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Chronic kidney disease in pets (CKD) can be a frustrating condition. Many pets show no signs of illness at home; cats are especially good at masking issues until a problem becomes advanced. The disease can be slowed and managed but neither cured nor reversed. Some estimates suggest 10 to 30 percent of older dogs and a whopping 80 percent of cats over 15 suffer from this ailment.
The causes may be breed-related, genetic and/or diet-related, especially for pets who eat only dry food and whose kidneys must work harder. Every case and treatment plan will be different.
What Is Chronic Kidney Disease in Pets (CKD)?
The body has few organs more important than kidneys, but what do they do? Simply, they filter waste products from the blood, removing electrolytes such as phosphorus and potassium. They also regulate blood pressure and produce a hormone to stimulate red blood cell production. When they slide into a progressive, irreversible decline in these functions, that’s CKD.
Diagnosis and Staging of CKD
Unless you request regular blood work for your pets at veterinary checkups – and perhaps even then – you probably won’t recognize the earliest signs of CKD. You might observe subtle changes in thirst and urination at home, though appetite may remain constant.
At this stage, lab work performed by your veterinarian may show slightly increased kidney values in three areas: SDMA, an amino acid produced when proteins are broken down by cells; creatinine, a waste product from protein or muscle function; or BUN, which measures the amount of urea nitrogen in the blood. (Healthy kidneys deal with all of these efficiently.) A urinalysis may detect signs of inadequate urine concentration.
A vet who suspects chronic kidney disease will recommend a complete staging to determine the extent and severity of the disease. This classification into stages helps identify the most appropriate treatments to slow the progression of CKD and provide the best quality of life.
Staging includes a combination of blood work, urinalysis, urine protein quantification, blood pressure monitoring and probably some type of imaging, such as ultrasound. Owners should expect periodic restaging, so vets can adjust treatments as the illness progresses.
Treatment of Chronic Kidney Disease in Pets (CKD)
Above all, make sure pets stay hydrated. Every patient needs access to fresh, clean water at all times. Patients with CKD are prone to dehydration because they can’t concentrate their urine; that means they can’t reduce the amount of water in the urine to conserve body fluid and excrete wastes. Owners can encourage water intake by supplying water fountains or strategically placing multiple water bowls. They may also offer high-moisture treats and a diet of canned food with a high moisture content.
In nearly all cases, a vet will recommend a change to a prescription renal diet. Prescription diets formulated for kidney disease serve multiple functions: They’re calorically dense and restrict intake of protein and phosphorus. However, these diets may not be appropriate for individual pets – for instance, those with food allergies or fat intolerance – so you’ll need to discuss options with your veterinarian.
In some cases, subcutaneous fluids administered under your pet’s skin – at home, which isn’t difficult, or in a vet’s office – can supplement normal hydration. Owners should also be ready to respond to any problem that increases the risk of dehydration, such as vomiting or diarrhea. Those affect patients with CKD more significantly than patients with normal kidney function.
Medications for CKD
Depending on the stage of the disease, some patients may benefit from oral medications that include phosphate binders, given alongside a prescription diet to reduce phosphorus content in the body. That often slows progression of the disease and improves appetite and quality of life.
Blood pressure medications may reduce systemic hypertension and/or address protein in the urine, slowing disease progression. During later stages, some patients benefit from anti-nausea medications and/or appetite stimulants; pets with kidney disease may struggle to eat, and their caloric intake can drop too far. Patients may also need treatment for CKD-associated anemia through oral or injectable medications that stimulate red blood cell production.
Prognosis for CKD
Every animal (including humans) loses some degree of kidney function with age. That doesn’t mean chronic kidney disease in pets will cut a life short. But as your pet ages, you’ll want to work with your veterinary team to create a schedule of routine wellness exams, screening lab work, and blood pressure monitoring to identify not only CKD but other chronic diseases.
Catch those early, and you’re likelier to make changes that benefit your pet’s health. The prognosis for CKD depends on each patient’s stage, response to treatment and stability once treatment takes place. Staying abreast of CKD ensures your pet will get the appropriate care and maintain the best quality of life in each stage of the disease.
Charlotte Animal Referral and Emergency (CARE) is open 24 hours a day for 365 days a year, operating like a medical center for people. It offers all sorts of treatment, from emergency attention to board-certified specialty work once you get a referral from your primary care veterinarian. Please take a visual tour of the practice at carecharlotte.com/tour.
