Kidney/bladder stones or Kidney disease/ Failure

Even though this page is written with dogs in mind, the same principles count for cats as well, so don’t let me writing the word dog put you off from reading through this page

It is important that you know if your pet has kidney/ bladder stones or is suffering from (chronic)Kidney disease/ failure.
There are different treatment methods and dietary needs for kidney/ bladder stones and kidney failure even though one can lead up to the other.
For example:
A dog that is susceptible to kidney/ bladder stones is often better off on a low purine diet, as where a dog that has or is more likely to develop kidney disease is better off on a low phosphorous diet
The importance with both is to catch it as early as possible and start treatment as soon as possible to prevent deterioration.

Kidney/bladder stones

Just like us humans, dogs get kidney/ bladder stones, known in the medical community as nephrolithiasis.
Kidney/bladder stones happen when dense deposits of minerals and salts form inside the kidneys.
When it comes to kidney/ bladder stones, a build-up of the mineral calcium is likely to blame.
Just like in us humans, kidney/bladder stones in dogs can be painful to deal with.
Many times, kidney/bladder stones can be passed via their urine, it’s a painful process but unlike some other medical complications not necessarily a death sentence.
Dogs experiencing kidney/bladder stones should see a vet to put a proper treatment plan in place.
Kidney/bladder stones can show up on x-rays that are being taken for unrelated reasons, as a so called “incidental finding.”
For instance, they may be discovered when you think your dog could have eaten/swallowed something he shouldn’t have, like a piece of his toy. (Your vet found a stone instead.)
While kidney/ bladder stones can sometimes present without symptoms, some signs to look out for are fever, abdominal discomfort, blood in the urine, lack of appetite,vomiting, fatigue, and either increased or decreased urine production.

There are a few different reasons why kidney/ bladder stones form.
The different causes will predict which type of stone is most likely to form.
The type of stone affects what treatment plan would be needed.
Dogs with small kidney/bladder stones may not show any signs at all.
A kidney/bladder stone that allows normal urine flow may be one that your vet watches closely, but ultimately leave untreated.
However, if the stone gets larger, or if little pieces break off and get stuck in the ureter (the tube that connects each kidney to the bladder) it becomes a ureterolith and can be very painful.

Kidney colic, signalled by abdominal symptoms/pain discomfort and even vomiting can happen and the kidney can also swell and
become damaged.
If this happens to both kidneys at the same time, and the blockage persists, your dog will become critically ill from the disrupted flow of urine.
For these reasons, if you think your pet’s abdomen is painful, or his urination changes in any way, please contact your vet right away.
A urinary obstruction is a life-threatening emergency that must be
treated!

Signs of kidney/ bladder stones in dogs

  • Fever
  • Abdominal discomfort
  • Kidney pain
  • Blood in the urine (hematuria)
  • Altered urine production (increased or decreased)
  • Lethargy
  • Poor appetite
  • Vomiting
  • Weight loss

Causes and types of kidney/bladder stones
Bladder stones are somewhat common in dogs, and struvite stones are the most common.
In clinical studies, up to 26% of all bladder stones were found to contain struvite.
Together, struvite and calcium oxalate uroliths have been found to comprise over 85% of all uroliths submitted for laboratory analysis.
Based on the results of tens of thousands of stone analyses, it has been found that the number of struvite bladder stones has been declining in dogs while the number of calcium oxalate stones has been increasing during the past ten years.
Struvite uroliths were noted to be more common in female dogs (however often more painful and with a higher risk of an obstruction in males) and calcium oxalate uroliths in male dogs.
Breeds most commonly diagnosed with struvite and calcium oxalate bladder stones and who seem to be at higher risk of developing these type of stones are some (smaller) dog breeds

  • Miniature schnauzerBichon frisé
  • Lhasa apso
  • Shih Tzu
  • Yorkshire terrier

Bladder stones (uroliths or cystic calculi), are rock-like formations of minerals that form in the urinary bladder, and are more common than kidney stones in dogs
There may be a large, single stone or a collection of stones that range in size from sand-like grains to gravel.
Metabolic kidney/bladder stones, are stones formed due to some blood or urinary imbalance, and is more common in dogs than stones caused by infection and one of the more common uroliths in the dog is composed of
calcium oxalate (CaOx) crystals

Some dogs form stones multiple times in their lifetime, despite precautions being taken to prevent them.
Calcium oxalate is one of the most common types of kidney stones, and is common in the bladder, too.
Stones that form in the bladder or kidney because of chronic bacterial infection are usually struvite.
The stone components are magnesium, ammonium and phosphate.

Diagnosis of kidney/bladder stones
Certain stones don’t consistently image well, especially urate stones, so simple x-rays may not give enough information.
Once a stone has been found, predicting the stone type is challenging, so your vet will need some diagnostics to help with that.
He/she will want to do some tests to see what impact the stone(s) may be having on your dog’s kidney health, and whether other conditions may be present that might increase the risk of stones.

Just as with most other illnesses, the prognosis of kidney/ bladder stones in dogs fluctuates from case to case.
The prognosis varies widely, from good to severe (life threatening), depending on how long the stone has been present and whether it’s caused damage to your dog’s kidney function.

If a kidney/ bladder stone is suspected or diagnosed your vet will likely want to have a minimum data base to start from, consisting of the following tests:

  • Complete blood count (CBC)— Low red blood cells (anaemia) or high white blood cells are important findings
  • Blood chemistry with electrolytes. Testing for evidence of kidney disease and risk factors for stone
    formation
  • Urinalysis— The urine quality may predict kidney disease and help identify white blood cells and red blood cells that suggest bacterial infection, or crystals that may help predict stone type
  • Urine culture with susceptibility— Identifies bacterial infection and best antibiotic choice(s)
  • Abdominal ultrasound and or x-rays to examine the size and shape of the kidneys and look for urinary stones
  • Systemic blood pressure— To identify an important complication of kidney disease

Additional tests that may be suggested:

  • Ultrasound— This will help with finding the location of any stones and the suspected degree of any obstruction
  • Contrast radiography— Dye studies may be needed to confirm blockage and help to show the contribution that each kidney makes to urine production

Struvite stones

Bladder stones are somewhat common in dogs, and struvite stones are the most common.
Some stones called struvite stones are often associated with a complication of urinary tract infections, caused by bacteria that produce an enzyme known as urease.
This enzyme breaks down the urea that is normally present in the urine causing an excess production of ammonia.
This ammonia production then causes the urine to become alkaline.
Ammonia in the urine also causes bladder inflammation.
Under these environmental conditions, struvite crystals will precipitate out of solution and collect around any cells or debris that may have formed in the bladder as a result of inflammation.
Female dogs tend to get these types of bladder infections and stones more often than males, probably because their shorter, wider urethra makes it easier for bacteria to pass up the urethra into the bladder.
Other causes of alkaline urine such as certain kidney diseases, long-term use of diuretic drugs or antacids, and other conditions that cause elevated urine pH or elevated levels of urinary phosphorus or ammonia can also predispose a dog to the formation of struvite bladder stones.

These infections can make patients extremely uncomfortable and cause blood to be seen in the urine, increased frequency of urination, straining to urinate and foul-smelling urine.
Other symptoms include abdominal pain, discomfort, and painful or difficult to pass urine.
Patients can become extremely sick if they have a stone that is blocking urine flow, causing painful inflammation and potential kidney failure
Struvite and oxalate stones usually show up readily on plain x-rays, but small stones may be hidden by whatever else is in your dog’s belly.

Treating struvite bladder stones
Dogs that have/ had struvite bladder stones will often be recommended to be fed a diet that’s lower in phosphorus and magnesium and promote acidic urine for life (with a pH less than (6.5).
The PH will help dissolve struvite stones that are already present in the urine and prevent formation of new stones.
To promote dissolution of the stones increased water intake is advised, which will help to dilute the urine.
A preventative diet is NOT the same as the diet that promotes dissolution of the stones. Often medications to acidify the urine may be needed.

As most dogs develop struvite bladder stones as a result of a bladder infection, antibiotics will be needed while the stones are being dissolved.
This is important because, as stone are dissolving, bacteria that have become trapped in the layers of stone are released into the bladder and when left untreated these bacteria can form another infection.
Some dissolve struvite stones within two weeks while others can take up to 12 weeks.
Your dog will need to have antibiotics during this whole period.
In addition, careful routine monitoring of the urine to detect any signs of bacterial infection is also recommended.
Your vet will recommend a urinalysis and bladder x-rays every four to six weeks during treatment.
Some bladder stones can be ‘mixed’ or composed of multiple layers of different types of mineral, which may complicate treatment.
If follow-up x-rays show that the stones are no longer dissolving, this could indicate that the stones are mixed, and the treatment plan needs to be adjusted.

Small stones in some cases may be removed by flushing the stones out of the bladder.
Surgical removal is often advised in cases where the stones are too large, when there are many stones in the bladder, if there is an increased risk of an obstruction of the urinary tract, or if the client wishes to have the problem resolved as quickly as possible.

Bladder x-rays and urinalysis will be performed one month after successful treatment and then every three to six months for life.
Dogs showing any clinical signs of urinary tract infections such as frequent urination, urinating in unusual places, painful urination or the presence of blood in the urine should be seen immediately.
Keep in mind that the greatest risk factor for developing struvite bladder stones in a dog is a urinary tract infection.

Urate stones

Bladder stones (uroliths or cystic calculi), are rock-like formations of minerals that form in the urinary bladder, and are more common than kidney stones in dogs
There may be a large, single stone or a collection of stones that range in size from sand-like grains to gravel.
One of the most common uroliths is composed of urate crystals (commonly found in Dalmatians).
Urate bladder stones are most commonly the result of a genetic abnormality that causes a defect in the metabolism of uric acid.
Other causes of urate bladder stones include liver diseases such as portosystemic shunts.
In these situations, urate bladder stones can form if the urine is highly acidic or becomes extremely concentrated.
If urate bladder stones or crystals are diagnosed in a dog that is not a Dalmatian, the dog should be tested for the presence of a liver shunt.
If you have a Dalmatian, or thinking of adding a Dalmatian to your family,
starting him/ her on a strict diet from the day you take them in to your home is essential (prevention is always better than curing)

While bladder stones are somewhat common in dogs, urate stones constitute only about 5% of all bladder stones diagnosed, according to recent studies. Breeds most commonly diagnosed with urate bladder stones are:

  • Dalmatians
  • English bulldogs
  • Black Russian terriers

In these breeds, genetic testing should be performed before breeding to reduce the occurrence of this condition.
Urate bladder stones are more common in male Dalmatians (97%) than females (3%).

The general symptoms of bladder stones are very similar to the symptoms of an uncomplicated bladder infection or cystitis.
The most common signs of bladder stones are

  • hematuria (blood in the urine)
  • dysuria (straining to urinate)

Hematuria occurs because the stones rub against the bladder wall, irritating and damaging the tissue and causing bleeding.
Dysuria could be the result of inflammation and swelling of the bladder walls or the urethra, muscle spasms, or due to a physical obstruction to urine flow caused by the presence of the stones.
Large stones can act almost like a valve or stopcock, causing an intermittent or partial obstruction at the neck of the bladder, the point where the bladder attaches to the urethra.
Small stones may flow with the urine into the urethra where they can become lodged and cause an obstruction.
If an obstruction happens, the bladder cannot be emptied fully
If the obstruction is complete, the dog will be unable to urinate at all.
If the obstruction is not relieved, the bladder may rupture.
A complete obstruction is potentially life threatening and requires immediate emergency treatment
If urate bladder stones form as a result of a portosystemic shunt, the dog may also show signs of neurologic impairment (dullness or disorientation, head pressing, or seizures).

How are urate bladder stones diagnosed?
Small stones may be removed non-surgically in some cases by flushing the stones out of the bladder.
But this is only possible if the stones are small.
Diets lower in lower in purines, one of the building blocks of urate crystals, and promote slightly alkaline urine are recommended.

Calcium Oxalate Stones

The exact cause of calcium oxalate stones is complex and poorly understood.
Normal dog urine is slightly acidic and contains waste products from metabolism including dissolved mineral salts and other compounds.
These mineral salts will remain dissolved in the urine as long as the pH stays within a narrow range, and as long as the urine does not become too concentrated.
Current research shows that urine high in calcium, citrates, or oxalates and is acidic predisposes a pet to developing calcium oxalate urinary crystals and stones.

Recent studies have shown diets that cause high urine acidity (urine pH less than 6.5), may predispose dogs to develop this type of bladder stone.
There are likely other causes of calcium oxalate bladder stones.
Over-usage of antibiotics could reduce numbers of the intestinal bacteria Oxalobacter formigenes whose sole nutrient is oxalate.
In dogs with low populations of Oxalobacter, excess oxalate is secreted in the urine, increasing the likelihood that calcium oxalate crystals and stones can form if the urine is highly concentrated or becomes acidic.

The only way to be sure that a bladder stone is made of calcium oxalate is to have the stone analyzed

Small stones can be removed non-surgically in some cases by flushing the stones out of the bladder.
But this is only possible if the stones are small.
Surgical removal is often recommended in cases where the bladder stones are too large, when there are many stones in the bladder, if there is an increased risk that the patient will develop an obstruction of the urinary tract, or if the client wishes to have the problem resolved as quickly as possible.

Male dogs are at a much higher risk of developing an obstruction in the urinary tract as a result of bladder stones, so when bladder stones are diagnosed in a male dog, your vet will often strongly recommend surgical removal.
Diets that promote less-acidic and more dilute urine are recommended.
Dogs diagnosed with calcium oxalate stones should avoid calcium supplements unless specifically advised by your vet.
They should not be fed high oxalate foods such as chocolate, nuts, rhubarb, beets, green beans, and spinach.

Treatment of kidney/ bladder stones
Even if complications of kidney/ bladder stones are not obvious, their presence may contribute to the progression of chronic kidney disease (CKD).
Since oxalate stones do not dissolve, treatment can be challenging for your pet and for your vet.

In some cases, kidney/ bladder stones in dogs can be left alone and the
dog eventually passes the stones, stones that are not causing clinical signs can be left in place and monitored by a vet.
Struvite stones that are not causing an obstruction can be treated with medical management.
For example, the right diet can help to dissolve the stones.
If the stone is calcium oxalate, surgical intervention is needed to remove the stone if it is causing problems for your dog.

Surgical intervention and lithotripsy are the primary methods used to remove kidney stones, although they aren’t the only methods used.
In cases that it can be managed by conservative treatments, sometimes a
combination of antibiotics, diet changes and water can be enough.
But in other cases, the process of completely dissolving kidney stones can often take months.
Any early reduction in size is a good start.
For bigger stones or those that do not respond well to conservative treatment, surgical removal is recommended.

Medical efforts to dissolve kidney/ bladder stones are usually safer than surgery but don’t work for all stones.
Skilled surgery is widely available, but does risk permanently damaging the affected kidney, even if the surgery goes smoothly.
Veterinary urologists can offer special techniques to break stones into smaller pieces so they can just pass out in the urine.
This alternative procedure to surgery could offer a safe cure for kidney stones.
For bigger stones, specialists might break them up from the inside using endoscopes and special tools.
It’s always good to ask your doctor if a recommended surgery is the only option, or if there might be a new technology to try, instead.

Monitoring and Management of kidney/ bladder stones
If your dog is suffering from kidney/ bladder stones, there are several things you can do to make your pet more comfortable.
Fresh water should always be available to a pet, the water should not be treated with water softeners.
Owners should monitor pets for signs of urinary tract infections such as foul-smelling
urine, bloody urine, straining to urinate or difficulty urinating.

If your vet suspects oxalate kidney stones, he/she may suggest using diet and some medication to reduce or slow stone growth, with a significant
emphasis on increasing water intake.
A general strategy involves reducing mineral concentration to discourage crystal and stone formation.
Increasing water intake makes the urine more dilute and should reduce the amount of mineral available to form a stone.
A variety of diets have been used successfully to prevent or manage urinary
stones but finding the best fit for your dog could take some trial and error.
These strategies are worth the effort to try to avoid the pain and problems that a growing kidney stone may cause.
If an underlying cause for stones is suspected, then resolving that problem will be another important way to protect those kidneys from more stone damage.

Even if the stones don’t seem to be active or causing infection or
blockage, regular monitoring of lab tests for kidney function and urine quality will continue to be important for the rest of your dog’s life.
Your vet will want to make sure that the prevention strategy is working, to see that the stones are not growing or causing complications.
That evaluation will likely need some form of imaging rechecks, with either
x-rays or ultrasound.
If the stones were removed or treated medically, monitoring for their recurrence will be key to keeping your dog healthy.
You and your vet can determine the monitoring schedule that best matches your dog’s condition.

Kidney disease (CKD)/ kidney failure (CKF)in dogs

Many important tasks are carried out by the kidneys when they
are functioning normally.
Any condition which stops the kidneys working properly is referred to kidney or renal disease and can vary greatly in severity.
It means damage is in progress but there is still functional tissue left.
In renal failure, the kidneys have stopped working altogether and is far more serious.
Kidney disease is classified in two ways; acute and chronic.
Kidney disease (CKD)/ kidney failure (CKF) is more common in older dogs
It is estimated that more than 1 in 10 dogs will develop kidney disease,
When healthy, the two kidneys efficiently:

  • Filter the blood
  • Process protein wastes and excrete them into the urine
  • Conserve and balance body water, salts and acids
  • Produce a hormone that encourages red-blood cell production
  • help control blood pressure
  • Aid in calcium metabolism and sustain phosphorous levels.
  • Maintaining an overall healthy metabolic balance.

Kidney disease happens when one or more of these functions are compromised or reduced.
Since kidney tissue cannot regenerate when destroyed, the kidneys have a large amount of spare capacity to perform their various functions.
Unfortunately, it often goes undetected until the organs are functioning at roughly 33% to 25% of their capacity.
In many cases, this means that the destruction has been going on for months to years (chronic) before failure has become noticed.
In dogs, chronic kidney failure is associated with aging, and in simple terms can be considered to be”wearing out” of the kidney tissues.
The age of when it began is often related to the size of the dog.
For most small dogs, the early signs of kidney failure happen at about ten to fourteen years of age.
However, large dogs mostly have a shorter life span and may undergo kidney failure as early as seven years.

Dogs with moderate to severe chronic kidney disease (CKD) are prone to dehydration and you may notice that your dog is lethargic and has a poor appetite.
Treatment options for advanced kidney disease are usually limited to treating the symptoms because dialysis and kidney transplants are not readily available for dogs.
Protecting your dog from kidney disease means you should be prepared to look for problems early on.
When kidneys don’t function properly, toxins build up in the blood and
a dog will become ill.

What Causes Kidney Problems in Dogs?
Acute kidney failure is an abrupt decline in function that happens
within a few days.
When the condition is acute, it is a complication of another condition such as kidney stones, cancer, or the consumption of something toxic.
In this case, symptoms can be severe and come on quick but, depending on the cause, the condition can sometimes be treated and resolved.
Other reasons for this type of kidney failure include decreased blood
flow or oxygen delivery to the kidneys, infections and urinary obstruction.

While some kidney problems have an immediate cause that can be treated,
chronic kidney disease shows up over a longer period and its causes are harder to determine.
Chronic kidney disease is an irreversible long-term condition which progresses gradually over time.
But, because dogs have much more kidney tissue than is essential for day to day life, chronic disease can also appear to start suddenly because symptoms often only show when a lot of damage has already happened.
Although there is no cure for chronic renal disease, early intervention can sometimes limit the damage done to the kidneys and slow the progression of the disease.
Chronic kidney disease is normally caused by a primary malfunction of the kidneys and not another illness or toxicity, although acute renal failure can sometimes develop into a chronic form of the condition
This condition develops slowly and affects mostly older dogs.
It is often caused by underlying illness and congenital and hereditary
conditions and environmental factors can also damage the organs, such as
chemicals, toxic foods, infections and some medications.
But more surprisingly, is that it has been suggested that the main cause
of chronic kidney failure in dogs is dental disease.
Bacteria associated with advanced dental disease enter the blood stream
and invades multiple organs, causing irreversible damage to the heart, liver and kidneys.

Causes of chronic kidney disease in dogs.

A group of vet specialists studying kidney disease in dogs and cats list several risk factors that make pets more susceptible to kidney disease, such as age or breed, and investigate reversible factors that initiate or accelerate kidney damage.
Such factors include:

  • Glomerulonephritis
  • Pyelonephritis (kidney infection)
  • Nephrolithiasis (kidney stones)
  • Ureteral obstruction hydronephrosis (stones causing a blockage)
  • Tubulointerstitial disease (involving the kidney tubules)
  • Leptospirosis
  • Cancer
  • Amyloidosis (protein problem)
  • Hereditary nephropathies (genetic problem)

What Are Some Signs of Kidney Problems in Dogs?

  • Change in water consumption (drinking more)
  • Change in volume of urine produced (Weeing more. E.G. Having to go out at night, having accidents)

Taking water away from your pet in these cases could only make chronic
kidney disease worse
Having your dog seen by a vet when you note a change in water intake and urine production is important.
Dogs are pretty sensitive to changes in their blood levels of waste so even mild to moderate changes may cause signs of illness.

  • incontinence (urine leakage)
  • Dehydration
  • Lethargy
  • Reduced appetite
  • Vomiting
  • Weight loss
  • Bad breath with a chemical smell
  • Mouth ulcers
  • Pale appearance
  • Depression and listlessness
  • Loss or decreased appetite
  • Blood in urine
  • Mouth ulcers
  • Pale gums
  • Stumbling, acting drunk

If your dog shows any of the above symptoms, please take her to see your veterinarian immediately.

How Can Kidney Problems Be Prevented?
To prevent kidney problems due to poisoning, make sure your dog
does not have access to potentially dangerous substances and that he/she is
always supervised when outside.
Do not give your dog any over-the-counter medications without
instruction by your vet and make sure that your dog always has access to fresh water.
Good oral hygiene helps to maintain good overall health.

How Are Kidney Problems Treated, managed and monitored?
It is important to identify kidney failure and begin treatment in its earliest stage.
Your vet can determine if kidney disease is present and start appropriate treatment.
Depending on whether the problem is acute or chronic.
Pets with signs of kidney disease that include dehydration will likely need more intensive care in a hospital, while those that are happy and are self-supporting will often be treated at home.
For your vet to be able to confirm a diagnosis of chronic kidney failure, he or she may need to run a blood chemistry panel, complete blood cell count, urinalysis, and blood pressure testing.
Findings typically include some combination of:

  • dilute urine
  • elevated blood urea nitrogen (BUN)
  • increased levels of creatinine in the blood
  • anaemia (low red blood cell count)
  • high levels of phosphorous in the blood
  • low levels of potassium in the blood
  • high blood pressure

Severely affected dogs may need to stay at the vet clinic to receive IV fluids and begin treatment for any other symptoms they might have.
Once a dog with chronic renal failure is stable enough to continue their treatment at home, they can be discharged from the hospital.

Your vet will work diligently to find a treatable cause of kidney disease and make individual recommendations for your dog.

Appropriate treatment for chronic kidney failure depends on the specific symptoms and biochemical abnormalities that a dog has.
Many patients require fluid therapy to combat dehydration.
This can be achieved by increasing the water content of a pet’s diet and through intermittent subcutaneous fluid (Sub-Q) treatment (giving boluses of sterile fluid under the skin).
Your vet may also prescribe a special diet to help promote kidney function and counteract biochemical abnormalities that commonly occur in the body.
Treatment may include the following:

  • Medication that encourage urine production
  • Fluid therapy (This can be given through an intravenous drip or
    subcutaneously (injected under the skin).
  • Management of blood electrolyte abnormalities
  • Medications
    to lower blood pressure (e.g., amlodipine or enalapril)
  • Monitoring of urinary output
  • Control of vomiting
  • Medication for gastrointestinal problems
  • Dialysis
  • Nutritional supplements that reduce BUN (Azodyl) and phosphorus levels (Epakitin) in the blood
  • Omega 3 fatty acids to protect the kidneys
  • Medications to treat or prevent stomach ulcers (e.g., ranitidine, famotidine, omeprazole, sucralfate)
  • Potassium supplements
  • Aluminum hydroxide to decrease blood phosphorous levels
  • Calcitriol to slow the progression of chronic renal failure
  • Medications to treat anemia (e.g., erythropoietin or darbepoetin)
  • Anti-nausea medications (e.g., maropitant or ondansetron)
  • Dietary management (this is often those low in protein, phosphorus, calcium and sodium but high in omega 3 fatty acids)
  • Therapy for any specific underlying causes identified (example:
    antifreeze toxicity, infection)
  • Kidney dialysis (In cases where all other treatment options have been exhausted, a vet may recommend kidney dialysis to further prolong or enhance your dog’s life. But this is not common practice as it is only offered at a small number of specialist centres, and can be very expensive

Chronic kidney disease prognosis
Some dogs with chronic kidney disease will live years after diagnosis and have a good quality of life.
Others will not be so lucky.
Your vet will evaluate after testing is finished.
Kidney transplants may be an option for pets who meet specific criteria.

Can kidney disease in dogs be prevented?
As kidney disease can be inherited, responsible breeding can play a role in
preventing the chronic form of the disease.
Many acute cases of the condition can also be prevented by keeping pets away from toxic substances like antifreeze and rat poisons, as well as certain foods including raisins, grapes and some plants.
The infectious disease, leptospirosis, can also cause kidney disease
A balanced, species-appropriate diet will also supply your pet with the
fundamental nutrients needed for their body, which will give your dog the best chance of staying healthy.
Perform regular health checks on your dog at home and contact your vet
promptly if your pet seems unwell, is drinking more or losing weight.
Take them to your vet for a regular health check to ensure any signs of disease can be spotted as soon as possible.

What Happens if Kidney Problems Go Untreated?
If left untreated, end-stage kidney failure will occur, leading to a
fatal outcome.

If you have any questions or concerns, you should always call or visit your vet.

Some references used
http://www.pethealthnetwork.com/,https://www.bluecross.org.uk/, https://pets.webmd.com, https://www.petmd.com