When to Euthanize a Dog With Kidney Failure

Recovery in dogs with renal failure is conditioned by its evolution. If the disease is mild or detected early, the animal can recover without sequelae based on specific and symptomatic medical treatment. If the condition is severe and it is diagnosed in its later stages, the animal's ability to recover will depend on the extent of the kidney damage.

In general, the ability of kidney tissue to repair itself is limited. The kidneys are vital organs responsible for filtering waste products from the blood and maintaining essential bodily functions. While some regeneration of kidney tissue can occur, especially in response to minor injuries, the kidney's overall capacity for self-repair is limited compared to other tissues like the liver.

In cases of acute kidney failure (AKF), if the underlying cause is addressed promptly, some reversible damage may heal as the kidneys regain function. However, chronic kidney disease (CKD) in dogs involves progressive and often irreversible damage to kidney tissue. This typically does not allow for full tissue repair. We will have to rely on managing the dog's symptoms and protecting the kidneys to ensure a longer life expectancy.

Another factor is the other health or lifestyle issues from which the dog might suffer. If the animal already has been weakened by previous pathologies and the condition is very serious, it is likely they will not be able to recover from kidney disease.

It is vital to emphasize that if symptoms related to kidney failure in dogs are observed, you need to take them to a trusted veterinarian as soon as possible.

Also known as renal failure, Kidney failure in dogs can manifest in cute kidney failure (AKF) and chronic kidney failure (CKF). The symptoms may vary depending on the type and stage of kidney failure. The following are some common symptoms for both types:

Symptoms of acute kidney failure (AKF) in dogs

• Sudden and severe symptoms: AKF often comes on rapidly and severely.
• Decreased urination: dogs may urinate less or not at all.
• Vomiting and diarrhea: gastrointestinal issues are common.
• Lethargy: affected dogs are typically very weak and lethargic.
• Dehydration: dogs may show signs of extreme thirst and dry mucous membranes.
• Anorexia: a loss of appetite is common.
• Halitosis (bad breath): dogs may have a distinctive ammonia-like breath.
• Oral ulcers and stomatitis: mouth sores can occur.
• Neurological signs: seizures or disorientation may be observed.

Symptoms of chronic kidney failure (CKF) in dogs

• Gradual onset: CKF usually develops slowly over time.
• Increased urination and thirst: dogs may urinate more frequently and drink more water.
• Weight loss: progressive weight loss is common.
• Poor appetite: dogs may eat less or refuse food.
• Vomiting and nausea: gastrointestinal symptoms can occur.
• Lethargy: affected dogs may seem tired and weak.
• Oral ulcers: mouth sores or bad breath can develop.
• Dehydration: as CKF progresses, dehydration may occur.
• Poor coat and skin condition: dogs may have a dull coat and flaky skin.
• Ammonia breath: dogs may have breath that smells like ammonia.

It's important to note that these symptoms can be associated with various other health conditions, so a proper diagnosis by a veterinarian is essential. Since kidney disease can be degenerative, it is something which is considered a common health problem in older dogs. This means we should be extra vigilant if we are caring for a senior dog.

Learn more about neurological disorders in older dogs which can further complicate the clinical picture of kidney disease.

It is important to know that there is no exact way to calculate the life expectancy of a dog with kidney failure. This is very important to remember when considering when to euthanize a dog with kidney disease. We want to prolong their life, but we also want to ensure they have a certain quality of life which does not cause them undue suffering.

In general, dogs that are diagnosed with chronic kidney disease have an estimated 65% survival rate from the moment of diagnosis. Within this percentage, the average survival time is 226 days. However, it varies greatly depending on whether it is a case of kidney failure in elderly dogs or in a healthy animal without previous pathologies.

Another factor to take into account is the IRIS (International Renal Interest Society) classification of chronic kidney patients. Dogs in the stage IRIS IV (the most severe) are up to 5 times more likely to die than those in IRIS I. Some factors that improve the Prognosis are the use of a renal diet, good body condition, prescribed treatment for proteinuria and high blood pressure. The IRIS classification is as follows:

• IRIS I: creatinine and SDMA (symmetric dimethylarginine) values below the pathological level (1.4 and 18 respectively), there may be incontinence problems not related to the kidney, incidental findings on ultrasound or renal biopsies with lesions. Chronic kidney disease can be diagnosed early.
  
  
• IRIS II: creatinine and SDMA between 1.4-2.8 and 18-35, respectively. Clinical signs are usually mild or absent.
  
  
• IRIS III: 2.8-5 creatinine and 36-54 SDMA. There are clinical signs related to azotemia, but they can be very variable.
  
  
• IRIS IV: creatinine above 5 and SDMA above 54. Very marked systemic clinical signs and probably begins with uremic crises.

As we have mentioned, the life expectancy of a dog with stage IV kidney failure will be much shorter. We do insist it is not possible to indicate an exact lifespan. In cases of kidney failure in elderly dogs, it is advisable to establish a regular check-up schedule with the veterinarian in order to control the evolution of the disease.

As it is a progressive and irreversible disease, treatment will be aimed at relieving symptoms and improving the quality of life of our pet. Depending on the state of the animal, different guidelines can be proposed to improve their clinical picture. To the extent possible and depending on each particular case, these guidelines may increase life expectancy:

• Specific kidney feed: this feed contains essential amino acids, antioxidant agents and low concentrations of salts to facilitate the proper functioning of the kidney. Learn more with our homemade diet for dogs with kidney failure.
  
  
• Phosphorus binders: with the aim of reducing the concentration of phosphate in the blood.
  
  
• Sodium bicarbonate: in case of metabolic acidosis.
  
  
• Fluid therapy: to correct electrolyte imbalance. While we can help improve hydration at for the dog at home, IV fluid therapy will be performed in a clinical setting.
  
  
• Antiemetics, stomach protectors and antacids: these are a series of medications which can be used to reduce digestive symptoms.
  
  
• Vasodilators: with the aim of improving kidney function and reducing high blood pressure.

These guidelines will need to be discussed with a veterinarian who will set out a specific treatment plan and prescribe the corresponding medications. They may also change during the last days of kidney failure in dogs. During the terminal phase, they may have reduced appetite so you can give them any food they find appetizing. Keeping them hydrated is also very important since the dog may stop drinking water.

Deciding when to euthanize a dog with kidney failure is a difficult and highly personal decision. It's typically based on a combination of clinical signs, the dog's overall quality of life and the veterinarian's guidance. Here are some considerations and clinical signs that may lead to the decision for euthanasia:

• Quality of life: the most critical factor in making the decision is the dog's quality of life. You should assess whether your dog is suffering and if their condition is causing more harm than good.
  
  
• Clinical signs: veterinarians will consider the severity of clinical signs, which may include extreme weakness, loss of appetite, persistent vomiting, uncontrollable nausea, lethargy and other symptoms previously mentioned in this article.
  
  
• Response to treatment: if the dog is not responding to treatment or the disease has reached an advanced stage, euthanasia may be considered.
  
  
• Pain and suffering: dogs in kidney failure may experience pain and discomfort. If their suffering cannot be adequately managed with medication, it may be kinder to euthanize them. Learn more about how to recognize the signs of pain in dogs.
  
  
• Dehydration and malnutrition: if the dog's condition is causing severe dehydration or malnutrition, it can indicate a poor quality of life.
  
  
• Mobility and control: loss of mobility, inability to control bodily functions or signs of extreme distress can be significant factors.

• Breathing difficulty: when they experience severe kidney failure, the dog may exhibit breathing difficulties which can be very distressing and lower their quality of life.

• Veterinarian's assessment: your veterinarian's expertise is crucial. They will provide guidance based on their assessment of your dog's condition.
  
  
• Communication: maintain open communication with your veterinarian about your dog's condition, response to treatment and any concerns you may have.

Ultimately, the decision to euthanize a dog with kidney failure is made with the best interest of the pet in mind. It's essential to consult with your veterinarian to discuss your dog's individual case and to ensure the decision is made compassionately and in the dog's best interest. Euthanasia is often chosen when a dog's suffering becomes unbearable or if there is no reasonable hope for improvement in their quality of life.

Learn more with our article on what to expect with euthanasia in dogs.

This article is purely informative. AnimalWised does not have the authority to prescribe any veterinary treatment or create a diagnosis. We invite you to take your pet to the veterinarian if they are suffering from any condition or pain.

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