Kidney disease, also known as renal disease, is one of the most common diseases in dogs and cats that come to Sunset Vet. Kidney disease is very serious, as the kidneys are essential to filter the blood, excrete excess nitrogen and other toxins, regulate water and electrolyte balance, and produce hormones. When the kidneys become damaged and can no longer filter the blood, they cannot carry out those functions properly. Furthermore the kidneys are very poor at healing, unlike other organs. This means that the damage is usually irreversible.
On the plus side, all mammals are born with 2 kidneys and can usually function well with just one, so there is some spare capacity. In fact pets do not start showing signs of kidney failure unless there is less than 30% functionality left. This is the reason why humans can donate a kidney to a relative in need of one, and still live a normal life with one kidney, as long as that remaining kidney is a healthy one. In other words, when we start to see symptoms of kidney failure, this means that already 70% of the kidneys have been damaged.
There are two different types of kidney disease – acute (sudden) or chronic (long-term). Chronic kidney disease is more common in cats, and what we will discuss here. The earlier we treat chronic kidney disease, the longer we can prolong life expectancy.
Symptoms of chronic kidney disease
Some of the following symptoms of chronic kidney disease are seen late in the disease. Early detection of any of the following signs can help to treat kidney disease and preserve the remaining functioning parts of the kidney.
- Polydipsia/Polyuria (increased thirst/urination)
- Losing weight
- Poor coat quality
- Bad breath (halitosis)
- Mouth ulceration
- Losing appetite
- Sudden onset blindness (retinal detachment)
What can cause chronic kidney disease?
Chronic kidney disease has a number of possible causes. Some have the potential for prevention or effective treatment if detected early enough.
- Degenerative kidney disease, associated with ageing
- Bacterial infections (these can ascend from the bladder, or spread through the blood stream)
- Congenital abnormalities of the kidney (e.g. Persian cats born with polycystic kidneys)
- Kidney tumours (Lymphosarcoma is the most common, a cancer of white blood cells)
- Hypertension (high blood pressure)
- Viral infections (Feline Immunodeficiency Virus (FIV) or Feline Infectious Peritonitis (FIP))
- Amyloid deposition in the kidney
How is chronic kidney disease diagnosed?
Many of the clinical signs indicative of chronic kidney disease are vague, and can also be indicators of other disease processes occurring. In order to diagnose kidney disease, it is important that further tests are carried out. These tests can be done before the cat is unwell, when early detection is still possible.
- Physical Examination – during your annual check-up the vet can palpate the kidneys and will take a full history about how much the cat is drinking and urinating. The normal drinking amount is around 50ml/kg/24hrs. If your pet is drinking >100ml/kg/24hrs then this could be an indicator of kidney disease.
- Blood Test – A ‘biochemistry’ blood panel is important to check levels of urea and creatinine in the blood (indicators of kidney function), red and white blood cells, potassium, phosphorous and other electrolytes.
- Urine Sample – A urine sample will be assessed based on its concentration (‘specific gravity’), giving an indication of how well the kidneys are able to concentrate or dilute the urine. If the Specific Gravity is over 1.012 then the kidneys are still able to reabsorb water and concentrate the urine. The urine will also be assessed for protein, red and white blood cells, and any bacteria for further information. Additionally, a further test may be performed to check where damage has been done in the kidney. This is called a “urine protein creatinine ratio” and can guide medications to help minimise protein loss.
- Abdominal Ultrasound – an ultrasound (USG) is a non-invasive way to assess the kidneys. This can be done conscious without sedation, but may require clipping of the fur on the flanks. The vet can look for signs of amyloid deposition, shrinking of the kidneys due to fibrosis, a tumor or swelling due to infection.
Cat Kidney Disease Treatment Options
The appropriate treatment depends on how advanced the kidney disease is, based on the above diagnostic tests.
- Intravenous Fluids – This is the first line treatment recommended for a sick, dehydrated cat. IV fluids help to flush the kidneys, reduce toxin levels in the bloodstream, and rehydrate your cat.
- Appetite Stimulants (cyproheptadine) and AnabolicSteroids (laurabolin) – These are used to get your cat eating again, and to combat muscle wastage.
- Dietary Change – A prescription kidney diet has reduced levels of protein and phosphorus. This will minimise the work the kidneys have to do, and the levels of toxins in the blood stream.
- Phosphate Binders (Ipakitine) – Damaged kidneys have a limited ability to process phosphate. This medication will bind phosphorus in the intestines so it doesn’t cross into the circulation and build up in the blood stream.
- Antibiotics – If a urinary tract or kidney infection is, appropriate antibiotics will be prescribed – usually ones excreted in the urine such as amoxicillin.
- Potassium Supplementation – Excessive loss of potassium when kidneys fail results in muscle weakness and poor coat quality.
- Blood Pressure Monitoring – Blood pressure is monitored in order to reduce the chance of further damage to kidneys. Treatment (usually enalapril or amlodipine) will be started if high blood pressure is detected.
- Anaemia monitoring and treatment – Damaged kidneys fail to produce the hormone ‘erythropoietin’ needed for the production of red blood cells. If available, this can be given in synthetic form to stimulate red blood cell production.
- Providing lots of water – Encourage your cat to drink with multiple water bowls, ensuring they are always full with fresh water as cats with chronic kidney disease are at increased risk of dehydration.
Early detection during annual check-ups
At Sunset Vet we recommend all cats over 12 years old come to the clinic at least every 3 months for a geriatric check-up, so that if diseases such as chronic kidney disease, hypertension or hyperthyroidism are present, we can catch and treat them early and maximise your pet’s life expectancy.
Sunset Vet offers veterinary services via their Kuta (24hr) and Ubud (8am-10pm) clinics. For further information or to make an appointment call them on 03619348915 (Kuta) or 0361975296 (Ubud), or visit www.sunsetvetbali.com or www.facebook.com/sunsetvetbali or Instagram: sunset_vet_bali
Copyright © 2018 Bali Advertiser
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Ugonjwa wa figo ni moja ya magonjwa ya kawaida katika mbwa na paka ambao wanakuja kwa Sunset Vet. Ugonjwa wa figo ni muhimu sana kwa sababu figo zinahitajika kusafisha damu, kutenganisha nitrojeni na sumu nyingine, kudhibiti usawa wa maji na umeme, na kutengeneza homoni. Figo zinapoharibika na haziwezi tena kusafisha damu, haziwezi kufanya kazi hizo vizuri. Isitoshe, figo haziponyeki vizuri kama viungo vingine vya mwili. Hilo lamaanisha kwamba kwa kawaida uharibifu huo hauwezi kurekebishwa. Kwa upande mwingine, mamalia wote huzaliwa na figo mbili na kwa kawaida wanaweza kufanya kazi vizuri na moja tu, kwa hivyo kuna uwezo wa ziada. Kwa kweli, wanyama hawawezi kuonyesha dalili za kushindwa kwa figo isipokuwa kuna chini ya 30% ya utendaji iliyobaki. Hii ni sababu kwa nini wanadamu wanaweza kutoa figo kwa jamaa anayehitaji moja, na bado kuishi maisha ya kawaida na figo moja, kwa muda mrefu kama figo iliyobaki ni moja ya afya. Kwa mfano, ikiwa dalili za kukosa figo zinaonekana, inamaanisha kwamba figo za mtu zimeharibiwa kwa asilimia 70. Kuna aina mbili tofauti za ugonjwa wa figo - ugonjwa wa ghafula (wa ghafula) au ugonjwa wa kudumu (wa muda mrefu). Ugonjwa wa figo ni ugonjwa wa kawaida kwa paka, na ni kwa sababu hii kwamba ni muhimu sana kwa wanyama. Kadiri tunavyochunguza ugonjwa wa figo, ndivyo tunavyoweza kuongeza muda wa kuishi. Dalili za ugonjwa wa figo ni dalili za ugonjwa wa figo unaoendelea, na dalili za figo ni dalili za ugonjwa wa figo unaoendelea. Kugundua mapema dalili yoyote ya dalili zifuatazo kunaweza kusaidia kutibu ugonjwa wa figo na kuhifadhi sehemu zilizobaki za figo zinazofanya kazi. - Polydipsia (kuongezeka kwa kiu) - Kupoteza uzito - Ubora duni wa manyoya - Pumzi mbaya (halitosis) - Majeraha ya mdomo - Kupoteza hamu ya kula - Kifo cha upofu cha ghafula (kuondolewa kwa retina) Ni nini kinachoweza kusababisha ugonjwa wa figo sugu? Ugonjwa wa figo usio na kudumu una visababishi kadhaa. Baadhi yao yanaweza kuzuiwa au kutibiwa kwa njia yenye matokeo ikiwa yatagunduliwa mapema vya kutosha. - Ugonjwa wa figo degenerative, kuhusishwa na kuzeeka - Maambukizo ya bakteria (hizi inaweza kupanda kutoka kibofu cha mkojo, au kuenea kupitia mtiririko wa damu) - abnormalities congenital ya figo (kwa mfano Mifupa ya figo (Lymphosarcoma ni ya kawaida zaidi, kansa ya chembe nyeupe za damu) - Hypertension ( shinikizo la damu la juu) - Maambukizo ya virusi (Feline Immunodeficiency Virus (FIV) au Feline Infectious Peritonitis (FIP)) - Amyloid depositions katika figo Ugonjwa wa figo wa muda mrefu unagunduliwaje? Dalili nyingi za kliniki za ugonjwa wa figo ni zisizoeleweka, na pia zinaweza kuwa dalili za magonjwa mengine yanayotokea. Ili kugundua ugonjwa wa figo, ni muhimu kwamba vipimo zaidi vifanywe. Uchunguzi huo waweza kufanywa kabla ya paka kuwa mgonjwa, wakati ambapo bado kuna uwezekano wa kumtambua mapema. - Uchunguzi wa kimwili <unk> wakati wa uchunguzi wako wa kila mwaka daktari wa mifugo anaweza kugusa figo na atachukua historia kamili kuhusu jinsi paka anavyo kunywa na kukojoa. Kiasi cha kawaida cha kunywa ni karibu 50 ml kwa kilo 24 kwa saa. Ikiwa mnyama wako ana kunywa zaidi ya 100ml kwa saa, hii inaweza kuwa dalili ya ugonjwa wa figo. - Uchunguzi wa damu <unk> <unk>biochemistry<unk> damu panel ni muhimu kuangalia viwango vya urea na creatinine katika damu (viashiria vya kazi ya figo), nyekundu na nyeupe ya damu, potasiamu, phosphorus na electrolytes nyingine. - Mfano wa mkojo <unk> Mfano wa mkojo utachunguzwa kulingana na mkusanyiko wake ("uzito maalum"), ukitoa dalili ya jinsi figo zinavyoweza kukusanya au kuondoa mkojo. Ikiwa uzito wa kipekee ni zaidi ya 1.012, figo zinaweza kuondoa maji na kuunganisha mkojo. Mkojo pia utachunguzwa kwa ajili ya protini, chembe nyekundu na nyeupe za damu, na bakteria yoyote kwa habari zaidi. Kwa kuongezea, mtihani mwingine waweza kufanywa ili kuchunguza mahali ambapo uharibifu umefanywa katika figo. Hii inaitwa "kiwango cha protini ya mkojo na creatine" na inaweza kuongoza dawa kusaidia kupunguza upotezaji wa protini. - Ultrasound ya tumbo <unk> ultrasound (USG) ni njia isiyo ya uvamizi ya kutathmini figo. Hii inaweza kufanyika fahamu bila sedation, lakini inaweza kuhitaji clipping ya manyoya juu ya pande. Daktari wa mifugo anaweza kuangalia ishara za amyloid, kupungua kwa figo kwa sababu ya fibrosis, uvimbe au uvimbe kutokana na maambukizo. Matibabu ya ugonjwa wa figo ya paka inategemea jinsi ugonjwa wa figo unavyoendelea, kulingana na vipimo vya utambuzi vilivyotajwa hapo juu. - Mtiririko wa umajimaji <unk> Hii ni matibabu ya kwanza inayopendekezwa kwa paka mgonjwa, aliye na upungufu wa maji mwilini. Dawa za mkojo husaidia kuondoa figo, kupunguza viwango vya sumu katika mtiririko wa damu, na kumpa paka wako maji. - Vichocheo vya hamu ya kula (cyproheptadine) na AnabolicSteroids (laurabolin) <unk> Hizi hutumiwa kupata paka wako kula tena, na kupambana na kupoteza misuli. - Mabadiliko ya lishe <unk> Lishe ya figo ya dawa imepunguza viwango vya protini na fosforasi. Hilo litapunguza kazi ambayo figo zinahitaji kufanya, na viwango vya sumu katika damu. - Phosphate Binders (Ipakitine)  Figo zilizoharibiwa zina uwezo mdogo wa kuchanganua phosphate. Dawa hii itaunganisha fosforasi katika matumbo ili isiingie katika mzunguko wa damu na kujikusanya katika mtiririko wa damu. - Antibiotics <unk> Kama mkojo wa njia ya mkojo au figo ni, antibiotics sahihi itakuwa kuagizwa <unk> kawaida wale excreted katika mkojo kama vile amoxicillin. - Potasiamu Supplementation  hasara ya kupita kiasi ya potasiamu wakati figo kushindwa matokeo katika udhaifu wa misuli na ubora duni ya kanzu. - Ufuatiliaji wa shinikizo la damu <unk> Shinikizo la damu linadhibitiwa ili kupunguza uwezekano wa uharibifu zaidi wa figo. Matibabu (kwa kawaida enalapril au amlodipine) itaanza ikiwa shinikizo la damu la juu linagunduliwa. - Ufuatiliaji na matibabu ya upungufu wa damu <unk> Figo zilizoharibiwa hazitokezi homoni <unk> erythropoietin <unk> inayohitajika kwa uzalishaji wa chembe nyekundu za damu. Ikiwa inapatikana, hii yaweza kutolewa katika fomu ya synthetic ili kuchochea uzalishaji wa chembe nyekundu za damu. - Kutoa maji mengi <unk> Kuhamasisha paka wako kunywa na vikombe vingi vya maji, kuhakikisha kuwa daima vimejaa maji safi kama paka wenye ugonjwa wa figo sugu wana hatari kubwa ya dehydration. Kwa wale ambao wana umri wa miaka 12 na zaidi, Sunset Vet inashauriwa kuja kwenye kliniki angalau kila baada ya miezi mitatu kwa uchunguzi wa wazee, ili ikiwa magonjwa kama ugonjwa wa figo sugu, shinikizo la damu au hyperthyroidism zipo, tuweze kuwakamata na kuwatibu mapema na kuongeza muda wa maisha ya mnyama wako. Sunset Vet inatoa huduma za mifugo kupitia kliniki zao za Kuta (24hr) na Ubud (8am-10pm). Kwa maelezo zaidi au kwa ajili ya kuweka miadi, piga simu kwenye 03648915 (Kuta) au 0364996 (Ubud) au tembelea www.sunsetweb.com au www.facebook.com au sunsetweb.com au Instagram: sunsetweb.com Copyright 2018 Bali Advertiser.