Did Your Vet ... ?

[tonyb286]

I am currently looking into another aspect of canine kidney failure and would appreciate your response to the question:

During the diagnosis period, did your vet measure your dog's blood-pressure?

There are reasons for me asking this, but please forgive me for not explaining them at this stage.

Tony

[Kaymbsc]

Thanks, Tony. You're right. I missed that tidbit in the supplements article. Thanks so much!

[tonyb286]

Hi again. Raw cabbage has a compound called thiocyanate, which suppresses the thyroid gland leading potentially to hypothyroidism over time. The cooking process destroys thiocyanate, making it safe for dogs (humans aren't affected by it). This is just another example of how different a dog's anatomy and systems are, despite the apparent similarities. This info is contained in the Supplements article I did:

http://www.infobarrel.com/Supplements_Useful_For_Kidney_Failure_Dogs

... but after a lot of reading, you may have missed it.

Tony

[Kaymbsc]

Thanks, Tony. I wasn't aware that raw cabbage juice isn't suitable for dogs. Why not?

[tonyb286]

You're very welcome, Kay. Great news that the vet travels to your location twice a month. Just to add one further point ... humans tend to drink juiced cabbage from raw, but this isn't suitable for dogs, so always make sure you cook it first (just in case you weren't aware). Tony

[Kaymbsc]

Thanks, Tony. Yes, at your recommendation when I first came on here about a month ago, I started adding about a teaspoon of chopped cooked cabbage to Mandy's meals, which I was surprised to find she liked. In fact, if I put food side-by-side, one with and one without the cabbage, she always chose the food with cabbage.

Since then I've done a bunch of reading about cabbage, kidney disease and ulcers. Many humans with ulcers drink cabbage juice. So I took the plunge and ordered a masticating juicer which is the best kind of juicer for cabbage leaves. http://www.healthambition.com/make-cabbage-juice-ulcers/

You are spot on about the vet. The good thing about this vet is he travels to Myrtle Beach (where I live) twice a month, so our next appointment is in our home town.

Thanks, as always, for all your suggestions, ideas, and sharing your wealth of knowledge.

Kay

[tonyb286]

Hi. Great stuff. That all makes absolute sense. I'm pleased you now have a vet that seems more experienced and knowledgable about the issues involved. And they are right, CKF is extremely complex and affects so many other systems that sometimes the symptoms don't follow an expected route.

It IS a balancing act between giving meds that will both help and hinder in different ways. Protein loss - and the resulting increase in toxaemia - is only one side of the story, of course, because the fact is that things can change rapidly. It's worth hanging on to this vet and maintaining good routine blood checks on the creatinine and BUN (and phosphorus) levels.

If you haven't already done it, I would add a very small amount of chopped cooked cabbage to meals on alternate days, as this will certainly help prevent ulcers forming, without any stress to the kidneys.

Mandy is probably going to need the BP medication for the remainder of her life, and I would tend only to withdraw it if things deteriorate to the point when it won't matter. Your vet got it exactly right ... high BP damages the kidneys much more, which means it is essential to bring it under control as quickly as possible.

Although the vet is a long way from your location, you have at least found one that is helping Mandy now, so it's definitely worth the inconvenience.

Tony

[Kaymbsc]

When my dog Mandy was diagnosed with CKD in early 2014, my vet said nothing about BP. I became proactive and consulted with a veterinary nutritionist at Ohio State University. It was she who said CKD dogs are often hypertensive. So then I went back to my vet, requested a BP reading, and found Mandy's systolic BP at 173 was high. Mandy was then put on Enalapril.

Much has happened since then. Disappointed with the vet I had been using for 28 years, I changed local vets. Additionally, I consulted with two other out-of-town vets who practice integrative medicine.

I've learned every vet has a different opinion, and there's no single right answer, but in the process of consulting with so many specialists, I now better know what to ask, question, doubt, and pursue.

As of 10/2/14, Mandy's BUN came down to 79 (from 105) and her Creatinie came down to 3.4 (from 3.9) but her Albumin at 2.0 was low, and she still didn't want to eat. We ran a liver panel, but that looked find. So I took her to a board-certified ACVIM vet. There are none nearby, thus we drove 2.5 hours one-way. I'm so glad we did. He tweaked Mandy's meds, prescribing Sucralfate for bleeding ulcers and Zantac (aka Ranitidine) for acid, Mandy's also getting 100ml SQ fluids 2x daily.

What I learned from the ACVIM vet is that dogs like Mandy with PLN (Protein Losing Nephropathy) are more symptomatic at lower levels of BUN & creatinine than dogs that don't have protein loss. He said other dogs with BUN & creatinine at Mandy's levels but who are not losing protein often eat well.

He also said dogs with protein losing issues are prone to blood clots forming.

Since putting Mandy on sucralfate and zantac, she seems to be feeling much better and her appetite has improved.

We go back to the ACVIM vet on Oct. 21 at which time he's going to discuss aspirin and Calcitriol therapy.

As for her BP meds, several months ago, Mandy had developed a bad cough. I learned that 5% of human patients on Enalpril develop a cough, so we switched her to Benazepril.

Now Mandy's systolic BP is around 150. My thought was that we should cut back on her BP meds, but the ACVIM vet advised that in Mandy's case, it's more for BP at the kidney level than at the systemic BP level. She needs to be on an ACE inhibitor to lower the protein loss from the kidneys; because she can have elevated pressure at the kidney level which forces more protein out into the urine. That, he thinks, is why the albumin is low.

[tonyb286]

Thanks. Let me know ... and if they don't do it without you prompting, please tell them you've been reading up on CKD and suggest it would be a good idea. Tony

[14Karit]

Hi Tony. Ginger's vet did not but we're new to the diagnosis so maybe when we return in a few weeks?

[tonyb286]

Thanks Charlene. Tony

[DogBlog]

Sammie's vet did measure hers many times but it was always normal.

Charlene

[tonyb286]

Thank you both. Tony

[Fitmaltesemom]

Dr. Schultz actually did measure Oliver's blood pressure the morning I brought him in when he was going through severe kidney failure.

[mydogsaremylife]

Hi Tony.  My yorkie was already on two blood pressure meds prior to his kidney diagnosis.  My vet associated his high blood pressure with his known health issues at that time (pancreatitis, cancerous tumor).