How Far Can You Go in Treating Canine Kidney Disease?
While advanced medical treatments such as kidney transplants and dialysis are available to owners of cats with kidney disease, dog owners don’t have the same options.
Kidney transplants for dogs are still considered experimental
Canine kidney transplantation has been performed since the early 1900s, serving as a model for various research studies, training for human transplant surgeons and as a potential treatment for chronic kidney disease in dogs. Specialists in veterinary surgery are well-versed in the technical aspects of the surgical procedure. Yet despite that understanding and tremendous advances in veterinary renal (kidney) medicine, kidney transplantation in dogs has not been nearly as successful as the procedure has been for cats. Most, if not all, U.S. veterinary teaching hospitals that were pioneering canine kidney transplantation during the first decade of the 21st century have stopped offering the surgery.
The biggest obstacle to successful kidney transplants in dogs is the dog’s own immune system. Dogs present a unique challenge for organ transplantation due to their genetic diversity and difficult-to-suppress immune system that tends to quickly reject the newly transplanted kidney. Powerful immune-system-suppressing drugs can be given for the rest of the dog’s life to reduce rejection, but those medications make the dog more susceptible to severe and life-threatening infections. At the time of surgery, dogs are also at risk for blood clots and intestinal intussusception, a condition in which the intestine folds like a telescope with one segment folding into another and forming a blockage.
The success rate for kidney transplants in dogs at the University of California–Davis was about 40 percent when the program was put on hold. Although there have been reports of some transplant recipients surviving three to eight years after surgery, a published review of 26 dogs undergoing kidney transplantation at UC–Davis found the median (midpoint) survival time was 24 days and only 36 percent of dogs lived 100 days after surgery.
Today the cost of a kidney transplant surgery without complications is an estimated $15,000 to $20,000, a price tag that puts this treatment option out of reach for most dog parents — even if it was available. And that’s just the beginning of the medical expenses; frequent veterinary visits, blood and urine tests, and anti-rejection drugs would be needed for the rest of a dog’s life.
Dialysis may be an option for some
Most people with end-stage chronic kidney disease rely on dialysis treatments two to three times per week unless they receive kidney transplants. Some form of dialysis — intermittent hemodialysis, continuous renal replacement therapy (CRRT) or therapeutic plasma exchange — is available for dogs and cats in a handful of locations. These therapies, where available, are typically performed at university veterinary teaching hospitals or large specialty referral and emergency veterinary hospitals, and the type of “blood cleaning” procedure varies from hospital to hospital.
Veterinary specialists use hemodialysis and CRRT most often to treat patients with life-threatening acute kidney injury, poisonings, imbalances in electrolytes and acid-base balance problems (blood that’s too acidic or alkaline). In these cases, the possibility for kidney function recovery exists. Hemodialysis, CRRT and therapeutic plasma exchange can be used to help stabilize critically sick pets and, by removing dissolved wastes and/or poisons, give the kidneys time to recover sufficient function to support the dog.
It’s important to understand these treatments will not cure kidney disease. But they may give a dog (or cat) more time for healing. To learn more about dialysis for pets, check out the University of California Veterinary Medical Center’s frequently asked questions. And don’t forget to talk with your veterinarian to learn about potential kidney disease treatments in your area.
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