Your pet is suspected of having chronic kidney disease. Kidney disease is one of the most common disease of older cats and is 2-3 times as frequent as kidney disease in dogs.

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 good quality life for as long as possible. I recommend the following diagnostics for any newly diagnosed pet with kidney disease:blood chemistry (already performed)red and white blood cell count (already performed)urinalysis - to look at concentration of the urine or signs on infectionthyroid level (in cats)blood pressureabdominal ultrasound to evaluate the structure of the kidneysAfter 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.

Generally we recommend the following therapies for patients newly diagnosed with kidney disease: Kidney Diet - there are many available. These diet 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. I recommend trying a bunch to see which your pet likes best. These can be ordered online (Chewy, 1800 pet meds, etc.) or they can be picked up at PetSmart with a Rx. If you would like a written Rx please let me know.

Benazepril- ACE inhibitor- blood pressure medication- this alters the blood pressure inside the kidney to help slow the disease process by allowing the kidneys to "not work quite as hard" . This can also help loss of protein through the urine. This medication may be considered depending on blood pressure results. Benazepril - please give _ tablet(s) by mouth every 24 hours. Your pet 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: fresh water daily or the use of a water fountainfeeding wet or moistened food.

Fluids administered under the skin, either at a hospital, or we can teach you how to do this at home.

Intravenous fluids via hospitalization - may be needed if Your pet gets very dehydrated, lethargic, or stops eating.

Additional blood pressure medication (often amlodipine) if your pet has high systemic blood pressure.

Please schedule a progress examination in _ days for a recheck of his/her kidney values and a blood pressure check.

I know this is a lot to process. Our goals are to keep Your pet happy and feeling as good as possible for as long as possible. We will tailor treatment to his/her individual needs and response to treatment. A helpful website with up-to-date, accurate and informative material is here. After digesting this information, please feel free to reach out to me to discuss further if you have questions or concerns.

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