Kidney (renal) disease in dogs happens when their kidneys stop working properly. Kidney disease may be acute (sudden) or chronic (gradual).

Acute kidney failure (acute kidney injury) is a life-threatening illness. It can affect dogs of any age, breed or sex. Around 0.5 to 7% of all dogs will develop some form of kidney disease in their lifetime. Acute kidney failure usually develops within a matter of days and symptoms become very serious very quickly.

Acute kidney failure happens when your dog’s kidneys suffer damage and stop working. They may stop producing any urine at all, which leads to a build-up of fluids and toxic waste in the body. This makes your dog very unwell. Acute kidney failure can sometimes be reversed with rapid and intensive vet care. But it’s a life-threatening illness and around 30-50% of dogs who develop acute kidney failure won’t survive. Dogs who do recover may develop long-term problems, especially chronic kidney disease (CKD). The sooner acute kidney disease is recognised and treated, the better the chances of long-term recovery.

What is acute kidney failure in dogs?

The kidneys are 2 small, but essential, organs in your dog’s abdomen (tummy).

Their functions include:

• controlling fluid and salt levels in the body

• removing toxins and waste from the blood

• producing some hormones.

When the kidneys stop working, the body can’t control fluid and salt levels. All the organs and tissues which depend on this control also stop working. This includes the heart, muscles and brain. Harmful waste products accumulate and damage the body even more.

Acute kidney failure happens because of one (or more) of the following:

• Severe or recurrent kidney infections (pyelonephritis)

• Reduced blood flow: deprives the kidneys of vital oxygen from red blood cells

• Trauma (road accidents)

• Shock (sepsis, organ failure)

• Heart failure (cardiomyopathy, cardiac failure)

• Severe dehydration

• Urinary blockages: if the exit from the bladder is blocked urine builds up in the kidneys and makes them swell. Stones or crystals (uroliths) can block the tube which transports urine from the bladder to the outside (the urethra). Male dogs have the biggest risk of urethral blockage. They have a longer narrower urethra than females.

• Poisons

• Chemicals: antifreeze, cleaning products, batteries, insecticides, paint

• Some foods: raisins, chocolate

• Medicines: certain painkillers, antibiotics and anti-fungal drugs

• Infections: Leptospirosis, Parvovirus

• Cancer: can begin in the kidneys themselves or spread there from other parts of the body.

Symptoms of acute kidney failure in dogs

Symptoms of acute kidney failure in dogs will often overlap those of other serious illnesses.

• Not eating (around 80% of dogs with AKD)

• Lethargy and weakness (75%)

• Vomiting, possibly with blood (55%)

• Diarrhoea- dark to black in colour due to internal bleeding (37%)

• Severe halitosis (bad breath)

• Not drinking anything and not passing any urine

• Sudden blindness or collapse

• Seizures

Find your nearest vet if your dog is collapsed, having seizures, or has been vomiting blood.

Dogs at higher risk of developing acute kidney failure

Some dogs will have more risk of developing acute kidney failure, depending on their general health.

Older dogs

Dogs with other illnesses that affect the blood supply and health of the kidneys, for example:

• Chronic kidney disease

• Cancer

• Heart disease

• Kidney and bladder stones (urolithiasis)

• Certain Infectious diseases (parvovirus)

• Immune diseases

Certain Breeds with inherited problems that weaken their kidneys, including Basenji, Bernese Mountain Dog, Shar Pei, Doberman Pinscher

Certain Medicines: side effects of medication may include kidney damage, even at the recommended dose.

• Painkillers (non-steroidal anti-inflammatory drugs)

• Certain antibiotics

• Antifungal treatments

Is my family at risk of catching acute kidney disease?

Acute kidney failure itself is not a risk to humans or to other pets. However, some infectious illnesses that can cause acute kidney failure spread between dogs in vomit and body fluids. This includes Leptospirosis and Parvovirus.

Diagnosis of acute kidney failure in dogs

Vets diagnose acute kidney failure from the following checks and tests:

• Symptoms

• History

• Blood tests to check for levels of important proteins, chemicals and electrolytes (salts) in the blood

• Urine test – analysis and bacterial culture

• Blood pressure check

• Ultrasound Scan

• X-rays

How vets treat acute kidney failure in dogs

Acute kidney failure is a life-threatening condition that needs intensive care at a vet clinic or hospital. Treatment includes:

• Fluids given directly into your dog’s veins to flush fluid through the kidneys.

• Antibiotics to control infection

• Rebalancing electrolytes (salts) in the body

• Protecting stomach and intestines from acid and toxin damage (gastrointestinal protectants)

• Controlling blood pressure

• Giving medicine to start the kidneys making urine again

• Relieving pain

• Treating the underlying cause of the kidney failure, if possible

• Replacing essential vitamins

Specialist treatments:

Kidney dialysis keeps dogs with acute kidney failure stable while the kidneys recover. This is a specialist treatment carried out in some Veterinary Referral Hospitals. It’s only appropriate if the underlying cause has been found and is curable.

Kidney transplants? Kidney transplants for dogs happen in some countries. There are welfare and ethical concerns for both the donor dog and the sick dog. Kidney Transplants are banned in the UK. Kidney transplant would be unlikely to help a dog with acute kidney failure. The disease develops suddenly and there is often widespread damage to other organs.

Home care for dogs with acute kidney failure

Acute kidney failure needs intensive treatment by a vet at a vet practice. There are no home remedies for this life-threatening disease.

Dogs who survive the early stages of acute kidney disease will need ongoing treatment and nursing at home.

• Give prescribed medicines at the right time and dose.

• Encourage your dog to drink lots and add water to food.

• Feed your dog a prescription diet recommended for kidney disease.

• Encourage your dog to eat by warming the food up or adding in salt-free stock.

• Give vitamin supplements recommended for dogs with kidney disease.

Living with a dog with acute kidney disease

Dogs who survive acute kidney failure may develop with long-term complications, such as chronic kidney disease and high blood pressure. Ensuring the best possible outcome for your dog:

• Encourage your dog to drink lots

• Feed your dog a prescription kidney diet

• Give vitamin supplements recommended for dogs with kidney disease

• Keep up-to-date with preventive care, including vaccinations, flea treatment and worming

Sadly, half of the dogs who get acute kidney failure don’t recover.

Some die before the condition is recognised and treated. Others succumb in the early stages of treatment, despite the best efforts of their owners and vets. For those who do survive the acute illness, there is often a long road to recovery. Your dog may not fully recover or may seem to do well for a while at home, then suffer recurring illness. When this happens, you may worry about your companion’s quality of life. You wonder if it’s fair to carry on with treatment, or whether the time’s come to think about euthanasia.

You may be anxious about about whether you’ll know if it’s time to say goodbye. It’s a decision that’s very hard to make and distressing for everyone involved. The best any of us can do is focus on what’s best for our beloved companion. We can start by thinking about their quality of life.

• Do good things outweigh the bad?

• Is your dog still interested and responsive?

• Is pain or distress controlled?

• Is giving medication straightforward or is it a fight that’s worsening quality of life for both you and your dog?

There are guides available online to help you assess your dog’s quality of life. Talk things through with a vet if you are concerned about your dog’s quality of life.

Assess quality of life

Tips for preventing acute kidney failure

• Keep potential toxins (chemicals and foodstuffs) out of sight and reach.

• Ensure your dog is up-to-date with regular vaccinations, worming and flea control.

• Use medicines only as advised by your vet.

• Only use medicine approved for dogs. Human medicines can be very dangerous for dogs.

• Treat other illnesses promptly.

• Ensure your dog has a good quality diet recommended for their age and lifestyle.

When to worry about your dog with acute kidney failure

Many dogs with acute kidney failure will not survive the immediate illness. For dogs who come home, recovery may be prolonged and setbacks can happen.

Call your nearest vet practice if your dogs recovering from kidney failure:

• Starts vomiting, especially with blood.

• Collapses

• Seems suddenly blind

• Has a seizure

Joii can help with advice on:

• Tempting your dog to eat

• Finding the right diet for your dog with kidney disease

• Giving medication

• Reducing the risks of poisoning

• End of life care

• Bereavement support