Why do so many dogs get kidney disease

Kidney Disease in Dogs: Signs, Symptoms, and Treatment

Your dogs kidneys are essential organs that filter waste products from the bloodstream. When the kidneys are weakened, either by acute or chronic kidney disease, your dogs health could suffer. Because kidney disease progresses over time, its important to learn the common symptoms so tha you can recognize them. If you catch kidney disease in dogs early on, treatment can slow down the progression and allow your dog to live longer.

What Is Kidney Disease in Dogs?

Kidney disease in dogs is sometimes called renal or kidney insufficiency because it occurs when a dogs kidneys stop doing their job as efficiently as they should. The main job of the kidneys is to help clear and excrete waste products from the blood and convert them to urine, says Dr. Jerry Klein, Chief Veterinary Officer for the AKC. If the kidneys are not working properly, these waste products can build up in the blood, causing detrimental effects.

Dogs can get either acute kidney disease, which develops suddenly, or chronic kidney disease (CKD), which develops slowly and worsens over an extended period. Both involve loss of kidney function, but they result from different circumstances. Acute kidney disease is a sudden attack or injury to the kidney, whereas chronic kidney disease is a slow, degenerative loss of kidney function, Dr. Klein explains.

What Causes Kidney Disease in Dogs?

Dr. Klein warns that kidney disease could be caused by a lot of things, including infection (such as with the bacteria that causes leptospirosis), trauma, genetics, drugs, toxins, cancer, mechanical obstructions (like kidney stones), and degenerative diseases (where the job and form of the affected body part get worse over time). Anything that decreases blood flow to the kidneys, such as dehydration or heatstroke, can cause the kidneys to fail.

Acute kidney disease in dogs can be caused by exposure to hazardous materials, including toxic plants such as lilies, certain drugs, harmful foods such as grapes or raisins, or antifreeze. Puppy-proofing your home and yard can keep your dog away from potentially harmful items or foods that could be toxic.

Chronic kidney disease in dogs is also associated with growing older. Because kidney tissue cant regenerate once its damaged, the kidneys can wear out over time. As small-breed dogs often live longer than large-breed dogs, they tend to show early signs of kidney disease at an older age10 years old or more, compared to as young as 7 for the large breeds.

What Are the Symptoms of Kidney Disease in Dogs?

The earliest signs of kidney disease in dogs are increased urination and therefore increased thirst. Other symptoms dont usually become apparent until about two-thirds of the kidney tissue is destroyed. So, in the case of CKD, the damage may have begun months or even years before the owner notices. Because of this, its common for the signs of kidney disease in dogs to seem like they came out of the blue when in fact, the kidneys have been struggling for a long time.

Other signs of chronic kidney disease in dogs to watch for include:

Dr. Klein says there are some rarer symptoms of kidney disease in dogs to be aware of, as well. On occasion, there can be abdominal painurinary obstructions or stonesand in certain instances, one can see ulcers in the oral or gastric cavity. In extreme cases, little or no urine is produced at all.

What Are the Stages of Chronic Kidney Disease in Dogs?

Kidney disease in dogs is measured in stages. Many veterinarians use the IRIS scale, which has four stages. Blood work measurements like creatinine and SDMA (biomarkers for kidney function) allow your vet to assign your dog to a particular stage which will determine the exact treatment.

Dr. Klein explains, The stages determine how well the kidneys can filter waste and extra fluid from the blood. As the stages go up, the kidney function worsens. In the early stages of CKD, the kidneys are still able to filter out waste from the blood. In the latter stages, the kidneys must work harder to filter the blood and in late stages may stop working altogether.

How Is Kidney Disease in Dogs Treated?

Dialysis (a medical procedure that removes waste products and extra fluid from the blood) is far more common in humans than in dogs, although peritoneal (kidney) dialysis can be performed in some cases. On rare occasions, surgical kidney transplant is possible in dogs.

But Dr. Klein specifies that depending on the type and stage of kidney disease, the main treatments for CKD are diet changes and administration of fluids, either directly into the veins (intravenous) or under the skin (subcutaneous). The balancing and correction of electrolytes are extremely important in the management of kidney patients, he explains.

Proper nutrition is needed, and there are many available diets formulated for cats and dogs with kidney issues, some by prescription only. Your veterinarian can help guide you to the most appropriate diet for your pet.

Because kidney disease, particularly in the late stages, can cause a dog to lose their appetite, it can be difficult to encourage your dog to eat enough. Dr. Klein advises, There are medications used as appetite stimulators available, such as the prescription drug mirtazapine. Capromorelin has recently been FDA-approved for dogs to address appetite in chronic kidney disease.

When Do You Need to Call Your Vet?

The prognosis and expected life span for a dog with kidney disease depend on the type of disease, the speed of progression, and underlying conditions present in the dog. However, the more serious the disease, the poorer the outcome. Thats why its so crucial to catch the illness early on.

According to Dr. Klein, In chronic kidney disease, there are methods, such as diets and medications, that can be used to lessen the burden of work the kidneys need to do and may help slow down the progression from one stage to the next. In acute kidney disease, there is less time and fewer choices available to prevent further damage to the kidneys and to try to jump-start the kidneys to get them to function normally.

Regular veterinary exams, including bloodwork, are an excellent way to spot kidney problems before the outward symptoms become apparent. And if you notice any of the above signs, dont hesitate to get your dog to the vet for further testing. It can make a huge difference in preserving kidney function and your dogs well-being for as long as possible.

Why Do So Many Cats Have Kidney Disease

Q: Ive had three cats in my life that have died at an older age of complications due to kidney disease. This is the fourth cat now Ive had diagnosed with kidney disease with some new test, and shes only 7 years old. Why do so many cats die of kidney disease? B. S. C., Tacoma, WA

A: We dont know why so many older cats develop chronic kidney disease (CKD), but were trying to find out, says Dr. Vicki Thayer, executive director of the nonprofit Winn Feline Foundation, which funds cat health studies. The good news is that an early diagnosis may add to your cats lifespan, as well as to enhance quality of life.

A new test, which is presumably the test you mention, can provide an earlier diagnosis of kidney than veterinarians ever could; the test is called Symmetric dimethylarginine or SDMA. The test is offered with the IDEXX regular blood chemistry panel.

Before SDMA, and likely with your previous cats, by the time kidney disease was discovered, 75 percent of kidney function was likely gone. Using SDMA testing, kidney disease is typically diagnosed far earlier, while the loss of function doesnt yet affect quality of life.

Steve Dale Pet World, LLC; Tribune Content Agency

Chronic Kidney Disease: What Does Kidney Failure in Dogs Really Mean?

Kidney disease is more common as dogs age. It is estimated that more than 1 in 10 dogs will develop kidney disease over a lifetime^1,3, so its an important topic to understand. When healthy, the two kidneys efficiently:

• Filter the blood
• Process protein wastes and excrete them into the urine
• Conserve and balance body water, salts and acids
• Help to maintain normal red blood cells

Kidney disease occurs when one or more of these functions are compromised or reduced. Unfortunately, it typically goes undetected until the organs are functioning at approximately 33% to 25% of their capacity. Dogs with moderate to severe chronic kidney disease (CKD) are prone to dehydration and you may notice that your dog is lethargic and has a poor appetite. Treatment options for advanced kidney disease are usually limited to treating the symptoms because dialysis and kidney transplants are not readily available for dogs. Protecting your pooch from kidney disease means you should be prepared to look for problems early.

Causes of of chronic kidney disease in dogsThe International Renal Interest Society or IRIS is a group of veterinary specialists studying kidney disease in dogs and cats. They list several risk factors that make pets more susceptible to kidney disease, such as age or breed, and investigate reversible factors that initiate or accelerate kidney damage. Such factors include:

Signs of chronic kidney disease in dogsOne of the earliest signs of kidney disease in dogs is urinating and drinking more (polyuria/polydipsia or PU/PD). Often, dogs need to urinate at nighttime (nocturia) or have "accidents." There are many other causes of PU/PD, but kidney disease is one of the most serious concerns. Taking water away from your dog could make chronic kidney disease worse, so please dont try to do this without your veterinarians direction. Having your dog examined promptly when you note a change in water intake and urine production is key! Dogs tend to be pretty sensitive to changes in their blood levels of waste so even mild to moderate changes may cause signs of illness.

Other signs of chronic kidney disease include:

Testing your dog for chronic kidney diseaseYour veterinarian will often suggest these basic tests:

Physical Examination The first test your veterinarian is likely to perform will be a physical examination, and remember that taking your dog in for routine physical examinations is an excellent way to help protect him. Even normal physical exams may be useful later as a baseline of comparison. During the exam, your veterinarian might detect:

• Enlarged, painful kidneys
• Back or flank pain
• Changes in the prostate or urinary bladder

A rectal examination can give more detail about the possibility of urethral, bladder or prostatic disease that might relate to kidney disease. Finding a large bladder in a dehydrated pet, or other, less specific, findings may also warn your veterinarian about a kidney problem, for example:

• Low body temperature
• Excessive skin tenting
• Dry gums (showing dehydration)
• Unkempt hair coat

Other testing may include:

• Complete blood count (CBC)The CBC may reveal anemia (too few red blood cells) or an elevation in white blood cells consistent with infection, stress or inflammation. Less commonly, blood parasites or circulating cancer cells are found.
• Chemistry profile with electrolytes
• Urinalysis with sediment examExamining a urine specimen, especially prior to any treatment, is a simple and economical way to gauge urine quality.
• Urine culture with susceptibility
• Urine protein to creatinine ratio
• Infectious disease testingRegular testing for heartworm infection and for vector borne diseases such as Ehrlichiosis and Lyme can identify risk factors for kidney disease.
• Diagnostic imagingUsing radiography (X-rays) and diagnostic ultrasound to identify changes in the size, shape and architecture of the kidneys may suggest a specific blockage that needs emergency treatment.
• Blood pressure measurementHigh blood pressure is common in dogs with chronic kidney disease.
• Kidney Sampling

Management and monitoring of chronic kidney diseaseSick pets with signs of kidney disease that include dehydration will likely require more intensive care in a hospital setting, while those that are happy tail waggers and are completely self-supporting will often be treated at home. Your veterinarian will work diligently to find a treatable cause of kidney disease and make individual recommendations for your dog. General treatment goals for dogs with kidney disease include:

• Providing adequate and appropriate nutrition with a kidney friendly diet (always check with your veterinarian before making any diet changes).
• Ensuring excellent hydration.
• Balancing salts and acid-base levels.
• Aggressively treating any protein problems or high blood pressure, since these conditions tend to worsen kidney damage².
• Keeping plenty of fresh water availablethis is essential!

Keep in mind that dogs with kidney disease are usually going to need more trips outside for bathroom breaks, so building this into the household schedule will be important. A friendly neighbor can help out, or a professional dog walker can come to give your pooch a midday break and help you avoid coming home to a puddle or two on the floor. He really cant help it!Your pets condition, any other illnesses found and your personal goals for treatment will help determine the course of treatment and dictate how often you visit the veterinarian.Chronic kidney disease prognosis/advancesSome dogs with chronic kidney disease will live years after diagnosis and have a good quality of life. Others will not be so lucky. Your veterinarian will evaluate after testing isfinished.As a motivated pet guardian you can take an active role in your pets preventive care by planning for wellness exams and routine lab testing. Team up with your veterinarian to address any problems before they get worse. The discovery of new biomarkers for kidney function, such as SDMA, provides for early recognition of kidney disease before other blood values change and offers the prospect of earlier intervention and kidney care³.

If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.

Resources:

1. Brown SA. Renal dysfunction in small animals. The Merck Veterinary Manual website. Updated October 2013. Accessed January 14, 2015.
2. Polzin DJ et al. Evidence-based management of chronic kidney disease. In Bonagura J, Twedt D (eds), Kirks Current Veterinary Therapy XIV, Elsevier Saunders, St Louis 2009: 872-879.
3. https://www.idexx.com/small-animal-health/solutions/articles/sdma-diagnose-kidney-disease.html