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9 y.o. Berkley just diagnosed - what's next?

Thank you all for sharing your stories and knowledge here! My 9 yo Shih Tzu, Berkley was just diagnosed with CKD. I brought him to the hosptial for an ultrasound and he comes home today after 4 days of IV fluids and assistance. He started not eating 2 weeks ago.
Original abnormal labs:
Creatinine: 2.9
BUN: 48
Phosphorous: 4.6
TP: 8.4
Globulin: 5.5
HCT: 37.2
MCV: 58.5
Monocytes: 1.59
Ultrasound showed definite chronic kidney changes but they have not atrophied.

Broad-spectrum antibiotics, Mirtazipine and Cerenia were started.

Yesterday morning the tech noticed some coughing, and the x-ray showed some pneumonia in his left lung. His temp was 103.2. So, an antibiotic was added.

He has been taolerating syringe feedings well (until this morning) and still won't eat on his own. He is drinking fine.

His urine culture came back negative.

My Emergency vet is letting me take him home today since his lab values are way better. He'll be on sub-Q fluids for support and watched closely. We'll repeat labs every 48 hours. He'll stay on the antibiotics, in addition to Tramadol and Gaba Pentin (for IVDD). Repeating labs prior to discharge as well.

Like everyone here, my heart too breaks for my little guy. He showed no signs of illness until this suddenly came up. My head understands the gravity of his condition, but my heart hasn't fully grasped it yet.

I would love some advice on what to feed him to ensure he's getting the nutrients he needs, including water. He had just started Royal Canin Renal Support wet food before the hospitalization. Is it better to just cook for him for a while? Most likely he will still be on syringe feedings at first.
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1916673 tn?1420233270
Hi. Please go easy with the Tramadol, as that can cause a deterioration of the kidney disease. Only give when really needed. The antibiotics will also likely cause stress on the kidney function, so I wouldn't necessarily anticipate any improvements to bloodwork until the course(s) have finished.

I'm delighted you are giving SubQs at home. This is really maintenance after IVs, to help support the good work the IVs have achieved. SubQs should be done DAILY, which I hope are being done. Also, the dose needs to be accurate - can you let me have your dog's weight and current creatinine level, so I can check that for you.

Has your vet checked his blood pressure? If not, that needs doing. Further details in my article below (follow the link), which I am sure you will find helpful.

http://www.infobarrel.com/My_10-Point_Plan_for_Dogs_with_Kidney_Failure

I think it is best for you to keep to the canned kd food for now, rather than start homecooking. There will be a time when you need to homecook, as almost all kd dogs go off their food at some stage and it can be an uphill struggle to get them to eat at that time. The kd canned food hopefully will give you plenty of time to research homecooking more fully so you can be adequately prepared. In the meantime, there are a couple of my articles on diet which I would like you to read please ...

http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease

http://www.infobarrel.com/Changing_Diet_During_Canine_Kidney_Disease

In terms of useful supplements, I would start now giving pure organic salmon oil together with a canine formulated Vitamin E capsule. This provides omega-3 fatty-acid, which is a very good anti-inflammatory to help support kidney function.

I wouldn't worry too much about him not drinking water. Not all dogs are good drinkers. The canned food will help, as it contains about 80% water, so will help flush the toxins from his system and keep him hydrated. Always have fresh water down for him, and if possible use filtered water as it contains less sodium. You could also give a chicken broth if you feel he needs more hydration (just cook up human-grade chicken with some veg, like green beans, and pass it through a sieve for him to lap at. This is both nutritious and hydrating.

If possible, feed much smaller meals more often. Six meals 2 hrs apart or four meals 3hrs apart help relieve the stress on the kidneys, as they don't have to work as hard removing the by-products of eating.

Kind regards

Tony
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