DIAGNOSIS AND THERAPEUTIC MANAGEMENT OF RENAL FAILURE IN DOGS
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Date
2018-03-08
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CSKHPKV, Palampur
Abstract
ABSTRACT
The present investigation was aimed to study the clinical, diagnostic and therapeutic aspects of renal
failure in dogs. The study was conducted on 3311 dogs presented in the Teaching Veterinary Clinical
Complex, Palampur. On the basis of history, clinical examination, haemato- biochemical profile, urinalysis
and imaging studies, 140 dogs were suffering from renal failure thus representing an incidence of 4.2%. Out
of 140 affected dogs, 16(11.42%) dogs suffered from acute renal failure (ARF) whereas 124(88.58%) were of
chronic renal failure (CRF). 52 (37.14%) dogs were in Stage III whereas 88 (62.86%) were in Stage IV of
renal failure. Maximum incidence of ARF was reported in 5-8 years whereas CRF was most prevalent
(75/124; 60.48%) in dogs more than 8 years of age. Labrador was the most common breed affected followed
by Pomeranian and German Shepherd. Major clinical signs observed were anorexia, vomition, dehydration,
halitosis, hypothermia and anaemia. Pre renal, renal and post renal causes were present in 12.5%, 6.25% and
18.75% dogs with ARF whereas these were 1.61%, 62.10% and 3.22% respectively in CRF dogs. Dogs
suffering from ARF were having leucocytosis, marked elevation of BUN (129.20 ± 8.06mg/dl) and
Creatinine (5.40 ± 0.45 mg/dl) whereas potassium was marginally increased with no alteration in acid base
status. Urinalysis revealed presence of proteins, glucose, RBCs and decreased urine pH. CRF dogs had lower
values of Hb, PCV, TEC, markedly elevated BUN (114.23 ± 5.16 mg/dl), Creatinine (8.60 ± 0.95 mg/dl) and
phosphorus (9.32 ± 0.31mg/dl) along with marked decrease in blood pH, bicarbonate (HCO3) and Base
excess(BE) indicating metabolic acidosis. Urinalysis revealed presence of blood, protein, glucose, decreased
specific gravity with increased urine protein creatinine ratio. Microbiological examination of urine revealed
presence of Leptosira illini in 3 dogs through Polymerase chain reaction (PCR). E.coli was the predominant
bacteria followed by Staphylococcus aureus and Staphylococcus epidermidis and were most sensitive to
Ceftriaxone followed by Nitrofurantoin and Cefotaxime. Urethral stone, pyometra, cystitis, ascites, merging
densities of cortex and medulla, end stage kidney and hydronephrosis were diagnosed through radiography
and ultrasonography. Histopathological examination revealed glomerular and tubular necrosis. ARF dogs
treated with dopamine, broad spectrum antibiotics and fluid therapy resulted in 87.5% (14/16) recovery. CRF
dogs were further divided into 5 subgroups for therapeutic purpose. Group I CRF dogs (n = 60) were treated
with conventional treatment including fluid, antibiotics, diuretics and antiemetics which led to marked
reduction in BUN and Creatinine levels and correction of metabolic acidosis and recovery in 61.66% dogs. In
Group II CRF dogs (n=40), the use of phosphate binders helped in effective regulation of
hyperphosphatemia. In Group III, 12 dogs had severe anaemia and blood transfusion proved to be life saving
measure in severe haemocrisis. In Group IV CRF dogs (n = 12), addition of erythropoietin resulted in steady
rise of haematological parameters. In Group V CRF dogs (n=5), peritoneal dialysis proved to be effective in
reducing severe uraemia. It was concluded that blood transfusion, phosphate binders and peritoneal dialysis
as per need along with conventional therapy helped in recovery from chronic renal failure.
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