Renal failure most often develops in elderly dogs against a background of acute and chronic kidney disease. Renal failure is a serious pathology in which the kidneys stop performing their functions - cleaning the body of toxins, removing the fluid, synthesizing hormones, maintaining the water and electrolyte balance.
- Классификация видов почечной недостаточности 1. Classification of types of renal failure
- Стадии прогрессирования заболевания 2. Stages of disease progression
- Причины возникновения патологии 3. Causes of pathology
- Симптомы патологии и причины их появления 4. Symptoms and pathology of pathology
- Методы диагностики заболевания 5. Methods of diagnosing the disease
- Методы лечения патологии 6. Methods of treatment of pathology
- Медикаментозная терапия 7. Drug therapy
- Диетотерапия 8. Dietotherapy
Classification of types of renal failure
The disease is classified according to the speed of the pathological process on:
- chronic renal failure.
Acute renal failure occurs as a result of the toxic effects of various substances. The disease is accompanied by an acute course and marked symptoms. The acute stage is divided into several forms:
- prenital - arises from the violation of blood supply in the body and the drop in blood pressure. Often is a consequence of general anesthesia during surgery;
- Parenchymal - appears when the body parenchyma directly affects an infectious or chemical agent;
- Obstructive - manifested as a result of blockage of the urinary tract by concrements. Most often it is the result of advanced urolithiasis, parasitic invasion or bile duct obstruction.
If in the prerenal form of acute renal failure in dogs the blood supply is disrupted, but not completely terminated, no more than a few hours, then the structure and function of the organ can be restored. With a longer disturbance, the structure of the tissues is destroyed, and the pathology passes into the next form - parenchymal.
Chronic renal failure is characterized by a slow gradual development. At the same time there is a progressive irreversible loss of kidney parenchyma, which manifests itself in the form of impaired glomerular and tubular function, uremia develops and an imbalance of water-electrolyte and osmotic homeostasis occurs. Chronic renal failure occurs with massive damage to kidney tissue.
Stages of disease progression
There are several classifications that describe the progression of pathology:
- Stage 1 - compensated - only the reserve properties of the kidneys are reduced without disturbing the body's homeostasis;
- Stage 2 - subcompensated - increased nitrogen and creatine in the blood, a violation of the partial properties of kidney tissue;
- Stage 3 - decompensated - the symptoms of the disease are expressed, the creatine content in the blood exceeds the norm several times;
- Stage 4 - terminal - the final stage, in which the kidneys cease to function, the animal falls into a coma and dies.
The causes of chronic renal failure are diverse.
Causes of pathology
The disease can be caused by a variety of different causes:
- pyelonephritis , which in dogs leads to complete tissue destruction and organ failure;
- intoxication as a result of vital activity of parasites;
- hereditary diseases characteristic of some dog breeds, for example, amyloidosis;
- exposure to toxic substances , including drugs;
- cysts ;
- neoplasms of various etiologies ;
- concrements in the kidneys , large or small.
In old dogs, pathology is caused by natural degenerative processes occurring in the body. Since the causes of the pathology are different, then the symptoms of the disease are different. But there are general, caused by malfunction of the kidneys.
Symptoms and pathology of pathology
The initial stages of the pathological process in the kidneys is asymptomatic, since compensation processes still operate, and healthy tissue cells perform the functions of the altered ones. Symptoms of renal insufficiency begin to appear when 25-30% of tissues are affected. Symptoms are expressed in:
- Dyspnea , which appears due to the accumulation of under-oxidized products. An increase in their number causes metabolic acidosis compensated by respiratory alkalosis, caused by rapid breathing;
- vomiting , which results from an imbalance in the water-electrolytic state. Urea and creatine accumulate in the body, which can not be compensated for by hyperventilation. Intoxication and causes vomiting in the dog;
- intoxication , which is increasing, affecting the central nervous system. Initially, the animal behaves restlessly, then there is a depression of the nervous system, expressed as apathy, refusal to eat. Acceleration of the process leads to seizures, trembling of the limbs. The most severe consequence of intoxication with metabolic products is coma and death of the animal;
- edema caused by an imbalance of electrolytes, a decrease in the number of proteins in the blood plasma, increased fluid intake;
- an increase in diuresis , which appears as a result of increased protein catabolism, and an increase in the release of endogenous water. Difficulty urinating can be the result of blocking the urinary tract;
- the formation of ulcers in the oral cavity;
- violation of defecation .
If these symptoms appear in the dog, then 2/3 of the organs are already affected, and the disease has become chronic. Progression of renal failure in dogs leads to malfunctions in the functioning of the cardiovascular system. First, blood pressure is lowered, then hypotension is transformed into persistent arterial hypertension.
With prolonged current anuria, the symptoms of heart failure in the animal are increasing. On the background of heart failure may appear edema of the lungs, brain pathologies. To conduct differential diagnostics and determine pathology at an early stage, while the process of destruction of kidney tissues is still reversible, modern instrumental and biochemical methods of research are used.
Methods of diagnosing the disease
Biochemical and clinical analyzes of blood and urine are prescribed to clarify the diagnosis and its stage. In the blood of dogs with kidney failure there are signs of a violation of carbohydrate and mineral metabolism:
- the level of sugar decreases ;
- significantly increases amylase ;
- increases lactate dehydratase - an enzyme involved in the metabolism of glucose. An increase in the amount of enzyme in the blood indicates the destruction of liver cells;
- increases the direct and total bilirubin, aspartate aminotransferase , which indicates a hepatotoxic syndrome, concomitant renal failure in dogs;
- the level of urea and creatine increases, nitrogen - the main diagnostic sign of pathology.
In dogs with renal pathology, the activity of creatine phosphokinase increases, which signals a progressive heart failure or some medications. The violation of mineral metabolism is manifested in the increase or decrease in the level of some important minerals - sodium, potassium, calcium, phosphorus, magnesium, chlorine.
Kidneys are the most important organ in the regulation of phosphorus balance. If there is a violation of filtration in the glomerulus of the kidneys, the extraction of phosphorus decreases. The level of the mineral triggers a chain of compensatory reactions, for example, an increase in the activity of thyroid hormones is observed. Secondary hyperparathyroidism is typical for dogs with renal insufficiency.
A blood test in a dog confirms the diagnosis of renal failure, which should be clarified with the help of instrumental research methods:
It is recommended to conduct regular examinations not only after the symptoms of pathology have already appeared, but also preventive - in animals belonging to risk groups:
- dogs, over 7 years;
- representatives of breeds predisposed to renal pathology (chow-chow, shar-pei, bull terrier).
It is recommended to examine animals from these groups every 3-6 months to prevent the disease, correct the nutrition in time, and to carry out preventive medication. However, the listed reactions are revealed when more than half of the functional structures of the kidneys have already been affected. Based on the results obtained, an individual strategy for the treatment of the animal is developed.
Methods of treatment of pathology
Since renal failure is the result of progressive pathologies accompanied by irreversible changes, pathology therapy is aimed at reducing the severity of symptoms, preventing the progression of the disease and prolonging the life of the pet. As the main methods of treatment of renal failure are used:
- drug treatment;
- diet therapy.
Depending on the reasons that caused the disease, they choose the tactics of treatment.
Therapy depends on what causes caused the dysfunction of the glomeruli of the kidneys. If the cause of kidney failure is an inflammatory process caused by an allergy or infection, then a course of drugs that suppress inflammation is prescribed - drugs from a group of non-steroidal anti-inflammatory drugs or antibiotics.
In order to normalize the water-electrolyte balance, it is necessary to carry out infusion infusions of solutions - saline solution, glucose solution, buffer solutions, etc. To maintain the functioning of the liver and heart, prescribe the appropriate drugs. In order to stabilize blood pressure, the dog is given antihypertensive drugs, sedatives, probiotics to improve digestion.
Many dogs with drug therapy have allergic reactions and side effects on drugs. When appointing several drugs simultaneously, the doctor must take into account their interaction. Many therapeutic agents are excreted by the kidneys, and with reduced renal function and a longer period of excretion of metabolites, the veterinarian should prescribe the dosage of drugs taking into account these features. To correct the dose are guided by the clearance of creatine. To reduce the level of phosphorus, the dog is given preparations that bind the mineral to an insoluble form, which are excreted with feces.
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The basis of treatment of renal failure is diet therapy, which can be both an independent method of therapy, and be used in conjunction with drug treatment. The dog must be provided with food, which gives energy for the functioning of the body. To do this, it is necessary to reduce the breakdown of proteins, the depletion of the animal and the manifestation of azotemia.
On average, the dog should receive at least 130-159 calories per kilogram of body weight per day. The greatest energy intensity is possessed by fats and carbohydrates. Therefore, food should contain more fat and carbohydrates than in healthy dogs. A portion of the special food is less than non-dietary food, which reduces the risk of vomiting and defecation.
Proteins, disintegrating, cause azotemia and uremia. Therefore, a special feed should contain high-quality proteins in a reduced amount. But it is found that a smaller amount of food adversely affects the dog's condition - immunity decreases, wounds heal worse, body weight and physical activity decrease. Therefore, therapeutic nutrition is prescribed to dogs when the condition is stabilized. Many companies produce special feeds, for example - Hill's Prescription Diet k / d food, created specifically for the diet of dogs with kidney failure.
If the dog is weakened, refuses food or every meal is accompanied by vomiting, then the animal is fed with a probe or injected the necessary substances with injections and infusions. The condition of a dog with renal insufficiency and the duration of its life depend not only on adequate treatment, but also on the care of the animal of its owner.