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Chronic Kidney Disease (CKD) in Dogs

What Is Chronic Kidney Disease (CKD) in Dogs?

Chronic Kidney Disease (CKD) in dogs pertains to the gradual decline in kidney function, which plays a pivotal role in sustaining various bodily functions. The kidneys function to filter and expel toxins and waste materials from the body while also regulating fluid, mineral, and electrolyte levels. They are crucial for conserving water and protein, maintaining blood pressure, and generating red blood cells.

Numerous factors contribute to the progressive deterioration of kidney function, and unfortunately, once damaged, the kidneys cannot regenerate. Consequently, the accumulation of unfiltered waste products and toxins in the bloodstream induces a pervasive sense of nausea and discomfort in dogs. Untreated or poorly managed CKD significantly diminishes a dog’s quality of life.

Early detection and intervention are essential for effectively managing the disease and preserving the dog’s comfort and overall well-being. CKD is typically characterized into four stages, determined by laboratory assessments and clinical manifestations:

  • Stage I: No observable clinical signs are evident.
  • Stage II: Some clinical symptoms may become noticeable.
  • Stage III: Many clinical indications manifest, and affected pets often experience feelings of sickness.
  • Stage IV: The majority of clinical signs become pronounced, often escalating into an emergency situation. At this point, the pet’s quality of life deteriorates significantly.

Is Chronic Renal Failure the Same Thing as Chronic Kidney Disease?

Chronic kidney disease (CKD), renal insufficiency, and chronic renal failure (CRF) are terms often used interchangeably to depict the progressive decline in kidney function. As time passes, the kidneys become less effective in their essential functions, posing life-threatening risks to overall health.


Symptoms of chronic kidney disease (CKD) in dogs typically manifest when the kidneys have lost approximately 75% of their functioning capacity. The severity of symptoms correlates with the stage of the disease, with more advanced stages showing more pronounced signs.

Dogs at any stage of CKD may display the following symptoms:

  • Anemia, characterized by a low red blood cell count
  • Changes in urine output, often an increase in frequency
  • Decreased appetite
  • Dehydration
  • Increased thirst
  • Muscle wasting
  • Nausea
  • Oral ulcerations and bad breath
  • Pale gums
  • Poor coat appearance
  • Sporadic vomiting
  • Vision loss, usually associated with secondary hypertension (high blood pressure)
  • Weakness and lethargy
  • Weight loss


Causes of chronic kidney disease (CKD) in dogs typically develop gradually over time, representing a progressive and irreversible condition. Despite extensive testing, the exact cause often remains unidentified for some dogs.

CKD can result from various factors, including:

  • Severe kidney injuries caused by conditions such as infections (e.g., leptospirosis, tick-borne diseases, or pyelonephritis), heat stroke, envenomation (from venomous bites or stings), or ingestion of toxic substances like antifreeze, NSAIDs (ibuprofen), or certain antibiotics.
  • Association with specific immune-mediated diseases or cancer.

Certain dog breeds are predisposed to CKD, including:

  • Basenji
  • Bernese Mountain Dog
  • Boxer
  • Bull Terrier
  • Cairn Terrier
  • Cavalier King Charles Spaniel
  • Cocker Spaniel
  • English Cocker Spaniel
  • Shar-Pei
  • West Highland White Terrier


Veterinarians employ a comprehensive approach to diagnose chronic kidney disease (CKD) in dogs, beginning with a thorough physical examination, bloodwork, and urinalysis. These diagnostic tools focus on assessing various kidney values, including:

  • Blood urea nitrogen (BUN): Elevated levels are indicative of kidney failure.
  • Calcium
  • Creatinine (CREA): Reflects the kidney’s filtration ability.
  • Electrolytes: Such as sodium, potassium, and chloride.
  • Phosphorus: Increased phosphorus levels are associated with CKD.
  • Red blood cell count: Reduced counts often occur secondary to CKD.
  • Symmetric dimethylarginine (SDMA): Utilized for early detection of kidney disease.
  • Urine specific gravity: Determines kidney concentration ability; higher concentration signifies better water conservation by the kidneys.

Additional testing may be recommended by the veterinarian, including:

  • Urine protein to creatinine (UPC) ratio to assess protein loss in urine (proteinuria).
  • Urine culture, as CKD dogs are prone to urinary tract infections.
  • Blood pressure evaluation, as hypertension is common in CKD dogs.
  • Radiographs or abdominal ultrasound to screen for kidney stones, tumors, or infarcts (areas of tissue necrosis).


Treatment of chronic kidney disease (CKD) in dogs aims at managing the condition, although it remains incurable once symptoms manifest due to irreversible damage. Tailored recommendations, depending on the CKD stage, are designed to address the specific needs of your dog. Dogs in more advanced stages (III or IV) require more intensive care compared to those in earlier stages (I or II). Common therapeutic approaches for CKD include medication, dietary adjustments, fluid therapy, and addressing underlying conditions or triggers. In cases where dogs require more extensive support, placement of a feeding tube might be necessary. Additionally, appetite stimulants like capromorelin and mirtazapine could be recommended.

Veterinarians often prescribe dietary management involving a balanced diet low in protein, salt, and phosphorus, and alkalinized to counter CKD-related side effects. Recommended diets include Royal Canin® Renal Support, Hill’s® Prescription Diet k/d, and Purina® Pro Plan Kidney Function Diet NF.

Fluid therapy plays a crucial role. Fluids aid in flushing out toxic waste substances that the kidneys should eliminate regularly and help restore hydration. They can be administered intravenously in the hospital or subcutaneously (under the skin) at home. It’s vital to ensure your dog has access to fresh water at all times, and a water fountain can be especially beneficial for encouraging hydration at home.

Living and Management

Recovery and management of chronic kidney disease (CKD) in dogs demand continuous attention and monitoring as symptoms evolve. Dogs affected by CKD necessitate more frequent veterinary visits and assessments compared to others. Throughout all stages of CKD, the evolving symptoms should prompt regular evaluations of the dog’s quality of life. Adhering to the veterinarian’s recheck schedule and maintaining prescribed medications and dietary regimens are crucial, as many treatments are long-term requirements.

Various measures can contribute to the comfort and enhanced quality of life for dogs with CKD. Similar to the treatments and medications previously outlined, the long-term management of CKD in dogs involves:

  • Dietary supplements like Azodyl™, a pre/probiotic, which aids in reducing waste products not effectively eliminated by the kidneys.
  • Other supplements such as aluminum hydroxide and Epakitin®, designed to assist with managing low potassium and high phosphorus levels.
  • Prescription of anti-nausea and anti-emetic medications as necessary, particularly for dogs experiencing intermittent vomiting and appetite loss.

Regrettably, due to the severity of symptoms often associated with dogs in Stage III or IV CKD and the extensive care and attention they require, euthanasia may become the most compassionate option.

Chronic Kidney Disease (CKD) in Dogs FAQs

How long can a dog survive with kidney disease?

CKD progresses at varying rates, making it challenging to predict the extent and timing of progression. With proper veterinary care and management, some dogs can live for several years, while others may need to be euthanized shortly after diagnosis.

How quickly does kidney disease advance in dogs?

The advancement of CKD in dogs is unpredictable, with symptoms becoming noticeable over weeks to years. By the time symptoms are evident, it is typically estimated that around 75% of kidney function has been lost, and the damage is irreversible. The rate of deterioration varies among individual dogs, depending on the underlying cause. Regular checkups and veterinary visits are essential for early detection of CKD, ensuring your dog’s comfort and overall improved quality of life.

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