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Excess Acidity in the Blood in Dogs

Renal Tubular Acidosis in Dogs

Renal tubular acidosis (RTA) presents as a rare syndrome in dogs, marked by an abundance of acids in the bloodstream. The condition arises from the kidneys’ incapacity to adequately expel acid through urine. Dogs afflicted with RTA also exhibit abnormal potassium levels in their blood. RTA manifests as a component of the metabolic process wherein food is converted into energy. While RTA can affect both cats and dogs, its occurrence in cats is exceedingly rare.

Symptoms and Types

Several common symptoms may be observed, including:

  • Fever
  • Panting
  • Lethargy
  • Dehydration
  • Weight loss
  • Muscle weakness
  • Lack of appetite (anorexia)
  • Bloody urine (hematuria)
  • Excessive thirst (polydipsia)
  • Frequent urination (polyuria)
  • Difficulty urinating (due to bladder stones)

There are two primary types of RTA:

  • Type 1 RTA (or distal) involves reduced hydrogen ion secretion in the kidney.
  • Type 2 RTA (or proximal) is characterized by the inability to excrete acid into the urine. Abnormal metabolic processing of bicarbonates leads to metabolic acidosis, marked by abnormally high levels of acids in the blood and abnormally low levels of acids in the urine.

Type 2 proximal renal tubular acidosis has been observed in dogs in association with Fanconi syndrome, a genetically recessive kidney disease where the kidneys are unable to reabsorb phosphate, glucose, and amino acids, resulting in their excretion in the urine. This process causes an imbalance of acids in the blood, leading to renal tubular acidosis.


Common underlying causes of RTA include kidney and ureter infections, as well as feline hepatic lipidosis, a form of liver disease. However, there are instances when RTA is idiopathic.


Your veterinarian will conduct a comprehensive physical examination of your dog, which includes a blood chemical profile, a complete blood count, a urinalysis, and an electrolyte panel. These tests help your veterinarian rule out or confirm an underlying systemic disease. Providing a detailed history of your dog’s health before the onset of symptoms is essential.

Results from a blood gases analysis, along with those from the electrolyte panel, should indicate a normal anion gap (the sum of cations minus anions in the plasma) with metabolic acidosis, suggesting abnormal alkaline urine. This serves as a key diagnostic feature of type 1 RTA.


Your dog will require hospitalization until metabolic acidosis and low potassium levels are resolved. During this time, they will receive potassium citrate and sodium citrate (occasionally substituted with sodium bicarbonate) until metabolic acidosis and low potassium levels return to normal. Additionally, dogs with low potassium levels may receive potassium gluconate as part of the treatment plan.

Living and Management

Your veterinarian will arrange follow-up appointments to monitor any underlying disease your dog may have and to track your pet’s recovery progress. Dogs without an underlying disease generally have a favorable prognosis for recovery when the condition has been treated properly and effectively.

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