Reasoning for obligatory preclinical diagnostics of feline chronic kidney disease
Abstract
Diseases of the urinary system of various etiologies are common in all species of animals and over time, they can lead to the development of chronic kidney disease (CKD) as the progressive process in which renal function gradually decreases over several years. In modern veterinary medicine, there is a problem of a steeply increase in cases of chronic kidney disease in cats. Pathology occurs most often in aged animals, but recent studies have registered cases of chronic renal dysfunction in young ones as well. In chronic kidney disease the kidneys do not work well for a long time, causing a number of changes in the body. Unfortunately, early symptoms are often missed by pet owners and the disease is not noticed for a long time. In most cases, the diagnosis of chronic kidney disease is established only when effective treatment is no longer possible or ineffective and treatment is able to maintain the homeostasis of the body only to a certain extent and for a short time. Undoubtedly, this approach to the diagnosis and treatment of kidney disease requires changes. In view of the fact that the duration of the preclinical stage of CKD can reach several years, the goals of our study were to show the benefits of early diagnosis of chronic kidney disease in cats and the introduction of a new concept of systematic body screening of clinically healthy animals and animals at risk. Also, the goals were to delay the moment of the kidneys compensatory reserve exhaustion and onset of clinical symptoms, which require constant symptomatic and replacement therapy. Reducing the percentage of early mortality of patients and the maximum possible increase in the duration of the preclinical stage of renal pathology were also aimed at. Efforts were also aimed at reducing the percentage of early mortality of patients and the maximum possible increase in the duration of the preclinical stage of renal pathology. Since nephroprotective therapy at the preclinical stage is highly effective in most clinical cases and allows to significantly slow down the progression of any chronic nephropathy, including CKD, there is a need for the formation of innovative diagnostic approaches at the early stages of the disease. It is proposed to conduct a cumulative assessment of the anamnesis in animals from risk groups, monitoring the level of creatinine in the blood serum, complete clinical analysis of urine, ultrasound examination of the kidneys, measurement of protein concentration, since these indicators have not only prognostic value and determine the tactics of treatment, but are also important factors pathogenesis of CKD. Since each parameter will not provide a complete state of the disease, since none of them is 100 % specific, an integrated approach to the early diagnosis of chronic kidney disease is needed for. It is necessary to take into account all the methods listed above, as well as monitoring the condition of the body of animals that have contracted any viral or bacterial infection, or have acute kidney damage, diabetes, hypertension, or metabolic disorders.
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