Extracorporeal Therapies
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Internal Medicine and Critical Care Now Offer Advanced Veterinary Extracorporeal Therapies.
We are honored to be among the few facilities in the US to offer these cutting-edge treatments that provide new hope for pets suffering from acute kidney injuries, chronic kidney disease, immune-mediated diseases, and life-threatening toxicities.
Procedures Available:
The veterinary extracorporeal therapies we are now offering include:
- Hemodialysis
- Therapeutic Plasma Exchange
- Hemoperfusion
WHAT TO EXPECT
Extracorporeal Therapies
Hemodialysis serves as an “artificial kidney” by filtering a pet’s blood to remove harmful substances such as waste, toxins, and excess fluids. While it does not directly heal the kidneys, it provides a vital window of time for recovery, while significantly improving comfort and quality of life for the pet during this critical period. Hemodialysis is most commonly used for acute kidney injuries, severe electrolyte imbalances, fluid overload, and certain toxicities.
- Hemodialysis treatments are usually 4-6 hours in length however it may be longer (8-12hrs) during initial treatments. Patients are typically treated as inpatients for the initial treatments but can be transitioned to outpatient care once stable. Treatments for kidney injury are typically given once daily for three days and then three times per week. Some patients may only need a few treatments if there is improvement in kidney function, while others may take weeks to months of treatment.
- Patients with chronic kidney disease can also be treated with dialysis. This treatment acts as a maintenance long term therapy, as patients are not expected to regain kidney function.
Therapeutic Plasma Exchange (TPE) is a procedure designed to remove harmful substances from a pet’s plasma, replacing it with donor plasma. This therapy is particularly effective in managing severe immune-mediated conditions such as immune-mediated hemolytic anemia (IMHA) and myasthenia gravis, as well as certain toxicities. Pets may experience rapid improvement particularly with immune-mediated diseases that are unresponsive to conventional treatments.
Hemoperfusion involves filtering a pet’s blood through a cartridge containing activated charcoal or similar materials to adsorb toxins. This technique is especially valuable in cases of NSAID overdoses (e.g., ibuprofen, carprofen) or exposure to other harmful substances where no antidote exists.
- Treatments are generally completed within 2-4 hours, and a single session is often sufficient if administered before organ damage occurs.
- With toxicities, time is of the essence and prognosis is much better if the toxin can be removed prior to any organ damage occurring.
- Many poison control hotlines are not aware of the potential for hemoperfusion for toxicity treatment, contact our hospital to see if this option is recommended.
Frequently Asked Questions
No, most pets do very well with treatments where they get to relax in a soft bed with ongoing attention from our staff. Sedation is rarely needed.
Dialysis does not directly do anything to fix the kidneys. It can remove build up of substances that may be life threatening in pets with kidney disease. This can be life saving and make pets feel better while extending the window of opportunity for the kidneys to hopefully heal. Whether the kidneys eventually heal depends upon the cause and extent of injury and in most cases can not be easily predicted at the start of therapy.
We can treat most companion animals. The small size of some patients do present challenges but can be safely treated. Blood transfusions may be needed for small patients to allow for safe treatments and this is supported by VRCCO’s own blood bank.
This depends on the type of treatment.
- Toxin removal with hemoperfusion is typically only one treatment.
- Total plasma exchange for certain toxins or immune mediated disease may be 3-4 treatments.
- Hemodialysis for patients in kidney failure may be as little as 1-3 treatments with some acute kidney disease. Average is 4-6 treatments however full kidney recovery may take weeks to months in some cases.
- Roughly half of patients treated with dialysis will not regain kidney function despite dialysis giving them additional time for healing.
- Keep in mind that these are patients that have already 100% failed traditional medical therapy.
Many patients with kidney injury may respond well to traditional medical and fluid therapy and not need dialysis. Indications for considering dialysis include:
- Oliguria/anuria: When little or no urine is being produced by the kidneys.
- Fluid Overload: When attempts to treat with IV fluids result in accumulation of fluid in the body (skin, lungs, organs, etc), there can be life threatening complications from this excess fluid. Dialysis can effectively remove this extra fluid through a process called ultrafiltration.
- Hyperkalemia: Potassium levels can increase with kidney failure and result in cardiac rhythm abnormalities which may be life threatening. Potassium levels can be rapidly corrected with dialysis.
- Severe acidemia: Kidney failure causes an accumulation of substances in the blood that make it more acidic (acidosis) leading to illness. This is corrected with dialysis treatments.
- Azotemia: Elevation of levels in the blood called BUN and creatinine occur with decreased kidney function. There is no absolute cutoff of these numbers to indicate when dialysis is indicated however when they are not improving with medical therapy then dialysis should be considered.
It is important to know that dialysis does not directly fix the organ dysfunction that occurs secondary to kidney failure. Waiting too long to start dialysis may result with a worse prognosis. It is always best to start dialysis prior to severe complications such as organ dysfunction and fluid overload.
VRCCO utilizes the same advanced dialysis machines and materials used in human medicine, ensuring the highest standards of care.
Dialysis patients are under continued direct observation by skilled staff trained in these therapies. Pets are continuously monitored for vital parameters such as blood clotting times, fluid balance, hematocrit, electrolytes, and cardiac health, with personalized attention and compassionate care from their team members.
Due to the specialized equipment required and the continuous skilled care provided by veterinarians and veterinary nurses, treatment costs can be significant. Several factors may influence these costs, including the number of treatments needed (which can be difficult to predict), the level of additional medical support based on the severity of illness, and the potential need for supplemental blood transfusions or blood products. Costs for hemoperfusion and therapeutic plasma exchange are generally more predictable and can be estimated with greater accuracy. However, for patients with kidney disease, the uncertainty of their response to treatment makes it challenging to forecast the time and expense involved. Comprehensive treatment plans are provided to help guide appropriate financial planning.
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