Kidney Disease and Kidney Failure in Dogs: Signs, Care & Treatment Options

The kidneys serve vital functions in your dog’s health. They help to remove dangerous toxins that build up in your dog’s body from normal cell function. Moreover, they also help to maintain the balance of important electrolytes in the body while simultaneously stabilizing blood pressure, regulating calcium balance and excretion, and participating in the production of red blood cells through the hormone erythropoietin.

When the kidneys fail, all of these important processes are impaired. This is a serious condition, and the prognosis varies depending on the cause, with acute kidney injury carrying a high risk of death. Of course, kidney dysfunction takes on several forms, and if you pay attention, you might be able to notice some of the signs before it becomes catastrophic. In this article, we will discuss in-depth the signs of kidney failure, how it’s caused, how to prevent it, and how kidney problems can be managed after a diagnosis.

Acute Kidney Injury vs Chronic Kidney Disease

There are two ways kidney failure can occur in canines. Acute kidney injury happens very quickly, and it’s often caused by the ingestion of a toxin. Chronic kidney disease, on the other hand, is a long-term condition that progressively impairs kidney function, though the early signs are often missed.

Acute Kidney Injury

Acute kidney injury is a rapidly developing condition. Toxins such as ethylene glycol (antifreeze), certain plants, medications including NSAIDs, and contaminated or spoiled foods can all cause acute kidney injury if consumed. Toxins are the most common culprits, but there are other possible causes. A blood clot, for instance, can also result in acute kidney injury as blood flow to the kidneys decreases and they lose oxygen. Furthermore, conditions such as heat stroke, bacterial infections (such as leptospirosis), dehydration, and snake bites can all result in acute kidney injury.

Chronic Kidney Disease

Since chronic kidney disease takes such a long time to develop, it’s most common in older dogs. Early signs of chronic kidney disease are often so mild that they’re not even noticed. Chronic inflammation and systemic infection, such as severe untreated periodontal disease, may contribute to kidney damage over time, since the kidneys filter waste and circulating inflammatory byproducts. Other causes of chronic kidney disease include genetics, environmental factors, chronic mild dehydration, immune-mediated disease, congenital abnormalities, or medications known to affect kidney function, such as long-term NSAID use.

Signs of Disease and Kidney Failure in Dogs

Unfortunately, once renal tissue is damaged, there is no treatment to recover it. Therefore, kidney disease can only be managed to stop or reduce its progression. Sadly, the signs of kidney failure are typically only evident when about 66% to 75% of the kidney’s tissue has already been affected. So, to preserve as much of the remaining kidney function for as long as possible, it is important to learn what signs to look for:

• Loss of appetite
• Rapid weight loss
• Blood-tinged urine
• No interest in interaction or playtime
• Decreased thirst
• Increased thirst
• More or less frequent urination
• Signs of dental disease (bad breath, ulcers in the mouth, pale gums)
• Vomiting
• Diarrhea
• Oral ulcers 
• Ammonia-like breath
• Dehydration
• Weakness or muscle loss
• Neurologic signs, such as disorientation or tremors, in severe cases

Diagnosing Kidney Problems in Dogs

If you notice your dog displaying any of the signs of kidney problems, you’ll want to contact the vet immediately and take your dog in for assessment. Kidney disease and injury diagnosis usually includes a urinalysis to evaluate kidney function and a blood chemistry analysis to check kidney values and electrolyte balance.

During a urinalysis, the vet will be looking for urine specific gravity, protein levels, glucose, sediment, and possible evidence of infection. One possible indication of kidney failure is a low urine-specific gravity. The amount of protein in urine may also be increased, a finding called proteinuria, providing diagnostic signs of potential problems.

A blood chemistry analysis measures the blood for concentrations of two different waste products from protein metabolism. High levels of blood urea nitrogen and blood creatinine are signs that the kidneys are experiencing a decrease in function. Modern diagnostics also include SDMA, an earlier marker of reduced filtration rate. Additional blood tests will be requested to measure the levels of other important substances in the blood, including globulin, potassium, calcium, and blood cell counts. Ultrasounds or X-rays might also be required. This information will give your vet a better idea of the overall picture of your dog’s health, enabling them to pick the best course of treatment with the highest chance of success.

Treatment Options for Kidney Issues

Kidney issues aren’t “cured” but managed. If your dog’s kidneys have already been severely damaged prior to the diagnosis, it’s likely too late for full recovery of function. But if you manage to catch the signs of kidney issues early enough, a management treatment can potentially prolong your dog’s life. Often, when caught early enough, kidney disease hasn’t become full-blown kidney failure yet, making it much easier to manage.

The first step in treating kidney disease or acute kidney injury is to address the type and state of the damage, and there are IRIS (International Renal Interest Society) staging guidelines with four different stages for chronic disease and graded severity for acute injury. The treatment will depend on both the stage and the underlying cause of the kidney problems.

As part of the treatment, it may be necessary to flush out the kidneys and blood. In dogs with failing kidneys, the blood has toxins that have been building up over time, and they must be removed. This is attained by the administration of IV fluids and carefully monitored diuresis. Once completed, the healthier environment will enable the kidney cells that aren’t too damaged to begin functioning properly again. If you’re lucky, there may even be enough working cells left in the kidneys to continue normal processes and keep your dog’s body running after the toxins are removed.

Once the blood and kidneys are stabilized, medications and additional treatments for disease management will need to be administered. The goal of this second treatment phase is to help the kidneys continue functioning for as long as possible. This phase will likely include fluid and electrolyte replacement therapy and changes to your dog’s diet in the form of a therapeutic renal diet formulated to reduce phosphorus, provide controlled high-quality protein, and support metabolic balance. To control signs like nausea and vomiting and to regulate the parathyroid gland and calcium levels, a range of medications, including anti-nausea drugs, antacids or gastroprotectants, binders, blood pressure medication (to help lessen the degree of proteinuria), fluid therapy, and bone marrow stimulators, may also be used, depending on your dog’s condition and the severity of the damage.

With proper care and a little bit of luck, your dog could live many happy years after dealing with kidney disease or chronic renal insufficiency.

However, keep in mind that in cases where too much of the kidney’s tissue has already been damaged, a procedure known as continuous renal replacement therapy or even intermittent hemodialysis might be necessary, though at this point, the prognosis is guarded to poor.

Being familiar with the signs of this disease and getting your dog checked by the vet as soon as you notice anything concerning will increase the likelihood of your dog being around for longer.

Reducing the Risk of Kidney Disease and Acute Kidney Injury

Although kidney injury and kidney disease are sometimes manageable conditions, the best form of treatment is prevention. Granted, some factors will be out of your control, but there are many things you can do to reduce the chances of your dog experiencing kidney failure.

Remember that acute kidney injury is most often caused by the ingestion of toxins. So, to help prevent this, you’ll need to store all cleaners and chemicals in a safe place that can’t be reached by your dog. They need to be high up where your dog can’t reach or behind locked doors that your dog can’t enter.

You also need to ensure that potentially dangerous foods, such as grapes or raisins, are kept in places where your dog can never get to them. Another important precaution is to ensure that your dog has no access to your OTC or prescription medications.

Chronic kidney disease is also commonly associated with dental disease, so one way to prevent this is by making your dog’s dental health a top priority. Brush their teeth regularly, and take them to get a dental check and professional cleaning as needed. You can also ask your vet for more instructions on how to best provide dental care for your dog.

Conclusion

Kidney failure is a serious condition that often leads to death. Knowing the signs of kidney disease and injury can help you spot it before the kidneys shut down completely. When it’s caught early enough, there’s a good chance that your dog can have many years of a healthy and happy life with proper treatment and a management plan. However, if it progresses too far, by the time that it’s diagnosed, it will already be too late. Make sure to keep chemicals, cleaners, OTC medications, and foods that are toxic to dogs locked up or out of reach, and keep up with your dog’s dental health if you want to prevent kidney problems from ever occurring.

See also:

• Best Dog Foods for Kidney Disease (Vet Approved) – Reviews

• Why Raisins & Grapes Are Toxic To Dogs (Vet Answer)

Featured Image Credit: Lindsay Helms, Shutterstock