Kidney Disease

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Common Questions For Dogs

EverPal client with a cat in a virtual vet visit

Common Questions For Cats

Learn more about

chronic kidney disease

in dogs and cats

Terminology

Understanding Chronic Kidney Disease

From a practical standpoint, the terms chronic kidney disease, chronic renal failure, renal insufficiency, chronic kidney failure, and kidney insufficiency all refer to the same condition.

Normal Kidney Functions

Kidney function goes far beyond urine production. Kidneys separate necessary chemicals from those to be excreted in urine. Normal functioning kidneys regulate body hydration, remove metabolic wastes, regulate the balance between calcium and phosphorus, and control electrolyte balance to conserve potassium.

Renal Insufficiency

Patients with chronic kidney disease are categorized by the stage of insufficiency they are facing and their symptoms. Early treatment focuses on preventing further progression, while later stages aim to maintain quality of life.

The Role of Kidneys

The kidney is an amazing organ, responsible for much more than just making urine and eliminating toxins. It manages hydration, blood pressure, red blood cell production, pH balance in the blood, calcium, and phosphorus balance, among other functions.

Diagnosis

Diagnosing the different stages of chronic kidney disease (CKD) in pets involves a combination of blood tests, urine tests, and sometimes imaging. Blood tests will give us indication on BUN (Serum Creatinine and Blood Urea Nitrogen), SDMA (Symmetric Dimethylarginine), and Phosphorus levels.

Stage I
Abnormal ultrasound or elevated SDMA will be able to help with diagnosis. We recommend quarterly checks for any sign of progression if abnormalities are found.

Stage II
At Stage II, same as Stage I, we will put added focus on phosphorus levels (keeping below 4.6 mg/dl) and potassium levels, especially in cats.

Stage III
In Stage III, In addition to the tests in previous stages, red blood cell numbers and blood pH are monitored.

Stage IV
At Stage IV, similar to earlier stages but the patient should aim to adjust phosphorus goals (6.0 mg/dl).

Common Symptoms

Patients with chronic kidney disease are categorized by the stage of insufficiency they are facing and their symptoms.

Stage I
Characteristics: Known kidney disease based on abnormal ultrasound or slightly elevated SDMA.

Stage II
Stage II is characterized by mild kidney damage. In this stage, the kidneys have lost some of their ability to function effectively, but the pet might not show obvious signs of illness.

Stage III
In Stage III, patients are likely to show symptoms such as reduced appetite or occasional nausea.

Stage IV
At Stage IV, the patient is almost certainly experiencing noticeable symptoms. The focus is on maintaining sufficient calorie intake.

Treatment Options

Treatment plans for Chronic Kidney Disease in dogs and cats should be individualized based on the stage of the disease and the pet's overall health. Regular monitoring, dietary management, and appropriate medications are key to managing CKD and improving the pet's quality of life.

Stage I Goals: Early Detection and Monitoring
Introduce a renal diet low in phosphorus and moderate in high-quality protein. Encourage water intake through fresh water or wet food.

Stage II Goals: Slowing Progression and Addressing Early Symptoms
Diet change to a renal diet to encourage early acceptance by the pet. Medications may be necessary if diet alone is inadequate. Use phosphorus binders if dietary restriction is insufficient.

Stage III Goals: Symptom Management and Slowing Progression
At this stage, we continue to maintain a strict renal diet, and can also start to consider using calcitriol (active vitamin D supplementation).

Stage IV Goals: Quality of Life
At Stage IV, fluid support at home, such as adding water to food, subcutaneous fluids, or hospitalization with IV fluids, may be necessary. Continue phosphorus binders and potassium supplements as needed. Add appetite stimulants if needed.

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