The kidneys, lying just under the spinal column, receive nearly 25% of the blood pumped out of the heart. The kidneys maintain water and electrolyte balance, regulate blood pressure and provide an elimination route for toxins. Illness due to kidney disease may be due to infection, inflammation, toxin ingestion (e.g.: lilies and antifreeze), and cancer. Symptoms of kidney disease vary widely depending on the underlying cause. Dogs with acute (sudden) kidney failure are quite ill: vomiting, lethargy, and anorexia. In contrast, dogs with chronic (slow onset) kidney failure may not show any outward signs of a problem; the kidney disease is often incidentally found on screening lab work. Regular wellness testing with blood and urine evaluations allows early detection and treatment of kidney disease.