Hemodialysis is a clinical treatment for acute and in some cases chronic kidney disease that is offered by the University of Florida Small Animal Hospital. It is important to understand that hemodialysis is a treatment which will not cure kidney disease; it will just allow our patients more time for the kidneys to recover from an acute injury.
Hemodialysis in Acute Kidney Injury
The hemodialysis service is currently offering hemodialysis treatment to feline and canine patients with acute kidney disease. In some cases, we will consider chronic hemodialysis treatment on a case by case basis. We will also consider hemodialysis for other species on a case by case basis.
We will perform hemodialyisis in patients with kidney failure and life threatening electrolyte abnormalities, severe azotemia, or severe hypervolemia. If you consider hemodialysis for your pet, then you should be committed for at least two weeks of treatment. Two weeks will give us enough time to stabilize the patient and to get a better understanding, what could have caused the kidney failure and to give you a more accurate prognosis. It is very important to remember before you start the treatment, that hemodialysis will not improve kidney function. The hemodialysis machine will replace kidney function for the time the patient is on hemodialysis, so that the body has more time to recover from the initial kidney injury. As soon as you stop the hemodialysis the kidney values will increase again, if the kidney function has not recovered.
Typical cases we perform hemodialysis on are dogs and cats with acute kidney injury due to toxicities (e.g., raisins, grapes, ethylene glycol, aspirin-like drugs), pyelonephritis, heat stroke and leptospirosis infections (in dogs). We also use hemodialysis to stabilize cats with severe azotemia with ureter stones before surgery.
Hemodialysis/Hemoperfusion in Toxicities
Hemodialysis and hemoperfusion (during which the blood is pumped through a charcoal filter) have great potential to filter out toxins from the blood stream. There are a large variety of toxins which can be completely cleared from the blood stream with hemodialysis/hemoperfusion treatment.
Toxicities which have been successfully treated with hemodialysis or hemoperfusion are:
1) Ethylene glycol toxicity (and all of its metabolic endproducts)
2) Ibuprofen toxicity
3) Caffeine toxicity
4) Phenobarbital toxicity
5) Pentobarbital toxicity
6) Baclofen toxicity
There are many other toxins and medications which can be dialyzed, please just give us a call if you have a potential patient and we will research for you if this toxicity would benefit from hemodialysis or hemoperfusion.
Hemodialysis in Combination with Kidney Transplantation
The hemodialysis service works hand in hand with the renal transplant team at the University of Florida. Many possible renal transplant candidates will benefit from initial hemodialysis, in order to become more stable before surgery. We typically perform hemodialysis in renal transplant patients with severe azotemia (BUN>120 mg/dl) prior to surgery. Patients with this degree of azotemia, have a larger risk of developing disequilibrium syndrome after kidney transplantation, if their kidney values have not been lowered gradually with hemodialysis.
Presently, the overall success rate for hemodialysis depends entirely on the reason for the kidney injury. Leptospirosis has an excellent prognosis with approximately 75 – 80% of the anuric patients making a full recovery. The average number of dialysis treatments for dogs with leptospirosis is 4 – 6 treatments. Ethylene glycol toxicity if treated late (after azotemia has developed) has a very poor prognosis (less than 20% recovery) and a long recovery period (many patients will need months to recover). In many cases of acute kidney injury we will be unable to determine the cause of the acute disease. In cases like these it is almost impossible to give an accurate prognosis at the time of starting hemodialysis.
Cost for hemodialysis ranges greatly depending upon how severe the pet’s renal disease is. A detailed evaluation on how often the patient will require dialysis is necessary prior to writing an estimate of care. Additional charges may be incurred if a longer time in ICU is required.
To make an appointment or if you have further questions, please contact:
Small Animal Admissions at (352) 392-2235 and ask for the Hemodialysis Coordinator.
Please address faxes ATTN: Hemodialysis Coordinator and fax to: