Kidney Failure in Dogs
Symptoms of Kidney Failure in Dogs
Early clinical signs of kidney failure in dogs
- increased water consumption
- increased urine production.
Clinical signs of more advanced kidney failure in dogs
- loss of appetite
- very bad breath
- ulcers in the mouth.
Treatment of Kidney Failure in Dogs
Treatment of kidney failure in dogs occurs in two phases. The first phase
is to "restart" the kidneys. Large quantities of intravenous fluids are
given to "flush out" the kidneys. This flushing process, called diuresis,
helps to stimulate the kidney cells to function again. If enough functional
kidney cells remain, they may be able to adequately meet the body's needs
for waste removal. Fluid therapy includes replacement of various
electrolytes, especially potassium. Other important aspects of initial
treatment include proper nutrition and drugs to control vomiting and
There are three possible outcomes from the first phase of treatment of
kidney failure in dogs: 1) The kidneys will resume functioning and continue
to function for a few weeks to a few years. 2) The kidneys will resume
functioning during treatment but fail again as soon as treatment stops. 3)
Kidney function will not return. Unfortunately, there are no reliable tests
that will predict the outcome.
The second phase of treatment in dogs is to keep the kidneys functioning
as long as possible. This is accomplished with one or more of the following,
depending on the situation:
1. A special diet. The ideal diet is low in protein, low in phosphorus, and
not acidified. This type of diet helps to keep the blood tests as close to
normal as possible, which usually makes your dog feel better. Also, once
kidney disease is advanced, a decreased protein diet will decrease the
workload on the kidneys.
2. A phosphate binder. Phosphorous is removed from the body by filtering
through the kidneys. Once the filtration process is impaired, phosphorous
begins to accumulate in the blood. This also contributes to lethargy and
poor appetite. Certain drugs will bind excess phosphates in the intestinal
tract so they are not absorbed, resulting in lower blood levels of
3. Fluids given at home. Once your dog is stabilized, fluids can be given
under the skin (subcutaneously). This serves to continually "restart" the
kidneys as their function begins to fail again. This is done once daily to
once weekly, depending on the degree of kidney failure. Although this might
not sound like something you can do, you will be surprised at how easily the
technique can be learned and how well most dogs will tolerate it.
4. A drug to regulate the parathyroid gland and calcium levels. Calcium and
phosphorus must remain at about a 2:1 ratio in the blood. The increase in
blood phosphorus level, as mentioned above, stimulates the parathyroid gland
to increase the blood calcium level by removing it from bones. This can be
helpful for the sake of the normalizing calcium:phosphorus ratio, but it can
make the bones brittle and easily broken. Calcitriol can be used to reduce
the function of the parathyroid gland and to increase calcium absorption
from the intestinal tract. This is recommended if there is evidence of
abnormal function of the parathyroid gland.
5. A drug to stimulate the bone marrow to produce new red blood cells. The
kidneys produce erythropoietin, a hormone that stimulates the bone marrow to
make red blood cells. Therefore, many dogs in kidney failure have a low red
blood cell count, anemia. Epogen (or Procrit), synthetic forms of
erythropoietin, will correct the anemia in most dogs. Unfortunately for some
dogs, the drug cannot be used long term because the immune system recognizes
the drug as "foreign" and will make antibodies (immune proteins) against it.
This is recommended if there is persistent anemia present.
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