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Typically, the veterinarian will monitor kidney enzyme levels in the blood and possibly monitor changes in urine via routine urinalysis. If your dog does well with the renal diet and the meds, and the kidney values don't change, then there is no need to add in fluid therapy. If these treatments are in place and the values increase then it's time to add in the fluids. I assume we are talking about Hills k/d as the diet. This diet is proven to be effective in patients with kidney disease/failure. Not only is it low protein but it also has reduced amounts of phosphorus and sodium. I would not stray from this diet, as it is one of the best you can offer your pet. If you are feeding a dry diet and are concerned about fluid intake you can add some water to the food.
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