Ask the Vet: Collie has kidney failure
Our vet has just told us that our Collie has kidney failure. He is only nine. He is thirsty and has a reasonable appetite, but we are devastated. The vet says he can't cure him. Is there anything else we can try?
I'm sorry to hear that, Gordon, but you must not despair. It is true that we can rarely cure kidney failure, but with the correct treatment and careful monitoring, I now expect most of my patients to live a good quality of life for a very long time. On initial diagnosis things can seem much worse than they really are, so I would always ask clients to hold off on big decisions until we attempt to stabilise things a bit first. Chronic renal failure is prone to sudden deterioration (sometimes called 'acute on chronic'), with rapid worsening of function.
Often this is the time that we see clinical signs first, and so the initial blood tests can look terribly bleak, even perhaps falsely suggesting an untreatable situation. Once, however, the wee dog has been rehydrated on intravenous fluids for a few days, any concurrent urinary tract infection brought under control and any hypertension medicated, things can be very much better.
We now know how best to preserve life, and maintain renal function for much longer than ever before. After the initial crisis has been managed, your vet will encourage you to get your dog onto the correct diet. Clinical studies have proven that life can be extended threefold for kidney patients if they are fed the correct diet, and especially if the vet can keep the phosphate level in the blood low enough.
In my career that is the one most striking improvement in any major chronic illness just associated with diet alone. There are several companies competing to make the best renal diet, but the current evidence is that any of these prescription diets confer significant advantage over a standard food, so it really is just a case of offering several until you can find one he likes. No longer is kidney failure a diagnosis without hope, so do have a careful discussion with your vet. We don't yet do proper renal dialysis for dogs in the UK, but there remains much we can achieve even without that assistance.
Craig is a partner in Cedarmount Veterinary Clinic, Bangor (cedarmountvets.co.uk). Send your pet queries to firstname.lastname@example.org. Craig can only respond to questions through this column, and these answers cannot substitute for treatment decisions based on a full history and clinical examination by your vet