Clinical Presentation

4. Clinical Presentation

The onset and spectrum of clinical and pathological events occurring in patients with CRF will vary depending on the nature, severity, duration and rate of progression of the renal disease in addition to the presence or absence of coexisting disease. Historical findings include anorexia, depression, weakness, lethargy, weight loss, halitosis, nausea, vomiting, diarrhea, melena, polyuria and polydipsia. Pale mucous membranes, dehydration, hypothermia, stomatitis, oral ulceration, dull dry hair coat and poor body condition may be noted on physical examination. Abdominal palpation reveals small irregular kidneys. Congenital and familial causes of CRF should be suspected on the basis of breed, family history, and age of onset of the renal disease (Table 1). Some patients will present with polydipsia/polyuria as the only historical sign, while other patients may be recognized by isothenuria noted on routine geriatric or pre-anesthetic laboratory screening.