Puddles of Pee, Roast Chicken and Pound Cake: My First Experience with Chronic Kidney Disease.
Chronic kidney disease (CKD) is something we most often associate with elderly cats, but it can affect dogs too, and sometimes in a younger pet. It is a progressive, degenerative disease that eventually will lead to diminished quality of life, but if detected early, may be managed with diet, medications and fluids. This article talks about what chronic kidney disease in dogs and cats is, how to ensure your pet enjoys as much quality of life as possible and how to know when it may be time to say goodbye.
Written by Dr. Mavi Graves, Caring Pathways Veterinarian in Colorado
A Personal Tale: Poncho’s Journey with CKD
Before I moved back to Colorado to go to vet school, I was working one of my favorite jobs to date: walking dogs in Brooklyn, NY. I still tell the story of one dog I used to pet sit for, a Shihtzu named Poncho. Poncho was deeply loved by his two moms and while I didn’t know at the time what was wrong with him, I knew they were grappling with him with being in his end of life journey. One of the owners shared that she thought it was time to let Poncho go, but Poncho belonged to her wife first, and so the decision was ultimately hers.
Daily Struggles and Adjusted Care
When I showed up for our twice daily visits, I could hear Poncho hop off the bed and waddle towards the front door in anticipation of our walk. As he labored towards the door, he peed all the way down the hallway, down the stairs of their brownstone and continuing into the street. I couldn’t believe how much urine this small dog could hold! Poncho did not actually want to walk. As soon as he emptied his bladder, he would go back inside and lay down. After our walk I would mop the hallway and wrestle Poncho onto my lap to give him his subcutaneous fluids, which he tolerated begrudgingly.
Poncho had long since stopped eating his prescription dog food and his owners left me with a recipe to prepare his favorite roast chicken. If he was picky about that, they said to try hand feeding it to him. If all else failed, they said he will almost always eat pound cake, and they kept a stash of Sara Lee All-Butter Pound Cakes above the fridge. Poncho ate the roast chicken the first night, but then seemed to lose interest. As instructed, I microwaved the chicken and then, warm grease dripping between my fingers, allowed Poncho to eat his meals out of my hands, with a side of pound cake if he didn’t finish the chicken.
Reflecting on the Journey
I now know that Poncho had CKD. His story highlights some aspects of the disease, the care that is sometimes required to sustain a pet in end-stage kidney disease, and the quality of life considerations that families face.
What is Chronic Kidney Disease in Pets?
If the Kidneys Ain’t Happy, Ain’t Nobody Happy
Chronic kidney disease in dogs or cats is a progressive, incurable condition where kidney function is lost over months to years. The kidneys wear many hats, including: eliminating waste from the blood, conserving water, regulating blood pressure, maintaining electrolyte and pH balance, and even supporting red blood cell production. Thus, when enough kidney function is lost, pets can experience many different symptoms. Most commonly, they are drinking and urinating more (and becoming dehydrated) and experiencing nausea, vomiting and loss of appetite. They can also become anemic, or go blind from having high blood pressure, or can even experience respiratory distress because their blood pH is too low.
Can Chronic Kidney Disease in Pets be Cured?
An Ounce of Prevention is Worth a Pound(cake) of Cure.
Chronic kidney disease cannot be cured but if caught early, steps can be taken to slow its progression and ensure as much quality time with your pet as possible. Your veterinarian may recommend yearly bloodwork and/or urinalysis at a minimum to monitor for kidney and overall health. If kidney disease is detected, your vet may recommend a diet lower in protein and phosphorus that will help slow kidney deterioration. If their disease worsens, they may prescribe medications to reduce nausea, regulate blood pressure, etc., as well as subcutaneous fluids to keep them hydrated.
Decision Making in End-Stage Kidney Disease
End-of-Life decision-making for your beloved pet is as unique as they and your family are. Some pets may not tolerate medications or SQ fluids, or those therapies may not be practical for some pet families. Other pets do really well with those therapies and this can be a mutually positive phase of the human-animal relationship. Regardless of where your pet is in their CKD journey, it’s important to keep track of their good and bad days and not let standards slide downhill. I recommend making a list of 5 things your pet enjoys and when 2-3 of those go away, it may be time to help them make their peaceful transition.
How Caring Pathways can Help
If your pet has been diagnosed with chronic kidney disease or another life-limiting disease, and you have concerns about their quality of life, consider scheduling a TeleAdvice appointment or an In-Home Quality of Life Assessment; or take our online Pathway to Care Assessment.
About the Author: Dr. Mavi Graves
Dr. Mavi moved back to CO to attend vet school at CSU. While at CSU, she served as a manager of the student volunteer pet hospice program and that’s when she discovered end-of-life care as her veterinary calling. Dr. Mavi feels that the end-of-life journey is an incredibly sacred and meaningful time to serve pet families and she feels strongly about the importance of letting pets pass away at home.
It is an honor to facilitate gentle and peaceful euthanasia experiences and to that end, Dr. Mavi has earned her Fear-Free Certification. She is also working towards acupuncture certification and strives for excellence and personal betterment in supporting pet owners through what may be one of the most difficult days of their lives.
