Dog has Stage 4 Kidney Failure

[cj1085]

The weekend of April 25, 2015, we noticed our 6 year old spayed female dog (Matilda) was vomiting and not eating.  On Sunday, April 26, we took her to an emergency vet, who diagnosed her with Stage 4 kidney failure.  Her Creatinine level was 12.2, which we were told was "off the charts".  We admitted her to a 24 hour vet clinic, who started her on IVs, etc.   Just yesterday (Sunday, May 3, 2015) her Creatinine level had dropped down to 6.1, but appeared to "plateau" at that level (it had gone from 6.9 to 6.2 to 6.1 throughout the previous 3 days).   We took her home last night with specialized kidney diet food (provided by the vet), and are caring for her at home now.   From researching this topic online, I see that a Creatinine value over 5 is considered Stage 4 failure.  The vets goal was to get it down to below 2, but that seemed impossible.  We stopped the treatments at the vet, as we were told the IVs were starting to affect her liver, and she was having bouts of high blood pressure.  Is there any hope, and when will I know when it's time to euthanize?  Any help or advice is much appreciated.  

[Earlsteffie]

I was reading your post, then what Tony's response was........The first thing that jumped out with me was your Dog's age. My very first thought was 'Acute Renal Failure' given how abrupt the symptoms appeared. As Tony had questioned,...'Did the Vet run urine tests'??

The other thing that stood out in your post was the acknowledged 'Liver' problem. Both Liver & Thyroid problems will expose themselves with bouts of 'wanting to throw up', but, from what you said, all came up suddenly.

I realize the financial strain on running tests, but, the Vet didn't seem to exhaust their search to rule out 'other' potential causes for the kidney values.. This is a 'Must'.

Sure hope you're able to possibly visit another Vet real soon.

[tonyb286]

Hi. I was reviewing your post and my response and wondering whether this is definitely kidney disease or a secondary reaction to a primary illness or even toxaemia. The iv fluids reaction is unusual, providing the fluids given were an appropriate mix and not too excessive (too much fluid can cause issues). I think it may be worth undertaking tests for increases in protein leakage (microalbuminuria) into your pet’s urine, which are a more accurate indication of kidney problems. The liver can be affected by various problems, but any damage to this organ (unlike the kidneys) can often be corrected. Of course, much depends on what your vet means by the fluids "starting to affect her liver".

Just wanted to add that.

Tony

[tonyb286]

Hi. You've come to the right place. We are a supportive bunch here and most of us have had are currently have a dog suffering from kidney disease. I'm sure you will get lots of good advice from our family of friends.

Aggressive iv fluids can indeed affect the liver and the heart, so your vet's cautious approach is wise at this stage. However, a good fluid intake by normal means is advantageous (it helps flush toxins out), so it's worth ensuring your dog receives enough (ideally filtered) water or broths that are low in phosphorus and sodium.

I'm interested in the kidney diet your vet has advised ... please tell me this is canned, not dry food.

Your dog is quite young to have developed kidney disease. It would be useful to know what you have been feeding her prior to this event, including regular treats. The questions is ... is this acute or chronic renal failure. Did your vet consider an answer to this or take a history about routine diet?

A kidney specific diet is now advised and that means withdrawing phosphorus, sodium and low-quality proteins. My article on diet for KD dogs might be useful to you. The link for it is here:

http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease

Did your vet devise a plan for continuous monitoring of your dog's blood pressure? This can have important consequences, depending on the results. Bouts of high blood pressure are common amongst KD dogs, and it's relevant to get the blood pressure down with medication. Has your vet prescribed an initial treatment with a suitable ACEI (angiotensin-converting enzyme inhibitor)? If not, this needs urgent attention.

Has the vet checked calcium and potassium levels. These can also be very important checks.

Creatinine levels are indicative of renal failure when high, but it is not diagnostic on its own. There are correlations between creatinine, BUN (blood urea nitrogen) and phosphorus, as well as other important readings.

The question about euthanasia is always difficult. That time may come, if your dog doesn't rally and the levels get steadily worse. But, for now, there are many things worth trying, so stay strong.

Hope this helps.

Tony