Chronic Renal Failure

Understanding Your Pet's Medical Diagnosis

What is chronic renal failure?

Chronic renal (kidney) failure is the build up of toxins in the blood (uremia) caused by long-term kidney disease. Normally, the kidneys excrete these uremic toxins in the urine. When the kidneys are diseased to the extent that at least 85% of the kidney function has been lost, these uremic toxins accumulate in the blood.

What causes chronic renal failure?

Chronic renal failure has many causes including:

Inherited and congenital kidney disease
High blood calcium concentrations
Kidney infections
Kidney stones (nephroliths)
Glomerulonephritis (infection or inflammation of kidney filtering units)
Amyloidosis (accumulation of deposits in the kidney)
Polycystic kidney disease (cysts in the kidney tissue)
Chronic urinary tract blockages
Drugs or toxins that damage the kidneys
Feline infections peritonitis (FIP of cats)
Acute renal failure that results in permanent kidney damage

What are signs of chronic renal failure?

You may not notice any severe signs in your pet. You may observe increased drinking and urination (polyuria/polydipsia; often more noticeable in dogs), loss of appetite (anorexia), lack of energy (lethargy), vomiting, weight loss, passing urine at night while sleeping (nocturia), constipation, or diarrhea. Less common signs include sudden blindness (due to high blood pressure), and seizures or coma. Cats may also experience excess saliva production (due to nausea or mouth ulcers) and muscle weakness (due to low blood potassium concentration). Some cats and dogs develop bad breath due to the accumulation of urea toxins in the body.

How is chronic renal failure diagnosed?

Chronic renal failure is diagnosed by measuring the blood concentration of urea nitrogen (BUN), blood levels of creatinine, and performing a complete urinalysis. The creatinine and BUN concentrations are high in chronic renal failure and the urine is excessively dilute. Other tests are often performed on your pet to check for a cause of the renal failure and to check for complications. These tests may include a complete blood count, serum biochemistry profile, urine bacterial culture, blood pressure determinations, abdominal radiographs (X-rays) and ultrasound.

How is chronic renal failure treated?

Treatment of chronic renal failure usually includes feeding a special diet designed to counteract changes in the body resulting from the organ malfunction. Medications recommended for your pet may include phosphate binders, anti-vomiting medications (H2-receptor antagonists such as famotidine), anti-hypertension medications, home or in-hospital fluid therapy, vitamin or fatty acid supplements, replacement hormones (calcitriol or erythropoietin), and, in cats, potassium supplements. Pets with renal failure may occasionally develop a toxic crisis requiring hospitalization for intravenous fluid therapy, and administration of an intensive regimen of medications. A special diet may be prescribed.

What is the prognosis for pets with chronic renal failure?

The prognosis for pets with chronic renal failure must be evaluated on a short-term and long-term basis. The short-term prognosis varies, and depends upon how severely the kidneys are failing. Pets with severely impaired kidney function have a poor prognosis. Chronic renal failure tends to progress over months to years; therefore the long-term prognosis is guarded to poor. However, the rate of progression varies greatly from one pet to another. The rate of progression of the renal failure should be monitored by periodic re-evaluations of blood and urine samples by your veterinarian. This will provide a program to identify changes in your pet's health that may require adjustments in therapy.

Link to site for home made diets for cats and dogs.

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