Chronic Kidney Disease
(5min read)
Kidney disease is a general term to describe several conditions that can affect the kidneys or damage kidney cells. Some types of kidney disease are reversible but chronic kidney disease is a progressive disease that is irreversible. However, pets can have a good quality of life for many years after being diagnosed with chronic kidney disease.
What is a Kidney Disease?
Kidney disease is the term used to describe several conditions that can affect the kidneys or damage kidney cells. If kidney disease progresses, it can lead to kidney failure and death. Kidney failure in older cats is generally as a result of the aging process with a gradual reduction in the ability of the kidneys to do their job. There are also several medical conditions that can be associated with kidney disease in dogs and cats, and these include:
• Nephritis (infection of the kidneys, including the spread of systemic diseases, eg leptospirosis, Lyme disease, that can cause kidney damage)
• Nephrotoxicosis (damage to kidney cells associated with a drug or poison, eg antifreeze)
• Polycystic kidney disease (genetic condition in which kidney cells become cysts, losing their ability to function properly)
• Kidney stones
The kidneys are responsible for several important functions in the body, including:
• Eliminating waste products through the urine
• Producing a hormone involved in the production of red blood cells
• Helping to maintain the body’s fluid balance/hydration
• Participating in the breakdown and elimination of many types of drugs
• Helping regulate levels of important electrolytes such as potassium and sodium
Kidney disease reduces the kidneys’ ability to carry out these functions, resulting in illness and (often) further progression of disease.
What is Chronic Kidney Disease?
Kidney failure can be acute (occurring over a period of hours or days) or chronic (occurring over a period of weeks to months or longer). Acute kidney failure can be reversed in some cases, and the pet can live a normal life.
Chronic kidney disease (CKD) is not reversible. It can be caused by conditions such as polycystic kidney disease or kidney stones, and an age-related decline in kidney function in senior pets. It tends to be progressive, i.e it gets worse over time. Although not reversible, it is often possible to slow the progression of CKD and manage some clinical signs so that your pet is more comfortable.
What are the signs of CKD?
The clinical signs of CKD often start off as very mild, becoming worse as the disease progresses:
- Vomiting
- Appetite loss
- Increased drinking and urination
- Dehydration
- Lethargy (tiredness)
- Weight loss
- Constipation
- Decreased grooming
- Drooling (due to nausea or ulcers in the mouth)
How will my vet diagnose CKD?
Your veterinarian will want a medical history of your pet. Your veterinarian may ask about any medications or supplements your pet has received, changes in appetite, drinking, or urination, previous illnesses, or any current signs of illness.
Diagnosis of kidney disease may require a combination of several tests, eg:
• CBC and chemistry profile: the CBC (complete blood cell count) shows the numbers of red blood cells (needed to carry oxygen to all the body’s tissues), white blood cells (needed to help fight off infection), and platelets. The kidneys are involved in the production of red blood cells so pets with CKD may have low numbers of these cells. The white blood cell count may also be abnormal if infection is present. The chemistry profile measures the levels of several substances that can change if there is a problem with the kidneys, such as CKD.
• Urinalysis: a urine sample from your pet can provide information about how well the kidneys are working. Urine that is too dilute or contains material that should not be present can indicate that a pet may have kidney disease.
• Radiography (x-rays): X-rays of your pet’s abdomen may show kidney stones or abnormally shaped or sized kidneys.
• Ultrasonography: ultrasound of the abdomen can be used to examine the kidneys. It can detect masses, cysts, or other problems that can contribute to CKD.
How is CKD treated?
CKD is a progressive, irreversible condition. While it cannot be treated or cured, it can be well managed in many cases. Effective management may slow progression of disease and improve the pet’s quality of life.
Hospitalization and intensive care may be required before your pet becomes stable enough to continue recovering at home.
A Prescription kidney diet will be recommended by your veterinarian to help support the kidneys and slow the progression of kidney disease. Specialised kidney diets such as Royal Canin Renal or Hills K/d are specifically designed to maintain lean muscle mass with high quality protein and have restricted phosphorus and sodium to help protect kidney function.
In some cases, your pet may require medication to reduce protein loss in the urine or reduce high blood pressure. This will depend on your pet’s initial results and your veterinarian will advise whether this is required.
What Ongoing Monitoring is Needed?
Frequent monitoring of your pet’s blood tests and urine is needed, especially in the early stages after diagnosis of kidney disease. A check-up is needed at 1 month and 3 months to monitor for progression of kidney disease.
If your pet is doing well after the first few months, they will need less frequent monitoring but will still require 6 monthly consultations with your Veterinarian to closely monitor your pet’s condition. After the initial tests your Veterinarian will advise when repeat testing is required depending on how your pet is doing at home, in general this will involve:
– Repeat Urinalysis (urine tests) – every 6 months
– General Blood test Monitoring – every 6 months (to monitor kidney function)
– Repeat Abdominal Ultrasound– every 12 months
If you have any concerns or notice any changes in your pet’s condition, please contact your Veterinarianimmediately to make a recheck appointment.
