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The pet food recall that began in early March of 2007 occurred because dogs and cats were developing acute renal failure after consumption of food containing wheat gluten that had been contaminated by melamine. The chemical was proven to be the toxin by independent laboratory testing that confirmed that it was present in the specific source of wheat gluten, in the foods that contained this wheat gluten, and in the urine of affected animals.
Acute renal failure is a condition in which the kidneys suddenly fail or stop working normally. When the kidneys stop functioning, waste products from digestion build up in the bloodstream, and the levels of sodium and other electrolytes that are normally regulated by the kidneys become unbalanced. The most common symptoms of acute renal failure are vomiting, diarrhea, and anorexia. In severe cases, the accumulated toxins will cause the patient to have convulsions. Urine production will vary, depending on how the individual’s kidneys have failed. A complete shutdown of the kidneys will mean that urine production will stop, while a failure of the kidneys to filter and reabsorb water or electrolytes will mean that there will be excessive urine production accompanied by severe dehydration. The patient’s condition may rapidly progress to shock.
Acute renal failure may be primary or secondary, meaning that the problem has occurred primarily in the kidneys, or that the problem has occurred elsewhere in the body and has secondarily affected the kidneys. Secondary acute renal failure most commonly occurs when a urinary tract obstruction prevents urine from being eliminated from the body, causing urine to back up into the kidneys. It may also occur as a result of heart failure or other organ failure. Primary acute renal failure may be caused by trauma, by infectious agents such as leptospirosis, or by a toxin, which may be a chemical, a drug or a natural poison. The most common toxins that affect the kidneys of animals are chemicals such as automotive antifreeze (ethylene glycol) or pesticides, medications such non-steroidal antiinflammatory drugs (NSAIDs) or chemotherapy agents, or poisonous plants such as lilies.
The diagnosis of acute renal failure will be based a combination of a medical history and physical examination findings coupled with the results of blood and urine tests. In some cases, it may be possible to identify the specific cause of the failure. In many cases, more extensive testing may be required to determine the degree of failure and the patient’s prognosis. The kidneys have very little ability to regenerate, so severe kidney destruction is irreversible.
Early and aggressive treatment will give the patient the best chance to survive. The cornerstone of treatment for acute renal failure is intravenous fluid therapy. Fluid therapy will be given to correct dehydration and electrolyte imbalances, to eliminate any circulating toxins as soon as possible, and to restore circulation to the failing kidneys, minimizing further kidney damage. If a specific toxin is suspected, a more specific treatment or antidote may be available. It may be necessary to empty the patient’s stomach and/or administer activated charcoal to prevent further toxin absorption if the toxin entered the body through the intestinal tract. Specific drugs may be needed in individual cases to control other symptoms, especially vomiting, diarrhea, or convulsions.
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