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Kidney Disease in Dogs Treatment Plan: Steps and What to Expect

German Shepard dog at vet for kidney disease
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A dog’s kidneys have many important roles, such as helping with red blood cell production, maintaining blood pressure, and regulating fluids and electrolytes. They are also responsible for filtering out waste from the bloodstream. Kidney disease in dogs occurs when the kidneys become damaged and do not function properly. 

When the kidneys become damaged, dogs can become very sick. Once diagnosed, dogs with kidney disease must be closely monitored and managed with an appropriate treatment plan. 

Treating Kidney Disease in Dogs: Overview

It can be overwhelming for pet parents to learn that their dog has been diagnosed with kidney disease. Navigating initial treatments and long-term management of this condition may be daunting at first, but with the help of a veterinarian, pet parents can become educated and better equipped to care for their canine companions.  

Treatment for kidney disease in dogs will depend on the type and severity of disease. There are two main types of canine kidney disease:

  • Acute kidney disease
  • Chronic kidney disease (CKD)

Acute kidney disease typically develops rapidly and can occur in dogs of any age. It is most commonly due to the ingestion of some type of toxin, and it usually requires hospitalization and intensive treatment. Chronic kidney disease is a common condition among older dogs, and it is considered an irreversible, progressive condition. It can be present for an extended period of time without noticeable symptoms

Dogs with acute kidney disease usually need to receive treatment specific to the underlying cause of the condition. If a toxin was ingested, an appropriate treatment plan would be developed to counteract the toxin and provide supportive care. Typically, this treatment is only needed in the short-term, but it is possible for acute kidney disease to become chronic in some dogs, which would require additional treatment.  

Dogs who have chronic kidney disease require long-term management through medications, fluid therapy, and a prescription diet. These dogs will need to see a veterinarian on a regular basis. Veterinary visits are at least every six months but may be more frequent depending on the severity of the disease and how the dog is responding to treatment. 

Kidney Disease Dog Diet: What to Feed

Veterinarians typically recommend switching to a prescription diet specially formulated for kidney disease. These diets have lower amounts of protein, phosphorus, and sodium. Many contain antioxidants to support kidney function as well. 

Since dogs with kidney disease have an increased risk of urinary tract infections, some diets are also formulated to promote bladder health. 

Homemade dog food is not recommended for dogs with kidney disease because it is difficult to regulate the amounts of ingredients within them and ensure proper support for the kidneys. 

Dogs with kidney disease typically pass large amounts of dilute urine so they must have access to fresh, clean water at all times to compensate for this. Dehydration can exacerbate kidney disease, so it is important to keep these dogs well-hydrated at all times. 

Pet parents must also be cautious about the type of dog treat they are giving their dogs. Many treats contain ingredients that may not support optimal kidney function. Fortunately, there are several prescription treat options available.

Below are some vet-recommended prescription dog foods to help kidney function:

Purina Pro Plan NF dog food
Hills k/d kidney care dog food

Dog Kidney Disease Medications

Various medications can be given to help dogs with kidney disease. Some common medications prescribed by your veterinarian may include the following: 

Phosphate Binders

These medications bind excess phosphorus in a dog’s blood which accumulates if the kidneys fail to excrete it. High levels of phosphorus in the bloodstream can also increase calcium levels, which can have serious side effects. These medications help restore this balance and are given orally. 

Popular phosphate binders for dogs include:

Naraquin phosphate binder
Epakitin powder for dogs
Phos-Bind for dogs

ACE Inhibitors

Because hypertension can be a consequence of kidney disease, these medications are used to reduce high blood pressure. Untreated high blood pressure can negatively impact various other organs, such as the brain and eyes, so it is important to manage this condition. In turn, these medications also reduce the amount of protein found in the urine. They are given orally. 

Common ACE inhibitors prescribed for dog kidney disease include benezepril and enalapril. Buy them from your veterinarian here:


These medications are given to treat bacterial infections. They are only given if a concurrent infection, such as a UTI, is present in a dog with kidney disease to eliminate the bacteria. They are most commonly given orally, but some antibiotics may be given intravenously at the veterinary clinic if needed.

Common antibiotics used to treat infections associated with kidney disease in dogs include clavamox, amoxicillin, cefpodoxime, and cephalexin. These medications can be purchased from your veterinarian.

Clavamox chewables
amoxicillin for dogs
Simplicef cefpodoxime for dogs
medication for dogs

Proton Pump Inhibitors or H2 Antagonists

These medications are given to reduce acid within the stomach. Dogs with kidney disease often have increased acid production which can lead to stomach ulcers and mouth sores. Too much acid can also cause nausea, which can further decrease appetite. Pet parents usually give these medications orally, but H2 antagonists may also be administered via injection by a veterinarian.

Medications in this category include omeprazole and famotidine.

Appetite Stimulants

Many dogs with kidney disease have poor appetites because they feel nauseous and unwell. Providing an appetite stimulant by mouth can help increase their desire to eat and give them more energy. Some common veterinary-prescribed appetite stimulants include Entyce and Mirtazapine.

Dog medication in bottle

Fluid Therapy

Dogs with kidney disease benefit from additional fluid intake to ensure adequate hydration and perfusion of the kidneys. Fluid therapy can also treat electrolyte imbalance. Fluid therapy can be administered into a vein at the veterinary office, or trained pet parents can administer the fluids underneath the pet’s skin at home.


Because kidneys play a role in red blood cell production, dogs with kidneys that do not function well are at risk for anemia. If this occurs, this medication may be used to stimulate the bone marrow to produce red blood cells and counteract anemia. It is given via injection underneath the skin. 

Additional medications may be prescribed by the veterinarian depending on the unique needs of the patient, including any concurrent health conditions that are present and the underlying cause for the kidney disease. 

Tips for Managing Kidney Disease Pain in Dogs 

Many dogs with kidney disease experience pain as a result of their condition. This pain can be alleviated using certain oral pain medications or through a holistic approach. 

An oral pain medication that can be used in dogs with kidney disease is acetaminophen, which is non-acidic and better tolerated than other types of NSAIDs. The frequency and dose of this medication is dependent on the pet’s condition [1]. 

Holistic treatment for kidney disease in dogs may include acupuncture and various types of herbal supplements to reduce pain and support the kidneys.

Kidney Disease in Dogs Treatment: Additional Tips and Advice 

Treating kidney disease in dogs often requires lifelong management, but many dogs with kidney disease can live long, happy lives with proper treatment and care. 

Monthly costs will vary, but pet parents can expect to spend $75 or more on veterinary visits, medications, supportive care, and a prescription diet. 

Once a dog’s kidney disease is well-managed, some of the first signs pet parents notice are reduced thirst and urination. Most dogs have more energy and are more playful once they feel better too. They may also start to have better appetites and as a result, gain a little weight. 

If a dog becomes lethargic or starts drinking and urinating more frequently while kidney disease is being managed, you should contact your veterinarian for guidance. This could indicate an underlying issue and may require a medication adjustment or additional treatment. 


  1. Lascelles, D., & Epstein, M. (2016). Canine and feline pain management: expert insight into practitioners’ top questions. Today’s Veterinary Practice, 6(6), 36-40.