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Chronic kidney disease (CKD) is one of the more common conditions that affects dogs and one of the leading causes of death in pets. In fact, up to 10% of older dogs are diagnosed with the disease, according to Michigan State University Vet Diagnostic Lab. Our dog Brody was diagnosed with CKD, which was quite the gut punch since it is progressive and irreversible. But we pulled ourselves together and educated ourselves on what to do to prolong our good boy's life. Here are 12 questions answered about chronic kidney disease in dogs, including what to look out for, what you can do to manage it and more.
Dog kidneys function similarly to the human organ. Their main purpose is to remove waste from the blood, balance and regulate nutrients (like potassium and sodium), maintain hydration and produce urine. They also help control blood pressure, increase red blood cell production, and metabolize calcium.
In simple terms, CKD is the "wearing out" of the kidneys. It means that the kidneys are not working properly or efficiently to filter out waste from the blood. It does not mean your dog won't produce urine. In fact, quite the opposite is true - dogs with CKD produce a lot of urine, it just doesn't have the proper amount of waste that should be eliminated from the body.
CKD is also called chronic renal failure, chronic kidney failure and renal insufficiency. This may cause some confusion, as the term "failure" makes it sound acute. But the reality is that because CKD is progressive and irreversible, kidney failure is the outcome, though it won't be acute.
The specific cause for individual dogs is usually unknown, though it is associated with aging. This is because it's a slowly progressing disease with early signs often being mild and undetectable. But there are some known causes of CKD, including:
While the cause is usually unknown, there are factors that can contribute to CKD or make certain dogs more prone to it. These include:
The first most commonly detected signs of CKD are excessive thirst and urination. This occurs because the kidneys aren't filtering properly, so blood flow to the organ increases (since less toxins are being removed from the blood) in an attempt to increase filtration. This leads to higher urine production as well as higher water consumption to prevent dehydration. Overall, signs include:
As the disease progresses, symptoms may worsen and include:
CKD is diagnosed using basic lab tests to measure kidney function such as a complete urinalysis, a blood chemistry analysis, a complete blood count (for CBC) and blood electrolyte tests.
When a dog is diagnosed often relates to their size in that smaller dogs tend to show signs between 10-14 years old, and larger dogs can show signs as early as seven years old. But because early CKD is hard to detect, the disease is often diagnosed when at least two thirds of the kidneys are dysfunctional. Kidneys have a large reserve to continue performing their jobs, since the tissue can't regenerate once destroyed. This is why clinical signs don't show up until much of the organs have lost function. Unfortunately, this means dogs are usually diagnosed in stage two or beyond and kidney deterioration has been occurring for months or years.
There are four stages of CKD, with one being the least severe. Your vet will compare the lab results and blood pressure to the International Renal Interest Society (IRIS) staging system to determine the severity of CKD. The IRIS uses creatinine levels, with a sub-staging of protein levels using a urine protein to creatine ratio (UPC), to categorize the various stages of CKD:
Assessing the stage of CKD allows your vet to better tailor treatment, monitor the progression of the disease and provide an estimated prognosis.
As aforementioned, CKD is progressive and irreversible. But that doesn't mean there aren't ways to manage and treat the disease to prolong your dog's life by several months or years. Exact treatment depends on the severity of the disease and what side effects your dog is experiencing. Also, it's important to note that treatment will change as the disease progresses. Various treatments include:
The prognosis for dogs with CKD varies greatly, depending on the severity of the disease and your dog's response to treatment. But there are general estimates based on the stage:
Though CKD is progressive and irreversible, some dogs can live for several years thanks to treatment. Other dogs may only live for a few months, even with the proper treatment. It all depends on how far along the disease is and how your dog responds to treatment.
Though your dog may end up with CKD anyway, there are ways to try and prevent that from happening. These include:
1. Dental Care
Maintaining good dental hygiene for your dog is important for their long term health. This is because bacteria on your dog's teeth can enter the digestive system during eating or drinking and damage kidneys over time. A few ways to provide your dog with dental care include: