There are many possible causes of kidney disease including dental disease, chronic sources of inflammation, and some infectious diseases. Most commonly, we are not sure of the exact underlying cause of a particular patient's kidney disease. Bloodwork, a urinalysis and urine culture, blood pressure, and abdominal ultrasound are recommended in any case of newly diagnosed kidney disease.

When we monitor blood values for "kidney values" what we are referring to is Blood Urea Nitrogen (BUN), SDMA, and Creatinine. These are all values in the blood that increase with kidney disease. Normal range for BUN is 5-36, SDMA is <15.0, and Creatinine should be 0.6- 1.6. BUN and creatinine become elevated when >75% of the kidney is not functioning so by the time we see these values elevated on bloodwork there is already significant disease present. This is the case in all species, including humans.

The kidney has many functions besides filtering blood to create urine. The kidney controls electrolyte balance and is involved in the process of making red blood cells. Depending on which part of the kidneys are diseased, we can see abnormalities in electrolytes, vitamin D, and sometimes anemia. Kidney disease also can be related to high blood pressure. For these reasons, we recommend regular monitoring of electrolytes, blood pressure, kidney values, and red blood cells.

It is important to know that chronic kidney disease is progressive and incurable. What we hope to achieve through treatment is a good quality life for as long as possible. I recommend the following diagnostics for any newly diagnosed pet with kidney disease: blood chemistry, red and white blood cell count, urinalysis - to look at concentration of the urine or signs on infection, thyroid level (in cats), blood pressure, and abdominal ultrasound to evaluate the structure of the kidneys. After initial diagnostics and initiation of therapy, I recommend rechecking kidney values and blood pressure every 1-3 months to assess progress and to check for electrolyte or red blood cell abnormalities. We would treat electrolyte disturbances, hypertension, or anemia if identified.

Kidney Diet: There are many kidney diets available. These diets have been shown through clinical trials to extend the life of patients with kidney disease. Royal Canin, Purina, and Hills all have multiple dry and wet food flavors. We recommend trying multiple to see which your pet likes best. You will need a prescription for these diets from your pet's veterinarian.

Blood Pressure Monitoring/Medication: A blood pressure medication may be considered depending on blood pressure results. If this medication is appropriate for your pet, s/he will likely be on this medication forever.

Water consumption:It is very important to encourage water consumption and hydration, since diseased kidneys can not save water the same way a normal kidney would. You may have noticed your pet having increased thirst and urination. This is a very common symptom of kidney disease. Ways to encourage consumption/hydration include providing fresh water daily or the use of a water fountain and/or feeding wet or moistened food. Sometimes other fluid therapy is needed (IV or subcutaneous fluids) as the disease progresses.

If your pet is diagnosed with kidney disease, our goals are to keep your pet happy and feeling as good as possible for as long as possible. Many cats can live with well-managed kidney disease with good quality of life for years. Treatment will be tailored to his/her individual needs and response to treatment. A helpful website with up-to-date, accurate and informative material is here if you would like a more in depth look at kidney disease.

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