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Close up of a cat drinking water.
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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.

Siamese cat drinking from a puddle on a driveway.

Antifreeze is extremely toxic to animals and can cause fatal kidney failure. Unfortunately, dogs and cats find the liquid quite tasty and will eagerly drink it up when given the chance.

What should I do if my pet ingests antifreeze?

Contact a veterinarian immediately if you see your pet drinking antifreeze or suspect it had access to antifreeze. Very small amounts of antifreeze can be fatal.

For example, a cat can ingest a fatal amount of antifreeze by simply licking its paws after walking through a puddle of the chemical. Five tablespoons are enough to kill a medium-sized dog.

If you suspect your animal has ingested antifreeze, staff at the WSU Veterinary Teaching Hospital are available for emergencies 24/7 and can be reached at 509-335-0711.

What are the signs of antifreeze poisoning in dogs and cats?

Signs of antifreeze poisoning depend upon the time after ingestion. In the first hours after ingestion, the pet may be depressed, stagger when moving, and have seizures. They may drink lots of water, urinate large amounts, and vomit.

The pet may appear to feel better only to get much worse a day or two later as its kidneys fail. Signs of kidney failure include depression and vomiting. The amount of urine they pass will often decrease to a very small amount.

How is antifreeze poisoning in pets diagnosed?

The diagnosis of antifreeze poisoning is made by blood and urine tests, although some of these tests will show negatives by the time kidney failure develops. Antifreeze poisoning should be considered in any free-roaming dog or cat with consistent signs.

How is antifreeze poisoning in pets treated?

Treatment for antifreeze poisoning needs to be started as soon after ingestion as possible to be effective. The earlier treatment is started, the greater the chance of survival. Once kidney failure develops, most animals will die.

If the pet is seen within a few hours of ingesting antifreeze, vomiting is induced to remove any antifreeze still in the stomach, and charcoal is placed in the stomach to bind antifreeze in the intestine. Antifreeze itself is not very toxic but it is broken down by the liver to other components that cause the damage. If the pet is presented to a veterinarian soon after drinking antifreeze, a drug is given that impairs the liver from converting antifreeze to these toxic products, allowing the unconverted antifreeze to pass in the urine. These drugs are useful only when given early and are not effective after the pet is showing signs of kidney damage.

Animals that present to a veterinarian in kidney failure due to antifreeze poisoning can occasionally be saved with aggressive treatment. Some specialty veterinary practices offer dialysis that can be used to eliminate waste products not being removed by the diseased kidneys to keep the pet alive and give the kidneys a chance to repair. Whether the kidneys will repair themselves or not depends on how severely they are injured. Unfortunately, kidney damage caused by antifreeze is usually severe and irreversible. Kidney transplantation has been performed in dogs and cats.

How can I prevent antifreeze poisoning?

There are several steps you can take to protect your pets from being poisoned by antifreeze.

  • Keep new and used antifreeze in a sealed, leak-proof container
  • Take used antifreeze to a service station for disposal – don’t pour it on the ground
  • Check driveways for puddles of antifreeze that may have leaked from the car
  • Consider the use of alternative antifreeze products that are less toxic to pets
  • If antifreeze is placed in toilets make sure the lid is down and the door to the room is closed

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 proc

Blue green algae never the shore.
Photo credit

As temperatures climb during the summer months, conditions can become ripe in waterways to produce toxic blue-green algae – or cyanobacterial – blooms that can be deadly to pets, with animals often dying within 15-20 minutes after exposure.

Animals can be exposed to blue-green algae and its toxins by simply contacting any affected water body, including ponds, lakes, streams, rivers, or even residential decorative ponds and neglected swimming pools.

What are blue-green algae?

Cyanobacteria, also referred to as blue-green algae, are microscopic organisms that live in fresh bodies of water that usually multiply and bloom when water is warm, stagnant, and rich in nutrients like phosphorus and nitrogen from sources such as fertilizer runoff.

The toxins that cyanobacteria produce come in four types and can be very deadly. The toxins can specifically affect the liver, the kidneys and liver together, the nervous system, or the skin.

How do I know if water is contaminated with blue-green algae?

It is impossible to tell whether a given body of water has a toxic bloom currently without sophisticated testing. During warmer months, it is best to assume all surface waters are potentially contaminated.

Sometimes, blooms will present as thick, gooey, green slime on and in surface waters and eddies of running waters. Blooms can also be red or brown.

Often, concentrations will occur in just one part of a waterway.

Dead fish, waterfowl, or other animals around a water source may indicate the presence of blue-green algae.

What are the symptoms for an animal exposed to blue-green algae?

Signs of poisoning usually occur within 15-20 minutes after ingestion. Symptoms can include:

  • Skin rashes
  • Vomiting
  • Diarrhea
  • Blood in stool or black, tarry stool
  • Weakness
  • Pale mucous membranes
  • Jaundice
  • Seizures
  • Disorientation
  • Coma
  • Shock
  • Difficulty breathing

What should I do if I think my pet may have been exposed?

Immediately contact your vet or the WSU Veterinary Teaching Hospital at 509-335-0711.

The time from exposure to death can be mere minutes to hours without aggressive and experienced veterinary intervention.

How can I protect my pet from blue-green algae?

To reduce the chance of your pet being exposed to blue-green algae:

  • A good rule of thumb for you and your pet is: When in Doubt, Stay Out!
  • Don’t let animals swim or drink where there is noticeable algae in the water or scum on the shore.
  • If pets swam in water that could have harmful algae, rinse them off with fresh water immediately. Don’t let them lick their fur.
  • If your pet experiences any symptoms after exposure to algae, contact your veterinarian immediately.

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.

Australian Shepherd

What is multidrug sensitivity?

Some dogs and cats have a mutation in the MDR1 (multidrug resistance 1) gene also known as the ABCB1 gene, which plays an important role in limiting drug distribution to the brain and in enhancing the excretion of many drugs. Animals with the mutation may have severe adverse reactions – including tremors, disorientation, blindness, lack of muscle control, and death – to some common drugs.

How common is the MDR1 mutation?

It can occur in up to 75% of some dog breeds and it affects 4% of all cats. Herding breeds, like collies and Australian shepherds, and long-haired whippets, have the highest occurrences. It is also found in Shetland sheepdogs (shelties), old English sheepdogs, English shepherds, German shepherds, silken windhounds, and a variety of mixed breeds.

Which drugs should I be concerned about?

Many different drugs and drug classes have been reported to cause problems in dogs with the MDR1 mutation. Drugs that have been documented to cause reactions include:

  • Ivermectin (antiparasitic agent) While the dose of ivermectin used to prevent heartworm infection is safe in dogs with the mutation (6 micrograms per kilogram), higher doses, such as those used for treating mange (300-600 micrograms per kilogram), will cause neurological toxicity in dogs that are homozygous for the MDR1 mutation (MDR1 mutant/mutant) and can cause toxicity in dogs that are heterozygous for the mutation (MDR1 mutant/normal).
  • Eprinomectin (antiparasitic agent) Cats with the MDR1 mutation have experienced severe neurological toxicity and death after being treated with a monthly heartworm preventive containing eprinomectin. In contrast to dogs, these adverse effects occurred when the product was used at the manufacturer’s recommended label dose.
  • Selamectin, milbemycin, and moxidectin (antaparasitic agents) Similar to ivermectin, these drugs are safe in dogs with the mutation if used for heartworm prevention at the manufacturer’s recommended dose. Higher doses (generally 10-20 times higher than the heartworm prevention dose) have been documented to cause neurological toxicity in dogs with the MDR1 mutation.
  • Loperamide (ImodiumTM; antidiarrheal agent) At doses used to treat diarrhea, this drug will cause neurological toxicity in dogs with the MDR1 mutation. This drug should be avoided in all dogs with the MDR1 mutation.
  • Acepromazine (tranquilizer and pre-anesthetic agent) Dose reductions are required for dogs MDR1 mutant/mutant and MDR1 mutant/normal.
  • Butorphanol (analgesic and pre-anesthetic agent) Dose reduction required for dogs MDR1 mutant/mutant and MDR1 mutant/normal.
  • Chemotherapy agents (Vincristine, Vinblastine, Doxorubicin, Paclitaxel) Dose reductions are required for dogs MDR1 mutant/mutant and MDR1 mutant/normal to avoid severe toxicity.
  • Apomorphine This drug is used to induce vomiting in dogs that have ingested poisons/toxins. It can cause central nervous system depression in dogs with the MDR1 mutation at standard doses.

How do I find out if my animal has the MDR1 mutation?

Our team at WSU has developed a test that can tell you if your pet has the MDR1 gene mutation. Order a testing kit by contacting the WSU Program in Individualized Medicine by email at or by calling 509-335-3745. Order a test online.

Why should I get my test from WSU?

WSU researchers made the initial discoveries of both the canine and feline MDR1 mutations and were the first to develop diagnostic tests to determine an individual animal’s MDR1 genotype. Scientists at WSU continue to conduct research to identify problem drugs.

WSU holds the patent and is the only organization licensed to perform stand-alone MDR1 genotyping in the United States.

Washington State University holds the U.S. Patent (US 6,790,621 B2) for the MDR1 genetic test.