How do you diagnose kidney disease in dogs?

Kidney disease in dogs often creeps in quietly, so quiet that even the most attentive owners might miss the first hints. Those small changes—a little more water lapped up from the bowl, a few extra trips outside to pee, or a sudden disinterest in dinner—can feel like nothing to worry about at first. But these are often the earliest whispers that something’s off with their kidneys, and catching them early makes all the difference.​

What do you actually look for? Let’s start with the signs you might notice at home. Your dog might start drinking way more than usual, to the point where you’re refilling the water bowl twice as often. Along with that, they’ll probably need to urinate more, sometimes having accidents in the house even if they’re house-trained. Appetite can drop off too; that once-enthusiastic chowhound might turn up their nose at meals, and over time, you might see their ribs start to show as they lose weight. Lethargy creeps in too—less interest in walks, more time napping in their bed. These aren’t just “old age” things; they’re clues worth chasing.​

When you head to the vet with these concerns, they’ll start by getting to know your dog’s routine. Has there been a change in what they eat? Any new medications? That context helps. Then comes the physical exam—feeling your dog’s abdomen to check if the kidneys are swollen or tender, listening to their heart and lungs, checking their gums for signs of anemia, which can pop up with kidney issues. It’s not just poking and prodding; it’s putting puzzle pieces together.​

From there, the real detective work often involves tests. A blood panel is key here—vets look at levels of creatinine and urea, waste products that healthy kidneys filter out. If those numbers are high, it’s a sign the kidneys might not be working as they should. A urine test usually goes hand in hand with this. You might not think much about your dog’s pee, but vets can spot things like excess protein or dilute urine, both red flags for kidney trouble. Sometimes they’ll do a urine culture too, to rule out infections that could be masking or worsening kidney issues.​

Imaging can help fill in more blanks. An ultrasound lets vets see the kidneys’ size and shape—are they smaller than normal? Full of cysts? X-rays might show stones or other blockages that could be damaging the kidneys over time. These tools don’t just confirm there’s a problem; they help figure out how far it’s gone.​

It’s easy to brush off small changes, but with kidney disease, time matters. Dogs are masters at hiding discomfort, so by the time you notice obvious symptoms, things might have progressed. That’s why regular check-ups—even when your dog seems fine—are so important. Your vet can catch subtle shifts in blood or urine before you see any outward signs, giving you a head start on care.​

Watching for those little clues—more water, less appetite, a slower step—could be the first step toward helping your dog. And when in doubt, a chat with your vet is never a bad idea. Kidney disease isn’t something to panic about, but catching it early? That’s one of the best gifts you can give your loyal friend.