Treatment for kidney failure

Answer 1

Treatment for kidney failure is based primarily on slowing the degeneration of the organs - it will not stop further damage nor repair the damage already done. In animals, dialysis is not an option outside of research labs at veterinary colleges so the primary methods of treatment are medications and dietary changes.

Medications to treat the symptoms of kidney failure actually don't primarily affect the kidneys - they are geared toward reducing the cardiovascular degradation caused by the malfunctioning kidneys. These include treatments for high blood pressure, diuretics to encourage water excretion through the kidneys and drugs aimed at supporting heart function. In late stages, additional medications to counteract the secondary problem of bone resorption may be added.

Dietary changes focus on minimizing work for the kidneys and all the major pet food companies have prescription diets formulated for kidney failure patients based on the latest research. The modifications include dropping protein levels to the minimum required levels (most commercial foods actually have excess protein in them, which healthy animals can easily handle), dropping phosphorus and sodium levels to the minimal requirements and focusing on highly digestible nutrients carried in a relatively higher level of soluble and insoluble dietary fiber. The ultimate goal of this is for the food to provide exactly what is needed but no more, because any excess will likely be excreted through the kidneys which increases the work load on the kidney.

If your pet has been diagnosed with kidney failure, please understand that this is a chronic progressive disease that is eventually fatal. While it is extremely distressing and painful to think about, now is actually the best time to start thinking about what signs you will watch for to know when to have your pet euthanized. The actual day of euthanasia may be several years down the road, depending on the degree of kidney damage and the animal's response to treatment, but it is emotionally easier to face this while you have some time to slowly say goodbye. In my opinion, it is better to frame the question in terms of "what quality of life does my pet have?" Some things that may (but don't always) indicate a loss of quality of life include: inability to control the bladder or colon (urinating or defecating outside of the litter box or inside the house), inappetance (reluctance to eat), significant weight loss (your vet can help give you perspective on this), reluctance to play with favorite toys, significant increase in the amount of time spent sleeping, disengaging from the family (won't come when called, doesn't seem interested in being petted, etc.). If you have a list of "signs I know my pet is no longer enjoying his life", it becomes a little easier to say "my pet is suffering, I can no longer ease his/her pain so he/she can enjoy life and I think it may be time to end his/her pain through euthanasia". Talk to your vet - he/she is trained and experienced in these discussions and can help you sort through your emotions, thoughts, beliefs and experiences to help you arrive at a decision you can live with. Also, death from kidney failure is not necessarily painful depending on the secondary problems so you may not need to euthanize to relieve your pet's pain - he/she may be comfortable passing away from natural causes at home without euthanasia.