In this article
- Understanding Kidney Disease
- Types of Kidney Disease
- What Causes Kidney Disease in Dogs?
- Recognizing the Stages and Symptoms
- Treatment Options for Kidney Disease
- Life Expectancy with Kidney Disease
- When to Consider Euthanasia
- The Comfort of In-Home Euthanasia
- Final Thoughts
- Frequently Asked Questions
Senior Pet Care: A Comprehensive Guide to Supporting Your Aging CompanionKidney Disease in Dogs: What it is and when to euthanize
Kidney Disease in Dogs: What it is and when to euthanize
Dr. Bethany Hsia
April 17, 2023
Get help navigating end of life care and euthanasia decisions in dogs with kidney disease. Learn what symptoms to watch for that may indicate your dog is in pain and when to let them
As a veterinarian who has dedicated my career to compassionate end-of-life care, I've helped countless families navigate the challenging journey of kidney disease with their beloved dogs. I believe that understanding this condition—from early signs to treatment options and eventually making difficult decisions—empowers pet parents to provide the best possible care for their companions. Through my experience founding CodaPet and specializing in at-home euthanasia services, I've witnessed firsthand how knowledge and preparation can transform a heartbreaking situation into a peaceful, loving farewell.
Kidney disease is a progressive and often irreversible condition that affects many dogs, gradually diminishing their quality of life. While early detection and proper management can help extend their time, there comes a point when treatment is no longer enough to keep them comfortable. Recognizing when your beloved companion is suffering and making the compassionate choice to say goodbye at home can be one of the most difficult yet loving decisions a pet owner faces.
Understanding Kidney Disease
The kidneys are amazing little organs that remove toxins from the body. Blood is filtered through the kidneys and the toxins are pulled out and excreted in urine. The kidneys also keep vital electrolytes in balance, manage blood pressure, produce urine, maintain water balance in the body, signal bone marrow to make new red blood cells and regulate calcium and phosphorus levels.
As you can see, it is a big job, and the kidneys play a large part in keeping the body in balance. Luckily, the kidneys are tough and have a large reserve; therefore, they can withstand minor insults over the course of a dog's life while still maintaining homeostasis (biological stability).
However, when kidney damage becomes significant—whether from aging, infection, toxins, or genetic factors—your dog's overall health can deteriorate quickly. When the kidneys are damaged significantly, they begin to lose function and the body's homeostasis is thrown off. Toxins start to build up and the systems that are so delicately managed go off the rails.
Types of Kidney Disease
Kidney disease typically presents in two forms:
Acute Kidney Disease:
- Develops suddenly, often from a specific incident causing major kidney damage
- Your dog may become very sick, very quickly
- Requires immediate and swift action as treatment is necessary and can improve prognosis
- May be reversible with prompt treatment
Chronic Kidney Disease (CKD):
- Develops gradually over months or years
- Often sneaks up on you slowly, and you may not notice until changes in blood tests are identified by your veterinarian
- Usually diagnosed in middle-aged to senior dogs
- The most common form I see in my practice
What Causes Kidney Disease in Dogs?
Kidney disease in dogs can be caused by aging-related degeneration, where the kidneys gradually lose function over time. Other common causes include infections, toxins (such as antifreeze or certain medications), and underlying conditions like high blood pressure or diabetes. Some dogs are also born with congenital kidney defects, making them more susceptible to kidney failure at a young age.
Through my years in practice, I've seen kidney disease develop from various causes:
- Age-related degeneration - The most common cause, especially in senior dogs
- Exposure to toxins - Such as certain medications, antifreeze, grapes, or lilies
- Infections affecting the kidneys
- Underlying conditions - Such as high blood pressure or diabetes
- Genetic predisposition - Some breeds are more susceptible
- Chronic dehydration - Inadequate water intake over time
Recognizing the Stages and Symptoms
Kidney disease is typically classified into four stages based on the severity of kidney function loss:
Early Stages (Stages 1-2)
Stage 1: Kidney function is mildly impaired, and there may be no visible symptoms. Blood tests may show slightly elevated kidney values, but the dog usually remains healthy and active.
Stage 2: Kidney function declines further, and mild symptoms such as increased thirst, urination, and slight lethargy may appear. Kidney values in blood tests are more noticeably elevated, and early intervention is key to slowing progression.
Early-stage kidney disease can develop gradually, often becoming noticeable in middle-aged to senior dogs (typically around 7+ years old). Pet owners may observe subtle behavioral changes, such as their dog drinking more water or urinating indoors unexpectedly. While these symptoms may not seem alarming at first, they indicate the kidneys are struggling, and without intervention, the disease will progress.
Advanced Stages (Stages 3-4)
Stage 3: Kidney function is severely impaired, and noticeable symptoms such as significant weight loss, vomiting, and lethargy become more apparent. Blood tests show markedly elevated kidney values, and the dog may require more frequent veterinary care to manage the disease.
Stage 4: Kidney failure is end-stage, and symptoms intensify, including extreme lethargy, dehydration, and loss of appetite. At this stage, the dog's kidneys are no longer able to function effectively, and euthanasia may be considered if quality of life deteriorates significantly.
In the later stages, kidney disease progresses rapidly, and pet owners may notice their dog's condition worsening quickly. Severe symptoms will impact daily life, and the focus shifts from treatment to managing comfort, ensuring the dog's remaining time is as comfortable as possible.
Congenital Kidney Disease
Congenital kidney disease in dogs is a condition where kidney abnormalities are present from birth, often due to genetic factors. Unlike the gradual development seen in age-related kidney disease, congenital kidney disease typically manifests earlier in life, often in puppies or young adult dogs. This form of kidney disease can progress through the stages similarly to acquired kidney disease, but it may move more rapidly through stages 1 and 2, depending on the severity of the defect. Dogs with congenital kidney disease may reach stage 3 or 4 more quickly, often requiring earlier intervention to manage symptoms and slow the progression.
Treatment Options for Kidney Disease
Treatment depends on the severity of chronic kidney disease and the stage of the condition. While chronic kidney disease cannot be cured, there are many ways to manage it and maintain your dog's quality of life:
Medical Treatment
- Intravenous fluids are administered to help flush toxins from the kidneys
- Anti-nausea medications
- Blood pressure medication
- Appetite stimulants if the dog is not eating well
- Phosphate binders
- Medications to address underlying conditions
The veterinarian will tailor the approach based on the individual dog's needs. I've found that a customized treatment plan that adapts as the disease progresses gives the best results for both the dog and their family.
Home Management for Comfort
In addition to following your veterinarian's treatment plan, you can also try to keep your dog as comfortable as possible while at home. Managing the conditions at home that may cause your dog stress will help their overall wellbeing.
- Make sure they have access to plenty of fresh water and allow access to appropriate bathroom areas. Potty pads or diapers may be utilized. You can also use waterproof coverings over bedding to make clean up easier.
- Be creative with meals if appetite is an issue. Appetite stimulants may be necessary, and this is where creative menus can be utilized. If you notice lip smacking or drooling, your dog may be nauseous, and medications may help with appetite.
- Prevent pressure sores on elbows and hips, which can occur if your dog is laying down a great deal. Make sure there is a large amount of padding and treat any wounds immediately to avoid infection.
- Watch for ulcers in your dog's mouth. You may notice drooling and/or bad breath. Your vet can prescribe a mouthwash that can help with this.
Dietary Considerations
The best homemade diet for a dog with kidney failure should focus on high-quality, easily digestible protein sources, such as lean chicken or turkey, to reduce kidney strain. Keep in mind that protein should be served in moderation. Some examples include:
- Chicken (skinless, boneless)
- Fish (such as salmon or whitefish)
- Eggs (cooked, in moderation)
- Pumpkin (pureed)
- Sweet potatoes (cooked)
- Rice (well-cooked white rice)
- Carrots (cooked or raw, in moderation)
- Green beans (steamed or cooked)
Adding omega-3 fatty acids from fish oil can help support kidney function and reduce inflammation. Additionally, incorporating ingredients like sweet potatoes and carrots provides essential vitamins and minerals while maintaining a balance of electrolytes, such as potassium, for overall health.
For a dog with kidney failure, it's important to limit protein intake, as too much protein can stress the kidneys. However, protein should not be entirely eliminated, as dogs still need it for essential bodily functions. Avoid high-protein foods like red meat and organ meats, which can be too difficult for the kidneys to process, and focus on providing a balanced diet that meets the dog's specific nutritional needs without overloading the kidneys. Some examples of foods to avoid include:
- High-protein meats (e.g., beef, lamb)
- Processed meats (e.g., bacon, sausage, deli meats)
- Dairy products (e.g., milk, cheese, yogurt)
- High-phosphorus foods (e.g., organ meats, certain fish)
- High-sodium foods (e.g., canned foods, salty snacks)
- Canned vegetables with added salt
- Grains with gluten (e.g., wheat, barley)
Life Expectancy with Kidney Disease
The lifespan of a dog with kidney failure can vary greatly depending on factors such as the stage of the disease, overall health, and how well the condition is managed. On average, dogs diagnosed with kidney failure may live for anywhere from a few months to a few years with appropriate treatment, including diet management, medications, and regular veterinary care. Early detection and intervention can help extend a dog's life and improve their quality of life. It's essential to work closely with a veterinarian to monitor kidney function and make adjustments to care as needed.
Dogs with chronic kidney disease can live anywhere from several months to a few years, depending on how early the disease is diagnosed and how well it is managed. Quality of life plays a significant role in longevity, as effective management through diet, medication, and supportive care can help maintain comfort and function for a longer time.
When to Consider Euthanasia
Knowing when to euthanize can vary for each dog and person. Remember that there isn't always an exact time, but a window where it is appropriate to make the decision to let them go. Sometimes, you can look at your beloved dog and know that the light is gone. The fight is over, and they are ready. Sometimes you cannot see the light go out, but you can see their bodies fail them.
The end stages of kidney disease occur when the kidneys no longer work, and the body is not responding to treatment. Your dog may become very lethargic, or sleepy, and have a hard time rising. They likely have lost a great deal of weight and their appetite is usually diminished. They may be too nauseous to keep food down. Confusion is often a sign of late-stage disease and is caused by the toxins present in the bloodstream.
It is important to be able to look at your dog objectively and know when things change. Helpful tools are out there such as the Quality of Life Scale quiz. It can be helpful to keep a list of 6-8 characteristics that make your dog unique and truly "your dog". When more than half of those things can no longer happen, it is often within that window of time.
Your veterinarian can help you determine if your dog's quality of life has diminished. Together, you can make an informed decision so that you can feel comfortable that you are doing the right thing.
The Comfort of In-Home Euthanasia
Humane euthanasia of your beloved dog is always an emotional and challenging decision. It is wise to think about how you want to have this done so that you are prepared, and you do not have to make decisions when you are panicked or in an emergency. A wonderful option is in-home euthanasia. When the veterinarian comes to you, the process can be one of the most beautiful, rewarding experiences.
The stress level is lower because you are in the comfort of your own home with no distractions. Your veterinarian will give an injection of sedatives, and this will allow your dog a peaceful slumber while veins are accessed for the final injection. Other benefits of letting your pet pass at home are that family, both human and four-legged, can be nearby to say goodbye.
Through my work with CodaPet and my years of veterinary practice, I've found that in-home euthanasia offers significant benefits for both pets and their families during this difficult time. I founded CodaPet because I believe a peaceful passing is the last gift we give our pets, and it's a gift best given at home.
CodaPet's in-home euthanasia services offer a peaceful and stress-free environment for dogs with kidney disease, allowing them to pass away in the comfort of their own home. This service ensures that your dog's final moments are filled with love and dignity, without the added stress of a trip to the veterinary clinic.
Final Thoughts
Growing up with many pets myself, and now watching my own children form bonds with our family pets, I deeply understand the special connection we share with our animal companions. Through my years of practice and especially through founding CodaPet, I've learned that navigating kidney disease in dogs isn't just about managing medical symptoms—it's about preserving the bond between pet and family for as long as quality of life can be maintained.
When the time comes to say goodbye, remember that providing a peaceful passing is perhaps the final, most loving gift we can give our faithful friends. It's a privilege to help families through this journey, and it's what inspired me to focus my career on compassionate end-of-life care.
If you're currently caring for a dog with kidney disease, please know that you're not alone. With thoughtful management and regular veterinary care, many dogs continue to enjoy a good quality of life despite their diagnosis. And when the time comes to make difficult decisions, compassionate options like in-home euthanasia through services like CodaPet can help make the final transition as peaceful as possible.
Frequently Asked Questions
What are the final stages of kidney disease in dogs? In the final stages, dogs experience severe lethargy, vomiting, weight loss, dehydration, and organ failure, leading to a poor quality of life. Confusion is often present due to toxin buildup in the bloodstream.
How do I know when to euthanize a dog with kidney disease? Euthanasia should be considered when your dog is in constant pain, refuses to eat for several days, becomes severely weak, or no longer enjoys daily activities. When bad days consistently outnumber good days, it's time to have this difficult conversation with your veterinarian.
What is the life expectancy of a dog with kidney disease? Life expectancy varies greatly, but with proper treatment, some dogs live months to years, while advanced cases may only have weeks or months. Early diagnosis and consistent management play significant roles in extending quality time.
Dr. Bethany Hsia is a veterinarian who graduated from the University of Illinois College of Veterinary Medicine in 2010 and is a cofounder of CodaPet, which provides compassionate in-home euthanasia services. The ability to calm and comfort animals has been a natural gift throughout her life, and she believes a peaceful passing is the last gift we give our pets.
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