End Stage Renal Disease in Dogs

A dog can live a long life even after the diagnosis of renal disease if he has the proper care, nutrition and medication. There are two types of renal disease: acute renal failure (ARF) and chronic renal failure (CRF). Acute renal failure is the sudden shutdown of kidney function due to infection, trauma, toxic substance ingestion or a blockage in the urinary tract. Chronic renal failure occurs when proper kidney functioning deteriorates over time.

Causes of Renal Disease

Renal disease can occur in any breed, gender or age of dog. Some common causes of kidney disease are:

• Parasites
• Infections (fungal, viral or bacterial)
• Trauma
• Age
• Cancer
• Inflammation
• Inherited disorders
• Autoimmune diseases
• Toxins such as poisons or medications
• Abnormal protein deposits in the kidneys (amyloidosis)

Symptoms of End Stage Renal Disease

Some of these symptoms are indicators of other diseases as well, so testing is necessary to determine if renal disease is present and its severity.

• Lethargy
• Vomiting
• Diarrhea
• Increased thirst
• Changes in urination (increased, decreased, lack of or urination during the night)
• Blood in the urine
• Weight loss
• Decreased appetite
• Withdrawal behavior
• Poor hair quality
• Abdomen tenderness
• Hunched over posture, reluctance to move
• Depression
• Fever
• Dehydration
• Bad breath
• Oral ulcers on tongue, gums or inside of the cheek
• Retinal changes due to high blood pressure
• Fluid accumulation, causing swelling in the abdomen and limbs
• Changes in the kidneys (enlarged or small and irregular)
• Anemia, as indicated by pale mucous membranes
• Softening of the jaw bones in juveniles (hereditary)

Diagnosis of Renal Failure

Several tests will reveal the presence of kidney disease and its severity: blood tests, urinalysis, x-rays, ultrasonography, urography, imaging scans and a biopsy. Kidneys are not functioning properly if there is an increase in phosphorous, creatinine and/or nitrogen in the blood, along with a decrease of red blood cells. An increase of protein, sediment and the concentration of urine indicates kidney disease.

Treatment and Management

Acute renal disease can be reversible; however, chronic renal failure is not, since the disease has taken its toll over the course of time. Rehydrating (often intravenously) is key in fighting this disease. A high quality, low quantity protein diet with omega-3 fatty acids keeps the dog nourished properly, benefiting any dog in stage IV kidney failure by improving his quality of life. Medications will fight the vomiting and diarrhea while blood pressure medications and antibiotics will regulate secondary problems.

Regular monitoring will determine if the treatment must be modified, and dialysis may be necessary to flush toxins from the dog's system periodically. Kidney dialysis is necessary for dogs that do not respond to normal therapies, do not produce urine or for those with toxins in the kidneys. Kidney transplants may be required for the most severe cases; however, only a few hospitals provide this service since the success rate is relatively low. With proper treatment, a dog can live for years despite chronic renal failure.