Kidney disease is a very common diagnosis in older pets and can be managed to slow the progression and ensure a comfortable end-of-life. While renal disease does not exclusively affect older pets, it is certainly more common in the elderly. Young animals can experience kidney damage after exposure to certain toxins, which may cause lasting effects. Unlike the liver that can heal itself over time, the kidneys, unfortunately, can not. Just another reason to seek medical attention immediately if your pet ingests or is exposed to any toxins.
Recently, it was confirmed that our dog Sox is in Stage 3 Kidney Failure. We have known for about 2 years that her kidneys would be an issue in the future. Sox has a tucked vulva, which holds moisture on the skin every time she urinates. This was never a problem when she was young and her immune system could fight off infections without intervention. Now that she is in the geriatric stage of her life and has hypothyroidism, as well as mast cell tumors, her immune system is compromised and she can no longer fight off infections on her own. The tucked vulva has led to multiple urinary tract infections over the past couple of years. Her kidneys have taken the brunt of the damage from the UTI’s and the necessary antibiotics. While the UTI’s have been recently prevented with a homecooked diet, frequent potty breaks, and a high dose of cranberry supplements, her kidney disease has progressed. This is the nature of kidney disease. You can slow the progression with support, but you can not cure it.
Tips For Keeping Your Kidney Patient Comfortable
Tip 1: Ensure that your pet is eating. The most common symptom with kidney disease patients is a loss of appetite followed by rapid weight loss. Commercial kidney diets are available that provide lower phosphorus levels to reduce stress on the kidneys. Lowering phosphorus levels often means lowering protein amounts within the diet. Studies have shown that using a kidney diet too early can cause early muscle wasting and does little for the progressing kidney disease. So don’t panic if your pet’s bloodwork shows one or two slight elevations in kidney values. Your veterinary team will let you know when it’s time to offer a prescription food. It is now recommended to wait until later stages of the disease to offer these diets. Studies do seem to suggest that late-stage kidney disease patients can live longer with a better quality of life when offered a kidney support diet.
Tip 2: Keep them hydrated! Kidney disease patients are in a chronic state of dehydration. They simply can not drink enough water to compensate for their increased need to urinate. One of the easiest ways to improve hydration is to switch from a dry kibble diet to a canned or cooked diet. At a certain stage during the disease progression, your veterinarian may recommend administering subcutaneous (SQ) fluids to improve hydration and help flush out the kidneys. Purina also now has a feline product called Hydracare that is a highly palatable “drink”. Cats are not natural drinkers. They get the majority of their moisture through their food sources. Purina Hydracare encourages your cat to drink more fluids by offering a tasty alternative to the water bowl.
Tip 3: Monitor nausea and vomiting. Kidney patients often become nauseous as their disease progresses. Your veterinarian can prescribe medications to reduce vomiting and nausea, as well as increase appetite. If your pet is nauseous, they are more likely to refuse food and water. Once the nausea is under control, be sure to offer high value and smelly foods to entice your pet to eat. Simply heating the canned or cooked diet in the microwave for 15-30 seconds can bring out some of the enticing smells.
Tip 4: Listen to your veterinary staff and use common sense. The veterinarian may recommend that you start a kidney diet, however if your pet refuses to eat these specific foods, it’s more important that your pet eats. In some cases, an extremely slow transition from the old food to the new food will work. Instead of transitioning the food over a 7-10 day period, extend that time to 10-15 days and mix the food well. Commercial kidney diets are not known for their palatability, so many pets simply refuse them. Our previous cat, Otie, went into kidney failure at a young age due to the previous owner’s neglect. He hated the taste of Hills Science Diet K/D and Royal Canin Renal Support, but loved Purina NF. Towards the end of his fight, he refused all foods except for Fancy Feast Gravy Lovers and pureed baby food.
Tip 5: Improve quality of life by offering and doing what your pet loves. Daily exercise can help maintain muscle mass, improve circulation, and improve gastrointestinal mobility. Kidney disease patients often become lethargic and dehydrated, which leads to constipation. If you need to give subcutaneous fluids, offer a distraction or a cuddle session to keep your pets mind off of the chilly fluids going under their skin. Our cat Otie really appreciated cuddling with my husband and having his undivided attention while I administered the SQ fluids. Sox’s favorite snack is peanut butter. So I spread some peanut butter on a silicone lick mat to keep her occupied while I administer her SQ fluids.
Clients are notorious for ‘yessing” the doctor when a diagnosis and treatment plan are given, only to turn around and refuse medical advice or argue the plan of action with the technicians. I once had a client say to me “if it’s not curable, why bother with any treatments?”. In the case of kidney disease, treatment means an improved quality and improved quantity of life. Treatments will not make the kidney disease go away, but it will make your pet feel better, maybe even feel normal, for whatever time they have left. Without treatment, your pet’s quality of life will decline rapidly because likely they are already experiencing vomiting, nausea, or inappetence which prompted you to bring them to the vet for bloodwork. Without treatment, your pet may only have a couple of weeks.
Treatments can slow the progression of the disease, giving you and them more time. Studies have shown supportive care for kidney patients can extend their life by up to 2 years. So why not keep your pet comfortable?