"My pet eats normally and seems active. How could a routine health check reveal kidney disease?" This is one of the most common questions veterinarians hear from pet owners. The biggest challenge of chronic kidney disease (CKD) in dogs and cats is that it often develops silently. Because the kidneys have remarkable compensatory capacity, pets can continue living normally even after a significant decline in kidney function. As a result, many owners do not notice any abnormalities until their dog starts drinking excessive amounts of water, urinating more frequently, losing weight, or showing a reduced appetite. Unfortunately, by this stage, kidney damage has usually been progressing for quite some time.