Kidney Failure in Dogs: Signs, Symptoms & Treatments

Reviewed by Dr. Fiona Lee

You know something is wrong: Your dog has lapped up countless bowls of water, paced at the door to go outside, refused to eat her kibble and developed the worst case of doggie breath ever. It could be kidney disease.

Kidney disease in dogs affects up to 7% of our canine companions. It's much more common in older dogs, and certain breeds (including Yorkshire Terriers, Pomeranians, Shetland Sheepdogs and Boxers) tend to be at higher risk. But kidney disease—and kidney failure—can be diagnosed in any dog, at any age.1

What is kidney failure in dogs?

The kidneys are some of the hardest-working organs in your dog's body. The essential organs help regulate mineral levels, remove waste products from the bloodstream, conserve water and produce urine. Sometimes, the kidneys don't function efficiently, leading to chronic kidney failure.²

There are two main types of renal failure, and distinguishing between the two is important when it comes to treatment and prognosis:³

• Acute kidney disease generally happens suddenly and is usually due to exposure to toxins or infection. It can progress to chronic kidney disease.
• Chronic kidney disease is a much slower, progressive condition and generally occurs in older pets.

Since it is common, recognizing the symptoms of kidney failure in dogs and learning about treatments for kidney failure in dogs is important.

 

Symptoms of kidney failure

Early onset dog kidney failure can occur months—or even years—before symptoms are noticed or the diagnosis of chronic kidney disease is made. In large breeds, kidney failure in dogs may be diagnosed at 7 years of age, while smaller breeds tend to be diagnosed as late as 14 years old.²

Since the kidneys' main job is to produce urine, changes in the frequency of urination are often the first thing pet owners notice. Your dog may be having more accidents in the house, asking to go outside more frequently and peeing larger amounts; these are all signs that could point to kidney disease. Other symptoms of kidney disease in dogs include:²

• More frequent urination
• Increased thirst
• Loss of appetite
• Lethargy
• Vomiting
• Diarrhea
• Bad breath and mouth ulcers due to a buildup of toxins

When your dog is in kidney failure, the organs are less efficient and effective at filtering toxins and their body must increase blood flow to the kidneys to get the job done, which leads to increased production of urine. And dogs that pee more frequently need to drink more water to replace the lost fluids. For that reason, increased thirst and urination are often the first signs of renal failure in dogs.²

Common causes of kidney failure

Although older dogs are more prone to kidney failure, age is not the only reason these essential organs fail. Common causes of kidney failure in dogs include:⁴

• Toxins such as raisins, radiator fluid and antifreeze
• Medications, including diuretics and ibuprofen
• Leptospirosis, which is a bacterial infection that's transmitted through exposure to water or urine contaminated by deer, cattle, raccoons or other infected animals
• Heatstroke
• Severe dehydration
• Bee stings, snake bites and other injuries that cause damage to body tissues

Chronic kidney failure is generally caused by aging, and not necessarily related to exposure to toxins or infection.

 

Diagnosing kidney failure in dogs

Diagnosing kidney failure requires a trip to your veterinarian's office. Your vet will do a thorough physical exam and run blood and urine tests to accurately diagnose kidney disease.⁴

The results of the laboratory tests will provide important information about serum creatinine and levels of blood urea nitrogen. These are waste products that a normally functioning kidney will excrete in urine. When the kidneys stop doing their job well, these waste products build up in the blood.

The urinalysis is very important because the kidneys' main job is to produce urine. Your vet will be looking for signs of infection, levels of protein in the urine and how concentrated the urine is. In conjunction with the blood work results, the urinalysis is used to determine the specific stage of kidney disease and to offer a prognosis.

More advanced diagnostic tests may be needed to best understand why your dog's kidneys are not working well. Imaging the kidneys with an abdominal ultrasound can be helpful in some cases, and X-rays may be indicated, especially if bladder or kidney stones are suspected. Your veterinarian may even want a kidney biopsy to examine the tissue closer.

Prognosis for kidney failure

Kidney failure is generally irreversible and fatal, except in some cases of acute kidney failure due to such things as infection or raisin ingestion, from which some dogs can recover.

There are four stages of kidney failure in dogs. How long can a dog live with kidney disease? It depends on the severity of the disease. In stage one, the median survival time is over 400 days, but the survival time shrinks to fewer than 80 days in dogs with stage four kidney disease.⁵

Treating kidney failure in dogs

Typically, kidney disease is progressive and irreversible. There is no cure, but there are treatments for kidney failure in dogs that can alleviate the symptoms and help extend your dog's life span.

Hydrating and flushing the kidneys

Your vet might recommend hospitalization with intravenous diuresis—a process that uses intravenous fluids to flush the kidneys and the bloodstream to remove toxins. This may not be helpful for chronic cases of kidney failure, but in cases of acute renal failure, this treatment is very important. IV therapy also helps replace lost electrolytes.⁶

In chronic cases of kidney disease, you might consider giving your dog subcutaneous fluids at home to prevent dehydration and help flush toxins.⁶ However, not every dog will tolerate at-home administration of fluids.

Specialized diet

A therapeutic kidney diet is the mainstay of treatment for kidney failure. Studies show that, post-diagnosis, dogs who were fed a therapeutic diet had survival rates three times longer than those of dogs who were fed a normal maintenance diet.⁶

A kidney diet is one that is reduced in protein and phosphorus, which can decrease the amount of toxins the kidneys need to expel. Kidney diets often contain less sodium and have more soluble fiber than maintenance diets. In addition, they have higher caloric density and are supplemented with omega-3 fatty acids and antioxidants to reduce inflammation.⁶

Toxins like urea nitrogen, creatinine and phosphorus are the cause of nausea and lethargy your dog may be experiencing. Kidney diets reduce stress on the kidneys so they don't have to work as hard.

Specialized kidney diets are available via prescription from your veterinarian only. Feeding canned or moistened food can also help your dog stay better hydrated, so your veterinarian may recommend switching to canned food versus kibble.

Medications for kidney failure

There is no specific medication for kidney failure. Any drug prescribed will be used to manage the symptoms that often accompany kidney disease. For example:

• Many dogs with kidney failure become anemic, and treatment with the medication Erythropoietin can help stimulate red cell production.⁶
• Hypertension (high blood pressure) can accompany kidney failure, so medications aimed at reducing blood pressure may be indicated.²
• Dogs with excessive levels of phosphorus due to failure of the kidneys to excrete this may benefit from a phosphorus binder to help reduce circulating blood levels.⁶
• Medications for nausea or to stimulate the appetite may also be used to help manage the gastrointestinal signs that often accompany kidney failure.²

Preventing kidney failure in dogs

Your dog's kidneys work hard to balance fluids, filter waste and maintain blood pressure, and organs inevitably wear out over time. There is nothing you can to do reverse deterioration due to aging, but you can take steps to prevent other causes of kidney disease.⁷

• Keep vaccines up-to-date: Leptospirosis vaccines are especially important in endemic areas, or if your dog has a lifestyle that includes being around wildlife. Talk to your veterinarian about your dog's risk of contracting this bacterial infection, which can cause kidney failure in dogs.⁸
• Practice good dental hygiene: Dogs with dental disease can release toxins into their bloodstream, which impairs kidney function. Brush your dog's teeth and schedule regular dental cleanings with your veterinarian to prevent dental disease.⁹
• Securely store toxins: Keep raisins, medications, pesticides, rodenticides, antifreeze and other toxins in secure locations where dogs cannot access them.⁷
• Prevent obesity: Excess weight can have a negative impact on all your dog's organs, including their kidneys.⁷

The cost of treating kidney failure in dogs

The cost of treating kidney failure in dogs varies depending on the severity of the condition and the cause. Acute kidney failure due to antifreeze or raisin toxicity may be very expensive and require intensive hospitalization for days or weeks. On the other hand, treating chronic kidney failure may only cost as much as the prescription food your vet recommends.

With that in mind, costs can range from a few hundred dollars per month for dogs that require a specialized diet and IV fluid therapy to thousands of dollars for hospitalization and lab work.¹⁰ Since kidney failure is a chronic condition, the costs are ongoing and it can be difficult for pet parents to cover the cost of expensive treatment.¹⁰

How pet insurance can help

Pet insurance was designed to help cover vet costs, which can be a lifesaver if your dog is diagnosed with kidney failure. Although there are three different types of pet insurance plans (accident-only, accident and illness, and preventive) only accident and illness plans reimburse the costs for diagnosing and treating kidney failure in dogs.

As the name suggests, preventive plans cover routine wellness care, including annual exams, vaccinations and spay/neuter surgeries, while accident-only plans cover broken bones, accidental poisoning and other emergency needs. In contrast, accident and illness plans cover illnesses ranging from arthritis and diabetes to chronic conditions like kidney failure.

Since most pet insurance companies don't cover preexisting conditions, it's best to purchase a policy when your dog is young and healthy and maintain the coverage throughout her life. This will ensure that your costs for diagnosis and treatment of kidney failure in dogs are reimbursed if your dog gets sick.

Pets Best insurance can help cover the cost of treating kidney failure in dogs. Treatment won't cure kidney failure, but it can alleviate symptoms, help your dog feel better and possibly prolong their life, allowing you to focus on spending quality time together instead of worrying about expensive vet bills.

Sources/Citations

1. Coyne, M., Szlosek, D., Clements, C. et al. Association between breed and renal biomarkers of glomerular filtration rate in dogs. The Veterinary Record. Published November 12, 2020. Accessed April 21, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7799420
2. Llera, R., Weir, M., Ward, E. Chronic Kidney Disease in Dogs. VCA Animal Hospitals. Accessed April 21, 2023. https://vcahospitals.com/know-your-pet/kidney-failure-chronic-in-dogs
3. Brown, S.A. Renal Dysfunction in Small Animals. Merck Veterinary Manual. Updated October 2022. Accessed May 19, 2023. https://www.merckvetmanual.com/urinary-system/noninfectious-diseases-of-the-urinary-system-in-small-animals/renal-dysfunction-in-small-animals
4. Acute Kidney Failure in Dogs. BluePearl Pet Hospital. Published January 17, 2018. Accessed April 21, 2023. https://bluepearlvet.com/medical-articles-for-pet-owners/acute-kidney-failure-in-dogs/
5. Pedrinelli, V., Lima, D.M., Duarte, C.N. et al. Nutritional and laboratory parameters affect the survival of dogs with chronic kidney disease. PLoS One. Published June 30, 2020. Accessed May 3, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326232
6. Foster, J.D. Canine Chronic Kidney Disease: Current Diagnostics and Goals for Long-Term Management. Today's Veterinary Practice. Published September/October 2013. Accessed April 21, 2023. https://todaysveterinarypractice.com/urology-renal-medicine/canine-chronic-kidney-diseasecurrent-diagnostics-goals-long-term-management
7. Heather M. Is Kidney Disease Curable in Dogs? ASPCA. Accessed April 21, 2023. https://www.aspcapetinsurance.com/resources/kidney-disease-dogs/
8. Adams, L.G. Acute rental failure: leptospirosis is more common than you think. dvm360. Published November 1, 2010. Accessed May 19, 2023. https://www.dvm360.com/view/acute-renal-failure-leptospirosis-more-common-you-think-proceedings
9. Barnette, C. Dental Disease and Its Relation to Systemic Disease in Pets. VCA Animal Hospitals. Accessed May 19, 2023. https://vcahospitals.com/know-your-pet/dental-disease-and-its-relation-to-systemic-disease-in-pets
10. Kidney Failure in Dogs. Small Door Veterinary. Accessed April 21, 2023. https://www.smalldoorvet.com/learning-center/medical/kidney-failure-in-dogs