Chronic kidney disease (CKD) is a common condition that can have devastating consequences for your pet, but with early detection, appropriate management can help prolong your pet’s quantity and quality of life. Our Town & Country Animal Hospital team provides CKD information and explains why early detection is so important.
What is chronic kidney disease in pets?
CKD progressively damages your pet’s kidneys, inhibiting their ability to function. In many cases, the cause is never identified, although issues such as systemic infection, kidney stones, tick-borne illnesses, and toxin ingestion can lead to CKD. The kidneys play numerous important roles in the body, and when they can’t function properly, health complications include:
- Toxin accumulation — The kidneys are made up of nephrons (i.e., filtering units) that are responsible for removing waste products from the bloodstream. CKD damages these nephrons, toxins accumulate, and a condition called azotemia results.
- Inability to conserve water — In a dehydrated body, the kidneys concentrate urine to remove toxins using the least possible amount of water. CKD inhibits the kidneys’ ability to produce concentrated urine.
- Electrolyte imbalance — The kidneys are important for balancing electrolytes, such as sodium and potassium. CKD inhibits the kidneys’ ability to conserve potassium, leading to low levels and weakness.
- Hypertension — The kidneys are responsible for regulating blood pressure, and CKD commonly leads to high blood pressure
- Protein loss — Nephrons typically filter waste while conserving important proteins, but CKD damage leads to significant protein loss.
- Decreased red blood cell (RBC) production — The kidneys produce erythropoietin, which is a hormone that signals the bone marrow to produce RBCs. CKD reduces erythropoietin production, thereby decreasing RBC production.
- pH imbalance — CKD interferes with the kidneys’ ability to balance the body’s pH, which inhibits many important metabolic processes.
Why should I be concerned about chronic kidney disease in pets?
CKD in dogs and cats commonly decreases their quality of life, and can cause death. In older pet populations, CKD affects up to 10% of dogs and 35% of cats. While CKD is common, most pets don’t exhibit signs until their condition is advanced, which negatively impacts their prognosis.
How is chronic kidney disease diagnosed in pets?
CKD signs include lethargy, decreased appetite, weight loss, vomiting, and diarrhea, but because signs typically don’t manifest until the condition has advanced, routine wellness checks are the best way to ensure early CKD detection, when the disease is more easily managed. Adult pets should be evaluated by a veterinary professional at least once a year, and senior pets should be assessed every six months. Screening tests that help our team detect CKD include:
- Physical examination — CKD pets may have foul-smelling breath, and we may be able to appreciate abnormalities when we palpate their kidneys.
- Complete blood count (CBC) — A CBC evaluates your pet’s red blood cells (RBCs), white blood cells (WBCs), and platelets. CKD pets may have a low RBC count.
- Phosphorus — High phosphorus levels can indicate CKD.
- Creatinine — Creatinine is a chemical waste product of creatine, which is mainly used to supply energy to muscles. If levels are elevated, the kidneys may not be functioning appropriately.
- Blood urea nitrogen (BUN) — BUN is a waste product made when the liver breaks down protein. Elevated levels can mean the kidneys are not functioning appropriately.
- Symmetric dimethylarginine (SDMA) — Approximately 70% of the kidneys’ functioning ability must be lost before creatinine and BUN are elevated. SDMA is an amino acid produced when protein is broken down, and SDMA elevations occur when as little as 25% of kidney function is lost, so including this test when screening for CKD is important.
- Urinalysis — Evaluating your pet’s urine also gives our team valuable information about kidney health.
If we determine your pet has CKD, we may recommend further diagnostics, such as blood pressure measurement, urine protein-to-creatinine ratio, X-rays, and ultrasound, to further evaluate your pet’s kidney health.
What is chronic kidney disease staging in pets?
If your pet is diagnosed with CKD, we will stage the disease to determine an appropriate management strategy. Staging is based on your pet’s clinical signs and creatinine and SDMA levels.
- Stage 1 — No clinical signs are present, and SDMA levels are mildly elevated.
- Stage 2 — Clinical signs are usually mild or absent. Creatinine levels are normal or mildly elevated, and SDMA levels are mildly elevated.
- Stage 3 — Clinical signs vary in severity. Creatinine and SDMA levels are moderately elevated.
- Stage 4 — Creatinine and SDMA levels are significantly elevated, and the pet is at high risk for a CKD crisis.
How is chronic kidney disease managed in pets?
Your pet’s CKD management strategy will be based on their disease stage, but possible approaches include:
- Fluids — Intravenous or subcutaneous fluids are important to maintain blood flow to the kidneys.
- Diet — A prescription CKD diet that typically is low in phosphorus, phosphate, sodium, and protein is usually recommended.
- High blood pressure management — Hypertension can worsen CKD, and your pet may need medication to control the problem.
- Phosphate binders — If limiting dietary phosphorus does not adequately control rising phosphorus levels, phosphate binders may be necessary.
- Erythropoietin — Erythropoietin can be administered to address anemia.
Contact our American Animal Hospital Association (AAHA)-accredited team at Town & Country Animal Hospital to schedule your pet’s annual wellness exam, so we can screen them for CKD and possibly increase their quantity and quality of life.