[music plays]>>Kelly Runyon: When it comes to our pets, it's important to remember their yearly exams.

Now without those annual checkups, a deadly disease in dogs and cats can go undetected.

On this episode of the Paw Report we're joined by Dr. Sally Foote from the Okaw Veterinary Clinic in Tuscola to talk about managing kidney disease in our pets.

So, stay with us.

[music plays] >>Rameen Karbassioon:Okaw Vet Clinic in Tuscola and Dr. Sally Foote remind you to properly take care of your pets, and are happy to help support the Paw Report on WEIU.

Okaw Vet Clinic, located at 140 West Sale Street, in Downtown Tuscola.

More information available at okawvetclinic.com.

Dave's Decorating Center is a proud supporter of the Paw Report on WEIU.

Dave's Decorating Center features the Mohawk SmartStrand Silk Forever Clean carpet.

Dave's Decorating Center, authorized Mohawk Color Center,in Charleston.>>Kelly Runyon: And we're glad you've joined us for this episode of the Paw Report.

And joining us for this episode is our friend and pal, Ranger, of course, and Dr. Foote from the Okaw Veterinary Clinic in Tuscola, Illinois.

Thank you so much.

You're a recurring pal for the Paw Report.

We're glad you're here.

And today we're going to talk about kidney disease.

Something that you probably see a lot, something that you meet with clients regularly about.

And so, I thought that was an important topic, and you did as well.

So, we're going to start with talking about the kidneys overall, and their general function in our body.

>>Dr.

Sally Foote: Mmhmm, the kidneys are a very important organ in our body.

Their job is to filter out of the body a lot of toxins or residues from, say like what do we eat, medications, things that you know, you may even inhale or, you know, just get in the system out in life.

The liver does part of that, but whatever the liver can't do or does only half of them, the kidney.

Literally I think of it almost like is the coffeemaker, that all the blood comes through the kidney.

There's a part of the kidney that literally filters, like a coffee filter does, out the toxins and concentrates that, and that's what is urine.

And that's what passes down to the bladder.

But then the kidney's job is also to hold part of the good things we need still back in the bloodstream.

Okay, not to filter everything out, but to hold some things back in the bloodstream and return back to the body, like some very important proteins, actually the water that our body needs as well.

And then the kidney also controls certain things like how our red blood cells are made.

You know, it has a certain hormone to stimulate the bone marrow, even for red blood cell production.

So, there's a lot of work the kidney needs to do.

The kidney is very important for living and surviving, and maintaining like our hydration and a lot of our general health.

>>Kelly Runyon: What factors, and you just talked about some, what are some of the factors that can cause kidney disease, especially in our pets?

>>Dr.

Sally Foote: Well the first factor is aging, you know.

Just like say as the heart ages, you can get, you know, start to get heart disease or heart insufficiency, it then could go on into heart failure.

The same thing with aging on the kidney, just because over time in life there's going to be maybe times there was a fever, and that took a little damage on the kidney.

Or maybe there was a time the pet might have gotten into some kind of a toxin or herbicide or something, and that too might have damaged something on the kidney.

Or, and we had that whole, you know, the food, whatever the Melamine in the food years ago, but at times there might be something that the dog just ate or cat ate that could actually be damaging the kidneys.

Like for cats especially, lilies are highly poisonous to the kidney.

>>Kelly Runyon: Lilies, the flower that we have in our yards and gardens.

>>Dr.

Sally Foote: Yeah, in vases, and even in the water that like a flower, say you got a bouquet of flowers for Mother's Day, and there were some Asian lilies, you know, or the stargazer lily in there.

The toxin from the lily leeches into the water.

And you know, the cats who like to dip their paw into the water and drink, they could get poisoned that way.

And even if it was a small amount kind of chronically, then that could cause some damage to the kidney that could show up at age like 10 or something.

So anyway, aging is one thing.

The second thing is exposure to say, like toxins or, you know, poisons.

Thirdly, some medications, but not so much of a problem on the kidney with medications.

And you know, other things like heat stroke or not having access, not being able to get, say good fresh water.

And lastly, proper nutrition for the age of the pet, what we call life stage nutrition.

You know, that the older pet is getting a diet that's more better for like the older pet, as compared to say, a puppy diet.

You don't want to feed a puppy diet to a 10-year-old dog because the higher concentration of proteins and other nutrients is more, they don't need that, and then that creates more work for the kidneys to have to filter out and get rid of.

>>Kelly Runyon: So, is that damage that accumulates over time?

Let's say there was an incident with a toxin, there was an incident with, you know, the cat getting to a lily.

Does it happen over time, or can it be one incident that...?

>>Sally Foote: It could be either way.

Most commonly it's that accumulation of time.

But it can happen that we have acute or sudden onset of kidney failure.

And then usually that is related more to either an infectious disease.

They might have like a blood parasite that the blood's breaking down, and now the kidney has to filter out all this extra hemoglobin, and it's really putting a lot of work on them.

Or again, the dog ran out in the field after anhydrous ammonia was just applied on it, and they get covered in anhydrous ammonia.

Or they go over to that puddle after a rainy day like this, and all the anhydrous is in the puddle and they drink out of the puddle.

And they get this huge overload of, you know, ammonia in their system, and they're vomiting and having sick, and then that ammonia level has to be, it just boom, puts too much on them.

Sometimes you get a blood clot in the kidney, and that can cause sudden onset of kidney failure.

Or lastly, tumors.

We can see tumors arise in the kidney, and that's usually to do with aging as well.

>>Kelly Runyon: What are the other household... You know, like I keep going back to the lilies, just because that's surprising.

Any other household areas, products, natural tendencies that can cause problems in the kidney?

>>Dr.

Sally Foote: Some of the big first things we think of is antifreeze, ethylene glycol is a big problem.

So, now they've put some of these bitter tasting agents in there.

So, if you have like a leak in your radiator, you know, in your garage and your dog or cat goes through the garage or is in the garage part of the time, because it tastes sweet they may lick at it.

And again, that can damage their kidneys.

So, that's a common, you know, toxin.

As I said, about the lilies is another one.

There are other plants, particular plants like mother-in-law tongue.

They can have, you know, what are they called, oxalates or things in the leaves.

So, the ASPCA's Pet Poison Control hotline has a wonderful website, and there's even a pamphlet that lists like 101 common toxins in households for your pet.

And most of those toxins are going to have a bad effect on the kidney or the liver, but you know, kidney too.

And so, you can look that up online, or if you want to call my office.

And I think even our clinic website, we have a link to that page.

But those are the first things that I, you know, think about and you know, worry about.

>>Kelly Runyon: What are the signs and symptoms, if your pet could be suffering from kidney failure, kidney disease?

What are some things that you look at?

Maybe you could talk about some not particular clients, but some situations that you've encountered over the years.

>>Dr.

Sally Foote: Well say if we have, when I say a younger pet, I'm going to say a pet under, dog under 7-years of age, a cat under like 9-years of age.

So, we're more of a middle-aged to younger pet.

If they suddenly seem sore or painful in the back.

And when I say that, they're not going to cry, they're not going to limp.

And maybe like I'm petting Ranger, and now he goes [squeals], and he doesn't want me to touch here over the middle of his back, that's where the kidneys are.

And if the kidneys are inflamed, that would be more like that acute kidney failure, they're going to be painful.

And so, you know, he may still be say, eating some.

Usually the appetite's going to be decreased.

They may be drinking more water.

They're usually putting out more urine volume.

And this is very true in the older pet.

And people tend to think of kidney, like kidney failure, kidney problems as not being able to make urine, but that's at the very end-stage, like when they're dying from it.

The early stage, it's the opposite.

They make more urine volume because that job of the kidney is like the first one that's lost, you know, that's not working right.

So, if they're making more urine volume.

If you can sense that they may be like, losing weight and that you can now like, ooh I can feel your backbone a little bit, you know, that they're losing muscle tone.

The number may not be changing, their belly might actually look a little bit bigger.

Because sometimes, with the protein loss they retain fluid.

But you can tell, he's just kind of like sinking away.

You know, I can feel like his skull bone.

You know, I can feel his backbone.

Occasionally might see an increase, like the need to urinate more frequently.

The dog's getting you up in the night to be let out to go to the bathroom.

You might think [huffs], this is kind of obnoxious.

[laughing] You're bothering me.

Or the cat may be missing the litter box, not using the litter box, urinating elsewhere because they have more urine volume to put out.

So, that's where you get that blending of behavior and medical.

And so, any change, any change in how frequently they're urinating, how much they're drinking, how much they're eating, vomiting, yeah, vomiting, or like when you pet them, you're like well, you know, you feel a little bonier.

It could be the kidneys.

And so, you know, bringing in a urine sample when you bring the pet in for a checkup, or the veterinarian may recommend you need to get a urine sample besides blood work to check this out.

>>Kelly Runyon: That's tough to do, to get a sample.

>>Dr.

Sally Foote: Well we've got ways that are easier.

[coughing] Excuse me.

>>Kelly Runyon: But a pet owner to try to get a urine sample can be tough.

>>Dr.

Sally Foote: Yeah, well what we do is we have what's called the golden ladle.

[laughing] It's very easy.

Tuck it underneath there.

For our very toy breeds, our vaccines come in these trays that have like a flat top that's only about an inch deep.

And then you can just slip it underneath the dog very easily and catch a sample that way for catching it.

And there's a way that's best to take it called a cystocentesis.

And this is where [clears throat], excuse me, with the pet, we actually take a very thin needle and go straight in the bladder, and draw the sample out that way.

Sometimes we don't always have to do that, and in cats it can sometimes be a little challenging because they make very small urine volume.

And so, we might have to like hold them in a cage for eight hours, you know, to have them fill their bladder up enough to be able to reliably get a good sample.

So, they do make for cats a nonabsorbent litter that we can also do a home collection that way.

And this one is kind of a silica litter.

It's really great.

We use it in the office a lot.

So, when they urinate it just beads right up, and we send the owner, pet owner, sorry, with a kit with a little pipette and a little tube, and they put that cat alone in his own like a bathroom with maybe a disposable 13X9 cake pan so, you know, there's no contamination from past litter use, and put this litter in there.

Pretty much overnight the cat's going to use it, and then we have a sample we can do.

And that makes it easy too sometimes for clients if they need to monitor at home for like blood or anything like that.

>>Kelly Runyon: Going back to some of the symptoms and signs, you mentioned urination, you mentioned how much they're eating and their eating habits.

And of course when you're touching them, petting them, loving on them, if they tend to cringe a little bit.

Any other signs or symptoms that maybe aren't as obvious to pet owners?

>>Dr.

Sally Foote: Well yeah, this may sound strange, but especially in cats, excuse me, if their stool is more firm and dry.

Because, the colon, and the same thing too with dogs, if you're starting to see constipation.

But I don't mean that they're straining that bad, but you're just like, oh that's not as much as you used to put out and it's a little bit harder.

Because, the colon is an area of the body that reclaims a lot of water for the body.

So, when the kidneys aren't working so well, and so they're losing water out through urine, and the body's saying "I need water in the body," the colon sometimes starts to take on that job.

So, you see dry stools or constipation.

So, we may have a cat who's putting a bowel movement outside of the litter box.

They're peeing in the box, but the bowel movement's outside of the box because it's harder for them to pass the stool in the box.

They get in there and nothing happens, and later it's like whoa, I've got to go now.

Or the dog, who is like rubbing his bottom or scooting a bit, it may actually, while there's a sign here about GI disease, why is he starting to make such a concentrated stool when he's having the same amount of water or even more water, and we haven't changed the diet, and he hasn't, you know, it can be because of early kidney disease.

So, sometimes these like slightly things.

A dry hair coat.

The hair coat may look like a little more dry and scaly because the skin tone will not be as, you know, as elastic.

That's the word I'm looking for.

Because again, that level of how much water is in the body is what keeps all that healthy.

So, sometimes it might just be like, well you look just a little flakier here and things like that.

So, that's why when pets get to be middle-aged, we are recommending just running and checking like a baseline blood work.

When I say that I mean like a blood sample that checks some of the main kidney enzymes, main liver enzymes, main protein, blood sugar level, red count, as like a standard part of an annual checkup.

So, we know A, is this pet healthy, what's their normal, and we can check it earlier.

Because, the changes happen in the bloodstream before they happen physically.

And actually to see the changes on the blood work, you have to have in a dog about two-thirds of both kidneys' ability to work to not be working so well.

And in the cat it's closer to about three-quarters.

So, they actually have a lot of changes going on, which is where the urine sample can sometimes pick up problems even before the blood work shows a difference.

And we may see more dilute urine before they've had enough toxin buildup to show the changes in the bloodstream.

So, that's why looking at both urine and blood is important.

>>Kelly Runyon: So, that's the diagnostic process.

So, a pet owner will come in, and you will go through all of that process with them.

Once it's, first of all, I mean how do you determine is it levels, is it toxicity, is it all of those things that determine yes, your pet has the disease.

And then you start putting them on a regime.

>>Dr.

Sally Foote: Right, so there are normal ranges of these like enzyme levels and red count, and things, and how concentrated the urine is.

There's a normal ranges, and then when you start to get out of that normal range, that's indicating that we've got a problem here.

Then there are some more specific tests to really work up the diagnosis more in how advanced it is and staging it.

So, ultrasound on the kidney, a couple other specific blood tests.

So, when you figure out, okay we've got kidney inflammation, we've got kidney infection, then the doctor's going to formulate the plan for how we're going to, say if we know we have an infection in the kidney, we're going to need to treat with the antibiotics.

But we're also going to need to change the diet to a diet that is specific for helping the kidney to heal and to function at its best.

And so, these diets are adjusted in the level of some of the minerals, adjusted for the level and the quality of the protein in them and other things to help reduce the work on the kidney and to help encourage the kidney to possibly regrow some healthy tissue back.

There's a... kidney disease is like on a spectrum, you know.

You catch it earlier, you have it here.

And so, we want to, you know, treat to help the kidney and see if we can get, you know, back here and get some regeneration.

Fluids oftentimes we're giving, it depends on how far advanced they are.

They may need to be hospitalized for IV fluid care.

And then after that, and that's to get these toxin levels down to a more normal level.

Because, those high toxins hurt the heart, they heart the intestinal tract, and things start to snowball downward.

And then after that, oftentimes you're giving them like fluid under the skin, it's call subcutaneous fluid, to help kind of boost up, you know, to get more fluid into their system and be able to adjust when they can really be off of that.

Sometimes for older pets, dogs and cats, we'll teach the owner how to do that at home maybe once or twice a week.

And that helps them to really, you know, stay feeling good, eating good and functioning well.

>>Kelly Runyon: Do you ever see cases so extreme, and is it even possible to do transplants?

>>Dr.

Sally Foote: Yes, it is.

>>Kelly Runyon: I mean, we hear about it in humans, but... >>Dr.

Sally Foote: Yes, it is.

That's when you're at end stage kidney failure.

And whether it's because of an acute problem or more of a chronic problem.

It is an option.

It's not available widely because it's just not something many people can afford to do.

Or when the kidneys are that bad, there may have been so much, you know, damage or other problems to the rest of the body, it's a big decision weighing out the quality of life and the process, you know, going through that kidney transplant.

>>Kelly Runyon: What is the survival rate?

What is the longevity if-- And I know you said that kidney disease is on a spectrum, and then there's infections, you know, that you can treat at the beginning.

But let's say somewhere in the beginning, somewhere in the middle, what's the longevity of life after your pet has been diagnosed?

>>Dr.

Sally Foote: Well first thing it will depend on what stage are they in.

There's what's called a stage 1 through 4 rating system.

And stage 1 is really just things are just a little tweak off of normal.

And so, we may only make a change in diet, maybe some nutritional supplement.

And then nothing's really coming down from their normal life expectancy.

So, whatever point that's diagnosed, if we maintain those things and they stay in stage 1, whatever age they're at, you know, like Ranger, he might live to be an 18-year-old cat, you know, live another eight years.

If we're more like at stage 3 and stage 4, the more advanced disease, which is commonly when we end up diagnosing it because that's when there might be some kind of symptom that gets the owner to bring the pet to us, you know, then longevity will depend frankly on following the management plan.

This problem is managed.

It's not necessarily cured.

So, that means are you sticking with the diet.

There was a study done by one of the prescription pet food companies years ago, where they tracked where treatment was the same between this group of animals with kidney disease and that with kidney disease.

But the difference was did the owner stick with the prescription kidney diet for this pet, or did they fall off of it.

And for the families that stuck with the prescription diet, that was the only difference between these two things, these animals lived two years longer with less complication, or problem or advancement of disease.

So, the real big factor is sticking with whatever the management plan is.

If it's diet, if it's subcue fluids, say once a week for Ranger, he could live another five years, even if he was already say, 16-years of age because it's keeping those levels, you know, maintained down.

It's the maintenance.

>>Kelly Runyon: Mmhmm, as we wrap up our talk today, is kidney disease more common in a certain breed?

Is it more common in dogs, in cats, or is it about the same across the board?

>>Dr.

Sally Foote: No, we do see difference.

I would say that in the cat as an aging, you know, health problem, kidney disease is one of the most common aging problems we see in the cat.

In the dogs we do see it, but we do see it more in certain breeds of dogs.

Sometimes there can even be genetic or inherited disorders of the kidney, like one's called polycystic kidney disease.

And that may be where they didn't completely form a kidney normally.

It's a genetic, it's like a birth defect.

And we see it more in certain breeds, you know, than others.

Thirdly, what's the lifestyle of the pet.

We've got say, a dog who's always running loose around the neighborhoods, and you don't know all the stuff they're getting into and eating or they got hit by a car at age 2, and then they got into the antifreeze at age 5, and then they got into the rat poison at age 9.

They've got a whole lot more hits on their kidneys, so lifestyle's another, is I guess the third factor.

>>Kelly Runyon: And breeds?

Different dogs, bigger dogs, smaller dogs?

>>Dr.

Sally Foote: You know, frankly that's a little bit hard to say because our smaller dogs live longer.

They do.

You know, like a poodle, a lot of poodles get up to 20-years of age.

So, as compared to say, a great Dane that might live to 11, or a saint bernard.

And so, which organ problems we see, I would say maybe a little bit more in the smaller breed dogs, you know, the toy breed and smaller breed dogs.

Yet they're more of a geriatric dog, you know.

>>Kelly Runyon: What about a pet owner, I'm a funny pet owner I would say, and I have a puppy or I have a year-old or a 2-year-old, can I say, "Can you just check him for that anyway?"

I just want to be sure, I want to be sure it's okay, instead of it being the middle-aged dog that-- >>Dr.

Sally Foote: Sure, yes.

Let's check urine.

>>Kelly Runyon: And that's something you would do?

>>Dr.

Sally Foote: Yes, let's check his urine once a year, you know.

We can do, even if it's just a free catch sample, like I said, the most important things that we're looking at is how well is able to, you know, screen for early changes in the kidney.

How well is he able to concentrate that urine, and we check that specific gravity.

Then we do our little dipstick, are we seeing any change in protein level, any flare-up of say, blood or that.

And in veterinary medicine, we always do a complete urinalysis.

And what that means is we're checking how well is urine concentrated, is there glucose, is there, you know, protein with what we call the little dipstick test, and we look at the cells, that we spin down the sample and look at the cells and see what's going on inside there.

It's called the sediment.

And that frankly is not often done when you and I go to the doctor, unless we're really presented with a disease.

So, urine is relatively easy to get.

You know, we help you with the tips on getting that.

And it can give a lot of information, and can be checked regularly.

There are even ways-- I've had clients where I've sent them home.

Let's say we had a problem with say, infection or something.

I've sold them even just little test strips and then they monitor the pH at home on their own pet's urine, and showed them here's how you can check it.

And then maybe every three months bring in a sample here, and we'll do the complete urinalysis.

So, yes you can.

>>Kelly Runyon: It's an investment by a pet owner.

If you want to make sure Ranger lives to his full potential, then you have to make the investment as a pet owner.

>>Dr.

Sally Foote: Right, right.

>>Kelly Runyon: Alright, well Dr. Foote, thank you so much for joining us for this episode of the Paw Report.

And Ranger, as always, we love having you.

You're a good guest.

He just sits there and enjoys the lights and enjoys the conversation.

So, thanks again.

Some good information.

And thank you for joining us for this episode of the Paw Report.

We'll see you next time.If you're a veterinarian, trainer, groomer, specialist, rescue organization, or shelter that would like to partner with the Paw Report by providing expert guests for the show, please contact us by emailing weiu@weiu.net, or call 217-581-5956.

If you have a topic you'd like to see on the show or questions for our experts, contact us with those, too.>>Rameen Karbassioon: Dave's Decorating Center is a proud supporter of the Paw Report on WEIU.

Dave's Decorating Center features the Mohawk SmartStrand Silk Forever Clean carpet.

Dave's Decorating Center, authorized Mohawk Color Center, in Charleston.

Okaw Vet Clinic in Tuscola and Dr. Sally Foote remind you to properly take care of your pets, and are happy to help support the Paw Report on WEIU.

Okaw Vet Clinic, located at 140 West Sale Street, in Downtown Tuscola.

More information available at okawvetclinic.com.

[music plays]