Peer-reviewed veterinary case report
Acute on chronic kidney disease in dogs: Etiology, clinical and clinicopathologic findings, prognostic markers, and survival.
- Journal:
- Journal of veterinary internal medicine
- Year:
- 2020
- Authors:
- Dunaevich, Asia et al.
- Affiliation:
- Veterinary Teaching Hospital
- Species:
- dog
Plain-English summary
This study looked at 100 dogs with a sudden worsening of chronic kidney disease (CKD), which is a common issue in dogs. The most frequent signs observed were not eating (84%), being very tired (77%), vomiting (55%), and having diarrhea (37%). The reasons for this worsening were often unclear, but some cases were linked to inflammation or infections. Dogs that survived tended to stay in the hospital longer, and the study found that certain factors, like breathing rate and specific blood test results, could help predict how well a dog would do in the short term. Overall, while some dogs did recover, the long-term outlook remains uncertain, with a median survival time of about 105 days for those that were discharged.
Abstract
BACKGROUND: Chronic kidney disease (CKD) and acute exacerbation of CKD (ACKD) are common in dogs. OBJECTIVE: To characterize the etiology, clinical and laboratory findings, and short- and long-term prognosis of dogs with ACKD. ANIMALS: One hundred dogs with ACKD. METHODS: Medical records of dogs diagnosed with ACKD admitted to a veterinary teaching hospital were retrospectively reviewed. RESULTS: The most common clinical signs included anorexia (84%), lethargy (77%), vomiting (55%) and diarrhea (37%). Presumptive etiology included inflammatory causes (30%), pyelonephritis (15%), ischemic causes (7%), other (3%), or unknown (45%). Median hospitalization time was 5 days (range, 2-29 days) and was significantly longer in survivors (6 days; range, 2-29 days) compared with nonsurvivors (4 days; range, 2-20 days; P < .001). Mortality rate was 35%. International Renal Interest Society (IRIS) acute kidney injury (AKI) grade at presentation was associated (P = .009) with short-term survival, but presumptive etiology was not (P = .46). On multivariable analysis; respiratory rate (P = .01), creatine kinase (CK) activity (P = .005) and serum creatinine concentration (SCR; P = .04) at presentation were associated with short-term outcome. Median survival time of dogs discharged was 105 days (95% confidence interval [CI], 25-184), with 35 and 8 dogs surviving up to 6 and 12 months, respectively. Presumptive etiology (P = .16) and SCR (P = .59) at discharge were not predictors of long-term survival. CONCLUSION AND CLINICAL IMPORTANCE: Short-term outcome of dogs with ACKD is comparable to those with AKI but long-term prognosis is guarded. The IRIS AKI grade at presentation is a prognostic indicator of short-term outcome.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/33044036/