kidney disease in dogs symptoms
Chronic Kidney Disease (CKD) in Dogs
What Is Chronic Kidney Disease (CKD) in Dogs?
Dogs have two kidneys, which are vital for maintaining lifes day-to-day processes. They have a variety of functions, the foremost of which is to filter and excrete toxins and waste from the body. Other tasks of the kidneys include regulating fluid, mineral, and electrolyte balance; conserving water and protein; maintaining blood pressure; and producing red blood cells.
Many causes are associated with progressive loss of kidney function, and unfortunately, once lost the damage is irreversible. As a result, unfiltered waste products and toxins build up in the bloodstream, leading to a generalized state of nausea and malaise. When left untreated or unmanaged, a dogs quality of life suffers. Early diagnosis and intervention are vital to managing the disease and maintaining your dogs comfort and well-being.
CKD is a progressive disease that has often been present for some time before it is diagnosed. It is typically classified into four stages, based on laboratory values and clinical signs:
Stage I: No clinical signs are seen.
Stage II: Some clinical signs are seen.
Stage III: Many clinical signs are seen, and pets often feel sick.
Stage IV: The majority of clinical signs are seen, often as an emergency. The quality of life for the pet is poor.
Is Chronic Renal Failure the Same Thing as Chronic Kidney Disease?
Chronic kidney disease (CKD), renal insufficiency, and chronic renal failure (CRF) are different terms often used interchangeably to describe declining kidney healthwhere over time the kidneys become less efficient in their required tasks and the results are life-threatening.
Symptoms of CKD in Dogs
Dogs typically wont experience any symptoms until the kidneys have lost about 75% of their functioning capacity. The higher the stage (meaning the greater the extent of kidney disease present), the more symptoms are exhibited.
Dogs in any stage can experience the following symptoms:
Anemia (low red blood cell count)
Changes in urine output, usually increased
Decreased appetite
Dehydration
Increased thirst
Muscle wasting
Nausea
Oral ulcerations (sores in the mouth) and bad breath
Pale gums
Poor coat appearance
Sporadic vomiting
Vision loss, often attributed to secondary hypertension (high blood pressure)
Weakness and lethargy
Weight loss
Causes of CKD in Dogs
Chronic renal failure by definition is a disease that occurs over a period of time; it is an ongoing, progressive, and irreversible process where, for some dogs, the cause remains unknown despite extensive testing.
Often CKD develops after a serious kidney injury such as from a severe infection (e.g., leptospirosis, tick-borne disease, or pyelonephritis), heat stroke, envenomation (from a venomous bite or sting), or the ingestion of toxic substances like antifreeze, NSAIDs (ibuprofen), or certain antibiotics. CKD is also associated with certain types of immune-mediated diseases or cancer.
Dogs breeds commonly prone to CKD include:
How Veterinarians Diagnose CKD in Dogs
A veterinarian will start with a physical exam, bloodwork, and a urinalysis to look specifically at kidney values such as:
Blood urea nitrogen (BUN): higher values correlated with kidney failure
Calcium
Creatinine (CREA): indicator of the kidneys ability to filter wastes from blood
Electrolytes: sodium, potassium, chloride
Phosphorous: higher phosphorus levels seen with CKD
Red blood cell count: low red blood cell counts are often seen secondary to CKD
Symmetric dimethylarginine (SDMA): an indicator used for early detection of kidney disease
Urine specific gravity:determines the kidneys concentrating ability; the more concentrated the urine is, the greater the ability of the kidneys to conserve water
Your veterinarian may also recommend additional testing such as:
A urine protein to creatinine (UPC) ratio to determine how much protein is lost in the urine (termed proteinuria)
A urine culture, as dogs with CKD are more likely to acquire urinary tract infections
A blood pressure evaluation, as dogs with CKD often have hypertension (high blood pressure)
Radiographs or abdominal ultrasound to screen for kidney stones, tumors, or infarcts (areas of dead tissue)
Treatment of CKD in Dogs
CKD is a manageable but incurable diseasesince by the time dog is symptomatic, irreversible damage has already occurred. Recommendations based on the stage of CKD will be tailored to match your dogs needs, with dogs in Stage III or IV warranting greater care and therapy than dogs in Stage I or II. Common therapies for CKD include medications, diet, and fluid therapy, along with treatment for any underlying condition or inciting factors.
Medications such as Cerenia, ondansetron, or omeprazole can help aid nausea, vomiting, and lack or loss of appetite. For some dogs with more extensive needs, a feeding tube may be placed. Additionally, appetite stimulants such as capromorelin and mirtazapine may be recommended.
Most vets will prescribe dietary management with a balanced diet that is lower in protein, salt, and phosphorus and is alkalinized to help combat side effects associated with CKD. Recommended diets typically include:
Fluid therapy is essential. Fluids will flush out toxic waste substances that the kidneys should be doing on a routine basis and restore hydration. They can be given intravenously in the hospital or subcutaneously (underneath the skin) at home. Your dog should have access to fresh water at all timesa water fountain can be an especially important item to add to your home.
Recovery and Management of CKD in Dogs
CKD is a serious lifelong condition that requires ongoing care and monitoring as symptoms continue to develop. Dogs with CKD require more frequent veterinary visits and testing than others, and at all stages of CKD, quality of life should be assessed as symptoms change. Be sure to adhere to your veterinarians recheck guidelines and continue all medications and diet as recommended; many will be required for life.
Depending on the circumstances, certain measures can help keep your dog comfortable and offer a good quality of life for as long as possible. Similar treatment and medications to those outlined above also are applicable for long-term management of CKD in dogs, such as:
Dietary supplements such as Azodyl, a pre/probiotic, that can help decrease waste products not eliminated by the kidneys.
Other supplements, such as aluminum hydroxide and Epakitinare geared to aid with low potassium and high phosphorus.
Anti-nausea and anti-emetic (anti-vomiting) medications can be prescribed as needed for dogs who experience intermittent vomiting and lack of appetite.
Unfortunately, given the severity of symptoms often experienced by dogs with Stage III or IV and the extensive amount of care and effort they require, euthanasia may be the best option.
Chronic Kidney Disease (CKD) in Dogs FAQs
How long can a dog live with kidney disease?
CKD is progressive; however, its difficult to anticipate the degree and timing of the progression. Some dogs can live for years with proper veterinary care and management, while others may have to be euthanized shortly after diagnosis.
How fast does kidney disease progress in dogs?
The progression of CKD in dogs varies, taking weeks to years for symptoms to be noticeable. Once known, though, it is estimated that 75% loss of kidney function has already occurred, and the damage is irreversible. Depending on the underlying cause, some dogs will deteriorate much faster than others. Frequent checkups and routine veterinary visits can help detect CKD sooner, which will ensure your dogs comfort and garner an overall better quality of life.
Featured Image: Adobe/Alan
WRITTEN BY
Michael Kearley, DVMVeterinarian
Dr. Michael Kearley graduated from the University of Florida College of Veterinary Medicine in 2013. He graduated with a certificate in...
Chronic kidney disease
I'm Dr. Andrew Bentall, a kidney doctor at Mayo Clinic. I look after patients with kidney disease, either in the early stages, or with more advanced kidney disease considering dialysis and transplantation as treatment options. In this video, we'll cover the basics of chronic kidney disease. What is it? Who gets it? The symptoms, diagnosis and treatment. Whether you are looking for answers for yourself or for someone you love, we're here to give you the best information available.
Chronic kidney disease is a disease characterized by progressive damage and loss of function in the kidneys. It's estimated that chronic kidney disease affects about one in seven American adults. And most of those don't know they have it. Before we get into the disease itself, let's talk a little bit about the kidneys and what they do. Our kidneys play many important roles keeping our bodies in balance. They remove waste and toxins, excess water from the bloodstream, which is carried out of the body in urine. They helped to make hormones to produce red blood cells, and they turn vitamin D into its active form, so it's usable in the body.
There are quite a few things that can cause or put you at higher risk for chronic kidney disease. Some of them are not things that can be avoided. Your risk is simply higher if you have a family history of certain genetic conditions like polycystic kidney disease or some autoimmune diseases like lupus or IgA nephropathy. Defects in the kidney structure can also cause your kidneys to fail, and you have an increased risk as you get older. Sometimes, other common medical conditions can increase your risk. Diabetes is the most common cause of kidney disease. Both type 1 and type 2 diabetes. But also heart disease and obesity can contribute to the damage that causes kidneys to fail. Urinary tract issues and inflammation in different parts of the kidney can also lead to long-term functional decline. There are things that are more under our control: Heavy or long-term use of certain medications, even those that are common over-the-counter. Smoking can also be a contributing factor to chronic kidney disease.
Often there are no outward signs in the earlier stages of chronic kidney disease, which is grouped into stages 1 through 5. Generally, earlier stages are known as 1 to 3. And as kidney disease progresses, you may notice the following symptoms. Nausea and vomiting, muscle cramps, loss of appetite, swelling via feet and ankles, dry, itchy skin, shortness of breath, trouble sleeping, urinating either too much or too little. However, these are usually in the later stages, but they can also happen in other disorders. So don't automatically interpret this as having kidney disease. But if you're experiencing anything that concerns you, you should make an appointment with your doctor.
Even before any symptoms appear, routine blood work can indicate that you might be in the early stages of chronic kidney disease. And the earlier it's detected, the easier it is to treat. This is why regular checkups with your doctor are important. If your doctor suspects the onset of chronic kidney disease, they may schedule a variety of other tests. They may also refer you to a kidney specialist, a nephrologist like myself. Urine tests can reveal abnormalities and give clues to the underlying cause of the chronic kidney disease. And this can also help to determine the underlying issues. Various imaging tests like ultrasounds or CT scans can be done to help your doctor assess the size, the structure, as well as evaluate the visible damage, inflammation or stones of your kidneys. And in some cases, a kidney biopsy may be necessary. And a small amount of tissue is taken with a needle and sent to the pathologist for further analysis.
Treatment is determined by what is causing your kidneys to not function normally. Treating the cause is key, leading to reduced complications and slowing progression of kidney disease. For example, getting better blood pressure control, improved sugar control and diabetes, and reducing weight are often key interventions. However, existing damage is not usually reversible. In some conditions, treatment can reverse the cause of the disease. So seeking medical review is really important. Individual complications vary, but treatment might include high blood pressure medication, diuretics to reduce fluid and swelling, supplements to relieve anemia, statins to lower cholesterol, or medications to protect your bones and prevent blood vessel calcification. A lower-protein diet may also be recommended. It reduces the amount of waste your kidneys need to filter from your blood. These can not only slow the damage of kidney disease, but make you feel better as well. When the damage has progressed to the point that 85 to 90 percent of your kidney function is gone, and they no longer work well enough to keep you alive, it's called end-stage kidney failure. But there are still options. There's dialysis, which uses a machine to filter the toxins and remove water from your body as your kidneys are no longer able to do this. Where possible, the preferred therapy is a kidney transplant. While an organ transplant can sound daunting, it's actually often the better alternative, and the closest thing to a cure, if you qualify for a kidney transplant.
If you have kidney disease, there are lifestyle choices. Namely quit smoking. Consuming alcohol in moderation. If you're overweight or obese, then try to lose weight. Staying active and getting exercise can help not only with your weight, but fatigue and stress. If your condition allows, keep up with your routine, whether that's working, hobbies, social activities, or other things you enjoy. It can be helpful to talk to someone you trust, a friend or relative who's good at listening. Or your doctor could also refer you to a therapist or social worker. It can also be helpful to find a support group and connect with people going through the same thing. Learning you have chronic kidney disease and learning how to live with it can be a challenge. But there are lots of ways to help you to be more comfortable for longer before more drastic measures are needed. And even then, there is plenty of hope. If you'd like to learn even more about chronic kidney disease, watch our other related videos or visit mayoclinic.org. We wish you well.
