Kidney Disease, an Overview
Anne Jones RN, BSNE
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The kidneys are major organs of the body, affecting health in many
ways. The kidneys function to filter waste (urine), to maintain a
balance of the normal chemicals in the body, as well as regulation
of blood pressure. Healthy kidney function is critical! Symptoms of
kidney failure should be understood by all pet owners. Kidney
disease may occur as an acute illness but at other times, it can be
slow to manifest symptoms and can be quite insidious. The symptoms
of kidney disease may be masked because they can be similar to (or
the same as) other major diseases. Because of the interaction of the
major organs, symptoms alone will not be sufficient to diagnose
disease and further study is always needed, starting with urinalysis
and blood chemistry.
The kidneys are located on either side of the backbone and just
under the last ribs. The kidneys are a filtering organ made up of
microscopic nephrons, structures that filter and reabsorb fluids
passing through the kidneys. Many substances (chemicals, poisons,
germs) can damage the nephrons, as can aging, trauma and disease.
Long term damage may occur over months and years until such damage
reduces kidney function to as few as one quarter of the nephrons
before total kidney failure occurs. In the other extreme, sudden and
acute kidney failure may be sufficient to permanently destroy kidney
function and may be irreversible. One such event, frequently seen in
the fall and early spring, is the destruction of kidneys by the
consumption of antifreeze! The sweet taste is an immediate
temptation to the dog who wanders past as the radiator is drained or
fluids cleared from boats that have been winterized. Be aware
because you have only hours to save the dog’s life when he takes in
as little as a spoonful of antifreeze!
Signs of possible kidney or bladder ailment may be any of the
following: excessive drinking; excessive urination; blood in the
urine; stiff legged gait and a hunched back. A dog that has a stiff
legged walk, hunched back and seems to be carrying himself gingerly
may well be expressing to the owner his discomfort from diseased
kidneys. In Bichons, frequent urination and/or blood in the urine
can be a sign of bladder infection or bladder stones. Untreated
bladder infections may cause the bacteria in the bladder to back up
through the ureters until the kidneys themselves become infected.
Chronic inflammation of the kidney is called pyelonephritis. This is
the name given to infection which may come from other parts of the
body and seat itself in the kidneys. Pyelonephritis can occur over a
period of years and may begin with malformation of the kidney(s) or
from infection and may be well advanced before symptoms are noted.
Because of failing nephrons, the dogs produce large amounts of
dilute urine due to the inability to concentrate the urine. In the
earlier stages, this condition may be treated and may be somewhat
reversed.
In acute pyelonephritis - kidney failure caused by disease, poisons
(rat poison, antifreeze), some antibiotics and chemotherapy drugs -
damage to the nephrons occurs so quickly that the surviving nephrons
do not have time to compensate. Again this situation requires
immediate treatment! Antifreeze (ethyleneglycol based) will usually
be fatal but fast treatment may save the dog that has consumed rat
baits. It is ironic that some of the very antibiotics given to treat
non-kidney disease can harm the kidneys and any dog receiving those
drugs known to damage the kidneys must be closely monitored during
treatment.
Every dog owner must be aware that giving dogs grapes or raisins
is tantamount to giving them poison! Grapes can cause acute kidney
failure and must not be fed even in small amounts!
Chronic kidney failure may result in another long-term condition
called glomerulonephritis, in which the immune system proteins
damage the blood vessels of the nephron. Nephrosis is the scarring
of tissues of the kidneys by diseases such as leptospirosis,
distemper, herpes and hepatitis. Kidney cancer can also occur.
Any of the diseases of the kidneys if untreated will lead to the
final kidney failure known as uremic poisoning. Signs of uremia are
apathy, depression, failure to eat or drink, ammonia odor to the
breath, general signs of poor health and eventually a comatose
condition from which the dog will not recover.
Kidney failure is often the diagnosis in the aging dog with signs of
failing health. It is imperative that a Bichon receive annual
examination after age 12 that includes urinalysis and blood
chemistry in order to have early warning of insipient kidney
disease. Remember that kidney function is closely tied to the health
of all organs of the body and must be monitored and treated early.
Every Bichon, with a tendency in the breed to bladder infection,
needs fresh water available at all times. Bladder infections
need prompt treatment and proper diet. Be sure to see the article on
Bladder Stones
to understand the difference between inherited bladder problems and
those that are from infection and remember that the stones must
be properly assayed to determine which are from an inherited
condition.
It is also a good idea to familiarize yourself with other
metabolic
health issues sometimes seen in Bichons because proper treatment of
any of these conditions will help to prevent chronic kidney disease.
Information in this overview article on kidney disease comes from
http://www.petshealth.com and Dog Owners Home Veterinary
Handbook, Carlson DVM and Giffen MD and other publications on canine
health.
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