Despite medical advances in veterinary nephrology, dogs with chronic kidney disease (CKD) eventually succumb to their disease. Additional medical approaches to address disease progression are urgently needed to treat this common condition in dogs. Emerging evidence in veterinary and human medicine highlights the importance of metabolic acidosis, which has been linked to major adverse clinical outcomes and has been identified as a significant risk factor for CKD progression and mortality in patients with kidney disease and is, therefore, now considered a therapeutic target. The role of alkali therapy in improving clinical outcomes in dogs with CKD remains unknown. This research aims to fill this knowledge gap by determining the effect of alkaline therapy (sodium bicarbonate) in managing metabolic acidosis in dogs with CKD. We hypothesize that alkaline therapy will be well tolerated with minimal adverse effects and improve metabolic acidosis and long-term clinical outcomes in dogs with CKD. This, in combination with the results from a current CHF-funded study that is expected to find that ammonia excretion, can be used as an early marker of patients at risk for the development of metabolic acidosis and poor outcomes that could benefit from alkali therapy, could synergistically revolutionize the way in which veterinarians both diagnose and manage kidney disease patients with metabolic acidosis, which has deleterious consequences on quality of life and disease outcomes.