Management of chronic kidney disease in cats and dogs

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Management of chronic kidney disease in cats and dogs

Chronic kidney disease (CKD) is a common condition in cats and dogs and the diagnosis of the condition remains a challenge. The International Renal Interest Society (IRIS) have published a staging system to stage chronic kidney disease in cats and dogs and assist the decision making process for the appropriate therapy and management of the disease.

O’Neill, D.G. et al. (2013) Canine chronic kidney disease in UK veterinary practices: prevalence, risk factors and survival. Journal of Veterinary Internal Medicine, 27 (4), pp. 814-821 Available on open access https://onlinelibrary.wiley.com/doi/abs/10.1111/jvim.12090 [Accessed 10/4/2018]
Lefebvre, S. (2011) Literature review – epidemiology of feline chronic kidney disease. Banfield Applied Research & Knowledge Team Report. Available free online: https://www.banfield.com/getmedia/cc31e44a-f06e-4660-b3b7-e32478e26069/9e7f2a34-c7e5-4504-b04a-2524b8331c42-pdf0 [Accessed 10/4/2018]

A comprehensive list of references from a search on CAB Abstracts is available to download.

Diagnosis and staging

- Sparkes, Andrew H. et al (2016) ISFM consensus guidelines on the diagnosis and management of feline chronic kidney disease Journal of Feline Medicine and Surgery, 18 (3), pp. 219-239 [This article can be accessed via RCVS Knowledge Library membership, click here]
- IRIS Staging CKD for dogs and cats; and the Substaging CKD by proteinuria and by blood pressure Available from: https://www.iris-kidney.com/guidelines/staging.html [Accessed 10/4/2018]
- Chalhoub, S. (2018) Staging chronic kidney disease: how and why? Feline Focus, 4 (3), pp. 57-65 [Access to this article requires registration for ISFM Veterinary Nurses and Technicians Membership. Membership is free]

See list of references for more information on diagnosis and staging of the disease.

Biomarkers

Serum/plasma levels of fibroblast growth factor-23, cystatin C and SDMA (symmetric dimethylarginine) are some of the biomarkers highlighted in recent published research and will be of future interest. A persistently high level of plasma SDMA seems to indicate the onset of reduced renal function: SDMA is now a new biomarker commercially used for renal disease.

Dahlem, D.P. et al. (2017) Plasma symmetric dimethylarginine concentration in dogs with acute kidney injury and chronic kidney Journal of Veterinary Internal Medicine, 31 (3), pp. 799-804 Available on open access https://onlinelibrary.wiley.com/doi/abs/10.1111/jvim.14694 [Accessed 10/4/2018]
Relford, R., Robertson, J. and Clements, C. (2016) Symmetric dimethylarginine: improving the diagnosis and staging of chronic kidney disease in small animals. (Special Issue: Chronic kidney disease). Veterinary Clinics of North America, Small Animal Practice, 46 (6), pp. 941-960 [This article can be accessed via RCVS Knowledge Library membership, click here]
Ghys, L. et al. (2014) Evaluation of Cystatin C for the detection of chronic kidney disease in cats. Journal of Veterinary Internal Medicine, 28 (4), pp. 1152-1164 Available on open access https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.14256 [Accessed 11/4/2018]

See list of references for information on other renal biomarkers for the assessment and staging of chronic kidney disease.

Therapy and management

- McLeonard, C.A. (2017) Are adult cats fed on wet maintenance diets less at risk of developing chronic kidney disease compared to adult cats fed on dry maintenance diets? Veterinary Evidence, 2 (4),130 Available on open access https://veterinaryevidence.org/index.php/ve/article/view/130 [Accessed 10/4/2018]
- Ograin, V. (2017) Innovations in nutritional therapy for cats with chronic kidney disease. The Veterinary Nurse, 8 (10), pp. 534-541 [This article can be accessed via RCVS Knowledge Library membership, click here]
- King, J.N. et al. (2017) Effects of benazepril on survival of dogs with chronic kidney disease: a multicentre, randomized, blinded, placebo-controlled clinical trial. Journal of Veterinary Internal Medicine, 31 (4), pp. 1113-1122 Available on open access https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.14726 [Accessed 10/4/2018]

See list of references for information about therapies and the management of chronic kidney disease.

To continue with the topic on kidney diseases in cats and dogs, the next In The Spotlight topic will be on urinary tract infections, urinary incontinence, calculi, stones, crystals and uroliths.

Upcoming free webinar

Royal Canin are hosting a mini-series of 3 x 30 mins webinars on Evidence-based veterinary medicine: a practical approach which will look at the what, how and why EBVM is so critical to our future success. The third webinar in this series on 1 May 2018 is of particular interest to this topic – Dr. Rachel Dean BVMS PhD MSc(EBHC) DSAM(fel) SFHEA MRCVS will talk about “Why: a (nutritional) case study in practice” which will look at the clinical application of EBVM with a focus on chronic kidney disease in cats. For more information on this mini-series of EBVM webinars and to register for free https://vetportal.royalcanin.co.uk/cpd/webinar2018/

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Management of chronic kidney disease in cats and dogs