Dogs with renal dysplasia should have their blood chemistry and urine content monitored periodically to determine whether their kidney function is changing for the better or the worse over time. They should be fed a low sodium diet to prevent excess water retention. Many authorities recommend feeding dogs with kidney damage a diet that is low in protein and comprised only of high-quality protein sources, because protein is usually poorly metabolized by dogs with compromised kidney function. Most veterinarians and nutritional experts agree that phosphorus intake should be restricted in dogs with kidney disease. Dietary modification can be used to reduce phosphorus intake. Medications are also available and may be necessary, together with dietary adjustments, to lower and maintain circulating phosphorus at appropriate levels. Several different prescription diets are available through veterinarians that are specifically formulated to help manage and relieve some of the symptoms of kidney dysfunction. The appropriate “kidney diet” should be tailored to the individual patient.
Free access to fresh, clean water should be provided to dogs with kidney abnormalities at all times, unless otherwise recommended by the treating veterinarian. Dogs with symptomatic renal dysplasia will produce and excrete abnormally large amounts of urine and will need to drink enough water to compensate for their excessive urine output to avoid dehydration. In some cases, intravenous (IV) or subcutaneous (sub-Q) fluids may need to be administered. IV fluids must be given in the veterinary clinic. However, most owners can easily learn how to administer sub-Q fluids at home. This can be very important to a dog’s comfort, especially during the end-stages of renal failure. If a dog is dehydrated due to vomiting and/or diarrhea, certain medications – called anti-emetics and anti-diarrheics - can be prescribed to reduce vomiting and firm up the dog’s stool.
Other management options that may be recommended by veterinarians for dogs with renal dysplasia include supplementing their diets with vitamin B and/or sodium bicarbonate. Many dogs with kidney disease excrete B vitamins in their urine and can be helped by vitamin B supplementation. Sodium bicarbonate may be recommended by the veterinarian if the dog has what is known as an acid-base imbalance. Acid-base regulation involves the body’s maintenance of appropriate pH levels in circulating blood. The kidneys and the respiratory tract are involved in maintaining normal acid-base ratios. This is an extremely complex, but also an extremely important, process.
Dogs with renal dysplasia that become severely dehydrated can decompensate very suddenly and go into what is called a uremic crisis. These animals need to be hospitalized immediately and rehydrated with intravenous fluids and balanced electrolyte solutions, to restore hydration and correct acid-base imbalances.
Dogs with severe bone pain associated with kidney dysfunction can be given prescription anti-pain medications called analgesics. Analgesics can be administered orally, subcutaneously or intravenously and can range from very mild pain relievers to stroing opioid drugs. Administration of oral calcitriol or other supplements may delay or help prevent the bone changes that can result from kidney disorders. The appropriate balance of blood calcium and phosphorus levels can be very tricky to maintain in dogs with renal dysfunction.
Kidney dialysis, and kidney transplantation, may be available for dogs with severe renal dysplasia, although these procedures are only offered at highly specialized referral centers and at some veterinary teaching hospitals. They are quite costly. These potential treatment options should be discussed with the dog’s attending veterinarian to determine whether they are realistic options.
The prognosis for dogs with renal dysplasia depends upon the degree of their kidney dysfunction, their age at the time of onset of symptoms, the severity of their functional abnormalities at the time of diagnosis and the effectiveness of medical management. Underdeveloped and dysfunctional kidneys almost always result in renal failure and, eventually, death. In most cases, the long-term outlook for survival is poor. However, if only one kidney is affected (unilateral renal dysplasia), and if the other kidney functions normally, affected dogs may live a normal, full life. Most dogs do very well with just one healthy kidney. Unfortunately, unilateral renal dysplasia is the exception, not the rule.