Updated September 25, 2026. Fact-checked against veterinary sources; review by a licensed veterinarian is in progress. See our editorial policy.
Quick answer: Chronic kidney disease (CKD) is common in older dogs. Early signs are subtle: drinking and urinating more, weight loss, and a pickier appetite. It can’t be cured, but it can often be slowed. The most proven steps are a kidney (renal) diet, controlling blood pressure and protein loss in the urine, and keeping your dog hydrated. Regular senior checkups with blood and urine tests catch it early, when treatment helps most.
Signs
- Drinking and urinating more, including accidents or needing to go out at night
- Weight and muscle loss
- Poor or picky appetite
- Vomiting, nausea, or bad breath
- Lethargy
- Pale gums (from anemia) in later stages
Diagnosis and staging
Your vet will use:
- Blood tests: creatinine and SDMA to measure kidney function, plus phosphorus and electrolytes
- Urinalysis: urine concentration and protein (urine protein:creatinine ratio)
- Blood pressure
- Imaging to look at kidney size and check for stones or other causes
- Tests for treatable causes, such as infection or tick-borne disease
The International Renal Interest Society (IRIS) stages CKD from 1 to 4, which guides treatment.
Treatment
- Renal diet: lower phosphorus, moderate high-quality protein, added omega-3s, and less sodium. In a controlled trial, dogs with CKD eating a renal diet had fewer kidney crises and lived longer.
- Controlling protein loss in urine with medications such as benazepril or telmisartan.
- Blood pressure control, often with amlodipine.
- Phosphate binders if phosphorus stays high.
- Anti-nausea medication and appetite support.
- Fluids under the skin at home for some dogs in later stages.
- Treating anemia in advanced disease.
Home care
- Fresh water always available. Never restrict water.
- More bathroom breaks for the increased urine.
- Stick to the renal diet and kidney-friendly treats. See foods to avoid for dogs with kidney disease.
- Weigh regularly and keep a log of appetite and energy.
- Keep up with rechecks of bloodwork, urine, and blood pressure.
What to avoid
- NSAID pain relievers without close monitoring: they can reduce blood flow to the kidneys. Your vet may still use them carefully for arthritis.
- Human pain medications, which are dangerous for dogs.
- High-phosphorus and salty treats: jerky, cheese, deli meat, bones.
- Human kidney supplements or herbal “detox” products.
- Grapes and raisins, which can cause kidney failure.
When to call your vet
Call promptly if your dog stops eating, vomits repeatedly, becomes weak or lethargic, stops drinking, or produces much less urine. These can signal a kidney crisis.
Frequently asked questions
How long can a dog live with kidney disease?
It varies widely with the stage at diagnosis. Dogs diagnosed early often live comfortably for years with treatment.
Is kidney disease painful for dogs?
It isn’t usually painful, but nausea and dehydration can make dogs feel unwell. Treatment focuses on keeping them comfortable.
Should my senior dog eat less protein?
Not unless kidney disease has been diagnosed. Healthy senior dogs need good-quality protein.
Sources
- International Renal Interest Society (IRIS): Staging of CKD and treatment recommendations for dogs
- Jacob F, et al. Clinical evaluation of dietary modification for treatment of spontaneous chronic renal failure in dogs. JAVMA. 2002
- Merck Veterinary Manual: Chronic kidney disease in small animals
- Acierno MJ, et al. ACVIM consensus statement: Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats. J Vet Intern Med. 2018
This article is for general education and is not a substitute for care from your own veterinarian. Learn about The Pet Vet and our editorial policy.