Our Archives: kidney

Question from Susanne Hayward: how come no symtems to know if your dog has kidney failier Answer from Shanika Winters: Hi Susanne and thank you for your question about how to know if your dog has kidney failure.  I will answer your question by discussing what kidney failure is, how we diagnose it and what signs you can look out for in your dog. So what is kidney failure? The kidneys are two bean shaped organs present mid way along the back of your dog’s abdomen (tummy); they have a large blood vessel going in and another large blood vessel coming out of them.  The job of the kidneys is to filter your dog's blood and remove toxic/waste products but make sure that the important useful chemicals e.g. proteins, nutrients (sugars and fats) and blood cells remain in the blood.  The kidneys are also involved in breaking down some chemicals such as medications.  The Kidneys are also important when it comes to keeping the correct amount of water in your dog's blood, this ensures that all the body cells are adequately hydrated and can function at their best. Kidney failure is a term used to describe a stage of kidney disease once more than two thirds of your dog's kidney function has been lost.  That means that out of the function of your dogs two kidneys there is a third or less now working.  Kidney disease is a broader term used to describe any problem with the kidneys this could be infection, neoplasia (tumour), polycystic (disease where kidneys are taken up by lots of cysts or cavities) or loss of function with age. So how does my vet look for kidney disease? Whenever you take your dog to see your vet they will ask you questions regarding how your dog is doing in general including how they are eating, drinking, urinating (weeing) and defecating (pooing).  These along with other questions will give your vet an idea as to your dog's general state of health and is called a history. The answers to the questions your vet asks along with anything they find on physically examining your dog along with the reasons as to why you brought your dog to see the vet will help your vet to try and work out what is going on with your dog. Some specific findings in kidney disease: Whether your pet is young, middle aged or elderly the following may be found: Anorexia Some dogs either completely stop eating or have a reduced appetite due to the build-up of toxins in their blood which makes them feels under the weather. Weight Loss Most dogs will start to lose weight as they are eating less but also as they are losing important substances such as proteins from their blood as these are not reabsorbed by he kidneys and end up being lost into the urine (wee). Polydypsia/Polyuria This means increased drinking and urination, and happens as the kidneys try to remove more waste products and toxins by flushing them out by producing more watery urine. Change in kidney size The kidneys can become small and hard or even large.  With some tumours or polycystic kidney disease the kidneys can become larger.  In cases where the kidney function has decreased and the working part of the kidneys has become replaced by fibrous tissue then the kidneys can become smaller and harder.  Usually the size of the kidneys is something your vet will try and feel or look at on a scan or x-ray. Halitosis Some dogs may show a strange unpleasant smell on their breath, this can happen when waste products such as urea build up in the blood and can give off a smell. Blood changes Your vet may suggest doing blood tests of your dog, this is to identify changes to chemicals in your dogs blood such as increased levels of urea, creatinine, potassium and phospahate but also decreased levels of proteins and blood cells.  The blood results can be used to monitor how your dog's kidney disease is going. Urine changes Dogs with kidney failure tend to produce large quantities of very dilute urine which can contain protein.  As kidney disease progresses the actual amounts of urine produced can sometimes decrease as the kidneys are no longer able to filter out and flush out the waste products from the blood.  Testing your dog's urine is a non-invasive way for your vet to monitor your dog's kidney disease. How can my dog's kidney disease be treated? Depending on the stage of your dog's kidney disease the following treatment options are available: Diet There are specially formulated diets for dogs with kidney disease which have the correct balance of protein, fat, carbohydrate and minerals to ensure your dogs body can function with minimal extra work for its kidneys. Medications There are a wide range of medications available for dogs with kidney disease starting with drugs to improve the blood flow to the kidneys, some to decrease blood pressure (high blood pressure can be damaging to the kidneys), some to bind harmful chemicals and also some to decrease fibrosis (a change where functional kidney tissue is replace by scar tissue). I hope that my answer has helped you to recognise some of the signs of kidney failure/disease in dogs and that along with the help of your vet we can now give dogs with kidney disease the best chance possible when disease is detected early. Shanika Winters MRCVS (Online Vet) If you have any worries about your pet, please make an appointment with your vet, or try our Symptom Guide.

[caption id="attachment_755" align="alignleft" width="225" caption="Lilies - the stamens can easily be removed but ALL parts of the plant are poisonous if eaten"][/caption] As far as plants go, lilies are among the most beautiful. They smell lovely and seem to last forever, making them a fantastic addition to any floral arrangement. Humans adore them and most animals aren’t bothered by them, but for cats, lilies are positively deadly. And it doesn’t take much. A single bite of leaf or lick of pollen can be all it takes to send a cat into irreversible kidney failure. As cat owners, we all need to be aware of how dangerous this common household plant can be, and take the necessary steps to keep our unsuspecting pets safe. What makes lilies so toxic to cats? • We don’t know exactly which chemical within the lily is so dangerous, but we do know that ingesting the smallest amount of leaf, stem, flower or even pollen can be deadly. • Most types of lilies are poisonous, including asian lilies (Lily asiatica), tiger lilies (Lilium tigrinum), stargazer lilies (Lilium orientalis) and Easter lilies (Lilium longiflorum). • Other animals, including dogs and rabbits, can eat lilies with just a bit of mild stomach upset and do not seem to suffer from toxicity. What are the symptoms of lily poisoning? • At first, lily poisoning can mimic other cases of ‘dietary indiscretion’ as we like to call it (eating something that they shouldn’t have), so it can be difficult to know what has happened unless you saw them eat it. Signs include vomiting and lethargy, lack of appetite and shaking. If your cat does vomit, always take a look to see what they brought up – this may be icky but it could save your cat’s life if you can tell the vet what they got into. • These initial symptoms can actually disappear for a few hours to a few days, after the plant has passed through the digestive tract but before the real disease becomes obvious. • Within a few days, however, the symptoms become those of kidney failure. This includes increased thirst and urination, dehydration, and worsening lethargy, vomiting and inappetence. Eventually, this increased urination turns into a decrease in urination, and finally no urination at all, which indicates that the kidneys are no longer functioning. What can be done about it? • If you think your cat has eaten any amount of any part of a lily, it is critical that you take them to the vet right away, even before clinical signs appear. And of course, if you notice any of the symptoms listed above, get them to the vet immediately. If it happens outside of your vet’s normal opening hours, phone the designated emergency clinic. • If they make it to the vet within a few hours of ingestion, the vet will likely induce vomiting and possibly give a substance called activated charcoal, which will help lessen the effects of the toxins. • Then, or if too much time has already gone by, the vet may put your cat on a drip and give IV fluids for as long as necessary. These fluids will help support the kidneys as they try to process the poison and flush out any toxins that do make it into the blood stream. • There is no special blood test to diagnose lily toxicity, so many cases go undiagnosed. Your vet will however likely run a general blood and urine test to check how badly the kidneys may have been damaged. These tests will probably need to be repeated several times during their stay in hospital. What happens next? • If you are able to get your cat to the vet within a few hours of ingestion, the chances are much greater that they will make it through the incident with the appropriate medical care. It is vitally important that your cat see the vet as soon as possible to begin treatment. • If it has been more than 4 hours since ingestion and the lily toxins have already been absorbed, the prognosis is significantly worse and kidney damage to some degree is likely. • If no treatment is given, or the kidneys have been damaged to the point where urination is starting to decrease, then sadly the chance of survival is very low. • The feline kidney is a very delicate structure and unlike other organs such as the skin or the liver, it does not heal itself once damaged. Therefore, the chance of permanent kidney damage is high and even if the cat survives the initial incident, they may suffer from chronic kidney disease later in life. Long-term fluid therapy and regular blood tests may be necessary to monitor kidney function even after recovering from the initial toxicity. How can lily poisoning be prevented? • The best way to prevent lily poisoning in your own home is to prevent lilies from entering your home in the first place. This is easier said than done when well-meaning significant others or dinner guests bring home a lovely bouquet, however most people will understand your concerns. • Remember, however, that it’s not just lilies in your house that can be deadly, always check your own garden for these and other toxic plants. The internet is a good resource for finding out which plants are child and pet-friendly and which should be avoided, just always make sure you trust the source of your information. • Spread the word - by telling other people about the dangers of lilies, you are helping to increase awareness of the problem. The ISFM (International Society of Feline Medicine) has launched a campaign to help educate the public about lily toxicity. Their website has informative posters and tags to be put around floral arrangements that contain lilies at the florist. The more people know about lily toxicity, the safer all of our cats will be. If you are concerned that your cat may have eaten any part of a lily, or any other toxic material, contact your vet immediately. If you are sure lilies are not to blame our Interactive Cat Symptom Guide can be used to check out any problems you are worried about.

[caption id="attachment_755" align="alignleft" width="225" caption="Lilies - the stamens can easily be removed but ALL parts of the plant are poisonous to cats if eaten."][/caption] Lilies are beautiful flowers, exotic in appearance and heavily scented. They are often included in bouquets and floral arrangements, but cat owners need to know that they are extremely poisonous if eaten, or even if pollen is accidentally swallowed whilst grooming after brushing against a lily. It is thought that all parts of the lily flower and plant are poisonous to cats if eaten, and the effects are very serious and very fast. Only a very small amount needs to be eaten to cause devastating effects. Unfortunately kittens are most susceptible, not only because of their size but also because of their natural curiosity and tendency to investigate everything. The poison acts mainly on the kidneys and is absorbed very rapidly. The first sign is usually severe vomiting but cats may also show loss of appetite, depression, salivation, twitching or collapse. Sadly, a high number of them will die due to irreversible kidney damage. Others will survive but have permanent kidney damage. Only a lucky few will survive without long-lasting effects. The most important factor in treatment is seeking rapid veterinary help. Any cat which has been seen to eat part of a lily or is vomiting and has had possible contact with lilies, should be considered a veterinary emergency. There is no specific antidote to lily poisoning, but the chance of survival will be increased by giving fluid therapy as early as possible. By placing the cat on a drip, the kidneys are helped to eliminate the toxin and limit the damage to the kidneys. The rate of administration of fluids will be much higher than usual and will need to continue for several days if the cat is recovering. If a cat is presented very early, even before vomiting has occurred, it might be useful to induce vomiting to try to stop toxin being absorbed, or to lavage, or wash out, the stomach or to try to line the stomach with a charcoal substance to reduce further absorption. Other drugs may be given as well, particularly if there are neurological symptoms such as twitching, salivating or fitting. I have seen several cases of lily poisoning in cats over the years, and sadly, at least half of them died or were put to sleep because the effects were so severe. In my opinion, the warnings on lilies sold in some shops are not obvious enough. Some labels may carry a single line such as “Lily pollen is harmful to cats if eaten”, but this does not really convey the seriousness of the situation or advise the buyer that immediate action is needed. Some supermarket lilies have had the pollen bearing parts removed, but this does not change the fact that all parts of the plant are poisonous if eaten rather than just brushed against. If you own a cat it is worth considering keeping lilies out of your house altogether, or at least out of reach. Bear in mind that a healthy curious cat can reach most things if it puts its mind to it! If you are worried that your cat may have eaten part of a lily, or about any other health problems, please contact your vet immediately.