Chronic kidney disease in dogs
Overview
- Chronic kidney disease (CKD) is when the kidneys slowly stop working over a period of months or years.
- Symptoms can include increased thirst, peeing more, decreased appetite, weight loss, vomiting, and low energy.
- There is no cure for CKD — it’s a condition that gets worse over time, but there are ways you and your vet can manage your dog’s condition and help reduce the symptoms.
The kidneys filter waste products from the blood into the urine so that they can be removed from the body when your dog pees. If the kidneys don’t work properly, these waste products build up and cause your dog to become poorly.
Chronic kidney disease (CKD) is when the kidneys slowly become less efficient and eventually stop working over a period of months to years. It is more common in older dogs as they have more wear and tear on the kidneys as they age. Certain breeds of dogs are more prone to be born with kidney problems that can lead to CKD in younger dogs. This includes Bull Terriers, Cocker Spaniels, West Highland White Terriers and Boxers.
CKD is different to acute kidney injury, where the kidneys stop working very suddenly, usually because they have been damaged by something such as an infection or a toxic substance like antifreeze.
Symptoms
In the early stages of CKD there might be no symptoms because the kidneys are still able to manage. Once the kidneys have been significantly damaged and aren’t able to cope, symptoms of CKD will start to appear. Some of the symptoms may appear very slowly and can be hard to spot. Symptoms of CKD in dogs include:
- Drinking more
- Peeing more
- Going off food
- Weight loss
- Vomiting/nausea
- Lethargy (low energy)
- Constipation
- Bad breath with a chemical smell
Dogs severely affected by CKD might have additional symptoms including:
- Twitching muscles
- Mouth ulcers
- Collapse
- Blood in poo
Dogs with these severe symptoms need to be seen by a vet as an emergency.
Diagnosis
If your vet suspects kidney disease, they will test your dog’s blood and urine to look for indications that the kidneys aren’t working properly and for any possible cause. These tests can also help to grade your dog’s kidney disease, which indicates how serious or how advanced it is. If your vet requests a urine sample you can check out our video on how to collect a urine sample. Your vet might also check your dog’s blood pressure.
In some circumstances, your vet might take X-rays and/or use an ultrasound scan to look at the shape and size of the kidneys.
Treatment
With CKD, it isn’t possible to reverse the damage that has already been done to the kidneys, so the condition can’t be cured. Treatment is aimed at slowing down further damage and managing the symptoms. Treatment includes:
- Fluids — if your dog is very sick or dehydrated when they are diagnosed with CKD it is likely they will be given a fluid drip.
- Increasing water intake — you will need to encourage your dog to drink as much as possible to support their kidneys and prevent dehydration. Make sure they have fresh clean water at all times in multiple bowls around the house. You can also add water to their food.
- Feeding a special kidney diet — special kidney diets for dogs have the right levels of protein, sodium and phosphorus for dogs whose kidneys aren’t working properly. Ideally, choose a wet food to increase the amount of water your dog takes in from their food. Your vet can help you choose the right food for your dog. Changing your dog’s food should be done gradually.
- Medication for blood pressure — if your dog’s blood pressure is too high, your vet may prescribe them with blood pressure medication.
- Vitamins — your vet may prescribe vitamin supplements for your dog.
- Other treatments — your vet might prescribe treatments for other symptoms of CKD, for example to help an upset stomach or lack of appetite.
- Regular monitoring — your dog will need regular check-ups with your vet. This might include blood and urine tests or blood pressure monitoring. Your vet will let you know how often they would like to see your dog.
Outlook
If your dog is very poorly when they are diagnosed with chronic kidney disease the outlook is much worse, so it is better to see your vet as soon as symptoms appear.
It is possible for a dog with chronic kidney disease to live for months to years with treatment and regular monitoring. Over time, the symptoms will get gradually worse so it is important to monitor them and consider their quality of life. Once treatment isn’t helping anymore and their quality of life is affected it may be kindest to consider euthanasia (putting them to sleep). Your vet can help you with this difficult decision.
When to contact your vet
It is important to contact your vet if:
- You notice any of the symptoms of CKD in your dog, as the earlier it is detected the better.
- If your dog has been diagnosed with CKD and their symptoms are getting worse, especially if they are eating less.
You know your dog best, always contact your vet if you’re concerned.
Cost
Treatment and monitoring for CKD can become very expensive. It’s important to speak openly to your vet about your finances, the cost of treatment, as well as what you think is right for your dog. There are often several treatment options so if one doesn’t work for you and your pet then the vet may be able to offer another.
Consider insuring your dog as soon as you get them, before any signs of illness start. This will ensure you have all the support you need to care for them.
- How do I get my dog to eat their kidney diet?
- What are the stages of chronic kidney disease?
- When should I think about euthanasia?
How do I get my dog to eat their kidney diet?
If your dog isn’t eating their kidney food, you could try a different brand, or you could feed both wet and dry food — dry food is better than no food. You could also add a small amount of warm water to the food to try to tempt them. If this doesn’t help then contact your vet for their advice.
What are the stages of chronic kidney disease?
There are four stages of CKD — stage one is the least severe and stage four is the most severe. Although staging isn’t always necessary, it can help your vet decide on a treatment plan. If necessary, your vet will be able to find out which stage your dog is in based on their blood, urine and blood pressure test results.
When should I think about euthanasia?
Although it’s a difficult decision, euthanasia (putting your dog to sleep) might be the kindest option if they are poorly with chronic kidney disease and treatment isn’t helping. Think about your dog’s quality of life — are they in pain, are they eating and drinking, are they keeping clean and are they coping overall? You should also think about yourself and whether you are coping with looking after your dog. Don’t be afraid to discuss this with your vet, who will be able to support you in making this decision.
Published: May 2023
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Sign up to our e-newsletterWritten by vets and vet nurses. This advice is for UK pets only. Illustrations by Samantha Elmhurst.