Marci acquired her first bedlington terrier from Coral Anderson in 1998

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Article to be published in the fall issue of Tassles and Tails

Kidney Overview

by Marci Berman

Anatomy and Function

The kidneys play a vital role in the health and well being of all dogs. Kidney failure has been cited as the second most likely cause of natural death in dogs and cats. This fact alone makes the information on how the kidneys work and what their prime function is in the normal course of your dog’s life extremely important

The kidneys have several functions such as eliminating waste products from the body, regulating the level of water in and outside of the cells within the body by concentrating or diluting the urine output and producing hormones which help the bone marrow to grow red blood cells. The kidneys help control blood pressure, maintain the proper balance and removal of calcium and phosphorus.

The basic unit within the kidney, which acts as a filtration device is called the nephrons. Kidney failure occurs when three- fourths of the nephrons of both kidneys are damaged or unable to function. The most common causes of kidney damage include immune-mediated diseases, kidney infections, kidney stones and congenital diseases. The main problem for the nephrons is any damage can cause irreversible changes and, therefore, function cannot be restored.

Another function of the kidneys is to regulate the volume of extra-cellular fluid in order to maintain a stable internal environment for cells. This is accomplished by regulation of water, electrolytes and calcium and phosphorus production. The fluid that remains is urine, which is collected in a central area of the kidney and funneled into a small tube called the ureter. The ureters (one from each kidney) run from the kidney to the bladder, which is located just in front of the pubic bone of the pelvis.

Causes of Kidney Disease

Hereditary/Congenital Abnormalities	Trauma	Toxins: External and Internal
Bacterial Infections	Blockage of Urine Outflow	Medications
Fungal Infections Such as Blastomycosis	Cancer	Autoimmune Diseases

http://www.thepetcenter.com/gen/kf.html

Types and Descriptions of Kidney Disease

The chart below is a list of several different types of specific kidney diseases and describes them.

Kidney Disease Description

Polycystic kidney disease	(PKD) is not very common and creates cystic areas in the kidneys where normal function and structure are lost.
Familial glomerulonephritis	Patients present heavy proteinuria, often with microhematuria, hypertension and with normal or slightly depressed renal function. This is an autosomal dominant disease.
Hereditary nephritis	Defect is in the structure of the glomerular basement membrane
Renal agenesis	Also called kidney aplasia, occasionally occurs and the individual is born with one or both kidneys not present. Dogs, cats and humans can survive quite well if one normal kidney is present and functioning.
Renal hypoplasia	is a condition where the kidney(s) do not develop completely.
Renal cortical hypoplasia	a condition where the cortex of the kidney develops incompletely.
Renal Dysplasia	Abnormal differentiation of kidney tissue
Renal tubular dysfunction	Occurs when the filtering tubules of the kidneys do not function properly. In Basenjis, glycosuria develops and is called Fanconi syndrome familial glomerulonephritis in the Bernese mountain dog.
Hereditary nephritis	abnormality in glomerular basement membrane
renal amyloidosis	amyloid deposition most disruptive in kidneys; other organs (spleen, liver, pancreas) can be affected but with minimal clinical signs; may also have intermittent fever and joint swelling
polycystic kidney disease	kidney tissue gradually replaced by fluid-filled cysts
protein-losing enteropathy and nephropathy	Excessive loss of plasma and proteins into the gastrointestinal (GI) tract is called protein-losing enteropathy. It can result from any condition that damages the lining of the GI tract. The latter condition is thought to be related to adverse food reactions, and there is also loss of protein from the kidney (see also familial renal disease).
familial glomerulonephropathy	irregularities in glomerular basement membrane
renal telangiectasia	multiple dilated renal blood vessels

http://www.thepetcenter.com/gen/kf.html

Share Your Information via CHIC

In the Bedlington community, we are getting anecdotal information about kidney issues. While the incidence of kidney disease was low in the BTCA Health Survey of 2003-2004, we are hearing enough anecdotal stories to warrant watching this, arming you with information, and gathering factual information.

If you have any kidney disease, it would help us improve the breed if you would please make the information available in the CHIC (Canine Health Information Center) registry. Entering anecdotal kidney disease information in CHIC is optional.

CHIC is the national database where breed-recommended health tests and results can be found. The BTCA recommends that three health screening tests be conducted and registered with the option of anecdotal information about kidney disease. The three required tests for Bedlingtons are:

· DNA test for Copper Toxicosis (including the commd1 test available 5/1/06)

· CERF exam within the past year

· OFA patellar luxation evaluation after one year of age

Optional

· Any kidney disease occurrence

Note that a write-up of CHIC and the BTCA recommendation is available on the BTCA website. In addition, if you have questions about CHIC, you may contact Lucy Heyman at laheyman@elkincarillon.com.

Treatment for Kidney Disease

Given the long list of different kidney diseases, covering possible treatment was beyond the scope of this article. However, there is excellent information available from the referenced web sites below. If you have specific questions about treatment that you believe would benefit the larger Bedlington community, please send them to Marci Berman at Gentlegroomer@sbcglobal.net and the Health & Wellness Committee will consider addressing it.

References

http://www.thepetcenter.com/gen/kf.html

http://www.kidneydir.com/

http://www.lhasa-apso.org/health/hrd.htm

http://www.vetinfo4dogs.com/dkidney.html

http://www.cah.com/library/caninekidney.html

http://www.cah.com/dr_library/caninekidney.html

http://www.workingdogs.com/doc0118.htm

Diet for Dogs with Affected Kidneys

by Dess June

When dogs are treated with prescription drugs for the problems that often accompany commercial diets, they are given nonsteroidal anti-inflammatories (NSAIDs), antibiotics, and other medications that are damaging to the kidneys. I also question the use of food additives and preservatives and the use of fluoride in drinking water, and don’t forget environmental toxins like lawn chemicals and other pesticides, including those that we use around ourselves and our companion animals.

The Protein Debate
As soon as they diagnose kidney disease, most American veterinarians prescribe a low-protein diet. They believe that protein harms the kidneys and that reducing protein consumption slows the progress of kidney degeneration. This is because early research on rats was assumed to be true for dogs, and excess protein causes problems for rats. A number of pet food manufacturers sell low-protein prescription diets for dogs with chronic renal failure, and those who prepare their own food at home are warned against feeding meat, poultry, and other foods that are high in protein.

“Those recommendations are based on a myth,” says Wendy Volhard, author of Holistic Guide for a Healthy Dog. “In fact, the whole theory of low-protein diets for dogs with kidney disease was blown apart in 1975 by David Kronfeld, PhD, who was at the time a veterinary researcher at the University of Pennsylvania. His concept was not to feed less protein but rather to feed higher-quality protein.

“The low-protein myth is like an old-wive’s tale, something based on ignorance that just won’t die. Yes, inferior-quality protein can harm a dog’s kidneys, but the solution isn’t to continue with inferior-quality ingredients and feed less of them. The solution is to improve the quality of ingredients and in that way provide what the dog needs for good health.” Studies disproving the prevalent low-protein prescription have been widely published

“Too many dogs are forced to eat Prescription Diet k/d® or similar low-protein prescription foods,” says Straus. “These can actually cause harm. When protein levels are very low, the body will cannibalize itself to get the protein it needs. This creates more waste products than if you feed the proper amount of high-quality protein in the first place. Also, k/d is not very palatable, and many dogs with kidney disease will eat only enough of it to survive, or stop eating entirely if that is all they are offered.”

Older dogs actually require a higher level of protein to maintain their body stores of protein than do younger adult dogs, says veterinary nutritionist Patricia Schenck, DVM, PhD, of Michigan State University’s Center for Veterinary Medicine. In an article published in Veterinary Nutritionist, Dr. Schenck wrote, “Reducing dietary protein in older pets may have adverse effects. As pets age, their ability to utilize nutrients decreases. The only time dietary protein restriction is appropriate in renal failure is when the disease has become severe.” Healthy geriatric dogs require about 50% more protein than young adults, say canine experts.

Dietary goals
When developing a diet for dogs with kidney failure, the recommendations from leading experts are to feed

• moderate to high amounts of fat,
• moderate amounts of high-quality protein,
• low amounts of phosphorus,
• moderate amounts of low-phosphorus carbohydrates,
• and plenty of water, juices, broth, and other liquids.

Although guidelines vary, a sensible goal is a diet whose total calories come 1/3 from fat, 1/3 from protein, and 1/3 from carbohydrates.

Fat provides calories and energy, and most dogs have an easy time digesting it. Good sources of saturated fat include fatty meats, butter, whole-milk yogurt, egg yolks, and coconut oil.

Polyunsaturated vegetable oils, such as canola, corn, soy, safflower, sunflower, and flax seed oil, are not recommended for CRF patients. Neither is cod liver oil, because of its high vitamin D content, which failing kidneys have difficulty processing. But fish oil (fish body oil, not fish liver oil) has been shown to help dogs with CRF. When adding fats and oils to the home-prepared diet, start with small amounts and increase quantities gradually. Too much too soon can lead to diarrhea. Dogs prone to pancreatitis should be fed additional fats only in consultation with your vet.

· If you choose to feed a prescription dry or canned food rather than a home-prepared diet, add fresh protein foods, either raw or cooked, such as meat, eggs, egg whites, and tripe, especially in the early stages of the disease.

· If you feed a diet based on raw meaty bones, substantially reduce the amount of bone.

· If the diet calls for bone meal, like the Natural Diet developed by Wendy Volhard, follow her advice to switch from lean to fatty meats and substitute calcium carbonate for the bone meal to reduce phosphorus levels.

Whole wheat, oatmeal, brown rice, millet, and other whole grains are moderately high in phosphorus and should not be fed often or in large amounts. White rice is low in phosphorus, and glutinous or sticky rice is the lowest-phosphorus grain. To help make grains more digestible (as described in “It’s All in How You Make It,” WDJ March 2001), soak them overnight to remove enzyme-suppressors and naturally occurring toxins.

Green tripe can be added to food as a flavor enhancer, as can Seacure, a very fishy-smelling powder sold as a protein supplement. “If you feed a commercial food like k/d and your dog won’t eat it, find something else, preferably a homemade diet that provides high-quality protein while controlling the amount of phosphorus,” she says. Plus, she adds, most dogs love fresh food. “The higher moisture levels in fresh foods help protect their kidneys, and they feel better and enjoy life more.”

Dess June is our diet specialist on the Bedlington Terrier Health & Wellness Committee. If you have questions about diet or wish a complete article, please e-mail Dess at dessjune@sbcglobal.net.