Every year during the annual visit and examination, we ask questions that give us insight into the health of your pet. We weigh the pet to see if there have been any dramatic gains or losses. We evaluate the diet you are feeding to determine adequacy and deficiencies. We ask if there have been any changes in behavior, appetite, drinking, or urination. The answers to your questions provide us with information needed to fully evaluate your pet's health.
Sometimes owners are amazed at the amount of weight a pet has gained or lost; gradual changes may not be noticed at home. Often, owners assume that weight loss or gain, increased water consumption, and decreased activity are normal changes to expect as pets age. However, these changes can signify underlying problems that can be serious.
One of the most common, and serious, changes relates to decreased kidney function. According to Chinese Medicine Theory, the kidneys hold the life essence, or Jing. Healthy people are born with 100 years of life essence. If you live a balanced life with no excesses or deficiencies, your kidney fire will not burn out until your 100th year. While pets are not born with 100 years of life, the healthy dogs and cats are born with the animal equivalent. That means the average dog should make it to 14 to 18 and cats should live to be almost 30 years old. Sadly, this is a rarity these days.
Highly processed, deficient diets, coupled with environmental pollution, poor genetics, overuse of vaccinations, medications, and chemicals all combine to greatly shorten the lives of our beloved pets. If you are vigilant, you will notice the signs of kidney disease in the early stages, which will give you an opportunity to make changes that can help your pets live longer.
- Increased thirst. Decreased kidney function means the kidneys are not able to retain moisture.
- Increased urination. Usually goes along with increased thirst, but may also have a decreased ability to hold urine.
- Leaking urine.
- Decreased appetite.
- Bad breath (toxins in the blood stream cause a bad odor).
- Decreased appetite early in the day, preferring to eat in the afternoon or evening.
- Dark tarry stools (caused by ulceration of the stomach and intestines in later stages of disease)
- Weight loss.
- Decreased muscle mass.
- Bad odor to the urine may accompany urinary tract infection.
- Sudden blindness. Can result from high blood pressure secondary to kidney disease which can cause a detached retina.
- Seizures, Coma (in the later stages of disease)
How is kidney disease diagnosed? The best tests include analysis of blood, looking at:
- BUN (blood urea nitrogen, which is a waste product from the breakdown of protein in the diet)
- Creatinine (a chemical produced from the breakdown of creatine, which is generated from muscle metabolism)
- SDMA (an amino acid excreted by the kidneys that shows kidney dysfunction much earlier than BUN or creatinine)
- Amylase (an enzyme produced by the pancreas that filters through the kidneys)
- Red blood cells (will be decreased in late kidney disease as the kidneys make a hormone that tells the bone marrow to make red blood cells)
- Electrolyte levels may be abnormal (Potassium, Sodium, Chloride)
- Increased Phosphorous levels
- Low Calcium levels
- Decreased protein, particularly albumin
A urinalysis may show:
- Increased levels of protein (protein is lost in the urine when the kidney filtration is altered)
- Red or white blood cells in the urine (indications of infection)
- Decreased specific gravity (measure of urine concentration; diseased kidneys will not be able to concentrate urine)
- Casts, which are an indication of damage to the kidney tubules that filter the urine.
Treatment for kidney disease will vary, depending on the stage of disease. The most important treatment is a high moisture diet. Kidney function requires moisture, which is why these dogs drink a lot. If your veterinarian insists on a prescription diet and you agree (which I do not recommend), please insist on the canned version of the diet and do not accept the dry form. A species appropriate, high moisture diet would be my recommendation. While traditional veterinarians usually recommend severely restricted protein in the diet, most holistic veterinarians will only want moderate restriction. These pets need protein to maintain muscle mass. I have many patients with kidney disease that do very well on raw or home prepared diets that are modified to lower the phosphorous. Other therapies may include:
- Subcutaneous or intravenous fluid therapy.
- Omega 3 fatty acids to decrease inflammation in the kidneys.
- Medications to lower blood pressure, like enalapril or benazepril.
- Phosphorous binders to lower the blood phosphorous levels.
- Vitamin D supplementation.
- Herbs to support kidney function.
- Amino acid supplements to stabilize kidney function.
- Antacids like pepcid or famotidine.
- Vitamin B12 injections.
- B vitamin and iron supplements.
- CoQ10 as an antioxidant.
- Homeopathic products for urine leakage, if present.
- Erythropoietin if animal is severely anemic.
Don't wait until your pet is in the advanced stages of disease to get a diagnosis. If you notice changes in attitude, water consumption, weight, or appetite, have your pet examined. Take a urine sample with you and ask to have a blood panel run. Be pro-active. A recent study showed that the worse a pet's dental disease was scored, the more likely the pet was to develop azotemic (advanced stage) kidney disease. Take care of those teeth! Check out my dental drops for easy treatment.