Followup And Longterm Survival
Followup data were available in 61 of the 65 dogs discharged. The MST was 105days , with 35 dogs and 8 dogs surviving up to 6 and 12months, respectively. Three dogs were alive 24months after presentation with ACKD .
KaplanMeier survival curve of dogs with acute on chronic kidney disease discharged alive from the hospital
The MST of dogs based on SCR categories at discharge was as follows: SCR < 1.4 mg/dL, 155days SCR between 1.42.8 mg/dL, 130days SCR between 2.95 mg/dL, 89days and SCR > 5 mg/dL, 32days . No difference was found in MST among categories 3) or in MST among presumptive causes of AKI . No association was found between SCR at presentation and longterm survival .
KaplanMeier survival curve of dogs with acute on chronic kidney disease categorized by SCR comparable to IRIS chronic kidney disease stages at discharge from the hospital. IRIS, International Renal Interest Society SCR, serum creatinine concentration
Stage : Creatinine 14
Think of this as mild chronic kidney disease. Most dogs in this stage still dont show any symptoms that they are sick. If they do show signs, they will be mild and might include a decreased appetite or weight loss.
Each of the veterinary laboratories have different cut-offs for what they consider normal creatinine values. The lower values of creatinine for this stage may still be normal according to some laboratory reference ranges. But IRIS guidelines still consider dogs with those values to have chronic kidney disease.
How Long Can I Expect My Dog To Live
The prognosis is quite variable depending on the dog’s response to the initial stage of treatment and your ability to perform the follow-up care. Veterinarians encourage treatment in most situations because many dogs will respond well and maintain a good quality of life.
“Treatment and follow-up care is relatively easy and inexpensive…”
Treatment and follow-up care is relatively easy and inexpensive and extending the length and quality of life for their faithful companion represents the ultimate reward for many clients.
|Contributors: Ernest Ward, DVM Updated by Malcolm Weir, DVM, MSc, MPH
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Symptoms Of Chronic Renal Failure In Dogs
Clinical signs are often related to the severity of the CRF stage, meaning there are additional and more severe signs noted with stages III and IV than there are with stages I and II. Dogs often exhibit symptoms including:
Increased thirst and urination
Some dogs may show muscle wasting and signs attributed to high blood pressure, such as vision loss and weakness.
What Is The Prognosis For Chronic Kidney Failure
The IRIS staging system means that we can provide some average survival ranges based on the current stage however there is significant variation. This is because each patients disease will progress at different rates dependent on many factors including how they are treated and the complications they have developed as a result of their disease.
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Possible Outcomes From The First Phase Of Kidney Failure Treatment
With this first phase of treatment, there are three possible outcomes:
The kidneys will resume functioning and continue to do so, whether it be a few weeks to a few years.
The kidneys will resume functioning during treatment but will fail again once treatments stop.
Kidney function will not return at all.
There is no test that can reliably predict the outcome of the first phase of kidney failure treatment so each case should be treated aggressively and monitored very closely. Even in severe cases of kidney failure, if the treatment goes well there is always a possibility that the dog can return to a normal quality of life.
Next Steps if the First Phase of Kidney Failure Treatment is Successful
If fluid therapy is successful, the next phase is to help keep the kidneys functioning as usual and for as long as possible. Depending on the situation, this can be accomplished in a few ways:
Causes Of Kidney Disease
While chronic kidney disease tends to affect older dogs, acute renal failure can happen for a variety of reasons. Dogs may experience this life-threatening condition due to toxin exposure, infection, or other bodily issues that decrease blood flow or oxygen to the kidneys.
The following causes of chronic and acute kidney disease can occur:
- Aging: Chronic kidney disease is the result of degenerative changes in the kidney that affect its ability to function properly. CKD is most common in aging dogs and tends to come on gradually.
- Exposure to toxins: Acute renal failure in dogs is most commonly caused by toxin exposure. Common culprits include antifreeze, some over-the-counter human painkillers, and rat poison .
- Infection: Kidney infections are another potential cause of acute renal failure. Severe urinary tract infections may develop into kidney infections if left untreated .
- Acute renal failure may also occur if there is decreased blood flow or oxygen delivery to the kidneys. Examples include trauma, severe dehydration, and heatstroke. Certain congenital or acquired health conditions may lead to acute renal failure.
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What Is Iris And What Makes Their Guidelines So Useful
IRIS stands for the International Renal Interest Society. It was created in 1998 by an international group of veterinarians devoted to advancing the scientific understanding of kidney disease in small animals. IRIS is led by a board of 14 independent veterinarians from countries all over the world. Each has expertise in kidney function and kidney disease.
The mission of IRIS is to help veterinary practitioners better diagnose, understand, and treat renal disease in cats and dogs. They knew that to achieve that mission they needed to first establish an internationally recognized set of guidelines on the diagnosis and treatment of kidney disease. That way everyone was speaking the same kidney disease language.
I would say they did a pretty good job.
The guidelines IRIS developed help veterinarians communicate clearly among themselves and to pet parents dealing with kidney disease. They accomplish this by providing a clear and systematic way to stage the degree of kidney dysfunction.
How To Make A Dog With Kidney Failure Comfortable
Now that you know all about chronic kidney failure including what to look for and how its treated, lets talk about how to keep your dog comfortable during chronic kidney failure.
Often times, the treatment itself will make your dog feel much better.
Flushing all the toxins out of his system and easing the strain on his body will have him feeling much better in relatively little time.
A dog with chronic kidney failure will require special care for the rest of his life, and the best way to keep him comfortable is to follow his treatment exactly.
The following steps will help you keep your dog comfortable throughout his chronic kidney failure management:
- Follow diet and medication prescriptions exactly.
- Dont feed extra snacks.
- Feed your dog small meals throughout the day rather than one or two big meals. Small meals are easier on his kidneys.
- Keep clean, fresh water on hand at all times and never withhold water for any reason.
- Warm your dogs food up just a bit if his appetite is poor. This can often entice him to eat.
If your dog is diagnosed early enough and you follow the treatment laid out by your vet, your dog could do very well with his chronic kidney failure.
Remember, diagnosis, treatment, and adherence to medical advice are the keys to both treating his chronic kidney failure and to keeping him comfortable throughout the rest of his life.
If you do those things, and your dogs kidney failure isnt too severe, he could have several years of good living left.
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Is Kidney Failure In Dogs Painful
Kidney failure in dogs can be painful depending on the type of injury, insult, or disease that causing kidney failure. It is always difficult to determine pain in dogs, as they cannot speak to us, but we can tell if they are uncomfortable or sick. Your veterinarian can help you keep your canine friend as comfortable as possible while fighting kidney failure.
Causes Of Chronic Renal Failure In Dogs
The term chronic in chronic renal failure means that the process has been ongoing, is progressive, and unfortunately, cannot be reversed. For some dogs, the disease could have occurred after a serious kidney injury such as from a severe infection or ingestion of a toxic substance such as anti-freeze, grapes, or raisins, and certain antibiotics.
For others, it could be inherited, such as with glomerular disease and amyloidosis as seen in breeds like the Bernese Mountain Dog and Shar-pei.
For others, it could be attributed to underlying immune-mediated diseases, stroke-like events, or even from clotting disorders. In cases for newly diagnosed dogs the underlying cause will likely remain unknown.
What Are The Clinical Signs Of Chronic Kidney Disease
When disease or advanced age causes the filtration process to become inefficient and ineffective, blood flow to the kidneys is increased in an attempt to increase filtration. The body must increase the amount of blood flowing through the kidneys since less and less of the toxins are being removed each time. This results in the production of more urine. To keep the dog from becoming dehydrated due to increased fluid loss in the urine, thirst and water consumption is increased.
Therefore, one of the earliest clinical signs of kidney failure is increased water consumption and urination, and is called compensated renal failure. After approximately 2/3 of the kidney tissue is destroyed, there is a rapid rise in waste products in the bloodstream and an apparent sudden onset of severe disease. The clinical signs of more advanced kidney failure include loss of appetite, depression, vomiting, diarrhea, and very bad breath. Occasionally, ulcers will be found in the mouth.
List Of Symptoms Of Kidney Disease In Dogs:
Now the symptoms of kidney disease in dogs can be quite easily identifiable. Some common clinical signs of kidney disease include:
- Polydypsia: Excessive thirst
- Blood tests can show anemia, abnormal calcium and phosphorus imbalances
- Consistent vomiting and nausea
- Oral ulcers may be the most common sign during the later stages of kidney failure, due to the inability of the kidney to filter out toxic substances from the blood.
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Diagnosing & Treating Kidney Disease In Dogs
Your veterinarian will perform a full physical examination for your dog if a serious illness is suspected. If your pooch is diagnosed with chronic kidney disease, the severity of your dog’s case and a number of individual factors such as their health and age will be assessed before the vet recommends appropriate treatment. Treatment for kidney disease often includes a number of dietary changes or restrictions, combined with medications. While medications are used primarily to reduce symptoms of the disease, a therapeutic diet will help slow the progression of the disease and help to reduce the work your dog’s kidneys need to perform.
How Is Chronic Kidney Failure Diagnosed
There are two basic tests for kidney function: a complete urinalysis and a blood chemistry analysis.
A urinalysis is needed to evaluate kidney function. A low urine specific gravity is the earliest indication of kidney failure. An increase in protein in the urine also indicates decreased kidney function.
A blood biochemistry analysis assesses the function of various internal organs. Measuring the level of two waste products in the blood, namely blood urea nitrogen and blood creatinine , indicates decreased kidney function. Tests to measure the blood levels of other substances such as albumin, globulin, potassium, sodium, phosphorus, and calcium, as well as the red and white blood cell counts are important in order to determine the extent of failure and the best course of treatment.
A recently developed blood test to assess levels of SDMA has been used to determine if early renal failure is occurring. SDMA concentrations increase above the normal reference interval well before serum creatinine becomes elevated. This will help your veterinarian provide treatment for your dog at a much earlier stage in the disease.
“SDMA concentrations increase above the normal reference interval well before serum creatinine becomes elevated.”
A dog diagnosed with low urine specific gravity as well as elevated BUN and CREA is said to be azotemic.
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What Is Kidney Disease
Canine kidney disease is a condition that inhibits the organ’s ability to filter waste from the body, eventually leading to renal failure. Like humans, dogs cannot survive without any kidneys, but they can live with only one kidney. To understand how kidney disease affects the dog’s body, it’s helpful to learn how the kidneys function.
The kidneys are vital organs in vertebrates, including dogs and humans. A dog’s kidneys are located in the mid-abdomen near the back . They are attached to an extensive network of blood vessels that connect to other vital organs. The kidneys are complicated organs that serve several purposes.
Kidneys are responsible for maintaining a proper electrolyte and pH balance in the blood. They also filter out waste from the blood and produce urine through which the waste is excreted. Another function of the kidneys is to produce hormones and enzymes that help regulate various functions throughout the body. The heart and kidneys work together to keep the body in operation.
Causes Of Acute Kidney Failure
- One of the most common causes of acute kidney failure in dogs is ingestion of toxins, such as antifreeze, rodenticides, or some human medications . Dogs are such curious creatures and this trait can increase their risks for toxin exposures.
- Infection with a bacterial organism called Leptospirosis can lead to kidney failure in pets and people.
- Various drugs can also cause kidney failure in certain pets.
- Severe infections or illnesses like sepsis or pancreatitis can also lead to acute kidney failure.
- Obstruction of the urinary tract caused by kidney stones or bladder stones that restricts urine flow.
- Anything that decreases the flow of blood through the kidneys, including dehydration, heatstroke, bee stings, or snake bites.
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Chronic Kidney Disease: Living With Your Pet And The Diagnosis
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Risk Factors Associated With Survival In Ckd
In this study, increased serum SDMA was associated with a decreased survival time, since the increase in its serum concentration correlates well with GFR decline , which in turn relates to increased death risk associated with CKD severity . Furthermore, SDMA is also a guanidine with uremic toxin potential and can generate cellular damage . It has been described that SDMA favors nitric oxide production decrement, stimulating reactive oxygen species production and a proinflammatory effect . The presence of hyperphosphatemia was also related to a decreased survival time, in line with what other authors have reported . This is attributable to the clinical complications that it entails, such as renal secondary hyperparathyroidism development and its consequences, i.e., renal osteodystrophy, tissue mineralization , and aggravation of anemia . Furthermore, the presence of anemia was also associated with a decreased survival time . This can be related to the harmful effects that arise from the decreased tissue oxygen supply and oxidative stress that occurs secondarily to anemia . Moreover, low BCS was associated with decreased survival time, in line with what other authors have reported , and could be associated with the inflammatory, catabolic, and oxidative state that occurs secondarily to cachexic states , all related to a lower survival time .
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Kidney Disease In Dogs: Causes Symptoms Treatments And More
Kidney disease in dogs, sounds scary right? Has your dog been diagnosed with kidney disease?
Kidney disease in dogs is a generalized term that talks about the various diseases and metabolic problems that may disrupt the normal functioning of your dogs kidneys.
So, if youve got a pooch with any kind of kidney problems then this article is just for you! Here we will cover all you need to know about kidney disease in dogs.
Possible Treatment Plans For Acute Kidney Failure In Dogs
If your dog is diagnosed with acute kidney failure, here are some treatments that may be offered:
- Treatment for the primary disease causing the acute kidney failure
- Intravenous Fluids: used to restore electrolytes and hydration and help the kidneys continue to flush out the wastes and toxins from the bloodstream.
- Urinary Catheterization: measuring the urine output is key in monitoring how the kidneys are rebounding and responding to treatment.
- Medications: Antibiotics, anti-nausea medications, gastro protectants, appetite stimulants, blood pressure medications, cardiac support, and pain medications if your dog is painful
- Temporary Feeding Tube: Many dogs feel lousy and do not want to eat. A feeding tube can help deliver nutrition directly to their stomach until they are ready to eat on their own.
- Monitoring: Bodyweight, urine output, electrocardiogram, blood pressure, temperature, and urine and blood testing will assist your veterinarian in closely monitoring your dogs status.
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