By Kevin Fitzgerald, DVM
What it is: Acute or chronic kidney disease is not uncommon. The acute form is caused by some toxin, injury, or insult to the kidney, such as antifreeze, grapes, or raisins; rodenticides; nonsteroidal anti-inflammatories; or leptospirosis. Chronic kidney disease is a progressive, destructive process that has been present for an extended period (usually three months or longer). In addition, whereas acute kidney injury may be reversible, generally chronic kidney disease is viewed as irreversible and progressive. Diagnosis: How long the chronic form has been going on can be estimated through the medical history, the physical examination, blood chemistries, renal-imaging studies, and renal pathology. Once diagnosed, the chronic form is usually staged. The staging system is based on renal function, the amount of protein in the urine, blood pressure, and renal pathology based on biopsy and imaging. 
How to treat: Therapies in kidney disease attempt to treat and prevent complications of decreased function, manage conditions associated with kidney disease, and slow down the loss of kidney function. No other conservative method of therapy for disease is more likely to enhance the long-term outcome and quality of life than a renal diet. Effective, balanced renal diets differ from regular diets in several ways: reduced protein, phosphorus, and sodium; increased B-vitamins and soluble fiber; increased caloric density; a neutral effect on acid-base balance; supplemented omega-3 polyunsaturated fatty acids; and other antioxidants. It is not enough simply to put kidney-disease dogs on senior diets with restricted protein. Your veterinarian can direct you to several specially formulated, commercially available kidney diets and provide you with recipes for home-prepared meals helpful to the patient. Note: Usually renal diets are not as palatable as the old food, and kidney diets must be introduced gradually to keep the dog eating. Increase the amount of renal diet in the old food over 10 to 14 days. The dog must continue eating and be monitored closely for food intake, body weight, and body condition as the new diet is being inserted. Dogs with kidney problems who fail to eat will quickly become dehydrated, anemic, and much more vulnerable to the various effects of kidney failure. Although not curable, with therapy and diet your veterinarian may be able to improve the quality of life of your dog with kidney disease. Originally published in AKC FAMILY DOG. To read more from FAMILY DOG, click here. Photo credit: Illustration by Wendy Wahman 