Renal failure in a dog: symptoms, stages, treatment and prognosis. Renal failure in dogs Treatment of CKD in dogs

The kidneys in the body are the most important system for clearing toxins and other harmful substances. That is why any “malfunction” of this organ greatly affects the health of the dog.

Since pathological processes in the kidneys develop very slowly, the owner of the animal most often notices the presence of problems in his pet rather late. In order to stop the disease in the early stages and have time to help the dog stay healthy, you need to be attentive to any, even very insignificant “bells”, signaling that something is wrong with your pet.

We will tell you about the manifestations of such a difficult disease as kidney failure in dogs, about its diagnosis and treatment tactics.

Causes and stages of the disease

As we have already said, the kidneys are a powerful body filter that purifies the blood of various harmful substances. Naturally, this does not pass without a trace for them, and the cells of the kidney tissue begin to gradually die off. The remaining cells take over the work of the dead cells and continue to work in an enhanced mode, so initially this does not affect the dog's health in any way.

Most often, renal failure begins to manifest itself in an animal in old age, because the process of cell destruction is not fast.

The first signs of the disease appear when the dog has already affected more than half of the kidney tissue. At first glance, it seems that with such a development of events, the animal has little chance of life, but this is not true, because if the treatment of the disease is started at this stage, then your pet will be with you for a long time.

There are two forms of the course of the disease:

1. Acute renal failure in dogs develops quickly and has all the symptoms inherent in this disease, but is less common than the chronic form.
2. Chronic renal failure (CRF) is the most common variant of the pathology and develops over a long period of time.

Depending on how severely the kidney cells are affected, there are several stages of the disease:

1. The initial stage is less than 50% of dead cells.
2. Clinical stage - about 50% of kidney damage.
3. The final stage - more than 70% of dead kidney tissue.

Everyone understands that it is easiest and most effective to treat kidney failure at the initial stage, but for this you need to catch the first symptoms and immediately go to the veterinarian.

Signs of the disease

Some of the symptoms that indicate the development of a dog in kidney failure may be similar to other diseases. These include:

• lethargy, apathy;
• lack of appetite.

But there are other signs that specifically point to kidney failure:

• strong thirst;
• frequent urination;
• the smell of acetone from the mouth.

Moreover, the combination of two symptoms - thirst and frequent urination - are the most characteristic of this disease.

Acute renal failure may have the following manifestations:

• vomit;
• diarrhea;
• change in the color of the mucous membranes;
• swelling.

In the final stage, when the body is severely poisoned by harmful substances, the characteristic symptoms of intoxication appear:

• ulceration of the mucous membrane;
• shiver;
• convulsions.

If you observe similar symptoms in your pet, we recommend that you immediately contact your veterinarian to examine the dog and find out the reasons for this condition. Early diagnosis of kidney failure is the key to successful treatment and prolonging the life of a pet.

Diagnostics

As we have already noted, the primary stage of the disease does not have pronounced symptoms, and it is difficult to determine it with the help of laboratory tests, since the kidneys are still doing their job well, despite the changes that have begun in them.

At the onset of the clinical stage, a blood test for urea and creatinine reveals an increase in these indicators, and this is what makes it possible to understand that the dog has diseased kidneys.

If you have even a slight suspicion that your pet has kidney problems, then it is necessary to periodically take tests to determine the level of urea and creatinine and, when they approach the upper limit of the norm, discuss with the veterinarian the question of further actions.

Treatment of the disease

Treatment of a disease such as renal failure in dogs is carried out in almost the same way in all cases.

Firstly, to remove the intoxication of the body, infusion therapy is prescribed, that is, the introduction of solutions that cleanse the body of toxins. In addition to cleansing, the restoration of lost fluid is achieved, and the dog ceases to feel constant thirst, and the load on the kidneys, which work in an enhanced mode, also decreases.

The schedule for such infusions will depend on the degree of the disease directly, i. the more severe the case, the more often the solution will need to be injected. For example, in the final stage, the dog has to be given drips or intravenous injections several times a day, and in the initial stage, subcutaneous injections every few days can be dispensed with.

As an adjunct treatment, infusion therapy can be supplemented with any medications.

And another very important factor in the treatment of kidney failure is the diet that the dog will follow for the rest of his life.

Diet for dogs with kidney problems

Nowadays, almost every food line has a specialized food for dogs with diseased kidneys. Therefore, you can easily choose the right and well-balanced dietary food for your pet.

But if your dog is used to eating natural foods, then when feeding, remember the recommendations that will help the dog stay healthy and stop the progression of kidney failure:

1. Fat provides the dog with the energy it needs to live and is fairly easy to digest in the body, but it should not be too much in the dog's diet. For a dog suffering from chronic renal failure, it will be useful to add eggs, meat with fat and butter to food, but sunflower oil and fish oil can only do harm.
2. As a source of protein, you can use egg white, but not more than one piece per day, you can also offer the dog raw chicken, rabbit meat and offal. The amount of protein consumed by a dog depends on the degree of CRF: the higher the degree, the less protein the dog is supposed to.
3. Do not give meat bones, cheese and fish with bones, as they contain a lot of phosphorus, which is dangerous for dogs with diseased kidneys.
4. You need to try to reduce the amount of carbohydrates consumed as much as possible, i. no oatmeal with milk, cookies, buns, etc. Carbohydrates in the diet of a sick dog should be complex and low in phosphorus, and rice has such properties.
5. Another important factor that guarantees the well-being of the dog is the restriction of salt in his diet, which must be eliminated. It should be borne in mind that it is also present in finished products, for example, cottage cheese, canned food, etc.
6. The dog should always have fresh drinking water in the free access zone.
7. Since the appetite of a sick dog may not be very good, you need to offer the dog the food that he likes best.

Dieting is not only a treatment, but also a prevention of kidney problems. If your pet is still diagnosed with kidney failure, then do not be upset, since the prognosis for dogs with this disease, detected in the early stages, is very good. With proper nutrition, treatment and care, your dog will have a long life ahead.

We hope that our article will become for you only a source of information and you will not have to apply its recommendations in real life!

MAIN PROVISIONS

• Chronic renal failure (CRF) is the most commonly diagnosed kidney disease in dogs.
• Clinical signs of the disease appear only after at least 67% of the renal parenchyma ceases to function.
• Diagnosis of early stages of impaired renal function allows timely use of protection techniques, incl. transfer the animal to a special diet and prescribe appropriate drug therapy in order to slow down the development of further lesions of these organs, speed up recovery and improve the quality of life of the animal.
• The plasma clearance test for exogenous creatinine can be used in routine veterinary practice.

Chronic renal failure (CRF) is the most commonly diagnosed kidney disease in dogs. It develops as a result of the progressive and irreversible loss of functioning nephrons. Clinical signs of renal failure begin to appear when 67-75% of the renal parenchyma ceases to function. Polyuria and polydipsia are usually the first signs of kidney disease, but they are often overlooked for a long time. It is generally accepted that a decrease in the specific gravity of urine and azotemia (i.e., the excess of the concentration of creatinine and / or urea of ​​the permissible norm) occurs only after the failure of at least 67% and 75% of the renal parenchyma, respectively (Fig. 1). Therefore, CKD is usually diagnosed at a relatively late stage of kidney disease. Over the past 20 years, significant progress has been made in diet therapy and drug treatment of chronic renal failure, but the problem of its early diagnosis is still relevant. Establishing a violation of kidney function at the very beginning of the disease makes it possible to use means to protect these organs from further damage, incl. prescribe a special diet or drug therapy. This will slow down the development of kidney disease, shorten the recovery period and improve the quality of life of sick animals. This publication describes a number of strategic approaches to the detection of renal impairment in dogs with subclinical CKD.

Figure 1. The consequences of kidney disease and the development of uremic syndrome with it.

Informing and educating pet owners, identifying risk factors

CRF is frequently reported in dogs. Therefore, every dog ​​owner should be informed about chronic renal failure, its prevention, manifestations of diagnostic significance, as well as factors contributing to the development of this pathology. Particular attention should be paid to dog breeds that show a predisposition to kidney disease. It is important to reassure breeders that kidney problems can occur even in clinically healthy dogs. Owners should be advised to monitor their pets on a regular basis so that they can judge whether the disease is progressing or not and seek timely help from specialists for further examinations. Well-informed breeders can provide very important information about the water and food intake of their pets, as well as changes in animal body weight.

Risk factors associated with the development of CKD in dogs are poorly understood, but apparently this pathology is most often manifested in adult animals of this species: 45% of dogs with CKD are over 10 years old. This does not mean that any adult dog can get sick, but suggests the need to determine the concentration of creatinine in the blood plasma and specific gravity of urine (URG) in animals as the most important indicators of the health of aging animals. Hereditary nephropathies have been reported in some dog breeds (Table 1), although their incidence remains unknown. These hereditary diseases can develop in puppies, young, adult and aging dogs. If it is suspected that dogs of these breeds have impaired renal function, it is necessary to collect anamnestic data on whether such a disease has occurred in animals of this line (in parents, littermates, other relatives). CRF can be caused by various causes, and the establishment of any of these etiological factors (for example, according to anamnestic data that the animal had had piroplasmosis, hypertension, etc. in the past) (Fig. 2) should serve as a reason for kidney studies.

Figure 2. Causes of Acquired Chronic Renal Failure

Regular assessment of animal water intake, diuresis, appetite and body weight

Polyuria and polydipsia resulting from loss of the ability to concentrate urine are not specific to CKD but are considered early clinical manifestations. It can be difficult for owners to determine how much urine their dogs produce. To accurately determine this indicator, the animal is hospitalized and placed in a metabolic chamber for a day (usually this is used for experimental purposes, and not for routine diagnostic examinations). Before being placed in the chamber and before being released from it, the animal is made to perform the act of urination. An adult dog excretes urine in the amount of approximately 20-40 ml/kg of body weight during the day (in puppies this figure is higher).

Assessing a dog's water intake is much easier, especially when the animal's access to water is controlled. Owners of dogs at high risk for CRF are advised to conduct an annual control determination of their pets' water intake. This indicator is considered normal if it does not exceed 100 ml / kg of body weight. The volume of water drunk daily by animals is variable, as it depends on a number of factors, incl. physical activity, air temperature, type of diet, etc. Therefore, the measurement of the amount of water consumed by the dog is carried out for 3-4 days in a row. To avoid subjectivity in determining this indicator, the dog owner needs to weigh a bowl of water 2 times a day (with an interval of 24 hours).

Some decrease in appetite and body weight, although not specific to CRF, often accompanies this pathology. Daily feed intake is estimated by weighing it at each giving to the animal. When changing diets, an animal's appetite may change depending on how attractive the new food is to them. Weighing animals is less subjective, but should be done regularly and on the same scales.

Indirect assessment of kidney function based on the results of repeated studies of blood plasma and urine

This article discusses the possibility of diagnosing CRF only in those animals in which this pathology is asymptomatic or manifests itself with mild clinical signs. The best markers of kidney function in this situation are creatinine and urine specific gravity.

Plasma creatinine concentration

Creatinine is constantly produced in the muscles as a result of creatine metabolism. It is excreted from the body only in the urine, being completely filtered in the kidneys through the glomeruli and only slightly secreted in the renal tubules. Plasma creatinine concentration is considered the best indirect indicator of kidney function, although many factors influence the accuracy of its determination.

In this regard, it is impossible to discount the influence of various factors acting before taking the analysis and during its implementation. Blood samples for its implementation should be taken from animals on an empty stomach (a 12-hour overnight fast is enough). Most foods contain some creatinine, so after taking them, dogs can experience an increase in its blood concentration above the acceptable level, which causes non-specific test readings. Physical activity does not lead to a significant change in the concentration of creatinine in the blood plasma in dogs. Plasma creatinine concentration is better determined by the enzymatic method, and not by the Jaffe method, since the indications of the latter are influenced by an increased (> 50 μmol / l) concentration of bilirubin in the blood.

Figure 3. Dependence of plasma creatinine concentration and glomerular filtration rate (GFR) is graphically expressed by a curved line. This indicates an early stage of renal dysfunction, manifested by a decrease in GFR and a corresponding slight change in plasma creatinine concentration. In contrast, dogs with severe renal insufficiency show significant fluctuations in plasma creatinine levels, with relatively limited fluctuations in GFR.

It is believed that an increase in the concentration of creatinine in the blood plasma indicates a decrease in the functional state of the kidneys. The dependence of this indicator and GFR is graphically depicted by a curve (Fig. 3). Meanwhile, the concentration of creatinine in blood plasma depends on a combination of factors such as the formation, distribution and excretion of creatinine from the body. This means that this indicator can be increased in dogs with developed muscles or suffering from dehydration. In animals with renal insufficiency, endogenous creatinine production is reduced (2). As a consequence, elevated plasma creatinine does not necessarily correlate with GFR, as creatinine production can also be reduced as a result of decreased muscle mass. Dehydration can lead to a decrease in the volume of distribution of creatinine, which depends on the total body water supply. However, dehydration usually occurs only in the later stages of CKD.

A once determined concentration of creatinine in the patient's blood plasma is usually compared with the maximum allowable value of this indicator. If the concentration of creatinine in the blood of the animal is higher than the latter, then the presence of kidney pathology is assumed, and if it is below the permissible level, then the animal is considered healthy. But in some situations this approach is wrong. Literature data on the permissible value of such an indicator are very variable (Fig. 4), which is partly due to the characteristics of the populations of dogs in which blood testing was performed, its dependence on age, breed, and a number of other factors. In dogs of different breeds and animals of different ages, the normal concentration of creatinine in the blood is not the same. For example, it is higher in adult dogs compared to puppies, as well as in breeds of dogs with more developed muscles. Therefore, one should be very careful in interpreting a slight excess of this indicator of the norm. Impaired renal function can also occur in cases where the concentration of creatinine in the blood plasma remains within the normal range.

Figure 4. Various allowable values ​​for canine plasma creatinine levels (according to veterinary guidelines or from Reflotron, Kodak and Vettest analyzers). There are significant discrepancies between data obtained from different sources, which may be due to differences in control samples or methods of analysis

Nevertheless, even the results of a single determination of the concentration of creatinine in blood plasma provides valuable diagnostic information, on the basis of which the International Renal Interest Society has recently proposed a classification of stages of CRF in dogs and cats, based on the value this indicator (table 2).

Significantly more accurate readings are obtained by serially determining the concentration of creatinine in the blood plasma in a dog for some time (for example, one year). At the same time, it is important to standardize the conditions for testing in order to to avoid the influence of factors that complicate the interpretation of the results. So, for example, blood should be taken from the dog on an empty stomach each time, the same testing method should be used, and the body condition of the animal should not change throughout the entire study period. Blood plasma samples are stored until the study is frozen (at a stable temperature not exceeding -20°C). When it is time to study the next blood plasma sample, the one taken the previous time is thawed and examined simultaneously with the last one. This establishes a "critical change" in the measurable index, which is the minimum difference between two consecutive levels of plasma creatinine concentration and reflects biologically significant changes in kidney function in healthy dogs. dl).

When a dog suddenly develops significant changes in the concentration of creatinine in the blood plasma, their relationship with the state of health of the animal is checked by a repeated study, which makes it possible to exclude diagnostic errors (Fig. 5).

Figure 5. Variation in plasma creatinine due to analytical errors. From the blood plasma samples of the dogs, they were blinded twice in the same laboratory. Very large discrepancies in the results of testing one sample were obtained - 0.7 (62 µmol/l) and 2.1 mg/dl (186 µmol/l). These observations indicate the need to re-examine serum samples in cases of unexpectedly high or low readings compared to previous plasma results from the same animal.

Specific Gravity of Urine (SPM)

TPM is the ratio of the mass of a certain volume of urine to the mass of the same volume of pure water at the same temperature. UPM is determined using a refractometer. Changes can occur already at the initial stage of renal failure. However, TMR - highly variable even in healthy dogs - can change with the animal's water intake and diet. The TFR also varies from day to day, from one sample to another. When the body is normally hydrated, the BMR usually ranges from 1.015 to 1.045, but can decrease to 1.001 or increase to 1.075. If the TMR rises above 1.030, the dog begins active resorption of water from the renal tubules and collecting ducts of the kidneys. With a decrease in the UPM below 1.008, the animal begins the resorption of salts from the filtrate located in the renal tubules. In both cases, the kidneys compensate for these changes. When determining the RPM, the degree of hydration of the animal's body is taken into account: too low RPM (<1,030) на фоне обезвоживания организма указывает на первичную дисфункцию почек или другие причины, повлекшие за собой снижение концентрирования мочи. Однако возможна и такая ситуация, когда при обезвоживании организма у собаки с субклиническим нарушением функции почек УПМ оказывается выше 1.030. Из-за вариабельности УПМ однократно выявленные изменения этого показателя не обязательно указывают на полиурию, но критериями последней служит персистентное значение УПМ в пределах от 1,008 до 1,029. Сопутствующая азотемия дает больше оснований подозревать наличие заболевания почек, но не позволяет поставить окончательный диагноз.

Other indicators

Plasma urea (or "blood urea nitrogen") concentration is also important in the diagnosis of clinical CKD. A number of researchers believe that this indicator correlates better with the clinical signs of the latter than the concentration of creatinine in blood plasma. However, plasma creatinine seems to be a better reflection of GFR decline than blood urea, due to the presence of many extrarenal factors that can affect the value of the latter indicator. These factors include feeding and starvation, metabolic activity of the liver, dehydration, etc. Therefore, the concentration of creatinine in the blood plasma is more important for diagnosing the early stage of impaired renal function and the latter in subclinical cases.

Electrolyte disturbances (hyperphosphatemia, hypokalemia, hypocalcemia) are noted during a period of significant impairment of kidney function, but they are absent in the early subclinical stages.

Proteinuria can develop at any stage of CRF. and its intensity is largely determined by the etiology of the disease. When proteinuria is detected, additional studies are necessary to establish the cause of the disease. However, in many animals with CRF, proteinuria is mild.

Testing the ability of the kidneys to concentrate urine

With chronic renal failure, the ability of the kidneys to concentrate urine decreases, but other factors also influence the value of the ULR, incl. treatment with diuretics and glucocorticoids, glucosuria, diabetes insipidus, imbalance of basic electrolytes. The test, based on the restriction of the dog in water, allows you to evaluate the concentrating activity of the kidneys in polyuria or polydipsia without determining their causes. It should not be used to examine dogs suffering from dehydration and/or azotemia, as its administration in such cases is associated with the risk of harm to the health of animals and since dehydration in patients with low TLR is itself evidence of the loss of the ability of the kidneys to concentrate urine. This test can be carried out in two versions (table 4). However, its sensitivity in the diagnosis of early stage CKD has not been documented.

Direct method for determining GFR

GFR is currently considered the best direct indicator of kidney function. Over the past 30 years, many new methods for determining this indicator have been proposed and tested, based on determining the clearance of certain markers in urine and blood plasma from the corresponding marker.

Urine and plasma clearance, application restrictions

Determination of inulin clearance in urine is considered a reference method for assessing GFR. The calculation is simple, and for its implementation it is necessary to know only three indicators: the volume of urine excreted by the animals for a certain period, as well as the concentration of the marker in the urine and blood plasma. Despite providing valuable diagnostic information, urine clearance tests are rarely used in veterinary practice, because they are time consuming and labor intensive. In addition, it is necessary to collect urine at a certain time, and in the process of frequent catheterization, the risk of injury and infection of the urinary tract of animals increases. While the dog is in the metabolic chamber, urine collection can be limited to 24 hours, but there is a need for repeated washings of the chamber to maximize the collection of the marker, the remains of which in subsequent tests can cause an incorrect determination of clearance.

For these reasons, tests designed to determine plasma clearance (especially those involving a single intravenous administration of a marker) are considered an alternative to appropriate urinalysis in cases where urinary excretion of the marker is negligible. The main advantage of the test, which determines GFR by its clearance from blood plasma after a single intravenous injection of a marker, is that only one blood sample is required to obtain a result. Radiopaque agents (eg, iohexol and iothalamate), inulin, various radioactively labeled substrates, and creatinine are used as markers. These tests have a number of limitations. For example, radioactively labeled nucleotides cannot be used in routine diagnostic practice due to safety and legal restrictions. Detection of most of the available markers is difficult, costly, or simply out of the reach of the conventional veterinary practice. The iohexol test requires a rather large volume of blood plasma (3-4 ml, i.e. approximately 8 ml of blood), which is too much for small breed dogs. This marker is detected by a specific fluorescent glow in x-rays. Finally, when determining plasma clearance, which is the ratio of the dose of the marker administered to the animal and the area under the curve of its plasma concentration (AUC) over time, complex calculations are required (data modeling using exponential equations), which discourages veterinary practitioners from its application.

Plasma clearance test for exogenous creatinine (ECPEC)

TCPEC was developed recently and tested on dogs in comparison with known methods for assessing GFR (tests to determine the clearance of inulin and endogenous creatinine in the urine, blood plasma from iothalamate). Plasma and urine clearance from creatinine is consistent with GFR in dogs. With its help, it is possible to diagnose subclinical kidney dysfunction in this animal species. The main advantage of TCPEC is the ability to determine the baseline plasma creatinine concentration, which provides a direct estimate of GFR, regardless of the volume of distribution and endogenous production of creatinine.

The main stages of the TCPEC

> Determination of fasting baseline (initial) plasma creatinine concentration before the test.
> Intravenous administration of a certain amount of creatinine.
> Determination of plasma creatinine concentration.

Calculation of blood plasma clearance.

The main advantages of TKPEC:

> The test can be performed in normal veterinary practice because it is simple, easy to perform (intravenous marker injection and blood sampling) and time-consuming.
> Only 1 ml of blood is needed to obtain a result, which makes it possible, if necessary, to re-sample blood from small breed dogs or puppies, and, in addition, limits the number of manipulations performed on the animal.
> Creatinine is safe: an increase in the plasma concentration of creatinine in CRF dogs after intravenous administration to 8000 µmol/l (90 mg/dl) does not lead to undesirable side effects.
> There is no need to resort to the services of specialized laboratories, because Plasma creatinine concentration can be quickly determined using a conventional veterinary chemistry analyzer.
> The results of the test are received immediately after it is set.
> Determination of creatinine clearance does not require complicated calculations
> TCPEC does not require large financial outlays.

There are no commercial preparations of creatinine - they have to be prepared independently, although preparations are underway for the production of this reagent.
- The last blood sample must be taken from dogs for examination no later than 6 hours after administration of creatinine. Therefore, the dog has to be hospitalized for the whole day during the test.
- Limits of normal GFR values ​​for dogs have not been definitively defined. Currently, the maximum allowable value of this indicator is 1.5 ml / kg / min, but the results of further studies may make their own adjustments.

Conclusion

The fight against CRF is one of the main problems in ensuring the health of small domestic animals. Currently, its early diagnosis is difficult, because in the initial stages of chronic renal failure is asymptomatic. However, a number of useful actions can be taken in this direction: informing pet owners about this pathology, regular examination of their pets, including determining changes in TLR and plasma creatinine concentration in their blood over time, and assessing GFR (if available in this need). The main hope is that early diagnosis of CRF will help to start treating a sick animal in a timely manner and transfer it to a special diet, which will both prolong the patient's life and improve its quality.

Herve P. Lefebvre
Herve P. Lefebvre, DVM, PhD, Dipl ECVPT, Professor of Physiology
Jean-Pierre Bron
Jean-Pierre Braun, DVM, PhD, Dipl ECVCP, Professor of Biochemistry, Physiology and Therapy, Department of Pathophysiology and Experimental Toxicology, National Veterinary School in Toulouse, France
A. David J. Watson
A. David J. Watson, BVSc, PhD, FRCVS, FAAVPT, MACVSc, Dipl ECVPT,
Associate Professor of Veterinary Medicine, Department of Veterinary Sciences, University of Sydney, Australia

Kidney failure, which our most beloved dogs often fall ill with, is considered the most dangerous, severe kidney disease, manifested by impaired filtration (the main function of the kidneys). In other words, taking into account various reasons, the kidneys are not able to remove toxic substances that are dangerous for its body from the blood of an animal, which are formed during the life process of the body. Immediately after the kidneys cease to function normally, poisoning is observed in dogs.

kidney failure- one of the most dangerous diseases, often leading to the death of pets. This problem has recently gained such an extensive turn that veterinarians are interested in it closely.

I would like to immediately emphasize that such a disease as kidney failure does not exist in general either in animals or in humans: it is a series of external manifestations of a number of kidney diseases. Kidney failure, like in humans, in dogs is caused by various reasons, but the general symptomatology still exists - the kidneys work very poorly, and ultimately, if they are not treated, they fail, the dog dies.

Causes of the disease

Cause of kidney failure:

• An infection that has entered the body of a dog from the outside.
• Toxic substances from the environment.
• Injury and disease once suffered by a dog.
• Bad foods high in salt.
• Age changes.
• genetic propensity.

Symptoms of kidney failure

For dogs, kidney failure is quite serious illness accompanied by intense thirst. Consider the fact that a healthy dog ​​(per kilogram of weight) consumes up to fifty milliliters of water per day. A sick dog consumes 2 times more liquid. Also, the dog's body suffers from dehydration, a sharp decrease in temperature, an oppressed general condition of the animal's body is observed, an unpleasant, sour smell often comes from the mouth, the dog often swears and vomits. Vomiting does not immediately manifest itself: at first, the animal begins to eat little, then it eats food reluctantly and intermittently, and then stops eating altogether, because vomiting is observed after each meal. Also, the dog may have frequent urination or vice versa, with a long delay.

If a dog's kidney failure has passed into an acute stage, the animal generally ceases to show any signs of activity: it does not play, does not jump, but only eats a little and sleeps a lot.

The diagnosis of "renal failure" is made by the veterinarian only after he has carried out all the necessary studies. Having received the results of the tests and all the data on how the animal feels, the doctor prescribes the appropriate treatment. Urinalysis is very important in this aspect. The urine of a dog with kidney failure contains a nitrogen-containing carboxylic acid (creatine) and phosphorus. Poor dog urine test - significant protein content, excess glucose. In addition to urine analysis, the veterinarian may additionally prescribe an ultrasound, x-ray and biopsy.

Stages of disease development

Kidney failure in a dog does not just happen. It is a consequence of the above reasons and is divided into stages, each of which is too significant not to pay attention to it.

There are two common stages of kidney failure, and both are very dangerous: acute stage: toxic effects on the body of too toxic substances used by the dog; shock, taking poisonous, chemical drugs in the treatment of other diseases of the animal. The acute stage of kidney failure in dogs is not as dangerous as chronic, after all, it is possible to completely cure the dog in the acute stage, while in the chronic form, the disease "renal failure" is no longer curable.

The acute form of renal failure is divided by veterinarians into the following stages:

• The stage of compensation, which takes up to ninety percent of the time of development of this disease. At this stage, the dog does not manifest itself in any way, as usual, frolics, sleeps and eats well. But ... if an observant owner smelled the unpleasant smell of urine, noticed, if the opportunity presented itself, an unusual consistency and color of urine, passed it for analysis to a veterinary clinic, the doctor will very quickly identify the disease.
• The disease has not yet manifested. Significant morphological and functional disorders gradually increase in the tissues of the kidney, although one should not be afraid of a sad outcome. Having passed the dog's urine for analysis to a veterinary clinic, you can find out that the dog has kidney failure, but without a biochemical analysis of the animal's blood, the veterinarian will not be able to tell the owner about the stage. An additional diagnostic ultrasound examination by a highly qualified veterinarian will not be superfluous.
• Decompensation. The dog is in a very bad condition, and the owner himself notices this. The dog is still drinking and eating, but is less active and joyful than before. Urinalysis is mandatory.
• Terminal (most dangerous) stage. The kidneys are failing, and the day is not far off when it is already possible to say goodbye to the dog, as it is overcome by a renal coma.

I would like to note that a veterinarian can make a diagnosis of "acute renal failure" without problems if modern advanced diagnostic equipment is installed in his clinic. If you love your pet, never think about money and time while watching your pet friend misbehave for a couple of days. Take him to the veterinarian and make timely diagnostics and tests to save his life.

Treatment of the disease

Treatment for kidney failure in dogs includes :

• intensive infusion therapy with sorbilact, special solutions, rheosobilact, with the help of Ringer-Lock, a salt-based plasma-substituting liquid;
• the use of dopamine, lespenephril, mannitol and lasix;
• enterosorption therapy. The dog should be given Canephron, Belosorb-P and Heptral;
• diet low in protein;
• homeopathic therapy: give Solidago compositum C

Prevention of kidney failure

Prevention of this disease is based, first of all, on providing the animal with proper nutrition. If the dog still has an excellent appetite and eats well, we recommend supplementing his diet with diet food and a protein diet.

An excellent modern remedy for the treatment of renal failure in animals, the renal diet is the basis of advanced medical treatment for pets at any stage of the disease. This renal diet helps to prevent or even significantly reduce uremia during the acute stage, restore electrolyte balance, and prevent the chronic form from developing rapidly. In recent studies, it was found that the kidney diet (food) that is added to the daily diet of dogs significantly prevents the risk of kidney disease in dogs.

Diseases of the urinary system are relatively common in domestic animals, with kidney disease playing a particularly important role. Some of them are very dangerous and cause severe harm to the health of animals. For example, kidney failure in dogs. We note right away that such a disease does not exist in principle: this is the name of a whole complex of symptoms. Simply put, kidney failure itself can be caused by a variety of reasons. They are similar in that they lead to a deterioration in the functioning of the kidneys, and subsequently to their complete failure. Ideas about this pathology have changed significantly over the past 10-15 years. You can find out about the current situation in the field of its diagnosis and treatment by reading this article.

There are a huge number of pathologies that cause the development of renal failure in animals. It should be emphasized here that kidney problems are one of the most topical issues in modern veterinary medicine, since they occur very often, and there are no “canonical” treatment regimens. Of course, in dogs, these diseases are far from being as widespread as in cats, in which CRF is almost the “norm” for old animals, but the frequency of their occurrence is steadily increasing every year. By the way, it would be completely wrong to assume that kidney failure is common only among more or less old animals. Some breeds of dogs are predisposed to this pathology from a very early age. Kidney failure is an extremely dangerous disease also because more or less pronounced clinical signs can appear only after the loss of 80% of all renal tissue. Naturally, at this stage, there is no talk of any recovery. In general, with kidney diseases, it is extremely important to identify the moment of onset of the disease as early as possible, since in this case there is every chance for a successful outcome.

The syndrome of renal insufficiency does not occur "suddenly". The process can be divided into several well-defined stages. Let's list them in more detail:

• stage of compensation. It takes up to 90% of the development time of the disease. At this moment, the animal looks and feels absolutely healthy, jumps and plays, experiencing absolutely no inconvenience. Only a urine test performed in a well-equipped clinic can reveal the true state of affairs.

• "hidden" period. In the renal tissue, morphological and functional disorders begin to gradually increase, but it is still far from the critical point. Urinalysis, as in the previous case, will show the presence of a pathology, but so far it has not been possible to identify violations in blood biochemistry. Sometimes at this stage, kidney failure can be detected by an experienced specialist.

• stage of decompensation. There are the first signs that something is wrong in the dog's body. The general condition of the animal is deteriorating significantly, but the dog still continues to drink. Urine analysis will show a sharp deterioration in its quality.

• Terminal stage. The kidneys have already failed or are close to being, the animal may fall into a renal coma.

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Note that acute renal failure in dogs can be detected even in the early stages, since the capabilities of modern diagnostic equipment quite allow this. Never take the time to take your tailed pet to the veterinarians at least a couple of times a month: this can save his life (or at least seriously extend it)!
What are the types of kidney failure?

Unlike acute, chronic renal failure in dogs occurs when the kidney tissue is exposed to negative factors for a long time, when the gradual death of nephrons occurs.

Major predisposing factors

As we have already said, the causes of insufficiency can be very different. There are the following main groups of predisposing factors:

• Golden Retrievers and some other dog breeds have one hereditary problem - amyloidosis. Naturally, with the complete degeneration of the renal tissue, one cannot speak of the organ performing its direct work. The prognosis in this case is unfavorable, since these diseases are not treated in principle.

• , poisoning. The kidneys are especially bad when salts of heavy metals enter the body. In some cases, their complete fatty degeneration is observed. The result is similar to cases of amyloidosis, the kidneys cannot perform their direct "duties".

• on the kidneys. In dogs, there are cases when these formations are nothing more than echinococcus or alveococcus. In some cases, the state of the organ can partially recover after a professionally performed surgical intervention.

• Neoplasms- benign or malignant tumors. It is especially typical for old dogs, especially those that grew up in large cities.

• Stones and sand in the kidneys. This occurs much less frequently than in cats, but dogs are not at all immune from this pathology.

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How does the disease manifest itself?

So what are the main symptoms? First, the mode of urination changes. The dog starts to urinate a lot more. This is largely due to a sharp increase in thirst ( polydipsia and). The state of the animal remains completely stable for a long time, without changes. Initially, while the state of the kidneys is still compensated by the protective reserves of the body, its composition practically does not change, but subsequently the density decreases rapidly. Microscopic examination of such urine can reveal many cells that have exfoliated from the inner surface of the renal pelvis. The dog drinks more and more, it is tormented by constant calls to urinate, and up to 40% of them are false. Due to the constant accumulation of nitrogenous bases in the blood, sometimes the dog's skin begins to smell like ammonia, for the same reason massive stomatitis appears, the treatment of which by conventional methods does not give any effect.

It should be noted that the concept of "renal failure" includes damage not only to the kidneys themselves, but also to the adrenal glands. Their "failure" is much more noticeable. For example, in a dog, blood pressure can rise sharply, to a critical level. By the way, in experienced veterinarians, one diagnostic method is associated with this feature: in dogs with suspected renal failure, the fundus is checked. If it is full of hemorrhages, the diagnosis is almost always positive. And further. In the case when your pet's eyesight began to deteriorate for no reason, you urgently need to take him to the veterinarians: it is possible that the problem is even more serious than you might think. Subsequently, the dog loses weight, her appetite completely disappears. Periods of severe profuse diarrhea alternate with constipation. This is due to the increasing autointoxication of the body. In some cases, pronounced nervous phenomena (seizures,) and death from cerebral encephalopathy are possible.