Insuficienta renala cronica la animalele de companie

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Insuficiența renala cronica este o problema comuna  cainilor si pisicilor. In urma digestiei  alimentelor, se  produc  deseuri care sunt transportate de către sange la rinichi. Rinichiul  urmează să  filtreze  și sa excrete sub forma de urina. În cazul în care rinichii nu mai sunt capabili sa elimine aceste deseuri  iar toxinele se acumuleaza  in sange  apar  semnele  clinice de boala renala. Toate rasele de orice varsta pot fi afectate, prevalenta  crescand  cu inaintarea in varsta.

Vârsta medie de diagnostic la câini si pisici este de sapte ani. Rase de caini considerate a fi mai sensibile :

  •   Cocker spaniel
  •   Shih Tzu
  •  Pinscher
  •   Doberman
  • Golden  retriever
  •  Bull terrier
  •  Ciobanesc german
  •  Samoyed

Insuficienta renala cronica  afecteaza aproape toate rasele de pisici.

Mecanismele care produc boala:

  •    filtrarea anormală de sange și retentia deseurilor
  •   dereglarea  productiei de hormoni   inclusiv a celor care stimulează producerea de celule roșii din sânge (eritropoietină)
  •  tulburari ale electrolitilor și echilibrului acido-bazic

Boala renala cronica poate fi cauzata de mai multe procese. Acestea pot include boli, dintre care unele pot fi secundare  altor procese patologice sau traumatisme,  cum ar fi:

  •   toxinele
  •  fluxul  redus de  sange  și lipsa de oxigen (ischemie)
  •  boală inflamatorie
  •  Infecții
  •  cancer (neoplazie)
  •  anomalii ale sistemului imunitar

Manifestari clinice:

  •  Creșterea  consumului de apa
  •  Creșterea frecventei  de urinare
  •  Letargie
  •  Varsaturi
  • Respirație ingreunata
  •  Anorexie
  • Slabiciune
  •  Lipsa de coordonare in  mers
  •  Depresie

Diagnostic:

Sunt necesare teste de laborator  pentru a identifica Boala renala cronica și a exclude alte boli.

  •  istoricul medical complet   va contine  întrebări cu privire la modificarea consumului de apă și frecventa de urinare, expunerea la etilen glicol (antigel), intervenții chirurgicale recente sau anestezie,  prezenta/absenta poftei de mâncare, scădere în greutate, boli anterioare, si  consumul anterior de medicamente.
  •     Examen fizic complet
  •      Teste de Biochimie
  •       Sumar de urina /Urocultura
  •       Hemoleucograma completă .
  •       Ecografie  rinichi
  •       Analiza gazelor din sange
  •       Raport proteina / creatinină  urinara

     Tratament :

Desi boala nu se poate vindeca, depistarea precoce poate incetini progresia bolii sub un tratament corespunzator.  Boala renala cronica pune viața în pericol,  necesită spitalizare și tratament pentru stabilizarea  animalelor de companie afectate.

Medicul veterinar va efectua terapia cu fluide, reechilibrarea  electrolitilor,reglarea hiperfosfatemiei,tratarea anemiei, monitorizarea atenta a diurezei.

Hrana recomandata va fi dietetica adaptata  gradului de afectare  renala.

Ingrijire la domiciliu

Insuficiența  renala cronica pune în pericol viața animalului de companie, iar dacă  observati  una din manifestarile clinice descrise mai sus,  contactati medicul veterinar cat mai curând posibil.

Hrana pentru animalul tau de companie va fi dietetica,  recomandata de medicul veterinar.

Asigurarea accesului liber la apă  în orice moment.

Se administreaza  toate  medicamentele  prescrise  de catre medicul veterinar.

Preventie

Nu exista recomandări specifice pentru prevenirea insuficienței  renale  cronice. Cu toate acestea, recomandarile  generale includ:

  •  Observati  frecventa de  urinare și consumul de apa.
  •  Evitati  accesul  animalului  la etilenglicol, care poate provoca leziuni  renale acute.
  • Efectuati un set minim de analize biochimice de screening  cel putin o data pe an.

 Boli cu semne clinice asemanatoare bolii renale cornice: 

  • Insuficiență renala acuta (apariția brusca  a  insuficientei  renale)
  •     Diabetul insipid (o tulburare metabolica  datorata  insuficientei  hormonului ADH )
  •  Diabetul zaharat ( funcționarea deficitara a pancreasului,  care produce și elibereaza insulina)
  •  Medicamente (diuretice, corticosteroizi)
  •  Administrarea excesivă de lichide parenteral.
  •  Hiperadrenocorticismul (boala Cushing)
  •  Hipercalcemia
  •  Hipoadenocorticism (boala Addison)
  •  Hipopotasemia
  •  Boala de ficat
  •  Mielom multiplu
  •  Obstructie partiala a tractului urinar
  •  Policitemia
  •  Diureza post-obstructivă
  •  Pielonefrita
  •   Piometrul

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