Glomerulonephritis In Dogs – Diagnosis & Treatment

The term ‘Glomerulonephritis’ represents a broad spectrum of kidney damage, ranging from a mild disease that is undetectable clinically to acute renal failure that is deadly.

Also called nephritis and nephrotic syndrome, Glomerulonephritis is the outcome of any one of the several conditions that can affect the tiny clusters of looping blood vessels in the kidney (called glomeruli). Physiologically, Glomerulonephritis occurs when a chunk of immune cell products (mixtures of antigens and antibodies) are filtered out of the bloodstream and gets stuck within the tangle of blood vessels. When there are large boluses of trapped compounds, the body responds by activating its more immune elements, and this leads to further damage to the glomeruli.

Glomerulonephritis can be broadly classified into acute or chronic. Acute Glomerulonephritis’ happens suddenly (in hours or days) leading to proteinuria, azotemia, and hematuria, while chronic Glomerulonephritis happens gradually over time and causes irreversible damage to kidneys. Almost all types of acute glomerulonephritis have a possibility of progressing to chronic glomerulonephritis.

Nephrotic syndrome is defined as when the filtering units of the kidney are damaged, there will be large amounts of protein, low serum albumin, high serum cholesterol, edema, or other uncharacteristic accumulation of fluid. Dogs with nephrotic syndrome may develop abnormal blood clots and high blood pressure resulting in a variety of signs associated with edema (swelling) or blocked blood vessels.

• Blood in urine
• Decreased urine output
• Breath that smells like chemicals
• Fluid retention of the face, legs, and ankles (edema)
• Uncoordinated movement such as stumbling
• Seizures
• Fatigue/weakness
• Nausea
• High blood pressure

The treatment of kidney injury varies depending on the underlying cause, the dog's overall condition, and the severity of symptoms.

Sometimes, glomerulonephritis dogs require hospitalization and intensive care to recover.

Aggressive treatments may include hospitalization for a kidney transplant, dialysis, Temporary Feeding Tube, or intravenous (IV) fluids.

For milder cases - antibiotics, fluid therapy, and other medications.

Glomerulonephritis in dogs- treatment protocol focuses on slowing the disease progression, and severity and improving the quality of life for the pet.

Peritoneal Dialysis: A tube is placed directly into the peritoneum in the abdomen, then the fluid is pushed into this membrane (acts as a natural filter) and dissolved substances are later drained out.

Kidney dialysis (Hemodialysis) is required for:

• Acute kidney failure due to infection-related glomerulonephritis
• Critical electrolyte abnormalities
• Lack of urine production
• Overhydration as a result of fluid administration

Treatment of appetite changes, blood pressure alterations, anemia, fluid imbalances, electrolyte disturbances, gastrointestinal problems, and nausea is typically necessary.

Check with your veterinarian, usually once a month to ensure the health of the dog and to check for any infection.

• Keep dogs away from household chemicals such as antifreeze and other cleaners.
• Dogs can easily poke their nose through plastic bottles and ensure bottles are kept up high or in locked cabinets where dogs cannot reach them.
• Keep raisins, Grapes, prescription and OTC drugs, like ibuprofen out of reach of dogs.
• Clear away contaminated water sources
• Talk to your vet about your dog's dental hygiene and how often you should have your dog’s teeth cleaned
• Vaccination against infectious diseases (like leptospirosis) can prove highly effective to prevent acute glomerulonephritis.

There are many causes of Glomerulonephritis, so there is no breed disposition.

Shar Pei, Soft Coated Wheaten Terrier, Bull Terrier, Dalmatian, Samoyed, Bernese Mountain Dog, Doberman Pinscher, Newfoundland, English Cocker Spaniel

1. Causes:

• Severe pancreatitis (inflammation of the pancreas gland)
• Autoimmune disease (E.g., lupus)
• Tumors
• Inflammation of the prostate
• Infections: Pyelonephritis, Leptospirosis infection, Lyme disease, Primary bacterial kidney infection
• Toxicity: Anti-freeze ingestion, Amyloidosis, Nephrolithiasis, Medications such as cardiac and anti-inflammatory medications, Damage to kidney tubules (tubulointerstitial disease), and Certain foods such as grapes/raisins in dogs

2. Stages of kidney injury due to glomerulonephritis:

The International Renal Interest Society (IRIS): kidney injury is often progressive and stages of chronic renal failure are numbered 1 to 4 (with increasing severity).

There are higher chances of morbidity and mortality at stages 3 and 4.

3. Mortality:

Median survival time for dogs:

Stage 1: >more than 400 days

Stage 2: 200 to 400 days

Stage 3: 110 to 200 days.

4. Diagnosis:

• Inflammatory or infectious disease testing (in certain cases)
• SDMA test: SDMA (a naturally occurring biological indicator for kidney function)
• IRIS (The International Renal Interest Society) staging system - urine protein: creatinine ratio (UPC)
• Urine testing (urinalysis and urine culture)
• Abdominal ultrasound
• Blood work evaluation

5. Prognosis:

Many instances of acute glomerulonephritis can be reversed depending on the cause and with prompt treatment.

The stage or severity of the disease determines the prognosis.

In some dogs, medical intervention will offer a much-needed healing period for kidneys and in other cases, dogs may get well but develop irreparable damage that is clinically significant leading to chronic kidney diseases.

Contact your vet right away, if you notice any of the following:

• Fluid retention of the face, legs, and ankles (edema)
• Decreased or no urine output

Foods to avoid:

• Grapes, garlic, onion, purines, and raisins
• Pretzels, chips, and crackers
• Coconut/Chocolate, coffee, and caffeine
• Dairy, eggs
• Salty/processed snack foods like canned and packaged snacks)
• Macadamia and other nuts
• Onions, garlic, chives
• Raw, processed, or undercooked meat
• Yeast dough
• Xylitol

Special diet for glomerulonephritis:

Lower in protein, reduced amounts of sodium and phosphorus, with increased levels of omega-3 fatty acids, potassium, and high-alkaline foods

Protein: 14-20%, 35 g/1000 kcal of high-quality protein

Sodium: ≤ 0.3%

Phosphorus: 0.2 - 0.5%

Potassium: 1.1- 2-3%

Omega-3 fatty acids:

1 g of EPA and DHA per 1000 kcal of diet = 25 mg/kg of DHA combined with 40 mg/kg EPA q24h

Glomerulonephritis in dogs that go untreated is deadly. When you suspect any kidney-related issues with your dog, don’t try to treat the condition with any conventional home remedies.

Within a few days of starting the proper reatment, most of the acquired glomerulonephritis symptoms will be relieved. The clinical signs acquired due to underlying conditions can be controlled by appropriate treatment.