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Kidney (Renal) Disease

Kidney disease is one of the prevalent syndromes we deal with in veterinary medicine. With our improved diagnostic skills, better nutrition, and a willingness of our clients to invest in good preventive care, our beloved pets are living longer, healthier lives. As our pets age, thier list of maladies increase. It is safe to say that if a pet lives long enough, it will have to face the prospect of kidney disease. I am constantly telling my clients that age is not a disease, but as we age, we face a myriad of ills as our bodies wear out.

Most clients become aware of kidney disease in their pet when they become clinically ill. The most common clinical signs are an increased thirst, increased urination, weight loss, and in the latter stages diminished appetite. The two main functions of the kidneys are to excrete urinary biproducts and to concentrate urine. As the kidneys fail, they are unable to concentrate urine and the pet dehydrates. They try to compensate by drinking more. Unfortunately, they cannot drink enough to replenish what they have lost, and they dehydrate more, worsening the kidneys’ function. The other main function of the kidneys is to rid the body of urinary waste products, ie urea and creatinine. These are products of protein metabolism and are toxic. A normal functioning kidney removes these toxins in the urine. When the kidney begins to fail, these toxins build up in the bloodstream, causing inappetance,
nausea, and ulcers. The kidneys have to be 80% compromised before the first elevations in kidney enzymes are noted in the bloodwork. This is why early preventive blood screening is so important.

Treatment is aimed at restoring hydration and flushing the bloodstream of these urinary toxins. In the early stages of kidney disease, we treat with a low protein diet and check blood pressure. Hypertension can cause kidney disease and vice versa. If hypertension is present, we treat with anti-hypertension drugs which can help preserve kidney function as well. We always check a urine sample. The urine is an excellent barometer of kidney function. Dilute urine and protein in the urine are indicators that the kidneys’ function is becoming compromised. As the disease progresses, we prescribe medications that can help combat the urinary toxins. In the latter stages of kidney disease, we often begin intravenous or subcutaneous (under the skin) fluid administration. This helps flush out the impurities and rehydrates the patient. Clients can be taught administer subcutaneous fluids at home. This is very easy to do, well tolerated, and cost effective. We have had clients manage their pets’ kidney disease for years with these treatment protocols. The take home message is, routine wellness screenings will enable us to detect kidney and other diseases at their earliest, most treatable, and least expensive stages.

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