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Kidney Failure and Excess Urea in the Urine in Dogs

Renal Failure and Acute Uremia in Dogs

Acute uremia is a sudden condition characterized by elevated levels of urea, protein products, and amino acids in the blood. This condition typically occurs following sudden kidney injuries or when the urinary tubes connecting the kidney to the bladder (ureters) become obstructed. This obstruction disrupts the flow of urine, causing an imbalance in fluid regulation and resulting in the accumulation of potential toxins in the body. Fortunately, acute uremia can be effectively treated and cured if diagnosed promptly and managed appropriately.

Most dog breeds, regardless of gender, can be affected by acute uremia. However, exposure to chemicals such as antifreeze increases the risk of uremia. Consequently, the incidence of acute uremia is higher during the winter and fall seasons compared to other times of the year. Additionally, dogs are most vulnerable to acute uremia between the ages of six and eight. The condition described in this medical article can affect both dogs and cats.

Symptoms and Types

As the potentially toxic blood circulates through the dog’s body, most systems are impacted, including the urinary, digestive, nervous, respiratory, musculoskeletal, lymphatic, and immune systems.

During examination, dogs may appear to be in normal physical condition, exhibiting a typical hair coat, but may display signs of depression. When symptoms manifest, indications can include loss of appetite, lethargy, vomiting, and diarrhea, which may contain traces of blood. Other symptoms may encompass tongue inflammation, ammonia-scented breath (due to urea), mouth ulcers, fever, abnormal heartbeat rate (either fast or slow), decreased or increased urine output, and in severe cases, seizures. Palpation may reveal enlarged, tender, and firm kidneys.


Kidney failure or blockage of urine flow can stem from various factors, including:

  • Inflammation of the kidneys
  • Formation of kidney or ureteral stones
  • Presence of foreign objects in the ureters
  • Damage to kidney tissue leading to urine reflux
  • Reduced blood flow to the kidneys due to trauma, excessive bleeding, heatstroke, heart failure, etc.
  • Ingestion of certain chemicals such as certain pain relievers, dyes used in internal imaging, mercury, lead, and antifreeze


Your veterinarian will conduct a comprehensive blood profile, including a chemical blood profile, complete blood count, and urinalysis. Dogs affected by acute uremia may exhibit elevated packed cell volume and an increased white blood cell count. Additionally, levels of certain protein enzymes and chemicals like creatinine, phosphate, glucose, and potassium may be elevated.

Urine samples may be obtained through catheter insertion or fine needle aspiration, revealing high protein and glucose levels, along with the presence of blood cells. Contrast dyes may be introduced into the bladder to facilitate clear visualization and examination of the urinary system using X-ray and ultrasonography imaging.


If uremia results from toxic poisoning, the initial step involves eliminating toxins from the body. This can be achieved through gastric lavage to cleanse the stomach or by administering activated charcoal to neutralize the toxin. Specific antidotes may be given if the toxic substance is identified.

Treatment also focuses on restoring fluid balance, blood circulation, and normalizing blood chemical levels. Close monitoring of fluid intake, food consumption, and nutritional intake is crucial during treatment.

Depending on your dog’s response to the medications, your veterinarian may recommend dialysis or surgery.

Living and Management

Typically, the prognosis for recovery from this condition is poor. Potential complications include seizures, coma, hypertension, pneumonia, gastrointestinal bleeding, cardiac arrest, fluid overload, septicemia, and multiple organ failure. The cost of treatment can be significant. In some cases, dialysis may be utilized until the dog is stable enough to undergo surgery.

Following treatment procedures, it’s crucial to monitor daily fluid and mineral levels, body weight, urine output, and overall physical condition. The recovery process depends on various factors, including the extent of organ or system damage, the underlying cause of the disease, and the presence of any additional pathological conditions or affected organs.

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