As veterinary medicine and general pet care have evolved, more and more of our patients are considered geriatrics. Pets live much longer, on the average, then when I started in practice over 30 years ago. Treating cats and dogs in their late teens has become common.
Chronic kidney disease (CKD) is seen in about 30 percent of geriatric cats and 7 percent of geriatric dogs. There is a commercial on a local radio station that says, “This is the sign of kidney disease (in people)” and it’s followed by silence. In its early stages, kidney insufficiency or kidney disease is also often silent or without symptoms in our pets. Veterinarians encourage owners to allow us to do blood tests and a urinalysis on their pets when they come in for annual physical examinations, especially our older patients. If we catch CKD in its early stages, while we can’t reverse or cure kidney disease, often we can slow its progress and improve a pet’s quality of life. In CKD’s later stages, pets are brought in with symptoms of weight loss, muscle wasting, dehydration, and exhibiting increased drinking and urinating. Otherwise perfect pets have started to pee in the house. Hypertension can develop and pets may become anemic or have concurrent diseases such as heart disease. Cats may be hyperthyroid which produces similar symptoms to kidney disease.
Once diagnosed, the cornerstone to treating chronic kidney disease is diet. We know a therapeutic renal diet made up of high-quality proteins and reduced phosphorus can slow the progression of CKD by decreasing waste products and helping maintain normal blood pressure. Pets, especially cats, don’t always buy into eating the new diet and this can be frustrating for everyone. To increase fluids the ideal diet for a cat is a canned diet. A 2002 study showed dogs with late-stage kidney disease lived at least 13 months longer on a renal diet. If pets refuse renal diets, owners can get recipes for appropriately formulated home-prepared diets. Pets with late-stage CRD frequently have poor appetites or are anorexic, so switching a pet to renal diets in early CKD often involves a more cooperative patient.
The successful treatment of chronic kidney disease as it progresses may include drugs to lower blood pressure, control nausea, stimulate appetite, and fluids to rehydrate the patient, but diet remains the most important long-term component of that success.