Signs and symptoms of kidney disease

[tanzanyte]

There isn’t much written about kidney disease in gerbils other than to tell you it's common, so I thought I’d start a thread that people can hopefully add to with any signs or symptoms they've noticed with their gerbils, even if they are the same. Hopefully we can get some more data.

Around June 2020, when Vanilla was about 2.5 years old she lost weight, despite being active and seemingly well. We tried giving her food and treats away from her sister (who was tipping the scales the opposite way). It helped slightly, but we felt her weight should have increased more than it did.

We then noticed that she would wee when out for play time. She'd never wee’d before whilst out, but suddenly it was every time.
At the beginning of July we took her to see a vet who gave us some Sulfatrim to treat any possible UTI, and sent us home with a pipette and vial to get a urine sample for testing protein. The test highlighted kidney failure and we were advised to give her a low protein diet, although they said this may be difficult for a gerbil. We also took Vanilla to another vets in case there was anything else that could be done, but both vets gave the same prognosis and advice. Neither vet had any other options to offer.
I did some research with regards to lower protein alternatives in the UK so will add them at the end. However our vet did say that changing their food can be very stressful for them so it needs careful consideration.

I didn’t notice Vanilla's water intake go up, nor any other behaviour changes, but we managed to stabilise her weight. However, the urine frequency gradually increased.
I still didn’t notice any significant difference in her water intake, even after her sister died in October.

Vanilla managed ok until November when we noticed she had started behaving oddly. She wasn't as active, yet her back started to feel thinner. She also slept just outside her bed over a couple of nights - not something she had ever done before. She seemed lethargic, although was still moving around a little. Her eyes didn't seem fully open as normal, and we also noticed that a small amount of her poo was black. We took her to the vets who said Vanilla was more active when she examined her. The only thing she could suggest was a subcutaneous fluid injection in the back of her neck to get the fluid levels back up.
She wasn’t sure how much she would be able to administer as it depends on how the gerbil behaves. Thankfully she managed to give her a good dose of about 10ml.

When we got back we noticed immediately that Vanilla was licking every surface possible. I did try and research deficiencies but there wasn’t much available. In desperation I went straight out and bought a mineral wheel, which she nibbled a bit but it didn’t stop her licking. I managed to buy a Rosewood Himalayan salt lick the following day and she licked this and thankfully stopped licking everything else.
It took about 3 days for her to get back to her old self between the fluid injection and the salt lick.

We checked in with the vet who suggested we monitor her rather than taking her for a fluid injection every couple of weeks if she didn’t need it. We were checking her weight every couple of days but it decreased slowly by 2 grams across a span of 3 weeks.
We gave her small amounts of fresh fruit and veg as usual and used baby fruit puree pouches to try and get more fluid in her. We also offered the water bottle up to her and put another water source in the play area. Vanilla stopped drinking from the bottle, preferring the tiny beco dish to drink from.
Almost 4 weeks after her fluid injection, Vanilla deteriorated very fast. She seemed ok the night before when we went to bed. By morning she was in one of her soft hides in her play area, but she felt cold and wasn't really moving much, and had her eyes partially closed.
This time there was no black poo, which I had been looking for as a sign to take her back for another injection.
We put her on a heat pad and rushed her straight to the vet who said that her abdomen was bloated and she was dehydrated. She administered a bigger dose of fluid at the back of the neck, however Vanilla died a few hours later.

I have taken pictures of her poo for future reference as I had no idea what I was supposed to be looking out for.
Hopefully it shows that the poo is more shrivelled and uneven, although not all of her poo was like this. It can also be hard to tell with the increased urine output as they frequently wee at the same time that they poo and it looks more normal then.

I was told that I may see blood in her urine, another sign I was looking out for, however there never was any. We were also told the darker, more yellow the urine, the better it is because the kidneys are still filtering something, whereas if their urine is clear the kidney's aren’t functioning well at all. Her urine still seemed yellow when I cleaned up, but it’s hard to know if it was more diluted towards the end and just wasn’t noticeable to me.

If your gerbil isn’t well and the vet can’t feel any tumours and they don’t have any other possibilities. Please get them to test the urine. If they can’t manage to get a sample there and then, they can give you a pipette and vial to collect a sample yourself to drop back off for testing.

If your gerbil has been diagnosed with kidney issues and they haven't already suggested it, ask if they can administer a subcutaneous fluid injection at the back of the neck.
If possible book in for regular injections rather than leave it and look for signs because the deterioration is so fast. Check with your vet and see how long they suggest leaving it, but I would try to get in to a regular pattern with the injections.

In case this helps anyone else, this is what I've found out for protein percentages in complete gerbil UK available:
Mr Johnsons Advance Hamster and Gerbil - 19% protein - www.mrjohnsons.co.uk/product/advance-hamster-gerbil-food/
Beaphar Care+ Gerbil and Mouse - 17% protein - www.beaphar.com/en-gb/product/beaphar-care-plus-gerbil
Science Selective Complete Gerbil - 17% protein - supremepetfoods.com/products/science-selective-complete-gerbil/
Versele Laga Hamster and Gerbil - 17% protein - www.versele-laga.com/en/be/complete/products/complete-hamstergerbil
Cliffi Physiologic Piccoli Omnivori - 16.9% protein - www.cliffi.com/en/products/2-small-mammals-aquarium-reptiles/11-piccoli-mammiferi/53-physiologic-mangime-conigli/245-n-a
Burgess Hamster, Gerbil and Mouse - 15% protein - shop.burgesspetcare.com/other-small-animals/Hamster,-Gerbil-and-Mouse/63
Oxbow Essential Hamster and Gerbil - 15% protein - www.oxbowanimalhealth.com/our-products/fortified-food/essentials-hamster-gerbil-food/
Sainsbury's Hamster, Gerbil and Mouse - 15% protein - www.sainsburys.co.uk/gol-ui/product/small-animals/sainsburys-small-animal-hamster--gerbil---mouse-nuggets-1kg

[LilyandDaisy]

Thanks for this tanzanyte. I found a snippet from Merck Manuals that said gerbils are prone to a kidney disease called glomerulonephritis, and this is often found alongside tumour growth (though it didn't say why). Did your vet ever mention this condition?

[Thea]

Thank you so much for this. I'll add anything I can think that Rolo was doing if I can think of it, as I am sure she had kidney failure or similar kidney issues.

edit: I've also been sure ever since he started becoming ill that one of my boys, Caramel, had kidney problems. I can't remember all that happened to him unfortunately, but he got loads skinnier and weed a lot more outside of the cage. After a couple of weeks he also had blood in his wee. 

[betty]

Great detail there thanks tanzanyte - really detailed. Just also checking were those pale poops also his (and if so were they 'fresh' ones that pale or did they fade to that after?

[Markpd]

Thanks for this detailed post Tanzanyte, very useful!

lilyandaisy

Interesting, I was just reading about glomerulonephritis (after you mentioned it) from the PetMD website (as well as the NHS website, for people of course, but we're all mammals ), they both say that salt intake should be reduced, with the PetMD site suggesting Vitamin B supplements too.

So I was wondering if Tanzanyte's gerbil was suffering from some other kidney disease? Unless the glomerulonephritis itself causes a perverse craving for salt?

I only wonder that, because just prior to when I was diagnosed with T1 diabetes I became very thirsty, ironically the only thing that really quenched my thirst was sugary drinks! (the last thing you should have!). I believe the 'mechanics' for that is my cells were being starved of energy (glucose) and so my body demanded more (but just wasn't getting it due to a lack on insulin to transport the glucose to the cells). I did lose a lot of weight!

Also the thirst is the body trying to flush out the excess glucose in my blood. Post diagnosis I gave up sugary drinks of course!

Anyway,  my point is I wonder if Vanilla was craving salt because her cells were somehow deficient of it due to the failing kidneys? That's just a guess though as I have no idea what the mechanisms are for how the body takes up salt (that'll be something for my reading list! ).

[LilyandDaisy]

I think any kind of excessive fluid loss can cause salt craving due to the loss of electrolytes. A few years ago I had a medical procedure which involved fluid loss and I woke up craving anything salty.

[Markpd]

Yea true, and something else I've remembered from diabetes (which maybe directly related to glomerulonephritis) high blood glucose levels in diabetics causes greater thirst and so greater urination, this can cause excessive 'flushing' of salts from the body (like you said) (which for us can lead to cramps amongst other things), perhaps the gerbils greater urination is the cause of the salt crave? If so, reducing salt intake would seem counter productive? (at least for the body, perhaps not the kidneys).

If found this interesting, from this very technical article! (I only read the small section about water balance and the kidney).

In cases of CKD[chronic kidney disease], the failing kidneys lose the capacity to concentrate the urine maximally, which means that they must excrete more water to eliminate the solutes acquired in the diet. As a consequence, patients are forced by thirst to drink more water to cover the loss linked to solute excretion. However, in cases where the volume of water ingested cannot be excreted fully with urine output due to a defect in maximal urine dilutional capacity, an individual can enter a hyponatremic state.

From wiki - Hyponatremia is a low sodium concentration in the blood.

And this article is interesting discussing urinary composition, including how sodium, calcium and protein excretion is related.

I think I see where the PetMD and the NHS et al are coming from now regarding restricting salt intake. If I understand correctly, the strategy is by reducing salt intake their are less solutes to remove so less work for the kidneys to do, meaning less water to pass and slowing down the deterioration of the kidneys, and so less salt passed too. Anyone know if that's right?

[tanzanyte]

Good question, Betty. I would say old and faded as I never noticed any change in colour other than when they went black, but I don't know for sure as it could have been something I missed. I wasn't quick to clean out her play area and it was only whilst doing this that I suddenly thought to check through everything and take pictures. Most of her poo seemed normal at the time, especially as it was most often with a puddle. There were some tiny poos I also noticed towards the end, which were odd as well.

LilyandDaisy, I think it is one and the same, although they didn't use that language with me. However I'd probably have panicked if they'd have come out with that. I'm not sure it would be normal terminology for a vet to use with the family? PetMD and Merck were the only ones I found but I did look at human research.

I found a few articles that mentioned making sure you have enough sodium with kidney failure.
www.livestrong.com/article/461350-relationship-between-low-sodium-levels-low-kidney-function/
Given that Vanilla had been managing with kidney disease without licking anything for months, I took a guess at it being a deficiency. I figured I was going to lose her so it was worth a shot. She didn't spend much time licking the salt block versus the amount of time she was trying to lick every other surface beforehand, so I assume she got what she needed and carried on doing her gerbily things.
I did check it with the vet, who said if it was helping then to leave her to it.

[Markpd]

Fair enough.
What information I found out there appeared conflicting, so I'm still not sure what's meant to be done with salt with kidney disease! Although I found more that said cut salt intake when suffering with kidney disease.

[tanzanyte]

I think you should cut salt wherever possible with kidney issues. It just depends on the signs and symptoms you are seeing. Vanilla lasted months without the need for any salt. It's not something I would have considered buying had she not been licking everything, but even with the subcutaneous injection, she didn't pick up as quickly as I'd hoped or expected.