Dialysis for Canine Kidney Failure: A Comprehensive Guide

Dialysis, while more commonly associated with human medicine, is also an advanced treatment option available for dogs suffering from kidney failure. This specialised therapy can help prolong life and improve quality of life in certain cases of canine kidney failure, although it is not widely available and is generally reserved for more severe conditions.

In this comprehensive guide, we'll explore how dialysis works for dogs, what it involves, and important considerations for owners facing this difficult diagnosis.

Understanding Healthy Kidneys and Kidney Failure in Dogs

The kidneys play a crucial role in filtering waste and toxins from the bloodstream, maintaining fluid balance, and regulating electrolytes. When they fail to function effectively, harmful substances accumulate in the body, a condition known as kidney failure.

Kidney failure occurs in stages, ranging from mild impairment to complete loss of kidney function. The stage and severity of the disease, along with underlying causes, determine prognosis and treatment options.

Owners may observe signs such as excessive thirst (polydipsia) and frequent urination (polyuria), although these symptoms can also be caused by other medical conditions. A veterinarian will perform blood and urine tests to confirm kidney function and identify elevated toxin levels.

It is essential to rule out alternative causes, such as dietary influences like a high-protein diet, which can impact blood markers without indicating true kidney failure. Only after thorough assessment can a vet determine whether dialysis is a viable option.

What is Dialysis and How Does it Help Dogs?

Dialysis, specifically haemodialysis, is a process where a machine temporarily takes over the kidney's filtering duties. Blood is drawn from the dog through a catheter—usually placed in a large vein such as the jugular—and passed through a dialyser that removes toxins, excess fluid, and balances electrolytes.

The cleansed blood is then returned to the dog's circulation. Treatments typically last between 3 to 8 hours depending on the dog's size, toxin levels, and the dialysis method used. Frequent sessions may be required, often every other day during acute illness.

There are two main types of dialysis utilised in veterinary medicine:

• Prolonged Intermittent Renal Replacement Therapy (PIRRT): Lasts around 6 to 8 hours and is more commonly used.
• Continuous Renal Replacement Therapy (CRRT): A slower, continuous process lasting 18 to 22 hours, less commonly used.

For very small dogs weighing under 4 kg, peritoneal dialysis may be considered as an alternative, though it is less commonly applied due to limited effectiveness.

Who is a Suitable Candidate for Dialysis?

Dialysis is primarily used in cases of acute kidney injury (AKI), where kidney function has decreased suddenly, often due to toxins, trauma, infection, or severe illness. Dogs showing:

• Severe reduction or absence of urine production
• Life-threatening electrolyte imbalances, such as hyperkalemia (high potassium)
• Fluid overload impacting heart or lungs
• Symptoms from toxin build-up including vomiting, lethargy, or neurological signs

may benefit from dialysis as a supportive treatment while the kidneys recover.

It is important to note that dialysis is usually not recommended for dogs with chronic kidney disease (CKD). In chronic cases, kidney recovery is unlikely, and the need for frequent, lengthy dialysis sessions can negatively affect the dog's quality of life.

The Dialysis Procedure: What Owners Can Expect

Dogs undergoing dialysis are catheterised under sedation or local anaesthesia. The process requires close monitoring in a specialist veterinary centre with intensive care facilities.

Sessions last several hours and may be repeated multiple times per week based on the dog's condition. Sedation may be necessary to keep the dog calm and still during treatment, though some dogs tolerate dialysis without sedation.

Repeated access to veins may lead to implantation of a permanent catheter under the skin for easier treatment administration in dogs requiring frequent dialysis.

Costs and Accessibility of Veterinary Dialysis

Dialysis is a specialised treatment available only at advanced referral centres or veterinary teaching hospitals equipped with the necessary machines and expertise.

Costs are significant and include the procedure itself, hospitalisation, monitoring, catheter placement, and supportive care. Many pet insurance policies with comprehensive plans cover dialysis if prescribed by a vet, but the repeated nature of the treatment can rapidly reach policy limits.

Owners should discuss financial considerations and prognosis thoroughly with their vet or veterinary specialist before proceeding.

Conclusion: Is Dialysis Right for Your Dog?

Dialysis offers a valuable life-support option for dogs with severe acute kidney failure, potentially improving survival and stabilising symptoms while the kidneys undergo healing. However, it is not a cure and carries logistical and financial challenges.

Dogs with chronic kidney disease are typically managed with dietary changes, medications, and standard veterinary care rather than dialysis.

If your dog has been diagnosed with kidney failure, consulting a veterinary specialist can clarify whether dialysis is a suitable option based on your pet’s condition, overall health, and your circumstances.

Supporting your pet through illness with compassion and responsible care remains paramount in all treatment decisions.