When managing kidney disease in dogs, stage of disease helps inform the treatment plan. Integrative veterinarian Dr. Julie Buzby explains how veterinarians use the IRIS chronic kidney disease staging guidelines. She also discusses how the guidelines can help dog parents know what to expect as they navigate kidney disease with their senior dog.
If your beloved senior dog has just been diagnosed with kidney disease or kidney failure, you may be feeling overwhelmed right about now. Perhaps your mind is swimming with questions and worries. And you wish you could have a clear idea of what the road ahead looks like.
Fortunately, there is a comprehensive set of guidelines that can help you understand how severe your dog’s kidney failure is at the moment. Plus, it lays out treatment guidelines for each stage of kidney disease.
We will talk more about this tool and its uses in a moment. But first we need to pause to take a closer look at some of the kidney-related terms that get thrown around.
Kidney disease, kidney failure, etc.—What does this mean?
Veterinarians often use the terms “kidney failure” and “kidney disease in dogs” somewhat interchangeably. Both phrases indicate that the kidneys are not functioning at their normal capacity. You may also hear or see terms like “renal failure,” “renal disease,” or “renal insufficiency.” Without additional context, these terms don’t tell you much about how severe the problem might be.
It is no surprise then that the veterinary community quickly realized how important it was to have a unified way of describing the severity of kidney disease. Their solution was to simplify things by breaking kidney disease into stages and substages. Thus, the IRIS chronic kidney disease staging guidelines were born.
What is IRIS and what makes their guidelines so useful?
IRIS stands for the International Renal Interest Society. It was created in 1998 by an international group of veterinarians devoted to advancing the scientific understanding of kidney disease in small animals. IRIS is led by a board of 14 independent veterinarians from countries all over the world. Each has expertise in kidney function and kidney disease.
The mission of IRIS is to help veterinary practitioners better diagnose, understand, and treat renal disease in cats and dogs. They knew that to achieve that mission they needed to first establish an internationally recognized set of guidelines on the diagnosis and treatment of kidney disease. That way everyone was speaking the same “kidney disease language.”
I would say they did a pretty good job.
The guidelines IRIS developed help veterinarians communicate clearly among themselves and to pet parents dealing with kidney disease. They accomplish this by providing a clear and systematic way to “stage” the degree of kidney dysfunction.
IRIS is committed to helping pets with kidney disease
In addition to creating these important guidelines, IRIS also investigates ways to accurately diagnose early chronic kidney disease and acute kidney injury (i.e. acute kidney failure). Plus, IRIS researches new treatments to improve the prognosis of dogs and cats diagnosed with these diseases.
Medicine is constantly changing, so these guidelines are always a work in progress. IRIS continues to modify them as researchers develop new tests and treatments and experts learn more about this complex disease process.
IRIS structured their guidelines to encourage and facilitate the diagnosis of chronic kidney disease in its earliest identifiable stages. This is the time when treatments to slow progression can have the greatest impact.
I want to clarify, though, that these guidelines are not a method for DIAGNOSING kidney disease. Instead they are a way to tailor treatment, monitor disease progression, and provide prognostic information AFTER diagnosis.
How is kidney disease diagnosed?
Unfortunately, reaching a diagnosis can be a bit tricky, especially early in the process. You see, your pup was born with plenty of extra kidney function. This is generally good news. But it also means that months to years of kidney damage can accumulate before anyone knows there is a problem.
The first indication of kidney failure in dogs is often abnormally dilute urine. Here’s why. The kidneys are primarily responsible for maintaining the right balance of water, minerals, and electrolytes inside the body. To do this, they get rid of what they do not need by producing urine. Properly functioning kidneys can produce very concentrated urine.
As kidney function decreases, the urine becomes more and more dilute. You may notice increased thirst in dogs because your dog will have to drink more water to avoid becoming dehydrated. By this point, 66% of kidney function has already been lost.
Sometimes, if your dog has a urinalysis at that stage, the vet will diagnose the kidney disease then. Other times, kidney disease doesn’t become evident until your vet runs some screening bloodwork on your dog. By the time your dog has elevations in the kidney values (BUN and creatinine) on standard blood panels, 75% of kidney function has been lost.
We can all agree that not being able to diagnose kidney failure until a dog reaches 66 to 75% kidney function loss is far from ideal. But for a long time, that was just the way it was.
SDMA – the kidney disease diagnosis superhero
Fortunately, veterinary renal experts have developed a relatively new blood test that can help identify kidney disease earlier in the process. This test measures symmetric dimethylarginine (SDMA), a compound that rises in the blood in kidney disease earlier than creatinine. It has the potential to detect kidney disease when as little as 25 to 40% of kidney function is lost.
Since this is a new test, researchers are still determining the best way to use it. But SDMA looks quite promising as a way to detect kidney disease earlier. As such, IRIS recently modified their guidelines to include SDMA values as part of their staging criteria.
What are the IRIS stages of kidney disease in dogs?
After your veterinarian has performed a physical exam, urinalysis, and chemistry panel, he or she can compare these results to the IRIS guidelines. One caveat to that is dogs who are ill or dehydrated at the initial vet visit. In that case, your vet can’t accurately stage your dog’s kidney disease until your dog is rehydrated and feeling better.
The guidelines divide the progression of chronic kidney failure into four sequential stages. IRIS bases the stages on clinical findings plus creatinine and/or SDMA values (preferably both). The stages are as follows:
Stage 1: Creatinine <1.4 mg/dL and/or SDMA <18 µg/dL
You can think of this as early stage kidney disease. Your dog will not feel bad from his or her kidney disease in Stage 1.
Stage 1 can be confusing because a creatinine <1.4 is considered normal. So, if your veterinarian only evaluates creatinine, then your dog must have some other signs of kidney disease to fall within Stage 1. Your dog may have Stage 1 kidney disease if they have a normal creatinine but also have:
- Dilute urine
- Kidneys that feel abnormal on exam
- Kidneys that look abnormal on ultrasound
- Abnormally high amounts of protein within the urine
Alternatively, the normal range for SDMA goes up to 14. So if your veterinarian runs a blood panel that checks SDMA and your dog’s SDMA value falls between 14 and 18, the vet can use this alone to categorize your dog as being in Stage 1.
Stage 2: Creatinine 1.4-2.8 mg/dL and/or SDMA 18-35 µg/dL
Think of this as mild chronic kidney disease. Most dogs in this stage still don’t show any symptoms that they are sick. If they do show signs, they will be mild and might include a decreased appetite or weight loss.
Each of the veterinary laboratories have different cut-offs for what they consider normal creatinine values. The lower values of creatinine for this stage may still be “normal” according to some laboratory reference ranges. But IRIS guidelines still consider dogs with those values to have chronic kidney disease.
Stage 3: Creatinine 2.9-5.0 mg/dL and/or SDMA 36-54 µg/dL
This stage would be classified as moderate chronic kidney disease. At this stage all creatinine values fall outside of “normal” laboratory parameters.
Dogs within this stage tend to have the most variable signs. Some dogs with early Stage 3 chronic kidney disease have mild symptoms like intermittent loss of appetite, change in haircoat, or weight loss. Other dogs, especially those with creatinine values closer to 5, may feel quite unwell. Some dogs may vomit, have diarrhea, or be a lethargic dog.
If your dog has Stage 3 chronic kidney disease your veterinarian will want to monitor other blood values. Additional lab work abnormalities such as high phosphorus levels or low potassium levels are common. These abnormalities can contribute to weakness, nausea, and a decreased appetite.
Stage 4: Creatinine >5.0 mg/dL and/or SDMA >54 µg/dL
This stage would be considered severe chronic kidney disease or late stage kidney disease. Unfortunately, most dogs that fall into this stage show significant clinical signs related to their disease. Once your dog is in the final stages of kidney failure, your veterinarian will work with you to offer supportive care options to keep your dog as comfortable and happy as possible for as long as possible.
What if creatinine and SDMA don’t match?
The guidelines described above are great when every lab test and clinical sign matches up correctly. But what happens if your dog’s creatinine value puts him or her in one stage and SDMA in another? Not all veterinary laboratories perform the SDMA test. But if the laboratory your veterinarian uses includes this test, then this scenario is possible.
Happily, the experts of IRIS have accounted for this situation and provided guidelines to follow if your pup’s results are not so clear-cut.
First off, IRIS guidelines remind vets that creatinine levels can be influenced by muscle mass. So dogs that have lost significant muscle are likely to have a creatinine level that underestimates the severity of their kidney disease. If this is the case for your dog, then your veterinarian will rely on the SDMA level to decide which stage they fall into.
Other times there is not an outwardly obvious reason for the discrepancy. In that case, the IRIS guidelines recommend retesting SDMA and creatinine levels in two to four weeks. At that time, if the values still place your dog into two difference categories, they recommend assigning them to the higher stage.
What are the IRIS substages of kidney disease?
Now that you have the stages down, we will add another layer of complexity. Within each stage, dogs are also substaged based on whether they have protein in the urine (i.e. proteinuria) or increased blood pressure (i.e. hypertension in dogs).
Both proteinuria and hypertension are well-known complications of chronic kidney disease. Also, they are both “chicken and egg” phenomena. In other words, untreated proteinuria or untreated high blood pressure can BE CAUSED BY kidney disease. But they can also CAUSE progressive kidney damage. This is why it is so important to assess and treat for these conditions, and why they are part of the IRIS guidelines. Let’s take a closer look at these two criteria.
Hypertension
Dogs with kidney disease should have their blood pressure checked regularly. Just like people, dogs can suffer from the “white coat effect.” In other words, they have elevated blood pressure readings due to the anxiety surrounding a veterinary visit.
To accurately interpret your dog’s blood pressure, your veterinarian will do everything possible to help ease your dog’s anxiety. This may mean checking your dog’s blood pressure first thing—before an exam or any other diagnostics. Or maybe the vet will place the blood pressure cuff, let your dog acclimate to it for several minutes, then take the reading.
IRIS recommends taking multiple readings and averaging them to help maximize accuracy. Ideally the veterinary team would take readings during different visits on different days. If this is not practical, then the team may perform the readings during the same visit. In that case, the goal is to give your dog a significant period of downtime in between readings.
Interpreting blood pressure results
The vet will interpret the blood pressure based on the following table. Note that this is based on a repeatable blood pressure (i.e. consistently getting numbers in that range, not just a one-time thing).
| Blood pressure | Interpretation |
|---|---|
| <140 mmHg | normal |
| 140-159 mmHg | prehypertensive |
| 160-179 mmHg | hypertensive |
| >180 mmHg | severely hypertensive |
Proteinuria
In addition to keeping fluid and electrolytes within the body, properly functioning kidneys should also prevent protein from leaking into the urine and leaving the body. Losing significant protein within the urine is not normal. But it is not always a sign of kidney disease.
The most common cause of protein within the urine is actually a urinary tract infection (i.e. UTI in dogs). If your dog has a UTI, he or she will have increased white blood cells and red blood cells in the urine. These cells are made of protein, hence the proteinuria.
However, significant protein in the urine without any evidence of an infection, blood, or inflammation is much more concerning. This type of proteinuria, known as renal proteinuria, signifies that the filtering portion of the kidney (i.e. the glomerulus) is not working properly.
All dogs with chronic kidney disease should be screened for the presence of protein in their urine. Your veterinarian will first perform a urinalysis. If the urinalysis indicates proteinuria, your vet will next try to determine if this protein could be due to blood or bacterial infection. Once a UTI is ruled out, your vet will likely recommend a more specific test to quantify the amount of protein being lost. This test is known as a urine protein to creatinine ratio test, or UPC test for short.
Your vet will use the results of this test to determine if your dog needs oral medication to decrease protein loss into the urine. This is important since continued protein loss leads to progressive kidney damage.
Interestingly, the amount of protein lost in the urine can actually decline as renal dysfunction worsens. So proteinuria may be a less frequent finding in dogs that are in Stage 3 or 4 chronic kidney disease.
Interpretation of UPC results
Your vet will use the following table to interpret your dog’s urine protein to creatinine (UPC) results.
| UPC | Interpretation |
|---|---|
| <0.2 | not proteinuric |
| 0.2-0.5 | borderline proteinuric |
| >0.5 | proteinuric |
How does kidney disease stage dictate treatment?
Once your vet assigns your dog a kidney disease stage and substage, it is time to think about treatment. You know that your dog is special and unique. Fortunately, IRIS knows that too. They provide guidelines on treatment for the different stages. But they make an important note that these are merely recommendations that your veterinarian can use to tailor the final treatment plan to your dog’s unique situation.
All these treatments for chronic kidney disease are either aimed at slowing the progression of disease or improving your dog’s quality of life. During Stages 1 and 2, most dogs do not have any signs of illness. So treatments the vet initiates during this time focus on preserving kidney function and slowing disease progression.
In the later stages, treatment shifts to combine both types of treatments—those that slow progression and those that improve signs of illness to support quality of life.
Regardless of the stage, it is vitally important that dogs with kidney disease always have free access to fresh water. Otherwise, the specific stage-related management recommendations are:
Stage 1
- Avoid any medications known to be hard on the kidneys
- Check for any treatable conditions like kidney infections (i.e. pyelonephritis in dogs) or stones within the urinary tract
- Monitor for high blood pressure and protein loss in the urine
- Visit your veterinarian promptly for any illness that might lead to dehydration so the vet can correct dehydration prior to it causing additional kidney damage
Stage 2
- All the recommendations for Stage 1, plus:
- Consider starting a prescription renal diet (usually a lower sodium, lower phosphorus, and moderate protein diet)
- Reduce phosphate intake to keep the blood phosphorus level <4.6 mg/dL
- If a prescription diet alone does not reduce phosphorus, then add in a phosphorus binding oral medication to be given with meals
Stage 3
- All the recommendations for Stage 2, plus:
- Feed a prescription renal diet
- Keep the blood phosphorus level <5 mg/dL
- Treat any nausea or vomiting with anti-nausea medications
- Some dogs with late Stage 3 disease may benefit from regular fluid therapy under their skin (subcutaneously) to help maintain their hydration
- Treat imbalances of the acid/base status (metabolic acidosis) of the blood with oral medication if indicated
- Treat anemia (i.e. low red blood cell numbers) with injectable synthetic hormone medications if indicated due to clinical signs of anemia or a PCV (packed cell volume) <20%
Stage 4
- All the recommendations for Stage 3, plus:
- Keep the blood phosphorus level <6 mg/dL
- Consider adding in the oral medication calcitriol (may prolong survival times in some cases)
- Most dogs with Stage 4 disease will benefit from regularly receiving fluids under their skin (i.e subcutaneous fluids) to help maintain their hydration
- Prioritize adequate nutrition and consider assisted feeding with a semi-permanent feeding tube if indicated
- Feeding tubes can also assist in maintaining hydration and can ease medication administration (see photo below)
Treatment for hypertension
If your dog’s blood pressure is persistently above 160 mmHg, your veterinarian will want to start treatment. This is the case regardless of what stage of chronic kidney disease your dog is currently in. Your veterinarian will work to reduce your dog’s blood pressure gradually to avoid potentially dangerous drops in blood pressure that can happen with more aggressive treatment.
There are several blood pressure medications available. Your veterinarian may recommend using them individually or in combination, depending on your pup’s specific situation and response to treatment.
Most dogs with chronic kidney disease who also have high blood pressure will need to remain on blood pressure medication for life. Your veterinarian will want to periodically recheck your dog’s blood pressure and may adjust the dose and types of medication over time.
Treatment for proteinuria
As alluded to earlier, the first step for any dog with proteinuria is to rule out any other conditions that might be causing the protein loss. If your dog has borderline renal proteinuria, your vet won’t start him or her on medication yet. However, your dog will require extra monitoring.
Once the UPC is above 0.5, IRIS recommends starting medication to treat proteinuria. Your veterinarian will likely start with a type of medication known as an ACE inhibitor. If this type of medication alone does not improve the protein loss, then your vet may want to add in an additional type of medication known as an angiotensin receptor blocker (ARB).
Like the treatment for high blood pressure, the treatment for proteinuria will likely continue for the remainder of your dog’s life.
How might the stage and substage change over time?
The stages and substages are not permanent classifications and should be revised as needed based on periodic recheck laboratory testing. Chronic kidney disease is a progressive disease process and over time (hopefully a very long time) your dog’s kidney values are likely to worsen as kidney dysfunction worsens.
As the values change, your dog will move up in the classification system. If your dog has either proteinuria or hypertension and medications are used to treat these conditions, then the substage classification may change as well.
What is the prognosis for kidney disease?
Knowing that kidney failure is progressive, it is natural to wonder how long your dog might live with kidney disease. This is a difficult question to answer since the rate of progression varies significantly between individual dogs. IRIS has not provided any specific prognosis or life expectancy for each stage. But in general, you can assume that the prognosis worsens as the stages progress.
With careful monitoring and treatment, some dogs with chronic kidney disease can live for years with a good quality of life. Unfortunately, if your dog is in Stage 3 or Stage 4 at the time of diagnosis, then he or she is more likely to succumb to kidney disease in months rather than years.
An older study gave a median survival time of >400 days for dogs with Stage 1 disease, 200 to 400 days for dogs with Stage 2 disease, 110 to 200 days for dogs with Stage 3 disease, and 14 to 80 days for dogs with Stage 4 disease (end stage kidney failure). But again, this can vary from dog to dog.
Take advantage of this kidney disease roadmap
Even without looking at those survival numbers, it’s understandable to feel worried if your beloved canine is diagnosed with chronic kidney disease. Being handed a new diagnosis of kidney failure is stressful. So is watching your sweet pup deal with chronic kidney disease for an extended period of time. And facing the inevitable progression of your dog’s disease can feel overwhelming at times.
I hope, though, that learning about the stages of kidney disease has given you more hope than heartache. Think about the staging guidelines as your roadmap to living with a dog with kidney disease. They give you an idea of where your dog is, where he or she may be headed, and how to make the path as smooth as possible along the way.
In short, understanding the IRIS guidelines can help you navigate this journey and advocate for your dear dog. And your veterinarian can help too. Together you can use the many kidney disease management tools discussed in the guidelines to help optimize your dog’s quality of life and hopefully give you more good days together.
Have you found the IRIS chronic kidney disease staging guidelines helpful?
Please comment below.
I’m confused either my vet’s diagnosis. He said the was in the beginning stages of kidney disease, but ordered an IRIS test. She was also diagnosed with a UTI. If she’s just in the beginning stages, wouldn’t she be generally fine?
Hi Isaac,
I am sorry your pup is facing this difficult disease. I wish I could offer guidance, but without knowing all the details of your girl’s case, it is hard to make specific conclusions. I am not sure if you are referring to the UTI as being a strange symptom with early kidney disease? UTI’s can occur with or without underlying kidney issues and if left untreated can sometimes cause damage to the kidneys. I hope you will get the information you need once the IRIS testing is complete. Hoping for favorable results and praying for a positive outcome for you and your sweet girl.
Hi, our 5 year old cavapoo had an acute kidney injury three weeks ago. Kidney function seemed to return to normal after a week in hospital with fluids. But on check up it has risen again. Vet is checking for protein level in urine. If there is permanent damage, does that lead to the progressive condition? Struggling to understand how they link. Thank you
Hi Liz,
So sorry to hear that your dog had an acute kidney injury. I’m sure that was scary! It is hard to say for sure since I didn’t examine or treat your pup, but I am guessing that there might have been some lasting damage that is showing up now that your dog is no longer on IV fluids, that whatever process caused the acute kidney injury is still going on, or a bit of both. Kidney damage can end up being progressive in some situations. For example, if the dog had damage to the tubules of the kidney which caused him or her to leak protein into the urine, the body’s reaction to the proteinuria (protein in the urine) can actually cause more damage. Over time, the changes related to kidney damage can worsen overall kidney function, causing the dog to progress through the different stages of kidney disease. Kidney disease is a huge topic but hopefully this helps a little. Feel free to reach out to your vet or to me if you have more questions. I hope that your dog stabilizes soon and has many wonderful years ahead of him or her!
My little Mini Foxy x Chihuahua is 15.5 yo and has recently (on Saturday) been diagnosed with Stage 2 CKD, with a BUN of 29.12, Creatinine of 211, a BUN/Creatinine ratio of 0.138 and Phosphorus 1.39 – these measurement are all in mmol/l as that is how we report it here in Australia. Pochi’s vet say she isn’t too bad yet and the rest of her blood-work looks fine, too, and she has no heart murmurs and her gut feels soft and easy. She is still active and happy but might have lost some appetite. I have spent the last few days agonising over her condition and scouring the internet for home-cooked recipes kidney friendly food that might help strengthen her kidneys and keep her healthy for a bit more. What is the prognosis for a stage 2 CKD for a little dog with her readings? Many thanks.
Hi Mei,
I am sorry your girl has received this difficult diagnosis. I am glad your vet was able to catch this before it progressed and allow time to try and intervene with treatment. It is hard to make specific conclusions about prognosis because it varies widely from dog to dog. The article does give some insight to this in the section labeled “What is the prognosis for kidney disease?”. I hope Pochi will continue to feel well and maintain her quality of life. Wishing you both the best and praying for many happy days ahead.
My darling labrador was diagnosed last week with Stage 4 Chronic Kidney failure.
We were and still are in shock as I am sure are many other furry pet owners.
His Cre is 5.7 BUN 132 and Phos 11.3. We had no clue he was sick. He went in for some stitches and they did a blood test. The rest is history.
The strangest thing is that he is eating normally with a good appetite, drinks a little less but the weather is getting cooler. His poop and pee are normal, and he is at the same activity level.
We are cooking him home made food per nutritional guidelines on maintaining a healthy and balanced diet for his condition, but it’s only been a week of cooking so we will see.
I keep checking on him all the time because he is at stage 4 and waiting to see a change in his health or mannerisms. Of course, I don’t want to see anything negative and don’t want to talk it up but so far so good.
Hi Susie,
I am sorry your boy has received this difficult diagnosis. He is lucky to have you taking such good care of him and cooking him nutritious meals. What a blessing he is still feeling well and able to enjoy life. Wishing you continued success and many happy days ahead. Bless you. ♥
Wishing your boy all best. I took my Beagle Bella to the vet as she didn’t eat her breakfast which was unheard of. Blood tests shows she was stage 4 of kidney disease and very far gone. We had no idea she was even sick or that she was now dying. We had to say goodbye to her the next day and it’s the hardest thing I have done and she was young at 7. Thanks Dr for your article most informative and your most compassionate to people. I am broken and lost and my heart aches for my best friend .
Hi Rania,
My heart goes out to you on the sudden loss of Bella. It is never easy to lose a beloved furry family member, especially when they seem so healthy and then rapidly decline. I hope that you are able to find a measure of comfort in all the good memories you shared and the wonderful life she had with you. ❤️
my dog i just put down yesterday, lived 1 year with stage 4. 5.7 creatine all because of 9ne supplement my vet gave me. until 3 weeks ago, you would never of known he had kidney failure or even stage 4
Hi Robert,
My heart goes out to you with the recent loss of your beloved pup. What a blessing you gained so much extra time with him. Thank you for sharing your experience and offering support to others. Wishing you comfort and peace for your heart. Bless you.
My little (shitzu) dog Shakespeare has just been diagnosed with Cushing’s. He has no symptoms, but his cortisol level is 1556. He is energetic, cheerful, active. We think he is at least 8, but since he is a rescue, we’re not sure.
I am 83 and also have Kidney Disease (stage 4) but am in pretty good health except for that.
Do you think there is a relationship there?
Since he has no symptoms yet, what is his prognosis? Even the SDMA test is so expensive. We put him in a “Care Club” but a lot is not covered. Do you know of any other financial help?
We “scrape by” on Social Security.
BTW, he also has arthritis (as do I) but greatly improved when I started giving him vit. C.
Hi Ann,
I understand your concern for your pup and how hard it can be when finances limit our choices. I wish I could offer some great insight but without playing a personal role in Shakespeare’s medical care it is hard to make specific conclusions. Also, I am a bit confused if you are asking about the prognosis with Cushing’s disease or kidney disease? If his cortisol level is the only abnormality on his lab work, I would not think kidney disease was an issue at this time. Here is a link to another article with more information about Cushing’s: Cushing’s Disease in Dogs: Symptoms, Diagnosis, Medications
Hoping your sweet boy will continue to stay active and enjoy life. Wishing you both all the best.
Hi I have a question about my dog who is suffering from chronic kidney failure. My dog is 7 y/o and her urea is around 880 and creatine 50. First week of the IV treatment (lasting 1-2 hrs) she started showing better results. then they started giving her fluids under the skin rather than directly into the vein so she started getting worse. After 2 weeks of receiving in the skin I switched my vet and today she started getting IV treatment lasting 8 hours instead of 1-2 hours. She is getting injections treating nausea, specific food for kidney disease (Renal, pronefra). She usually sleeps throught the day but sometimes she gets a bit energetic, doesnt show an intrest in eating only on rare occasions (but i force feed her), but she drinks water, she doesnt have diarrhea anymore. Do you have any advice on what to do and what is the prognosis on the advancment of the disease? Thank you for the answer in advance!
Hi Lana,
I am sorry your girl is battling kidney disease. I understand your concern and think it is great you are searching for ways to help. Unfortunately, no matter what treatment is administered, eventually kidney disease will turn into kidney failure. Hopefully we can find ways to support kidney function and extend life as long as possible. Some dogs maintain well and go on to live for years after their diagnosis. Here are links to other articles with more information:
1. Kidney Failure in Dogs: Signs, Symptoms, and Treatment
2. Dog Kidney Failure: When to Euthanize Your Dear Dog
Don’t forget you can always ask for a consultation with a specialist if needed. Wishing you and your sweet girl all the best as you navigate this difficult path. Keep up the good work!
My 15 y/0 Amstaff/Boxer/Greyhound mix was diagnosed with Stage 2/3 CKD this past Wednesday. Her vet said at best we are looking at 3-6 months. Unfortunately, her muscles are very weak and she has very severe Arthritis throughout her spine, in her hips and in her legs. I have done everything possible to keep her comfortable through that. Now, CKD. My girl has been through a lot lately. She lost her little Chihuahua buddy on 6/4/2024. My best friend of 46 years passed on July 1. I lived with her. Belle was home with her all day while I was at work. She has been very obviously depressed losing both of them, as have I. I am also getting ready to move next weekend. All of these things combined led me to the difficult decision to euthanize my precious girl on this coming Tuesday. She rarely eats. Drinks tons and then nothing for a day or two. I have to carry her in and out, up and down the stairs, etc. I keep second guessing my decision right now. What I read gives me some hope. But then I think about how difficult these last months could be on her already stressed and weakened body. I guess I just need to let this out here. Not looking for answers. Just wanted to share my difficulties with all of this. My heart hurts from all of the losses I just went through and am about to go through again, all in such a short period of time. I have considered every day that I have had with her for the last couple of years as a gift as she has been with me for 15+ years. Thank you for letting me share.
Dear Janet,
My heart goes out to you as you grieve the loss of Belle. I am sorry you have had to say goodbye to your other pup and best friend in the past few months as well. I am certain your choice to let go was the most loving option, but I understand that doesn’t lessen the pain. I hope with time your heart can begin to heal and you will be comforted knowing you gave your girl a wonderful life. May her memory be with you always. Bless you. ♥
Hi Julie,
I am from India. I have 10years lab. But he is suffering from Kidney diseases and have Creatinine level 17 and Urea level is 440. He is not eating from last 8-9 days. Doctors told us to give fluid therapy, Now he is not able to move himself and doing vomiting daily.
Is there any chances of recovery from this. We are tried our best to give him the best solution. Kindly I requested you pls suggest something that will work form him. Its very hard to see him as he is.
Dear Sahil,
I am sorry your senior Lab is not well and experiencing these worrisome issues with his kidneys. Without examining him myself, it is hard to offer specific recommendations. Unfortunately, some dogs just don’t respond to treatment and the kidney failure progresses until it is fatal. From what you describe, I am afraid your boy may be nearing the end of his life. It may be best to say goodbye and offer him peace and rest. Hoping you can find the answers you need to make the hard decisions ahead. Praying for your strength and comfort.
Our 13 year old sweet Pomeranian Max got suddenly sick with vomiting, diarrhea, hunched over, unsteady, and rapid breathing. Blood work and tests show liver and kidney failure, tumor (7.8 cm in right cranial ventral abdomen), anemia, and aspiration pneumonia. Preexisting conditions are collapsed trachea and seizures.
Our vet felt we are at a crossroads and woke put him through a tremendous amount and very little in return. Have you seen dogs recover from this or are we just prolonging the inevitable? Some of the numbers are listed below.
Phosphorus – 33
Bun – 246
Creatinine – 8.5
ALT – 1446
ALP – 3000
Thank you!
Dear Jessica,
My heart goes out to you as you face this emotional situation with your senior pup. I wish I could offer advice, but without playing a personal role in his medical care, it is hard to make specific conclusions or recommendations. I agree this doesn’t sound good and am concerned Max may be nearing his final days. Praying for clarity and strength as you navigate this difficult path. Bless you and your sweet boy.
I have a 2 yo Italian Greyhound, Gigi, who had a serious bought with Leptospirosis. She was in ICU for 10 days and her Creatinine and BUN scores were very high. I’ve had her home for almost a month and she has been great! She’s eating, (I’ve been feeding her boiled chicken and rice/sweet potato) playing, drinking, everything seems to be working and she’s her sweet wonderful self.. She is on Doxycyline and will continue to be in it for a while. I took her back to get a blood test today and her scores were 2.2 creatinine and 75-80 BUN. I was shocked because she is doing so well. They basically told me to enjoy my time with her and that she’d be okay until she wasn’t then it would be time for me to make a decision. I am beside myself at the thought of losing her. Thank you for your information it has helped. If there is anything else I should do or not do – please let me know.
Hi Vivianne,
I am sorry Gigi is facing this difficult diagnosis so early in life. It sounds like you are doing everything you can to ensure she is well taken care of. I will attach links to other articles that may be helpful as you progress to other stages. Praying for your strength as you walk this emotional path. Bless you and your sweet girl. ♥
1. Kidney Failure in Dogs: A Comprehensive Guide
2. Using a Quality of Life Scale for Dogs
3. Dog Kidney Failure: When to Euthanize Your Dear Dog
Dr Buzby
My dog was placed on stage 2 CKD last year, his creatanine was 1.9 and SDMA 20.4.
Subsequent tests showed SDMA down to 18.2, then 19.4, with creatanine 1.6 each time. Unfortunately UPC was not taken, i got the UPC done a month back and it came at 2.5, A few days back i got him retested. His SDMA was 14, BUN 25, creatanine 1.6 and UPC 13.5!
He is on Rubenal 300, pronefra, Neeri KFT and Renonadyl. Last year i had started him on a prescription diet but that wreaked havoc on his GIT, so now i give him high quality protein, fermented millet, eggs, kefir, veggies like bell peppers, pumpkin, carrots, bottle gourd and dehydrated raw green tripe. I am totally confused, i cant imagine why his UPC jumped to 13.5 and SDMA became 14. Could you share some insights. What do i do? do i reintroduce the renal diet gradually? Also his ultrasound both times showed blurred MODERATELY REDUCED, MEDULLARY RIM SIGN and CORTEX- HYPERECHOIC TO SPLEEN. Vet says not to worry, with structural changes this value is not bad but i am so worried, if it keeps increasing at this rate!!!! Any insights will be very helpful
Dear Niketa,
I understand your concern for your pup and think it is great you are taking such an active role in advocating for his health and well-being. Unfortunately, without personally examining him, it is hard to make specific conclusions and recommendations. My best advice would be to get the opinion of an internal medicine specialist if one is not already involved in your dog’s case. They would be able to sort through all these details and offer specific recommendations on testing and treatment moving forward. Hoping you can find the answers you need to ensure your sweet boy has many happy years ahead. Wishing you nothing but the best and praying for a positive outcome.
I have a 6 month Cavapoo puppy. Yesterday I took her to get Spayed. Her blood test shows. BUN 90 mg/dL;
Crea. 3.3mg/dL; K. 6.4 mmol/L
What does this mean? What stage is this fall under? She is fine. She has no symptoms. We’ve started on Renal Kidney Support diet yesterday, Vet’s recommendation. I took her to the Vet last month because she swallowed 2 Starburst candy. They had her throw up and checked her blood that was normal according to the Vet. I haven’t seen the blood test results then.
How in a month, can she be diagnosed with kidney disease? It’s possible she had consumed green grapes that we are not aware of. 75% kidney failure?
What are my realistic options? Thank you in advance.
Hi Sonny,
I am sorry your young puppy is facing this difficult diagnosis. Without playing a personal role in her medical care it is hard to make specific conclusions and recommendations. Grapes can definitely cause this type of kidney damage, but I would think you would see symptoms to go along with it. It is possible this is something genetic/congenital that is just now showing up. Without knowing a cause or if this is an acute or chronic issue, it is not possible to know the long-term prognosis. Hoping your vet can continue searching for answers and find a clear path forward with treatment. Wishing you and your sweet girl all the best and praying for a positive outcome.
Hi Dr. Buzby –
My 5 y/o GR was DXd with PLN in late December. The vet got him on a plethora of meds right away, Mycophelonate, Telmisarin, Amlodipine and Clopidegrel. He has been on a Renal diet of Hills K/D and we’ve had to add in Royal Canin Renal E wet food. He no longer will eat ANY of it! It’s been a few days since he’s kept anything down. He’s losing weight as well……… He has had loose bowels for a while which has since turned to diarrhea the last 4 days or so. We have tried many things for him to eat. He ate a piece of turkey luncheon meat and a couple green beans and 20 min later, vomited them up. Is this how the disease progresses? Will he starve himself to death? Is there something more we can be doing on our end? We’re trying to get him to the vet for follow up bloodwork, but thought I’d reach out for any other suggestions! Desperate for more time………..
Hi Janice,
I am so sorry your young dog is struggling, and his health is declining despite all the efforts of your vet. Unfortunately, some dogs just don’t respond to treatment the way we hope. Is your vet consulting with an internal medicine specialist about your pup’s case? If not, that would be my next recommendation. You can ask for a referral if needed. A specialist may have ideas about treatment or therapies that are not readily available in general practice. Also, your pup may need something like Cerenia to help with nausea and allow him to keep his food down. Please know that your comment didn’t disappear. All comments wait in moderation until they are read and responded to. We receive hundreds of comments each month so sometimes it can take a bit to reply to each one and give them all the individual attention they deserve. I agree that a recheck with your vet to do more lab work would be very helpful as well. Hoping you can find a way to get things back on track and praying for healing for your sweet boy.
I just returned from the vet. My dog has renal failure and stopped eating 48 hours ago.
The vet gave him 100mls of subQ fluids for dehydration, a shot of anti-nausia meds and.she sent home a med for me to give him an hour later increase his appetite. It worked. He ate his first meal
Hi Faith,
I am sorry your boy is facing this difficult diagnosis. I am glad to hear that the medications are working, and you are seeing some improvement. Hoping for continued success and wishing you both the best of luck.
Hi Julie
Thank you for this article, It has really helped me understand this disease better, especially since my 2 year old Great Dane girl was diagnosed with CKD 6 months back . We have been feeding her Royal Canine kidney food and also adding phosphate binder (as advised by the vet), However her creatinine levels have been rising slowly and now reached 2.7 ( this was two days back) after which she had fluid therapy for 2 days ( 4 sessions) and now her creatinine is 2.4, However, the vet is reluctant about continuing fluid therapy and says that fluid therapy is only useful in cases of acute kidney disease and not CKD. Also her RBC is dropping, though not her hemoglobin. Please share with us if you have any comments about her way of treatment. Would you advise anything different/additional? . We look forward to your comments. My mother, her primary caregiver, is extremely anxious.
Thank you for listening.
Dear Pall,
I am so sorry your big girl is having these issues at such a young age. It sounds like your vet is staying on top of things and I am not sure there is much else that can be done. You can ask for a consultation with a specialist just to see if they have any additional recommendations. Hoping you can find a way to keep your girl comfortable. Try to make the most of the time you are gifted. Praying for peace for everyone involved.
Dr. Buzby,
A year ago, my golden retriever was diagnosed with stage 2 kidney disease. At the date of diagnosis: creatinine (1.8), BUN (35), and SDMA (17). The Creatinine to Protein Ration was 3.9.
Since diagnosis, she has been on Azovast (probiotic), Galliprant (pain), and Benazapril. She is also on hill science KD. The vet has us giving her green beans as treats. To encourage water consumption, her food is softened with water before eating. Additionally, we give her small amounts of water with pumpkin throughout the day. (for any other readers we are religiously strict with the no unapproved treats and amount of food she eats).
The treatment has gone phenomenally well at slowing the progression. At follow-up appointments, we were able to get the BUN to decrease. Her phosphorus and iron levels are “great” according to the vet. The vet is also surprised with how well these numbers have been.
At the most recent appointment, her numbers were: Creatinine (3.1) and BUN (33) [she had an in between appointment where BUN had decreased to 26], They did not rerun SDMA. They checked her creatinine to protein ratio and it had decreased to 1. I realize this most recent appointment puts her in stage 3 kidney disease.
The vet wants to try a calcium blocker for the next six weeks to further slow the progression. The vet has suggested additional fluids. However, we have not started extra fluids since we recently discovered she drinks more water based on the bowls location. So we intend to try this out for the next 6 weeks. She is a nervous nelly so we do not want to cause her more anxiety.
Incase it helps, here is some relevant information about Arya: Age 10; Age of Diagnosis: 9; Sex: Female – Spade; Breed: Golden Retriever; and Weight: 80 pounds. We have two other younger dogs that seem to keep her “young” and active.
Do you know why a creatinine to protein ratio might decrease when the other numbers (Creatinine and BUN) are increasing?
There may not be a good answer but thought I would ask.
Hi Arya’s Mom,
I am so glad your girl is doing well and living her best life. She is very lucky to have you advocating for her health and well-being. The protein:creatinine ratio just gives us an idea of how much creatinine (a specific type of protein) is present when compared to all the other types of protein in the blood stream or urine. It is possible for changes in the total protein levels to alter this ratio when it is measured. While this ratio is helpful in monitoring trends and can give us insight to how the body is functioning, I would not use it alone or place too much emphasis on this result in and of itself. You are doing a great job taking care of Arya and I am so glad you shared her story with us. Wising you both continued success and happiness. Keep up the good work!
My 13 year old doxie got sick suddenly and diagnosed with acute kidney failure. His creatine was 5.8 at diagnosis. He was not eating but was still excited about walks and wagging his tail. It was a complete shock and I was devastated. He also has a heart murmur.
After two days of IV therapy, his creatine went down to 2.8. The vet decided to keep him on IV for 4 days. He is doing much better but not eating a lot. He is on anti nausea medication.
Does this mean he’s no longer in stage 4? I’m very concerned that he’s going to come home and decline without the IV. I will be giving him subcutaneous fluids.
What’s the best estimate on how much time we have with him?
Dear Heather,
I am sorry you are facing this worrisome situation with your senior Dachshund. The good news is with acute kidney injuries, if treated aggressively, they can make a full recovery and no longer show any signs of kidney damage. Not all dog’s kidneys are able to heal and recover, but many do! The discussion about prognosis is more for chronic kidney disease patients or dogs that had an acute injury that were not able to improve. So as long as your boy’s blood work is showing improvement, I would keep up with the intensive therapy and hold onto hope that he can fight this. Don’t hesitate to ask for an internal medicine specialist to get involved if you feel you need more in-depth information. Keep up the good work and I am praying for a positive outcome. ♥
hello mam
am from india and my dog have creatine level 26 and i want to make recover him so what should i do to .
please help me out mam i need my boy back 🥺
Hi Praseetha,
I understand your concern for your dog and wish I could offer the answers you seek. Unfortunately, without playing a personal role in your dog’s medical care, I can’t make specific conclusions or recommendations on how to proceed. What is your vet suggesting for testing and treatment? Do you have access to more advanced testing such as ultrasound? If your vet is worried about kidney function, then the next best step might be to test your dog’s urine to see if it shows any abnormalities. Hoping you can find the information you need to ensure your boy remains happy and healthy for as long as possible.
Hello…….
Can you send me the details of the doctor u r consulting….please
My 14-month-old Chihuahua just had a check-up with her vet. We wanted to set her up with a spay surgery but in order to be cleared for anesthesia, they did a blood test. The results just came back and her creatine level was 1.6 and BUN 34. I’m worried sick right now and since it’s Saturday, I have to wait until Monday to discuss this further with her vet. Can numbers like this be due to something as simple as her being dehydrated before the blood test, or do we have a real potential for my dog to have some issues with her kidneys? I feed her a high-quality dog food with freeze-dried fruits/veggies and beef heart as a meal topper. She also gets dried sweet potato wrapped with chicken jerky as a treat.
Hi Alyssa,
I understand your concern for you pup with these abnormal results on her lab work. I would not expect this to be due to mild dehydration. Discussing things with your vet sounds like the best plan of action. They may want to do some follow up testing or postpone surgery and recheck lab work again in a few weeks. Hoping all is well with your little girl.
Thank you so much for the helpful information! We just rescued a 2 year old Lab/Rhodesian ridgeback named Moose from Texas 2 weeks ago. They rescue told us he is just a very chill dog but as soon as we got him, we knew something was a little bit off. He was always very sleepy but we just put it off as adjusting to his new home. He had also gotten blood work done a month before while in the rescue and his BUN and CREA were completely normal and indicated a healthy dog.
This weekend he was throwing up and did not want to eat so we took him to the vet and found out he has CKD. We have already started him on a renal support diet and supplements to help. The vet told us that she suspects he is in stage 2 but after going through these comments, I am a bit worried due to his blood work. His BUN was 101 and CREA 8.7 which is extremely high. We are going back in 6 weeks to see if our treatments helps but I am just worried as it seems his numbers are so high compared to others going through this..
I am trying to learn whatever I can to know more about helping my pup but I don’t want to be overly positive and end up not being realistic.
Dear Emily,
I am so sorry you are facing this difficult diagnosis in your newly rescued pup. If Moose’s kidney values were normal a month before, this may not be chronic kidney disease and could actually be an acute kidney injury. Acute kidney injuries can sometimes resolve, especially with aggressive treatment. Here is a link to another article with more information about this type of kidney disease: Kidney Failure in Dogs: A Comprehensive Guide
I would encourage you to ask your vet about a consultation with a specialist or see if they thought Moose would benefit from a few days of intensive IV fluid therapy in the hospital. There is no guarantee his kidneys can heal and start to work properly again, but there is hope! Wishing you both all the best and praying for a positive outcome.
My 14 – 16 year-old Lhasa Apso had creatinine levels of 2.2 and BUN levels of 74. They just told us she had signs of kidney failure, and proceeded with a teeth cleaning, and pulled 5 teeth. They forgot to prescribe it IV fluids to her that day (a Friday), so we had to go back on Monday to pick up the fluids and start the treatment. She hated the fluid treatments, she would cry, yelp, whine and shake during them. 13 days after the first test, she had creatinine levels of 3.9 and BUN 67. The vet told me that was stage 4. My husband and I decided the fluid treatments were causing her too much additional pain, discomfort and was impacting her quality of life, so we decided to stop. She did seem happier for a while after that, but she passed away less than 2 months after the teeth cleaning. My question is, is it considered within medical guidelines for a vet to proceed with a teeth cleaning in a senior dog with that high of creatinine levels?
Hi Jennifer,
I am so sorry for the loss of your senior girl. I understand why you are searching for information and know how your brain tends to run through all the “what ifs” especially while grieving. Unfortunately, with this type of situation there are no clear-cut guidelines. The vet has to take into account all the medical details and make a judgement call on what is best for the health of the individual animal. If your girl’s dental disease was severe and causing pain (or at a stage that could lead to pain and suffering), then the dental procedure may have been the best option despite underlying kidney issues. Sometimes dental disease itself can cause kidney or liver dysfunction. I have seen dogs with abnormal blood work results show dramatic improvements when the blood work was rechecked after a dental cleaning was performed. Without playing a personal role in your girl’s medical care it is hard to make specific conclusions about the choices that were made. Ultimately, you did what you thought was best with the guidance of your vet. I am certain your girl lived a happy life and knew how much she was loved. I hope with time your heart will heal and I wish you all the best as you continue life’s journey.
my 18mth GSD was diagnosed with stage 2 kidney disease… birth defect, malformed kidney and architecture… She is currently on Hills prescription KD kibble and wet food and seems to be okay… how long can I expect her to stay in this stage ? she was taken off of Fortiker but I amsure there will be other medication in her future… she is such a cute girl and likes to tell everyone she is there guarding our yard but at least when she is barking I know she is okay.
Hi Lee,
I am so sorry your young dog has been given this difficult diagnosis. Unfortunately, there is no way to know how long it will take for her to progress to the next stage. Each case is different, and this type of disease is very unpredictable. I am hopeful that with this early intervention and good care she will have many happy years ahead. Wishing you both the best and keep up the good work!
Hi Dr. Buzby
Shadow is refusing food for days at a time and then will restart eating.. is this something to be concerned about? she is not losing weight from what I can tell and her behaviour has not changed..
I have been trying to hand feed her at least the kibble each day to ensure she has something..
thank you
Lee
Hi Lee,
Yes, Shadow’s lack of appetite does have me a bit concerned. It could be she is getting picky with her special food, but these can also be warning signs that the kidney disease has progressed. I would recommend you call your vet and see if they want to recheck her lab work. Hoping all is well and praying this will resolve on its own. Please keep me updated on how Shadow is doing!
We had to say goodbye to Locker, our 8yo Yorkie the same day we discovered she was suffering from Kidney failure.
is it normal for dogs to hide their symptoms? up until 12 hrs before she didn’t seem in pain. at that point we already had a vet appointment, she wasn’t eating and we thought maybe it was an infected tooth. the bloodwork showed kidney failure and we were shocked.
is kidney failure usually genetic?
5 years ago , when Locker was only 3, we went on a trip with just Locker and so I noticed her bathroom habits (more than I normally would with multiple dogs and the doggy door.) i thought it was a little odd sometimes she would hold her urine for very long periods of time, and pee only twice a day. at the time i thought maybe her routine was just out of sorts from being on vacation. Could this have been sign that something was not right with her kidney function for a long time?
Dear Nikki,
My heart aches for you with your recent loss of Locker. It is very common for kidney disease to develop with little to no symptoms and seem to come out of nowhere. I can almost guarantee you didn’t miss any symptoms and could not have done anything to prevent this from developing. Kidney disease can be genetic but also does not have to be. Normally once the kidneys start to fail a dog will have to urinate more frequently and start drinking more water. I would not think the bathroom habits you described would be a sign of kidney problems, so don’t carry around any guilt from that. It is normal while grieving to ponder all the “what ifs” and I understand the want to get answers for why things happened the way they did. I hope with time you will allow yourself some grace and be comforted knowing your girl was well loved and lived a great life. May her memory be with you always and be a blessing in your life.
Good day, my six yea old Boxer dog has recently been diagnosed with kidney decease. i have gotten the medication for treatment as well as the renal royal canin dog food. i have tried to put other food on it so that she can eat the pellets, but she eats around the food. try to make it softer so she cab intake some of the pellets. nothing helps. any advice on what else to try so she can atleast intake some of the pellets?
Hi Maryke,
I am sorry your Boxer is showing signs of kidney disease. Is your pup not eating the food because she doesn’t like the taste or is she having trouble eating due to weakness or dental disease? If it is just a taste issue, I recommend you discuss this with your vet. There are MANY different brands and kinds of prescription kidney diets available. So, it could be worth trying a different brand to see what your dog likes best. Also, I know prescription food is expensive. Luckily some companies will allow your vet to return the food if a dog is unwilling to eat it. Don’t hesitate to talk to your vet and the two of you should be able to troubleshoot this situation together. Best of luck to you and your sweet girl.
PS: Our little dog within a week was able to stop ALL meds she had been placed on for pain, nausea, Entyce, and something to prevent ulcers. The raw fermented goats milk took the place of all those meds, healed her intestines, gave her appetite back, peeing and pooping normal as opposed to chronic bouts of diarrhea. Our last set of labs about 3 months ago were almost back to normal parameters and way better than they had even been for the last couple of years. Rita Sue Memering
Rita Sue, where do you obtain raw fermented goat’s milk? I’ve never heard of it! Did it really reverse your dog’s kidney disease? Do you still feed the goat milk to your dog, and do you also feed any special kidney care diet?
Thanks!
Hello. I have a 15 y/o with CKD diagnosed in Jan 2023. She was not doing well at all and I was being encouraged by 3 different vets to end her suffering. She wouldn’t eat except for a little Royal canin kibble and was basically also starving to death. A friend referred me to a pet nutritionist , Dr. Cathy Alinovi in Clearwater FL. We had a phone consultation for $195 and she spent a lot of time with me. She had me stop the kibble immediately as it dehydrates the kidneys and hard for the kidneys to process. She had me start raw fermented goats milk from a pet specialty store, 1 cup a day for her weight of 5 lb, for a week for nutrition and hydration and the difference was remarkable. She is eating very good for her and still getting about 1/2 cup of goats milk a day. She is completely off prescription Royal Canin wet and dry commercial dog food. I’m home cooking and also alternating with Small Batch beef lightly cooked. I’m considering Farmers Dog or Ollie as that is human grade food for dogs, very high quality, and probably not that much more expensive than the prescription RC. She is thriving but there is one caveat, we are also giving her subcu fluids every other day at home, we get the fluids from our vet who let us watch the techs until we were comfortable doing it at home. Dr. Cathy saved our little girl and if you are out of options, you should reach out to her for your specific breed recommendations. Good luck and take care. Rita Sue Memering
Hi Rita,
This is wonderful information! What a blessing your senior girl has made such a dramatic improvement and is now thriving. Thank you for being willing to share your story with our readers. I did see all three of the comments you submitted and will make sure to get this and the “PS:” reply published on the site. Wishing you and your sweet girl the best as you continue life’s journey together!
A local pet bakery owner recommended raw goats milk for my dog and My Perfect Pet low phosphorus food several years ago for my now 17 yo Coton. I highly recommend these, but check with your vet (although my vets are wary of the raw goats milk, I know it helps my boy and he loves it).
I have a 14 year old Westie who almost died 6 months ago when, out of nowhere he was taken ill. When he recovered they discovered that he has Stage 2 Kidney disease..
Change of diet and he seemed much better but the disease can progress quickly and today he was diagnosed stage 4.
My other Westie, same litter, who has Sick Sinus Syndrome was also diagnosed stage 1 today, so far he has no symptoms
What I can tell you is that Royal Canin also make a Renal Select dog food with a more appetising taste and texture and a wet food in sachets which are both really good. I would definitely recommend the Renal Select over the regular Renal for fussy dogs, and mixing with the pouches will also add moisture which is important as dehydration can be a serious issue for dogs with Renal problems. The bags of renal select even show you how much of the dry to mix with the pouches to provide the correct nutrition.
Don’t forget to make sure there is always ample fresh water available at all times
Good luck.
Hi Simon,
Thank you for sharing your experience and offering some suggestions that could be very helpful to others. I am sorry both of your dogs are facing these health issues. It sounds like you are doing a great job advocating for their health and well-being. Wishing you all the best and keep up the good work!
Thank you for your website, very helpful.
My 11yr old dog had a creatinine of 5.8 on 7/29 (my vet told me 7/31) so immediately went to emergency vet and was admitted with a 12.56 creatinine, urine culture positive for e coli. Discharged 8/11 @ 3.7 creatinine.
Pushed SubQ fluids for several weeks at home, but she kept around 2.7 creatine on checkups.
Then today (8/30) she is 0.86 creatinine. Wild rollercoaster ride, hope this gives hope to anyone else who has an acute infection kidney failure.
Hi Michael,
I am glad your pup responded so well to the treatment and her blood work is looking better. Thank you for sharing your experience with our readers! Wishing her continued healing and praying for a full recovery. ♥
Hi! I think my 11 yr old shih poo is living a similar moment. He was 1.5 a year ago and again half a year ago and then in a matter of a couple days he just got sick, lost tons of weight and appetite. He is submitted to the hospital with a creatinine of 11… it went down to 10 but they’re seeing other issues. Did you see any other internal issues at the same time? Stones, swelling in pancreas, etc?
Can you send me the details of the doctor
My 16 month old shiba inu puppy just got blood work done and her results are SDMA – 19, Creatinine – 10.7. I thought she just wasn’t meshing well with her diet. I never thought in a million years it would be kidney disease since she’s just a baby. This is a great article and I wish I knew all this sooner so I could’ve caught it earlier.
Hi Ky,
I am so sorry your young pup is battling kidney disease. Praying she can keep fighting and get things turned around quickly. Wishing you both the best as you navigate this difficult path. Bless you.
Thank you for the in depth article on kidney disease / renal failure.
It’s is very helpful & informative for me & my family to better understand expectations for our beloved 4-legged family member..
We have an excellent & caring veterinary team but having access to this article is extremely helpful in setting expectations & milestones in our Dog, Nicki’s, journey.
Hi Casey,
Thank you for the positive feedback about the article. I am glad it was helpful and offered some guidance. Praying for your pup and your family as you navigate this unknown path. Wishing you all the best!
Our 14 lb. Mini Poodle was diagnosed with kidney disease. When we set her spirit free May 26.23 she was down to 9.2 lbs. Molly wore diapers for 2. 1/2 years/only at night, as there were a couple of accidents on the bed. Five months ago we thought we were going to lose her, but the vet put her on pills to curb the bouts of diarrhea, anti nausea pills to help her appetite, and pills to prevent stomach ulcers. She went one or two days without food, but then it became 4 days quite often; we tried all kinds of food to entice her. Molly started having accidents in the house which was unlike her. We were not ready to let her go, but did “the kind thing” as our vet put it. We second guessed ourselves as she had some ‘good days’, and that confused us. We had to make ourselves think logically, instead of only with our hearts the day she left the earth. We miss her terribly, and will til the day we die. I only tell the full story so that it may help others who are going through this and have to make ‘the hard decision’ to do ‘the kind thing’. Reading the posts on here helped us as we are grieving, I hope the posts will help others experiencing the sadness of losing a beloved pet.
Hi Arlene,
My heart goes out to you on the loss of Molly. It sounds like she had a wonderful life with you and that you took amazing care of her. I’m sure it was difficult, but I really appreciate you sharing your though process around making the decision to set her free. You are exactly right that sometimes you have to go with what your brain knows is right even when your heart can’t bear the thought of losing your beloved dog. I hope you are able to find comfort in remembering all the wonderful times you had with Molly. Thinking about you!
My dear friend Dr. Dawnetta Woodruff wrote a blog that talks specifically about making the decision to euthanize a dog with kidney failure, so I wanted to share it with you in case it can bring some comfort and peace: Dog Kidney Failure: When to Euthanize Your Dear Dog
Hi Dr. Buzby,
I have not been back to your site for 6 months. Thank you for your kind words. My husband and I are still struggling with the loss of our Sweet Molly. It has been 9 1/2 months, and I still have what I call ‘Molly Moments’ where the heart breaks and the tears flow. However, we are comforted in knowing that we did the right thing, to let Molly go peacefully. We did ‘the kind thing’ and set our Molly free, in time, before it got to the point of an emergency vet visit. If we had waited too long, it would have been more traumatic for our Molly, and we would have lived with the guilt of waiting too long, and letting her suffer. Thank you for the blue highlighted links to the articles. I read them, and HIGHLY recommend others read them as they are informative and comforting. (I do not know you, but would like to compliment you, as I can see that you are in the profession you are meant to be in, and that you are a kind, caring Doctor. Families and pets are blessed to have you)
Hi Arlene,
I truly appreciate the kind words and thank you for taking the time to give some feedback about the other articles. I know you miss Molly each day she is not by your side, but I pray that her memory will stay with you always and continue to be a blessing in your life. ♥
Thank you so much for your article. I have read it at least five times at various phases of us dealing with this illness. Our 6 year old rescue dog was diagnosed with CKD a year ago. She had no symptoms at the time and we found out on a routine blood test that her creatinine was elevated. Her levels were relatively under control for 7 months and slowly started to rise, when we admitted her for IV fluids. Her creatinine then came down from 3.8 to 2.4. It remained stable at 2.8 for 3 months and has now started to rise again. The past week her appetite has been s0-so and she’s started to get tired on her walks. She’s an extremely picky eater, and it’s really hard to keep up with a wholesome kidney diet. As her levels rise, we find that she only picks out the protein in her meal and refuses to eat anything else. I’ve read extensive articles talking about how nutrition is the cornerstone of managing progression, been through several diet charts, but it’s so hard to get her to eat full meals. Would you have any advice on how we can manage nutrition when we’re at the stage where they get really picky with their food?
Hi Veda,
I understand your concern for your pup and applaud you for taking such an active role in advocating for her health and well-being. Food aversion/decreased appetite in dogs can be so tough to manage. I always wonder if there is some level of nausea contributing to this problem. Even if a dog is not vomiting, they can still have nausea to the point that they would rather not eat. You could talk to you vet about a trial course of antinausea medication to see if that makes a difference. Also, probiotics can do miraculous things. You would be surprised at all the bodily functions gut health can affect. As things progress, your vet might also talk about adding on an appetite stimulant. I am hopeful you can find some ways to encourage your girl to eat. Praying you can keep her kidney issues stable and maintain her quality of life. Wishing you both the best for many happy days ahead.
Thank you, Dr. Buzby, for this excellent article. It was very clearly written and helpful to pet owners who are not VMDs. Our dog has an SDMA of 8, creatinine of 1.3, BUN of 28. Her initial symptoms were excessive urination (wetting the bed at night) and drinking. We are in the middle of additional tests. Our vet and we are hoping that this may be Cushing’s disease. Can you shed some light on the difference in symptoms of Cushing’s vs. kidney disease? What will tip this one way or the other? Could a dog have both Cushings and kidney disease? It sounds like if this does turn out to be kidney disease, we are fairly early in its progression. Our rescue dog is 13 years old. Thank you!
Hi Anne,
Thank you for your kind words! It is our mission to provide in-depth and high-quality information to dog parents, and I’m so glad to hear you enjoyed the article.
Those are some good questions! I suspect that by now you and your vet have already figured out if your dog ended up having kidney disease, Cushing’s disease, or both, and I hope she is doing well. But to answer your questions, yes, it is possible for a dog to have both conditions at the same time. Unfortunately, so many of the symptoms of the two conditions overlap that it can be hard to guess based on symptoms alone which of the two a dog has. This is where bloodwork, such as a ACTH stimulation test, low dose dexamethasone suppression test, and repeat checks of BUN, Creatinine, and SDMA can be helpful. If you have further questions now that you have a better idea of what was going on with your dog, please feel free to ask them. All the best to you and your rescue dog!
excellent article.. mine had an sdma of 26.4 this week; 6 months ago 14.7 and in august 2022: below 10.
his crea: 1 mg/dl & buen: 16.13 mg/dl. urinalysis show no problems.. sg: 1.030
we are putting him on stage 2 preventions plus giving him ipakitine.
my question is: up to what level protein can we give him. for example his food has 27% how much is too much.
thank you
Hi b.p,
I am sorry your dog is showing signs of progression of his kidney disease. I think it is great you are monitoring what he is eating and trying to make sure the nutrients are ideally balanced. Unfortunately, since I have not played a personal role in your dog’s medical care, I can’t make specific recommendations on his diet. This would be a great question for your vet! They can give you guidelines to follow when selecting a food for your dog. Also, they should have access to a veterinary nutritionist and internal medicine specialists if needed.
Thank you, these articles have been very helpful in understanding this horrible disease. Unfortunately, I had to let my 14.5 yr old baby Toby rest 3 days ago. He had excellent, normal bloodwork for a dog his age as of December. He had one bout of vomiting & diarrhea at the beginning of February, which the vet sad to see if it resolved at home w/ a bland diet & if not, bring him in. It resolved at home so I didn’t bring him in, which I am now deeply regretting.
On March 1st, he started skipping breakfast, & after 2 days of that, since he had always been a piglet regarding food, I brought him in. The vet didn’t even suggest kidney problems, but examined him & said he looked fine & that they could do a chest Xray because it might be Heart Failure (he had stage B1 valve disease). I’m the one that suggested kidney issues, as his “smell” had changed & it reminded me of my other dog that died of kidney failure in 2020. Sure enough, his creatinine was at 3.8. They advised an ultrasound to check for blockages, since his levels were normal 2 months earlier. Finding none, they admitted him to the hospital for 2 days, however they only kept him for 1 day because of his severe separation anxiety & he was freaking out in the hospital. They discharged him after one day with creatinine of 3.4. I had informed them of his separation anxiety & asked if there was an alternative, like giving him fluids at the hospital, but bringing him home at night, but this is a large specialty hospital & Internal Medicine refused to even speak to me & told the primary vet “just admit him”. They also discharged him with no kidney food, or any other medications besides Cerenia.
He also had ultrasounds there in September & December, as they felt his liver was enlarged during his Primary Care check up in August. Both times, they only mentioned nodules on his liver & some gall bladder sludge. The December Ultrasound was to clear him for the Dental that they encouraged. I told them I was concerned with putting him under for the Dental at his age & because I had 2 other dogs that seemed to go rapidly downhill after their dentals, but they claimed the oral bacteria was more of a danger. However, NO MENTION was ever made to me about “chronic age related changes” to his kidneys on his ultrasounds until March when he was admitted to the hospital, at which point they acted like I should have known that! I most certainly would never have agreed to the dental had they told me that, & it was never mentioned when he had the vomiting & diarrhea in February OR when I brought him in for skipping breakfast in March. This is a large facility & the communication is very poor & he saw a different vet every time, including some who were only Residents without my knowledge. I transferred his Primary Care there, since he was already seeing a Cardiologist & I thought it was better to have it all under one roof, and they are supposed to be “the best”. A grave mistake that I regret for the rest of my life.
My question is: should a 14 year old dog have been put under anesthesia for a Dental if he was already showing chronic kidney changes on his ultrasounds at least as early as September, aka Early Kidney Disease? It seems clear that this information was not added to his chart, as it was certainly never mentioned to me, & neither the vet from the vomiting episode in February or the vet from the inappetence in March suggested a connection to kidney disease either.
Dear Pamela,
I am sorry for your loss of Toby. It is obvious he was dearly loved, and I can only imagine how much you miss him. Kidney disease can be very cruel and progress quickly with little to no warning. Since I did not play a personal role in his medical care, it is hard to make specific conclusions about how things progressed or weigh in on the decisions that were made. I will say that I agree that the negative effects of dental disease can outweigh the risks of anesthesia for a dental procedure. I frequently will recommend dental cleanings for patients that have some underlying kidney issues and have put my own pups under anesthesia despite having some mild kidney changes on bloodwork. You made choices for your boy that were in his best interest and under the guidance of the veterinary team. I hope with time you will be able to lay down the unnecessary burden of guilt you are carrying and focus on all the good times you shared. May Toby’s memory be a blessing in your life. Wishing you peace and comfort for your heart.
My beagle Spike was just diagnosed with stage 4 kidney disease yesterday. He will be 13 August 1st 2023. Today is Friday I have not stopped crying since his vet visit Tuesday. I was really hoping the vet was going to say it’s just old age. The vet’s recommendation was give him the best month or 2 of his life then day goodbye. That is the last thing I want to do. I have had him since he was 6 months old. . His previous owners went to prison on over 50 animal abuse charges. We have gone thru hours surgeries from his past owners. The death of my late husband., an empty nest, to grandkids and me getting remarried and severe health issues in between. I tease and say he is my favorite child. How do I know when it’s time? I don’t want him to suffer. He has days when he will be walking down the hall and peeing at the same time, or sleep all day. To days he will play with the puppies in the backyard. I don’t want to be greedy and hold onto him and him suffer. He doesn’t deserve that. But what if he isn’t ready? I’m lost and confused.
Dear Tammy,
My heart goes out to you as you face this difficult decision for Spike. I can only imagine how hard it is to think about saying goodbye after all the years you have spent together and memories that have been made. I will attach links to other articles with more information and great advice from other readers. I am hopeful you will find the answers you need to make the best choice for you and your sweet boy. Praying for your comfort and strength. Bless you both.
1. Using a Quality of Life Scale for Dogs
2. Dog Kidney Failure: When to Euthanize Your Dear Dog
3. Preparing for Your Dog’s Euthanasia: 10 Thoughts for Peace
4. How Will You Know When It’s Time to Euthanize Your Dog? 5 Caring, Heartfelt Messages
we found out today same results as you.. we chose to bring him home and give him meds plus an IV. we are watching for the next 48 hours to see if he gets better. if he doesn’t we will have to say goodbye as well. My heart is so broken right now waiting to see if he can turn it around.
Dear Kandy,
I am so sorry you were faced with this most difficult situation. I hope your sweet pup was able to make a miraculous recovery and is still by your side. Feel free to leave an update if you have a chance. Keeping you in my thoughts. Bless you both.
thank you so much for this very informative article. My 10 yo golden was diagnosed a year ago after a “crisis” of vomiting/UTI/dehydration etc. Her levels were alarming but brought down a lot over 8 nights in hospital. Now a year later I can see we have progressed to Stage 3, she is medicated at the highest level and now I just have to constantly be on alert for food aversion caused by nausea etc and hope she continues the progression at the top end of the average survival rates, which might give us another 6 months with the most dedicated of our family. Its always difficult to remember later what the vets said and what various readings etc mean so articles like this are a really good reference point.
Dear Karen,
I am sorry your dog’s kidney disease has progressed and he is requiring intense treatment. He is a very lucky boy to have someone like you advocating for his well-being and dedicated to maintaining his quality of life for as long as possible. Thank you for the kind words about the article. I am glad it was helpful for remembering important details about this disease. Praying for your strength as you continue forward on this unknown path. Bless you and your sweet boy.
I just got back from the vet. They say my dog has kidney disease. Creatinine is 1.9 and the Bun is 34.5. They couldn’t give me a stage in a number just that is is bad . He has a UTI and was given antibiotics. A dog food specifically for kidney care. He had blood work in late December and everything was fine. Does this really happen that fast? They thought at first he had diabetes. With the extensive blood work they change to kidney disease. I am not sure if it’s super bad and I will lose him in like a month or so or will he survive till fall. He is 14.5 yrs old.
Hi Katue,
I am sorry your senior guy is having issues with his kidneys. Unfortunately, it is common for kidney problems to show up quickly and without much warning. There is really no way to know how this will progress. I am hopeful that your pup will respond favorably to the medications and prescription food. Make sure to stay in close contact with your vet and keep them updated on any changes to your dog’s behavior. Praying your sweet boy can keep fighting and have many happy days ahead. Wishing you both the best.
Thank you for this article
Out 14 month old German Shepard was just diagnosed with early signs of kidney disease. She’s so young I am just trying to understand.
Hi Nancy,
I am so sorry your young pup has received such a difficult diagnosis. Here is a link to another article that may offer additional information: Kidney Failure in Dogs: A Comprehensive Guide
My thoughts are with you as you navigate this uncertain future with your Shepherd.
Thank you for this information. My baby Oakley is just about to turn 8. He is in stage 4 renal failure and it’s devastating. If you looked at him you’d never know he was sick. He is still eating but not with gusto. We know our time with him is limited so now we just want to savor and enjoy our remaining time with him. I wish there were concrete reasons as to why his kidneys started failing. I thought we had years left with my Oaks. This wasn’t supposed to happen!
Hi Rosie,
I am so sorry Oakley is battling this tragic disease. I know you are facing some difficult times ahead but glad to hear your sweet boy is feeling ok for now. Make the most of the time you have and try to find joy in each day. When the time comes, I hope Oakley’s passing will be smooth and peaceful. You are in my thoughts. Bless you both. ♥
We just got back from vet. my 16yr old bichon has sdma @24
crea @3.0
bun @ 83.
Just is April the vet started to see slight kidney disease but this is so fast.
Your article helped me understand the disease much better. I appreciate you writing this for us.
Thank you,
Lynne & Snowball
Hi Lynne,
So sorry to hear that Snowball’s kidney values are worsening. It is always such a shock to go from mild kidney disease to much more significant kidney disease in a short time frame. My heart goes out to you. I’m glad to hear that my article helped you understand and process what is going on with Snowball. That’s what we are here for. Please feel free to reach out with an update or any questions. Hopefully Snowball’s kidney disease has stabilized and she is continuing to live her best life with you.
We have a 7 year old German Shephard that was diagnosed at 1 year old with only one functioning kidney with stage 1 kidney failure. We have him on Science Hill K/D diet RX food. He has been great and very healthy and energetic. He is now in early stage 4 kidney failure. He has had a great life and more to have him at least one more year. Find a great vet that checks your puppy’s blood regularly. Good Luck to you.
h
Hi cheryl,
I’m sorry to hear this. we have a similar situation with GSD mix and one kidney. He’s 6 now, and we’re not sure what stage he is at.
We’re hoping we are doing everything right and he lives happily for a few more years.
I hope the same for you too,
Bee
Hi Bee,
I am sorry your shepherd is battling kidney disease at such a young age. Thank you for offering support to others as they face a similar situation. Praying for comfort for your sweet boy and wishing you all the best for many happy years ahead.
This article was very helpful. My 14 year old yorkie (Olivia) has been to the vet 3 times in the last 2 weeks with a 48 hour stay. We were told that her renal function numbers were off the charts upon admission. The lab re-check after 2 days of fluids and IV antibiotics, her numbers improved significantly, however, I believe they are still high. They did say she also had a UTI, which has also improved., so they said she could come home. My issue is she still isn’t eating, it’s been 6 days, and they sent her home with oral medication in the form of pills. If I can’t get her to eat anything, how am
I suppose to give her the meds? I just don’t want to continue this cycle and putting her through all of this if the outcome isn’t going to change. At what point so I say enough and let her rest. My heart is shattering watching her struggle.
I need to mention that she is also toothless and blind and hypersensitive.
Dear Miranda,
I am so sorry you are in this difficult situation with your little pup. It does sound like Olivia’s health is declining rapidly and she may be nearing the end of her days. With her lack of appetite and the poor state of her kidneys, it would not be wrong to consider euthanasia in this instance. Sometimes saying goodbye is the most loving option and only way to give a beloved dog peace from their struggles. I highly recommend you have an honest conversation with your vet and ask them to do a quality-of-life evaluation for Olivia. I will attach links to other articles that may offer additional information and great advice from other readers. How are things today? I am hopeful you will find the answers you need to make the best decision for you and your sweet girl. Feel free to leave an update if you have a chance.
1. Dog Kidney Failure: When to Euthanize Your Dear Dog
2. Using a Quality of Life Scale for Dogs
3. Preparing for Your Dog’s Euthanasia: 10 Thoughts for Peace
My sweet girl is 11 years old, she was taken to the vet for what I thought was just an upset stomach or GI issue. Her blood levels never indicated kidney failure. After about a week of loss of appetite and vomiting and diarrheai took her back in for a full blood panel; there we were told her creanatine level was at 4.5. And that she was having kidney failure, just like that! She is currently submitted in the UCI on fluids and antibiotics trying to reverse the kidney levels. On day 1 her levels went down to 2.6 and since has gone back up to 4.1. BUN is down to 84 (was 109). Is this a sign she is not getting better? They are suggesting moving her to internal medicine. With the tests thus far she does not have pancreatitis, cancer, or high blood pressure. This keeps me optimistic but my heart is broken and I feel helpless and confused. Please help.
Hi Jackie,
I am so sorry your sweet girl is fighting for her life. I am not sure I can make specific conclusions about how things will progress without personally having a hand in her treatment and care. It sounds like she is in the right place, and everyone is working hard to give her the best chance of pulling through this. How are things today? I am praying the veterinary team has found some answers and your senior girl is still holding strong. Feel free to leave an update if you have a chance.
Our terrier mix has stopped eating, though he still drinks about the same amount. Our vet visit was less than informative and we appreciate your article. We were sent home with an expensive bill and special canned food and medication to be mixed in. Unfortunately, his chief symptom is loss of appetite, even for treats. He hasn’t eaten any of his usual food, much less the disgusting mix the vet prescribed. The few times he has taken a small treat he has later regurgitated it. He won’t even lick gravy off my finger.
As a result of his loss of appetite, he has dropped from a slightly overweight 15# to 11# in the past week. He is noticeably weaker, has no interest in play, and spends most of his time asleep. It is hard for him to jump up into our laps and he passively tolerates being picked up, something he has never enjoyed.
We have another appointment this afternoon.
Hi Fran,
My heart goes out to you as you navigate this difficult path with your little pup. I am sorry he is having so many issues and struggling to find the will to eat. It sounds like his kidney disease may be more advanced. How are things today? What did you find out at his follow up appointment? Here is a link to another article with more information that may be helpful: Kidney Failure in Dogs: A Comprehensive Guide
Praying you were able to get some answers and find a way to restore your sweet boy’s quality of life.
Thank you for sharing this comprehensive overview. It’s the best info I’ve been able to find so far! My 12 year old mini-Australian Shepherd was just diagnosed with early stage II kidney disease. She’s currently exhibiting increased water consumption, increased urination, incontinence, loss of appetite (unless it’s a treat), and has been somewhat lethargic. We are switching to a prescription kidney disease food with Hill’s. I’m hoping this extends her life as much as possible.
My questions are:
1. She has lived with (quickly treated) Lyme disease for most of her life, could this have caused her kidney disease?
2. She’s been on preventatives her whole life (Trifexis for a long time, and now Simparica). Could these have contributed to the disease at all? Should I take her off Simparica and switch to something else if it’s hard on the kidneys?
Again, thank you for your time and this info!
– Holly & Nova
Hi Holly,
I am glad you found the article informative. Thank you for the kind words! I am sorry your senior girl is dealing with kidney disease. I wouldn’t think the Lyme disease from her past would cause these kidney issues now, but it may be a contributing factor. Also, I would not be worried about the heartworm preventatives causing any negative effects. I think the prescription food is a great idea and there may be other treatments that could help prolong your sweet girl’s life. Here is a link to another article with more information: Kidney Failure in Dogs: A Comprehensive Guide
I am hopeful that you can partner with your vet to give Nova the best quality of life. Praying for many more happy days ahead!
After our previous dog of 14 yrs died in 11/2019 we were ready to adopt again and we found our little sweet Mimi right at COVID shut down (she was probably 6 months old maybe) and found out by end of May 2020 that she has chronic congenital renal failure due to her kidney structure from Ultra Sound. She started off in Stage3 sort of and now is definitely nearing the end of life in the very near future. All of her levels have sky rocketed. My kids have taken such care with her and she has led them through some very challenging times emotionally. Now it is up to me to prepare my two young children for her end of life and contacting an at home euthanasia vet- it has been an unpredictable journey as no one could really predict how long she would have since she was born this way. It has been 3years and 3 months of life and our Vet Staff have all fallen in love with her sweetness, zest for life and told me today that they were astonished at how long she has made it!
Strick kidney diet with phosphorus binder really helped her and we stuck to it!
She had subQ fluids yesterday and since then has been breathing with some difficulty and doing a little huffing, which leads me to believe that it was more negative (possible fluid overload in lungs) than positive. As she is still drinking and eating, I will not do another round of that. We are enjoying each hour we have with our Sweet Mimi!
Thank you for helping other owners – I am so grateful that we can help our animals pass with kindness and compassion.
Dear Vegas,
My heart goes out to you as you prepare for the end of Mimi’s life. What a blessing she was able to be with your family for over 3 years. My thoughts are with you as you navigate some difficult conversations with your kids. Praying for your strength and comfort. May Mimi’s memory be a blessing that stays with you always. ♥
Thank you for posting this. My 8 year old Tree Walker caught Lepto when he was 2 years old. This effected his kidney functions but with fluids, medications and diet change he made a great recovery. for the past 6 years his kidney levels were higher than normal but low enough to not need treatment. This June his levels began increasing and in October he was officially in Stage 3. We tried some different medications and adjusted his diet and in November his levels were even higher and now he is in stage 4. We are currently practicing comfort care with him and hope that we will get a few more months with our sweet boy. What are some things we should look for that will let us know its time to assist him over the rainbow bridge?
Hi Jessica,
I am sorry your dog’s health is declining and you are facing some tough decisions ahead. I think it is great you are trying to gather as much information as possible so you will be prepared when the time comes to say goodbye. What a blessing to have spent the last 8 years loving on your sweet boy. I will attach some links to other articles with more information and great advice from other readers. I also think it is good to contact the vet who will be preforming the euthanasia (either in clinic or at your home) and go over your wishes and concerns ahead of time so there can be less decision making when you are emotional and sad. I hope you can make the most of these last days together and find comfort in knowing your boy was well loved. Wishing you peace.
1. Dog Kidney Failure: When to Euthanize Your Dear Dog
2. Using a Quality of Life Scale for Dogs
3. Preparing for Your Dog’s Euthanasia: 10 Thoughts for Peace
4. Dog Euthanasia: Knowing When to Say Goodbye
This was so helpful to me. I read everything and you made it so easy to understand it all. I have a 16 year old peekapoo and she was just diagnosed with stage 3 kidney disease. She is doing well. She has intermittent vomiting and some tremors, and she did lose several pounds But she does have a strong appetite, always !! So that me feel better to see that she is managing ok for now. Thank you so much for the very valuable information
Hi Joanne,
I am sorry your senior girl is facing this difficult diagnosis. I am hoping with some treatment she can remain stable for a long time, and you will have many more happy days together. Thank you for the kind words about the article. Glad it could give you some peace of mind about what you are facing in the future. Wishing you both the best of luck.
The IV therapy seemed to make everything worse. When we picked her up from last IV therapy she must have weighed an extra 10 pounds and was breathing short fast breaths. She was not eating or drinking even a little over the next 5 days. I took her to an Internal Medicine Specialist at BluePearl Hospital and she had a seizure when the tech took her to see the doctor. The doc did many tests and determined she had fluid in her lungs, abdomen and swollen brain. Also, now her heart was enlarged on one side. Her kidney numbers were 6 points higher than the numbers were when I took her to her regular vet before the IV therapy just one week earlier. I suspect “Fluid Overload” by the regular vet since she went downhill immediately. The Specialist vet suggested euthanasia that day but was willing to treat her in hospital but made it sound futile. They did treat her brain swelling and gave her anti seizure meds. My daughters and I decided to take her home. We called Lap of Love to come to our home the next day. We enjoyed our 24 more hours with her and she drank water and ate a little bit because of the treatments the specialist did, BUT, It was the worst day of our lives to have to say goodbye to our precious baby. This was on Oct. 4th so you were right with your Oct. 2, 2022 reply to me. Thank you, Linda
Dear Linda,
I am so sorry for the loss of your sweet girl. My heart aches for you. You did everything you could to give her the best chance for recovery and ultimately made the most unselfish and loving decision to give her peace from her suffering. I have no doubt your pup knew how much she was loved. I hope with time your heart will heal. May her memory be a blessing to you and your family. ♥
Thank you for the article. My dog was just diagnosed with early stage two kidney disease.
That said, she already has completely dilute urine, and is drinking at least 4 to 5 times the amount of water she was four months ago. These symptoms do not seem to correlate to the stage to disease. What do you think?
Hi Susan,
It is difficult to give you specifics without having examined your dog myself. The staging for kidney disease is mostly based on blood work values and not necessarily the physical symptoms. If you have any concerns or lingering questions regarding your dog’s diagnosis, it would be best to talk to your vet. You can always request a referral to a specialist if you feel like more advanced testing needs to be performed. I hope your girl can remain stable for as long as possible and allow you to share many more happy days together. Best wishes to you both.
My only 12 week old Silver Lab puppy is suffering from kidney failure. Totally devastated. We don’t know what caused it – genetic or something he was exposed to in these few months he’s been alive and the 4 weeks we have had him. The vet is waiting on the results of a Lepto test. He has been in the care of a vet for just over 24 hours and the vet reported today that the lab results were worse than yesterday but an ultrasound showed his kidneys look healthy (large as opposed to small). I am hoping with the antibiotics he is being given for a UTI, him now eating and keeping it down, and I believe, he is getting an IV for hydration and therefore peeing, improvements in the lab reports will be reflective in the next 24-48 hours. Is is possible a dog gets worse before it gets better? What are some lab result numbers to ask the vet about? I’m afraid to ask the stage of kidney failure but it seems that is very important in understanding the situation better. Can the stage improve with treatment?
Dear Ann,
I am so sorry you are facing such a difficult and tragic situation with your puppy. Since I haven’t examined your dog myself, I can’t really make specific conclusions and recommendations. I am always worried about genetic issues in silver labs. It seems as though genetic diseases are more commonly linked to this novel coat color which has become popular over the last several years. Yes, it is possible to improve the kidney function with treatment, especially when dealing with an acute issue like your puppy. The cases that seem to respond poorly to treatment are the chronic cases like would be common in older dogs. With that being said, if your puppy’s lab work is looking worse after getting fluids then it makes me worry about the odds of a complete recovery being possible. The kidney values your vet is probably monitoring are the BUN, creatinine, BUN:Creatinine ratio, and SDMA. How is your puppy doing today? Any improvement? Praying for a miracle for your sweet pup. Feel free to leave an update if you have a chance.
Ann we had 4 dogs die of kidney failure due to the new dog food we started. They were different ages. Worked with FDA and WSU vet lab who determined it was bacteria. The food was a commercial dehydrated raw food from Mud Bay. We are devastated. Check your dog food.
My 13 year old female pug has been diagnosed with stage one. I am getting her blood pressure tested as requested so I will learn more about her treatment. I am also switching her diet to a senior food that the vet has recommended.
Your article was the most helpful explaining things that I have found. Thank you.
Hi Jenn,
I am glad you are being very proactive with the testing and treatment for your senior girl’s kidney dysfunction. Thank you for the kind words about the article. I hope your pup will continue to do well with the new food and have many happy days ahead. Best wishes!
Thank you for this article! My girl (Great Dane) just turned 10 just a little over a month ago. My vet didn’t specify what stage she is in, but from I’ve been reading and from what they’ve explained to me, she is in the final stage. We are trying an appetite enhancer but it doesn’t seem to be working. She’s refusing to eat. It’s so hard to know when it’s time as her mind is still there; she’s typically alert. It just seems her body is struggling.
Hi Corrie,
I am sorry your big girl is struggling with end stage kidney disease. My heart goes out to you as you face some difficult decisions about her quality of life. From what you are describing, it sounds like saying goodbye may be the most loving option if things don’t improve. I will attach links to other articles with more information and great comments from other readers. I hope you can find the strength and clarity to make the best choices for you and your sweet pup. Bless you both.
1. Dog Kidney Failure: When to Euthanize Your Dear Dog
2. Preparing for Your Dog’s Euthanasia: 10 Thoughts for Peace
3. Dog Euthanasia: Knowing When to Say Goodbye
Hi Corrie,
I found out in April that my dog was in end stage kidney failure, she came back from boarding and simply refused to eat, and became lethargic. We did all the appetite meds, but nothing seemed to work, after 2 weeks of trying, have no idea how many foods and combinations, we finally found that she would eat roast chicken mixed with one of the new kibbles we tried. My pet food store was amazing, and had loaded me up with every sample size of every brand they carried, free! They even gave me different canned foods to try,
Don’t give up yet, it may just take some time to find something your boy can stomach. I know all of our faithful sidekicks can be very different, and I can see subtle changes in my pup, and know her time is limited, so I Let her have anything she wants ( within reason), she still loves to go for short hikes, and has more good days than bad. Yes, she sleeps a lot, her breathe is that atrocious chemical smell, but she greets me with a happy tail every day. when her joy is gone will be the hardest day ever, but, we’ll have shared far more time than I was told we’d have (I was told 100 days at best and we’re at 7 months. Keep the faith.
Hi Laura,
Thank you for sharing your experience with Corrie and our readers! What a blessing to have a local pet food store willing to give you samples to try. I love it when a community of dog lovers comes together to make a difference in a pup’s life. I am glad you have gained so much extra quality time with your sweet girl. Wishing you both the best!
Thank you so much for this very helpful article my little baby Bella only three years old was diagnosed last year with Stage 3-4 kidney failure this is some hopeful news for your readers we, the vet Dr. Erman, Saugus Animal Hospital ( the best btw I have been to most in LA) got her on sub q fluids with vitamin B 12 added
and actually reversed the disease! she is now only a stage two! She has tons of energy and seeming to be a perfectly healthy dog! we have also got her on Hills K/D prescription diet which she loves the canned wet food chicken and vegetables, she loves this food and I give her this sub q fluids now only two times a week
it was a little challenging and still is challenging to give her these fluids as I am not a nurse and terrified of needles it is a definite learning curve for this administration somedays it goes very easy other days I have a host of problems like the fluid stopping midway or the needle coming out or her jumping off my lap unexpectedly ( while I am holding her in a headlock poor baby) but I am telling you she has returned to a normal healthy happy dog! 🙏🌈. Hoping you all can do this for your pup and have very positive results it is so so heartbreaking to get this diagnosis for your for your beloved furry friend. ♥️
Hi Brooke,
Thank you for sharing your experience with our readers. Maybe this will give hope to someone else in a similar situation. What a blessing for Bella to have responded in such a positive way to her treatment. I applaud you for being willing to try giving fluids at home and taking such an active role in Bella’s therapy. Praying she will continue to thrive, and you have many happy years ahead.
thank you for the article. Our sweet 7 yr old teddy bear dog Daisy was diagnosed with kidney disease. her BUN was 38. 2 years ago she had no signs of kidney disease so were not sure how she got to this point. what stage is a bun reading of 38? needless to say we are heart broken by our news. we have her on k/d special diet for dogs.
Hi Teresa,
I am sorry Daisy has been diagnosed with kidney disease. It does sometimes happen quickly and seem to appear overnight. I am not sure what stage your pup would be classified with as the classification system is based off of the creatinine and SDMA values from her lab work. The BUN is also a measure of kidney function but is less kidney specific and can be elevated for many different reasons. I am glad you started Daisy on a kidney friendly diet. I hope she can remain stable for a long time and continue to enjoy her life and make memories. Best wishes and bless you both.
Thank you for this article as it has been very informative. My Yorkie has just been diagnosed with stage 3 kidney failure with Creatinine level 3.5 and I’m having difficulty understanding how perfect lab work a year ago turns to kidneys failing now. Started her on sub-q fluids, she will NOT eat kidney diet, and am trying to get her to take Epakitin with her food which is tough because she doesn’t want to each much just sleep. She still loves to go for her walks and loves attention so I’ll take what I can now. It will be hard to know when she needs to cross over the rainbow bridge.
Hi Joyce,
I am sorry your Yorkie has received such a tragic diagnosis. It is common for this disease to develop quickly and without much warning. I am glad you are administering a combination of treatments to try and give your little pup the best quality of life possible. Here is a link to an article that may help with knowing when to say goodbye: Dog Kidney Failure: When to Euthanize Your Dear Dog
Your sweet girl is lucky to have you advocating for her health and wellbeing. Praying you can enjoy these last days together and make them full of love. Bless you both.
Thank you for this very helpful article! Our dog Bella was diagnosed with Stage 4 in March 2021 (BUN 91, Creatinine 4.2). I think the vet felt it was hopeless so prescribed canned renal dog food and sent us off. I began homemade alternatives and her sypmtoms really improved! I changed vets but they still treated her as hopeless, She had an emergency last weekend (stopped eating) and luckily I had read your article! Went to another new vet (open weekends) and he actually made a treatment plan: gave her subcutaneous fluid & meds for the first time–so helpful! Now we know tools to discuss to help Bella. Thank you!
Hi Kim,
Thank you so much for sharing your experience with our readers! I hope it will help someone else in a similar situation. I am so happy to hear you have found a vet that has partnered with you in helping restore Bella’s quality of life and wellbeing. I appreciate the kind words about the article. I am glad you found the information to be helpful and specific to Bella’s current condition. I hope the new treatments will give your sweet girl many more happy days ahead to enjoy life. Bless you both!
thank you for your story. I am going through this right now with my Giant schnauzer. he is currently being treated for UTI and kidney failure with antibiotics and fluid IVs. He started at BUN >130 (it was so high # value didn’t even register) CR 12.3. he is on 3rd day of IV and antibiotics. today BUN 119.9 CR 8.9. ultrasound was done today which confirmed renal failure so we are basically just monitoring to see if his levels will continue to drop (PRAYING FOR SOME MIRACLE) with continue IV fluids and his antibiotics while monitoring his blood pressure and K levels. I am curious to know what the homemade alternatives and changes you made to improve her symptoms. I’m happy to hear that you are still with Bella. these are stories I need to hear right now while I await Rocky’s condition status. He is 8 years old and I pray I get a few more years with him.
Hi Cristina,
I am sorry your senior guy is struggling to recover from this kidney insult. I can only imagine how worried you must be while waiting to hear of your pup’s progress. I hope he is able to continue fighting and stabilize. How is Rocky today? Praying you receive that miracle. ♥
What are those homemade alternatives? My dog, Max, don’t want to eat renal kibbles and he lost weight and developed anemia. and recormon is not helping much, so I am preparing rise and chicken for him and he is eating now.. .
Thank you for this informative article. You answered so many of our questions concerning our Greyhounds journey of life with kidney failure.
Hi N Speese,
Thank you for the feedback on the article. I am glad you found it informative and helpful. Best wishes to you and your Greyhound as you navigate this new path.
Thank you for the article. Our sweet dog was diagnosed 1.5weeks ago with mid stage 2 kidney disease, but she seems far worse than she should be according to your article. We are giving her fluids nightly and changed her to an all kidney friendly canned dog food (given by our vet). She is also on a nausea medication and an appetite accelerant. She has definitely declined in the last week. All she does is sleep. When we take her outside she stumbles. We are at the point where my husband has to pretty much carry her. She barely eats and drinks, but still loves us nearby and her tail wags when we come home or lie down and pet her. She is displaying all the signs of stage 4. I don’t want her to suffer, but it’s hard to let go when I keep reading that stage 2 is treatable. We are trying everything the vet suggests, but nothing seems to make her better.
Hi Aimee,
I am so sorry your sweet girl is struggling, and her health is declining. I agree that it sounds like her condition is much worse than previously thought. Unfortunately, the most loving option at this point may be “letting go”. Here is a link to another article with additional information: Dog Kidney Failure: When to Euthanize Your Dear Dog
I hope you can find the answers you need to make the best decision for you and your pup. My heart goes out to you while you walk this difficult path.
How does stage 2 insufficiency in a 4.5 year old dog impact the length of its life?
Hi Cathy,
Unfortunately, we really don’t know for sure. As the article states, an older study showed that dogs diagnosed with stage 2 kidney disease lived for 200 to 400 days on average. The rate of progression varies significantly between individual dogs and IRIS has not provided any specific prognosis or life expectancy for each stage.
This information was exactly what I’ve been looking for: help in understanding the stages and progression. I can now ask my vet more pertinent questions. This is so difficult!
Hi Karen,
I am so glad you found the article to be helpful and informative. Thank you for sharing your thoughts and taking the time to leave some feedback. Wishing you the best as you navigate this difficult path.
Thank you for this article. It has been extremely helpful, and like the above comment states, this article has given me the tools to ask questions and understand more about this disease.
Hi Lynne,
Thank you for the kind words about the article. I really appreciate you taking the time to let me know what you think! Glad the information was helpful and best wishes to you and yours. ♥
Yes I have found this verry helpful and it has given me the tools to ask questions and understand more about kidney disease .
Hi Jeanette,
I am glad you found the article helpful and informative. Thank you for taking the time to give some feedback!
My 11 yr old Min Pin is in stage 4 but was diagnosed about 2 years ago with first indication being just
her blood work numbers. She has been on renal support food since then with some admitted cheats of a puppachino once in awhile.. Her numbers were not too bad 6
months ago. Then all of a sudden 3 weeks ago with infrequent eating and some vomiting.
Vet tested and new numbers are highest possible on chart for both BUN and Creatine.
And now mild Pancreatitis added. She put her in IV fluids daily for 3 days at clinic. (not overnight). Tests show no change for kidneys but it did help Pancreatitis. She won’t eat or drink now.
The anti nausea meds and Entyce appetite inducer are not working to get her to eat. I carry her outside to pee small amounts. She will lick water off my finger but wont lap it
out of bowl herself. She is sleeping most of the time and wants me in her site or beside her. I can get her to take antacid pill in a smear of no sugar peanut butter. This is so painful.
Thank you for your information on this disease.
Hi Linda,
My heart aches for you as you watch your senior girl’s health decline so rapidly. It sounds like her final day may be approaching quickly. From what you are describing, saying goodbye may be the most loving option at this point. I will attach links to other articles with more information and great comments from other readers. I hope you can find the strength and clarity to make the tough decisions ahead. Bless you both.
1. Dog Kidney Failure: When to Euthanize Your Dear Dog
2. Signs Your Dog is Dying: A Caring Message to Bring You Peace
3. Preparing for Your Dog’s Euthanasia: 10 Thoughts for Peace