Chronic kidney disease
Progressive loss of kidney function, one of the most common serious diseases of older dogs.
Chronic kidney disease is usually well advanced before an owner notices anything, because the early signs are easy to read as ordinary aging: drinking more, urinating more, a little weight coming off. It is the condition the thirst measurement in the monitoring framework exists to catch, and it is one of the few places in geriatric medicine where a dietary change has a randomized trial showing a survival benefit.
How it is measured
Serum creatinine and SDMA, urine specific gravity, urine protein to creatinine ratio, and blood pressure. IRIS staging combines these into a stage from 1 to 4, which is what treatment decisions hang on.
Why this matters: canine pain and cognition trials rely heavily on owner-reported scores, and owners who know their dog is being treated tend to report improvement whether or not the drug works. Trials using objective measures such as force-plate gait analysis carry more weight here for exactly that reason.
Interventions, best evidence first
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Moderate evidence diet
Therapeutic renal diet
Hill's k/d, Royal Canin Renal, Purina NF
The best-evidenced treatment for canine kidney disease, and one of the very few interventions anywhere in geriatric veterinary medicine shown in a randomized trial to extend life rather than just relieve symptoms. The hard part is not whether it works, it is getting a dog with a poor appetite to eat it.