Tuesday, December 01, 2009

Chronic renal failure

I wanted to write about renal disease which is what Tilly had. Because of her advanced age of 14, there was more of a likelihood that she would develop renal failure as many aged dogs do. Over a year ago, we noticed that she was urinating more than usual. Blood workup revealed that she had elevated BUN and Creatnine levels, which are two products excreted by the kidneys. Elevated levels in the blood, also called azotemia indicated her kidneys were not functioning properly. She was also anemic at the time.

The kidneys are important because they filter out and excrete toxins from the body through output of urine. Tilly was drinking a lot of water and urinating more because her kidneys were damaged. The increase in water consumption is the bodies attempt to flush out the build up of toxins. The increased urination is caused by the increased water intake but the kidneys are unable to concentrate the urine so it is a almost clear in color with little to no odor.

Symptoms of kidney failure usually do not show until the disease is in an advanced stage – normally when the kidneys are functioning at only twenty-five percent function. By this time, it is often too late for treatment to do much besides make the dog more comfortable and help alleviate symptoms.

Tilly was given an influx in fluid over the past year. That helped to flush out her system. This flushing process, called diuresis, helps to stimulate the kidney cells to function again. If enough functional kidney cells remain, they may be able to adequately meet the body's needs for waste removal. Fluid therapy includes replacement of various electrolytes, especially potassium.

We also put her on a special renal diet which is low in protein and low in salt and phosphorus. Unfortunately, she didn't particularly like this food, and we resorted to cooking special meals for her and trying all sorts of foods to get her to eat. During the last two weeks she refused to eat or drink. We resorted to feeding her through an oral syringe with a calorie dense food to try to keep some weight on her and to give her subcutaneous injections of fluid to try to stimulate some kidney cell function.

Her heart, lungs and attitude remained strong. I think that was among the most difficult things because she still wanted to go for a walk and still loved being with us. However, she was in complete kidney failure according to blood tests done. So there was nothing left that could be done. It is hard to let go of our beloved dogs but when kidneys are worn out they can't be revived.