Acute Renal Failure & beyond 急性腎衰竭.. 然後?

Acute renal failure (ARF) usually comes fast and aggressive, taking owners by surprise. Due to the “unexpected” nature of this illness, owners are often left floundering on what steps to take to maximize the pet’s survival. Indeed, getting to see a veterinarian is the vital first step to saving your pet but what happens once the facts and options start to come at you? How do you know what is the best strategy for your pet? This post will give you a description of the problems your pet will face and in turn the choices you need to make to navigate through this rapidly evolving and potentially deadly illness.

What cause Acute Renal Failure?

Acute renal failure (ARF) can happen in dogs or cats of any age, sex and breed. Family lifestyle is an important consideration as ARF usually occurs subsequent to accidental or mistaken drug administration. Certain fauna are known to be fatally toxic to cats – most infamous being the Lilly flower. Another common cause of ARF is a serious episode of urine blockage causing urine to back-up through the ureters into kidneys.

How do you know?

Pets that suffer from ARF appear “fine” one day and the next day “dull” and “tired”. The clinical signs for ARF are non-specific therefore diagnosis is not considered straightforward. Most pets will not have an appetite and may begin regular bouts of vomiting. Their resilience often fools owners into believing this behavior is all but a phase. It is unfortunately not. For this reason, owners do need to train oneself to be attentive to their pets’ living habits. If a pet were brought up to have a healthy appetite and generally behave energetically – owners could pick up on abnormalities much quicker.

Upon presentation, diagnostic tests including (but not limited to) blood tests, radiography and ultrasonography will be necessary to determine the pet’s illness. It is important you bear in mind that even if an initial diagnosis of kidney failure were made, there remains many factors to consider which impacts both short and long-term treatment decisions. Some factors that need to be clarified include (but not limited to):

  • acceptance to therapy in hospital setting
  • compliance to regular handling and medicating
  • pet and owner’s ability to receive and perform home therapy
  • pet’s general health prior to ARF
  • root cause to development of ARF

Management strategy of ARF is usually two-pronged. Firstly, the acute illness subsequent to failure of kidneys to function means toxins are rapidly building up inside the body. Toxins accumulate in the blood and impact on other organs including the gastrointestinal system and brain. As such, these accumulated toxins have to be removed from the body. If toxins can indeed be removed from the body, the pet will need a long term management protocol to maintain a workable level of toxins in the system. The second prong of the strategy is the long-term care of the pet which is typically maintained by pet owners at home along with regular time-points for revisits with the veterinarian.

It is important to understand the implication of suffering from acute renal failure. Your pet’s kidneys were aggressively traumatized and as all injuries heal, scars will form in place of previously healthy and functional tissue. This is no exception to patients that recover from kidney disease especially those that suffered from acute renal failure. What this means is – blood test tracks the progression of a disease thereby providing prognostication to the illness. A patient is pronounced “recovering”, “recovered” or in “dire straits” based on the ups and downs of test figures. Yet are you aware that the kidneys require 60% functional tissue to be severely damaged before the blood test picks up an abnormality? This explains the optics of such a disease. From the pet owner’s perspective – the pet suddenly went downhill and all appeared unexpected. From the veterinarian’s perspective – the pet’s body was unwell and on the decline for a period of time but the mind can stay sharp and the appetite remains keen up to a certain point before it all implodes.

The treatment for acute illness is aimed squarely at ensuring the pet’s survival. Most of us tend to stay very much on our toes when handling such incidences but soon lose focus upon “recovery” – which is really just “making it through” the deadliest part of the disease. This mentality is often seen in handling cases of acute renal failure. Oftentimes, pets that recover (or better described as “did not die”) from an episode of ARF proceed to be diagnosed as suffering chronic renal failure (CRF). Owners should be very much aware of this possibility and be prepared for to learn about proper management of this disease.

Acute renal failure (ARF) is usually dealt with through hospitalization, aggressive fluid therapy, pain management, electrolytes and nutritional supplementation. In our opinion, fluid therapy is a vital and key to the success of recovering from an acute episode of kidney failure. Fluid therapy acts as a flushing mechanism of toxins from the body and also hydrates the kidneys. Kidneys function optimally when hydrated which means toxins are most likely to be removed from the body. Pet owners very often negotiate for an early release from hospital which can compromise the efficacy of therapy. You should expect minimum three days for your pet to stabilize with medical therapy in a hospital environment. During this period and likely beyond, regular to semi-regular blood testing is used as means to track the progress of your pets’ kidneys.

Pets that suffer from kidney failure always lose their appetite for any kinds of food. This is most likely contributed by the numerous toxins that have accumulated in the bloodstream due to malfunctioned kidneys. Toxins have to be removed and while fluid therapy is the cornerstone therapy, many oral supplements have been proposed to be fed to pets as alternate methods to remove these unwanted materials. Unfortunately, feeding oral supplements or medications can be difficult and stressful to the pet and its owner. Drugs, medications and supplements can interact and potentially induce discomfort to the pet. Your pet may experience nausea that triggers retching, regurgitation and vomiting. The bitterness of a medication or supplement gives the pet a negative experience which leads to increasing resistance with each subsequent administration. We very much advise against adding drugs into your pet’s food for this very reason. A meal that conveys bitterness (think vitamins and painkillers) or an undesirable smell (think antibiotic) leaves a negative imprint in your pet’s mind and will lead to rejection of future meals. As such, never never never mix drugs into the food of a pet that suffers from any disease or illness. Maintaining interest in food and a decent appetite is paramount to healing.

We offer mild-tasting remedies and skin-contact therapies (similar to transdermal therapy) to pets that suffer from an array of illness including acute and chronic renal failure. Acute renal failure requires aggressive attention using every available avenue to support the body’s energy level while maximizing the body’s detoxification abilities. Homeopathic remedy comes in the form of small volume salty liquids which is both easy to administer and extremely palatable. It can be used in conjunction with all mainstream therapy, providing anti-inflammation to the diseased kidneys but without the side effects of western drugs. Photobiomodulation should also be applied in the course of treatment for acute renal failure to reduce inflammation, ramp up anti-oxidants including the master anti-oxidant Glutathione and to subsequently repair the recovered kidneys via stem-cell therapy. These therapies can be easily applied at the clinic as an outpatient therapy and can be replicated in the comfort of a home environment where the pet can feel most relaxed and comfortable.

Acute renal failure (ARF) is a disease that can have dire consequences. Aggressive diagnosis followed by aggressive treatment that includes fluid therapy, pain management, diet modification and ongoing detoxification strategies are maintain conventional treatment protocols widely used in veterinary medicine. The outcome of ARF treatment can often times be disappointing if discovery or treatment was insufficient or instituted too late. Rapid detoxification and anti-inflammation in order to halt further damage to kidneys are important concepts that are usually not provided in standard medical protocols. The addition of complementary therapy modalities including homeopathy to promote gentle detoxification and photobiomodulation for rapid anti-inflammation, increase of anti-oxidants including glutathione and subsequent repair / regeneration via autologous stem-cell therapy are just two modalities all pet owners become aware of in order to increase the survival of their beloved pet. Provision of anti-oxidants and stem-cell can be provided via standard intravenous (IV) infusion, oral therapy and an exciting stick-on patch method!

In conclusion, acute renal failure (ARF) usually spells a disastrous outcome for pets especially in cats. As a pet owner, commit to memory some of the most common causes to ARF that includes drugs, Lilly flowers and perhaps poorly manufactured pet foods. ARF requires rapid identification followed by aggressive medical treatments in order to survive the ordeal. However, you must be prepared to deal with the subsequent chronic disease and inflammation left by the scourge of the acute kidney insult. Learning to harness complementary care that works wonderfully alongside medicines can offer a generally enhanced quality of life for your pet.

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