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Renal Clinic Support

Kidney disease is serious and is not to be ignored

Kidney disease is serious: not to be ignored. There is good news however. 

Even though we cannot arrange renal haemodialysis or a renal transplant, there are still very many things we can do to extend life expectancy, and improve quality of life for our renal patients. This is a team effort between owner, vet and vet nurse. Our aim is to keep your pet happy, maintaining appetite and body weight. We want them to enjoy life, and you to enjoy their company for as long as possible. The nurse clinics afford an opportunity to discuss issues, tailor dietary requirements and for us to ensure you have the best possible support for your pet. Together we can do this! 

The Therapeutic Plan

Firstly, we stabilise any acute injury or dehydration – this can transform a critically ill patient and can be urgent. It is usually done in the hospital over a period of days with drugs and intravenous fluids.

Secondly, we seek a definitive diagnosis of the cause if we can identify it: often this isn’t possible, as the illness has become chronic by the time of diagnosis. Vitally, we must eliminate any concurrent infection, as this will hinder recovery if it persists.

Once your pet’s condition is stable again, we then stage the renal disease. Staging allows us to target therapy to your pet’s specific needs and any complications attendant to his/her illness.

Our aim is to maximise success and a speedy return to a good quality of life. Staging also allows us to accurately monitor disease progress/recovery over time.

The veterinary nurse and vet team are very experienced, and trained to assist with all stages of renal failure. We cannot guarantee success, but we know from experience how well many of these patients do, especially the ones who can be successfully transitioned onto the prescription diets, and cooperate with their medications!

Our Renal Clinic allows us to regularly monitor your pet’s renal function, and any secondary problems that may develop.

Tests may include full health checks and body weight, blood tests, urine tests (often collected at the clinic by a simple technique called cystocentesis), blood pressure and eye examinations (to check for signs of high blood pressure) and occasionally ultrasound or x-ray investigation if we are looking for bladder or kidney stones etc.

Over a third of renal disease patients develop significant complications: it is critical that these are recognised early and managed well, if we are to extend life, and preserve quality of life. Our pets deserve the best possible outcome: together we can achieve that for them! 

Controlling the various complications that can arise such as high blood pressure, high phosphorus, urinary tract infections etc. through diet or medication can make a great difference for your pet’s quality of life and life expectancy. We have managed lots of dogs and cats with chronic renal failure for several years before eventually their quality of life deteriorated and we had to consider euthanasia, or another old age illness developed. The prognosis is variable, though and some cases deteriorate quickly despite our best efforts.

We are here to help, please use us!

What we monitor at each visit

  • BUN (Blood Urea Nitrogen) is a waste product excreted through the kidneys. BUN is more reflective of dietary impacts than creatinine. An increase in BUN can also be due to dehydration (a symptom of CRF and many other diseases and syndromes)
  • Creatinine is a waste product excreted through the kidneys. It is indicative of overall declining kidney function
  • Phosphorus – During CRF, high levels of phosphorus accumulate in the blood (hyperphosphataemia). Excess phosphorus intake can make CRF worse so monitoring is vital. Diet and / or medication can help control hyperphosphataemia
  • Potassium levels are critical in CRF cats and should be regularly monitored. Low potassium is called hypokalaemia. Even if your cat’s potassium is in the low normal range, it may be necessary to give him a potassium supplement. This is because with CRF, critical stored potassium in the tissues is used, often making the blood analysis appear normal
  • Haematocrit (PCV) is the measurement of red blood cells. Anaemia is common in CRF cats. Normally, 40-45% of the cat’s blood consists of cells and the rest is serum
  • Urinalysis is a vital part of monitoring as it tells us what the kidneys are producing. The sample can be collected from a cat in a litter tray using special non-absorbent granules (Catrine), by “free catch” from a dog or by cystocentesis, a straightforward, safe and painless technique to get a sterile sample directly from the bladder using a fine needle
  • Specific gravity is an important measure of how well the urine is being concentrated by the kidneys, and therefore, how well the kidneys are actually functioning as filters. In CRF the kidneys cannot adequately concentrate urine so a low specific gravity is indicative of renal failure, but it also can occur in many other conditions
  • Urine Culture and Sensitivity – Renal failure can sometimes be a result of a kidney infection, and animals with renal failure are more likely to develop a urinary tract infection, often with no clinical signs. If an infection is present, the culture and sensitivity test will show what type of bacteria is present and allow the vet to treat it with specific antibiotics. This test can ONLY be performed on samples collected by cystocentesis
  • Urine Protein Creatinine (UPC) Ratio – In some animals with renal disease the damaged kidney starts to leak protein into the urine. This protein in itself causes further damage to the kidney. The most accurate way to measure this is UPC. We can prescribe medication to reduce protein loss if it is present
  • Blood Pressure – Hypertension is a common sequel to chronic renal failure and if present will not only cause more damage to the kidneys but can also have harmful effects on many other organs such as the heart, brain and eyes. High blood pressure can be controlled with various medications.

Frequently Asked Questions

  • The correct food extends life threefold!! It is ultra-low in toxins the kidneys cannot deal with – ordinary food is full of these toxins, so after eating a bowlful of “normal food” the body has a load of these toxins circulating: these cause nausea and a “hangover” feeling! Thus it is a very short-lived benefit!!

  • Please be patient – this is NOT urgent – aim to transition slowly over weeks not days – target 8-10 weeks to be consuming 80-90% renal diets – don’t be overly ambitious early on – especially with cats. For those tricky cases we can give appetite stimulants or even fit feeding tubes, which can be very well tolerated.

  • Cats and dogs can be led to water but cannot be made drink it! Try various types of water – filtered, bottled, from a drinking fountain or dripping tap, try different bowl types, offer water in several rooms of the house – especially important with cats. Try making a simple “soup” by adding boiling water to the tinned/pouch food. If a feeding tube has been fitted, use that! Some clients prefer to take sterile fluids home and run them in under the skin at home – we can help if you would like to try that.

  • There are various different medications or supplements we can use to help control problems as they appear. Controlling urinary tract infections, blood pressure, protein loss through the kidneys etc. can make a huge difference, not only to the length of life, but to the quality of life for your cat or dog. If we don’t measure these parameters, we will not know if there is anything we can do to help. Each case is different so we can tailor your pet’s treatment to their specific needs.

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