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Health Chronic Renal Failure/Chronic Kidney Disease In Cats & Dogs

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Chronic Renal Failure/Chronic Kidney Disease In Cats & Dogs

This topic is long and covers many of the different aspects of Chronic Renal Failure aka Chronic Kidney Disease

 

Chronic Renal Failure also known as Chronic Kidney Disease is common in older Cats especially if they have been fed a steady diet of kibble most of their lives. There are many fantastic websites about the disease, it's symptoms, the tests that need to be done to confirm it, the treatment options and the diet changes you can make to have your beloved cat last longer. I am going to list my favourite websites about the disease, all of them have much information and will help you help your kitty once he or she has been diagnosed.

There are two very comprehensive websites that will give you everything you ever wanted to know about this disease, and help you through the mine field of choices available to you:

 

TANYA'S COMPREHENSIVE GUIDE TO FELINE CHRONIC KIDNEY DISEASE

 

FELINE CRF INFORMATION CENTER+

 

KIDNEY DISEASE IN DOGS  By DogAware

 

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A good article that will help you look after your kitty with CRF/CKD is here:  Kidney Disease in Cats November 18, 2010 By Jean Hofve, DVM

 

There is also this article by Dr Becker well known because of her newsletter:   Why Do So Many Domestic Cats Have Chronic Kidney Failure?

 

Another good article about Chronic Renal Failure/Chronic Kidney Disease: Assessing and Monitoring CKD  By: Dr. Lea Stogdale, DVM

 

From the University of Washington College of Veterinary Medicine:  Chronic Kidney Disease and Failure (CKD, CRF, CRD)

 

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The following articles are a little more technical but cover both dogs and cats. If you are interested in learning about the disease and how it will affect your kitty they are excellent sources of information:

Diagnostic Staging and Management of Dogs and Cats with Chronic Kidney Disease Dr Sheri J. Ross, BSc, DVM, PhD, Dipl. ACVIM (Internal Medicine)

 

One of the best resources, IF you have a moderate knowledge of medical and veterinary terminology is the  Merck Veterinary Manual.

 

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Prevalence & Symptoms Of CRF aka CKD In Dogs & Cats

 

Hill's has a few articles on their website that show the average age of onset of Chronic Kidney Disease in Dogs & Cats as well as other information:

 

 

 

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Stages In Chronic Kidney Disease In Dogs & Cats

 

There are a number of excellent articles about kidney disease in dogs and cats and I will post some of them here with their reference links.

 

The blood test results in the first article are for the USA. However I have added the results in SI (International) Units that a Veterinarian here in Canada would give Canadian pet parents (posted in blue).

Kidney Disease in Cats and Dogs


The stages of kidney disease:

Stage I: Normal BUN and Creatinine. (Creatinine < 140umol/dl)   Persistently dilute urine (Urine Specific Gravity < 1.035) on urinalysis. No clinical signs accept possibly a mild increase in drinking and urination. Because of the lack of clinical signs and blood changes, this stage of kidney disease is rarely diagnosed unless a urinalysis is examined as part of a geriatric profile or for an unrelated problem. These animals require no treatment, but should be monitored for progression of the disease. Unless clinical signs of disease progression are evident, annual testing is recommended. Medications that can potentially damage the kidneys should be avoided whenever possible. Clermont Animal Hospital, Inc.

Stage II: Creatinine 1.6-2.8 for cats (Creatinine 140umol/dl - 250umol/dl) 1.4-2.0 for dogs (Creatinine  125umol/dl - 180umol/dl)(mild elevation) . BUN normal to mildly elevated. USG < 1.035 in the presence of increased creatinine differentiates this from dehydration. Animals in this stage usually have mild signs including increased water consumption, increased urinations, lethargy, weight loss, and increased frequency of urinary tract infection. At this stage, the primary goal of treatment is to protect the kidneys from further damage and prevent the progression of the disease. Hydration can usually be maintained by insuring adequate water consumption. Monitoring tests are recommended twice a year.

Stage III: Creatinine 2.9-5.0 (Creatinine  250umol/dl- 440umol/dl) for cats , 2.1-5.0 (Creatinine  180umol/dl - 440umol/dl) for dogs (moderate elevation). BUN moderately elevated. USG<1.035. Animals in this stage usually have all of the signs noted in Stage II to a more noticeable degree. Additionally, decreased appetite, occasional vomiting, pale skin and gums due to anemia, and dehydration are often present, especially later in Stage III. The kidneys are often irregular on palpation or radiographic exam. While protecting kidneys from further damage is still important, treatment goals in this stage focus more on treating the problems that result from the kidney disease. Animal often benefit from short hospitalization for intravenous (IV) fluids. Subcutaneous fluids are often needed every one to three days during this stage to maintain hydration. Monitoring tests are recommended every three to four months.

Stage IV: Creatinine greater than 5.0.(Creatinine > 440umol/dl) Marked increase in BUN. USG<1.035. Animals in this stage have a more severe form all of the signs noted in Stage II and Stage III. Other signs that may now be observed include diarrhea, constipation, ulcers in the mouth, and neurologic signs. An abnormal breath odor is usually present due to the uremia (toxins in the blood that should be filtered by the kidneys but are not). Treatment at this stage focuses on minimizing the uremia and the problems that it causes, maintaining food intake, and maintaining hydration. Hospitalization for IV fluids is usually required initially and following any episodes of worsening. Subcutaneous fluids are almost always necessary to maintain hydration, and are usually given twice a day to every other day. Monitoring tests are recommended every one to two months.

For Testing, Monitoring and Treatment options please go to their pdf file:

http://www.clermontanimal.net/KidneyDz.pdf

 

Please NOTE: All blood test results that you receive for your dog or cat, depend on the Normal Results for the laboratory that your vet used, because every machine has slightly different normal values . So you can compare your individual results for your cat or dog against the results stated here or elsewhere on the internet, as they are Commonly Accepted wider than Normal Ranges that are considered to be correct for each test result. But please make sure that you remember that the most accurate interpretation will occur when you compare your animal's results with the normal values of the lab that tested his or her blood.

 

Also a routine Urinalysis from your pet, can help diagnose CRF/CKD. If the Specific Gravity of the Urine shows that the urine is dilute it often means the kidneys are not functioning well. The amount of Protein in the urine is always checked during a Urinalysis and if any is found, it indicates that your cat or dog's kidneys are not functioning properly.  There should never be any Protein found in a urine sample because when the kidneys are normal, all of the protein is filtered and returned to the blood circulating in the body. 

 

If you feed your dog or cat a raw food diet then please be aware that many blood test results are altered, often elevated slightly. There has been much more research done into dogs diagnosed with CKD, than into cats with CRF/CKD who are also fed a raw food diet.  However, in all the research I have read about these elevated blood test results, when both diet and a diagnosis of CKD are taken into account, in most cases the elevated BUN and Creatinine will still be within normal limits. Infrequently the BUN and Creatinine are higher than the normal range but if the Phosphorus level taken at the same time is within the normal range, there is no cause for concern.

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Stages In Chronic Kidney Disease In Dogs & Cats

 

Many websites show different Values for the different stages of Chronic Kidney Disease in Dogs & Cats. So I plan to post several different Value charts with a link to the website where I obtained the information:

 

 


Another list of the different stages and their associated Blood Test Results for Creatinine which measures how well the kidneys are functioning to remove poison from the cat's blood:

 

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Common Normal Blood Test Results For Cats With CRF/CKD

 

PLEASE NOTE: All blood test results that you receive for your dog or cat, depend on the Normal Results for the laboratory that your vet used, because every machine has slightly different normal values . So you can compare your individual results for your cat or dog against the results stated here or elsewhere on the internet, as they are Commonly Accepted wider than Normal Ranges that are considered to be correct for each test result. But please make sure that you remember that the most accurate interpretation will occur when you compare your animal's results with the normal values of the lab that tested his or her blood.


Also a routine Urinalysis from your pet, can help diagnose CRF/CKD. If the Specific Gravity of the Urine shows that the urine is dilute it often means the kidneys are not functioning well. The amount of Protein in the urine is always checked during a Urinalysis and if any is found, it indicates that your cat or dog's kidneys are not functioning properly.  There should never be any Protein found in a urine sample because when the kidneys are normal, all of the protein is filtered and returned to the blood circulating in the body.

 

 

An easy to understand explanation of the various blood tests done by all vets to diagnose and monitor Chronic Renal Failure/Chronic Kidney Disease from the   College of Veterinary Medicine at Washington State University  -  What do those Lab Tests Mean

 

 

 

Another good site with Information about Diagnostic Tests done for CRF is the Feline CRF Information Center

 

Please note the lab results on the page have US values only

 

 If you feed your dog or cat a raw food diet then please be aware that many blood test results are altered slightly. There has been much more research done into dogs on raw food diets that have been diagnosed with CKD, than into cats with CRF/CKD fed a raw food diet.  However, in all the research I have read about these elevated blood test results, when both diet and CRF/CKD are taken into account, in most cases the elevated BUN and Creatinine will still be within normal limits. Infrequently the BUN and Creatinine are higher than the normal range but if the Phosphorus level taken at the same time is within the normal range, there is no cause for concern

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Other Topics here in the forum about Chronic Kidney Disease In Cats & Dogs are here:

 

Diet In Chronic Renal Failure/Chronic Kidney Disease

 

Why Do So Many Domestic Cats Have Chronic Kidney Failure?

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