Universal Press Syndicate
The recent pet-food recall in response to the deaths of pets nationwide brought attention to an important body system that gets little attention until there's a problem: the kidneys.
The kidneys act like a water filtration system in reverse, trapping and recycling substances the body needs, such as proteins, and letting waste materials pass through. If any part of this complex filtration process breaks down, toxins in the bloodstream can rise to life-threatening levels.
"The kidneys are vulnerable, and once the kidney tissue is damaged, it is unlikely to regenerate," said Dr. Nancy Zimmerman of Banfield, The Pet Hospital, which is based in Portland, Ore., and has more than 600 locations nationwide.
Treatment -- often giving massive amounts of fluids -- is aimed at restoring the kidneys to normal function so they can resume doing their job of filtration. If that's not possible, the toxins in the blood must be reduced to safe levels some other way. Diet, drug therapy, agents that bind toxins and eliminate them, and even dialysis (see sidebar) can be used.
Chronic kidney failure is usually found in aging pets and can be detected with a simple blood test. Acute kidney failure is typically marked by vomiting, increased thirst, increased or lack of urination, lethargy, bad breath, diarrhea and lack of appetite. These symptoms signal a health crisis, with time being the difference between whether an animal lives or dies.
The critical issue of response is why veterinarians don't recommend that pet lovers wait a day or more after the onset of symptoms in hopes a problem will go away on its own. When sick pets finally arrive at the veterinary hospital, 75 percent of kidney function can already be gone for good. Wait much longer, and the chances of survival are not good.
Poisoning by pet food isn't by any means the normal trigger for acute renal failure, says Dr. Katherine James of the Veterinary Information Network, an online service for veterinary professionals based in Davis, Calif.
"In dogs and cats, we worry about ethylene glycol -- antifreeze," said Dr. James, who also has a Ph.D. in the study of kidney function. "In dogs, we also have the issue of grapes and raisins. That might be an issue in cats as well, except they won't eat the things. And in cats, of course, you have their sensitivity to lilies, which they will eat."
No matter what the cause is of sudden-onset kidney failure, the treatment needs to be swift. At the very least, says Dr. Zimmerman, the pet will need to be placed on intravenous fluids and may need to be provided with antibiotics as well as other medications to suppress vomiting and diarrhea. The treatment plan is designed to help to flush the kidneys while supporting the body through the crisis.
If the intervention is successful, the animal will be left with enough kidney function to survive, although perhaps with chronic kidney issues that need lifetime treatment.
Although the prognosis can be grim in many sudden cases of kidney failure, Dr. Zimmerman says it's always worth trying to save a pet.
"These cases are hard to predict at the beginning and very few times you can predict the outcome from the get-go," she said. "When there's a quality-of-life issue, then yes, it may be time to let go. But a lot of these animals are saved, and it's always worth trying."
(Gina Spadafori and Christie Keith contributed to this story.)
SIDEBAR
Dialysis, transplants also an option
Sophisticated -- and expensive -- medical procedures might save pets with some forms of kidney failure.
Dr. Larry Cowgill developed the world's first companion animal hemodialysis program at the University of California, Davis, in 1990. "We'll often see an animal with a recoverable disease who just needs to be kept alive until they're well," he said.
Dialysis can also be a near-miracle for pets who have consumed ethylene glycol products such as antifreeze. "If we get those animals soon enough," said Dr. Cowgill, "say, in the first 10 or 12 hours, we can get rid of that toxin before they get any kidney damage."
UCD is also one of the few places in the world where dogs and cats can receive kidney transplants. Cats in need of a donated kidney can get one from one of the hospital's own cats -- a cat who then has to be given a lifelong home. Dogs need to find their own donors. Pets who survive the first year post-transplant may go on to live for many years.
Costs are high. Transplantation costs range from $9,000 to $13,000. Dialysis setup runs around $3,000, with additional costs depending on the length of treatment. Veterinarians can refer clients to specialty practices or veterinary schools or colleges that offer such care. -- Christie Keith
Pet Connection is produced by a team of team of pet-care experts headed by "Good Morning America" veterinarian Dr. Marty Becker and award-winning journalist Gina Spadafori. The two are also the authors of several best-selling pet-care books. Contact Pet Connection in care of this newspaper, by sending e-mail to petconnection@gmail.com or by visiting PetConnection.com.
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