The contribution of the home veterinarian in the management of an animal suffering from chronic kidney disease
What is chronic renal failure?
Chronic kidney disease (CKD) is a common condition in dogs and cats, especially older ones. There are many causes: aging kidneys (age), kidney stones or tumors. Certain breeds of dog and cat are predisposed to this disease.
The kidneys are filtering organs that eliminate certain toxic substances from the blood, such as urea, in the urine. When the kidneys malfunction, these substances accumulate in the blood, causing a variety of symptoms.
What are the symptoms of chronic kidney disease?
- As the kidneys are dysfunctional, they can no longer concentrate urine: your companion urinates very frequently, and therefore drinks a lot to avoid dehydration.
- Urea accumulating in the bloodstream causes nausea: your dog/cat eats less and therefore loses weight.
- Similarly, increased urea in the blood irritates the digestive tract: your pet may experience vomiting and diarrhea.
- Finally, this increased urea is the source of a distinctive ammonia-like breath.
- The kidneys also produce erythropoietin (EPO), which stimulates the production of red blood cells. Over the long term, your companion may develop anemia.
How do you identify a CKD?
A simple blood test can be used to assess the level of urea and creatinine in the blood. These markers increase with CKD. They correlate directly with the degree of kidney disease and enable long-term monitoring of the disease.
CKD can also be accompanied by increased blood pressure (hypertension) and protein leakage into the urine. These parameters should be monitored during CKD.
What is the treatment?
Treatments for kidney failure in humans involve replacing the kidneys with a machine that filters the blood (dialysis) or replacing the kidneys altogether (transplantation). Unfortunately, such treatments are rare or non-existent in veterinary medicine.
On the other hand, we can slow the progression of the disease through diet, and combat the consequences of CKD: hypertension, chronic dehydration, nausea...
What does this have to do with a home vet?
Chronic kidney disease is one of those incurable diseases for which there is no hope of a cure. However, there are a number of treatments that can relieve your pet's suffering and extend its life expectancy!
Regular monitoring of blood pressure enables early management of hypertension, which itself aggravates kidney disease. Measuring blood pressure is virtually impossible in a veterinary clinic, where the animal is under great stress. It often requires hospitalization of your companion for half a day to repeat the measurements and obtain a reliable result. Otherwise, hypertension may be wrongly suspected, simply because of your pet's anxiety. When the vet comes to your home, your pet is relaxed, and the measurement reflects reality as closely as possible.
Similarly, urine monitoring is recommended to measure protein levels in the urine and check for urinary tract infections. Regular blood tests monitor kidney parameters. All these tests can be carried out "at your companion's bedside": the analyzer is placed in your home and gives a reliable result in 7 minutes, while a few milliliters of urine in a container are enough to assess the presence of bacteria (under a microscope) or proteins.
Finally, in more advanced cases, subcutaneous infusions will help your pet. Numerous publications show the benefits of administering saline under the skin, once or twice a week, to hydrate your dog or cat. This treatment plays a crucial role in extending the life expectancy of animals suffering from CKD. These infusions can be carried out directly at home, without having to make the trip to the vet.
Although there is no cure for kidney disease, there are many treatments available to extend the life expectancy of dogs and cats. A home vet allows you to continue caring for your companion in the comfort of his own home. You don't have to choose between "bothering" him (taking him to the vet) and giving him all the care he needs.
