kidney failure in a young dog

Kidney Failure In Dogs: Causes, Symptoms & Treatment Options

Kidney disease in dogs is a scary diagnosis for pet parents. After all, we want to spend as much time as possible with our furry family members, and the worries and concerns posed by the possibility of having to say an unexpected goodbye can take their toll. So, what is renal failure in dogs? Lets find out about the causes, the signs and symptoms, the treatment options, and how to know when its time for that final goodbye.

What Causes Kidney Failure In Dogs?

There are lots of causes of kidney failure in dogs. Toxicities from certain foods, anti-freeze, certain medications, and lilies can cause acute renal failure, even in young pets, while in some cases, the kidneys can lose their function slowly with age. Conditions like high blood pressure, cancer, bladder stones, and kidney infections can also contribute to kidney failure.

Which Foods Cause Kidney Failure In Dogs?

Grapes and raisins (and foods that contain them) can lead to kidney failure. This means that the festive period, where cookies, fruit cake, Christmas pudding, panettone, and other raisin-filled treats are everywhere, is a common time to see renal failure in dogs from toxicity.

Unfortunately, the underlying reason why grapes cause kidney damage is unknown, which means that theres no known toxic dose. Some dogs can eat grapes regularly and have no issues, while others can eat just one as a one-off with grave consequences. Therefore, its best to avoid giving your dog grapes altogether and keep them safely out of your dogs reach.

Signs Of Kidney Failure In Dogs

The signs of kidney failure in dogs are variable, depending on the stage of the disease and whether the kidney failure is acute or chronic.

Acute Kidney Failure

If your dog has acute renal failure from a toxin, obstruction, or severe infection, the symptoms are likely to come on very quickly and progress rapidly. You might notice symptoms within a couple of days of the toxicity or sooner in the case of anti-freeze. The first symptoms could be lethargy, pain, vomiting, or increased thirst. This could quickly progress to little or no urination, wobbliness, seizures, coma, or death.

Sadly, in many toxicity situations, once the kidney damage is severe enough to cause symptoms, there is far less chance of treatment being successful. Therefore, if you suspect your dog could have ingested any kind of toxin, call your veterinary clinic immediately so that appropriate measures can be taken to try to prevent any organ damage.

Chronic Kidney Failure

If your dog has chronic kidney disease, their symptoms are likely to be much more subtle and slower to develop. You might initially notice that your dog drinks more than normal or passes large volumes of urine more frequently. You might notice your pup has lost some weight, is vomiting, or hes not so interested in his food anymore. Canines with chronic kidney failure likely also seem to be subdued or lethargic.

As chronic kidney failure progresses, their thirst may become more and more excessive, but despite this, they might become dehydrated, leading to weakness and further lethargy. They may develop ulcers in their mouth, and you might notice an unpleasant smell from their mouth as the toxic waste products build up in their bloodstream. Eventually, theyll stop eating and drinking altogether, become very nauseous, and may seem painful in their abdomen.

What Causes The Symptoms Of Kidney Failure In Dogs?

The role of the kidneys within your dogs body is to control how much water leaves the body, regulate the loss of electrolytes, and remove waste products like urea from the bloodstream. In renal failure, the kidneys are no longer able to produce concentrated urine, so waste products build up in the blood. As more and more of the tiny kidney nephrons are affected, it puts more strain on the remaining parts that still work, which becomes a vicious circle.

The halitosis noted by pet owners who have dogs with chronic kidney failure is due to the build-up of these toxins and is known as a uremic smell. In some dogs, but primarily cats, small blood vessels are damaged by the urea compounds, leading to ulcers in areas like the edge of the tongue.

4 Stages Of Kidney Failure In Dogs

When it comes to the symptoms of kidney failure in dogs, stages matter. Kidney failure cases can be grouped into different stages, as formulated by the International Renal Interest Society (IRIS). The symptoms are combined with the urine concentration and blood measurements of urea, creatinine, and SDMA, which are waste products usually excreted by healthy kidneys.

In the early IRIS stages, symptoms are not apparent, whereas later, as the disease progresses, more and more symptoms appear. The IRIS stages of kidney failure in dogs illustrate the amount of kidney damage or the amount of kidney tissue that is still functional. They also aid veterinarians in determining the best treatment and management options.

Dog Kidney Failure Stages Chart

You can see the stages of chronic kidney disease in dogs in the following graphic:

How To Treat Kidney Failure In Dogs

Unfortunately, when a kidney tubule (or nephron) stops working, it cant be fixed. However, treatment and good management can help to slow down the progression of kidney disease and support the remaining functional nephrons. Dogs who are still eating well and arent vomiting may only require a prescription kidney diet.

If their phosphate levels are high, a phosphate binder medication will also help by preventing the absorption of phosphate from their food. If your dog is still in the early stages of chronic kidney disease but isnt eating well or is nauseous, an anti-emetic medication may also be used.

Finally, if your dog has late stage III or stage IV kidney disease, theyll probably need to stay in the hospital for a fluid drip to flush the waste products out of the body and lower the urea and creatinine levels. Unfortunately, this improvement will only be temporary, and over time, the levels will increase once again.

When To Euthanize?

Whenever youre dealing with a chronic health issue in your dog, its really difficult to know when to make the sad decision to euthanize them. After all, theyre likely to have good and bad days, and it might feel like they get a little bit better just when you are about to make the call. The most important thing is to consider your dogs quality of life whether theyre eating, mobile, or showing any signs of pain.

If theyre struggling in more than one of those areas, despite veterinary treatment, its likely to be time to say goodbye. Its also worth looking back over the last two weeks to see how many good and bad days theyve had. If the bad days outweigh the good, euthanasia is the kindest option for your canine companion.

Frequently Asked Questions

Here are some common questions about dogs with kidney issues. Dont see yours here? Ask us in our comments.

Does pet insurance cover kidney disease in dogs?

Yes, pet insurance covers kidney disease in dogsas long as no signs or symptoms appear until after policy enrollment and waiting periods have passed.

What happens in the last days of a dog with kidney failure?

In the last days of a dog with kidney failure, theyre likely to stop eating or drinking altogether. They may be weak and wobbly from dehydration, and their other organs may start to fail. If you notice that your dog with kidney failure is deteriorating, you should contact your vet as soon as possible.

Is kidney failure in dogs painful?

Acute kidney failure, due to causes like toxins, infections, or bladder stones, can be very painful and requires emergency assessment by a veterinarian. Chronic renal failure is unlikely to be painful initially, but in the more severe stages of the disease, your dog may feel nauseous, disorientated, or painful.

What is the cost of treating kidney failure in dogs?

The cost of treating kidney failure will vary depending on your location and the type of treatment your dog needs. The most costly would be a fluid drip and hospitalization, but ongoing prescription diets and phosphate binders can also add up in the long term.

How long can a dog live with kidney failure?

The length of time that a dog can live with kidney failure will depend on the stage when the diagnosis was made. If caught early, chronic kidney failure can be managed for several years in some cases. However, if the disease is already advanced or management guidelines arent followed, a dogs quality of life may suffer within a few weeks or months.

What level of creatinine indicates kidney failure in dogs?

A dogs creatinine level should always be evaluated alongside a urine sample. If the urine sample shows poor concentration and the creatinine level is raised, this indicates that the kidneys are not functioning effectively.

Understanding Dogs Health

Kidney disease in dogs is a complex subject, and if the diagnosis is made early, even before your dog shows symptoms, the prognosis is much more favorable. Therefore, it may be a good idea to consider routine blood tests once your dog is older than seven or eight, and you should keep a close eye out for possible symptoms. You might consider an at-home urine test, that can help detect things like kidney stones and urinary tract infections in dogs.

Managing Kidney Failure in Dogs

Kidney failure in dogs can seem like a devastating diagnosis. If you've been told by your veterinarian that your dog has a kidney problem that might end in kidney failure one day, don't lose hope. Depending on the circumstances, that day may be farther off than you think. With that note in mind, here are a few things you should know.

Identifying Kidney Failure in Dogs

Kidney failure (also known as renal failure) is the end result of any one of a large number of diseases that can affect the kidneys and related organs. Technically, it occurs when the kidneys can no longer efficiently perform their function, which is to filter out toxins, maintain a normal electrolyte balance, regulate hydration, and secrete hormones needed for the production of red blood cells.

There are two broad types of kidney failure in dogs:

• Acute renal failure: When kidney function suddenly declines (in hours or days), the process is referred to as acute. Acute renal failure in dogs is most commonly associated with infections and toxins.
• Chronic renal failure: When the loss of function is more gradual (over weeks, months or years), it's called chronic renal failure. The most common cause of chronic renal failure in dogs is degeneration associated with geriatric decline. All kidneys have their own natural lifespan, but some dogs' kidneys deteriorate more quickly than others.

One of the most notable differences between acute and chronic kidney failure is that acute kidney failure is reversible if treated early and aggressively, whereas chronic kidney failure can only be managed.

The Causes of Kidney Failure

Kidney failure is ultimately caused by any disease affecting the kidneys. These include:

• Bacterial infections, like leptospirosis, which the Centers for Disease Control and Prevention reports can be transmitted by drinking or swimming in contaminated water. This infection can lead to inflammation of the kidneys and consequent destruction of renal cells.
• Toxicosis, or kidney poisoning, leads to damage of the kidneys' cells. It occurs when your dog ingests drugs (like ibuprofen) or poisons (like antifreeze or grapes). The ASPCA's Animal Poison Control Center lists these and other common household items that should be kept out of your dog's reach.
• Congenital disease: Inherited conditions can lead to abnormal kidney function. The Merck Veterinary Manual includes a list of these congenital diseases, from cysts to agenesis (being born without one or both kidneys).
• Geriatric degeneration: When kidneys get old, their cells can decline and die. This is, by far, the most common cause of kidney disease in dogs.

Symptoms of Kidney Failure

The most common signs of kidney failure in dogs include:

• Vomiting
• Increased drinking and urination
• Lethargy
• Weight loss
• Pale mucous membranes in the mouth and elsewhere

The severity of clinical signs associated with kidney disease can vary depending on the presentation (acute or chronic), the extent to which the loss of kidney function has progressed and the underlying cause. Your vet can determine whether these signs point to a kidney problem or another issue, like diabetes mellitus.

Treating Kidney Failure in Dogs

The treatment of kidney failure varies depending on the underlying cause and the canine patient's overall condition. Dogs that are severely ill from acute kidney failure may need hospitalization and intensive care to recover. For milder cases, antibiotics, fluids, and other medications given on an outpatient basis can prove effective. Dialysis is even a possibility for a lucky few whose pet parents can afford the high cost of treatment.

In the case of chronic renal failure in dogs, treatment generally focuses on slowing the progression of disease and improving quality of life for the patient. Treatment of anemia, blood pressure alterations, electrolyte disturbances, fluid imbalances, nausea, and appetite changes is typically necessary. Most of these signs are managed through diet changes and medication. Pets can sometimes experience a good quality of life for years after a kidney failure diagnosis.

Preventing Renal Failure

Given that chronic renal failure in dogs is most commonly the result of genetically predetermined, age-related degeneration, it's not considered preventable. Nonetheless, regular physical examinations and wellness screenings can increase your dog's chances of early diagnosis and treatment.

Acute renal failure, however, is considered preventable in many instances. Vaccination against infectious diseases, like leptospirosis, for example, can prove highly effective. Clearing households of toxins, like antifreeze; being careful with grapes and raisins; and keeping all human medications out of the reach of dogs is also important.

Understanding Your Dog's Risk

The timing of kidney degeneration is likely linked to a dog's genetics. Consequently, chronic renal failure in dogs is effectively preprogrammed to occur at a certain age. Nonetheless, no specific breed predisposition is known to exist. Certain kidney diseases that can lead to renal failure in dogs, however, can disproportionately affect specific breeds. These include the following:

• Basenji dogs are especially affected by Fanconi syndrome, which disrupts electrolyte absorption.
• Bernese mountain dogs can suffer a congenital disease of the kidneys called glomerulonephritis.
• Collies, Shetland sheepdogs and German shepherds can be affected by lupus, an autoimmune disease affecting the kidneys and other organs.
• Shar-Peis can suffer a kidney disease known as familial renal amyloidosis.

It can prove difficult to determine which dogs will suffer these conditions in advance. New blood tests, however, are now helping identify kidney disease in dogs and cats early, sometimes even many years before signs become evident. One test called the SDMA (which IDEXX notes is named for symmetric dimethylarginine, a genetic marker for kidney function) is now considered very common. Many veterinarians consider it part of their annual wellness screening; be sure to ask your vet if this test is available for your dog at your next appointment.

The Role of Nutrition

Nutrition has long been a mainstay in the management of renal failure in dogs. Since maintaining electrolyte balance and managing blood proteins are a crucial part of the kidneys' role, altering the nutrients in a dog's diet can make kidney function easier. All dog parents whose pets suffer from kidney disease should talk to their veterinarian about the ideal therapeutic diet and any additional nutritional supplements that might be in order.

Dog parents have so many more options than ever before when it comes to treating and managing renal failure. Given advances in nutrition and drugs, the longevity of veterinary renal patients is most definitely on the rise. With your veterinarian's assistance, a long life for your pup is a possibility.

Contributor Bio

Dr. Patty Khuly

Dr. Patty Khuly is an honors graduate of both Wellesley College and the University of Pennsylvania School of Veterinary Medicine. She received her MBA at The Wharton School of Business as part of the prestigious VMD/MBA dual-degree program. She's now the proud owner of Sunset Animal Clinic in Miami, Florida. But that's not all. Dr. K is a nerdy reader, avid knitter, hot yoga fanatic, music geek, struggling runner, and indefatigable foodie. She lives in South Miami with three dogs, countless cats, two rescued goats and a hilarious flock of hens.

You can follow her writing at DrPattyKhuly.com and at SunsetVets.com.