Veterinary Guide to Canine Kidney Failure 2025 🩺🐶

By Dr. Duncan Houston BVSc

🧬 Kidney Function & Types of Failure

The kidneys filter waste, balance fluids, regulate blood pressure, and produce hormones. Kidney failure occurs when the can’t perform these functions. It manifests as:

• Acute Kidney Injury (AKI): Sudden decline due to toxins, infections, or obstruction.
• Chronic Kidney Disease (CKD): Slow degeneration over months–years, often in older dogs.

⚠️ Warning Signs

Early symptoms are vague; serious cases manifest clear signs:

• Frequent urination and excessive thirst—often the first sign.
• Appetite loss, weight loss, lethargy, nausea, vomiting, diarrhea.
• Skin ulcers, anaemia, bad breath, pale gums, weakness, or tremors.
• Hypertension, dehydration, and muscle weakness—common later.

🔍 Diagnosis & Staging

1. History & exam: note symptoms, hydration, oral changes.
2. Blood tests (creatinine, BUN, SDMA) and urinalysis (specific gravity, protein).
3. Imaging: ultrasound/X-ray assess kidney size, stones, or obstruction.
4. Blood pressure: to detect hypertension early.
5. Stage using IRIS: Stage I–IV CKD based on creatinine/SDMA—higher stage = worse prognosis.

🛠️ Treatment Approaches

• AKI

• Hospital IV fluids to correct dehydration & support renal function.
• Identify & eliminate cause: toxin removal, treat infection.
• Use of diuretics & close urine output monitoring to guide therapy.

• CKD

• Home subcutaneous fluids to maintain hydration.
• Prescription renal diet: low protein, low phosphorus, controlled sodium.
• Phosphate binders if blood phosphorus is elevated.
• Medications: antiemetics, antihypertensives, GI protectants, appetite stimulants, anemia support (EPO analogs).
• Ongoing monitoring: lab rechecks, BP, weight every 4–12 weeks depending on stage.

📈 Prognosis by Scenario

• AKI: Recoverable if treated early; outcome depends on cause severity.
• Stage I–II CKD: Median survival >200–400 days (~months to years).
• Stage III–IV CKD: Median survival ~110–200 days, <1 year common.
• Quality of life is key; humane decisions are made when the disease has advanced.

🏡 Home Care & Lifestyle Tips

• Ensure fresh water access; consider wet food or water additives.
• Feed small, frequent meals using the prescribed diet.
• Administer meds/supplements diligently; track dose schedule.
• Monitor weight, symptoms, hydration, and urination daily.
• Avoid toxins: grapes, NSAIDs, antifreeze; protect from infectious threats.

📱 Ask A Vet Telehealth Support

• 📸 Upload urine color photos, abdomen images, and weight logs.
• 🔔 Get reminders for fluids, meds, and rechecks.
• 🩺 Video consultations to assess hydration, appetite, and side effects.

🎓 Case Spotlight: “Lucy” the Senior Retriever

Lucy, a 10‑year‑old Golden Retriever, began drinking excessively and losing weight. Blood tests revealed Stage III CKD. She started on subcutaneous fluids at home, a renal diet, phosphate binder, and ACE‑inhibitor. With monthly lab monitoring and telehealth check‑ins from Ask A Vet, Lucy stayed energetic and ate well for 18 months before transitioning to palliative care. 🐕💛

🔚 Key Takeaways

1. Early detection is vital: look for thirst, urination, appetite, weight.
2. AKI needs swift hospital treatment; CKD is managed long‑term with diet, fluids, medications.
3. Stage determines approach & prognosis—supportive care can give months‑to‑years of quality life.
4. Close monitoring with vet input ensures early adjustments.
5. Ask A Vet telehealth offers remote support—from symptom triage and reminders to supply delivery and nutritional coaching 📲🐾

Dr Duncan Houston BVSc, founder of Ask A Vet. Download the Ask A Vet app to help manage your dog’s kidney health—from early symptom checks and home fluids to dietary support, medication guidance, and ongoing telehealth care 🐶📲