Q: My ten year old dog was just diagnosed with kidney failure.  What should I be doing for him?

            A: Kidney disease is a very common condition in dogs and cats.  When kidneys stop functioning well, pets begin drinking larger amounts of water and may eventually become ill.  Generally, the type of kidney dysfunction that older pets develop is called chronic kidney disease (CKD).  The older term, “chronic renal failure” implied a degree of hopelessness that is not necessarily the case with modern medical therapy.

We think of this condition as more or less an “aging” change of the kidneys, although some patients have underlying causes that can be identified.  The earlier the condition is detected, the easier and more successfully it can be treated.

            Many people know that you can donate one of your kidneys for transplant.  With only 50% remaining kidney function, there are no detrimental effects to the body.  Dogs and cats only show symptoms of illness once 90% of kidney function is gone.  Regular blood tests can now detect kidney disease when as much as 60% of their function remains! When caught before symptoms develop, kidney disease can be eliminated as a cause of death for at least seven out of ten patients.

            Depending on how early the disease was detected, your pet may or may not require several days in the hospital on IV fluids.  Toxins that should be eliminated from the body can reach high levels when the kidneys do not function correctly.  As long as some function remains, IV fluids will help reduce the levels.

            Although CKD patients often drink lots of water, their bodies suffer from a fluid deficit.  Maximizing fluid intake will help your pet’s kidneys function better.  Water dishes provided in multiple locations in the house should be changed twice daily.  Circulating water bowls should be considered, especially for cats.  Many veterinarians advise using canned food to boost fluid intake.  Some owners learn to give injections of a saline solution periodically to further increase fluid levels.

            All pets with kidney disease should be placed on a therapeutic diet with restricted phosphorous, moderate amounts of highly digestible protein, high levels of antioxidants, and added pH buffers.  Several of these diets have been proven to double life expectancy after diagnosis!  More than half a dozen brands exist with many flavors to choose from, so even the most finicky pets will usually find a type they can eat.

            Nutritional supplements are playing an increasingly important role in treating kidney disease.  Phosphorous binders, fatty-acids, and specific types of pro-biotics are designed to reduce kidney workload.  Always check with your veterinarian before giving any vitamin, herb, or supplement.

            Recent research has shown us that blood pressure plays an extremely important role in managing CKD patients.  All pets with CKD should have their blood pressure checked every 3-6 months along with blood and urine monitoring tests.

            CKD is not the only kidney disease that can affect pets.  Some causes of kidney dysfunction are quickly curable.  Others are universally fatal.  It is important to thoroughly investigate any abnormal kidney function.  Quantification of urine protein levels may aid in diagnosis and treatment.  A urine culture may be necessary to determine whether antibiotics could be helpful.  On some occasions, imaging studies using X-ray or ultrasound technology may be recommended.  Blood tests for systemic infections like Lyme disease and Leptospirosis are frequently indicated in dogs.

            Using routine screening of apparently healthy pets, modern diagnostic equipment, and advances in therapeutic nutrition, pets with kidney disease are living happier, longer lives than ever before.  Every family pet should be examined by a veterinarian twice each year.  A blood and urine panel should be run to check the function of the kidneys and other organs at least annually.  In older pets, these laboratory tests should be run every six months.  By following these recommendations, we can catch kidney disease, and other problems, in their very earliest phases – and make the most difference for your pet.