Dogs and cats with chronic kidney disease (CKD) suffer from a typically degenerative disease, which is associated with progressive worsening of clinical and laboratory parameters. Nonetheless, if well managed with appropriate therapies as well as an adequate monitoring, these patients can remain clinically stable for long periods. For this reason, clinical and laboratory follow ups of dogs and cats with CKD is very important as it is aimed at identifying the alterations of parameters that, if identified early, allow to set an adequate therapy thus slowing down the disease keeping a good quality of life. Clinical evaluations include the general examination and the examination of the urinary system; laboratory diagnostics should include all values required for IRIS staging. Monitoring procedures and timing of follow up are then decided based on the stage of the disease and the effectiveness of the therapies established. Non-proteinuric and non-hypertensive patients, or those in therapy for proteinuria and hypertension with control of the same, are usually checked every 12 months if in IRIS stage 1 and every 6, 4 months or 6-8 weeks if in IRIS stage 2, 3 or 4. In patients with a non-optimal control of proteinuria and / or hypertension, even in IRIS stage 1 and 2 it is advisable not to exceed an interval of 6 and 4 months respectively between the clinical evaluations. It is worth underlining that the proposed monitoring refers to stable patients other than it is advisable appropriate indications for home monitoring are provided to the owner.
Owners of dogs and cats with CKD should promptly report any increase in thirst or urine production as well as the presence of vomiting and / or diarrhea, reduced appetite and any weight loss equal to or greater than 5%. For veterinarians and owners, webmobile programs are currently available to simplify the management of patients affected by CKD.
Monitoring scheme of patients with clinically stable CKD
|
IRIS stage |
Follow up |
Clinical evaluation |
Diagnostics |
|
1 |
Once a year |
Fully clinical evaluation, body weight, BCS e MCS, blood pressure |
Urinalysis Renal parameters and CBC |
|
2 |
Every 6 months |
As in Stage 1 |
As in Stage 1 |
|
3 |
Every 4 months |
As in Stage 1 |
As in Stage 1, consider hemogasanalysis |
|
4 |
Every 6-8 weeks |
As in Stage 1 |
As in Stage 1, hemogasanalysis |
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