Renal insufficiency is a decrease in the
function of the kidney. As pets age many of them will develop renal
insufficiency. This happens because kidney cells that die and are not
replaced. To compensate, the remaining kidney cells must learn to do
their job better. Fortunately, it is possible to slow the rate of cell
death and to encourage the other kidney cells to function better, making
it possible to slow the progress of the disease.
Unfortunately, the disease is incurable and will eventually lead to the
death of the patient over time. However, with proper management, pets
with renal insufficiency can live several years with good quality of
If the signs are very mild, we will sometimes rely on diet alone to
manage the disease. When we do this, we prefer to check lab values on a
regular schedule. We are not really looking for improvement, we are
trying to make sure we catch any deterioration in kidney function
quickly. Many pets do actually show improvement in the kidney related
blood work with dietary control alone.
Adequate hydration help slow loss of kidney function. Sometimes, feeding
canned food is preferable to dry food due to the additional moisture
content. Going to subcutaneous administration of fluids early in the
disease process is often beneficial. Additional medications are sometimes
necessary. These can include blood pressure controlling medicine,
potassium supplementation, and phosphate binding agents. Phosphate
binding agents can be helpful but are much less necessary when using a
Figuring out if/when to add each of these medications is difficult
because each patient is different. Therefore, blood tests must be done
to make these determinations.
We should also make sure that complicating diseases are not present. The
most common complication is hyperthyroidism (over active thyroid). Pets
should be tested for if there is weight loss, especially if it is
accompanied by an increase in appetite. This test is also done with
blood and can be done along with the kidney function tests.
Monitoring urine specific gravity is helpful. It helps to determine how
well the kidneys can concentrate urine. Keeping track of the pet's
weight helps a great deal, too. Weight loss can actually be good for
patients with kidney problems but if it is occurring too fast it can be
a sign that additional therapy is necessary.
It is critical for pets with kidney problems to drink water on a regular basis.
A great increase in thirst often indicates that the
kidney situation is becoming unstable again and when pets with kidney
disease stop drinking they need to be checked to see if the kidney
disease is getting worse suddenly.
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