Chronic and Acute Kidney (Renal) Failure in Dogs
Key takeaways
Kidney failure in dogs describes a wide range of conditions that result in loss of adequate kidney function.
- Symptoms of kidney failure in dogs vary depending on the severity, cause, and how long the disease is present before treatment begins
- Kidney failure presents with symptoms ranging from alterations in volume of drinking and urination, lethargy, vomiting, and collapse
- The underlying triggers of kidney failure are numerous and include immune-mediated, inflammation, infection, toxins, tumors, and injury
- Diagnosis of kidney failure involves physical examination, blood work, urinalysis, blood pressure measurement, and diagnostic imaging including ultrasound and x-rays
- Treatment options and prognosis vary based on the underlying disease process
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A closer look: Chronic and Acute Kidney (Renal) Failure in Dogs
Kidney failure is a serious condition in dogs. The kidneys have limited ability to heal and recover kidney function once it is lost to injury or disease. Loss of function greater than 65-75% results in symptoms which normally progress over time.
Most conditions that lead to acute kidney failure, such as ingesting a toxin like antifreeze, are accompanied by other severe symptoms like tremors and collapse, which is an emergency.
Chronic kidney failure, such as what develops with old age, comes on more gradually and usually does not present an emergency.
Both forms require aggressive treatment and carry a guarded prognosis.
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Risk factors
Symptoms of kidney disease vary widely depending on severity and chronicity. Dogs show no symptoms until 65-75% of kidney function is lost and 90% loss of kidney function is fatal.
Chronic kidney disease often results in gradual increase in drinking and urination, weight loss, and anemia (pale gums and weakness)
Acute kidney injury usually presents with vomiting, lethargy, decreased or lack of urination, and collapse
Since the causes of kidney disease vary widely, there are a multitude of risk factors for this condition related to age, lifestyle, breeding, and body condition.
Dogs show no symptoms until 65-75% of kidney function is lost and 90% loss of kidney function is fatal.
Possible causes
The triggers of kidney disease are numerous and are categorized as acute kidney injury (AKI) or chronic kidney disease (CKD). Some conditions result in both forms.
Kidney failure can also be caused by injury, such as those sustained during dog fights or hit-by-car incidents, and by congenital kidney defects present from birth.
These diseases result in loss of kidney function which triggers:
- Loss of protein into the urine
- Increased blood pressure
- Increased phosphate in the blood
- Increase load on the remaining kidney function
These secondary features of kidney disease also result in further loss of function, leading to progression of disease.
Main symptoms
Symptoms of kidney failure are broad and increase in severity as the extent of the kidney damage increases.
Note: lack of urination or straining to urinate are medical emergencies requiring immediate medical attention.
Testing and diagnosis
Investigation of kidney failure involves:
- Physical examination
- Blood work
- Urinalysis
- Ultrasound
- X-rays
- CT scan
- Kidney biopsy
Steps to Recovery
Treatment options depend on the underlying disease process but involves:
Treatment of the disease trigger. Available options include:
- Toxicity treatment
- Antibiotics for infection
- Steroids for immune mediated conditions
Improvement of kidney function. This may include any or all of the following:
- Fluid therapy
- Correction of blood salt imbalance
- Improvement of blood flow through the kidney
- Maintenance of normal blood pressure
- Reduction of protein loss in the urine
In some cases, complete replacement of kidney function through dialysis may be the only possible treatment to prolong life.
In addition to specific treatments aimed at the disease process and restoration of kidney function, supportive treatment of symptoms may also be recommended. Symptomatic treatments may include
- Anti nausea medication
- Gastroprotectants
- Assisted feeding
The outcome of kidney failure varies depending on severity and whether the underlying disease process has been chronic for a sustained period of time. Low grade chronic disease or mild acute injury normally respond well to treatment. Progressive forms of chronic disease or severe acute injury are usually life limiting and some cases are rapidly fatal.
Prognosis is determined by the percentage of kidney function that is lost during the disease progression. Prompt diagnosis and treatment of kidney disease may delay progression but symptomatic cases of kidney disease usually require lifelong treatment.
Prevention
Prevention depends on the avoidance of underlying triggers. Not all cases are preventable but specific examples include:
- Vaccination against diseases such as leptospirosis
- Ensure correct storage of toxins such antifreeze
- Judicious prescribing of drugs
- Avoid breeding dogs with early onset chronic kidney disease
Is Chronic and Acute Kidney (Renal) Failure in Dogs common?
Kidney failure is a common presentation in dogs overall as a wide variety of conditions affect kidney function in the short or long term.
Typical Treatment
- Toxicity treatment
- Antibiotics for infection
- Steroids for immune mediated conditions
- Fluid therapy
- Correction of blood salt imbalance
- Improvement of blood flow through the kidney
- Maintenance of normal blood pressure
- Reduction of protein loss in the urine
- Dialysis
- Symptomatic treatment
