There is often a chemical odor to the breath, and teeth are sometimes discolored. Some puppies grow normally until they are diagnosed, and some appear as failures to thrive. Epogen, an expensive drug which needs to be carefully monitored, can be also be given to treat the hypoproliferative anemia of chronic renal failure. Some Veterinary schools are experimenting with kidney transplants, but transplanted kidneys in dogs are commonly rejected. These treatments are palliative at best, and the prognosis for JRD is grim.
Puppies usually die within several months of being diagnosed, almost always before age two.
I do know of several dogs who have JRD with less severe kidney involvement, and who are being well maintained on low protein diets. These dogs are both more than three years old, and were diagnosed before they were symptomatic. If a breeder is informed about a medical problem in a puppy she has sold, and often she is not, or, if just the owner of the dam is informed, and it is only one puppy in a litter about whom she is informed, it is usually treated as an isolated incident. Unless there are multiples in a litter, and the breeder is informed about each, the fact that the illness from which a puppy is suffering is a genetic disease is not recognized, and no recognition is made nor thought given to those littermates who are carriers. Without an understanding of the genetics involved, and most veterinarians treat isolated incidences as being from an unknown cause rather than as Juvenile Renal Disease, veterinarians are unable to offer counseling to breeders, and more and more carriers are unknowingly bred.