History, Examination, & Laboratory Findings of CKD & AKI*
Findings CKD AKI
Weight loss, poor coat, poor body condition + -
Small, irregular kidneys (on radiography or palpation) + -
Nonregenerative anemia + -
Acidosis/hyperkalemia - +
Oliguria/anuria - +
Small, irregular kidneys with hyperechoic cortices with or without loss of corticomedullary junction (on ultrasonography) + -
Chronic history of polyuria/polydipsia or stage 1 CKD + -
Urine sediment changes compatible with tubular cell damage (eg, granular casts, renal tubular epithelial cells) - +
Relatively severe signs for magnitude of azotemia - +

*+ = presence more likely; - = presence less likely

[ad override]

EXAMPLE OF Fluid Volume Requirements for A 20-KG DOG WITH 8% DEHYDRATION & AKI
Deficit needs (8% × 20 kg) over 6 hours = 1600 mL (replace over 4-6 hours)
Maintenance (60 mL/kg/day) = 1200 mL/day
Continuing losses (dog vomits 4 times at 100 mL/episode) = 400 mL/day
Total = 3200 mL/day (deficit replaced over 4-6 hours if possible)

Hypothetical Comparison of TOTAL FLUID NEEDS in Normal, Oliguric, & Polyuric Dogs
  Normal Oliguric Polyuric
Insensible fluid needs 20 mL/kg/day 20 mL/kg/day 20 mL/kg/day
Sensible fluid needs (urine output) 40 mL/kg/day 6 mL/kg/day 165 mL/kg/day
Total 60 mL/kg/day 26 mL/kg/day 185 mL/kg/day

[ad override]

AKI = acute kidney injury, BP = blood pressure, CKD = chronic kidney disease, PCR = polymerase chain reaction, UP:C = urine protein:creatinine, USG = urine specific gravity

References and author information Show

Suggested Reading

  • Cowgill LD, Langston C. Acute kidney insufficiency. In: Bartges J, Polzin D, eds. Nephrology and Urology of Small Animals. West Sussex, United Kingdom: Wiley-Blackwell; 2011:472-523.
  • Harison E, Langston C, Palma D, Lamb K. Acute azotemia as a predictor of mortality in dogs and cats. J Vet Intern Med. 2012;26(5):1093-1098.
  • Langston C. Acute uremia. In: Ettinger SJ, Feldman EC, eds. Textbook of Veterinary Internal Medicine. 7th ed. St. Louis, MO: Saunders Elsevier; 2010:1969-1985.
  • Ross L. Acute renal failure. In: Bonagura JD, Twedt DC, eds. Kirk’s Current Veterinary Therapy XIV. St. Louis, MO: Saunders Elsevier; 2009:879-882.

Gregory F. Grauer

DVM, MS, DACVIM (SAIM) College of Veterinary Medicine, Kansas State University

Gregory F. Grauer, DVM, MS, DACVIM (SAIM), is a professor and Jarvis chair of medicine in the department of clinical sciences at Kansas State University. He earned his DVM from Iowa State University and completed an internship and residency and earned his master’s degree at Colorado State University. Dr. Grauer has served as president and chairman for the ACVIM Board of Regents. He received the SmithKline Beecham Award for Research Excellence in veterinary nephrology and was appointed a Morris Animal Foundation Fellow for his work on canine glomerular disease. Dr. Grauer serves on the International Renal Interest Society board and is a past member of the advisory board of the American Society of Veterinary Nephrology and Urology. 

Sarah Guess

DVM, MS Columbia River Veterinary Specialists, Vancouver, Washington

Sarah Guess, DVM, MS, is an internal medicine veterinarian at Columbia River Veterinary Specialists in Vancouver, Washington. Her clinical interests include acute/chronic kidney disease, geriatric feline and canine medicine, endocrinology, immune-mediated and infectious disease, and endoscopy. Dr. Guess earned her DVM from Washington State University. She completed a small animal medicine and surgery internship in Mesa, Arizona, and completed a small animal internal medicine residency and earned her master’s degree in biomedical sciences at Kansas State University, where she was voted Resident of the Year. 

Material from Clinician’s Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us.

Up Next