Dog Kidney Failure - When To Euthanise | Cloud 9 Vets

Dog Kidney Failure – When To Euthanise


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Old Dog

Kidney failure in dogs is also known as canine kidney failure. This disease causes the kidneys to function abnormally – being unable to filter out toxins from the body. Resulting health issues include poor blood acidity regulation, uraemia, and high blood pressure.

As kidney failure can occur gradually over time – or suddenly as in acute kidney failure – it’s really important to recognise the signs of kidney failure in dogs. Find out more about dog kidney failure – when to euthanise here…

Reasons for Kidney Failure

Causes of kidney failure are wide-ranging and include:

  • Hereditary and congenital conditions
  • Ureteral obstruction when the urine flow is restricted
  • Heart conditions that reduce blood flow to the kidneys resulting in failure
  • Ethylene glycol found in antifreeze needing immediate treatment after ingestion
  • Lyme disease carried by ticks can result in chronic kidney failure
  • Ageing as chronic kidney failure can be related to the natural ageing process

Old Dog laying on sofa

Symptoms of Kidney Failure

There are two types of renal failure – Acute also known as IRA – and Chronic identified as CKD. Without treatment acute kidney failure is fatal.

The most common symptoms of acute kidney failure in dogs include:

  • Discomfort and disorientation
  • Excessive urination
  • Fatigue and disproportionate sleeping
  • Increased thirst
  • Lack of coordination
  • Vomiting
  • Weakness

Chronic kidney failure can develop for years without any symptoms. There are some signs that can signify the disease and these consist of:

  • Abdominal pain
  • Abnormal kidney size
  • Absence of urine
  • Anaemia
  • Bad breath
  • Blood in urine
  • Coma
  • Dehydration
  • Diarrhoea
  • Fluid retention in legs and stomach
  • High blood pressure
  • Mouth ulcers
  • Seizures
  • Vomiting

Old Dog Laying on floor

The Four-Stage Series Diagnosis

Dog kidney failure stages are determined by several factors including the levels of creatinine (waste products) and SDMA (a renal biomarker). The urine-to-protein ratio will be investigated as well as the systolic blood pressure.

The creatinine test results for:

  • Stage 1 – less than 1.4mg per decilitre
  • Stage 2 – 1.4 to 2.0mg per dl
  • Stage 3 – 2.1 to 5.0mg per dl
  • Stage 4 – greater than 5.0mg per dl

SDMA test results for:

  • Stage 1 and stage 2 – greater than 14
  • Stage 3 and stage 4 – more and significantly more than stages I and 2

Other clinical markers include UPC ratios in excess of 0.5 and systolic blood pressure ranging from hypertensive – with readings of 160-179, and severely hypertensive recording greater than 180.

This blood biochemistry analysis assesses the function of various internal organs. Other substances in the blood such as potassium, sodium, and globulin will also be measured. Red and white blood cell counts will determine the extent of failure.

Old dog

Treatment for Kidney Failure

Kidney disease in dogs will be treated dependant on the results of the blood tests. When the diagnosis is made early treatment may be successful giving your dog extra years of a normal lifestyle. Where kidneys are damaged beyond repair any medical treatment would be ineffective.

Immediate treatment involves flushing the kidneys with high doses of intravenous fluids. This is known as diuresis – and by removing toxins this helps mildly damaged kidney cells to regain their function. Fluid therapy involves replacing various electrolytes – followed by the appropriate drugs to control vomiting and diarrhoea.

The second phase of keeping the kidneys working properly includes the administration of drugs to regulate the parathyroid gland and calcium levels. And additional drugs to bind excess phosphates within the intestinal tract so they’re not absorbed into the bloodstream.

Drugs may be given to stimulate the bone marrow to produce new red blood cells and help with anaemia. Antibiotics will be used for infection.

Home fluid therapy involves you administering a small amount of fluids on a daily basis to prevent dehydration. And flushes toxins from the system continuously – providing additional levels of electrolytes.


As nutrition is one of the most effective treatments your dog will be put on a special diet. What foods should a dog with kidney disease eat? The diet includes low in protein and phosphorous food, without being acidified. This type of diet reduces the toxins that make your dog feel sick and lacking in energy.

Supplements of omega-3 fatty acids from fish oil have benefits – so an optimal dose of added fish oil of a high-quality brand may be recommended.

What to feed a dog with kidney failure who will not eat comprises of low sodium treats like some fruits and vegetables – but not grapes, raisins, onions, or garlic. Green beans and carrots are good as they’re low in calories and high in fibre and vitamins. Make sure your dog always has access to freshwater. And eats regularly.

What foods should a dog with kidney disease avoid include high protein treats such as deli meat, bread, and cheese?

Although chronic kidney failure isn’t curable treating the symptoms can reduce the progress of the disease. And providing the best-balanced diet according to age, weight, and size will help to prevent kidney problems.


Depending on how your dog responds to the initial treatment the prognosis is variable. And can often lead to a good quality of life. The proper follow-up care can also extend the length of life. You need to be part of all decisions that are made after diagnosis and regarding treatment.

If your dog is in pain constantly, stops eating and drinking, or experiences incontinence due to complete kidney failure, you may need to consider putting your dog to sleep. When your dog stops responding to treatment this is another reason for letting go.

Old dog Laying on the floor

End of Life Care

You’ll need the support and advice of an experienced and understanding vet to ensure your dog’s last days are as comfortable as possible – dog euthanasia at home may be the kindest and your final option to prevent further suffering.

Your dog’s welfare will always be the ultimate priority. And the gentle euthanasia procedure will be fully explained so that you can have any questions answered. When the time is right a sedative will be administered to send your dog to sleep. Then the anaesthetic agent will cause the heart to slow and calmly stop – and your dog will pass away peacefully.

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