TANYA'S

COMPREHENSIVE GUIDE TO

FELINE CHRONIC KIDNEY DISEASE

 

 

DIALYSIS

 

ON THIS PAGE:


What is Dialysis?


Haemodialysis


Peritoneal Dialysis


Continuous Renal Replacement Therapy


Enteric Dialysis


 

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Home > Fluid Therapy > Dialysis

 


Overview


  • When they first receive the CKD diagnosis, many people who are keen to do all they can to help their cat consider dialysis.

  • Unfortunately, ongoing dialysis is not appropriate for cats as it is for humans.

  • It is also only available in a limited number of centres, and is incredibly expensive - it costs up to US$25,000 for 2-3 weeks - so is beyond the reach of most people.


What is Dialysis?


 

The kidneys filter waste products from the blood, and discard them in urine. Damaged CKD kidneys cannot perform this function properly, so waste products build up in the bloodstream and make the patient feel unwell. Dialysis is a method of filtering the blood to remove the waste products so the patient feels better. Normally dialysis has to be performed on an ongoing basis.

 

There are two main types of dialysis, haemodialysis and peritoneal dialysis. Because of the cost and stress factor, neither type is commonly performed on cats, although haemodialysis is sometimes used to keep a seriously ill cat going prior to a kidney transplant, and peritoneal dialysis is occasionally used for cats with acute kidney injury.

 

A limited number of centres also offer a method called continous renal replacement therapy (CRRT).

 

How to choose the right dialysis modality (2012) Langston CL Presentation to the Advanced Renal Therapies Symposium, NYC, discusses the various types of dialysis (go to page 124).

The Advanced Renal Therapies Symposium (2012) Animal Medical Center, NYC has a list of dialysis units throughout the world (see page 140).

 


Haemodialysis


 

This is the type of dialysis which people usually think of when they hear the word "dialysis". It is available for cats at a limited number of facilities in the USA, and as in human patients, the process lasts several hours and has to be performed several times a week. It can only be given in hospital and is extremely expensive, with the Animal Medical Center in New York estimating the cost at US$20-25,000 for the first 2-3 weeks.  

 

Nephrology Knowledge is owned by Dr Cathy Langston, a veterinary dialysis expert. She explains more about how haemodialyis is performed.

 

Intermittent hemodialysis for small animals (2011) Bloom CA & Labato MA Veterinary Clinics of America Small Animal Practice 41(1) pp115-133 discusses the use of haemodialysis.

 

Long-term outcome of cats and dogs with acute kidney injury treated with intermittent haemodialysis: 135 cats (1997-2010) (2012) Eatroff AE, Langston CE, Chalhoub S, Poeppel K & Mitelberg E Journal of the American Veterinary Medical Association 241(11) pp1471-8 discusses the benefits of dialysis. It concludes "Although there was a high mortality rate prior to hospital discharge, those patients that survived to discharge had a high probability of long-term survival."

 

Veterinary hemodialysis: advances in management and technology (2004) Fischer JR, Pantaleo V, Francey T, Cowgill LD The Veterinary Clinics of North American Small Animal Practice 34(4) pp935-967 vi-vii, predicts haemodialysis will gradually become more widely available and will be used for cats with advanced CKD which does not respond to more standard treatment methods (such as sub-Qs).

 

Veterinary Partner has some information about haemodialysis for pets.

 

Availability


Ohio State University College of Veterinary Medicine mentions that "Only 22 veterinary hospitals in the U.S. and 40 worldwide offer dialysis services."

 

Nephrology Knowledge has a list of facilities, though sadly this is not up to date.

 

Intermittent hemodialysis for small animals (2011) Bloom CA & Labato MA Veterinary Clinics of America Small Animal Practice 41(1) pp115-133 has a list (current in 2011) of haemodialysis facilities worldwide.

 

University of California at Davis School of Veterinary Medicine explains more about haemodialysis, which it can provide.

 

University of Pennsylvania School of Veterinary Medicine offers information and provides haemodialysis.

 

Ohio State University College of Veterinary Medicine reports on the successful treatment of a cat given haemodialysis in 2016 at Ohio State.

 


Peritoneal Dialysis                                                                                                                 


 

This entails using the peritoneal cavity as a means of dialysis. The peritoneum is semi-permeable, so urea/BUN, creatinine and phosphorus can pass through it. In peritoneal dialysis, a sterile dialysis solution is introduced into the peritoneal cavity, and this solution then collects waste products and excess electrolytes by means of diffusion. However, it is very hard to maintain sterility and avoid infection using this method, so it is highly unlikely that you will come across this form of treatment in practice; it tends to be reserved for cases of acute kidney injury

 

Peritoneal dialysis in cats with acute kidney injury: 22 cases (2001-2006) (2011) Cooper RL & Labato MA Journal of Veterinary Internal Medicine 25(1) examines the use of peritoneal dialysis in cats with acute kidney injury.

 

Management of acute renal failure in cats using peritoneal dialysis: a retrospective study of six cases (2003-2007) (2009) Dorval P & Boysen SR Journal of Feline Medicine & Surgery 11(2) pp107-115, found that peritoneal dialysis greatly helped five of the six cats with acute kidney injury.

 

Peritoneal dialysis in dogs and cats: 27 cases (1976-87) (1989) Crisp MS, Chew DJ, DiBartola SP & Birchard SJ Journal of the American Veterinary Medical Association 195(9) pp 1262-6 reports on the success rates of peritoneal dialysis in dogs and cats.

 


Continuous Renal Replacement Therapy (CRRT)


 

Continous renal replacement therapy is used for acute situations when a cat is critically ill. It provides continous treatment and is usually only provided until the cat is stable once again, at which point the cat would often switch to haemodialysis.

 

The Veterinary CRRT Webpage has more information about CRRT.

 

Management of acute kidney injury with continuous venovenous haemodiafiltration in a cat 2015) Stanzani G, Jepson RE & Chan DL Journal of Feline Medicine and Surgery 17(6) pp551-556 reports on a cat who received CRRT in the UK.

 

Continous renal replacement therapy in dogs and cats (2011) Acierno MJ Veterinary Clinics of North America Small Animal Practice 41(1) pp135-146 reports on the use of CRRT.

 

CRRT is available at a number of US vet schools.

 

Ontario Veterinary College offers CRRT in Canada.

 

The Royal Veterinary College offers CRRT in the UK.

 


Enteric Dialysis


 

This is not a standard form of dialysis, though its goals are similar. It is a method of trying to relieve the load on damaged kidneys by expelling waste via the gastrointestinal tract. Nutritional management of renal disease: an evidence-based approach (2014) Sanderson SL Today's Veterinary Practice 4(1) pp51-56 explains the theory behind enteric dialysis.

 

There is more information about enteric dialysis on the Nutritional Requirements page.

 

 

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This page last updated: 25 July 2016

 

Links on this page last checked: 25 July 2016

 

 

   

*****

 

TREATING YOUR CAT WITHOUT VETERINARY ADVICE CAN BE EXTREMELY DANGEROUS.

 

I have tried very hard to ensure that the information provided in this website is accurate, but I am NOT a vet, just an ordinary person who has lived through CKD with three cats. This website is for educational purposes only, and is not intended to be used to diagnose or treat any cat. Before trying any of the treatments described herein, you MUST consult a qualified veterinarian and obtain professional advice on the correct regimen for your cat and his or her particular requirements; and you should only use any treatments described here with the full knowledge and approval of your vet. No responsibility can be accepted.

 

If your cat appears to be in pain or distress, do not waste time on the internet, contact your vet immediately.

 

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