Kidneys play a critical role in the healthy function of a dog’s body.

Not only are the kidneys responsible for filtering waste products from the blood, they help maintain proper hydration and electrolyte levels, as well as help with red blood cell production.

When your dog’s kidneys are not functioning properly, the entire body’s system becomes imbalanced, which can lead to toxic levels of waste in the body.

Chronic kidney disease develops over time, leading to the dog losing kidney function, so it’s important to be aware of the signs and symptoms.

Here’s a look at what causes kidney disease, the symptoms to look out for and how best to treat it.

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What Is Kidney Disease in Dogs?

Kidney failure can occur either gradually over time due to a chronic condition (such as chronic kidney disease, or CKD) or can be acute with sudden onset (such as acute kidney injury, or AKI).

Acute kidney failure can also develop into CKD.

“The most common form of kidney disease I see in my practice is chronic kidney (or renal) insufficiency, which is essentially a longer-term, age-related degeneration of kidney function in older patients,” says Dr. Rebecca Greenstein, D.V.M., veterinary medical advisor for Rover.

She adds that acute kidney failure can be “caused by anything from infections like leptospirosis to household toxins like grapes.”

Other causes of AKI include the following:

  • Urinary tract blockage
  • Shock
  • Congestive heart failure
  • Bacterial infection
  • Poisoning
  • Lyme disease

While CKD can develop in dogs at any age, it’s far more common in older dogs. In older animals at veterinary care facilities, CKD affects up to 10% of dogs. In the general population, CKD is estimated to affect roughly 1% of dogs, according to the Michigan State University Veterinary Diagnostic Laboratory.

Symptoms and Behaviors of Dogs With Kidney Disease

One of the hallmarks of kidney disease in dogs is an increase in drinking and urinating.

“They are two of the most common signs first noted by owners,” says Dr. Preston Turano, D.V.M., veterinarian and consultant with Figo Pet Insurance. “Dogs may start having accidents inside the house or the water bowl may be emptied quicker or more frequently than usual.”

Unfortunately, the progression of kidney disease in dogs is relatively slow, so symptoms can easily be missed. And, many of the symptoms are not exclusive to kidney disease and can mimic other conditions, Greenstein says.

As the disease progresses, dogs may also show the following signs of renal failure:

  • Change in appetite
  • Reduce playfulness or activity
  • Vomiting
  • Diarrhea
  • Loss of appetite
  • Lethargy
  • Weight loss
  • Bad breath
  • Dehydration
  • Weakness or incoordination
  • Changes in urine volume or color

What are the Stages of Kidney Disease in Dogs?

The Merck Veterinary Manual lists four stages of chronic kidney disease:

Disease Stage Physical Conditions Signs Treatment
Stage I
Damage to the kidneys but no elevated levels of waste in the blood.
There are no easily visible signs. While labs should be done, they may not show signs of disease yet.
Identify and treat the underlying cause of the kidney disease and any complications. Ensure the dog is receiving enough water.
Stage II

Waste filtering has slowed to <25% of the normal rate. There is now a buildup of waste chemicals and an imbalance of water in the urine.

The dog may be urinating more, but other clinical signs of kidney disease are not present. Tests will show an increase in waste chemicals in the blood.
Dogs should be treated for the underlying cause and for any complications. They may require a change in diet, including low salt. Ensure the dog is receiving enough water.
Stage III
Increased loss of kidney filtering function. The buildup of waste chemicals is now present in blood and urine.
Increased thirst and urination.
Dogs should be supported with a kidney disease diet, monitored for infections, and treated for underlying causes and complications.
Stage IV
There is now a severe loss of kidney filtering function. The toxic waste chemicals are building up in the blood, and affecting other organs in the body.
Symptoms include vomiting, depression, loss of appetite, weight loss, dehydration, mouth sores, diarrhea. Bones can become soft and brittle.
Dogs will require a special diet, treatment for the underlying conditions, and comfort care. They may require IV fluids, and in severe cases, kidney dialysis or a kidney transplant.
Source: Merck Veterinary Manual

During Stages I and II, the dog should be evaluated every three to six months, if not sooner if problems develop. In late-Stage II and Stage III, dogs will need to be evaluated every two to three months. And in late-stage III and Stage IV, veterinarians are likely to recommend evaluations every one to two months.

It’s also important to note that the progression of kidney disease can vary from dog to dog.

How to Test for Kidney Disease In Dogs

While increased urination and thirst are among the most common signs of kidney disease in dogs, those symptoms are also common in a number of other conditions.

It’s best to take your pet to the vet immediately if you see those symptoms, Turano says.

“Your veterinarian will discuss your dog’s clinical signs, perform an exam, and will recommend blood work that includes a complete blood count, blood chemistries and urinalysis,” he says. “This will be the best starting point to rule out chronic kidney disease or other causes such as diabetes and liver disease, to name a few.”

Pet parents need to take their dog to the veterinarian if they suspect their dog is exhibiting signs of kidney failure.

Other tests may also be required for a proper diagnosis including urinalysis, radiographs, ultrasounds, kidney biopsies and cultures.

What Is the Life Expectancy of Dogs With Kidney Disease?

The life expectancy of a dog with chronic kidney disease will depend entirely on the underlying cause, as well as the stage of the disease.

“Early detection and appropriate treatment can significantly extend a dog’s lifespan,” says Dr. Jamie Richardson, BVetMed, head of veterinary medicine at Small Door Vet, a chain of veterinary facilities in the Northeast.

“In some cases, dogs can live several years with proper management, while others may have a shorter prognosis,” Richardson adds.

In addition to early intervention, dogs will have a better prognosis if their owner is dedicated to ensuring their dog receives the proper care.

“It also depends on the commitment of the owners when following the recommended treatment plan and showing up for recheck appointments,” Turano says.

As kidney disease progresses, owners will need to bring their dog to the vet for multiple follow-up visits that include blood tests, for blood test, urinalysis, and blood pressure checks to monitor the stage of the disease, Turano notes.

“These guide treatments so that owners can give their dog the best chance at a longer life,” Turano adds.

Treatment Costs for Dogs With Kidney Disease

The total cost for treating kidney disease in dogs will vary depending on a variety of factors, including the stage of the renal disease, the dog’s size and the chosen treatment option.

“On average, treatment costs can range from $1,000 to $5,000 or more,” Richardson says.

Dogs that are in Stages III or IV of kidney disease may require hospitalization with IV therapy, ultrasound and numerous lab tests, Turano notes. A couple of night’s stay in an emergency pet hospital could be between $1,000 to $3,000, he adds.

Dogs that are in Stage II or early Stage III, the annual cost for managing the disease could be between $600 to $2,000, depending on how often they need lab work for monitoring, blood pressure checks, and whether they need a special diet or medications.

Richardson notes that that average total costs to treat kidney disease in dogs include the following:

  • Diagnostic tests: $200 to $500
  • Medications: $50 to $200 per month
  • Special kidney-friendly diet: $30 to $60 per month
  • Fluid therapy (if needed): $50 to $150 per session
  • Follow-up vet visits: $50 to $100 per visit

“Your best bet is to continue regular exams with your veterinarian, which should be more frequent for senior dogs, and recommended health screening,” Turano notes. “This helps with early detection which really can improve the dog’s long-term prognosis.”

Is Kidney Disease Covered by Pet Insurance?

Whether your pet insurance covers treatment for kidney disease will depend entirely on your individual coverage plan, and whether your dog was diagnosed before or after the coverage started.

Owners should read their pet insurance coverage carefully.

“Given that kidney disease often requires ongoing, long-term management and follow-up testing, there may be limits per year or per condition on the amount an insurance company will pay out on claims,” Greenstein says.

There are also some pet insurance companies that do cover pre-existing conditions with limitations.

Turano adds that pet owners with senior dogs should have a plan in place for the costs associated with their pet’s care, whether it’s a savings account or pet insurance.

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Is Kidney Disease Common in Senior Dogs?

Kidney disease is relatively common in senior dogs.

“Aging is one of the primary risk factors for kidney disease in dogs,” Richardson says. “Senior dogs should undergo regular veterinary check-ups to monitor their kidney function and detect any signs of the disease early.”

Other Common Health Conditions in Dogs: