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Kidney Disease

Good kidney function is vital for a healthy animal. The kidneys have the important function of regulating the water and salt balance of the body, as well as removing the wastes of protein metabolism from the blood. When the kidneys are not working properly your pet can start to feel very unwell from the build up of those waste products.

At Pittwater Animal Hospital we diagnose a variety of kidney diseases.

We discuss both chronic and acute kidney disease on this page. 

Acute Kidney Disease

These animals are really unwell because their kidneys have suddenly stopped functioning well. Animals need intensive medical care as well as a range of diagnostics ,which will help assess the underlying cause of kidney disease and the level of dysfunction.

Diagnostics

  • Blood tests – A range of factors are examined to help us know more about the cause of kidney disease and the likely progression or prognosis.
    • White blood cell indices may indicate an infection
    • SDMA is the most sensitive measurement for kidney dysfunction
    • Urea and Creatinine levels rise as the kidney is unable to process protein wastes
    • Phosphate will rise with longer term kidney disease
    • Na+, Cl and K+ salts will become abnormal with kidney dysfunction.
    • Red cell count will decrease and your pet may become anaemic.
  • Repeat blood tests are vital with kidney disease to assess response to treatment.
  • Urine tests can measure
    • The concentration of the urine – as kidney function fails, the kidneys are unable to concentrate or dilute urine.
    • The presence of protein – may point to a particular type of kidney disease or may indicate an infection.
    • Urine Sedivue – shows microscopic changes in urine. White blood cells or bacteria can indicate an infection. Unusual cells or specific accumulations of debris called casts ,can be released from the kidneys and picked up on urine tests.
    • Bacterial culture can be used to try to grow a sample of bacteria in urine that may be causing disease.
  • Xrays – May show the presence of stones (uroliths) in the bladder or kidneys.
  • Ultrasound  Can show the internal architecture of the kidney which is often changed by disease. Through ultrasound we can try to trace the ureters which carry urine from the kidney to the bladder, to ensure they are normal.
  • Blood pressure measurement – Kidneys are involved in the blood pressure regulation of the body. Measurement of blood pressure can be helpful in monitoring kidney changes.

Treatment

Acute kidney disease requires intensive treatment in hospital. Treatment may include

  • Intravenous fluid therapy – with adjustment of salt balance
  • Antibiotic medication
  • Nutritional support – kidney disease makes you feel unwell and not want to eat
  • Medication for nausea and gastric irritation
  • Monitoring of urine and blood
  • Monitoring and treatment of any secondary health problems

Prognosis

Treatment for acute kidney disease needs to be intensive and well monitored so that fluids rates can be adjusted. Successful treatment is often followed by good return to health and an excellent quality of life. Some animals may recover well but then need ongoing management for chronic kidney disease.

Chronic Kidney Disease

Is a term for the slow decline of kidney function and  is very common in animals as they age. Cats are particularly prone to chronic kidney disease.

Animals with acute kidney disease are suddenly unwell, whereas animals with chronic disease will have mild changes that may at first go unnoticed. The sooner it is discovered that your pet has changes in kidney function, the better for long term control. Although we can’t completely stop kidney deterioration, the problem can often be managed, especially in cats.

Symptoms of kidney disease

  • Increased water intake
  • Increased urine output
  • Weight loss
  • Sometimes decreased appetite
  • Occasional vomiting, increasing with frequency over time
  • Smelly breath

Diagnostics

  • Chronic kidney disease is diagnosed and monitored with blood tests. 
    • SDMA increases with early changes
    • Urea and Creatinine rise with more advanced kidney disease
    • Phosphate rises with long term kidney disease
    • Regular full blood profiles can also monitor all the body systems. Changes in any other system will also affect the kidneys.
  • Urine tests are also important
    • Animals with poor kidney function are unable to concentrate or dilute urine.
    • A Sedivue test can look for infection in the kidney/renal system.  Controlling any infection is important for maintaining kidney function.
    • The presence of protein may indicate a need for medication.

Management of Kidney Disease

Once kidney disease is diagnosed, a proportion of the kidney has been irreversibly damaged. The earlier a diagnosis is made, the more time we have to manage the problem and perhaps make positive changes. The goal is to maximise remaining kidney function.

Pittwater Animal Hospital offers a range of routine blood tests throughout your pet’s life. To encourage uptake we run various health promotions throughout the year such as seniors month and dental month. All these programs look for problems in the kidney, as it is such a common condition. Routine blood tests at desexing and dental procedures are a great way for us to get your pet’s normal values. The kidney factors from blood samples taken throughout your pet’s life are charted in our system. Changes can then be identified before they are even in the abnormal range. 

Changes we can make to help your pet maintain kidney function include;

  • Identification and management of any other causes of disease such as infections, heart disease and thyroid disease.
  • Dietary change to minimise the pressure protein and phosphate put on the kidneys. Medicated diets can be enormously effective in decreasing the levels of waste products in the blood. Royal canin renal diet for dogs and Royal canin renal diets for cats both wet and dry are available at reception.
  • Medication may be indicated depending on the diagnostic results and symptoms such as nausea.
  • Careful monitoring of body weight, appetite and urine changes to identify progression early.
  • When deterioration occurs, more intensive treatment in hospital as described in our acute kidney failure protocol may be needed. This is always under the guidance and advice of your experienced veterinarians

The key to good health in an animal with chronic kidney disease is maintaining good appetite. Our special kidney/renal diets are ideal, but keeping your pet eating is the most important factor for long term health. 

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FAQs about kidney disease.

What does it mean if my cat or dog has kidney disease

If your dog or cat has kidney disease they have a problem the waste disposal and fluid balancing system of the body. This can lead to chronic illness and death. 

 

Kidney disease can be picked up in routine screening when your animal is otherwise healthy. Changes in the blood and urine can happen well before your pet becomes unwell.

 

If picked up early, it is a great opportunity to slow down the progression of kidney damage.  We can then identify and treat any other problems, modify the diet and carefully monitor body weight, appetite and urine changes to identify factors which make things worse early.

What if my cat or dog is sick with kidney disease

Sick animals will have either acute (sudden onset) kidney disease which is best treated with intensive care, or they will have advanced chronic kidney disease. An unwell animal with advance, chronic kidney disease may have few treatment options.

What is end stage kidney disease?

When your cat or dog has significant changes in their kidney function they will often develop end stage kidney disease. In humans, these patients would be on regular dialysis and be waiting for a kidney transplant. Sadly this is not something offered for most of our pets.

 

The signs of end stage kidney disease in cats and dogs include

  • significant increase in water intake – often hanging their head over the water bowl.
  • decreased appetite – leading to not eating at all
  • chronic vomiting – daily or every second day
  • weight loss – often 500g or more in a cat 
  • smelly ulcerated mouth
  • possible seizures 

What can I do if my cat or dog has end stage kidney disease?

As kidney disease progresses your pet’s quality of life becomes worse and worse. Intensive treatment with intravenous fluids can improve their condition, however they will commonly deteriorate in the days and weeks after fluid therapy is stopped. Dying of end stage kidney disease is extremely unpleasant, as pets dehydrate and waste away then, commonly develop a seizure disorder. Most animals will be euthanaised to avoid this unpleasant death.  

When should I decide to euthanaise my cat or dog with end stage kidney disease?

Due to the chronic progressive nature of kidney disease, once your pet’s physical condition deteriorates things are likely to get worse in coming days. Once your pet is not eating or has started to seizure it is time to consider euthanasia. To learn more about what happens at Pittwater Animal Hospital look at Final Care For Your Pet.  

Could I have stopped my cat or dog from developing kidney disease?

Kidney disease is common in our pets, especially in any cats over 10 years of age. Keeping your cat or dog healthy in other ways through their lives with good dental health, treatment of any infections and a good quality diet is very protective.

 

Early diagnosis of kidney disease with routine blood and urine tests is extremely helpful in identifying at risk pets. Many pets live long healthy lives with underlying, early stage kidney disease.

When should my cat or dog have screening tests for kidney disease?

It is useful to have a routine blood test at desexing to establish your pet’s baseline blood values. Then any time your pet has an anesthetic, another blood test should be performed.

 

In dogs over 7 years and cats over 10 years a full senior assessment with blood and urine tests is invaluable for detecting and monitoring any changes in kidney function.

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