Chronic kidney disease and failure

Image by delphine_art_photographie on Pixabay.
Image by delphine_art_photographie on Pixabay.

What is chronic kidney disease in dogs and cats?

Chronic kidney disease is kidney disease that has been present for months to years. Chronic renal disease, chronic renal failure, and chronic renal insufficiency refer to the same condition.

What are the symptoms of chronic kidney disease in pets?

Because the kidneys have so many functions, there are many signs a pet may show when they are not properly working. Chronic kidney disease is progressive, and by the time the pet shows signs, the damage is severe. Despite the chronic nature of the disease, sometimes signs appear suddenly. Common signs include:

  • drinking too much (polydipsia) and urinating large volumes of urine (polyuria)
  • incontinence (leaking urine), especially at night
  • vomiting and/or diarrhea
  • lack of appetite and weight loss
  • general depression related to the elevation of waste products in the blood
  • anemia resulting in pale gums and weakness due to a low blood count
  • overall weakness from low blood potassium

Less common signs include:

  • weakened bones can result in bone fractures
  • high blood pressure can lead to sudden blindness
  • itchy skin from calcium and phosphorous deposits
  • bleeding into the stomach or gut or bruising of skin

What causes chronic kidney disease in pets?

There are many different causes but by the time the animal shows signs of kidney disease, the cause may no longer be apparent. Some potential causes include:

  • congenital malformation of the kidneys (birth defects)
  • chronic bacterial infection of the kidneys with or without kidney stones (pyelonephritis)
  • high blood pressure (hypertension)
  • diseases associated with the immune system (glomerulonephritis, systemic lupus))
  • acute kidney disease (for example, poisoning with antifreeze that damages the kidneys can lead to chronic kidney disease)

Often the cause of chronic kidney disease is unknown.

How is chronic kidney disease diagnosed?

The signs seen in pets with chronic kidney disease may be seen with many other diseases, so blood and urine tests are needed to make a diagnosis.

Additional tests – such as radiographs, ultrasounds, kidney biopsies, and cultures – may be performed to look for an underlying cause or to “stage” the chronic kidney disease. Staging estimates the severity of the disease. Stages are numbered 1 through 4, with 1 being the least severe.

How is chronic kidney disease in pets treated?

There is no cure for chronic kidney disease, and it is usually fatal in months to years, but various treatments are available to help keep the pet comfortable and to provide a good quality of life for months to years. The severity of the pet’s signs will determine what treatments are needed. Treatments are designed to reduce the work the kidneys need to perform, to replace substances that may be too low, and to reduce wastes that accumulate.

Pets with severe signs may be hospitalized for fluid and intravenous drug treatment to reduce the amount of waste products in their body. Many pets will feel better in response to treatment with IV fluids, but if the disease is severe, the pet may not respond to treatment. Dialysis and kidney transplantation are additional treatment options.

Pets still eating and not showing severe signs are often treated conservatively, introducing treatments incrementally as new symptoms develop. The initial response to conservative therapy may be relatively slow, taking weeks to months to see improvement.

Feeding of a kidney diet is usually recommended for pets with chronic kidney disease. It is also important to make sure the animal has fresh water available, as pets with kidney disease cannot conserve water by making concentrated urine.

What should I do if my pet is showing symptoms of chronic kidney disease?

If your pet is showing symptoms of chronic kidney disease, you should immediately contact your veterinarian or the WSU Veterinary Teaching Hospital at 509-335-0711.

This information is not meant to be a substitute for veterinary care. Always follow the instructions provided by your veterinarian. Washington State University assumes no liability for injury to you or your pet incurred by following these descriptions or procedures.