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My pet has been diagnosed with CHRONIC KIDNEY DISEASE

My-pet-has-been-diagnosed-with-CHRONIC-KIDNEY-DISEASE

What is chronic kidney disease?

Chronic kidney disease is an illness seen most commonly in older pets but can develop at any age.

When your pet has kidney disease it means the kidneys are not working as efficiently as they used to. The kidneys are responsible for many processes, the main being the removal of waste products to produce urine. In kidney disease all these processes can be interfered with, causing a wide range of different signs.

Unfortunately, chronic kidney disease is not curable and is a progressive disease i.e. will worsen over time. However, with appropriate support and treatment, we can slow down the progression of the disease and hopefully increase your pet’s quality and length of life.

 

 

Why do pets have kidneys?

Like all mammals, our pets have two kidneys located in the abdomen, which perform a wide variety of important roles, including:

  • Removing toxins from the blood

  • Maintaining water balance

  • Maintaining salt balance (and other electrolytes)

  • Maintaining normal blood pressure

Blood is constantly filtered through the kidneys to remove the toxic waste products of the body. This is how urine is produced. The kidneys then concentrate the urine by returning water to the body, preventing dehydration.

Fortunately, there is considerable ‘reserve capacity’ in the kidneys. It is well recognised that in healthy animals and humans, it is possible to remove one kidney completely without any adverse consequences. In fact, it requires around two thirds to three-quarters of the total functioning kidney tissue (of both kidneys) to be lost before signs of chronic kidney disease will develop.

What causes chronic kidney disease?

Chronic kidney disease comes about when there is irreversible long-term damage to the kidneys. This means the kidneys can no longer function correctly and all the processes the kidneys normally do are impaired. This can happen for a number of reasons, including infections, toxins, trauma, and can also be hereditary. However, in most cases the exact cause is unknown.


What are the signs of kidney disease?

Remember this is a progressive disease so initially, the signs are mild but will worsen over time.

The most common signs are:

  • Weight loss

  • Poor appetite (inappetence)

  • Lethargy (tiredness)

  • Increased thirst (polydipsia)

  • Increased urination (polyuria)

Other signs may include the following especially as the disease progresses:

  • Poor coat

  • Hypertension (high blood pressure)

  • Vomiting

  • Bad-smelling breath (halitosis)

  • Weakness

  • Anaemia

How is kidney disease diagnosed?

A diagnosis of chronic kidney disease is usually made by a collection of a blood and urine sample for testing.

In the blood sample the level of 3 substances is looked at – Urea, creatinine, and SDMA. In chronic kidney disease the concentration of these substances in the blood will increase and how high they are can indicate how far along the disease is. The blood tests may also show other complications that can develop as a result of chronic kidney disease e.g. low potassium levels (hypokalaemia), anaemia, and high phosphate levels (hyperphosphataemia).

In the urine sample, various things are measured. The main indicator used to help diagnose chronic kidney disease is how concentrated the urine is (the specific gravity) because as kidney function decreases the urine will become less concentrated. The quantity of protein being lost in the urine is also measured as this can indicate the progression of the disease.

High blood pressure (hypertension) is a relatively common complication of chronic kidney disease, especially in cats, so your pets’ blood pressure will be measured where possible. 

Sometimes other investigations such as X-rays, ultrasound, or even biopsies may be required depending on individual circumstances.

Using all the above the disease is then staged from 1 (early disease) to 4 (late disease) and this allows appropriate management to commence.

How is kidney disease managed/treated?

Treatment is symptomatic and supportive as chronic kidney disease is not curable and will progress over time. Pets may require initial intravenous fluid therapy to correct dehydration but once stable, treatment is aimed at supporting kidney function and minimising the complications of kidney disease. 

Dietary management is the main form of treatment. This will usually mean your pet will need to go onto a special renal diet. This diet will help reduce the strain on the kidneys by reducing the number of substances the kidneys have to filter out of the blood. The change over of diet should be done gradually as this will increase the chance of your pet accepting the new diet.

Your pet will also need to have water readily available at all times and with cats a wet diet might be more suitable than dry.

Management of kidney disease will also require regular and urine tests and also blood pressure measurements. This is to allow the monitoring of the progression of the disease (stages 1-2) but also the identification of any treatable complications e.g., anaemia, low potassium, high phosphate, urinary infections, and hypertension. 

As the disease progresses and complications arise your pet may be required to go onto various medications. This is to help with the various symptoms your pet is experiencing and to maintain a good quality of life. These medications are likely to be for the rest of your pet’s life.

How long will my pet live?

Many pets with chronic kidney disease are able to live fairly normal and happy lives. The rate of progression of renal disease varies considerably between individuals and appropriate support and treatment as described above can both increase the quality of life of affected pets and also potentially slow down the progression of the disease. However, as the disease progresses and reaches the later stages your pet’s quality of life may change and we as vets can discuss and help guide you through any difficult decisions that have to be made.

 

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