Introduction
Chronic renal failure can be present but asymptomatic for a long, long time. Normally, by the time an owner notices signs of chronic renal failure and a diagnosis is made, enough kidney tissue has been damaged to make the condition irreversible. Nevertheless, there are a number of supportive treatments and management techniques that can delay progression of the disease and enhance the dog’s quality of life.
Treating Chronic Renal Failure in Dogs
The goals of treating canine renal failure are to alleviate the signs of uremia (which is the nitrogenous waste build-up in circulation caused by chronic kidney failure) and to delay progression of disease. For dogs showing acute-onset of uremic signs (dehydration, anorexia, vomiting), hospitalization is necessary so that the medical team can commence aggressive intravenous fluid therapy. Most decompensated dogs will not tolerate oral fluids or medications well. Given this and the dehydration normally accompanying a uremic crisis caused by CRF, it is critical to flush accumulating waste products from the dog’s system. After dehydration has been corrected, intravenous fluid administration can be changed to fluids given subcutaneously. Most owners are able to give subcutaneous fluid therapy to their dogs at home without difficulty.
Dietary changes can be helpful. Most renal diets include reduced protein, phosphorus and sodium, and possibly supplementation with omega-3 fatty acids. Some dogs do not tolerate dietary changes well, and it may become more important to provide adequate calories to prevent weight loss than it is to provide a precisely balanced diet.
If vomiting or gastric ulceration are involved, a number of medications are available to decrease gastric acidity and sooth the stomach lining. Of course, free access to fresh water is always important. Veterinarians can recommend other drugs to help control hypertension and anemia. Renal transplantation may be available in limited cases and is expensive. It is uncommonly performed in companion dogs. Hemodialysis may be considered as well.
If your dog has been diagnosed with chronic renal failure, your veterinarian is in the best position to discuss the course of disease and treatment options with you. The prognosis for dogs with CRF is difficult to predict but can range from days to years. However, since the disease is incurable and progressive, the focus of management should be on maintaining the best quality of life for the animal as possible.