Chronic Kidney Disease in Dogs and Cats - Treat the Treatable!

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By Donald S. Westfall; DVM, MS, Diplomate ACVIM (Internal Medicine) Veterinary Referral Center of Colorado (VRCC)
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The Causes of Chronic Kidney Disease in Dogs and Cats

Have an older cat or dog? One important thing to watch for is kidney disease. The most common cause of acquired kidney disease in pets is age-associated changes to the kidneys, which affect their functioning. Although it can be seen in dogs, it’s particularly common in cats and can change the concentration of their urine and raise the kidney values in the bloodstream; this can be found through testing by your veterinarian. Other causes of kidney disease are congenital abnormalities, exposure to toxic substances, systemic diseases, infectious disease(s), and cancer.

If your pet’s kidney disease is congenital, that can often be found early on initial lab work prior to neutering or at wellness checks. In the case where exposure to something toxic is affecting the kidneys, common causes to think about can be exposure to antifreeze, consuming acetaminophen or ibuprofen (commonly known as Tylenol and Advil),  ingestion of grapes or raisins, certain plants (including those in the Lily family), and specific classes of prescription and chemotherapy drugs. If your pet has been exposed to any of these, it can cause a syndrome known as acute renal failure. True to its name, acute renal failure comes on quickly, as opposed to chronic renal failure. However, it’s important to watch your pet carefully all the time because exposure to smaller amounts of these toxins or drugs can lead to kidney injury and result in chronic disease later in life.

If it’s not a genetic or toxic cause, there are other diseases and conditions you should know about as a pet owner. Glomerulonephritis is a disease characterized by excessive loss of protein through the kidneys into the urine. This is oftentimes associated with inflammation of the kidney and complete work-up is indicated for this disease.  Amyloidosis is an extreme form of protein loss through the kidneys. If you have a Shar Pei or Abyssinian cat, be particularly watchful as they are affected more than other breeds. 

Infectious causes of kidney disease include bacterial infections, Leptospirosis and Lyme disease. Any infectious disease can cause inflammation and either acute or chronic renal failure.

In all cases, symptoms and signs of kidney disease you should watch for include:

  • Excessive thirst and urination
  • Unexplained weight loss
  • Decreased appetite
  • Vomiting

What You and Your Veterinarian Should Do

A thorough diagnostic work-up is indicated once kidney disease is suspected. Your veterinarian should run tests including  a chemistry panel, complete blood count and urinalysis, urine protein levels, urine culture and sensitivity, blood pressure determination, abdominal ultrasound, and, possibly, infectious disease tests.

Once a work-up has been completed, you and your veterinarian will work together to slow the progression of kidney disease. Here are some of the basic steps you may need to take that will be critical to your pet’s recovery:

  • Kidney-friendly diet: These diets are low quantity, high-quality protein diets and are available by prescription only. They help your pet maintain normal levels of electrolytes and phosphorous and decrease the amount of protein lost through the kidneys.
  • High blood pressure: This is common with kidney disease and is addressed by prescription drugs and careful monitoring of kidney values and blood pressure.  The kidney diet and additional therapies including giving ultra low-dose aspirin and fatty acid supplementation can also help with certain types of kidney disease.
  • IV fluids/medication: If your pet’s kidney failure is acute and comes on quickly, he or she will likely feel sick, become dehydrated, stop eating and drinking and possibly begin vomiting. Your veterinarian may hospitalize your pet, giving IV fluids along with anti-nausea medication.

The Future? 

As with any serious condition, the prognosis for kidney disease is variable and depends on what stage medical intervention is initiated. Early intervention is ideal and more likely, now that you know the signs and symptoms to watch for in your pet. I recommend your pet has yearly lab work performed to identify kidney disease as well as other endocrine and metabolic conditions as early as possible. With careful monitoring and by addressing the treatable conditions, many patients can live happily for years with kidney disease.