddenly. These may include depression, vomiting, fever, loss of appetite, and changes in the amount of urination. A good medical history and testing will need to be performed to find the cause. The cause may be an infection caused by leptospirosis an infestation with a parasite such as the exposure to toxins.
Blood and urine samples are ideally taken before the start of treatment so the treatment does not affect the test results.
- Nutrition: As the pet becomes rehydrated with the fluids, he typically starts feeling less nauseous and becomes more willing to eat. If the pet eats willingly or if tube feeding is performed, a high quality lower quantity protein should be fed. This limits the demands on the kidneys while providing the body with needed nutrition. In severe cases, parenteral nutrition may be given via an IV line.
If the animal is vomiting because of the renal disease, treatment may include giving frequent small meals and medications such as chlorpromazine. The nausea may come and go through the day so small meals offered throughout the day may increase the overall food intake.
- Other treatments: At the same time fluid therapy is started, treatment for the underlying cause is usually begun such as antibiotics for a bacterial infection or induction of vomiting for certain toxins.
Kidney dialysis can be done at some veterinary clinics, especially referral clinics or veterinary schools. Pets that may benefit from dialysis include those that fail to respond to normal therapies, those that have a nephrotoxic (toxic to the kidney) poison in them, those that are not producing urine, or those that require emergency surgery such as for repair of the urinary tract due to trauma.
- Kidney transplants for dogs and cats are an option available at a few veterinary hospitals at this time.
With early and aggressive treatment, acute renal failure in dogs may be reversible.
Treatment of chronic renal failure (CRF)
Chronic renal failure is characterized by irreversible lesions within the kidney. In most cases, improvement of the renal function should not be expected once the body has compensated as much as possible. If the renal failure is pre renal (caused by a disease other than actual kidney malfunction that decreases the blood flow to the kidney) or post renal (caused by a build-up of pressure in the urinary system from an obstruction, for example) components, it may be partially reversible with treatment. Renal function in chronic cases tends to be relatively slide for weeks to months barring unforeseen changes. Function does progressively deteriorate over weeks to months to years. The clinical and biochemical consequences of reduced renal function can be minimized by symptomatic and supportive therapy.
Many times, the earliest signs of CRF are missed by owners. These include a mild to moderate increase in thirst and urination (polydipsia and polyuria) and a need to urinate during the night (nocturia). Other common early clinical findings include variable weight loss, poor hair coat, lethargy, and selective appetite. As the condition progresses, more signs appear.
If the cause of the CRF can be identified, it should be treated if possible. Many times, the condition is found in older pets and is due to age.
Homoeopathic Treatment for renal failure in dogs
- Fluid therapy: The fluid need is greater in the CRF patient because the patient is unable to concentrate the urine so more water is passed out of the body in the form of urine. In earlier stages, patients may be able to maintain fluid balance by continuing to eat and increasing the amount of water consumed. The fluid level needs to be maintained to prevent dehydration. As the disease progresses, additional fluid in the form of subcutaneous (SQ) fluid may be necessary. Owners can typically give these fluids at home after being shown how at the veterinary clinic. The addition of potassium to the fluids or to the diet may be necessary to maintain proper levels of this electrolyte in the body. Low potassium levels cause generalized muscle weakness and heart rhythm disturbances. In some cases, intravenous (IV) fluids may also need to be given.
The pet should always have free access to fresh, clean water. Withholding water at night will not decrease the pet’s need to urinate overnight and may cause an acute crisis. The amount of water and food consumed each day should be monitored so the owner knows whether the pet is eating and drinking normal amounts. If not, additional fluids (IV or SQ) will be necessary to maintain hydration.
The body weight should be checked every week to make sure enough calories are being consumed to maintain weight and that dehydration is not a problem.
- Diet: The veterinarian may recommend a diet change to a lower, but high quality, protein diet, which may decrease the stress on the diseased kidneys. Often, canned food is recommended. The change may need to be done slowly to keep the pet eating. The protein restriction cannot be excessive or the pet may develop protein malnutrition due to loss of protein via the kidney or the gastrointestinal tract that is not found in healthy pets. The diet should be monitored by checking the pet’s weight, checking for anemia and checking for hypoalbuminemia. If these are present, an increase in protein content may be necessary. Always follow the dietary instructions given to you by your veterinarian.
Pets should be encouraged to eat an amount of food to maintain weight and provide the appropriate nutrition. To increase the appetite, it may help to feed several small meals a day; enhance the palatability of the diet with additives such as cottage cheese, yogurt, or chopped up vegeslides; or to add a medication that stimulates appetite. Warming the food may also increase the palatability. Do not feed hot food as burns may result. The appetite may come and go during the day, so try feeding at various times during the day. Food-induced nausea may happen at certain times of the day and not at other times. Medication to control nausea may increase the appetite also.
- Benzoic Acidicum