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Dog: Chronic Renal Failure

General information

Other common/scientific names: kidney failure, renal failure, renal insufficiency, renal disease, chronic renal disease, kidney insufficiency, chronic kidney failure, chronic kidney disease

The kidneys perform many jobs in the body. They eliminate waste products such as urea which is a product of protein breakdown. The kidneys also help to maintain hydration, regulate blood pressure and salt and electrolyte balance. They are made of thousands of filtration units called nephrons. Once a nephron is destroyed, it cannot be regenerated. Fortunately, the dog has many extra nephrons. Overall kidney function does not suffer until the kidneys are down to about 1/6 of the original number of nephrons.

Renal failure can be either acute or chronic. This article will discuss chronic renal failure. Chronic renal failure or insufficiency refers to a condition where the kidneys have not been functioning properly for some time - months to years. In this instance, there is a buildup of toxins in the blood stream and lab tests are abnormal. Dogs with chronic renal failure can experience uremic poisoning where not only are the laboratory tests abnormal indicating a buildup of the waste products, but the dog is showing clinical signs from these toxins. Chronic renal failure, as opposed to acute renal failure, is an irreversible condition. However, with proper treatment and management, dogs with chronic renal failure can live long, symptom free lives.

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Abb. GGTBFJLZ: Schematic illustration of the canine female urinary and reproductive organs.

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Abb. GGTBGTHI: Schematic illustration of a kidney.

Causes

Since almost any type of poisoning, medication, disease or infection has the potential to cause kidney failure, it is impossible to list every cause. However, some specific causes include:

  • Aging
  • Chronic periodontal disease
  • Any cause of acute renal failure
  • Congenital (present at birth). Breeds more prone to congenital causes are Basenji, Bull Terrier, Cairn Terrier, Chow Chow, Cocker Spaniel, Doberman, Lhasa Apso and Norwegian Elkhound.

Cardinal symptom

  • Increased drinking
  • Increased urination

Symptoms

Clinical signs of chronic renal failure include increased drinking, increased urination, weight loss, loss of appetite, poor hair coat, vomiting and diarrhea. Advanced cases of chronic renal failure can show pale mucous membranes, ulcers, detached retina, irritability, seizures and depression.

Diagnosis

While acute renal failure is diagnosed with blood tests and a urinalysis, a complete physical examination may reveal a dog with a chronic disease. A complete blood test, serum biochemistryand electrolyte panel and urinalysis should be performed on all dogs suspected of chronic renal failure. Abnormalities on these tests will determine the severity and stage of renal failure and also help determine the proper course of treatment.

Other diagnostic testing includes abdominal radiographs and ultrasonography which are used to assess the size and structure of the kidneys and blood pressure recording to assess hypertension.

A kidney biopsy may be necessary to determine the exact type of kidney insufficiency if the initial treatment is not successful. Kidney biopsies can be risky and expensive.

Treatment

In most cases of chronic renal failure, by the time the diagnosis is made, the initial cause is long gone. Therefore, the goal of treatment is to hopefully stop the progression of the disease. Hospitalization with intravenous fluids, medication and electrolytes may be necessary depending on the stage and severity.

Dogs with chronic renal failure may need to be on long term or lifelong oral medications which are administered by the owner. These include medications to treat anemia, reduce blood pressure and antiemetics and antacids to reduce nausea and vomiting.

It is important that dogs with chronic renal failure be fed a diet which is low in protein, phosphorous and salt. These diets are often specially formulated, prescription only diets meaning they can only be purchased with a prescription from a veterinarian.

Dogs with severe kidney disease can benefit from dialysis and/or renal transplantation. These treatments are not commonly used due to their expense and need for specialized equipment and knowledge.

Prognosis

If chronic renal failure is diagnosed early, many dogs can be managed successfully with the proper medications and diet. These dogs can live for months or even years. However, dogs with advanced kidney disease have a guarded prognosis.

Prevention

Any poison or toxin should be housed safely and out of reach of dogs. At home dental care and routine dental cleanings by your veterinarian can prevent periodontal disease. Annual blood tests and urinalysis in geriatric dogs can detect early kidney disease.

Tips

Provide plenty of fresh drinking water to help maintain hydration. When changing to a prescription diet, mix a small amount of the new diet with the normal diet. Gradually increase the amount of the new diet over 7-10 days. If your dog does not want to eat the prescription diet, the food can be moistened with a low salt beef or chicken broth. A small amount of garlic can be added to the food to enhance the flavor. Canned food can be heated slightly to encourage consumption.

Update version: 4/24/2014, © Copyright by www.enpevet.de
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