Dog Kidney Disease Treatment: Signs, Diagnosis & Care Options

Dog Kidney Disease Treatment: A Gaithersburg Pet Owner’s Guide

A kidney disease diagnosis can be scary, particularly if your dog looks pretty normal on the outside. One of the most frequently asked questions we get at Grove Center Veterinary Hospital is exactly what dog kidney disease treatment actually entails on a day-to-day basis and does a diagnosis mean it’s the end of a quality of life for a dog? The truth is, if your dog has kidney disease, with the proper treatment plan, many live comfortable months or years. This guide explains the causes of kidney disease in dogs, diagnosis and the complete treatment plan for dogs with kidney disease.

Learning about kidney disease in dogs. 

Kidneys remove waste products from the blood, maintain electrolytes, control blood pressure and contribute to the production of red blood cells. As the kidneys fail, wastes begin to accumulate in the blood, and the entire body begins to suffer.

There are two types of kidney disease that are generally recognized by veterinarians:

• Acute kidney injury (AKI): A rapid and frequently severe decrease in kidney function, usually due to toxins, infection or blockage.
• Chronic kidney disease (CKD): A progressive (typically irreversible) loss of kidney function which occurs over months or years, most often in older dogs.

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Most of the dog kidney disease treatment discussion we have with owners focuses on CKD because that is the more prevalent long term diagnosis, but the principles of supportive care are the same for acute cases.

So, what do you think causes a dog to develop kidney disease?

Kidney disease typically progresses without any clear cause. A few contributing factors are:

• Age. The function of the kidneys naturally wanes as dogs get older, making CKD much more prevalent in older dogs.
• Inherited factors & susceptibility from breed. Certain breeds, such as Shih Tzu and Cocker Spaniels are susceptible to inherited kidney diseases.
• Dental disease. Over time, the teeth in the mouth can lead to chronic infection that can impact kidney health.
• High blood pressure. High blood pressure is a factor in, and damages, kidney disease.
• Toxin exposure. Some food products, such as grapes and raisins, some human medications and antifreeze can lead to acute kidney injury.
• Infections or blockages. If not treated, UTIs, kidney stones or obstruction can cause damage to the kidneys.

When it is possible to determine the underlying cause, such as a treatable infection or blockage, an effective treatment plan can be developed for the dog’s kidney disease and sometimes partial or complete reversals of some of the damage can occur after eliminating the infection or blockage.

Recognizing the Signs

Dogs, being so good at hiding signs of illness, often have very non-specific early signs and symptoms that can be overlooked and attributed to the dog’s “old age.” Symptoms to look out for are:

• Increased thirst and urination
• Reduced interest in food or unusual food choices
• Weight loss
• Vomiting
• Sleepiness or lack of interest in activities
• Smelly breath with a chemical or ammonia smell
• Pale gums
• Despite trying to drink more water, the person becomes dehydrated.

If you notice multiple of these symptoms, particularly polyuria and polydipsia, it’s a good idea to take blood tests immediately. Kidney disease treatment has a much better chance of slowing the progression of kidney disease when caught early, before much damage has been done.

The process for the diagnosis and staging of kidney disease.

Diagnosing kidney disease at Grove Center Veterinary Hospital usually entails:

1. Bloodwork (creatinine and SDMA or symmetric dimethylarginine – a marker which can help identify kidney dysfunction earlier than creatinine can).
2. Urinalysis, to evaluate the kidneys’ ability to concentrate urine, and to see if protein is lost in the urine.
3. Urine protein-to-creatinine ratio (UPC): The continued loss of protein in the urine is now known to be a disease driver, rather than just a disease marker.
4. Blood pressure measurement – hypertension occurs in many dogs with kidney disease and untreated could shorten the process of damage if left untreated.
5. X-rays or abdominal ultrasound to detect stones, abnormalities or masses.

Dogs are staged after the diagnosis of CKD is made, using the International Renal Interest Society (IRIS) classification, which is based on the severity of the disease, from Stage 1 (early, mild) to Stage 4 (advanced). Staging is not just a formality — it will directly influence the dog kidney disease treatment plan as the goals and level of care will vary greatly between the treatment plan for an early-stage dog and that of one in advanced kidney failure.

The Central Method for Dog Kidney Disease Treatment.

Because there is no single treatment to reverse chronic kidney damage, dog kidney disease treatment involves a combination of therapies to slow the disease’s progression, alleviate symptoms, and help maintain quality of life.

1. Therapeutic Kidney Diets One of the most important components of dog kidney disease therapy is diet. Prescription renal diets have a limited amount of high-quality protein, but less phosphorus, to reduce the work load on the kidneys and control the accumulation of substances in the blood. Therapeutic renal diets have been proven to increase the longevity and improve health in dogs compared to dogs not placed on a therapeutic diet.
2. Fluid Therapy Affected dogs may not be able to drink enough fluids due to a decrease in the ability to concentrate urine. Fluid may be administered intravenously during a flare-up or it may be given under the skin (subcutaneous fluids) and helps to remove waste products and maintain hydration and comfort.
3. Blood Pressure Management Dogs that have hypertension (high blood pressure) as part of their kidney disease treatment receive blood pressure-lowering medications, which help the kidneys and slow kidney disease.
4. Medicines for lowering protein loss. Common medications prescribed for dogs are benazepril or telmisartan in cases of proteinuria. These not only help to preserve protein in the urine, but can also help to control blood pressure, so doing two jobs in one.
5. Managing Anemia Erythropoietin is a hormone made in healthy kidneys that helps to make red blood cells. Many dogs become anemic as the kidney function decreases. Treatment includes hormone therapy (darbepoetin) for the red blood cell count if it decreases, and a blood transfusion if it drops rapidly.
6. Correcting Mineral Imbalances Kidney disease upsets the balance of calcium and phosphorus in the body. Phosphate binders that are taken with food, and in some situations, calcitriol therapy, can restore that balance and maintain the health of the bones and organs.
7. Treating Nausea and Supporting Appetite Blood may get “clogged up” and lead to nausea and loss of appetite. This phase may involve anti-nausea drugs and/or appetite stimulants to help the dog stay well fed and strong.
8. Ongoing Monitoring Kidney disease is a chronic condition, which means that dog kidney disease treatment cannot be done once and for all. Your veterinarian will check your dog’s bloodwork, urinalysis and blood pressure regularly, making adjustments as your dog’s needs evolve.

The Recovery and Long-Term Management will look like:

In the case of acute kidney injury, early treatment may result in a significant recovery of kidney function at least in some patients. With chronic kidney disease, the focus is on managing the disease and making your dog comfortable for as long as you can while slowing the progression of the disease.

The first place that often means:

• Consistently following the renal diet – no table scraps that might be high in protein, sodium or phosphorus.
• Fresh and easily accessible water always provided, sometimes with pet fountain to promote water intake
• Taking medicines at the right time
• Close monitoring of changes in appetite, energy or thirst
• Following recommended recheck bloodwork, even though your dog appears healthy

With dog owners adhering to a treatment plan, many dogs live for many years with early to moderate kidney disease at a good quality of life. The key to treating dog kidney disease successfully is all about consistency.

Prognosis: What to Realistically Expect:

The prognosis is partly dependent upon the stage of the disease at diagnosis and promptness of treatment. If diagnosed in the early stages (Stage 1 or 2), dogs can benefit greatly from diet and medication and live comfortably for many years. Even if a dog is diagnosed at a later stage (Stage 3 or 4), treatment can still be beneficial, but this may include comfort and quality of life measures. Your veterinarian will be able to tell you where your dog is and determine what is likely to happen, as new blood work is received, and make adjustments to the care plan accordingly.

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If your dog is drinking more than usual, urinating more than usual, not eating as much as usual or not eating at all, schedule bloodwork, don’t wait to see if it gets better. Early detection of kidney disease makes it much easier to manage and early intervention can significantly improve the lifelong perspective of your dog. Your Gaithersburg team is here to help you through the diagnosis, staging and treatment plan tailored to your dog’s unique needs.

Conclusion

The diagnosis of kidney disease is not a sentence, it’s a beginning and an ongoing collaboration between you, your dog and your veterinarians. There is no cure for chronic kidney disease, but with the right dog kidney disease treatment, diet, medication, hydration, and monitoring, the disease can be slowed and a good quality of life can be maintained for a significant amount of time. Dogs that do best are those that their owners recognize the signs early and follow a plan that their veterinarian recommends. Contact Grove Center Veterinary Hospital if you’ve seen any changes in your dog’s thirst, appetite or energy level, so we can help you get ahead of it.

Frequently Asked Questions

1. What is the first step in dog kidney disease treatment? 

Diagnostic blood work and urinalysis is generally the first step to confirming diagnosis and also classification of disease. Your veterinarian then constructs a treatment plan specific to this stage that is likely to begin with a therapeutic renal diet.

2. However, can dog kidney disease be treated? 

Kidney disease is a chronic condition with permanent damage to the kidney but can be treated successfully for many years. Acute kidney injury, on the other hand, may be able to make a dramatic recovery with timely and vigorous treatment.

3. What should dog eat to heal kidney disease? 

Prescription renal diets containing good quality protein and low in phosphorus are typically the accepted standard of care. These diets are designed to specifically lighten the work for the kidneys and are an essential part of the treatment for kidney disease in dogs.

4. How do I know what stage my dog’s kidney disease is? 

The IRIS staging system is used to stage using bloodwork (creatinine and SDMA), urine testing, and blood pressure measurement. Your veterinarian will convey your dog’s particular phase and what that implies for treatment.

5. Do you have to use fluid therapy subcutaneously at home? 

Yes, fluid therapy is taught at home for dogs in later stages of kidney disease. It’s simply a component of regular management, which will help with hydration and comfort between vet visits.

6. If my dog is diagnosed with kidney disease, how often does he or she need blood tests? 

This will depend on the stage and your dog’s treatment response, but many dogs require rechecks every few months as kidney disease is a progressive disease and the treatment plan may need to be tweaked over time.

7. What are the symptoms if the dog kidney disease treatment is not effective? 

If weight loss continues or the appetite gets worse, if more vomiting occurs or if there is a significant increase in bloodwork values despite treatment, this means that the plan must be adjusted. Contact your veterinarian if you notice these changes.

8. Do dogs with high blood pressure have a higher chance of getting kidney disease?

 Absolutely, high blood pressure can cause damage to a dog’s kidneys and can also cause the kidneys to be harmed to the point of worsening blood pressure. That’s why monitoring and even treating hypertension as part of a dog kidney disease treatment regimen is often recommended.

9. Will my dog have to take medication for his or her lifetime? 

Yes, in most cases of chronic kidney disease. However, the condition is progressive and is almost always irreversible, so a diet and medication regimen are often a chronic aspect of treatment.

10. What is the life expectancy of a dog with kidney disease? 

Relies heavily on the stage at diagnosis and adherence to treatment. Early diagnosed and well managed dogs have a long and useful life, and late diagnosed dogs may also have a long and meaningful life if well managed.