You can detect dehydration by using the finger and thumb of one hand to grasp the scruff on your dog’s shoulders. Lift the skin vertically away from the backbone. When you let go the skin of a well hydrated animal springs back into place immediately.


In a dehydrated animal the skin lacks elasticity and may take a few seconds to fall back into place.
 A diseased kidney is less able to retain water, which causes water to be lost because it gets excreted out through your dog’s urine. If the loss of water exceeds the intake then your dog will become dehydrated.


To encourage your dog to drink, place large drinking bowls in every room the dog has access to.
Some dogs prefer to drink from flowing water so consider investing in a pet water fountain. Also, the chlorine in tap water makes some dogs sick, so try offering mineral water instead.
However, if your dog is severely dehydrated then your dog may need to be rehydrated with intravenous fluids. Not only does this rehydrate the dog but it also helps to dilute the toxins present in the bloodstream, which can help your dog to feel better. Unfortunately, intravenous fluids necessitate a 2 to 3 day stay at the vet clinic.
 Because the kidney cannot filter toxins as it should be able to, urea and phosphate remain in the bloodstream. Both of these substances can irritate the lining of the stomach, and the mucous membranes on your dog’s gums.


These high levels of urea and phosphate may result in ulceration, which can be seen as inflamed, ulcerated tissue on the gums or tongue, or will present as stomach ulcers. The latter is a serious problem because not only are they painful but they may bleed or completely ulcerate, which can lead to much more serious medical emergencies. Urea and phosphate are also associated with nausea, vomiting, and appetite loss.
 If your dog is vomiting regularly, or if the vomitus is blood-tinged, talk to your vet so that a treatment plan can be formed. Your vet will most likely prescribe Antepsin. This medication binds to exposed mucosa and forms a protective layer, allowing the area to heal.


The dose is 2.5 to 5 ml (half to one teaspoon) given by mouth two or three times a day., Antepsin is most effective when used with an H2 antagonist (a drug which reduces gastric acid secretion), such as cimetidine. However, the two drugs should not be given at the same time because the Antepsin stops any other drugs from being absorbed). Cimetidine reduces the amount of stomach acid produced, which gives the inflamed stomach lining a chance to settle down.


The dose for a dog is 5 to 10 mg/kg (thus a 30kg dog requires 150 to 300 mg) by mouth or injection, three to four times a day. This is given until the vomiting stops and the dog regains his appetite., Many dogs with kidney disease also suffer from high blood pressure (hypertension). This is because the decreased renal blood flow leads to an increase in distress hormones (renin and angiotensin). These hormones cause sodium retention and blood vessel constriction, which makes it physically harder to pump blood around the body and blood pressure rises as a result.


Untreated hypertension can result in blindness, a stroke, or even sudden death. Hypertension is measured by inflating a cuff around the arm, just as in humans, and a sensor placed on a vein under the tail or on the back of the paw. Three or more readings are taken, and an average value determined.
 If your dog’s blood pressure is between 160 and 180 mmHg then giving your dog an ACE inhibitor should be sufficient to protect the dog from the effects of hypertension. However, if the blood pressure is over 180 mmHg then a human anti-hypertensive medication—amlodipine—is prescribed.


The normal dose is 0.1 to 0.5mg/kg once daily. Thus a 30kg dog requires 3 to 15mg a day. The tablets are 5 mg each and, given the wide dose range, therapy is often started at 1 tablet a day (for a 30kg dog). The blood pressure will then be rechecked after 7 days and the dosage will be adjusted up or down accordingly., Concentrated urine is a natural antiseptic and produces a hostile environment for bacteria. However, dogs with kidney disease have diluted urine and so infections are more common. There is also a risk that bacteria will ascend from the bladder up to the kidney and cause infection there. This kidney infection then causes further damage. Many cases are "subclinical", which means they are lurking and sufficient to be a nuisance but not severe enough to cause obvious symptoms.


It is important that the subclinical infections are detected and treated with antibiotics, before they cause further kidney damage. The easiest way to do this is with routine 3-monthly urine culture, which gives a definitive answer as to whether an infection is present or not, and what antibiotics will work best for killing that infection.
Check to see if your dog is dehydrated.
Make sure your dog gets plenty of water.
Understand what a uremic ulcer is and know how to recognize its symptoms.
Get a prescription for the vet to treat uremic ulcers.
Talk to your vet about giving your dog an H2 antagonist with the antepsin.
Have your dog checked for high blood pressure.
Get your dog an ACE inhibitor.
Treat any urinary infections that occur.
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