Causes and Signs of Kidney Disease in Dogs

Cute dog with a bottle of lemonade

Written by: Alexa Waltz

The kidneys are extremely important players in the game of keeping the bodies of humans and animals healthy. Like humans, dogs are born with two kidneys that are primarily responsible for excreting wastes and toxins from the bloodstream and maintaining fluid and electrolyte balances within the body. Kidney disease goes by many other names like “renal failure”, “renal insufficiency”, “kidney damage”, “kidney insufficiency”, “kidney injury”, and “kidney failure”. All of these names imply that the kidneys are struggling to carry out their normal functions to some degree. Kidney disease can also be further described as “acute” (happening suddenly or quickly) or “chronic” (happening slowly over time).

So many questions revolve around the diagnosis of kidney failure in dogs, and it can be very scary and confusing for pet parents. How can I tell if my dog has kidney disease? What would cause my dog’s kidneys to fail? How does kidney disease affect the long-term health of my dog? Recognizing what the kidneys do for the body is key to understanding, diagnosing, and treating kidney disease.   

What Do the Kidneys Do?

Everyone knows at least one important thing about the kidneys: they make urine! The kidneys are made up of millions of little tiny cellular units called nephrons. As blood flows through the kidneys, each nephron is designed to regulate what stays in and what is filtered out of the blood and into the urine – be it waste products from metabolism, toxins, electrolytes, and water. The healthy nephron uses a system of highly specialized cellular channels, pumps, gates, gradients, sensors, receptors, and hormones to filter unnecessary materials from the blood without losing what is valuable – it is really an incredible process! For example, during times of dehydration in dogs, healthy kidneys will conserve water in the bloodstream and produce very concentrated urine (a dark yellow color) and in times of hydration, they will excrete that excess fluid and make a very dilute urine (a light yellow/clear color).

However, the kidneys do much more than just make pee! In fact, the healthy function of other organs hinges on the kidneys keeping everything balanced. Here is a brief summary of how the kidneys are incredible workhorses for the body:

  Maintain blood pressure

  Filter wastes and toxins

  Conserve or excrete water

  Regulate blood electrolyte and mineral levels (especially sodium, potassium, phosphorus, and calcium)

  Synthesize erythropoietin to stimulate red blood cell production

  Conserve important blood proteins

  Maintain blood pH balance

Give you pet the personalized care. Get the app!

How Do Kidneys Become Damaged?

Being the fragile filter of the body, unfortunately, the kidneys are in a highly vulnerable position and can be damaged by a variety of different types of medical problems. Here is a list of the most common causes of acute (sudden) and chronic (slowly over time) kidney failure:

  Ingesting Toxins (grapes, antifreeze, over-the-counter human NSAIDS like Ibuprofen)

–  Infections and Inflammation (Lyme disease, leptospirosis, pancreatitis)

  Dehydration, Heatstroke

  Aging (kidneys “wear out” over time)

  High blood pressure

  Kidney stones

   Diabetes (Link: diabetes)

–  Periodontal disease (Link: periodontal disease)

  Genetic and developmental abnormalities


The kidneys have significant reserve and are excellent at compensating, even as some nephrons wear out or become damaged and nonfunctional. In fact, changes in your dog’s lab work won’t be apparent until at least 2/3 of those millions of nephrons become compromised! Unfortunately, when damaged beyond repair, the kidney is an organ that does not regenerate itself. This is why it’s essential to start treatment for kidney disease and investigate the underlying cause of kidney damage as soon as a problem is detected.

Acute Renal Failure happens very quickly – usually over a matter of hours to days — with the sudden loss of kidney function. Infections, toxin ingestion, and severe dehydration/heat stroke are often causes of acute renal failure. With appropriate emergency treatment, acute kidney failure may be reversible! Aggressive treatment may help the kidneys regain some or all of their function again depending on the cause and the treatment received. Without treatment, acute renal failure can be fatal.  

Chronic Renal Disease, or chronic renal failure, is a more gradual process taking place over months and years. This means that over a long period of time at least ⅔ of the kidney’s nephrons have become damaged beyond repair. The kidney loses the ability to filter waste products, concentrate the urine, regulate blood pressure, balance electrolytes and minerals, and stimulate the production of red blood cells. They may also be leaking protein into the urine because those specialized filters just do not work anymore. Kidney function greatly affects other organs too, like the heart, GI tract, and eyes, so depending on the actions taken to support the failing kidneys, dogs can have a variety of concurrent issues arise. 

How Can We Tell if the Kidneys Are Damaged?

Physical Symptoms

Refilling that water bowl more than normal? If your dog is drinking more and in turn having to pee more, this is a commonly recognized symptom of chronic kidney disease. Increased thirst and urination closely resemble the symptoms of diabetes as well, which is another serious health condition. Along with changes in water consumption and urination, keep an eye out for weight loss, decreased appetite, low energy, weakness, vomiting, and diarrhea too.

AskVet Tip: Acute kidney failure can cause your dog to feel very sick and also suddenly decrease its urine production. This happens because the kidney tissue has been so severely injured that the kidneys have basically “closed up shop” and are not working at all! This is an extremely dangerous and life-threatening situation that needs immediate emergency care. Chronic end-stage kidney failure, when the kidneys have very little functional capacity left, may be accompanied by bad/sweet breath and vomiting blood or black flecks of digested blood. This is due to the buildup of harmful toxins in the bloodstream that cause ulcers in the mouth, stomach, and intestines. Your dog also may have lost a significant amount of weight and may not be eating much at all.

Blood and Urine Testing, Imaging, and Blood Pressure Readings

Sometimes kidney insufficiency is detected on lab work well before any of the above physical signs develop, and early detection is a great thing! This is one of the many reasons that a blood test and urine test are recommended routinely for dogs and cats even if they are not showing signs of being sick – to catch diseases early in their progression! This way, we can initiate some protective treatment early to preserve kidney function for as long as possible.

If you suspect your dog may be showing signs of kidney disease, your vet will perform a physical exam first, looking for signs of dehydration, checking bladder size, heart and respiratory rate, etc. Next, they will likely recommend a urinalysis (urine test) and blood testing as this is the best way to check on how her internal organs are functioning. The urine tests will show if there is infection or inflammation present, if the kidneys are concentrating the urine appropriately, and if there is any other evidence of kidney damage in the urine sample. The blood tests will have several kidney function markers (BUN, Creatinine, SDMA) that become elevated when nephrons are damaged and not filtering correctly. Protein levels, blood electrolytes like sodium and potassium, and mineral levels of calcium and phosphorus are also important in determining the degree of kidney damage. Anemia, or low red blood cell count, is an important observation too. Additional testing to further examine aspects of the blood or urine may also be recommended for your dog depending on the screening test results. X-rays and ultrasound of the kidneys and abdominal organs also help to examine the kidney size and appearance, check for stones in the urinary tract, visualize tumors, and scan for abnormalities in other organs. 

Lastly, measuring a dog’s blood pressure is also very important. Kidney disease can cause high blood pressure AND high blood pressure can further damage the kidneys! It is essential to obtain as much information as possible in order to tailor your dog’s treatments to preserve kidney function. 

AskVet Tip: Kidney disease is graded on a scale from 1-4, 1 being mild and 4 being severe disease. The results of diagnostic testing help to put the puzzle pieces together and determine the stage of kidney disease. At that time, the doctor and pet parent discuss the prognosis, treatments, and long-term expectations together. 

What About Long-Term Health?

The diagnosis of kidney disease does not necessarily mean doom and gloom for your dog! Your dog’s journey with kidney disease highly depends on the stage, initial cause, degree of damage, progression, and treatments. If the issue is detected very early and protective measures are put in place, it is possible for dogs to stabilize and live for many years without showing outward signs of having an issue.

It is important that dogs diagnosed with kidney disease follow up with their veterinarian every 6-12 months as recommended. This allows their vet to keep a close eye on any progression of kidney damage, and to determine when to tweak your dog’s therapy or add further treatments. It is very possible for dogs with kidney disease to live happy and comfortable lives!

Our AskVet Veterinarians are available to discuss all of your pet’s needs 24 hours a day, 7 days a week. Whether you have an immediate need or are looking to improve your pet’s overall wellbeing, just sign into your account, and one of our friendly and knowledgeable veterinary experts will attend to your needs, no appointment required!


Written by:

Alexa Waltz, DVM

Dr. Waltz was raised near the beaches of Southern California but has spent her adult life living all over the beautiful United States while serving in the military and as a military spouse. She left California for the first time to pursue a career as a veterinarian at Louisiana State University School of Veterinary Medicine and graduated as a Doctor of Veterinary Medicine in 2006. She was accepted into the US Army Health Professionals Scholarship Program during vet school and upon graduation spent her military years as a veterinarian in San Diego working for the US Marine Corps and US Navy Military Working Dog programs as well as caring for pets of service members. After her military service, she became a civilian veterinarian and continued as a small animal general practitioner at clinics in California, Rhode Island, Colorado, and Maryland. Dr Waltz loves to see her “in person” patients just as much as communicating with and assisting pet parents virtually on AskVet. Dr Waltz is also a Mom to 3 humans, 2 guinea pigs, and 1 Australian Shepherd and in her spare time she loves traveling, adventures, exercising, and doing just about anything out in nature!



Acupuncture for Dogs 101: What It Is & How It Works

Plush animal with acupuncture needles

If your pet is experiencing symptoms like separation anxiety, arthritis pain, vomiting, or allergies, you may be wondering about “alternative” treatments for your pet. The most effective and well-studied holistic therapy for pets is acupuncture – which can improve your pet’s quality of life and overall health!

Many pet owners have questions about acupuncture. What is it? How does it work? Is there any scientific benefit to acupuncture? What is involved in a typical acupuncture session?

Read on for answers to all of these questions.

History of Acupuncture

Acupuncture is one of five parts of Traditional Chinese Medicine (TCM). The practice of acupuncture on people and horses began approximately 3,000 years ago in China. Treating pet dogs and cats with acupuncture began approximately 100 years ago – which is still much longer than we have been using many of our Western therapies!

Interest in acupuncture (both human and veterinary) in the United States grew significantly in the 1970s, spurring the National Institute of Health (NIH) to sponsor research into the benefits of human acupuncture. Ultimately, the NIH released a consensus statement highlighting the promising future of acupuncture use in human medicine.

What Is Acupuncture?

Simply put, acupuncture is the insertion of tiny, thin needles into specific points on the body called “acupoints.” These acupoints are related to each other and connected by Meridians or Channels, which are located under the skin. These points are thought to be areas that, when punctured, relieve stress or pain.

Several methods are used to stimulate these points:

  • Dry needle: This is the use of needle insertion alone, which is the most common form of stimulation.
  • Electroacupuncture: This is when the needle is attached to an electrical lead that provides a mild current to further stimulate the meridians.
  • Aquapuncture: This is the injection of a liquid (usually vitamin B12) under the skin into the point.
  • Moxibustion: This is when you burn the herb Artemesia above the needles to warm them, which provides additional healing properties described in TCM.

Alternative Therapies: How To Get Started

Similar to Conventional Medicine, the success of any Traditional Chinese Veterinary Medicine (TCVM) treatment plan lies in the correct diagnosis. While your family veterinarian may have diagnosed your pet with “arthritis” or “intervertebral disc disease,” a TCVM diagnosis will be based on a more complex classification that includes any outward symptoms.

A TCVM vet might gather information from the animal’s habits, pulse, tongue color, pressure points, and many more physical changes in order to determine a diagnosis. This is called the Bian Zheng or pattern diagnosis. This may explain why one patient responds to conventional treatment while another pet with the exact same symptoms and disease does not!

Based on assessment of your pet’s diagnosis, your TCVM veterinarian then selects “points” for treatment. Some points have local effects – for example, in treating pain related to a torn cruciate ligament in the knee, the acupuncturist may select a specific point named ST35, which is located at the knee next to the tendon of the knee cap. Other points are distant from the site of disease and are selected based on relation to the Meridian that the problem lies along or a relationship with the organ system involved.

Some acupuncture points have specific actions and can be used as symptomatic treatments as well. For example, the acupoint GV14 located where the neck meets the torso on the top of the back is useful for reducing fever.

A nearby acupoint is used to help stop coughing. One of the most studied points is PC6, located on the inner forelimb above the wrist, which is very effective at preventing nausea. (You may be familiar with the wristbands that help with motion sickness in people!)

How Does Acupuncture Work?

The short answer is: there is no short answer! In general, when we discuss how TCVM works, there are two explanations: Western and Eastern.


The Eastern explanation is rooted in several principles. The most basic principle is something that may sound familiar: Yin and Yang. Yin and Yang represent the naturally occurring dichotomy in nature. Hot and Cold, Man and Woman, Day and Night, Excess and Deficiency are some examples you may be familiar with, but there are infinitely more!

Each half of a dichotomy is the polar opposite of the other, but one half cannot exist without its opposite. We only know what cold is because we’ve experienced hot, for example! Likewise, there is no night without day. What’s more: nothing is ever 100% Yin or 100% Yang.

Under this philosophy, the interactions and flow between Yin and Yang create harmony and health. Disease then occurs during periods of disharmony.

Another basic principle is the Five Treasures Theory. The Five Treasures are Jing (or congenital essence — basically DNA), Shen (the mind/spirit/psyche), Body Fluid (tears, urine, sweat, saliva, intestinal fluid, etc.), Blood, and lastly, Qi.

You can think of Qi as the electrochemical communications throughout the cells of your body. Qi is what gives life to our bodies, and where there is no Qi, there is no life. No, we’re not discussing philosophy — Qi directly refers to that intangible bioelectric force that animates living beings.

Qi flows through the Meridians in TCVM. Disease or pain occurs when Qi cannot flow properly. Think of when you have a pinched nerve: Your leg becomes painful, tingly, and you can’t move it as well. Alleviating this pinching can then allow your body to restore itself to a state of health. Something similar happens when the flow of Qi is restored.

Give you pet the personalized care. Get the app!


In Western Medicine, we tend to rely on a process called evidence-based medicine that seeks to prove theories through research. Fortunately, there have been numerous studies proving the effects of acupuncture.

Through this scientific research, we are learning that there are many complex biological mechanisms of action to explain the beneficial effects we see from acupuncture. Acupuncture stimulates a series of interactions between the nervous, immune, and endocrine systems.

It has been proven to :

  • Increase blood flow
  • Reduce inflammation
  • Strengthen the immune system
  • Improve muscle relaxation
  • Stimulate nerves
  • Release stem cells
  • Stimulate endogenous opioids (natural painkillers)
  • Release serotonin (the “feel good” hormone)

Because of this research, Western science has validated the use of acupuncture as a beneficial treatment for many different types of medical conditions.

What Can Acupuncture Do for Pets?

Treatment with acupuncture can be performed for virtually any disease! The most well-supported and well-known uses of acupuncture are for pain management and pain relief.

This alternative therapy can help to regulate nervous systems and the musculoskeletal system. Acupuncture can be used to treat skin conditions such as acral lick granulomas, reduce anxieties and other behavioral problems, relieve pain from hip dysplasia, gastrointestinal tract disorders like IBD and vomiting, kidney disease, and cancer.

Additionally, acupuncture can be done concurrently with the conventional therapies for all of these diseases so our pets can benefit from both Western and Eastern Medicine to live longer, healthier, and happier lives.

Conditions That Could Benefit From Acupuncture

There are some conditions that are used more frequently than others when it comes to pet acupuncture. If your dog suffers from the following, they might be a good candidate to try acupuncture treatment:

  • Arthritis: Acupuncture helps your dog’s body to release endorphins which can alleviate pain from arthritis. Depending on how well this pain relieving technique works for your dog, your DVM might take them off some pain medications.
  • Cancer: Acupuncture stimulates blood flow and naturally improves the body’s ability to heal itself. This can help alleviate pain from cancer treatment or medications used to treat unwanted symptoms.
  • Degenerative Joint Disease: If your pet is beginning to struggle with joint mobility, acupuncture might help to support flexibility and decrease tension to help them move better.
  • Trauma: If your dog is suffering from pain caused by some sort of trauma, acupuncture can be used to pinpoint the spots that hurt and try to help alleviate chronic pain.
  • Metabolic Diseases: Acupuncture is known to help regulate the endocrine system and relieve oxidative stress. This can help to increase blood circulation and help eliminate toxins inside the body.

Before you decide to move forward with acupuncture for your pet, you should always consult with their licensed veterinarian to discuss the benefits and any potential side effects (though there aren’t really any).

Is Acupuncture Safe?

Acupuncture is considered very safe! There are virtually no side effects when acupuncture is performed by a trained professional. The needles are extremely thin (typically smaller than the needles used to give vaccines), sterile, and single-use only for your pet’s comfort and safety.

Some animals notice the prick as the needle is inserted, but most do not mind the process. In fact, quite a few even fall asleep during an acupuncture session! Some animals experience fatigue the day of or the day after their acupuncture treatment, but otherwise, no significant side effects have been detected after years of study.

Do All Veterinarians Perform Acupuncture?

Veterinarians can become trained and certified in acupuncture through several schools, including Chi University, CuraCore, the International Veterinary Acupuncture Society (IVAS), and the Canine Rehabilitation Institute (CRI). The classes can take anywhere from months to years to complete. In addition to acupuncture, some veterinarians become certified in herbal medicine, Tui-Na, and Chinese food therapy to help their patients heal.

If you think your pet may benefit from animal acupuncture therapy, discuss this with your family veterinarian! Since not all veterinarians are trained in veterinary acupuncture treatment, your family veterinarian may refer you to a local practitioner who offers this treatment.

You can also look up practitioners on the websites of the individual acupuncture schools:

Chi University:




What To Expect From the Procedure

Before you can be treated with acupuncture, your veterinarian will discuss your treatment options before recommending you to a Certified Veterinary Acupuncturist with training in TCVM. Any information that is beneficial to understanding your pet’s issue will be sent over to the acupuncturist before the consultation, and during the consultation, any concerns should be voiced.

At the consultation, your dog might undergo blood work, lab testing, and x-rays to determine where the issue is. Once the acupuncturist has determined what the issue is and where the best points to be punctured are, you can go forward with the treatment. These sessions will last anywhere between 20 minutes and one hour.

While your dog might notice the prick of the needle as it’s being inserted, afterward, it can be fairly relaxing. Some animals even fall asleep during the procedure, which is totally okay. It should be a relaxing and comforting experience.

After the procedure is over, your dog might be a little sore and tired. You will want to allow them to rest up and drink plenty of water for the next day. Every dog is different and will be treated specifically based on their needs.

Some dogs might need several treatments a week or just a few a month to help keep them feeling healthy and happy. This is something that your acupuncturist will be able to discuss with you before starting the treatment.

Get to the Point With AskVet

No one expects you to be an expert when it comes to acupuncture, let alone for your pet (unless you literally are one). It can be scary to think about sticking needles into your beloved pup, but it’s painless and does a lot of good for your pet’s health and wellness.

Acupuncture is often where people end up when other pain medications and treatment methods aren’t relieving their pet as much as they hoped for. It’s not a “last ditch effort,” but it might not be the first thing you think of. In fact, you might want to bring it up with your vet at your next check-up.

If you have more questions about pet acupuncture, consider signing up with AskVet. Here, pet parents have 24/7 access to Certified Pet Lifestyle Coaches™, who can provide you with answers to any questions you might have – related to acupuncture or not. With this kind of access, you don’t have to worry when you have a question in the middle of the night.

AskVet’s goal is to provide you with quality care and answers so that you don’t have to spend any more time worrying about your pet than you already have. Plus, we don’t just have answers for cats and dogs — we include care for all (ranging from hamsters to snakes). Join for just $9.99/month and feel a sense of ease the next time you need some reassurance.



An Historical Review and Perspective on the Impact of Acupuncture on U.S. Medicine and Society | NCBI

About – Traditional Chinese Veterinary Medicine | Chi University

Effect Of Acupuncture On Pain And Quality Of Life In Canine Neurological And Musculoskeletal Diseases | NCBI

What’s Safe to Use in my Medicine Cabinet for Pets

Woman with first aid kit on gray background

Written by: Allison Ward

If you’re like most pet parents, you have probably wondered, “is there any human medicine for dogs or cats that is safe?” After all, there are many drugs and therapies that have been created for humans and which can help dogs and cats, too! However, many medications that are safe for YOU are actually dangerous for your pet. Always remember that cats and dogs are not small humans, and their bodies may process and react to certain human medication very differently.

Here, we’ll discuss the most common items in your own medicine cabinet that you may be tempted to use for your sick or injured pet! 

Pain Medications

You notice your precious pup or sweet kitty starting to limp on one of their paws. Of course, your first instinct is to try to make them feel better—but please DO NOT reach for ANY human pain medication. Unfortunately, there are NO SAFE OVER-THE-COUNTER PAIN MEDICATIONS that you can give your cat or dog. In fact, most human pain medications are downright toxic to pets—and, in some cases, can even kill your pet. 

These human pain reliever medications include (but are not limited to) aspirin, Aleve/naproxen, ibuprofen, and Tylenol/acetaminophen. Dogs and cats process drugs differently than people (and differently from each other!), so it’s important to stick with pain medication that is ONLY prescribed by your veterinarian.

But My Pet is in Pain—What Can I Do Instead?

If your pet is limping or seems painful, make sure you chat with an AskVet veterinarian to determine if your pup or kitty needs to be seen on an emergency basis, or if he can wait for a non-emergency scheduled appointment with your family veterinarian. 

If it is safe for your pet to wait to be evaluated in person, keeping your cat or dog confined to a small room (or even a crate or playpen, if they are trained to be confined) is usually the most effective form of pain control you can provide at home. Since we can’t tell our cats and dogs to stay off their feet, being confined is the only way to keep your pet from overdoing it on their injured leg, or from worsening a back or neck injury. 

Confinement also helps prevent your pet from following family members around the house, bounding up and down the stairs, or running to the door if they hear something outside–common ways for injured pets to make themselves more painful!  Dogs should only be taken outside on a leash to prevent them from excitedly chasing animals and people, and walk only long enough to use the bathroom before coming right back inside. Cats should have access to a shallow, easy-to-use litterbox while in their confined space. 

Sometimes, an injured area becomes swollen and it is obvious what part of the body is painful. In these cases, a cold compress can be your pet’s best friend! Place some ice cubes in a baggie, wrap it in a light towel, and hold it gently to the painful area for ten minutes at a time in order to help numb the pain. **Note: ONLY apply a compress if this is well-tolerated by your pet—it is NOT worth putting yourself at risk of getting bitten by a painful pet!** 

In some cases, a warm compress may provide more relief than a cold compress. For a warm compress, simply microwave a damp washcloth until it is comfortably warm–you can test it on the inside of your wrist, just like a baby bottle–place it in a baggie to keep your pet dry, and wrap in a light towel before gently placing it on the sore area.

Give you pet the personalized care. Get the app!

Stomach Medications

If your pet has begun vomiting, having diarrhea, or seems to have difficulty passing a bowel movement, you may be tempted to reach for medications to settle your pet’s stomach. In certain cases, antacids (such as Pepcid AC/famotidine), diarrhea medication (such as Imodium), or laxatives (such as Miralax or Metamucil) MAY be recommended by your veterinarian, once they have thoroughly examined your pet. 

However, the doses for these medications are very different between dogs, cats, and humans—and with certain medical conditions, some of these medications should be avoided altogether. That’s why these medications should NEVER be given unless they are vet approved from your family veterinarian. 

AskVet Tip: If your pet constantly struggles with an upset stomach, ask your family veterinarian for dosage guidelines specific to your pet for anything over-the-counter you can administer for future mild stomach flare-ups. Keep a written list of these in your medicine cabinet, and make sure to put a date on the recommendations in case they change over the years. 

But My Dog/Cat is Vomiting and Having Diarrhea…What Can I Do?

The safest home remedies for a vomiting dog or cat is to feed them very small meals of an easily-digestible bland diet to try to help settle their stomach. Also, knowing what to watch for in case a vet visit becomes necessary is essential pet parent education! 

My Pet is So Itchy!

We’ve all been there: your cat or dog is scratching incessantly, shaking their head, and sometimes even chewing on themselves! It’s so miserable to be itchy, and you desperately want to give your pet some relief! 

Two of the most useful tools in your toolbox with any itchy pet are #1: prescription-strength flea prevention, and #2: a good soothing shampoo. Since the most common cause of itchiness in dogs and cats is flea bites, it is always a good idea to stock up your cabinet with vet-recommended medication in order to get rid of fleas on dogs or cats ASAP.

Since dogs and cats can be sensitive to dust, pollen, household cleaners, and other sources of particulate residues in their home environment, bathing is an effective way to remove anything from the surface of their skin that may be causing any cat or dog allergies. Some shampoos also have soothing ingredients, such as oatmeal, that help to calm down mild skin redness and itchiness. If your pet has a chronic skin condition, ask your veterinarian if they recommend a specific shampoo that you can use at home for your fluffy kiddo on days with breakthrough itching. 

For especially itchy areas, or those that are painful from excessive scratching and chewing, you can use a cold compress (described above) to numb the affected area for 10-15 minutes at a time to give additional relief. Also consider pulling out that “cone of shame” that you have kept in your closet since your pet’s last surgery! Applying the cone until your pet can be evaluated by his veterinarian can help prevent him from licking and itching, making the area even more irritated. 

What About Benadryl and Other Antihistamines?

You may be tempted to reach for some Benadryl to help relieve that itching. Although Benadryl is generally safe in dogs (at a very different dose than used for people), it is only effective for itching in less than half of all dogs. In cats, Benadryl can sometimes cause hyperactivity and aggressive behavior–so this usually isn’t a veterinarian’s first choice for itch relief!

There are other over-the-counter antihistamines which are safe in dogs and cats, and may be more effective. Even though they still don’t work as well as prescription medications, sometimes they can help just enough to give your pet comfort until their vet visit. 

If your dog or cat has repeated episodes of itchy skin, ask your family veterinarian for a dosage of an over-the-counter antihistamine that is safe for your pet to have for future flare-ups. Write down the drug name, tablet size, and dosage as well as the date your vet made the recommendation and place it in your medicine cabinet for future reference! 

Knowing how much Benadryl is safe to give your pet in case of a severe allergic reaction (see below) is ALWAYS good information to have—so make sure to ask your vet about Benadryl, too.

AskVet Tip: DO NOT give ANY pet a “non-drowsy” version of your vet approved antihistamine. These formulations have additional medications that are dangerous for your dog or cat! 

Epsom Salt Foot Soaks

One of the most common symptoms of itchy skin is excessive licking of the paws. This affects dogs much more often than cats, and you may notice your pup’s paws are red, swollen, smell musty, and may have rust-colored staining of the fur. If your pet is suffering from itchy and painful paws, soaking the paws in an Epsom salt solution can provide a great deal of relief. 

For this home remedy, just follow the directions on the package of Epsom salts to make a solution with warm water, and soak the affected paw(s) in a shallow container for 10 minutes at a time. For pups with more than one paw affected, the easiest way to do this is to mix an Epsom salt solution in a few inches of water in the bathtub, and then have your dog stand in the water for 10-15 minutes at a time. 

**If your pet is experiencing sudden itchiness along with a swollen face, vomiting, or red bumps all over the body (hives), then these may be symptoms of a sudden and potentially life-threatening allergic reaction. Seek emergency vet care or chat with an AskVet veterinarian immediately if these symptoms are noted!**

Help! My Pet is Bleeding!

It’s easy to panic when you notice blood coming from your precious pet!

If your pet has suffered an injury such as being attacked by another animal, hit by a car, or falling from a height and is now bleeding, apply direct pressure to a bleeding wound and transport immediately to your family veterinarian (if they are open) or your closest veterinary ER facility. 

Fortunately, the most common bleeding issues we see at home are minor injuries that are oozing small amounts of blood. If your pet is otherwise acting normally and you can identify where the blood is coming from, use sterile gauze (available at most pharmacies) and/or a soft towel and apply direct pressure to the wound. Release the pressure and check the wound for further bleeding after five minutes. 

If the bleeding has stopped, call your family veterinarian or chat to AskVet for further advice. (Pictures of the wound are very helpful in these situations, and can be attached directly to your chat!) We may recommend first aid at home for your pet, or recommend that your furbaby be seen promptly by a veterinarian in person. If the bleeding continues for longer than 15 minutes, then a trip to the vet is warranted!  

If your pet is bleeding on one of her legs, it is tempting to try and bandage the area. Unfortunately, it is all too easy to cause damage by accidentally applying a bandage too tight and cutting off your pet’s circulation. Some pets are also notorious for ripping a bandage off with their teeth and swallowing the bandage material–leading to yet another urgent problem!

For these reasons, we do NOT recommend attempting ANY at-home bandaging techniques.  

AskVet Tip: If your pet has cut a nail and it is bleeding, don’t fret! Take some cornstarch or flour and add a bit of water to make a paste. Then, use your fingers to apply the paste directly over the bleeding nail. You may have to distract your pet with some peanut butter or a chew toy. Once the bleeding stops, inspect the nail for any breakage. 

The Bottom Line

To summarize, here are some items that are essential for every pet owner to keep in your pet medicine cabinet: 

  • Veterinarian-approved over-the-counter antacids and/or laxatives (if your pet  has a chronic condition)
  • Cold compress/warm compress (these can be the “instant” type, or just make 
  • sure to have supplies to make one!)
  • Oatmeal-based or vet-recommended soothing shampoo
  • Epsom salts
  • Benadryl (in case of allergic reactions) and dosage instructions from your vet
  • Veterinarian-approved over-the-counter antihistamine and dosage instructions
  • White rice in case your pet needs a bland diet
  • Flea control as recommended by your veterinarian 
  • Cone collar to prevent licking and chewing itchy areas and wounds
  • Sterile gauze or a clean towel to stop bleeding
  • Cornstarch or flour to stop a bleeding nail

At AskVet, we know how scary and frustrating it can be for your pet to be uncomfortable. Our veterinarians are available 24/7 to advise you on your pet’s symptoms, what constitutes an emergency, and what home care options are available to give your pet relief! Whether you have an immediate need or are looking to improve your pet’s overall wellbeing, just sign into your account and one of our friendly and knowledgeable veterinary experts will attend to your needs, no appointment required!


Written by:

Allison Ward, DVM

Dr. Allison Ward grew up in the suburbs of Washington, D.C. and started working in veterinary hospitals when she was 14 years old. After graduating from veterinary school in 2011, she completed a small animal rotating internship in New Jersey, followed by a neurology/neurosurgery internship in Miami. After completing this advanced training, Dr. Ward then moved on to general small animal practice. Dr. Ward’s professional interests include feline medicine, neurology, and pain management. Her passion for educating pet owners carries over into her work with AskVet, and she loves being able to help pets and their parents at all times of the day (and night!). She currently resides in sunny south Florida with her two cats, Larry and George.


Treatment of Kidney Disease in Cats

Thirsty tabby cat drinking water from a pet drinking fountain

Written by: Allison Ward

Now that you’re familiar with the numerous important jobs that your cat’s kidneys do for them, it’s time to discuss how we can help cats with kidney disease. If your cat has been diagnosed with acute (sudden) or chronic (long-term) kidney disease, read on to learn how to treat kidney disease in cats and help them live their best life for as long as possible. 

Consult Your Veterinarian About Any Recent Medications/Supplements

If your cat has recently been given medications, over-the-counter products, or supplements, make sure to inform your veterinarian. Many medications and supplements can cause the kidneys to work harder and may need to be stopped or reduced in dosage. If your cat is in acute (sudden) kidney failure, look around your household/garage to see if there is ANY possibility of your cat swallowing something toxic, like antifreeze. If you have any suspicions of your cat ingesting a toxic substance, speak with a veterinarian immediately. 

Fluid Therapy

As you know, one of the most important jobs that kidneys perform is filtering toxins out of the bloodstream and creating urine to further flush these from the body. In cats with kidney disease, this highly specific and balanced filtration process is impaired,  causing toxins to build up in the bloodstream and fluids to be lost. When the kidneys do not function normally, your kitty will produce an increased amount of urine in order to flush these toxins out. Even if you notice her drinking more than usual, this situation can easily lead to dehydration. 

When cats are dehydrated, they will become lethargic and feel very sick. A sick kitty will often stop eating and may drink less water too —intensifying that level of dehydration. On top of your kitty feeling crummy, the kidneys have lost the ability to conserve water so all of that precious fluid is ending up in the litterbox instead of hydrating their bodies. For these reasons, it’s important to make sure that any cat with kidney disease continues to be well-hydrated and to also correct any dehydration by administering extra fluids in order to help her body function as normally as possible.

Give your pet the personlaized care. Get the app!

Fluid Therapy in Acute Kidney Failure

In cats with sudden or acute kidney failure (or “acute renal failure”), this often means hospitalization for 24 to 72 hours (and sometimes longer). An intravenous catheter, or IV, is placed in a vein inside your cat’s front leg and fluids are delivered directly into the vein. This is the fastest way to hydrate your kitty and add the electrolytes back to the bloodstream that they may be lacking. Your kitty is monitored very closely with lab testing. As your cat’s hydration needs change, the rate of fluid being delivered into his system can be adjusted–sometimes even hour-by-hour. Don’t worry, though–the veterinarian taking care of your cat will make sure his fluid therapy is optimized to help him go home and be out of the hospital as quickly as possible! 

Fluid Therapy in Chronic Kidney Disease

With chronic kidney disease, extra fluids are not usually needed in the early stages because the kidneys are still doing a pretty good job on their own. However, since chronic kidney failure is often progressive and worsens over time,  your cat may eventually need to receive fluids at home. If your veterinarian recommends this type of treatment, don’t worry—your vet won’t expect you to place an IV! Instead, we utilize the space underneath all of that loose skin your kitty has and deposit fluid directly below the skin. 

This is called “subcutaneous fluids,” or “subcu fluids” for short, and the pocket of fluids looks like a little hump on their back. This fluid pocket is slowly absorbed over through the day and helps your kitty’s body receive that extra “drink of water”. This procedure is easier than it sounds and most cats tolerate it very well! Many tutorial videos are available on YouTube if you’re curious as to how this is done.

Kidney Diets

Your veterinarian may recommend transitioning your cat to a prescription kidney diet. These foods are specially formulated to minimize the work of the kidneys by containing protein, mineral, and electrolyte levels optimized to help those kidneys function. They are also specially balanced to provide nutrients for healthy metabolism and maintaining muscle mass, while containing beneficial fatty acids and antioxidants. All of these ingredients help kitty kidneys last longer. 

In general, the moisture and nutrients present in canned food are more helpful to struggling  kidneys than dry food. If your cat is used to the crunch of dry food, try the dry version of a kidney diet and gradually add more and more water to the kibble over time. Any extra water your cat can get just by eating and drinking will help with hydration and reduce stress on sick kidneys! 

AskVet Tip: Some kitties love sneaking sips of water in different areas around the house! Leaving that bathroom faucet on a slow drip into a small cup, investing in a kitty water fountain, or putting accessible sources of water out at various locations around the house may entice your kitty to stop for additional drinks throughout their day.

Medications for Upset Stomach/Appetite Stimulants

Sometimes, cats with kidney problems need some help in the stomach department, too! Dehydration and the buildup of toxins in the bloodstream can cause a cat to eat less than normal, or even to start vomiting. Once this happens, then your cat can become MORE dehydrated, since she isn’t taking in any moisture (and may be losing fluid through vomiting). 

Therefore, it’s very important to recognize changes in your cat’s appetite early on and alert your vet if you feel your cat is eating less, or if she starts vomiting. Medications such as antacids and nausea medication can be given to reduce any nausea your cat may be experiencing. Sometimes, veterinarians will dispense a longer-term supply of these medications for you to have on hand in case there’s a problem. 

In some cats who are not eating enough to prevent weight loss, or who are eating irregularly in spite of nausea medications, appetite stimulants can be prescribed. The most common is a medicated ointment that you smear inside your cat’s ear flap once a day called Mirataz. Another effective option is a once-daily liquid given by mouth called Elura. Your veterinarian can help you decide when and how often to use either of these medications. 

Blood Pressure Medication

As we discussed in our article on signs of kidney disease in cats, medications are sometimes needed to control high blood pressure. Since high blood pressure can further damage the  kidneys over time, it’s essential to recognize high blood pressure early on. These medications are usually given one to two times per day and include medications such as amlodipine and telmisartan. 

Reducing Urine Protein

As the kidneys continue to deteriorate, some kitties will experience the loss of protein from the bloodstream into the urine due to the damaged and leaky filtration system. Your veterinarian can perform a test on your cat’s urine called a “urine protein/creatinine ratio” which  determines if excessive protein is being lost into the litterbox. 

The urine protein/creatinine ratio is a helpful indicator of the severity of your kitty’s kidney disease — the higher the ratio, the more protein is being lost. Minimizing this loss is very important and can be managed with medications like telmisartan, enalapril, and benazepril. Not all cats with kidney disease will need medication for excess urine protein, however–some leaky kidneys still keep the protein in the body where it needs to be. 

Calcium and Phosphorus Balance

One of the most important functions of the kidneys involves regulating the amount of calcium and phosphorus in the body. You may be familiar with calcium and phosphorus as minerals that are essential to building strong bones—but the kidneys play an important role in regulating just the right balance of these two minerals! If the calcium level is creeping up in your kitty’s bloodstream due to kidney disease, a medication called calcitriol has been proven to help kidney patients survive longer by helping the kidneys achieve appropriate calcium levels. 

Phosphorus is another mineral that can cause nausea and damage to organs around the body if the level in your cat’s bloodstream is too high. For this reason, prescription kidney diets are low in phosphorous to reduce the amount of work your cat’s kidneys need to accomplish! As kidney disease worsens over time,, your vet may recommend starting a medication such as aluminum hydroxide to help your kitty excrete more phosphorus. 

Monitoring Kidney Disease

We know this list of therapies for cats with kidney disease probably seems overwhelming to you right now! Fortunately, very few cats need ALL of these different interventions. In early stages of kidney disease, for example, your veterinarian may recommend switching to a prescription kidney diet and repeating some lab work in a month or two. We can never be sure how quickly an individual patient’s kidneys will deteriorate, so rechecking lab work could be recommended on a monthly basis, every three months, or every six months. 

Here are some tests your veterinarian may recommend to monitor your cat’s kidney status after they have been diagnosed with kidney disease:


 Evaluates levels of toxins in the bloodstream that should be filtered out of the body through the kidneys. Examples include BUN (blood urea nitrogen), CREA (creatinine), PHOS (phosphorous), and CA (calcium). Increases in these numbers mean that the kidneys are struggling. Bloodwork can also tell us about the protein levels in your cat’s bloodstream, electrolyte levels, and red blood cell/white blood cell counts. 


 Evaluates the ability of the kidneys to concentrate urine, as well as monitoring for evidence of active kidney damage (“casts” in the urine) and evidence of infection in the urinary tract. 

Urine Protein/Creatinine Ratio

 Evaluates whether the cats kidneys are letting too much protein out of the body into the urine

Urine Culture

 The gold standard test for urinary tract infection, this test requires a sterile urine sample to be collected in the clinic and then waiting for bacteria to grow in the urine sample. Cats with kidney disease are more vulnerable to infections, and infections can worsen kidney disease. Many veterinarians recommend performing this test every 6 months, even if no clinical signs or symptoms are currently noticed at home. 

Blood Pressure

As kidney disease worsens over time, your cat’s blood pressure will likely increase. Sometimes this doesn’t happen for a year or two after diagnosis of chronic kidney disease, but catching this medical condition early can save your cat’s life. Therefore, many veterinarians recommend monitoring a kidney patient’s blood pressure at least every 6 months. 

The Bottom Line

Your AskVet veterinarians know that kidney disease can be overwhelming and confusing—and we are here to help! If you have any questions about your cat’s medical condition, or are wondering whether your cat with kidney disease needs urgent attention, then all you have to do is Ask Vet. We are here 24/7 to help you and your cat!

Written by:

Allison Ward, DVM

Dr. Allison Ward grew up in the suburbs of Washington, D.C. and started working in veterinary hospitals when she was 14 years old. After graduating from veterinary school in 2011, she completed a small animal rotating internship in New Jersey, followed by a neurology/neurosurgery internship in Miami. After completing this advanced training, Dr. Ward then moved on to general small animal practice. Dr. Ward’s professional interests include feline medicine, neurology, and pain management. Her passion for educating pet owners carries over into her work with AskVet, and she loves being able to help pets and their parents at all times of the day (and night!). She currently resides in sunny south Florida with her two cats, Larry and George.

Home Remedies for Cat Vomiting

Sick cat lying on a pillow

If your cat is vomiting, then you are likely worried about whether he is truly sick, or just has an “upset stomach.” For more about whether you should consider veterinary care for your vomiting cat, see our article on “Causes of Cat Vomiting” and chat with an AskVet Veterinarian!

Sometimes, your cat’s vomiting can be resolved with a bit of TLC and some care at home. This is especially true if it turns out your cat is vomiting because he ate something he shouldn’t have that has caused him to feel temporarily nauseous—but cats with serious illness WILL NOT get better with home care.

My Cat Just Vomited…Should I be Concerned?

This is one of the most common reasons kitty parents chat in to AskVet! In general, you SHOULD be concerned and consider veterinary care IF:

    • You suspect your cat may have swallowed a non-food item or a toxic substance
    • Your cat is not using the litterbox normally (this includes straining to urinate, being unable to pass urine, or urinating/defecating outside of the litterbox)
    • Your kitty is also acting like he feels sick: hiding from you, being less social (or in some cats, more “clingy” than usual), walking slowly, or is not as responsive as he normally is to favorite toys or cuddles
    • Your cat is also having diarrhea
    • There are multiple episodes of vomiting over a short period of time
    • Your cat is not willing to eat for longer than 24 hours, or is drooling (a sign of severe nausea)
    • Your cat is a young kitten (less than six months old), since he can become dehydrated VERY easily—creating an emergency situation

If none of these scenarios apply to your vomiting cat, then phew—your kitty may be eligible for home care!

Give your pet the personlaized care. Get the app!

How Do I Help My Vomiting Cat at Home?

First things first: think back and consider WHY is my cat vomiting? Is she grooming more frequently and swallowing lots of her hair—that has come out in a hairball? Or did you recently run out of her favorite cat food and switch food types all of a sudden? Have you seen her playing and chewing on a toy that is now missing? Or does she go outside and may have eaten something (like a prey animal or toxic substance)?

If you have recently changed your cat’s diet, fed your kitty a new treat, or given her some human food off your plate recently, then her stomach may just need a bit of rest and relaxation (so to speak!) to get back to normal. Cats have very sensitive stomachs and sometimes do not tolerate a sudden change in their diet, leading to vomiting. If you are changing your cat’s food, it’s important to GRADUALLY mix the new food in with the old food over about a week’s time to avoid an upset stomach.

The one exception to that rule is when you need to start a special diet to help your cat recover from vomiting. If your precious purrbox is otherwise acting like her normal self and has started vomiting, you can try offering her a bland diet for a few days to let her system take a break.

Bland/Easily-Digestible Diets

You may have heard of feeding dogs with an upset tummy boiled chicken and rice to settle their stomach. Did you know you can also use this to soothe a cat’s rumbling tummy, too? The only difference is that cats need VERY FEW carbohydrates compared to dogs—so the ratio of ingredients is a bit different.

You can feed your cat a mixture of 90% boiled chicken and 10% rice for a few days, in small amounts at a time (think in terms of tablespoons, not cups!). If your kitty doesn’t like rice, then you can eliminate it altogether for a pure protein bland diet of boiled chicken. Make sure the chicken is skinless and free of spices, oil, butter, and seasoning.

If your kitty has an intolerance for poultry, or just doesn’t care for chicken, then you can offer her some canned tuna—just make sure it’s in water, not oil (since the fatty oil may make her symptoms worse). Alternatively, you can boil some LEAN ground beef or ground turkey—just make sure to skim the fat off the top and let it cool before serving small amounts to your cat.

My Cat is Such a Picky Eater—What Else Can I Offer Him?

For cats who turn their nose up at the above bland diet, there are several safe flavor-enhancers you can mix in—like a few teaspoons of low-sodium chicken, beef, or bone broth. Another commonly-enjoyed bland food that is safe to mix in with the bland diet is meat-based baby food—yes, that’s right! You can feed your cat small amounts of beef, chicken, turkey, or ham baby food found in your local supermarket.

AskVet Tip: You may have heard that onions and garlic are toxic for cats—and this is true! Most broths and meat-based baby foods will list these ingredients on their packaging, but the amount of onion and garlic in these products is such a tiny amount that it is NOT going to be toxic for your cat in small amounts.

If your cat is happily eating the bland diet and otherwise acting normally, then continue to feed the bland diet for 48 hours (or until your cat has been vomit-free for at least 24 hours), before GRADUALLY mixing in his normal food over several days.

If your cat is NOT eating, if the vomiting continues for longer than 48 hours, OR if any of the other symptoms we listed as concerning pop up—then your cat should be seen by a veterinarian in person as soon as possible.

What About Over-the-Counter Medications?

Cat parents frequently ask us about giving a vomiting cat over-the-counter medicine. It’s important to realize that many of these medications are NOT safe for cats and are outright toxic (like Pepto Bismol). In other cases, medications may be dangerous for your cat depending on the underlying reason for their vomiting.

For these reasons, it is NOT safe to administer your cat ANYTHING over-the-counter unless it is on the advice of a veterinarian who has examined your cat in person. Please DO NOT give your cat ANY of the following: Pepto Bismol, Pepcid A/C, Miralax, olive oil/other plant-based oils, Zantac, or anything else without advice from your family veterinarian.

My Cat is Still Vomiting—What Can I Expect at the Vet?

If your cat is showing other symptoms in addition to vomiting, has vomited multiple times in a short period of time, or continues to vomit in spite of feeding a bland diet at home, then your kitty should see her veterinarian. In some cases, this means taking your cat to an emergency clinic. Your AskVet veterinarians are standing by 24/7 to help you make these decisions for your cat—so please chat with us any time!

As always, your cat’s veterinarian will start with a thorough physical exam. This includes evaluating his level of dehydration, whether he has any abdominal pain, listening to his heart and lung sounds, and looking for any other hints as to the cause of your cat’s vomiting. Next, your veterinarian will make recommendations on how to help your kitty feel better, and tests to look for causes of your cat’s upset stomach.

Symptomatic Treatment to Make Your Cat Feel Better

We all know how miserable it feels to be nauseous, and your cat is no different! Your veterinarian will often give anti-nausea medication to help settle his stomach as a first-line treatment. This medication is often given first by an injection in the vet’s office, since your veterinarian wants to make sure the drug is absorbed (and not vomited up if given by mouth!). This may be followed with nausea pills to be given at home, and your veterinarian may also add antacid medications, a nutritionally-balanced bland diet, and/or probiotics to re-balance the good and bad bacteria in your cat’s gastrointestinal tract.

Often, cats who are vomiting are also dehydrated. This is due to both loss of fluid in the vomit itself, and the lack of fluid intake if your cat is not eating or drinking normally. Depending on how dehydrated your cat might be, your veterinarian may give your cat a fluid pouch under the skin (“subcutaneous fluids”), which is absorbed over several hours to re-hydrate your cat and allow you to take him home. In cats with severe dehydration, your veterinarian will recommend hospitalization and fluids to be provided directly into your cat’s vein (“IV fluids”).

Specific Treatment for the Cause of Vomiting

Since there are hundreds of possible causes of cat vomiting, your veterinarian will likely recommend some testing to start narrowing down the list of causes in your cat’s case—and also evaluate whether specific treatment is needed to address the underlying cause of your kitty’s illness.

These tests include bloodwork and urine testing to look for problems with blood sugar and your cat’s internal organs, including her liver, kidneys, electrolyte levels, protein levels, white blood cells, and thyroid levels—just to name a few! A stool sample may be analyzed for the presence of intestinal parasites, which are easily cured with specific medication. Imaging of your cat’s abdomen with radiographs (x-rays) or an abdominal ultrasound may also be recommended to evaluate for signs of a blockage, inflammation of the pancreas, or other diseases.

If your veterinarian finds a specific reason for your cat to be vomiting, then further treatment will aim to fix the problem. For example, it may be that your cat is vomiting from hyperthyroidism and needs thyroid medication, or he may be diabetic, or she may have a urinary tract infection that needs antibiotics. In some cases, surgery may be recommended to remove a non-food object causing a blockage, or obtain biopsy samples, or to fix a gallbladder problem. 

As you can probably tell, the home remedies  for cat vomiting depend on the severity of your cat’s current condition, as well as if any underlying causes are found. The best outcome? A cat whose test results are all normal and who feels better with just symptomatic treatment!

Hoping For The Best!

While some cases of mild vomiting will resolve on their own with the above recommendations, always remain vigilant while your cat is not feeling well! Our veterinarians at AskVet are an excellent resource for triage and assistance with interpreting your kitty’s condition and symptoms if you are not quite sure if he needs veterinary help in person.

Our AskVet Veterinarians are available to discuss all of your pet’s needs 24 hours a day, 7 days a week. Whether you have an immediate need or are looking to improve your pet’s overall wellbeing, just sign into your account and one of our friendly and knowledgeable veterinary experts will attend to your needs, no appointment required!


Common Signs of Kidney Disease in Cats

kidney disease in cats

Written by: Allison Ward

Kidney disease—also known by the medical term, “renal insufficiency”—is a scary phrase to most cat parents. Unfortunately, kidney problems are a common occurrence as cats age, and can even affect some young cats (though this is much more rare!). 

You may be wondering if changes in your cat’s behavior or activity level could be signs of kidney disease. If your cat has already been diagnosed with renal insufficiency, you may be curious as to how you will know if your cat’s kidneys are getting worse over time. Read on to find out more about cat kidneys, and symptoms to watch for that may indicate a problem! 

What Do Kidneys Do, Anyway?

Before discussing what signs you may see with kidney disease in cats, it’s helpful to know the basics of what kidneys normally do in the body!

Fluid Regulation and Urine Production

You may remember from biology class that kidneys can be thought of as big filters: they filter out the normal toxins and electrolytes that build up in the bloodstream every day. Not only that, but the kidneys conserve water in the body, and create urine to pee out what the body doesn’t need. How do kidneys decide what to keep and what to eliminate through urine? It’s a very complex process that is too detailed to discuss here—but we’ll give you some basics to help you understand how kidneys work. 

In healthy kidneys, deciding how much water to keep in the body and how much water should be lost to urine production depends on whether the cat is dehydrated. When a cat is not drinking much water or has lost fluid through vomiting or diarrhea, then conserving water is a big priority! This is why dehydration leads to less urine in the litterbox in a cat with healthy kidneys. 

Another factor in how the kidneys control the amount of urine being produced is how much waste is dissolved in the urine. For instance, if a cat has sugar in her urine due to diabetes, the kidneys put more water into the urine to help flush out the sugar, which creates bigger clumps in the litterbox. The important thing to keep in mind is that when kidneys are damaged or just aging more quickly than the rest of the body, this ability to conserve water is affected—which also leads to more urine in the box, even if the kitty is becoming dehydrated (more on that later). 

Give your pet the personlaized care. Get the app!

Regulate Blood Pressure and Red Blood Cell Production

We all know that maintaining normal blood pressure is important to our own health—and it’s just as important to your cat’s health! Blood pressure can be thought of as the force with which blood travels through our veins and arteries, allowing the red blood cells (oxygen-carrying component of blood) to deliver oxygen to vital organs. When blood pressure is too high, tiny microscopic blood vessels can start breaking and bleeding. When blood pressure is too low, then vital organs are not able to get enough oxygen in order to function normally. 

Where do the kidneys come into all of this? They are part of a complex system your cat’s body uses to maintain the optimal blood pressure to stay healthy. Your kitty’s kidneys secrete hormones that help regulate blood pressure and contain receptors that serve as a feedback mechanism for the body to keep blood flowing at the perfect pressure. In addition, the kidneys also have millions of fragile, tiny blood vessels that can be damaged by blood pressure that is too high—which means that kidney disease can cause high blood pressure, and high blood pressure can cause kidney disease. It’s a real “which came first, the chicken or the egg?” scenario! 

In addition to hormones regulating blood pressure, the kidneys have another essential role in making sure your cat’s internal organs get the oxygen they need. Your cat’s kidneys secrete a special hormone, called erythropoietin, that tells the body to increase red blood cell production. These red blood cells can be thought of as  a taxi service that picks up oxygen from the lungs and drops off oxygen to the brain, liver, kidneys, heart, and all of the tissues in your cat’s body. Erythropoietin is like the head of the taxi factory, telling the body to make more. If a cat is in advanced kidney failure, they no longer manufacture enough erythropoietin, and so red blood cells are not made—depriving the tissues of much-needed oxygen. 

Symptoms of Kidney Disease in Cats

Now that you are familiar with kidney function and some of the important roles that your cat’s kidneys perform, symptoms of kidney disease will start to make sense. 

Increased Thirst and Urination

In the early stages of kidney disease, cat parents often notice their kitties spending more time at the water bowl. Instead of drinking once or twice a day, your cat may be drinking five, six, or more times per day—and seem to be drinking for longer periods of time. You may find yourself refilling the water bowl more often than normal, or finding your cat vocalizing to you because the bowl is empty and they are thirsty! All of that water seems to come out in the litterbox—and you will notice more and larger urine clumps. Since the kidneys are excellent filters, it is not a surprise that more water comes out in urine than usual when the kidneys are not able to do their job appropriately!

Drinking and urinating more frequently can be due to a number of different medical conditions, such as diabetes,—so if you notice these changes, make an appointment with your veterinarian right away. Bloodwork and urine tests will determine if your cat has kidney problems or something else as the cause of his increased thirst and urination.

Vomiting and Decreased Appetite

In cats with kidney disease, normal toxins that are passed out of the body in the urine start to build up in the bloodstream because ailing kidneys cannot filter these toxins out into the urine quickly enough. As these toxins increase in the bloodstream, your kitty will start to become nauseous. 

Early on, mild nausea may not be enough to cause vomiting—but it may be just enough to make your kitty queasy at the sight of food and to decrease their appetite. Since vomiting and poor appetite can also be seen with many other causes of cat illness, it’s important to see your veterinarian right away if you notice these changes in your cat.

Weakness and Lethargy

In cats with kidney disease, weakness can happen for a variety of reasons. Your kitty may feel nauseous (see above), or dehydrated from losing so much water through their urine. Also, since the kidneys can’t properly do their filtration work, electrolytes like sodium and potassium may not be regulated properly—too much may be lost into the urine, or too much can build up in the bloodstream. Either way, your kitty won’t feel well and will not be willing to play as usual, or may even be hiding from you and less social than normal. 


If your cat seems like she is suddenly blind, this could be caused by kidney disease. Signs of sudden blindness in cats include dilated pupils, frantic behavior/panic (just as you would be feeling if you suddenly could not see!), and bumping into objects. How and why could this be related to kidney disease?! 

It all comes back to blood pressure! As we discussed, kidney disease can cause high blood pressure, which leads to damage of fragile tiny blood vessels throughout the body. Some of the most fragile blood vessels in the body are in the back of the eye (called the retina), and these vessels are sometimes the first to experience damage and bleeding. If your cat has suddenly developed vision problems, please have her seen by a veterinarian immediately—even if that means taking her to an after-hours clinic. If her blood pressure is high, vision can sometimes be restored with blood pressure-lowering medications—as long as they are started right away!

 Seizures or Sudden Loss of Balance

Another area of the body with many fragile, tiny blood vessels is the brain. In cats with high blood pressure, they can experience bleeding of one of these vessels, leading to a stroke. Signs and symptoms of a stroke depend on where in the brain this bleeding occurs, and symptoms will come on very suddenly. 

You may see your cat fall to the floor with its legs moving and jerking rapidly for a few seconds (up to a few minutes), or you may see your cat suddenly start to walk like she is drunk and uncoordinated. If you are worried your cat has had a stroke, please have your cat seen by a veterinarian immediately. 

What Can Be Done for Kidney Disease?

Although kidney disease can cause many different signs, it’s important to recognize any changes in your cat’s behavior and discuss them with your veterinarian. Your vet can help determine the difference between kidney stones, acute kidney disease, chronic kidney disease, and end-stage kidney failure. A blood test and urine test, as well as imaging of your cat’s kidneys, may be recommended to decide the best way to treat kidney disease if it is present in your cat. 

Treatment of kidney disease depends on the underlying cause as well as the severity of kidney damage and what other organs are affected by these changes.

If you have questions about how to treat kidney disease in cats or possible symptoms that you are observing in your cat, please feel free to reach out to our AskVet veterinarians at any time. We are here 24/7 to answer your questions and help you and your kitty have a healthy life together! 


Written by:

Allison Ward, DVM

Dr. Allison Ward grew up in the suburbs of Washington, D.C. and started working in veterinary hospitals when she was 14 years old. After graduating from veterinary school in 2011, she completed a small animal rotating internship in New Jersey, followed by a neurology/neurosurgery internship in Miami. After completing this advanced training, Dr. Ward then moved on to general small animal practice. Dr. Ward’s professional interests include feline medicine, neurology, and pain management. Her passion for educating pet owners carries over into her work with AskVet, and she loves being able to help pets and their parents at all times of the day (and night!). She currently resides in sunny south Florida with her two cats, Larry and George.

Why is My Cat Vomiting?

Sick cat lying on the table nearby a house plant

As a cat lover, you know that dreaded sound: “hork-hork-GACK!” Your cat has just vomited—and hopefully not on your good carpet! While you’re cleaning up the mess, you start to worry—”Why did my cat vomit? Is my cat sick? Should I call my veterinarian?” 

At AskVet, we’re here to help you decide when to seek veterinary care, and to help you start narrowing down the list of possible reasons why your cat may be vomiting. 

Wait…Isn’t it normal for cats to vomit?

Many cat guardians are under the impression that cat vomiting is no big deal. They’ve been told that vomiting up hairballs and vomiting occasionally is a normal part of cat life….but is it really? Surprisingly, the answer in most cases is NO—it is not “normal” for your cat to vomit. Continue reading for more information about what might make your cat vomit and why, as well as when to talk to a trusted veterinarian. 

Cats Vomit from Abnormalities in the Gastrointestinal Tract 

It can be helpful to separate the causes of vomiting into two broad groups: problems within the gastrointestinal tract (which includes the esophagus, stomach, intestines, and colon), and problems outside of the gastrointestinal tract that make kitties nauseous. 

Don’t Eat That!

While cats are usually notoriously picky eaters, they can still scarf down things that cause an upset tummy. If your cat spends time outside, this could be a prey animal—such as a bird, lizard, or mouse. Even indoor cats can ingest bugs and other creepy-crawlies that make them nauseous and vomit. When this happens, usually cats will vomit once or twice but otherwise feel and act normally. 

However, cats can become sick from certain bacteria present in prey animals (“songbird fever” is another name for salmonella infection in outdoor cats). Your kitty can also pick up intestinal  parasites from swallowing prey animals and insects (including fleas!) which lead to vomiting and diarrhea, too! Fortunately, parasites are usually easily diagnosed and treated, but can make your cat quite sick until the problem is fixed. 

Cats can also swallow toxic substances (including antifreeze and chocolate), just like dogs–so even if you suspect that your cat’s predatory behavior is the cause of your cat’s vomiting, it’s important to keep an eye out for other symptoms. Cats are notorious for chewing on indoor and outdoor plants too, often resulting in vomiting. Some plants just cause a mild upset stomach, but occasionally curious kitties accidentally sample toxic plants too (like lilies!) and can become very sick. Ingestion of lilies can be life threatening and requires immediate veterinary care.  

Whether indoors or outdoors, any cat can swallow other non-food items like plastic, toy pieces, and fabric strings. Since these cannot be digested, they may get stuck and cause a life-threatening condition. 

Cats with an intestinal obstruction from swallowing a non-food item will have repeated episodes of vomiting, and eventually stop eating and become lethargic. Emergency surgery is usually required to relieve them of the obstruction, and this becomes more risky as they become more ill—so timely treatment is important!

Give your pet the personlaized care. Get the app!

The Dreaded Hairball

As cat lovers, we have all cleaned up that tube-shaped clump of hair and stomach contents after our kitty has coughed up a hairball. While an occasional hairball can be normal, especially in longer-haired felines, they should still be a “few and far between” occurrence. If your cat is vomiting up hairballs more often than once a month, then she may be overgrooming due to itchy skin or anxiety, or her gastrointestinal tract may be having difficulty moving things along. It’s best to see your veterinarian if you are noticing frequent hairballs—even if your kitty is otherwise acting normally.

Food Sensitivity

At AskVet, we frequently speak with cat owners who are concerned that their cat’s vomiting may indicate they need to change foods.. This is a very reasonable question, especially in light of how many pet foods are available and how they are marketed!

The most common food-related cause of vomiting in cats is the “scarf and barf”—when your kitty devours his food quickly, and then vomits up the undigested food within the next half an hour or so. If this is the ONLY time that your cat vomits, then try to slow down her eating first and see if that fixes the problem. This may be as simple as adding some water to your cat’s food (see our article on “dry versus canned food in cats”), or using puzzle and foraging tools to prolong your cat’s eating experience. (Note: these toys are also wonderful for your cat’s mental health!)

Surprisingly, some cats who eat dry food will vomit if the kibble is a certain shape (such as round pebbles), and not vomit if they are fed another shape (such as triangles). If you recently switched your cat’s kibble shape, then this might be the cause of your cat’s vomiting.

Cats can have allergies or sensitivity to the protein source in their food (for example, fish-based protein versus chicken-based), too—though this is relatively uncommon. If your veterinarian thinks your kitty might have a food allergy or sensitivity, they may prescribe a special diet with a novel protein source that your cat hasn’t eaten before, or even a hydrolyzed protein diet.

AskVet Tip: When changing your cat’s diet to a new brand, variety, or even opening a new bag of food, a slow transition is recommended to help your cat’s stomach and intestinal tract adjust to the new food. Cats can be very sensitive to diet changes! A gradual transition over 1-2 weeks, adding the new diet to the old food can help alleviate some of the possible tummy upset that can occur from introducing a new food. It is recommended to introduce the new diet by offering 25% more every 2 days, and simultaneously phasing out the old.

Inflammatory Bowel Disease

Sometimes, cats will develop inflammation of their stomach and intestines because their body is attacking the normal cells in these organs. This inflammation leads to nausea and vomiting, diarrhea, or both. Sometimes, the only symptom of inflammatory bowel disease that we see is weight loss from the decreased absorption of nutrients that occurs with the inflamed organs.

The only way to diagnose this disease is by looking under the microscope at small pieces of the stomach and intestines, which requires your veterinarian to perform biopsies. Since this procedure is expensive and somewhat invasive, your veterinarian will likely rule out other causes of long-term vomiting in your kitty before recommending testing for this condition.

Cats Vomit from Problems Outside the Gastrointestinal Tract

How can a problem outside of the gastrointestinal tract cause a cat to vomit? Great question! The sensation of nausea is complex and involves multiple organs—but always ends in your cat’s brain. The short answer is that anything that triggers the brain’s “vomiting center” will cause a cat to vomit.

These triggers can come from toxins that build up in the bloodstream (like when the kidneys can’t properly filter out the toxins produced by the body on a daily basis), so-called “stretch receptors in the stomach (such as when a cat eats too much and becomes too full too fast!), motion sickness, balance problems, and other stimuli. Stress and anxiety can also cause your kitty to vomit, too!

Problems with your cat’s kidneys, liver, blood sugar levels, and thyroid gland can all cause triggering of your cat’s vomiting center. Fortunately, your veterinarian can screen for these causes with bloodwork. The entire list of reasons for cats to vomit is too long to list here, but rest assured it would take up many pages!

How Do I Know When My Cat Needs to See the Vet for Vomiting?

Here are some guidelines for when you should seek veterinary attention for your vomiting cat:

–Your cat may have ingested something toxic/poisonous (like antifreeze, or leaves or petals from your beautiful bouquet of lilies), or a non-food item (maybe their favorite mousey is missing!) 

–Your cat is weak, lethargic, or hiding

–Loss of appetite/refusing to eat

–Straining to urinate or not using the litterbox

–Vomiting occurs more often than once a month (even if your cat is otherwise acting normally)

–Your cat has diarrhea as well as vomiting

–You have noticed your cat losing weight

If you do not notice the above symptoms and you are looking for home remedies for cat vomiting, see our article here! If you aren’t sure if your kitty should see a veterinarian for an in-person evaluation, or just wondering what to expect at your vet visit, our AskVet veterinarians are just a chat away to help you and your furry friend.  We are here to help you determine how urgent your cat’s vomiting problem is, discuss possible causes, and walk you through what testing and treatment your veterinarian may recommend. 

As always, our AskVet Veterinarians are available to discuss all of your pet’s needs 24 hours a day, 7 days a week. Whether you have an immediate need or are looking to improve your pet’s overall wellbeing, just sign into your account and one of our friendly and knowledgeable veterinary experts will attend to your needs, no appointment required!


Kidney Disease in Dogs: Common Symptoms & Treatment

Sick Jack Russel dog lies wrapped in a brightly colored blanket on a couch



Receiving the news that your dog has kidney disease can be scary and confusing for pet parents. Kidney disease occurs on a spectrum – some cases are an emergency, and your dog may be feeling very sick, vomiting, and acting lethargic.

In other cases, you just may note that the water bowl is empty more often than normal, and your dog is having to urinate frequently. And to complicate things more, kidney disease may be asymptomatic early in its course, only to be discovered via annual blood and urine testing. Every dog’s journey with kidney disease will be highly dependent on the cause, severity, progression, and treatments.

Managing kidney disease hinges on understanding all of the ways that the kidney supports the body. Kidneys are made up of millions of tiny cellular units called nephrons. These little nephrons are the true workhorses of the kidney and perform many essential functions for the body.

There are a variety of medical problems that cause nephrons to become damaged and result in kidney failure in dogs. Unfortunately, once healthy kidneys are permanently damaged, they cannot regenerate healthy tissue.

The kidneys are so good at compensating for damaged nephrons that by the time we start to see evidence of kidney damage on your dog’s lab work, at least 2/3 of the kidney’s functional capacity is already diminished! At that time, it is important that treatment is initiated to preserve as much kidney function as possible.

Let’s talk more about what the kidneys do.

What Do Dog’s Kidneys Do?

The kidneys are responsible for many functions that are crucial to overall health. One such function is removing excess waste, fluids, and toxins. This keeps the body healthy by preventing buildup.

When the kidneys can no longer filter out these substances, it is a sign that they aren’t working properly. Kidneys also control blood pressure and pH levels, help produce red blood cells and support bone health.

So what are the signs of this vital organ failing?

What Are the Clinical Signs of Chronic Kidney Disease?

Some of the most common symptoms include weight loss, decreased appetite, vomiting, increased or decreased urination, and thirst. You might also notice your dog’s gums becoming pale or that their breath has a chemical scent. Additionally, they might have trouble walking or staying balanced.

This wide range of symptoms will likely worsen as the disease progresses.

What Causes Kidney Failure in Dogs?

Now that you know the signs, you might be wondering how your furbaby became ill. Several things can cause kidney failure, ranging from damage to specific parts of the kidneys to ingesting household products that may contain dangerous toxins.

Let’s dive in:

Kidney Damage

There are many ways in which the kidneys could become damaged. Here are a few possible infections and other issues that may have caused your dog’s kidney failure:

  • Glomerular Disease: This disease occurs when the part of the kidney responsible for the filtration of waste products, called the glomerulus, becomes inflamed. The inflammation damages surrounding tissues within the kidney, which leads to the development of chronic kidney disease.

In the early stages, your dog may not exhibit symptoms, but it is vital to seek treatment as soon as possible to slow the progression of this illness.

  • Nephrolithiasis: Nephrolithiasis is a term used to describe kidney stones. Kidney stones may not be painful initially but can become painful if they result in a blockage or infection.
  • Blockage: If kidney stones become fragmented, they can move into the ureter along with urine as it reaches the bladder. The fragments could cause a blockage if they become stuck within the ureter, making it difficult for urine to leave the bladder. Consequently, the kidneys become enlarged and damaged.
  • Leptospirosis: This is a treatable bacterial infection that can cause acute kidney injury but may also contribute to chronic kidney disease. Prompt management of this infection is best to ensure a favorable outcome.

Household Products and Toxins

Some products you use in your home can be hazardous for dogs.

A few common household items that may contribute to kidney failure include:

Grapes and Raisins

Grapes and raisins are both poisonous as they stay in the stomach for an extended period of time and aren’t processed correctly within your dog’s gastrointestinal tract.

The exact amount needed to inhibit kidney function is unknown, but you should avoid giving these fruits to your dog altogether to minimize the risk.


Antifreeze can be found in products such as paint, motor oil, hydraulic brake fluid, and radiator coolant, more commonly referred to as automotive antifreeze.

Cardiac Medications

Some heart medications include beta blockers and calcium channel blockers, both of which are used in human and veterinary medicine to effectively treat high blood pressure and cardiac disease. Poisoning due to these medications can lead to a low heart rate and acute kidney injury.

Non-Steroidal Anti-Inflammatory Medications

It is not safe to give your dog over-the-counter medication meant for humans without first receiving guidance from your veterinarian upon consultation since many human medications are harmful to animals. This includes non-steroidal anti-inflammatory medications such as Advil and Motrin. These can cause intestinal ulcers and acute kidney injury.

Vitamin D3

Vitamin D3 is extremely harmful to dogs, and they could rapidly develop an acute kidney injury if this vitamin is ingested. Vitamin D3 can raise calcium and phosphorus levels, otherwise referred to as hypercalcemia and hyperphosphatemia. Consequently, the body’s soft tissues within the heart, kidneys, and GI tract will harden.

Several items in your home contain vitamin D3, including rat poison, prescription vitamins, multivitamins, and omega fatty acid supplements.

Give you pet the personalized care. Get the app!

Chronic Kidney Disease and Age

The age at which dogs could develop chronic kidney disease varies based on age and size.

Large dogs might show early signs of CKD as young as seven years of age because they tend to have a shorter life span than smaller breeds. In contrast, small dogs live longer and may not show signs of CKD until they are around ten to 14 years of age.

How Is CKD Diagnosed?

To diagnose CKD, your vet may conduct several tests, including three different blood tests, as well as urine testing, radiography, ultrasonography, and testing for infectious diseases.

Here’s what you can expect:

  • Radiography: This test uses X-rays to examine your dog for tumors or kidney stones. It might also help detect other health problems.
  • Ultrasonography: Ultrasounds are safer than radiographs because they use sound waves instead of radiation. However, both tests are essential: ultrasounds take images of the body’s tissue differently than radiographs.
  • Blood Urea Nitrogen: The BUN test is a blood test that is usually incorporated into blood panels. Elevated results are only shown on this test when kidney function has decreased by 60 to 70 percent, making it highly effective at uncovering kidney problems.
  • Blood Creatinine: Similar to the BUN test, the blood creatinine test will only show elevated results at 60 to 70 percent decreased kidney function. Creatinine is an amino acid in muscle protein. Both tests are influenced by factors unrelated to kidney function, such as exercise, diet, and muscle mass. For this reason, these tests can provide an accurate diagnosis after the disease has progressed, but a final blood test is needed to diagnose CKD in its early stages.
  • SDMA Test: Symmetric dimethylarginine tests for an amino acid called arginine. SDMA levels elevate well before BUN and creatinine, helping detect kidney failure early on. Your dog could be tested for phosphorus and calcium levels in their blood.
  • Urinalysis: Testing urine can provide information about the status of the kidneys that may not have been apparent in blood testing. This includes the detection of protein loss within urine, the presence of bladder stones, bleeding, and inflammation.

What’s the Outlook? The Future for Dogs With Kidney Disease

CKD is progressive, but proper treatment can allow dogs to live for months to even years with the diagnosis while still having a good quality of life. Starting treatment as soon as possible can help them live longer.

Geriatric Degeneration

As your dog ages, they could develop health issues, including CKD. We’ll discuss a few of them and their symptoms below.

Degenerative Joint Disease

This disease is also known as Osteoarthritis. Dogs can develop arthritis in old age, just like humans. Typically, this affects the function of any weight-bearing joints such as the knees and hips, which erodes the body’s cartilage over time. Osteoarthritis is progressive, but treatment can help ease your dog’s pain while slowing progression.


Older dogs may begin to show signs of cognitive dysfunction, including dementia. You’ll want to see your veterinarian for an official diagnosis if you notice your dog doing things like pacing, having accidents, appearing confused or lost, or withdrawing from the family. Dementia cannot be cured, but your vet can prescribe medications or supplements that might make these symptoms more manageable.


Dogs can lose their vision as they get older, and while there is no way to reverse it, their other senses can help them adapt. It is best not to rearrange your furniture so that they won’t be confused about their surroundings at home and keep them on a leash when you take them outside.


Canine diabetes is a frequent concern in elderly dogs and can present itself in one of two ways. The first and most common is insulin-deficient diabetes. This occurs when the pancreas is not functioning properly, preventing the body from producing enough insulin.

The second form is insulin-resistant diabetes, during which insulin is produced but is not used properly within the body. Diabetes can lead to abnormal blood chemistry, resulting in damage to organs, including the kidneys. If your dog has diabetes, they may experience weight loss, increased appetite and urination, and increased thirst.

Symptoms of End-Stage Renal Disease in Dogs

When your dog enters the end stages of kidney failure, their symptoms may worsen. Some of these could be similar to ones they experienced in prior stages of CKD, while others were not present before the final stages.

Review a few of them below:

  • Uremia: When waste productsbuild up in the body, this gives your dog’s breath a strong ammonia scent
  • Mouth Ulcers: Uremia could cause painful ulcers in your dog’s mouth.
  • Dull and shedding coat: Your dog might begin to shed more than usual, and their coat may appear unkempt.
  • Bloodshot eyes: During the final stages, the eyes may seem bloodshot.
  • Loss of body fat and muscle mass: The weight loss brought on by kidney failure can cause them to appear emaciated as they lose both muscle mass and body fat.
  • Dehydration: Although kidney failure causes increased thirst, it also causes frequent urination, leaving your dog constantly dehydrated.
  • Dry and pale gums: The gums could become pale and extremely dry due to the lack of fluids in your dog’s body.
  • Fatigue and lethargy: Your dog’s energy levels may decrease, causing them to sleep more and become less active.
  • Slow heart rate and trouble breathing: During prior stages, the heart rate may increase, but it becomes slower in the final stages. However, blood pressure could become elevated. Difficulty breathing could also arise.
  • Anemia: Anemia is the lack of healthy red blood cells in the body, resulting in reduced oxygen flow to the organs.
  • Tremors and shaking: Your dog might experience shaking, tremors, and loss of balance.
  • Seizures: Recurrent seizures are a major indication that your dog is in the final stages of kidney failure.
  • Depression and disorientation: Your dog may seem confused and lose interest in things they usually enjoy.

Acute or Chronic?

Acute Kidney Failure (acute renal failure) occurs when there is a sudden injury to the kidney tissue due to causes like toxin ingestion or infections like Lyme or Leptospirosis. This damage occurs quickly over minutes, hours, and days. Acute Kidney Failure is an emergency needing immediate treatment.

If the damage happens more slowly over time due to unknown reasons and old age, it is referred to as Chronic Kidney Failure (chronic renal failure). Treatment for this type of kidney disease involves long-term management to prevent progression and further loss of those important nephrons.

End-stage chronic kidney failure occurs when the damage is in such an advanced state that other body systems are also affected, and the condition of the dog is very poor overall.

Treatment of acute and chronic kidney failure are similar yet different since one happens on a much faster timeline than the other! How do we tell the difference between acute and chronic?

Using information from the pet parent about recent changes in your dog that you have observed at home, physical exam findings, blood and urine test results, blood pressure readings, and other diagnostic options like x-ray and abdominal ultrasound, your veterinarian can distinguish which type of kidney issue your dog is experiencing.

When a kidney injury is diagnosed, the goals of treatment are to address the original cause of the damage, restore as much kidney function as possible, and slow the damage and further loss of function. Some treatments also directly target the buildup of certain wastes in the bloodstream, aid in hydration, and maintain electrolyte balances.

How Is Acute Kidney Failure Treated?

The kidneys are very fragile and can be rapidly and severely injured by infections, toxins (grapes, raisins, antifreeze), and severe dehydration (heat stroke and shock). Without treatment, acute kidney failure is life-threatening. If the kidneys experience this sudden injury, the sooner treatment is received, the better the outcome!

Severely ill dogs can be expected to be hospitalized for several days. In some cases, acute kidney failure can be reversed; the kidneys can be jump-started again to resume their responsibilities.

In other cases, treatment is ineffective or not initiated in time, and the kidneys will suffer a degree of permanent damage.

Possible Treatment Plans for Acute Kidney Failure in Dogs

If your dog is diagnosed with acute kidney failure, here are some treatments that may be offered:

  • Treatment for the primary disease causing the acute kidney failure (such as antibiotics for an infection of the kidneys)
  • Intravenous (IV) Fluids: used to restore electrolytes and hydration and help the kidneys continue to flush out the wastes and toxins from the bloodstream.
  • Urinary Catheterization: measuring the urine output is key in monitoring how the kidneys are rebounding and responding to treatment.
  • Medications: Antibiotics, anti-nausea medications, gastro protectants, appetite stimulants, blood pressure medications, cardiac support, and pain medications if your dog is painful
  • Temporary Feeding Tube: Many dogs feel lousy and do not want to eat. A feeding tube can help deliver nutrition directly to their stomach until they are ready to eat on their own.
  • Monitoring: Bodyweight, urine output, electrocardiogram, blood pressure, temperature, and urine and blood testing will assist your veterinarian in closely monitoring your dog’s status.

Are There Renal Replacement Therapies for Dogs?

AskVet Tip: Unfortunately, treatments called “renal replacement therapies” (aka dialysis and kidney transplants) are not widely available options to treat kidney failure in animals. Some veterinary hospitals do have dialysis capabilities, but at this time, it is not routinely used and is very expensive.

For more information, refer to your veterinarian for dialysis options at referral centers and large veterinary hospitals in your area.

Acute kidney failure is a very serious and potentially fatal condition. Prognosis often depends on the initial cause of the kidney injury and how quickly appropriate treatment is begun.

Some dogs will beat the odds and have an excellent response to treatment, resuming their regular healthy lives! Unfortunately, other dogs will suffer permanent damage to the kidneys and live with some level of chronic renal failure, requiring ongoing care for the rest of their lives.

Treatment Options for Chronic Kidney Disease

Chronic kidney disease has a much slower progression and often takes place over months and years rather than hours and days. Since chronic kidney disease occurs from mild to severe, the International Renal Interest Society (IRIS) created a standard set of guidelines for treating chronic kidney disease based on the classified stage.

What Are the Four Stages of IRIS?

The IRIS has 4 stages – stage one being very mild disease and stage 4 being severe end-stage disease. IRIS staging is based on a complete assessment of kidney function, which includes blood and urine test results and blood pressure measurement. (You may hear your veterinarian discuss blood values such as creatinine, BUN, SDMA, and urine protein creatinine ratio!)

With mild kidney disease, only a few treatments may be needed to aid the nephron with filtration, maintain hydration, lower blood pressure, and balance electrolytes.

With advanced kidney disease, the filtering power of the nephron is greatly diminished, causing wastes and toxins to build up in the bloodstream affecting the function of other organs around the body.

Possible Treatments for IRIS

The following are some commonly recommended treatments for dogs with IRIS Stages 1-4 kidney disease in order to improve or maintain kidney function and quality of life for as long as possible:

  • Treat any primary disease-causing or complicating condition (such as high blood pressure)
  • “Renal diet”: Prescription diets with decreased protein and restricted phosphorus and sodium content to help support struggling kidneys and reduce the amount of work they have to do (Hill’s K/D and K/D Early Support, Purina Pro Plan NF and NF Early Care, Royal Canin Renal Support and Early Renal Support)
  • Supplements: Phosphorus binders (Epikatin, Aluminum Hydroxide), vitamin D supplements (calcitriol), potassiumsupplements, probiotics (Azodyl), omega-3 fatty acid supplements (fish oil)
  • Medications: Blood pressure medications (enalapril, telmisartan, amlodipine), anti-nausea medications (cerenia, ondansetron), appetite stimulants (mirtazapine, entyce), antacids (omeprazole, famotidine)
  • Intravenous or Subcutaneous Fluids: Maintain hydration and correct electrolyte imbalances. IV fluids can be given in the hospital and fluids under the skin (subcutaneous, or “SQ” fluids) can be given at home.
  • Erythropoietin: Injectable erythropoietin may become necessary if the red cell count becomes too low.
  • Feeding tube: Sick dogs sometimes do not want to eat, so a feeding tube can provide nutrition directly into the stomach for a period of time until he starts to feel better

How Can Kidney Failure Be Prevented?

The best thing you can do to reduce the chances of canine kidney failure is to schedule regular vet visits. This makes it less likely that they will develop any conditions you would be unaware of. When they are examined by your vet often, routine tests such as blood work and urine tests may detect early signs of kidney disease and other illnesses.

Your dog’s diet is another aspect of preventing kidney disease is keeping your dog on a healthy diet. Adding probiotics can support good bacteria that are already in their system. Feeding your dog high-quality food with protein as the main ingredient can help support kidney function.

Providing your dog with clean drinking water will also lessen the bacteria they consume. If your dog is susceptible to kidney problems or other issues, your vet might recommend specific foods to support kidney health.

You should always talk to your vet when navigating a CKD diagnosis, as they can assist you in coming up with a treatment plan that best suits your dog.

Goals of Treatment

The goals of treatment are to address any disease responsible for damaging the kidneys in the first place, support the remaining kidney function, and address any fluid, electrolyte, and mineral imbalances that arise due to the compromised kidneys.

Pet parents can take an active role in helping their pups by closely adhering to treatment plans and following up with the recommended recheck appointments and blood/urine tests.

The response to treatment can vary widely between dogs – some kidney function can improve with the above treatments allowing dogs to live an active and happy life for many years.

Other dogs may progress quickly and develop debilitating issues resulting in a poorer quality of life. Keeping your dog feeling good for as long as possible is the outcome we all strive for!

Our AskVetCertified Pet Lifestyle Coaches™ (CPLC) are available to discuss all of your pet’s needs 24 hours a day, 7 days a week. Whether you have an immediate need or are looking to improve your pet’s overall wellbeing, just sign into your account, and one of our friendly and knowledgeable veterinary experts will attend to your needs; no reservation required!

Join AskVet to discuss any lingering questions you may have and formulate a lifestyle plan totally tailored to any pet in your household.



Kidney Failure in Dogs – Signs & Symptom | Rossmoyne Animal Emergency Trauma Center | Mechanicsburg.

Kidney Failure in Dogs | Kirrawee Vet Hospital | NSW

Renal Failure in Dogs: Causes, Symptoms & Treatment | Flat Rock Emergency Vet

Hypercalcemia in Dogs and Cats – Endocrine System | Merck Veterinary Manual

Hyperphosphatemia in Animals – Metabolic Disorders | Merck Veterinary Manual


Written by:

Alexa Waltz, DVM

Dr. Waltz was raised near the beaches of Southern California but has spent her adult life living all over the beautiful United States while serving in the military and as a military spouse. She left California for the first time to pursue a career as a veterinarian at Louisiana State University School of Veterinary Medicine and graduated as a Doctor of Veterinary Medicine in 2006. She was accepted into the US Army Health Professionals Scholarship Program during vet school and upon graduation spent her military years as a veterinarian in San Diego working for the US Marine Corps and US Navy Military Working Dog programs as well as caring for pets of service members. After her military service, she became a civilian veterinarian and continued as a small animal general practitioner at clinics in California, Rhode Island, Colorado, and Maryland. Dr Waltz loves to see her “in person” patients just as much as communicating with and assisting pet parents virtually on AskVet. Dr Waltz is also a Mom to 3 humans, 2 guinea pigs, and 1 Australian Shepherd and in her spare time she loves traveling, adventures, exercising, and doing just about anything out in nature!