One of the most overlooked aspects of our pets’ health is kidney or renal care. The kidneys perform a wide variety of important roles. They are involved in toxin removal, blood pressure control, aiding in the production of new red blood cell formation and electrolyte, pH and water balance.
Fortunately, there is a considerable ‘reserve capacity’ in the kidneys, and it is well recognised that in both healthy animals and humans, it is possible to remove a kidney (for example to provide a transplant) without adverse consequences. In fact it requires around two thirds to three quarters of the total functioning kidney tissue to be lost before signs of renal failure will develop.
What is chronic kidney (renal) disease?
Chronic Kidney Disease or CKD is one of the most common conditions affecting older cats (1 in 3) and dogs (1 in 10). In most cases, CKD is progressive over time so that there is a gradual advancement and worsening of the disease. The rate of progression of the disease varies considerably between individuals.
CKD is recognised by decreased kidney function, where the kidneys are no longer able to remove waste products from the body and maintain the normal water and salt content of the body. There are a number of causes of CKD including:
- Inherited conditions (found in specific breeds such as Persian, Exotic & Abyssinian cats; Bull Terrier, German Shepherd, Cocker Spaniel & more)
- Bacterial infections of the kidneys & bladder
- Damage caused by toxins
- Genetic defects
- Persistent inflammation
In most cases, even if a specific cause can be found for renal failure, the treatment is aimed at management of the disease to delay the progression of the disease and improve quality of life. Where an underlying cause can be diagnosed, and if this is treatable, there may be a potential to halt progression of the disease and in some instance reverse it.
How common is Kidney disease?
Chronic Kidney Disease can occur in cats of any age, but is most commonly seen in middle to old-aged cats, and it becomes increasingly more common with age. It is estimated that one in five cats over the age of 15 years of age has renal failure. Although less common in dogs, the occurrence of renal failure in dogs increases from 7 years of age.
Symptoms of Chronic Kidney Disease (Renal Failure)
- Increased urination & thirst; increased urination is usually accompanied by less colour to the urine & the litter box may be more wet or have more urine clumps.
- Lack of appetite
- High blood pressure
- Weight loss & muscle wastage
- Acute blindness
- Seizures & comas
- Cats may have excessive drooling and muscle weakness with abnormal position of the head & neck.
Diagnosis of Chronic Kidney Disease
Diagnosis of CKD is made by collection of blood and urine samples for analysis. The urine is checked as a starting point, as it becomes more dilute with kidney disease. Two substances in the blood – urea and creatinine – are commonly analysed, as these are products of metabolism that are normally excreted by the kidneys. With CKD & renal failure the blood concentration of these two products will be increased, however, this is only once the kidneys have lost +- 65% of their function. SDMA is another much more sensitive and accurate test that can be run to diagnose kidney disease. This test is more specific to the kidneys, and abnormalities are seen much earlier, when they kidneys have only lost 40% of their function.
Treatment and management of Kidney Disease and renal failure
In some cases, a specific cause for renal failure may be identified (e.g. bacterial infection of the kidneys) and if this is the case, treatment for the cause may be possible. In most cases, however, a cause will not be identified and treatment is aimed at managing the renal failure. Some animals may require initial intravenous fluids to correct dehydration (and perhaps electrolyte abnormalities), but once stable, treatment is aimed at supporting renal function and minimising the complications of renal failure.
Dietary management is important for both cats and dogs with CKD, and there are food designed for pets with CKD, such as Hill’s Prescription Diet k/d, which has been shown to reduce the symptoms caused by renal failure and prolong patients with CKD, lives. It is vitally important that pets with CKD are provided with free access to fresh water at all times.
Sadly, chronic renal failure cannot be reversed, and in most cases, will progress over time despite appropriate therapy.
Food for thought – Earlier detection means earlier treatment and a longer healthier life.
Chronic Kidney disease is known as a silent killer because often when signs of kidney disease become apparent the disease is already well advanced.
Orange Grove Vet recommends that cats and dogs between 5 – 7 years of age should be tested for early signs of for Chronic Kidney Disease. We urge you to ask us for an inexpensive IDEXX SDMA screening test that helps to identify kidney issues much earlier than the conventional tests – up to 4 years earlier in cats and 2 years earlier in dogs.
If your pet is diagnosed with chronic kidney disease regular blood testing, urine anaylsis and blood pressure testing may be required to monitor changes in the kidneys health and progression of the disease.
For more information contact Orange Grove Vet on (011)728-1371 or email firstname.lastname@example.org.