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Kidney Failure in Dogs - Causes, Symptoms and Treatments

  • 18/05/2014

All of our bodies suffer from the wear and tear of time. In people, hearts are often the most vulnerable. In dogs, it is often the kidneys that wear out first. There is a slow, but steady and gradual loss of kidney function in all of our pets as they age. The fact is that nine in every 1000 dogs that are examined suffer from chronic renal disease, and most severely, chronic renal (or kidney) failure is the leading cause of illness in older dogs.

Kidney failure is defined as the kidney's incapacity of removing waste products from the blood. The accumulation of toxins produces the signs and symptoms of uremic poisoning. Kidney failure can appear suddenly (acute kidney failure) or happen gradually over months (chronic kidney failure). Most cases are of the gradual onset type and are caused by nephritis.

First of all, there is something we should know about what role kidney plays in maintaining the healthy life of your dog. Kidney - among with other things regulates blood sugar, blood pressure, blood volume, water composition in the blood, and pH levels, and produces red blood cells and certain hormones. Kidney failure can take place so slowly, and more severely, often we find out the disease when the symptoms are so clear, which means it may be too late to cure it effectively. In fact, dogs with kidney failure do not show signs of uremia until 75 percent of functioning kidney tissue is destroyed. Thus, a substantial amount of damage occurs before the signs are noticed.

What are the signs of kidney disease in dogs? One of the first things you may notice is that your dog drinks water and urinates more than usual. At first, this could be so normal that most owners ignore it. It might just be your dog wakes you up many times during the night to let her out or you need to fill the water bowl more than you used to before. These signs are due to the failure of kidneys to concentrate the urine. This leads to a large urine output over which the dogs are unable to control, with subsequent dehydration and thirst.

As kidney function declines, the dog retains ammonia, nitrogen, acids, and other chemical wastes in her blood and tissues. This stage is called uremia. The degree of uremia is determined by measuring serum blood urea nitrogen (BUN), creatinine, and electrolytes. Signs of uremia are apathy and dression, loss of appetite and weight. You will see your dog lose weight and become a more finicky eater. Dogs at this stage may urinate less than normal. Ulcers may arise in mouth. With the nephritis syndrome the dog develops edema and ascites. Vomiting, gastrointestinal and diarrhea, bleeding may occur. At the end stages of kidney failure, the dog falls into a coma.

As mentioned earlier, symptoms often occur gradually for a long time. Actually, dogs with kidney failure do not show signs of uremia until 75 percent of functioning kidney tissue is destroyed. Thus, a considerate amount of damage occurs before signs are noticed.

Kidney failure can be resulted from many reasons:

- Kidney diseases

- Poisoning, especially from antifreeze

- Complete urinary tract obstruction caused by a stone

- Congestive heart failure with low blood pressure and reduced blood flow to the kidneys

- Rupture of the bladder or urethra

- Shock, with inadequate blood flow to the kidneys

- Lyme disease

- Leptospirosis

Treating kidney failure

While chronic kidney failure cannot be reversed or cured, treatment and management aimed at reducing the contributing factors and symptoms can slow its progression.

Treatment of kidney failure in dogs takes place in two phases.

The first phase is to "restart" the kidneys. Large quantities of intravenous fluids are given to clean out the kidneys. This cleaning process, called diuresis, helps to get the kidney back to function again. If the dogs retain enough functional kidney cells, body's needs for waste removal maybe met. Fluid therapy includes replacement of various electrolytes, especially potassium. Other important things of initial treatment include proper nutrition and drugs to control vomiting and diarrhea.

The three possible outcomes from the first phase of treatment of kidney failure in dogs:

1) After resuming the function during the treatment, the kidney continues to work well for a few months or years;

2) During treatment, the kidney works well, but stops functioning as soon as treatment stops;

3) Kidney function will fail regardless of treatment. Unfortunately, there is no reliable proof to know what outcome will fall in.

The second phase of treatment in dogs is to keep the kidneys functioning as long as possible. This shall be achieved by one or more of the following treatments, depending on the situation:

1. A special diet. The ideal diet is not acidifies, low in protein and phosphorus. This kind of diet helps to keep the blood tests as close to normal as possible, which often makes your dog feel better. Also, once kidney disease is becoming severe, a decreased protein diet will decrease the workload on the kidneys, thus helps the dogs suffer less the kidney failure.

2. A phosphate binder. Phosphorous will be removed from the body by filtering through the kidneys. Once the filtration process is impaired, phosphorous begins to accumulate in the blood. This also contributes to lethargy and poor appetite. Certain drugs will bind excess phosphates in the intestinal tract so they are not absorbed, resulting in lower blood levels of phosphorus.

3. Fluids given at home. When your dog is stabilized, fluids can be given under the skin. This serves to continually "restart" the kidneys as their function begins to fail again. Depending on the degree of kidney failure, this treatment can be done once daily to once weekly.

4. A drug to regulate the calcium and parathyroid gland levels. The calcium and phosphorus must remain at about a 2:1 ratio in the blood. As mentioned above, the increase in blood phosphorus level stimulates the parathyroid gland to increase the blood calcium level by removing it from bones. This can be helpful in order to normalize calcium: phosphorus ratio, but it can make the bones brittle and easily broken. Calcitriol could be used to reduce the function of the parathyroid gland and to increase calcium absorption from the intestinal tract. This is recommended if there is evidence of abnormal function of the parathyroid gland.

5. A drug to stimulate the bone marrow to produce new red blood cells. The kidneys produce erythropoietin, a hormone that stimulates the bone marrow to make red blood cells. Therefore, many dogs suffer from kidney failure have a low red blood cell count, anemia. Epogen (or Procrit), synthetic forms of erythropoietin, will correct the anemia in most dogs. However, for some dogs, this drug cannot be used long term since the immune system recognizes the drug as "foreign" and will create antibodies (immune proteins) to against it. This is recommended if there is persistent anemia present.

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