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Hemodialysis is primarily used to treat pets with acute kidney damage (i.e. leptospirosis, toxin-induced kidney injury, etc.), but we also offer hemodialysis for patients with chronic kidney disease. Therapeutic plasma exchange treats immune-mediated diseases including immune-mediated hemolytic anemia and acquired myasthenia gravis. A form of dialysis called hemoperfusion is being utilized for removal of toxins from the blood. This is useful for pets who have consumed an overdose of certain drugs.
Indications for Renal Replacement
- Acute kidney injury of less than 2 week duration (leptospirosis, pyelonephritis, toxin induced AKI, Lyme nephritis)
- Creatinine > 3 mg/dl - Acute decompensation of chronic kidney disease
- Chronic renal disease not responding to conservative management
- Massive overdose of toxin or medication
- NSAIDs (including ibuprofen, naproxen, piroxicam, meloxicam, carprofen)
- Anticonvulsants including phenobarbital
- Ethylene glycol
- Chemotherapeutic agents (vincristine overdose)
- Antibiotics (accidental overdose of hepatotoxic or nephrotoxic drugs)
- Ethanol, methanol
- Acetaminophen (used for massive overdose)
Therapeutic Plasma Exchange (TPE) is a new technique that can be used to remove molecules from the blood that are too large to remove via hemodialysis. TPE has success in treating immune-mediated diseases such as IMHA, ITP, myasthenia gravis, Lyme nephritis, as well as hyperviscosity syndrome (e.g. multiple myeloma) and severe hyperlipidemia. There has been good success of using TPE for fulminate, severe cases of IMHA, ITP and myasthenia gravis. It is also useful for immune-mediated cases that aren't responding to standard immunosuppressive therapy, and treatment of drug toxicity.
Another therapy is cytokine removal in patients with severe sepsis. The patient undergoes continuous extracorporeal treatment and within the blood circuit, a specifically designed filter is utilized to remove cytokines. Human trials have shown positive outcomes, and this emerging therapy for dogs and cats with severe sepsis may be life-saving when the patient is not responding to traditional therapies.
Many pet insurances will cover these therapies. Given that early intervention results in improved outcomes, referral directly to NorthStar VETS for hemodialysis/TPE evaluation is available.