Dogs with Chronic Kidney Disease (CKD) - Staged Management & Care

Table of Contents

  1. What is CKD?
  2. Are dogs in pain with kidney failure?  
  3. Dog kidney failure stages and Survival rate 
  4. What happens when a dog's kidneys fail?
  5. How can I help my dog with kidney disease?
  6. How can I make my dog with kidney disease comfortable?

Kidney disease is quite common in dogs. About 1 in 10 dogs is estimated to develop kidney disease over a lifetime. Unfortunately, the disease typically goes undetected until the organs are functioning at approximately 33% to 25% of their capacity. 

When not addressed early enough, it becomes Chronic Kidney Disease (CKD). That is why  early diagnosis and treatment are critical. The progression of the disease can be limited and many dogs can continue to live happily for years after diagnosis.

What is CKD?

CKD is an irreversible and progressive deterioration of kidney functions, leading to the eventual death of the stricken pet.

Dogs, like humans, have two kidneys located in their abdomen that produce urine to eliminate waste products from the body. The function of a kidney is to continuously filter blood to remove waste products, such as ammonia, that will cause toxicity if allowed to accumulate. 

When about 65% to 75% of kidney function is lost, waste products will begin to accumulate in the blood, causing kidney failure signs. 

Symptoms of CKD include:

  • Loss of appetite
  • Weight loss
  • Diarrhoea 
  • Vomiting
  • Increased or decreased urination
  • Oral ulcers or pale gums
  • Enlarged, painful kidneys
  • Back or flank pain
  • Unkempt hair coat
  • Stiff-legged gait and arched back

Are dogs in pain with kidney failure?

There is no denying that dogs with CKD will feel pain. Like humans, the majority of CKD-stricken pets will suffer pain. And if your dog has a stiff-legged gait and arched back, it is a sign of painful kidneys. 

In addition, dogs with low potassium may develop painful muscles and generally, become weak. This will cause your pet stress. 

It is important that the proper medication is prescribed to the dog with CKD. As dogs vary in size, the dosage may differ. Thankfully, many of these dog medicines are mouth-fed so owners will need to learn how to feed dog medicines to their pets.

Dog kidney failure stages and survival rate 

Unfortunately, there is no known cure for CKD, but treatment can help relieve the symptoms and slow the progress of CKD. Successful treatment of CKD can only delay disease progression and extend your dog’s lifespan, as well as increase its quality of life.

There are four stages of CKD for dogs. As it depends on the severity of the disease and the health of the dog, survival times can vary. 

How long do dogs live with CKD?

The median survival times are:

  • Stage 1 - over 400 days
  • Stage 2 - from 200 to 400 days
  • Stage 3 - from 110 to 200 days
  • Stage 4 - from 14 to 80 days

The survival rate depends on the breed of the dog and condition of the pet. Some dog breeds, including English Cocker spaniels, bull terriers and German shepherds, are more likely to develop CKD.

Certain breeds tend to deteriorate at a faster rate so it is difficult to estimate how fast a dog will succumb to CKD. It also depends on how well the pet’s physiology will react to the medications. There is as yet a lack of substantial research on how CKD impacts each individual breed.

What happens when a dog’s kidneys fail?

Toxins like ammonia and nitrogen can build up in the dog’s body. These substances build up and it can be a painful experience for dogs as weakness, nausea, intestinal bleeding and even seizures develop.

Similar to humans, dogs will feel discomfort and pain. Towards the end, many dogs display difficulty breathing. Their breathing could be uneven, with lengthy gaps between inhaling and exhaling. This is also a painful time for owners as they see their four-legged babies visibly suffering.

The prognosis for CKD vary depending on response to the initial stage of treatment and owners’ ability to perform the follow-up care. Taking prompt action during the early stages of CKD is thus, critical.

Treatment is encouraged in most situations because studies have shown that many dogs have responded to medication and are able to maintain a good quality of life for up to four years. 

Owners need to ensure that their dogs have an adequate amount of clean water to drink. If a dog has been diagnosed with dehydration, supplemental fluids may be given intravenously. Phosphorus and sodium restriction are also important components of managing kidney disease.

How can I help my dog with kidney disease?

Treatment options for advanced CKD cases are usually limited to treating the symptoms because dialysis and kidney transplants are not readily available for dogs. Protecting the dog from kidney disease means owners should be prepared to look for problems early.

Treatment of chronic kidney disease in dogs aims at improving the quality of the pet’s life and slowing disease progression. Here are a few suggestions:

  • Dogs with CKD need to be monitored regularly so this means frequent check-up with the dog’s veterinarian although the frequency will depend on the disease stage. 
  • Dogs with early, stable kidney disease may only need to be rechecked every three to six months. 
  • Dogs with advanced CKD may require monthly or more frequent veterinarian appointments. This often involves examinations, blood work, urinalysis and possibly a blood pressure check if the dog also has high blood pressure, which could lead to further complications.
  • Medication and pet food may be recommended based on test results and exam findings.

The veterinarian will likely suggest changing a dog’s diet to food designed for dogs with CKD. The recommendation is usually to restrict dietary phosphorus- and sodium-high foods, control amounts of high-quality protein and supplements to strengthen the dog’s health

This includes omega-3 fatty acids, several B vitamins and vitamin C. This combination has been shown to improve overall quality of life and may minimize disease progression, prolonging the pet’s life span.

Food with high salt content may increase blood pressure and may worsen kidney damage, so diets designed for pets with kidney disease are low in sodium. 

Dog owners should also refrain from feeding treats high in salt such as cheese, bread, deli meat and certain commercial dog treats. Specialty pet treat store operators may offer dog treats for pets afflicted with CKD, as these specialty shops make treats from scratch and can cater to individual dog’s needs.

Remember that dogs with CKD will pee more frequently and in larger quantities. To compensate for this water loss, dogs with CKD will need to maintain their fluid balance by drinking more water. Clean water is best for dogs at this stage so monitoring their water intake is very important. 

How can I make my dog with kidney disease comfortable?

Part of the process of comforting your pet is to make its life easier. Offering it pure drinking water - whether it is carbon-filtered, reverse osmosis or distilled - would ease its suffering. 

Tap water contains chemicals and poisons which can worsen a dog’s health. Why make a dog’s kidneys work harder having to filter more chemicals and poisons from its blood? Filtered and distilled water aids in flushing toxins from the system.

Ease your pet’s access to water by providing a pet water fountain and placing clean bowls of fresh water in several locations around the home. This means that the dog will not have to go far just for a drink of water.

To ensure that dogs remain properly hydrated, owners are encouraged to add home-prepared whole food instead of dried ones to their diet, which will stress their kidney further. 

Feed your dog small meals, often, rather than giving him one or two large meals in a day. The dog’s appetite will be affected by CKD so smaller portions at more intervals is better. 

Offer fresh food at each feeding. The veterinarian will know what will be the recommended calories for your pet.

One of the best ways in the fight against CKD is stop giving the afflicted dog more toxins. Commercial pet food, dry or canned, even if it is branded as the newest, best, number one, organic or human-grade food, may be detrimental to the CKD-stricken dog. 

The reason is that it is simply too processed. Feeding the dog whole foods that are home prepared will ensure that there are no hidden toxic ingredients that will harm the afflicted pet further. 

A diet page of low protein and low phosphorus recipes can be recommended by the veterinarian or from reputable pet websites catering to dogs with CKD.

Other complications from CKD

Owners also need to be aware that while the dog’s kidneys play a critical role in removing harmful waste from the blood, these organs also play a role in keeping blood pressure in control and making hormones and enzymes required by the dog’s body.

So when the kidneys are not working properly, a number of other serious health problems can occur. These include high blood pressure, anemia, excessive stomach acid production, increased phosphorus levels in the blood and protein loss in the urine. 

The veterinarian will prescribe the appropriate medications if any of these medical issues occur. Regular veterinary visits are important as the veterinarian will want to fine-tune and individualize the dog’s therapy.

Kidney transplant

Like humans, kidney transplant is available for dogs although the procedure is costly and the dog has to be in good health to be receptive to a suitable donor. For now, this should be a last resort as there is a substantial risk. 

Although veterinary surgery specialists are well-versed in the technical aspects of the surgical procedure, kidney transplants in dogs have not been nearly as successful as the procedure has been for cats. Studies show that dogs have a success rate of about 40%, compared to cats’ 90%. 

In addition, this surgery is expensive. It can cost as much as $20,000 and that is if there are no complications. 

Lots of love

Dogs crave attention and love and dogs with CKD will need ample doses of love from their owners. Owners can still play with their pets as they still need regular exercise.

While stricken by CKD, dogs still need exercise to remain healthy. This doesn’t mean that owners should take their pets on marathons. Talking the dog for a walk in the park instead of playing fetch with it is better. 

Ask the veterinarian about an appropriate exercise routine that will help the dog stay healthy without causing it discomfort.

Finally, owners should celebrate with their dogs and their role in their family. As time may be more limited for some pet owners, consider creating a bucket list for man’s best friend and sharing their accomplishments with family and friends.


CKD isn’t reversible, preventable or curable but dogs can be stable for long periods with appropriate treatment. CKD is a progressive disease that worsens slowly. Some dogs’ condition may worsen faster than others. 

So before this happens, it is the best time to celebrate whatever time is left with that special four-legged family member.


By Anna Burke, Jan 2019, “How Much Exercise Does a Dog Need Every Day?”, [Online] Available at: [Accessed 25 July 2020]

By JD Foster, “Canine Chronic Kidney Disease: Current Diagnostics and Goals for Long-Term Management”, [Online] Available at: [Accessed 18 July 2020]

By Ernest Ward; Updated by Malcolm Weir, “Chronic Kidney Disease in Dogs”, [Online] Available at: [Accessed 18 July 2020]

By Five Leaf Pet Botanicals, “If your dog has Kidney Disease we want to help!”, [Online] Available at: [Accessed 22 July 2020]

By Dr Celeste Clements, “Chronic Kidney Disease: What Does Kidney Failure in Dogs Really Mean?”, [Online] Available at: [Accessed 20 July 2020]

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