Kidney Disease in Dogs: Signs, Diagnosis, & Treatment

Five Minutes
Jun 14, 2023

Kidney disease is a common dog disease that affects our canine pals. Whether you're a seasoned pet parent or a new dog owner, understanding the signs, causes, and treatment options for kidney disease in dogs can be important. Here’s what kidney disease looks like and how dog insurance could help you keep your four-legged companion happy and healthy.

What Is Kidney Disease in Dogs?

Kidneys remove waste from the blood, regulate essential mineral levels, and conserve water. The body eliminates waste through urine, which is produced by the kidneys.

Renal disease — the medical term for kidney disease — is a manageable but complicated issue to treat.1 Kidney disease inhibits your pet's ability to filter out toxins, no matter how much urine they produce.

What Causes Kidney Disease in Dogs?

There are two types of kidney disease: acute and chronic.2 Acute kidney disease can be caused by injuries, infections, or ingested toxins. Chronic kidney disease is a progressive condition that can be present for 3 months or longer. Acute kidney disease is generally reversible, while chronic kidney disease is typically irreversible.

Poisons and toxins

Dogs tend to eat just about everything, which can lead to unfortunate accidents. Ingesting certain things — like antifreeze, grapes, or rat poison — can lead to acute kidney failure without swift medical attention.2

Pet parents should keep hazardous household products away from their dogs. Also, familiarize yourself with dog-safe human foods before sharing anything with your pup.


Certain infections, like leptospirosis, can also cause acute kidney disease.2 Sometimes called “lepto” for short, this bacteria can thrive in warm and wet environments.

Luckily, there’s a lepto vaccine available for dogs to prevent these infections. Staying up-to-date on vaccines and wellness checks can help prevent infections that can lead to acute renal disease.


Some vets consider chronic kidney disease to be age-related, caused by the kidneys “wearing out” over time.1 Typically, small dogs show signs around 10 – 14 years old, while large dogs may have symptoms as early as 7 years old.1 Although aging is unavoidable, it’s possible to minimize disease in older dogs with exercise and a good diet.

Genetics and breed

Certain dogs may be more likely to develop kidney disease than others. Genetics can play a huge role in the diseases your dog may develop, especially in purebred dogs.1,2 For example, poodles may be predisposed to Addison’s disease. Untreated cases of Addison’s can compromise a dog’s kidneys and increase their risk for renal failure.

If you adopted your dog, consider a DNA test to know what they may have inherited. If you’re getting a purebred, ask the breeder for your puppy’s parents’ medical history. Or do a combination of both! Then, talk to your vet about your pet’s risk for renal disease.

Kidney Disease May Hurt Your Pet and Your Wallet

Pet Insurance Can Help

Symptoms of Kidney Disease in Dogs

Recognizing the signs of kidney disease in dogs can be crucial for early detection and prompt treatment. By staying vigilant, you can help your furry friend receive care. Below are some of the symptoms and signs that may manifest.

  • Increased thirst and urination: This may occur when the kidneys can’t concentrate and eliminate waste properly.1,2 
  • Decreased appetite and weight loss: The kidneys play a crucial role in maintaining a normal appetite and nutrient levels in the body, and these signs may occur in the advanced stages of the disease.1
  • Vomiting and diarrhea: As the disease progresses, more toxins remain in a dog’s tissues and blood because they aren’t being filtered out properly, leading to gastrointestinal (GI) upsets and ulcers in the mouth.3
  • Lethargy and weakness: Dogs with kidney disease may appear lethargic and weak because the kidneys are responsible for revitalizing the body by processing nutrients from food and water.1

How Is Kidney Disease in Dogs Diagnosed?

Two tests can assess kidney function: a urinalysis and a blood chemistry test.1

The urinalysis measures the amount of protein in your dog’s urine, which may indicate decreased kidney function. It’ll also look at the urine’s specific gravity (USpG), as a low USpG can indicate kidney failure.1

A blood test will look for nutritional issues and measure overall kidney function. It’ll look for benchmark levels of blood urea nitrogen (BUN), creatinine (CREA), and symmetric dimethylarginine (SDMA). All three are different metrics that tell your vet how well the kidneys are creating new blood cells and processing nutrients for your dog, along with indicating the extent of the kidney failure.1

Your vet may then use the IRIS (International Renal Interest Society) staging system to figure out what stage of kidney disease your dog is in. This helps them come up with a more detailed treatment plan and prognosis for your pup.1

Follow-up tests your dog may need

After receiving a kidney disease diagnosis, you can expect to revisit these tests regularly. The goal is to help your vet create the best treatment plan for your pet and their lifestyle.

Some vets may choose to take a survey of your dog’s kidneys to get a better picture of their kidney function.4 The vet may take an ultrasound or a radiograph to see which parts of the kidneys are damaged and how severely. In specific cases of chronic kidney disease, your vet may order a biopsy to see if there’s an underlying cause of the kidney failure.4

Dog sleeping on owner's lap

Kidney Disease in Dogs Treatment

In the first phase of treatment, vets may use a high dose of intravenous (IV) fluids to flush the kidneys and bloodstream to remove built-up toxins. If the kidneys aren’t too badly damaged, this may restore enough kidney function for your dog’s body to properly get rid of waste. If not, your vet will put together a more intense treatment plan.1

There are four main ways kidney disease can be treated — with diet, medications, fluid therapy, and regular check-ups. Depending on the severity of your dog’s medical condition, your vet may recommend combining some, if not all, of these treatment options to preserve your pet’s kidneys. Because vets consider chronic kidney disease to be incurable, the goal of treatment is to improve your pet’s quality of life.1

Dietary management

In the later stages of kidney disease, a special diet can help manage the health of the kidneys. In general, a diet for renal disease aims to provide:4,5

  • Low protein to minimize the buildup of waste that the kidneys are struggling to filter
  • Phosphate binders that manage phosphorus levels, which can further impair kidney function
  • A balanced amount of sodium to help the body’s blood pressure and ability to absorb water
  • Adequate amounts of fresh, clean water to prevent dehydration

Work closely with your veterinarian to develop a suitable dietary plan that best supports your dog's kidney health and overall well-being.5 You could make your pet’s meals yourself or purchase prescription diet food.

Medications and supplements

Your vet may prescribe medications and supplements to help your pet’s kidney function. Options include things like:1,2,4

  • Antiemetics, which controls nausea and vomiting
  • Omega-3 which can reduce inflammation in the kidneys
  • Vitamin B complex to improve overall health and maintain energy levels
  • Angiotensin-converting enzyme (ACE) inhibitors to manage high blood pressure that impacts kidney function
  • Probiotics to help the gut process nitrogen and other toxins

Your vet may prescribe additional medications to treat acute kidney disease caused by infections or injury.4 How much medication — if any — depends on your pet’s specific case.

Fluid therapy

Fluid therapy aims to maintain hydration, correct electrolyte imbalances, promote urine production, and improve overall well-being. There are two methods of fluid therapy: IV and subcutaneous fluids.1,4

IV fluids rapidly restore hydration and correct electrolyte imbalances in severely dehydrated dogs or those with acute kidney injury. Subcutaneous fluid therapy is often used to manage chronic kidney disease in dogs. Unlike IVs, subcutaneous therapy can be given at home, but this option requires proper hygiene practices and tools to monitor your dog’s well-being.1,4

Regular vet visits

Dogs with acute or chronic renal disease may need regular vet visits to monitor their kidney function. Regular check-ups ensure the effectiveness of your dog’s treatment plan and improve their quality of life. How often you’ll need check-ups depends on the treatment plan. However, early-stage pups may need check-ups every 6 months or so, while later-stage pups may need check-ups every 1 – 3 months.4

The Importance of Detecting Kidney Disease in Dogs Early

Don't underestimate the importance of regular veterinary visits to ensure your furry friend's well-being. Since symptoms may not become noticeable until at least 2/3 of the kidneys are damaged, routine examinations and blood tests play a vital role in identifying any signs of kidney disease at an earlier stage.1 By catching the disease early, prompt intervention and management can improve your dog's overall prognosis and quality of life.

Pet Insurance May Help With Treatment Costs for Kidney Disease

With the proper treatment and regular check-ups, most dogs can live normal, fulfilling lives after an early kidney disease diagnosis.1 The cost of care doesn’t have to get in the way of making sure your dog is happy and comfortable. Take a look at Leila’s story.

When Leila, a mixed pup in California, became sick, her pet parents took her to the vet. Leila’s urinalysis indicated she may have kidney disease. All of her diagnostic exams cost over $5,600. Luckily, Leila’s parents were reimbursed almost $4,500 through their dog insurance policy — allowing them to spend more time focusing on Leila’s recovery than the cost.6

Investing in a dog insurance policy with MetLife Pet can help you afford the best care for your furry friend. Learn more about how much pet insurance costs or get a personalized quote today.

Help Protect Your Pup
from Major Illnesses

**As with any insurance policy, coverage may vary. Review our coverage and exclusions

1 “Chronic Kidney Disease in Dogs,” VCA Animal Hospitals

2 “Kidney Disease in Dogs,” American Kennel Club

3 “Chronic Kidney Disease & Renal Failure,” Blue Pearl Pet Hospital

4 “Renal Dysfunction in Small Animals,” Merck Veterinary Manual

5 “Nutrition for Dogs with Chronic Kidney Disease,” VCA Animal Hospitals

6 All claims paid amounts are based on MetLife internal claims data from October 2022. Story altered for illustrative purposes.

Coverage issued by Metropolitan General Insurance Company (“MetGen”), a Rhode Island insurance company, headquartered at 700 Quaker Lane, Warwick, RI 02886, and Independence American Insurance Company (“IAIC”), a Delaware insurance company, headquartered at 11333 N Scottsdale Rd, Ste 160, Scottsdale, AZ 85454. Coverage subject to restrictions, exclusions and limitations and application is subject to underwriting. See policy or contact MetLife Pet Insurance Solutions LLC (“MetLife Pet”) for details. MetLife Pet is the policy administrator. It may operate under an alternate or fictitious name in certain jurisdictions, including MetLife Pet Insurance Services LLC (New York and Minnesota) and MetLife Pet Insurance Solutions Agency LLC (Illinois).

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