by Jennifer Coates, DVM
The kidney regulates blood pressure, blood sugar, blood volume, water composition in the blood, pH levels, and produces red blood cells and certain hormones, amongst other things. Failure of the kidney can take so place so slowly that the kidney will find ways to compensate as it loses functionality over the course of months, or even years.
If your dog has been diagnosed with chronic renal failure, this is what you can expect to happen next:
Medication: Medications and supplements that lower blood pressure, raise potassium levels, lower phosphorous levels, promote kidney function, treat anemia, treat gastrointestinal ulcers, and reduce vomiting may all be a part of therapy.
Diet: Special diets that promote kidney function and reduce the biochemical abnormalities in the body that result from renal failure are often prescribed. Canned food is usually best due to its high water content. Supplemental fluids may also be given under the skin.
Surgery: In rare cases, a kidney transplant may be considered.
What to Expect at the Vet’s Office
If your veterinarian needs to confirm your dog’s diagnosis of chronic kidney failure, he or she may need to run a blood chemistry panel, complete blood cell count, a urinalysis, and blood pressure testing. Findings typically include some combination of:
- dilute urine
- elevated blood urea nitrogen (BUN)
- increased levels of creatinine in the blood
- anemia (low red blood cell count)
- high levels of phosphorous in the blood
- low levels of potassium in the blood
- high blood pressure
After your dog has been definitively diagnosed with chronic renal failure, your veterinarian will determine whether hospitalization to initiate treatment is required. Severely affected dogs may need to stay at the veterinary clinic to receive intravenous fluids and begin treatment for any other symptoms they might have (see below).
Once dogs with chronic renal failure are stable enough to continue their treatment at home, they can be discharged from the hospital.
What to Expect at Home
Appropriate treatment for chronic kidney failure depends on the specific symptoms and biochemical abnormalities that a dog has. Many patients require fluid therapy to combat dehydration. This can be achieved by increasing the water content of a pet’s diet (e.g., feeding canned food only) and through intermittent subcutaneous fluid treatment (giving boluses of sterile fluid under the skin). Your veterinarian may also prescribe a special diet to help promote kidney function and counteract biochemical abnormalities that commonly occur in the body.
Additional treatment recommendations are based on a pet’s individual needs and may include:
- Medications to lower blood pressure (e.g., amlodipine or enalapril)
- Nutritional supplements that reduce BUN (Azodyl) and phosphorus levels (Epakitin) in the blood
- Omega 3 fatty acids to protect the kidneys
- Medications to treat or prevent stomach ulcers (e.g., ranitidine, famotidine, omeprazole, sucralfate)
- Potassium supplements
- Aluminum hydroxide to decrease blood phosphorous levels
- Calcitriol to slow the progression of chronic renal failure
- Medications to treat anemia (e.g., erythropoietin or darbepoetin)
- Anti-nausea medications (e.g., maropitant or ondansetron)
Kidney transplants may be an option for pets who meet specific criteria.
Questions to Ask Your Vet
Ask your veterinarian what the possible side effects are of the medications your dog is taking. Find out when he or she next wants to see your dog for a progress check and whom you should call if an emergency arises outside of your veterinarian’s normal business hours.
Possible Complications to Watch For
Chronic kidney failure is a progressive disease, but the rapidity of the decline can vary greatly between individuals. Some dogs may enjoy good quality of life for many months or even years, while others have to be euthanized soon after diagnosis.
Talk to your veterinarian if you have any questions or concerns about your dog’s condition, particularly if you notice a worsening of:
- lethargy, depression, or other abnormal behaviors
- poor appetite
- increased thirst and urination
- weight loss and/or muscle wasting
- vomiting or diarrhea (possibly containing blood)
- bad breath
- difficulty breathing
- poor vision