So my friend Cyrus (5y/o German Shepherd) was diagnosed with kidney failure this past January. I had blood work done because of his over drinking and urination, because I was thinking diabetes. The vet called and said no diabetes, but he is in kidney failure. His BUN came back 59 (normal being 7-27) and Creatinine 3.1 (normal being .5-1.8). Urine specific gravity was 1.014. I had his urine tested again in April because he seemed to be having accidents (something he NEVER did). and his urine specific gravity went to 1.007, also showed he was positive for Urine Occult Blood. Now, the past few days, he has been having accidents in his crate. He also isn't eating much(other than today, he seemed to want his food more than his water). Yesterday, he ate maybe half his bowl of food, which he threw up in about 15 minutes. He has had watery stool for the past 2 days (and has gone at least 6 times today, which isn't normal for him). As he was eating/drinking today, while standing, I noticed watery blood dripping from his "boy parts". He still tries to play with his toys, but doesn't seem to be lasting as long as he used to. Also, his back end looks terribly skinny, I can see everything from his ribs to his hip bones. About a month ago, he had bloody diarrhea. The vet then told us, it was time to start considering having him put to sleep. I didn't feel he was ready then, but now it seems this is all starting to take a toll on him. He's even slow walking up steps now. I do not want to wait until of his sense of pride is completely gone. Any advice would be greatly appreciated!
Hi. I would say, if this is kidney disease/failure, it is stage 3 of the condition. There are four primary stages of chronic kidney failure, stage four being when creatinine is above 5.0. The important thing right now is to rid his body of the toxin build-up, and this can be achieved with the help of IV Fluids - talk to your vet about undertaking this today.
The next important thing is to reduce protein in the diet, and that means a kidney specific renal diet - the best being tinned (not dry) manufactured renal diets that are on the market, because these have high quality protein, low in phosphorus and salts and high in nutritional value.
Finally, take a look at my article on this subject at: http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease
I know this is a really hard time for you, and once you have all the information at hand and have absorbed the useful data there, you will be in a better position to make a decision. I hope he isn't beyond helping, but it may take some serious work, time and effort from you and your vet to get his blood levels back down, and there is no certainty of achieving it.
My heart goes out to you. I know exactly what this is like, having gone through it myself with one of my dogs some years ago. Stay strong.
Thanks....my hubby talked to the vet today, and she said he is in "end stages" of his kidney failure. As far as the IV fluids and all the up keep to try and get him back down, is just not financial possible for me. And i feel terrible about that. I really don't want to see him gone, but I don't want to see "him" go away in front of me, if that makes sense. I would much rather have him go while he is still somewhat the dog I love soo much, verse having to see him sick and not enjoy anything. I don't know what to do, and the hard part is I am with him everyday..ALL DAY...so I'm the only one that can really make this decision because I know him better than anyone else.
Hello. I do feel for you. The reality is, a young dog has more of a fighting chance, but IV fluids would be essential (not having it is not an option in trying to help him). I believe you could get the levels back to more or less normal with intensive fluid therapy and other things, altering the diet and introducing some medications. Your vet says it's stage 4 (final stage), but his blood levels do not suggest this - they suggest stage 3 of the condition. Yes, stage 3 is close to the 'end stage', but not there yet.
Given the above, if his blood levels came down, then he could enjoy a reasonable quality of life, enjoying walks and food and the company of you and others for some time. There is no cure for kidney failure, but life can be prolonged for a year or two before it becomes impossible to treat anymore.
The decision is entirely yours. It's a burden, I know, but that's what we have to do when we care and love our dogs. Whatever you decide, do come back and let us know. We can be here to talk to, in grief, or to help support kidney failure management.
My best wishes for this difficult decision-making process.
We did IV FLUIDS FOR 6 days in animal hospital. I visited every day. By day 6 he was dancing around and playful again. The cost was only $600. We did that 8 months ago. The day that I took him to vet he only slept and vomited everything.
We are on renal diet and whatever else he wants. I know deli ham might be bad, but that's what he wants in the evening. :-) (he told me) ha
He is slowly worsening but still eats and cuddles and loves small walks and car rides.
EPAKITIN is the powder we use for phosphate binder, doc said they have flu like symptoms and this med just makes them feel better.
Pepcid stomach and mouth ulcers.
Tramadol just in case there's pain.
Ondansetron for nausea w every meal. He rarely vomits now and looks forward to meals.
Tony if you have any other thoughts or if I am on the wrong track pls comment.
Hi ... and welcome to the User Group. It sounds like you are doing the right things, and that your dog is doing well so far. Yes, there is often a slow deterioration, because that's the nature of this disease, but it can be so much faster (literally) without proactive management, diet changes and veterinary interventions. If you haven't already had a read of my article on diet and kidney failure, you can find it here:
There's nothing wrong with ham, but deli ham probably has sugars, salt and possibly garlic in it - these three elements are not good for kidney failure, so if you are going to give this please only give very small quantities very occasionally. It's like many things, while a dog may feel an instant 'hit' with bad foods, they suffer for many hours later on, sometimes quietly. I think there is a point when this disease progresses when we can afford to feed them whatever they want, because it won't make too much difference, but when a dog is being well maintained and is doing well, it's worth being that much more cautious about what we feed them.
The article above will also give you a few other tips on what is good to feed - and when to be cautious about things like tap water, meat proteins, dry food and treats, and so on. I think you will find it useful.
When is your next vet visit due for blood level analysis? This will almost certainly tell you whether the deterioration is accelerating or not, and it will also help determine whether any changes to medication and diet are due. When you get your next blood results, post them here and we can help assess them with you.
Great article Tony, wish I had found it a 3 years ago when my dog (Koko) was first diagnosed. She's a Nova Scotia Duck Toller mix and was about 6 years old at that time.
She had gone off her food, and vomiting when we took her in. Xrays revealed one kidney was solid stone and the 2nd had 7 stones about the size of chickpeas. Are vet actually recommended we see a specialist and very glad we did. She was clear that the prognosis was not good but if with the use of IV treatment, epataktin, and special diet, if we could get her flushed out and balanced that she might live a few months, maybe even 6 if we got lucky. She felt that as many as 4 or 5 IV sessions might be what was needed.
Koko responded to the first session of 2 day IV really well (prior to seeing specialist), but soon deteriorated, a 2nd session of 3 days, was okay but not as good as the prior session and when she quit eating we took her in for a third IV session for 4 days. When she came out the vet (our regular vet) informed us that he felt there was really no point in continuing but with the words of the specialist in mind we were going to let Koko keep trying a wee bit more.
When she came home she'd drink but not touch the KD food and this went on for three days. No improvement or deterioration. I found a home made diet online that recommended rice, squash, and chicken or egg white and then started doing some research into phosphorous levels in food. Eventually what I made was rice; one of Sweet potato/Squash/carrots; egg white; chicken; animal lard. Wasn't really sure of the correct ratios but ended up being about 6:6:3:1:1. She wouldn't eat on her own initially but was happy to eat from fingers, by about day 7 after returning from her last treatment she began eating on her own.
Also tried to catch a kidney stone without any success, and when Koko started avoiding me every time I came at her with a cup in hand I pretty much quit. I did find that her urine was acidic (ph test sheets), so added a bit of calcium to her food to neutralize her urine under the assumption she had the acidic based stones.
Well the vet and specialist were wrong, it's 3 years and 4 months later and she is now in her final few days, she's been a bit of a miracle. She's been vibrant and healthy throughout, no one could tell accept for me during her once or twice a year bad spells when her food intake would drop in half. It's only been the last 2 months that the disease has started taking a toll.
Looking over this groups information I realize I probably could have done a bit better for her with this resource. I know we probably just got really lucky and it wasn't the home made diet that kept her around so long but at the same time just in case it helps anyone else I thought I'd post it.
Hi. What a story ... it makes me feel very privileged to meet wonderful owners like your good self here in this User Group. I laughed and cried at your story. Laughing when I pictured you following Koko around with a cup ... and crying when clearly everyone felt her days were over, but with extraordinary courage and perseverance here you are 3 years later. Quite amazing.
I think however, you are wrong to say it probably wasn't the homemade diet that has kept her around for so long. I think it probably is (mostly) that - and the interventions you made early on - and of course the medications you have given with the guidance and assistance of your vet. I was fascinated to read you included animal lard in the mixture, as this rather confirms my opinion about fatty animal foods which give huge chunks of energy and weight-gain, while the low protein diet prevents forcing the kidneys to work so hard. I think you have hit on some excellent management practices, which I am sure will be invaluable to others in the same situation.
I think you deserve a huge pat on the back for getting here, to this point in time. If Koko could, she would thank you so much for helping her over the years. Even if things deteriorate (I really hope they don't, but the nature of this disease is so unpredictable), she has had at least a third more of life than she would otherwise have done without your care, love and attention.
Thanks for the kind thoughts Tony. I certainly like to think I made a difference, but a sample of one is hardly scientific, but I did want to pass my experience along just in case in can benefit someone else.
As for the lard, from what I had read they need the fat, and vegetable fat won't work for them. Never did find data for phosphorous content on lard but it seemed to be an essential requirement so it didn't matter either way.
And egg white was a great find. Originally started with just turkey or chicken meat but found they had egg whites in cartons. No need to separate and throw away yolks (which are tasty but high in sulphur and phosphorous) and they're the highest source of protein and lower in phosphorous than poultry meat.
Hi. Yes, egg yolks have about three times the phosphorus of the egg white, but they are rich in high quality protein, so there is some argument for suggesting a mixture of three egg whites to one egg yolk is good to balance things out. I'm still fascinated by the animal lard suggestion, and you're right, it's hard to find any real information about the analysis of nutrients. It's something I'm going to have to keep researching. I'm a huge fan of green tripe for dogs with CKF, as you may have worked out from reading the article ... my guess is the more variety of good foods we can muster here on this forum, the better, as it will help many more owners and their dogs. Tony
You will be pleased to note there is no phosphorus and no protein. That makes lard an exceptionally good part of a kidney failure diet, though there is some other minor bad ingredients, which are small enough to be safe. It's worth noting that as there is no protein at all - and no vitamins or minerals - lard can only be considered one part of a diet, as without a small amount of high quality protein and some supplementary vitamins and minerals, a lard diet on its own would not be good.
I still think you might have hit on something here though - and can't recall anyone else trying this as part of a controlled diet for canine kidney failure.
Oh no. I am so very sorry. I thought Koko was in with a good chance of bouncing back. It is hard when the time comes, I know, and you are very welcome to come back here any time, even if just to chat about the wonderful life you gave Koko, despite the health issues. Tony
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