Chronic Kidney Disease

Because kidneys compensate quietly for a long time, early CKD is often found on routine lab panels before any signs appear. As disease advances, owners typically notice:

• Increased thirst and urination (the kidneys can no longer concentrate urine)
• Decreased appetite and weight loss, sometimes dramatic in cats
• Vomiting or nausea, especially in the morning
• Bad breath with an ammonia or metallic odor (uremic breath)
• Lethargy, weakness, or reluctance to play
• Mouth ulcers or drooling in more advanced stages
• Pale gums if anemia develops alongside kidney disease
• Hiding or changes in social behavior, particularly in cats

Any combination of these signs in a middle-aged or senior pet warrants a full kidney workup right away.

CKD is rarely caused by a single event; it usually results from cumulative insults over time. Known contributors include:

• Age — the risk rises sharply in cats over 7 and dogs over 9
• Breed predisposition (Persians, Ragdolls, and Abyssinians for cats; Bull Terriers, Cocker Spaniels, and Shih Tzus for dogs)
• Prior acute kidney injury from toxins (lilies, grapes, raisins, NSAIDs, antifreeze), infections, or low blood pressure during illness
• Chronic dental or periodontal disease — bacteria that enter the bloodstream may damage kidney tissue
• High blood pressure (hypertension), which accelerates nephron loss
• Protein-losing kidney disorders (glomerulonephritis)
• Congenital or hereditary kidney malformations

Diagnosis involves bloodwork, urinalysis, and often additional tests to stage the disease and uncover treatable complicating factors. Our in-house laboratory allows same-visit results in most cases.

• Serum chemistry panel: creatinine, BUN, and phosphorus levels reflect overall kidney function; SDMA (symmetric dimethylarginine) is a more sensitive early marker that rises before creatinine does
• Urinalysis with urine protein:creatinine ratio (UPC): measures whether the kidneys are leaking protein, which worsens prognosis and guides treatment
• Blood pressure measurement: hypertension is common in CKD and requires its own management
• Digital radiographs and abdominal ultrasound: assess kidney size, shape, and architecture; rule out stones or masses
• IRIS staging: we use the international IRIS (International Renal Interest Society) system to assign a stage (1–4) that guides treatment intensity and monitoring frequency

There is no cure for CKD, but thoughtful management reliably slows progression and supports quality of life. A typical plan combines several strategies:

• Prescription kidney diet: reduced phosphorus and controlled protein lessen the workload on remaining nephrons; dietary phosphorus restriction is one of the most impactful interventions available
• Phosphate binders: given with meals when dietary control alone isn't enough to keep phosphorus in range
• Fluid support: subcutaneous fluids at home or in-clinic IV fluids during flares maintain hydration and help flush uremic toxins
• Blood pressure medication: ACE inhibitors or amlodipine if hypertension is confirmed
• Anti-nausea and appetite stimulant medications: keep the pet eating and comfortable
• Potassium supplementation: especially important in cats, who frequently become potassium-depleted
• Erythropoietin-stimulating agents: for anemia when the kidneys no longer produce enough EPO

Follow-up bloodwork every 3–6 months (or more often during flares) keeps the plan on track. Our kidney disease management program coordinates all these elements into one seamless care plan.

If your senior dog or cat hasn't had bloodwork in the past year, now is the time — CKD caught at IRIS Stage 1 or 2 carries a far better long-term outlook than disease found in crisis. If your pet is already showing signs like increased thirst, weight loss, or vomiting, call us promptly; we can often obtain same-week appointments. Dog & Cat Hospital Calabasas offers full in-house diagnostics and specialist-level internal medicine expertise, so you get answers the same day — not days later waiting for an outside lab. Book an appointment to get started.