The following case report describes the evaluation and treatment of a 12 year old spayed female Yorkshire Terrier dog, treated for bilateral renolithiasis, chronic kidney disease (CKD), pyelonephritis, and a urinary tract infection. The diagnostic workup included a complete blood count, chemistry panel, urinalysis with culture and susceptibility testing, abdominal ultrasound with pyelocentesis, thoracic radiographs, and renal scintigraphy. A bilateral nephrotomy was performed to remove the kidney stones. The assessment of the dog's renal function and the ultrasonographic appearance of her kidneys post-operatively were favorable. Unfortunately, severe post-operative pancreatitis developed, and the dog was euthanized without necropsy due to a presumptive intracranial vascular accident. This paper outlines the main treatment options that are available to manage canine renolithiasis and the diagnostic steps that are necessary to make the most educated and appropriate choice for each patient.