In hemodialysis, your animal's blood is allowed to flow, a few ounces at a time, through a special filter that removes wastes and extra fluids. The clean blood is then returned to their body. Removing the harmful wastes and extra salt and fluids helps control your animal's blood pressure and keep the proper balance of chemicals like potassium and sodium in its body.
Dialysis is available for both dogs and cats and can be used for acute or chronic kidney failure. Dialysis is used to treat:
- Acute or chronic kidney failure
- Animals for whom standard therapy (intravenous fluids, medication, etc.) has proven ineffective
- Animals with life-threatening complications of kidney failure (e.g. high potassium levels and fluid in the lungs)
- Animals who have eaten a poison that can be removed with dialysis
When dialysis is used for acute kidney failure, it is continued until the kidneys recover function or it becomes clear that the kidneys are not going to heal.
Most of the time, whatever kidney repair is going to happen will occur within four weeks. Occasionally the kidneys will heal sooner, and sometimes they take longer than four weeks to heal. There is no way to predict recovery time at the outset.
With chronic kidney failure, the kidneys are permanently damaged. Dialysis is continued three times a week for the rest of the patient’s life. In this case, kidney transplant is the only alternative to chronic dialysis.
Apheresis is a Greek term for "taking away" and is the therapeutic process of removing a portion of a patient's blood, while returning the remainder back to the patient. This is performed to remove toxic or pathologic substances from blood or to replace an abnormal component of blood.
When blood plasma is removed and donor plasma is administered to the patient the procedure is called Therapeutic Plasma Exchange (TPE) . Additionally, red blood cells and white blood cells can be exchanged (in the case of severe red blood cell parasitemia and other conditions) or reduced in quantity (in the case of leukemia). Platelets can also be removed, however this is typically performed for the purposes of collecting a platelet-rich blood product for donation.
TPE is the most commonly performed type of apheresis and has been used to treat a variety of diseases in veterinary medicine. Often, this procedure is performed to treat severe immune-mediated diseases, where circulating antigen-antibody complexes or other pathologic factors are contributing to disease. Diseases that are candidates for TPE include:
- Immune-mediated hemolytic anemia (IMHA)
- Immune-mediated thrombocytopenia (IMT)
- Myasthenia gravis (MG)
- Immune-complex glomerulonephritis (GN)
- Lyme-associated nephritis
- Pempahigus foliaceus (PF)
- Systemic lupus
- Hyperviscosity syndrome
- Pure red cell aplasia (PRCA)
- Immune-mediated polyarthritis (IMPA)
- Acute polymyositis
- Immune-mediated encephalitis
- Acute hepatic failure
- Drug overdosage
- Exogenous toxin removal (i.e., amanita)
Diseases have varying schedules for treatment. To discuss if your patient may be a candidate for apheresis or TPE, please contact our nephrology team.
Renal transplantation is a treatment option for renal failure in cats. It is important to recognize that renal transplantation is a treatment for renal failure, and not a cure. The goal of renal transplantation is to provide a good quality of life for a cat that would otherwise be unable to survive; however, “normal” life expectancy is not yet achievable by today’s technology.
The Feline Renal Transplantation Program at Penn Vet was successfully initiated in February 1998 by Dr. Lillian R Aronson, VMD, DACVS, Associate Professor of Small Animal Surgery. After she received her VMD and finished an internship at the University of Pennsylvania's School of Veterinary Medicine, Dr. Aronson completed a small animal surgical residency at the University of California, Davis.
Learn more about Renal Transplantation at Penn Vet.
Protein-Losing Nephropathy, or PLN, is a disease affecting certain dogs in which the filtering mechanism of the dog's kidneys is defective and the dog loses protein through urine. Because protein is such an essential nutrient to the body, its loss is a very serious problem. Certain breeds, such as the Soft-Coated Wheaten Terrier, the Bernese Mountain Dog, the Labrador Retriever, and the Golden Retriever. Affected dogs often have adverse reactions to food, including vomiting, diarrhea, or intense itching.
Dr. JD Foster and his team are conducting a clinical trial on PLN, in which silymarin, a supplement derived from the milk thistle plant, is used in combination with established standard medications.
Learn more about this trial and how to enroll.
Consultations and Referrals
Please inquire to learn more about the extracorporeal therapies now being offered at Penn Vet.
JD Foster, VMD, DACVIM
Director, Hemodialysis and Extracorporeal Therapies
Referring Veterinarian Office of Ryan Hospital
Vet Phone line: 877-736-6838
We will gladly consult on any cases that you feel will potentially benefit from blood purification. Please call or contact us with any questions.