What is Chronic Renal Failure (CRF)?
Chronic Renal Failure (CRF) is the gradual loss of function of the kidneys. The kidneys are responsible for excreting many naturally occurring waste products; when they begin to fail there is a build-up of substances such as blood urea nitrogen (BUN), creatinine, and phosphorus. An excess of these products is what makes the pet feel ill.
A build-up of these substances can cause oral and gastric ulcers, making the pet feel even worse and decreases their desire to eat. It is also common to see hypertension (high blood pressure). In addition, the kidneys produce a hormone known as erythropoietin that is responsible for communicating with the bone marrow to make new red blood cells.
When the kidneys fail, this hormone decreases and in turn decreases the production of new red blood cells causing the pet to become anemic. Studies show that 80% of kidney tissue is irreversibly damaged before clinical signs present and the disease is found in blood workups.
What Symptoms Can Present as the Disease Progresses?
- Increased urination
- Increased drinking/sitting near the water bowl
- Weight loss
- Decreased grooming
- Incontinence or inappropriate urination
- Changes in hair coat – dry, flakey, etc.
- Unusually bad breath
- Persistent early stages
- Oral ulcerations
- Reclusive behavior
- Decreased water intake and urination
- Severe weight loss
- Sunken eyes
- Stiff gait
- Continued incontinence
- Unable to rise
Crisis – Immediate veterinary assistance needed regardless of disease
- Difficulty breathing
- Prolonged seizures
- Uncontrollable vomiting/diarrhea
- Sudden collapse
- Profuse bleeding – internal or external
- Crying/whining from pain*
*It should be noted that most animals will instinctually hide their pain. Vocalization of any sort that is out of the ordinary for your pet may indicate that their pain and anxiety have become too much for them to bear. If your pet vocalizes due to pain or anxiety, please consult with your tending veterinarian immediately.
Common Signs of Pain
Panting, lameness, difficulty sleeping, pacing, abnormal posture, body tensing, poor grooming habits, tucked tail, dilated pupils, licking sore spot, muscle atrophy, decreased appetite, vocalizing/yowling, reclusive behavior, aggressive behavior, avoiding stairs/jumping, depressed, unable to stand.
How is CRF Treated?
The goals of treatment are to support the kidneys and medically assist them to complete the tasks that they are meant to do. The first priority is to place the animal on a low protein, low phosphorous diet in order to reduce the amount of BUN and phosphorous build-up in the body. There are several kidney diets on the market that are especially for CRF.
Administration of fluids under the skin can be done at home daily or a few times a week, depending on the severity of the disease. This is done to flush out the build-up of toxins and to keep the pet hydrated. Removal of excess phosphorous is also important, so an oral dosage of phosphate binders is recommended, if necessary.
There are also pharmaceuticals available to help treat oral and gastric ulcerations and hypertension. If the pet becomes anemic, it may be necessary to administer a blood transfusion or give erythropoietin, injected under the skin in order to stimulate the production of new red blood cells.
What Is the Prognosis for CRF?
Many pets that are diagnosed with chronic renal failure go on to live many more great years if they are managed appropriately. However, with any disease, there are some pets that do not respond positively to treatment and their condition quickly worsens.
It is important to have your pet checked regularly by a veterinarian so that renal function can be assessed and any change in kidney health can be addressed immediately. A personalized treatment plan is important to slow the progression of kidney disease. Talk to your veterinarians regarding the best treatment protocol.