Chronic renal (kidney) failure (CRF) is a common problem in all dog breeds. The digestion of food produces waste products, which are carried by blood to the kidneys to be filtered and excreted in the form of urine. When the kidneys fail, they are no longer able to remove these waste products, and toxins build up in the blood producing clinical signs of kidney disease.

All breeds of any age can be affected. However, older pets are commonly affected as the prevalence increases with age. The average age of diagnosis in dogs is seven years.

Breeds thought to be more susceptible include:

1. Cocker spaniel
2. Lhasa apso
3. Shih tzu
4. Norwegian elkhound
5. Doberman pinscher
6. Soft-coated wheaten terrier
7. Golden retriever
8. Bull terrier
9. Cairn terrier
10. German shepherd
11. Samoyed

CRF affects almost every body system causing many changes throughout the body and
usually results in the following:

Abnormal filtration of blood and retention of waste materials
Failure of hormone production (including substances that stimulates the production of red blood cells [erythropoeitin])
Disturbance of fluid, electrolyte and acid-base balance

CRF can be caused by several different processes. These may include diseases, some of which can be secondary to other disease processes or trauma, that may have caused acute kidney failure such as:

1. Toxins
2. Poor blood flow and lack of oxygen (ischemia)
3. Inflammatory disease
4. Infections
5. Cancer (neoplasia)
6. Immune system abnormalities.

What to Watch For

1. Increased thirst
2. Excessive drinking
3. Increased urination
4. Lethargy
5. Vomiting
6. Bad breath
7. Anorexia
8. Weakness
9. Lack of coordination when walking
10. Depression

Diagnosis

Diagnostic tests are needed to recognize CRF and exclude other diseases. Tests may include:

1. Complete medical history and physical examination
2. Complete medical history including questions regarding change in water consumption and urination, exposure to ethylene glycol (antifreeze), recent surgery or anesthesia, drug therapy, appetite, weight loss, previous illness, and medications
3. Complete physical examination
4. Biochemistry tests
5. Urinalysis
6. Complete blood count (CBC)

Other diagnostic tests may include:

1. Kidney ultrasonography
2. Excretory urography
3. Blood gas analysis
4. Endogenous or exogenous creatinine clearance
5. Urine protein/creatinine ratio
6. A fine needle aspirate
7. Fractional excretion of electrolyte
8. Kidney biopsy
9. Radioisotope clearance

Treatment

Although there is no cure, early detection can slow the progression of the disease.
CRF can be a life threatening condition that requires hospitalization and treatment for stabilization in extremely ill pets. Treatments may include:

1. Fluid therapy for dehydrated pets
2. Management of blood abnormalities such as hyperkalemia or hypokalemia (abnormal potassium blood levels), metabolic acidosis and hyperphosphatemia
3. Dietary therapy with protein a phosphorus restriction
4. Free access to water
5. Supportive care and careful monitoring of urine output
6. Control of vomiting with diet and drug therapy as needed
7. Management of anemia if needed (with Epogen)

Home Care

Chronic renal failure is life-threatening, and if you suspect your pet has this condition, you should see your veterinarian as soon as possible. Follow-up with your veterinarian for examinations, laboratory work and urinalysis. Blood and urine analysis should be repeated within five to seven days after discharge.

Feed your pet the diet recommended by your veterinarian. Provide free access to fresh clean water at all times. Some owners can administer subcutaneous fluid to their pets at home, if necessary. Your veterinarian can provide instructions when indicated.

Administer any prescribed medications as directed by your veterinarian. Drug therapy may include: phosphate binders; potassium supplementation; or drugs for vomiting (such as cimetidine or famotidine); or anabolic steroids for some patients. Epogen may be given for anemia two to three times weekly.

Preventive Care

1. There are no specific recommendations for prevention of chronic renal failure. However, general suggestions include:
2. Providing frequent attempts to urinate and free access to fresh clean water.
3. Avoiding exposure to ethylene glycol that can cause acute kidney damage.

Other medical problems can lead to symptoms similar to those encountered in CRF. Laboratory testing (blood work and urinalysis testing) will often diagnose CRF. Further diagnostic testing may be needed to determine the underlying cause.

Diseases that can appear similar to those with CRF include:

1. Acromegaly (abnormal enlargement of of the extremities of the skeleton due to overgrowth of connective tissue)
2. Acute renal failure (sudden onset of kidney failure)
3. Diabetes insipidus (a metabolic disorder, which results in a deficient quantity of the hormone ADH being released or produced, resulting in failure of reabsorption of water in the kidney)
4. Diabetes mellitus (malfunction of the pancreas, whose function is the production and release of insulin)
5. Drugs (diuretics, corticosteroids)
6. Excessive parenteral fluid administration
7. Hyperadrenocorti
8. cism (Cushing’s disease)
9. Hypercalcemia (high blood calcium)
10. Hypoadrenocorticism (Addison’s disease)
11. Hypokalemia (low blood potassium)
12. Liver disease
13. Multiple myeloma (cancer)
14. Partial urinary tract obstruction
15. Polycythemia (an increase in the circulating red blood cell mass)
16. Post-obstructive diuresis (an increased excretion of the urine due to the diuretic effect of urea and electrolytes retained during the period of obstruction)
17. Primary hyperparathyroidism (abnormally increased activity of the parathyroid gland)
18. Psychogenic polydipsia (excessive drinking caused by psychological causes, such as boredom)
19. Pyelonephritis (inflammation of the kidney and renal pelvis)
20. Pyometra (uterine infection of intact dogs)
21. Renal glucosuria (the presence of sugar in the urine)

Causes

1. Chronic interstitial nephritis (inflammation of the kidney) of unknown cause (most common)
2. Amyloidosis (when the protein amyloid is deposited in various tissues tissues become waxy and nonfunctioning)
3. Chronic glomerulonephritis (a variety of nephritis)
4. Chronic obstructive uropathy (any disease in the urinary tract)
5. Chronic pyelonephritis (inflammation of the kidney and renal pelvis)
6. Familial renal disease (disease pets can be born with such as in cocker spaniel, Lhasa apso, shih tzu, Norwegian elkhound, Samoyed, Doberman pinscher, soft-coated wheaten terrier, bull terrier, golden retriever, and others)
7. From acute renal failure
8. Hypercalcemic nephropathy (caused by high blood calcium)
9. Leptospirosis (an infectious disease of all species)
10. Cancer of the kidney
11. Veterinary care should include diagnostic tests and subsequent treatment recommendations.
12. Diagnosis In-depth
13. Diagnostic tests must be performed to confirm the diagnosis of CRF and exclude other diseases that may cause similar symptoms.

For further details please refer to: http://www.petplace.com/dogs/chronic-renal-kidney-failure-in-dogs/page1.aspx