How to Manage End Stage Renal Failure in Dogs

The function of the kidney is to rid the body of waste produced during metabolism. Removal of waste takes place within the kidneys through a system of nephrons. Contained in each nephron is a glomerulus (sieve-like filtering structure). This system maintains correct blood protein and cell levels while unneeded fluid and waste are excreted in the urine. As a dog ages, the kidneys lose the ability to filter the blood due to the destruction of the glomeruli. When 80 percent of these filters are clogged or destroyed, waste levels start to increase in the bloodstream and eventually lead to chronic kidney disease or stage four renal failure.

Things You'll Need

  • Fresh water
  • Calcitrol (optional)
  • Maalox (optional)
  • High-quality protein dog food
  • H2-receptor antagonist
  • Dietary supplements

Instructions

  1. Evaluation and Treatment

    • 1

      Evaluate your dog's condition. Kidney damage is irreversible; however, dogs in stage four renal failure can live comfortably for an indefinite period with proper management. Dogs should be evaluated by a veterinarian every one to two months. Monitor blood urea nitrogen (BUN) and blood creatine levels. These are both waste products which rise in the blood when there is not enough healthy glomeruli to excrete it in urine. These tests are normally run together, reported as BUN-creatine ratio and help determine which therapies to incorporate.

    • 2

      Provide fresh clean water at all times. Renal failure requires the dog to drink in excess to help flush the kidneys. Extra fluids may be administered either intravenously (IV) or under the skin (subcutaneously). This helps restore metabolic balance by flushing the dog's body of nitrogenous waste.

    • 3

      Avoid foods high in phosphorus. Phosphorus is normally filtered through the kidneys. When filtration is impaired, phosphorus levels rise in the bloodstream and calcium may be extracted from bone to correct the calcium-to-phosphorus ratio, which should be 2-1.Supplementing Calcitrol may help restore an imbalanced ratio. Or if necessary, specific phosphorus-binding drugs, such as Maalox, may be prescribed to lower blood levels.

    • 4

      Feed your dog high-quality protein at a level of 2.0-2.8 g/kg/day. There are commercially available foods formulated for animals with renal failure as well. Dogs suffering from decreased appetite, depression, vomiting, diarrhea and bad breath (uremia) may benefit from a dietary restriction of protein, and adding soluble fiber to help manage excess urea.

    • 5

      Administer an H2-receptor antagonist to reduce gastric acidity and vomiting. Products with active ingredients of ranitidine, cimetidine, famotidine or nizatidine work by decreasing the amount of acid produced in the stomach.

    • 6

      Add supplements. Dogs in stage four renal failure often suffer from digestive upset. This may inhibit the absorption of nutrients, causing weight loss and anemia. Adding B vitamins to the dog's diet will stimulate appetite. Supplementing iron will help offset the loss of red blood cell production. Flaxseed, Vitamin E and omega-3 fatty acids such as fish oil slow kidney destruction. If veterinary evaluation shows low potassium levels, potassium can be supplemented as well.