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What is Dialysis and Renal Replacement Therapy?

Dialysis is used to treat kidney failure. There are two types of dialysis: hemodialysis and peritoneal dialysis. When most people talk about dialysis, they are referring to hemodialysis. This involves filtering the dog’s blood through a machine called a hemodialyzer to cleanse it of toxins and waste. This machine contains a solution called dialysate, which is separated from the blood through a dialyzer membrane. Dialysate attracts toxins and waste from the blood through the membrane. Because the IV is long and large, an IV port may be left in place under the skin until the treatments are completed. A single hemodialysis treatment lasts between three to five hours. Peritoneal dialysis essentially uses the dog’s abdomen as the dialyzer membrane. Dialysate is administered to the abdomen and absorbs toxins and waste for several hours. The waste material is then drained.

Continual renal replacement therapy (CRRT) is similar to dialysis, but takes longer. Toxins are removed at a continuous rate between 24 to 48 hours. This procedure is meant to filter the blood of toxins just as the kidney would. With CRRT, fewer treatment sessions are required. It is less commonly performed than dialysis, is more invasive, and will require sedation or anesthetization as well as hospitalization. However, it is also associated with fewer complications.

Dialysis and Renal Replacement Therapy Procedure in Dogs

Hemodialysis

  1. A thorough physical examination is carried out at the start of each session.
  2. Dogs will lie on a soft pad and wear a special harness for the duration of the session. This is meant to comfortably restrain the dog while still allowing him to move.
  3. The dialysis catheter is unwrapped and cleaned prior to insertion.
  4. Blood samples are taken and analyzed before treatment begins.
  5. The lines hooked to the dialysis machine are attached to the catheter lines.
  6. The dialyzer extracts blood while simultaneously replacing it with specialized fluids to keep the dog stable during the procedure.
  7. Up to one cup of blood is cleaned at a time before it returns to the body, and new blood is drawn into the machine. This cycle continues for several hours until the treatment is complete.
  8. Dogs are allowed to eat and drink during the procedure.
  9. Once the dog is stable, he is released from the treatment center.

CRRT

  1. Steps 1-4 are repeated.
  2. The dog will be sedated or anesthetized.
  3. The catheter is connected to a special machine, which will filter the blood over a 24 to 48 hour period.
  4. Sedation or anesthetization is typically required for the full duration of treatment.
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Efficacy of Dialysis and Renal Replacement Therapy in Dogs

The efficacy of dialysis and CRRT will depend on the overall health of the dog and the nature of the disease. Improvement is typically seen within four weeks. However, healing times will vary based on the individual case. Some dogs, particularly those with chronic kidney failure, may need to remain on dialysis for the rest of their lives.

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Dialysis and Renal Replacement Therapy Recovery in Dogs

Most dogs will be lethargic on the return home, and will spend the day sleeping. Postprocedural pain is not usually a problem. Dietary changes are often recommended in conjunction with treatment. Some dogs will require intravenous fluid supplementation at home. For these cases, a veterinary dialysis specialist will train you. Stressful situations should be avoided, and the dog should be kept calm as much as possible. Follow-up appointments will be scheduled to administer additional treatments, monitor healing, and conduct additional tests.

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Cost of Dialysis and Renal Replacement Therapy in Dogs

The cost of dialysis and CRRT will vary based on the number of treatments needed as well as standards of living and additional costs incurred. The average price of dialysis and CRRT, for the first two to three treatments, ranges from $3,000 to $4,500. Subsequent treatments typically cost $600 to $700 each. This price may not include the cost of hospitalization.

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Dog Dialysis and Renal Replacement Therapy Considerations

Complications from dialysis may include, but are not limited to:

  • Nausea
  • Loss of appetite
  • Metabolic bone disease
  • Carnitine and taurine deficiency
  • Complications and infection associated with dialysis catheter placement

Dogs undergoing dialysis for chronic kidney failure will require treatment for the rest of their lives. The only alternative treatment for chronic kidney failure is kidney transplant.

These complications are not associated with CRRT. The primary complication with CRRT is blood clotting in the CRRT circuit. The dialysis specialist will discuss all potential complications with you prior to treatment.

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Dialysis and Renal Replacement Therapy Prevention in Dogs

Kidney disease and kidney failure are difficult to prevent because the cause often remains unidentified. Dietary changes may help prevent kidney disease. Poisons and toxic substances should be kept out of reach of pets at all times to prevent ingestion. Dogs treated for kidney failure, particularly chronic kidney failure, should not be bred.

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Dialysis and Renal Replacement Therapy Questions and Advice from Veterinary Professionals

Need pet health advice? Ask a vet

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Akamaru

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German Shepherd

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3 Years

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Serious severity

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Serious severity

Has Symptoms

Diarrhea
Increased Thirst
Increased Urination
Lack Of Appetite
Vommit,
Kidney Levels Elevated

My dog is currently suffering from Leptospirosis. The vet currently has him on IV with antibiotics for over 24 hrs. Earlier today he was vomiting so they gave him some other medicine to help with that. His kidney levels are elevated and he peed a little blood this morning I guess, which would imply kidney inflammation?. I am currently terrified and lost because this is a small area in western NY. I am concerned where to take him for dialysis if it comes to that. The vet tech on the phone said its to early to consider dialysis or transplants or anything but I am terrified things could keep going downhill. Do you possibly know the closest place for this? Or am I overreacting? this disease just seems so terrifying I am lost. He was just being his normal self a few days ago, but the increased third and urination has been at least 10 days.

June 12, 2018

Akamaru's Owner

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3320 Recommendations

It is too early to be thinking about dialysis and kidney transplants, focus first on getting Akamaru over the Leptospirosis. As far as I am aware, there are two practices in New York state which offer dialysis for dogs, both are in New York City; I don’t know about Cornell University Veterinary School, you should contact them if or when. As far as kidney transplants are concerned, they are generally unrewarding and have a high mortality rate; transplants in cats are a lot more successful. Regards Dr Callum Turner DVM https://bluepearlvet.com/queens-ny/hemodialysis/ www.amcny.org www.canine.vet.cornell.edu

June 13, 2018

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Oscar

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German Shepherd

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7 Years

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Serious severity

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Kidney Failure

I'm curious about peritoneal dialysis, which is mentioned above. I've read that its similarly effective as hemodialysis and CRRT and the equipment is much less expensive. However, my vet told me that although the procedure could be performed at the local clinic, the amount of time required to complete a full course of peritoneal dialysis treatment involves a high labor cost, so many clinics wind up referring their patients to regional hemodialysis centers rather than performing peritoneal dialysis locally. The problem with that is in many cases the nearest veterinary hemodialysis center is quite far away, and the treatment is still very expensive. Why doesn't that make locally-performed peritoneal dialysis an alternative? Is the labor cost really that high?

April 12, 2018

Oscar's Owner

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3320 Recommendations

Peritoneal dialysis is a method which doesn’t require expensive equipment, but your Veterinarian is right that it is a labour intensive process which requires a lot of input from veterinary staff and pet owners. The decision to perform peritoneal dialysis in house is down to your Veterinarian, some may do it whilst others may prefer to refer patients to a Specialist. Check the link below for more information. Regards Dr Callum Turner DVM http://vetnetinfo.com/tudasbazis/files/2016/02/Peritoneal-Dialysis-2006.pdf

April 12, 2018

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Sophie

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Rat Terrier

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15 Years

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Critical severity

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Is there a dialysis treatment center in Michigan. My dog has chronic kidney failure and is receiving renal treatment currently, but is not making good progress, and was wondering if she would be a candidate being that she is old. She is not eating very much while being under treatment.

March 19, 2018

Sophie's Owner

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I don’t know of anywhere in Michigan which offers dialysis, you can try contacting the Veterinary Hospital at Michigan State University (first link) for some local advice; there is a dialysis machine at Ohio State University in Columbus, OH (second link) but it is a bit of a journey. You should speak with your Veterinarian about Sophie’s suitability for dialysis as she may not be a good candidate. Regards Dr Callum Turner DVM https://cvm.msu.edu/hospital https://vet.osu.edu/vmc/referring-vets/news/dialysis-service-now-available-vmc

March 19, 2018

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h

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Labrador Retriever

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13 Years

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Critical severity

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Elevated Kidney Values

Hello, where can I find a dialisis center for my 13years old labrador? i am living in the Leigh High Valley area in Pennsylvania. Thanks ............................................................................................................................................................................................................................................................................................................................................................................................................................................................................

March 1, 2018

h's Owner

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Dr. Michele K. DVM

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Thank you for your email. I am not sure if there are any clinics in your area that offer dialysis, as it is not a commonly performed procedure in dogs. If H would benefit from this treatment, it would be best to ask your veterinarian, as they will know whether that might be the best therapy for her, and if she would benefit from that treatment.

March 1, 2018

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Clutch

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Labrador

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5 years

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Hello. I have a lab, Clutch who will be 5 in a few weeks on the 27th. She was recently diagnosed with renal and liver failure on Thursday, the 29th of November. Her numbers for her blood work are off the charts. I changed her diet up and started her with chicken and rice over her grain free dry food with liquid iron and omega 3 fish oil. I would also chop a half an egg every other meal, to give her a total of one egg per day. Her appetite was boosted almost instantly and she started eating very well for a couple days. All the sudden on Sunday she quit eating. I was able to get her to take a couple bites of chicken and rice yesterday (Monday), but I cant get her to eat anything now. I'm now interested in renal replacement surgery for her. She's so young I cant stand to loose her this early in her life. Do you think this would be a viable option considering her liver that is starting to fail? I'm not entirely sure how to receive your email. So if you could email my personal google account, that would be fantastic. "Scootertrashkid@gmail.com" Thank you and a have a wonderful day.

Dec. 5, 2017

Clutch's Owner

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The options you have at present for Clutch seem to be dietary management (which you are already trying), dialysis (if appropriate or other renal replacement therapy) and liver support with silybin and SAMe; each case is different and should be managed as such. You should visit a Specialist to discuss your options, but for kidney transplants in dogs, there hasn’t been much success unlike in cats and humans. Regards Dr Callum Turner DVM

Dec. 6, 2017

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Lucy

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Labrador Retriever

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8 Years

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Critical severity

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Lethargy
Loss Of Appetite

I have an 8 yr old Black Lab. She has had allergies beginning at age 1.She has been on short term predisone and then treated with Apoquel at age 6 . At age 7 she developed Pemphigus foliaceus . She has been on azathioprine and predisone (currently weened to 2.5-5mg )a day.She also developed hypothroidism and is being treated. The last blood draw showed a significant increase in creatintine -it was 4.8 ,she was hospitalized and given fluid came down to 3.2 ,she came home and just short of week stopped eating and was vomiting . Back to vet and Cr was now 5.7. Added Cerenia for nausea and pepcid 20 mg qd . She would eat chicken and turkey and now has stopped eating almost entirely ,refuses almost everything. Is there anything else I can do ? Like everyone , I hate to lose her and can not bring myself to euthanasia unless I am 100% sure there is nothing else to be done and I do not want her to suffer.