Renal Insufficiency In Dog

Canine renal insufficiency is a dangerous disease whose causal diagnosis and targeted treatment are complex. Both young and older dogs are affected, and there are also dogs with a genetic predisposition (e.g. Bernese Mountain Dog) that are more likely to suffer from kidney failure.

The Healthy Kidney Of The Dog

Dogs normally have two kidneys, whose main tasks are:

• Filtering waste and toxins and metabolic products from the blood and excreting them in the urine. These are the so-called “urinary substances”.
• Regulate the electrolytes in the body (e.g. sodium, and potassium) and control the water balance.
• Production of hormones: erythropoietin to form the red blood pigment and renin to regulate blood pressure.

The consequences of impaired kidney function, which results in a restriction or failure of these tasks, are correspondingly serious. The kidneys are capable of astounding performance: only when around 70% of the kidney tissue is no longer working do visible symptoms of the disease appear, such as nausea, vomiting, and a lack of appetite (see below for other possible symptoms).

What Is A Renal Failure In Dogs?

First of all, an insufficiency is a restricted functionality of an organ and there is this term for all organs of the body. The original performance required for a healthy animal can no longer be provided and, depending on the organ, corresponding consequential damage occurs.

This condition can be temporary (acute kidney injury that resolves with or rarely without medical attention) or permanent (chronic kidney injury). In addition, the condition may be stable, i. H. the performance of the kidney is at a constant level, or the disease may be progressive, d. H. the condition continues to deteriorate. The latter can also happen in phases: nothing happens for a few weeks or months, then the kidney problems in the dog suddenly worsen drastically.

The same applies to cats, which can also suffer from kidney failure.

How Does Renal Insufficiency Develop In Dogs?

There is an almost confusing number of causes of kidney damage:

• congenital diseases or those that develop over the course of life (heart failure, diabetes)
• kidney inflammation
• Obstruction of the urinary tract by urinary stones or tumors
• Poisoning, e.g. from grapes or raisins
• too low or too high blood pressure
• kidney tumors
• and much more

Damage to kidney tissue from various causes leads to a loss of kidney function.

This is initially compensated for by the healthy parts of the kidneys, which of course have to work harder for this. This permanent overload leads to damage to the remaining kidney tissue, which ultimately results in the complete loss of kidney function. Existing high blood pressure can further exacerbate this effect: Normally, the kidneys themselves regulate the pressure with which the blood flows through them. If it has lost this ability through damage and the dog suffers from high blood pressure, the excessive pressure also damages the kidney vessels.

These factors create a vicious circle that leads to further loss of kidney tissue.

Read on for information on Canine Acute Kidney Disease and Canine Chronic Kidney Disease.

Acute Renal Failure In The Dog

How Is Acute Renal Failure Defined?

Acute renal failure in dogs is the rapid loss of kidney function. This can vary in severity, which is why it does not always have to be kidney failure in the dog: mild kidney failure impairs kidney function, but does not have the effects of renal kidney failure (see below). It can be temporary or turn into chronic kidney failure in dogs if, for example, the causes are not remedied.

Consequences Of Acute Renal Failure In Dogs

After the damage caused by e.g. B.

• Poisoning (grapes, raisins, antifreeze)
• Infection (especially leptospirosis, but also e.g. distemper)
• urinary stones
• and much more

the main functions of the kidneys are suddenly reduced. Accordingly, there are negative consequences for the entire organism: A reduction in the filter function leads to the retention of urinary substances in the body (urea, creatinine, etc.), which are also referred to as toxins, i.e. toxins, and cause damage and negative effects in many organs trigger consequences.

How Do I Recognize Acute Renal Failure In My Dog?

Dogs that have acute kidney injury may show the following symptoms:

• Vomit
• loss of appetite
• Apathy/listlessness
• convulsions/convulsions
• Changes in urination: the dog urinates little or not at all or suddenly a lot.

Symptoms can vary in severity and there may be other signs that the dog is unwell. if e.g. If, for example, poisoning is the cause of kidney damage, diarrhea, cramps, tremors, or excessive salivation can also occur. If the dog has kidney failure, one symptom is a complete cessation of urine production. If you have any of these signs, go to the vet as soon as possible! In case of doubt, rapid treatment saves lives and in any case mitigates the negative effects of kidney damage.

You should be particularly careful if your dog was already suffering from a chronic illness prior to these symptoms, if it was exposed to stress or heavy exertion, or if you e.g. B. know that he may have eaten something poisonous. If you suspect poisoning, go to the vet as soon as possible, even if your dog is still fine at the moment! Treatment must begin immediately.

Diagnosis And Treatment

In addition to a thorough physical examination, a blood and urine analysis will help the veterinarian to diagnose acute kidney disease. Typical changes such as B. an increase in the phosphate concentration in the blood and possible indications of the cause of the kidney damage. The same applies to X-ray and ultrasound examinations: Both the direct condition of the kidneys and possible triggers can be made visible. In this way, the treatment can be carried out as precisely as possible, which of course improves the effect.

If known, the root cause of the kidney failure is treated: the excretion of toxins is accelerated if possible, the concentration in the body may also be diluted, and sometimes there is also an antidote. So the harmful effect is taken away from you as much as possible. Bacterial infectious diseases are treated with antibiotics, whereby care must be taken with all medications that they do not put additional strain on the kidneys. If urinary stones obstruct the urinary tract, they must be removed. Surgical interventions should only be considered when the dog’s circulation is stable again.

Severe nausea and vomiting are treated with medication, as is the frequently occurring high blood pressure (hypertension).

If the dog comes to the practice with acute renal insufficiency or even renal failure, it will usually be given an infusion. The fluid balance is balanced and medication to stimulate kidney function can be given. Your vet may only provide emergency care and then refer your pet to a larger clinic that has more options. If necessary, dialysis therapy (“blood washing”) can also be initiated here.

Feeding In Renal Failure

In the case of acute renal insufficiency, it often happens that the dogs do not want to eat for a long time. In order to prevent a further reduction in circulatory performance and supply to the organs, feeding via a tube is often necessary for addition to treating nausea and vomiting. For this purpose, a thin tube is inserted into the esophagus through which food and liquid can be administered. In the case of acute kidney failure in dogs, lifelong feeding of a kidney diet is usually not necessary, unlike in the case of chronic kidney disease. Temporarily, however, the administration of kidney food is also useful in the acute form.

Prognosis And Life Expectancy

Depending on the cause and extent of the disease, the prognosis for complete recovery from acute kidney failure in dogs varies. If treated quickly and comprehensively and if the cause of the disease can be remedied, there is a good chance that your darling will recover completely. Unfortunately, there are also dogs for which acute kidney disease is fatal.

Chronic Renal Failure In The Dog

Consequences Of Renal Insufficiency In Dogs

After damage (causes can be found above), the main functions of the kidneys are increasingly restricted. Accordingly, there are long-term negative consequences for the entire organism:

• By reducing the filter function, substances that have to be passed through the urine (urea, creatinine, etc.) remain in the body.
• The impaired reabsorption of water in the kidneys leads to increased urine output (polyuria).
• Electrolytes and nutrients are also increasingly “flushed out” and thus lost to the body.
• Urea is excreted through the lining of the stomach and mouth, causing a urine-like odor in the mouth. It comes to inflammation of the gastric mucosa with nausea, loss of appetite, and vomiting.
• Restricting the hormonal activity of the kidneys reduces the formation of red blood cells, leading to anemia.
• The endocrine system that regulates blood pressure is overstimulated, resulting in high blood pressure caused by the kidneys (renal hypertension).
• Last but not least, the processing of the precursors of vitamin D is reduced, which leads to vitamin D deficiency (see below).

Chronic Renal Insufficiency Dog: Symptoms

Unfortunately, a dog’s chronic kidney failure (CRF) is not clinically noticeable for a long time, i. H. the animal owner often does not notice the subtle changes at first. Then the disease may first become noticeable in stressful situations, e.g. B. if the dog suffers from another illness or has been exposed to great exertion.

Depending on the stage, CKD in dogs can be characterized by the following symptoms:

• increased drinking and increased urination (polydipsia and polyuria), nocturnal housebreaking
  nausea, vomiting
• Loss of appetite, emaciation
• Tiredness, pale mucous membranes (e.g. in the mouth)
• dull fur
• bad breath, gum changes
• brown, slimy deposits on the teeth
• in a very advanced stage, drowsiness, tremors, epileptic seizures

As you can see, renal insufficiency in dogs can present itself very variably and the symptoms do not always immediately indicate a kidney problem. If you observe these symptoms individually or in combination with your dog, please consult a veterinarian!

Diagnosis

The vet will examine your pet thoroughly. In addition to the physical examination, a blood test and a urine test are definitely part of it. If necessary, imaging methods such as X-rays or ultrasound are used. A blood pressure measurement can also provide important information about the condition of the dog.

Dogs with renal insufficiency show symptoms of the disease in addition to the symptoms that are visible to you

• Changes in the blood (anemia, increased concentration of urinary substances)
• Changes in urine (changed urine density, increased protein, glucose, bacteria, etc.)
  often high blood pressure
• Kidney changes in ultrasound and X-rays (calcification, reduction, enlargement, structural changes in the tissue, etc.).
• If the vitamin D balance is disturbed, a chain of effects can lead to the release of minerals from the bones, which in turn can be seen in the changed bone structure on X-rays.

There are medical guidelines for dogs with kidney disease that enable the veterinarian to assess the dog’s condition more precisely and adjust the therapy optimally. The IRIS stages I-IV mentioned there classify the existing symptoms and laboratory findings. The individual treatment of each animal is then based on them.

In addition, a distinction must be made between acute and chronic renal insufficiency in dogs. And the disease must be differentiated from other diseases that may cause similar symptoms.

Therapy

If the dog presents to the vet with kidney failure or severe symptoms of illness, the dog is often first stabilized with the help of an infusion to prevent worse things from happening. Severe vomiting or similar is relieved with medication. In the following, the therapy will try to restore the balance in the body, e.g. B. in relation to electrolytes and urinary substances.

In the long term, the treatment of chronic kidney failure in dogs aims to minimize the consequences and progression of the disease and ensure the best possible quality of life.

Various measures are necessary for this:

• Water: It is essential for the dog to have constant access to fresh water – even if it cannot hold all of its urine at night! (This is where a dog toilet or a dog diaper can help.) Hydration is vital!
• Nutrition: The dog receives a special kidney diet. It contains highly digestible protein from high-quality protein sources and little phosphate. Also important are vitamins and fatty acids.
• Medication: Vomiting, inflammation of the gastric mucosa, high blood pressure, etc. are treated with medication as far as this is possible. Drugs that put additional strain on the kidneys should be avoided.

Chronic Renal Insufficiency Dog: Nutrition

Dogs with chronic renal insufficiency receive food that is precisely tailored to their needs. The best way to calculate the ratio is with a veterinarian specializing in animal nutrition. There are now high-quality complete feeds for dogs with kidney disease.

Even though the kidney diets available have continued to improve over the past few years, some dogs just don’t like to eat them. However, it is important that dogs with kidney disease eat enough food. Here are a few tips that can help if your four-legged friend does not want to eat the food:

• Gradually switch to the kidney diet. Add the new food to the old in increasing amounts.
• Warm the food slightly before offering it to your dog.
• Give small portions several times a day. Especially with nausea, your darling will feel the little appetite to eat a large daily ration at once.
• Hold hands. Some dogs will find it helpful if you hand them the bowl and stay with it while they eat.
• If possible, nausea, vomiting, and, for example, gingivitis should be treated well – this significantly increases the appetite and willingness to eat of the four-legged friends.
• If none of that helps, you can cook the kidney diet for your darling yourself. This is sometimes eaten better. But be careful: Since the exact composition is essential for survival, always only in cooperation with a veterinarian specializing in animal nutrition!

Renal Insufficiency Dog: Life Expectancy

A dog with chronic renal failure can achieve a good quality of life with individual treatment and an appropriate diet and live with it for quite some time. It is crucial for a life expectancy that the disease is recognized as early as possible and treated consistently. Acute flare-ups are always possible and can lead to rapid deterioration of the dog’s renal insufficiency.

Can You Prevent Kidney Failure In Dogs?

Unfortunately, CKD in dogs cannot be prevented in this sense. However, you can use opportunities for early detection: During the annual check-up at the veterinarian (especially important for older dogs!), your darling can be checked for kidney failure. A blood test and possibly a blood pressure measurement and a urine test are helpful for this. If there are only slight signs, therapy can be started, which can significantly slow down the progression of the disease. Feel free to ask your treating veterinarian, who will explain everything important to you.