Renal Insufficiency

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 life.

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 prescription diet.

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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