Chronic Kidney Disease (CKD) in Dogs: Symptoms, Diagnosis, and Renal Diet

Introduction

Chronic Kidney Disease (CKD) refers to the irreversible progressive deterioration of kidney function in dogs. Contrary to acute kidney injury, chronic kidney disease occurs slowly over several months or even years. Due to the high reserve capacity of the kidneys, symptoms may not be evident until there is a significant loss of function, specifically up to 75% of the organ's function.

CKD in Dogs | Early Warning Signs & Management | VetInsight PK

​Why Is Chronic Kidney Disease on the Rise?

​Apart from advancing age, the recent increase in cases is attributed to:

​Periodontal Disease: 

Oral bacteria causing damage to the kidneys after entering the blood stream.

​Chronic Infection: 

Ehrlichia and Leptospirosis caused by ticks.

​Nutrition: 

High phosphorus levels and low-quality processed food.

​Common Symptoms (The "Red Flags")

​PU/PD (Polyuria & Polydipsia): 

Frequent urination and drinking. This is usually the first symptom observed.

​Uremic Halitosis: 

An unusual ammonia-smelling breath.

​Poor Appearance: 

Unthrifty appearance regardless of good appetite.

​Oral Lesions: 

Ulcers within the mouth caused by toxin buildup.

​Nausea: 

Morning vomiting due to hyper-acidic stomach fluids.

​Classification and Diagnosis

​Veterinarians rely on IRIS (International Renal Interest Society) classification based on:

​SDMA Testing: 

Innovative test able to diagnose CKD early with only 25% loss in renal function.

​Serum Creatinine & BUN: 

Classic indicators of glomerular filtration.

Urinalysis: 

Detecting low Specific Gravity (concentrated urine) and Proteinuria.

Blood Pressure: 

Hypertension is a typical consequence of CKD.

Multimodal Management of CKD

​CKD is an irreversible condition, therefore, the aim of treatment will be reducing the pressure on the kidneys and controlling Uremia:

​1. Dietary Modifications (The Most Critical Step)

​Low Phosphorus: 

Controlling Phosphorus levels is the most effective method for delaying CKD progression.

​High-Quality, Low Protein: 

This reduces "Uremic toxins".

​Omega-3 Fatty Acids: 

This helps reduce inflammation in the kidneys.

​B-Vitamins: 

As CKD dogs lose vitamins through urine, supplementation is required.

​2. Fluid Therapy (Hydration Is Crucial)

​Subcutaneous (SQ) Fluids: 

Giving subcutaneous fluids at home or in a clinic ends dehydration.

​Fresh Water Access: 

Ensure that the dog has access to fresh drinking water at all times since they have dilute urine due to the kidneys' inability to concentrate it, thus dehydrating easily.

​3. Pharmacological Interventions (Medications)

​Phosphate Binders: 

If low phosphorus levels are unachievable through dietary management, then Aluminum Hydroxide and Lanthanum can be given with food.

​ACE Inhibitors (e.g., Enalapril or Benazepril):

 These drugs help regulate blood pressure in the kidneys while reducing protein loss (Proteinuria).

​Antiemetics: 

Maropitant (Cerenia) or Famotidine can be given to relieve morning sickness and vomiting.

CKD Conclusion

​​Although being told that your pet has CKD can be alarming, it does not mean that your pet will soon pass away. If detected early enough by SDMA testing, following a diet prescribed to CKD patients, and managing fluid levels carefully, many dogs will enjoy a comfortable existence for years to come after diagnosis. It is best to take action before any symptoms become too serious. Keep track of your dog’s hydration and dental hygiene now to benefit his kidney health later.