Shih Tzu Kidney Disease: Renal Dysplasia, CKD, Signs, and Treatment
How we researched this guide: This article is based on the American Shih Tzu Club’s information on juvenile renal dysplasia, VCA Animal Hospitals guidance on chronic kidney disease, the International Renal Interest Society (IRIS), and the ASPCA Animal Poison Control Center. It is not a substitute for an exam. Last reviewed: September 2026.
Kidney disease is one of the more serious health problems a Shih Tzu can face. Shih Tzus can develop it in two ways: an inherited condition that shows up in young dogs, and the chronic kidney disease that affects many older dogs.
Kidney damage often goes unnoticed until it is advanced. VCA Animal Hospitals notes that at least two-thirds of kidney function must be lost before signs appear. That is why early testing matters.
Juvenile Renal Dysplasia: A Shih Tzu Concern
Juvenile renal dysplasia (JRD) is a developmental or genetic defect of the kidneys that the American Shih Tzu Club (ASTC) addresses directly for the breed. In affected dogs, parts of the kidney never develop normally.
- Age: The ASTC notes that severely affected puppies may fail to thrive by 2 to 3 months of age. Moderately affected dogs may seem normal until 5 to 6 months or later.
- Early signs: excessive thirst, large amounts of pale urine, poor growth, and weight loss. Later signs include vomiting, weakness, and kidney failure.
- Testing: The ASTC explains that standard blood tests (BUN and creatinine) may not rise until 70 to 75 percent of the kidney is not working. Urine tests for small amounts of protein and ultrasound can help detect it earlier.
- Inheritance: The ASTC notes the condition can pass silently through many generations.
If you are buying a puppy, ask the breeder about kidney health in the parents and earlier litters. Our Shih Tzu breeding guide covers health screening.
Chronic Kidney Disease in Older Shih Tzus
Chronic kidney disease (CKD) develops slowly, often with age. VCA lists causes such as inherited kidney defects, infection, inflammation, kidney stones, and some infectious diseases.
Signs of Kidney Disease
- Drinking and urinating more than usual (often the first sign)
- Poor appetite or weight loss
- Low energy
- Vomiting or diarrhea
- Pale gums
- Bad breath and mouth ulcers in advanced cases
Increased thirst can also point to other problems, such as diabetes. Read our guide to diabetes in Shih Tzus and see your vet if your dog is drinking much more than normal.
How Vets Diagnose It
Vets use blood tests (BUN, creatinine, and SDMA) and a urine test. The International Renal Interest Society (IRIS) notes that SDMA may detect kidney disease when about 40 percent of function is lost, earlier than older tests. Vets then use the IRIS system to stage CKD from 1 to 4 and check for protein in the urine and high blood pressure. Treatment depends on the stage.
Sudden kidney injury is an emergency. Some toxins can damage the kidneys quickly. The ASPCA warns that grapes and raisins can cause kidney damage in dogs. Antifreeze and some human pain medicines are also dangerous. If your dog eats any of these, call your vet or an animal poison control center right away.
Treatment and Management
Kidney damage cannot be reversed, but treatment can slow the disease and help your dog feel better. VCA lists these common treatments:
- Kidney diet: a prescription food with controlled protein and low phosphorus. IRIS notes that diet changes work best in stages 2 to 3, while appetite is still good.
- Fluids: given under the skin at home or into a vein at the clinic.
- Medicines: phosphate binders, anti-nausea drugs, blood pressure medicine, and drugs to reduce protein loss in the urine.
- Treatment for anemia in advanced cases.
- Regular rechecks of blood, urine, and blood pressure.
VCA notes that many dogs keep a good quality of life for months or years with proper treatment. Always keep fresh water available, and do not change your dog’s diet without your vet’s advice.
Frequently Asked Questions
What is juvenile renal dysplasia in Shih Tzus?
It is a developmental or genetic kidney defect. The American Shih Tzu Club notes that affected puppies may show heavy thirst, large amounts of pale urine, poor growth, and weight loss, sometimes from 2 to 6 months of age.
What are the first signs of kidney disease in a Shih Tzu?
Drinking and urinating more than usual is often the first sign. Later signs include poor appetite, weight loss, vomiting, low energy, pale gums, and bad breath.
How is kidney disease diagnosed?
Vets use blood tests such as BUN, creatinine, and SDMA, plus a urine test. IRIS notes that SDMA may detect disease earlier, when about 40 percent of kidney function is lost.
Can kidney disease in dogs be cured?
Chronic kidney damage cannot be reversed. Treatment with a kidney diet, fluids, and medicines can slow it down, and VCA notes that many dogs do well for months or years.
What foods can damage a dog’s kidneys?
The ASPCA warns that grapes and raisins can cause kidney damage in dogs. Antifreeze and some human pain medicines are also dangerous. Contact your vet right away if your dog eats any of them.
Sources
- American Shih Tzu Club: Juvenile renal dysplasia in Shih Tzu
- VCA Animal Hospitals: Chronic kidney disease in dogs
- International Renal Interest Society: What pet owners should know
- ASPCA Animal Poison Control: People foods to avoid feeding your pets
This article is for general information. It is not a substitute for advice from your veterinarian. Read our medical disclaimer.
