| CANINE CHRONIC RENAL FAILURE |
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Chronic renal failure is a disorder caused
by the gradual failure of the kidneys or by the
long-term consequences of severe acute renal
failure. The kidneys have several
life-sustaining functions that include
excretion, fluid conservation, and endocrine
processes. Kidneys filter waste products from
the bloodstream so that they may be excreted
from the body in the urine. Kidneys also produce
hormones, including erythropoietin, which
stimulates the bone marrow to produce new red
blood cells.
The symptoms of chronic renal failure
usually occur only after seventy-five percent of
a dog’s total kidney mass has become
dysfunctional. The most common signs of chronic
renal failure, increased water intake and
frequent urination, are attempts by the body to
compensate for a loss of kidney function by
flushing out waste products that have
accumulated in the bloodstream.
The most common cause of chronic renal
failure is the normal aging process, in which
the dog gradually loses kidney function. Because
the disease is progressive and irreversible,
dogs with chronic renal failure have a poor
prognosis. The primary goal for treatment of
this disease is the alleviation of symptoms that
compromise an animal’s quality of life.
Depending on how quickly the disease progresses,
dogs with chronic renal failure may live
anywhere from weeks to years.
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| AFFECTED
ANIMALS |
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Chronic renal failure may affect dogs of any
breed, sex, and age. The mean age for chronic
renal failure in dogs is seven years. Hereditary
chronic renal failure is known to occur in the
following breeds: basenji, beagle, bull terrier,
Cairn terrier, chow, cocker spaniel, Doberman
pinscher, German shepherd, Lhasa apso, miniature
schnauzer, Norwegian elkhound, rottweiler,
samoyed, Chinese shar pei, Shih tzu, soft-coated
wheaten terrier, and standard poodle.
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| OVERVIEW |
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Chronic renal failure, or CRF, is a serious
disease usually seen in older dogs. The most
commonly observed signs of this disease are
polydipsia, or increased water intake, and
polyuria, or frequent urination.
Chronic renal failure usually is caused by
the normal aging process, due to the declining
function of the kidneys with time. The most
common signs of chronic renal failure, increased
water intake and frequent urination, are
attempts by the body to compensate for a loss of
kidney function by flushing out waste products
that have accumulated in the bloodstream.
Because chronic renal failure is progressive
and irreversible, prognosis for dogs with this
disease is poor. While treatment rarely improves
the renal function of dogs with chronic renal
failure, it may alleviate symptoms and make the
dog more comfortable. Dogs with this disease may
live for a period ranging from months to years.
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| CLINICAL SIGNS |
The most commonly observed signs of chronic
renal failure are polydipsia, or increased water
intake, and polyuria, or frequent urination.
Other signs may include lethargy, anorexia,
weight loss, vomiting, diarrhea,
gastrointestinal ulcerations and bad breath,
weakness, and exercise intolerance, or the
inability to exercise normally without tiring.
If present in conjunction with hypertension, or
high blood pressure, chronic renal failure may
lead to acute blindness. |
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| DIAGNOSIS |
- A veterinarian will first identify and
correct any active renal disease that may
exacerbate or mask chronic renal failure. A
diagnosis of chronic renal failure requires a
physical exam and various laboratory tests.
- A physical exam of a dog with this disease
commonly will reveal dehydration, small and
irregular kidneys, cachexia or severe weight
loss, pale mucous membranes or gingiva, oral
ulcers, and uremic breath odor.
- Laboratory tests initially may include a CBC,
or complete blood count, blood chemistry
analysis, and urinalysis. Other tests that may
be recommended in order to diagnose completely
the cause of the disease include a urine
culture, x-rays, ultrasound, blood pressure
measurement, and biopsy.
- Some of these tests may require referral to
a specialist of veterinary internal medicine.
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TRANSMISSION OR CAUSE |
Most cases of chronic renal failure are
idiopathic, or have no specific cause beyond the
normal aging process of the dog. In some cases,
the following conditions are known to cause
chronic renal failure:
- hereditary and congenital renal disease
- nephrotoxins, or kidney toxins
- hypercalcemia, or high blood calcium
- glomerulonephritis, or inflammation of
the internal structures of the kidney
- pyelonephritis, or kidney infection
- polycystic kidney disease
- nephroliths, or kidney stones
- chronic urinary obstruction
- certain medications
- lymphoma, a kind of cancer
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| TREATMENT |
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Dogs diagnosed with less severe chronic
renal failure may be treated at home with
medications and dietary changes. A veterinarian
usually will prescribe a prescription dog food,
which has lower levels of protein, phosphorous,
and sodium than regular food and hence reduces
the workload on the kidneys. Dogs with chronic
renal failure should have fresh water available
to them at all times. Medications may be
prescribed in order to control nausea,
inappetence, mineral and electrolyte imbalances,
hormonal deficiencies, and high blood pressure.
Dogs diagnosed with moderate to severe
chronic renal failure may require subcutaneous
fluid therapy, along with follow-up monitoring
by a veterinarian on a regular basis. The
frequency of these visits will depend on the
severity of the dog’s disease and its response
to treatment.
Dogs with severe chronic renal failure will
require treatment in a hospital with intravenous
fluids, nutritional support, and medications.
Laboratory values are monitored for indications
of improvement during the hospitalization.
Complications associated with chronic renal
failure include uremic stomatitis, or ulcer
formation in the mouth; gastroenteritis, or
inflammation and ulceration of the stomach and
intestines; anemia, or a lower-than-normal
number of red blood cells; urinary tract
infections; and systemic hypertension, or high
blood pressure. The combination of chronic renal
failure and hypertension may lead to acute
blindness.
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| PREVENTION |
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Dogs believed to have hereditary renal
disease should not be bred. Owners of aging dogs
should watch for signs of renal disease in their
pets and seek veterinary care early on.
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| Have daily play sessions that apply obedience skills, such as retrieving objects. |
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matters. |
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