Aa
Not quite sure what to do/ask the vet next?
I have a beautiful female Lurcher crossbreed called Baillie she about 14 yrs old.
Up until last year we had no health issues with her at all... Following a check up at the vet for a little bit of stiffness she was prescribed Metacalm to help her. I gave the Metacalm as prescribed but my poor dog started to look not well. Following the 2nd tablet on the second day she started to vomit and have diarrhoea constantly- both day and night. I didn't give a 3rd Metacalm as I felt she was reacting badly to it but called the vet instead.
Apart from being useless they suggested to leave her for a further 24 hrs..my poor dog was refusing anything to eat or drink.
I took her back to the see the useless vet who gave her an injections to stop the vomiting and gave an injection of anyibiotic too etc. Anyone could see that my poor dog was unwell but clearlyt not a trained vet!
I took my dog back home and she continued to vomit and her diarrhoea started to become bloody too.
The next day I insisted the useless vet admit my dog as by this time she was becoming severly dehydrated. We were trying to coax her to eat and drink but she refused all the time.
By this time I started to look up reviews on Metacalm and side effects. What I read was exactly the same as my poor dog was suffering and some dogs were actually dying because of the side effects.
Baillie was taken into the useless vets and admitted overnight for rehydration. I was called the next morning to say she was fine to come home..at least she was able to walk out in comparison to being carried in..
I was not given an explanation as to the reason for my dogs sudden ill health and was too upset to ask as I was just so pleased she made it home ( this all happened in September 2015).
After a long recovery we managed to get her back to near normal and her diarrhoea too.
This medication I feel is to blame for where we are at the moment with my lovely dog.
I changed from the useless vet to a more understanding one straight away.
In January for no apparent reason Baillie became lame. Initially I thought she had something in her paw or pulled a muscle but it never went away. She started to become quite breathless as well and I put this down to old age! Then she started to struggle to walk combined with breathlessness I thought she had heart problems... visited the vet and took a urine sample Baillie was prescribed Benazacare as the test showed she was leaking protein and Tramadol for pain with the lameness and Prednisolone. Tramadol was the 2nd choice of pain med as the first caused a reaction. Shes a sensitive wee soul is my Baillie.
Baillie suffers from severe anxiety particularly when going to the vets. She shakes that much I fear at times she's going to have a heart attack, so I just phone the vet with symptoms and they diagnose from that -which I am happy with.
Anyway, Baillie began to get more and more breathless, eventually we had to ask the vet to come out. At this stage we weren't sure if she was going to be put down or not. The vet diagnosed Congestive Cardiac failure and prescribed Vetmedin and Frusemide. Baillie had also started to become incontinent for which Incurin 1 mg was prescribed.
She started to slowly make a recovery, her breathing coming down from a high 78 breaths per minute to 38/40.
I still felt there was something else going on and unfortunately for Baillie it meant a trip to the vet. I asked the vet to arrange a consultation with a cardiologist. This meant a sedation for Baillie but she had scans and xrays and bloods taken, I also managed to get a faecal sample as she had an accident in the car on the way home!
The outcome of this final consultation was her heart was fine and to stop the Vetmedin and Frusemide. She did have Chronic Bronchitis and shadows were found in her spleen. I refused a biopsy of them as I felt she had been through enough. The lab results showed her kidney function was getting worse ( I need to get the results from the vet). She is now on Royal Canin Renal wet dog food and loves it..the medications she's on irritate her bowel so we constantly fight diarrhoea which really gets her down. The cardiologist increased the Prednisolone to 5mg x 2 daily and prescribed an antibiotic which at the moment I haven't given due to her irritated bowel.
I don't know what stage of Renal failure Baillie is at..but I will ask.
We have been on an emotional rollercoaster as most owner have with dogs with this condition, most of the time I'm just glad she still alive rather than thinking of what questions to ask or even retain information.
For the last few weeks Baillie was getting up many many times during the night but since she is no longer on the Frusemide and a change in her diet I have also increased her last dose of Tramadol before bed to see if it helps her and so far it has.
At the moment she is lively (enough) eating small meals throughout the day rather than one big one and I am filled with hope... for a while anyway.
Our one concern is that she is not in any pain and hand on heart I don't think she is.
I am of the firm belief her kidney and bowel issues have been a direct cause of the Metacalm. Many dogs benefit from its use but there a some dogs who's life can be put in peril because of it and the owners are not warned of the consequences until its too late!
Is there anything I could or should be doing for my wee friend that at the moment I'm not?
Thanks for reading if you made it to the end of the post.
Up until last year we had no health issues with her at all... Following a check up at the vet for a little bit of stiffness she was prescribed Metacalm to help her. I gave the Metacalm as prescribed but my poor dog started to look not well. Following the 2nd tablet on the second day she started to vomit and have diarrhoea constantly- both day and night. I didn't give a 3rd Metacalm as I felt she was reacting badly to it but called the vet instead.
Apart from being useless they suggested to leave her for a further 24 hrs..my poor dog was refusing anything to eat or drink.
I took her back to the see the useless vet who gave her an injections to stop the vomiting and gave an injection of anyibiotic too etc. Anyone could see that my poor dog was unwell but clearlyt not a trained vet!
I took my dog back home and she continued to vomit and her diarrhoea started to become bloody too.
The next day I insisted the useless vet admit my dog as by this time she was becoming severly dehydrated. We were trying to coax her to eat and drink but she refused all the time.
By this time I started to look up reviews on Metacalm and side effects. What I read was exactly the same as my poor dog was suffering and some dogs were actually dying because of the side effects.
Baillie was taken into the useless vets and admitted overnight for rehydration. I was called the next morning to say she was fine to come home..at least she was able to walk out in comparison to being carried in..
I was not given an explanation as to the reason for my dogs sudden ill health and was too upset to ask as I was just so pleased she made it home ( this all happened in September 2015).
After a long recovery we managed to get her back to near normal and her diarrhoea too.
This medication I feel is to blame for where we are at the moment with my lovely dog.
I changed from the useless vet to a more understanding one straight away.
In January for no apparent reason Baillie became lame. Initially I thought she had something in her paw or pulled a muscle but it never went away. She started to become quite breathless as well and I put this down to old age! Then she started to struggle to walk combined with breathlessness I thought she had heart problems... visited the vet and took a urine sample Baillie was prescribed Benazacare as the test showed she was leaking protein and Tramadol for pain with the lameness and Prednisolone. Tramadol was the 2nd choice of pain med as the first caused a reaction. Shes a sensitive wee soul is my Baillie.
Baillie suffers from severe anxiety particularly when going to the vets. She shakes that much I fear at times she's going to have a heart attack, so I just phone the vet with symptoms and they diagnose from that -which I am happy with.
Anyway, Baillie began to get more and more breathless, eventually we had to ask the vet to come out. At this stage we weren't sure if she was going to be put down or not. The vet diagnosed Congestive Cardiac failure and prescribed Vetmedin and Frusemide. Baillie had also started to become incontinent for which Incurin 1 mg was prescribed.
She started to slowly make a recovery, her breathing coming down from a high 78 breaths per minute to 38/40.
I still felt there was something else going on and unfortunately for Baillie it meant a trip to the vet. I asked the vet to arrange a consultation with a cardiologist. This meant a sedation for Baillie but she had scans and xrays and bloods taken, I also managed to get a faecal sample as she had an accident in the car on the way home!
The outcome of this final consultation was her heart was fine and to stop the Vetmedin and Frusemide. She did have Chronic Bronchitis and shadows were found in her spleen. I refused a biopsy of them as I felt she had been through enough. The lab results showed her kidney function was getting worse ( I need to get the results from the vet). She is now on Royal Canin Renal wet dog food and loves it..the medications she's on irritate her bowel so we constantly fight diarrhoea which really gets her down. The cardiologist increased the Prednisolone to 5mg x 2 daily and prescribed an antibiotic which at the moment I haven't given due to her irritated bowel.
I don't know what stage of Renal failure Baillie is at..but I will ask.
We have been on an emotional rollercoaster as most owner have with dogs with this condition, most of the time I'm just glad she still alive rather than thinking of what questions to ask or even retain information.
For the last few weeks Baillie was getting up many many times during the night but since she is no longer on the Frusemide and a change in her diet I have also increased her last dose of Tramadol before bed to see if it helps her and so far it has.
At the moment she is lively (enough) eating small meals throughout the day rather than one big one and I am filled with hope... for a while anyway.
Our one concern is that she is not in any pain and hand on heart I don't think she is.
I am of the firm belief her kidney and bowel issues have been a direct cause of the Metacalm. Many dogs benefit from its use but there a some dogs who's life can be put in peril because of it and the owners are not warned of the consequences until its too late!
Is there anything I could or should be doing for my wee friend that at the moment I'm not?
Thanks for reading if you made it to the end of the post.
Hi. As calcium is high, you don't really want to be giving a calcium-based binder, as that would likely push the serum calcium level even higher. That's a very simplified answer to a very complex problem in canine kidney failure, because the high calcium could possibly also be a result of abnormal parathyroid hormone, which causes calcium to be drawn from bones and teeth - thus giving a false high calcium reading.
I think the safest bet is to go with aluminium hydroxide initially. If after 2 weeks the phosphorus level hasn't come down, then you might add a small dose of calcium to food in addition to the binder. Then re-test after a further 2 weeks.
There's more on this process in my Phosphate Binder article via my website at www.tonyboothwriter.com
Tony
I think the safest bet is to go with aluminium hydroxide initially. If after 2 weeks the phosphorus level hasn't come down, then you might add a small dose of calcium to food in addition to the binder. Then re-test after a further 2 weeks.
There's more on this process in my Phosphate Binder article via my website at www.tonyboothwriter.com
Tony
7 Comments
Thanks for that Tony..
At the moment Baillie is doing very indeed and we are all happy. I have reduced her Tramadol down slowly and at the moment she has gone from 125mgs daily to 50 mgs in one week and I will reduce further. I have also started buying bottled water for her so hopefully that will help too.
Here are the blood values as they were taken
Reference value. Results(Baillie)
Glucose 3.6-7.0mmol/L. 2.0
Urea 3.1-10.1mmol/L. 32.8
Creatinine 20-144.5mmol/L. 218
Phosphorus 0.80-1.60mmol/L. 3.51
Calcium 2.63-2.84 mmol/L. 2.99
Total protein 54.9-75.3 g/L. 78.4
Albumin 26.3 - 38.2g/L. 42.9
ALT. 19.8-124.0 U/L. 252.3
ALP <=130.0 UL. 507.0
Bilirubin 0.1-4.2 mmol/L. 2.7
Cholesterol 3.20-6.20 mmol/L. 11.22
Amylase 100-1,200.0 UL 522.0
Same you can see Tony Baillies levels are really high in comparison to the normal reference range.
Are you able to interpret these at all?
As I said before these levels to an untrained eye look critical but my dog is far from that in her manner and behaviour...in fact she hasn't been this good in a long time so could the blood results be inaccurate due to poor storage before they were tested as the machine in the vets office was broken when they went to test her blood and had to send it out for testing..
At the moment Baillie is doing very indeed and we are all happy. I have reduced her Tramadol down slowly and at the moment she has gone from 125mgs daily to 50 mgs in one week and I will reduce further. I have also started buying bottled water for her so hopefully that will help too.
Here are the blood values as they were taken
Reference value. Results(Baillie)
Glucose 3.6-7.0mmol/L. 2.0
Urea 3.1-10.1mmol/L. 32.8
Creatinine 20-144.5mmol/L. 218
Phosphorus 0.80-1.60mmol/L. 3.51
Calcium 2.63-2.84 mmol/L. 2.99
Total protein 54.9-75.3 g/L. 78.4
Albumin 26.3 - 38.2g/L. 42.9
ALT. 19.8-124.0 U/L. 252.3
ALP <=130.0 UL. 507.0
Bilirubin 0.1-4.2 mmol/L. 2.7
Cholesterol 3.20-6.20 mmol/L. 11.22
Amylase 100-1,200.0 UL 522.0
Same you can see Tony Baillies levels are really high in comparison to the normal reference range.
Are you able to interpret these at all?
As I said before these levels to an untrained eye look critical but my dog is far from that in her manner and behaviour...in fact she hasn't been this good in a long time so could the blood results be inaccurate due to poor storage before they were tested as the machine in the vets office was broken when they went to test her blood and had to send it out for testing..
Hi. It is unusual for so many values to be out of synch, so it is quite possible these results are not accurate. I would re-test immediately (assuming the vet's equipment has by now been sorted). Getting a repeat test will either confirm the above results or not - and that's exactly what is needed right now.
If the results prove to be accurate, then they are all of concern. I am particularly intrigued with the low glucose, as that isn't normal and is suggesting hypoglycemia. While there is a link between insulin production and kidney failure, it's not a result I would have expected from a dog that seems otherwise happy and contented.
Tony
If the results prove to be accurate, then they are all of concern. I am particularly intrigued with the low glucose, as that isn't normal and is suggesting hypoglycemia. While there is a link between insulin production and kidney failure, it's not a result I would have expected from a dog that seems otherwise happy and contented.
Tony
Hi Tony. I thought I would update you on the progress of my best friend Baillie.
Since my last post I decided to change vets. I started to lose confidence in them as they were treating her as though she was going to die and she was not appearing like that to us at all and also one of the vets kept talking about euthanasia which I wasn't ready to consider either and made me feel very uncomfortable.
The new thought the results were 'odd' like you did and the reason he gave after me giving him her history was that at the time of the bloods being taken (which I posted above) Baillie had been unwell, possibly bleeding into her stomach which would have given a high urea result as she was reabsorbing most of the blood!
She definitely at that time had diarrhoea and hadn't been eating a great deal so he thinks this is why certain levels are very high.
The issue with the glucose he thinks was that blood needs to be tested for glucose relatively quickly after being taken. In this instance he doesn't think it was stored properly and there was a time delay in getting it tests because as I mentioned the vets tasting machine was broken and they had to send it out for testing.
The new vet retested all of her bloods I house and I had a he results back in 10 minutes...here are the new ones.
Glucose..6.70 average 3.89-7.94
Urea 14.1 av 2.5-9.6 mmol/l
Creatinine 154 av 44-159 mmol
Phosphorus 1.74 av .81-2.19mmol
Calcium 3.07 av1.98-3.00
Total protein 70 av 52-82g/l
Albumin 31 av 22-39 g/l
Globulin 39 av 25-45 g/l
Alp 2,000 av 23 -212 u/l ( this is ok although raised as she is on prednisolone and is expected to be raised)
Bilirubin 7 av 0-15 mmol
Cholesterol 13.13 av 2.84- 8.27mmol
Amylase 560 AV 500- 1500 u/l
She also had a full blood count which came back fine and within normal parameters.
There is no doubt that the new renal diet food has worked wonders for her and brought down her levels of creatinine. She is now fed roughly 4 times a day small portions and I also add choppe cabbage to food as well as a spoon of white rice. She does have a liking for weetabix and milk for breakfast which I indulge!
I have managed to when her off most of her medication in particular Tramadol which she no longer takes. At the moment she has just finished her 20 day course of doxycycline and increased dose of prednisolone and it has really helped.
I now have her diarrhoea under control with a small drop of Promax in her food as well as yumpro to help any digestive problems and touch wood her bowels have been better than ever using this combination.
Her main problem is not now her kidneys and proteins leakage but chronic bronchitis which leaves her breathless so it's small walks at a slow pace for her. I can't tell you how delighted I am that I changed vets to ones that I hope will work with me for the benefit of my dog. I would say to any dog owners to question anything your not sure of and if you still aren't happy change vets if you can.
This site gave me the confidence to ask those questions when I wasn't getting answers but more important it helped me understand the condition so I could ask those questions.
I will keep posting any changes in the future.. Good luck to everyone who's best friend is going through this and are at different stages of this terrible disease.
Since my last post I decided to change vets. I started to lose confidence in them as they were treating her as though she was going to die and she was not appearing like that to us at all and also one of the vets kept talking about euthanasia which I wasn't ready to consider either and made me feel very uncomfortable.
The new thought the results were 'odd' like you did and the reason he gave after me giving him her history was that at the time of the bloods being taken (which I posted above) Baillie had been unwell, possibly bleeding into her stomach which would have given a high urea result as she was reabsorbing most of the blood!
She definitely at that time had diarrhoea and hadn't been eating a great deal so he thinks this is why certain levels are very high.
The issue with the glucose he thinks was that blood needs to be tested for glucose relatively quickly after being taken. In this instance he doesn't think it was stored properly and there was a time delay in getting it tests because as I mentioned the vets tasting machine was broken and they had to send it out for testing.
The new vet retested all of her bloods I house and I had a he results back in 10 minutes...here are the new ones.
Glucose..6.70 average 3.89-7.94
Urea 14.1 av 2.5-9.6 mmol/l
Creatinine 154 av 44-159 mmol
Phosphorus 1.74 av .81-2.19mmol
Calcium 3.07 av1.98-3.00
Total protein 70 av 52-82g/l
Albumin 31 av 22-39 g/l
Globulin 39 av 25-45 g/l
Alp 2,000 av 23 -212 u/l ( this is ok although raised as she is on prednisolone and is expected to be raised)
Bilirubin 7 av 0-15 mmol
Cholesterol 13.13 av 2.84- 8.27mmol
Amylase 560 AV 500- 1500 u/l
She also had a full blood count which came back fine and within normal parameters.
There is no doubt that the new renal diet food has worked wonders for her and brought down her levels of creatinine. She is now fed roughly 4 times a day small portions and I also add choppe cabbage to food as well as a spoon of white rice. She does have a liking for weetabix and milk for breakfast which I indulge!
I have managed to when her off most of her medication in particular Tramadol which she no longer takes. At the moment she has just finished her 20 day course of doxycycline and increased dose of prednisolone and it has really helped.
I now have her diarrhoea under control with a small drop of Promax in her food as well as yumpro to help any digestive problems and touch wood her bowels have been better than ever using this combination.
Her main problem is not now her kidneys and proteins leakage but chronic bronchitis which leaves her breathless so it's small walks at a slow pace for her. I can't tell you how delighted I am that I changed vets to ones that I hope will work with me for the benefit of my dog. I would say to any dog owners to question anything your not sure of and if you still aren't happy change vets if you can.
This site gave me the confidence to ask those questions when I wasn't getting answers but more important it helped me understand the condition so I could ask those questions.
I will keep posting any changes in the future.. Good luck to everyone who's best friend is going through this and are at different stages of this terrible disease.
I forgot to say that Baillie will be on Benazacare for life and possibly low dosage prednisolone. The vet didn't feel she needed a binder at the moment as her creatinine although towards the high end of normal was still good for her age..
Wow ... what a fantastic result. The blood values are impressive. I am absolutely delighted for Baillie and for you.
One thing to keep an eye on is the cholesterol. Dogs actually don't suffer from cholesterol issues (like us humans) and it tends not to affect the good health of dogs, even when it's higher than normal. However, many kd dog foods and home cooking recipes are higher in fat and that can cause pancreatitis, which needs careful monitoring. But, the good news is that amylase is well within normal limits, which means there is no pancreatitis present.
Keep up the great work. It's so nice to have some good news here, for a change.
Tony
One thing to keep an eye on is the cholesterol. Dogs actually don't suffer from cholesterol issues (like us humans) and it tends not to affect the good health of dogs, even when it's higher than normal. However, many kd dog foods and home cooking recipes are higher in fat and that can cause pancreatitis, which needs careful monitoring. But, the good news is that amylase is well within normal limits, which means there is no pancreatitis present.
Keep up the great work. It's so nice to have some good news here, for a change.
Tony
I know...I'm so happy really I am.
As I said before this forum gave me the confidence to ask questions and ultimately change vets too...so thank you.
I also went on my gut feelings too knowing that the first bloods and the way my dog was just didn't seem right.
Baillie loves cabbage and white rice which is what I'm adding to her Royal canin renal food along with a little chicken thigh meat and for a treat kangaroo meat.
When I look into my dogs eyes now I still see her there ( if you know what I mean) her eyes are clear and she is happy... I know she has other problems to deal with...chronic bronchitis, shadows in her spleen and still the leaking protein but I feel we can deal with those now rather than the decision being taken out of our hands and I hope our new vet will work with us for her benefit..
Will be back I'm sure Tony asking for advice at some point in the future, but thank you so much for your sound advice and Baillie thanks you so much too xx
As I said before this forum gave me the confidence to ask questions and ultimately change vets too...so thank you.
I also went on my gut feelings too knowing that the first bloods and the way my dog was just didn't seem right.
Baillie loves cabbage and white rice which is what I'm adding to her Royal canin renal food along with a little chicken thigh meat and for a treat kangaroo meat.
When I look into my dogs eyes now I still see her there ( if you know what I mean) her eyes are clear and she is happy... I know she has other problems to deal with...chronic bronchitis, shadows in her spleen and still the leaking protein but I feel we can deal with those now rather than the decision being taken out of our hands and I hope our new vet will work with us for her benefit..
Will be back I'm sure Tony asking for advice at some point in the future, but thank you so much for your sound advice and Baillie thanks you so much too xx
Hi
I am so pleased and I hope with all my heart that you and Baillie can enjoy lots of extra time together, share new experiences and adventures ... and make lots of new memories.
There will be good days and bad ones - but for now, things seem so positive.
Take care
Tony
I am so pleased and I hope with all my heart that you and Baillie can enjoy lots of extra time together, share new experiences and adventures ... and make lots of new memories.
There will be good days and bad ones - but for now, things seem so positive.
Take care
Tony
Hi Tony
About 10 weeks ago I asked the vet for a home visit as Baillie was panting heavily and very breathless. To her mum and dad she appeared to be struggling quite badly (prior to this all we knew was that she was leaking protein possibly in kidney failure and taking Benazacare, prednisolone and Incurin) and her resting breathing rate high at about 80....at this point we thought she would be going to Rainbow bridge hence the home visit.
All other discussions before this home visit in May 2016 with the vet tended to follow the line of keeping her comfortable, give her anything she needed as time is limited because she was in renal failure and yes Baillies condition tended to go up and down good days and bad,but I still felt there was something else we were missing!
Following this visit in May the vet was able to hear her heart much better than if I had taken her to see them as she gets so upset and panicky. The vet prescribed vetmedin and Frusemide as well as the other medication I have already mentioned. This new medication appeared to help her breathing became slower and more steady and her bladder performed overtime.
After collecting more medication from the vets surgery About 4 weeks ago I started talking to the receptionist who mentioned they had a cardiac specialist I could ask to see Baillie which I did..
Baillie had a whole range of X-rays, scans blood tests and faecal tests.
The outcome of this 4 weeks ago was her heart was fine for her age so we stopped the vetmedin and Frusemide.
He did find that she had Chronic bronchitis which would account for the breathlessness as well as 'shadows In her spleen' . ....I was asked if I wanted them to do a needle biopsy of the lumps in the spleen which I refused as I was afraid she might bleed too heavily after.
The specialist said he saw very good results in dogs with similar lung conditions when they took prednisolone 5 mgs twice daily and doxycycline 2 tablets daily.
I increased her prednisolone but wasn't able to give her doxycycline because I couldn't get on top of her diarrhoea until now so I'm waiting to see if it makes an improvement in her breathing.
All of the blood results I posted above were the ones taken by the cardiac consultant 4 weeks ago.
Following this our vet said we should now start Baillie on a renal diet which I have and which she absolutely loves. I'm not sure what's in it but she really can't get enough of the stuff. I have never seen her wait for her food and finish it off. I took your advice by giving her small but often meals with added boiled rice and cabbage.
Should Baillie still be on a binder if she is on the renal wet dog food which is ultra low in phosphate?
Should I mention to the vet about calcitrol too?
The doxycycline is a course for 20 days only so as long as it doesn't irritate her stomach or bowels we will continue with it.
Are you able to interpret the blood values I posted as they don't appear to be similar to anything I have seen at all. I was actually beginning to wonder if there had been a problem storing the blood sample before testing as I remember the consultant saying they had tried to test it in house but the machine was broken!
About 10 weeks ago I asked the vet for a home visit as Baillie was panting heavily and very breathless. To her mum and dad she appeared to be struggling quite badly (prior to this all we knew was that she was leaking protein possibly in kidney failure and taking Benazacare, prednisolone and Incurin) and her resting breathing rate high at about 80....at this point we thought she would be going to Rainbow bridge hence the home visit.
All other discussions before this home visit in May 2016 with the vet tended to follow the line of keeping her comfortable, give her anything she needed as time is limited because she was in renal failure and yes Baillies condition tended to go up and down good days and bad,but I still felt there was something else we were missing!
Following this visit in May the vet was able to hear her heart much better than if I had taken her to see them as she gets so upset and panicky. The vet prescribed vetmedin and Frusemide as well as the other medication I have already mentioned. This new medication appeared to help her breathing became slower and more steady and her bladder performed overtime.
After collecting more medication from the vets surgery About 4 weeks ago I started talking to the receptionist who mentioned they had a cardiac specialist I could ask to see Baillie which I did..
Baillie had a whole range of X-rays, scans blood tests and faecal tests.
The outcome of this 4 weeks ago was her heart was fine for her age so we stopped the vetmedin and Frusemide.
He did find that she had Chronic bronchitis which would account for the breathlessness as well as 'shadows In her spleen' . ....I was asked if I wanted them to do a needle biopsy of the lumps in the spleen which I refused as I was afraid she might bleed too heavily after.
The specialist said he saw very good results in dogs with similar lung conditions when they took prednisolone 5 mgs twice daily and doxycycline 2 tablets daily.
I increased her prednisolone but wasn't able to give her doxycycline because I couldn't get on top of her diarrhoea until now so I'm waiting to see if it makes an improvement in her breathing.
All of the blood results I posted above were the ones taken by the cardiac consultant 4 weeks ago.
Following this our vet said we should now start Baillie on a renal diet which I have and which she absolutely loves. I'm not sure what's in it but she really can't get enough of the stuff. I have never seen her wait for her food and finish it off. I took your advice by giving her small but often meals with added boiled rice and cabbage.
Should Baillie still be on a binder if she is on the renal wet dog food which is ultra low in phosphate?
Should I mention to the vet about calcitrol too?
The doxycycline is a course for 20 days only so as long as it doesn't irritate her stomach or bowels we will continue with it.
Are you able to interpret the blood values I posted as they don't appear to be similar to anything I have seen at all. I was actually beginning to wonder if there had been a problem storing the blood sample before testing as I remember the consultant saying they had tried to test it in house but the machine was broken!
2 Comments
Hi. First, yes, she should remain on a phosphate binder for the remainder of her life. This is extremely important, even while on a restricted kd low phosphate diet. Of course, it would also be helpful to have an up-to-date phosphorus blood reading.
Blood values differ according to the country and how laboratories undertake testing. It is more difficult to assess out-of-the-norm values, but I do have reference charts for every country and most laboratories. If you are posting them here, please be sure to post the result and the unit of measure alongside.
Tony
Blood values differ according to the country and how laboratories undertake testing. It is more difficult to assess out-of-the-norm values, but I do have reference charts for every country and most laboratories. If you are posting them here, please be sure to post the result and the unit of measure alongside.
Tony
Thanks for that Tony I will post the blood samples and reference values later today when I have more time.
What type of phosphate binder am I looking at? I wasn't sure if I should get a calcium binder given that her calcium is high or aluminium one?
What type of phosphate binder am I looking at? I wasn't sure if I should get a calcium binder given that her calcium is high or aluminium one?
Hi. It is absolutely possible that the Metacam was involved, but it is equally an impossibility to prove at this stage. It could have been an attack on the kidneys from other medications, annual vaccinations, diet and/or onset from age. In many ways, the important thing is you now have a more experienced and pro-active vet ... and someone that can help, rather than operate under too much guesswork.
The last blood and urinalysis results are key to my offering advice. Please get them and then post them.
I would be wary of giving too much Tramadol - or actually, any at all. Tramadol is very powerful and is contraindicated with existing liver disease, kidney disease, poor lung function or seizure disorders. So, while it is effective at reducing pain, it will cause damage to kidneys, liver and lungs, particularly at higher or frequent doses. Ask your vet about safer alternatives - or only give when absolutely necessary.
Tony
The last blood and urinalysis results are key to my offering advice. Please get them and then post them.
I would be wary of giving too much Tramadol - or actually, any at all. Tramadol is very powerful and is contraindicated with existing liver disease, kidney disease, poor lung function or seizure disorders. So, while it is effective at reducing pain, it will cause damage to kidneys, liver and lungs, particularly at higher or frequent doses. Ask your vet about safer alternatives - or only give when absolutely necessary.
Tony
4 Comments
Hi Tony
Thanks for that. I will certainly try to cut back on the Tramadol. There are times when she pants very heavily, is really unsettled and her ears are really warm. I have taken this that she is in pain hence the reason for the Tramadol. At the moment she is on about 125 mgs a day that is 50 mgs in the morning and 75 mgs at night. We did try another pain killer but she started to react to it quite quickly so I stopped it...can't remember the name at the moment.
She also has intermittent diarrhoea which is really draining for her. She can be up every hour during the night and has been recently wanting to go to the toilet, which makes for a very tired mum the next day. The regime I have found that works for her at the moment is yumpro satchels 1 am and 1 pm along with a daily dose of Promax.
At the moment she has 1 weetabix with milk for breakfast then every 2-3 hours I have been giving her a small satchet of Royal Canin renal wet food which she loves and I mix it with a tablespoon of cooked green cabbage and tablespoon of cooked white rice.
Baillie also has dementia ( going through the wrong door, looking out of windows aimlessly, pacing constantly particularly in the evening) and other things too. I had noticed a big difference when she was on Aktivait, most of the behaviour stopped!
I don't give her this anymore because as the vet felt she was already on too many tablets and her prognosis wasn't all good.
As her bowel habits are now settled I have started her on her course of Doxycycline 2 capsules per day for 20 days so we will see how she goes on them.
Here are Baillies blood results.
Glucose -2.0
Urea- 32.8
Creatinine- 218
Phosphorus-3.51
Calcium - 2.99
Total protein - 78.4
Albumin- 42.9
ALT- 252.3
ALP- 507
Bilirubin- 2.7
Cholesterol- 11.22
Amylase- 522
Urine protein creatinine ratio 0.8
Don't know what any of these mean apart from high in comparison to the reference values on the paper.
The vet did mention that the increase in calcium levels could be to do with the 'shadows they discovered in the spleen'
Any advice??
Thanks for that. I will certainly try to cut back on the Tramadol. There are times when she pants very heavily, is really unsettled and her ears are really warm. I have taken this that she is in pain hence the reason for the Tramadol. At the moment she is on about 125 mgs a day that is 50 mgs in the morning and 75 mgs at night. We did try another pain killer but she started to react to it quite quickly so I stopped it...can't remember the name at the moment.
She also has intermittent diarrhoea which is really draining for her. She can be up every hour during the night and has been recently wanting to go to the toilet, which makes for a very tired mum the next day. The regime I have found that works for her at the moment is yumpro satchels 1 am and 1 pm along with a daily dose of Promax.
At the moment she has 1 weetabix with milk for breakfast then every 2-3 hours I have been giving her a small satchet of Royal Canin renal wet food which she loves and I mix it with a tablespoon of cooked green cabbage and tablespoon of cooked white rice.
Baillie also has dementia ( going through the wrong door, looking out of windows aimlessly, pacing constantly particularly in the evening) and other things too. I had noticed a big difference when she was on Aktivait, most of the behaviour stopped!
I don't give her this anymore because as the vet felt she was already on too many tablets and her prognosis wasn't all good.
As her bowel habits are now settled I have started her on her course of Doxycycline 2 capsules per day for 20 days so we will see how she goes on them.
Here are Baillies blood results.
Glucose -2.0
Urea- 32.8
Creatinine- 218
Phosphorus-3.51
Calcium - 2.99
Total protein - 78.4
Albumin- 42.9
ALT- 252.3
ALP- 507
Bilirubin- 2.7
Cholesterol- 11.22
Amylase- 522
Urine protein creatinine ratio 0.8
Don't know what any of these mean apart from high in comparison to the reference values on the paper.
The vet did mention that the increase in calcium levels could be to do with the 'shadows they discovered in the spleen'
Any advice??
Hi. Can you let me have the actual units of measure (these are different for some laboratories). They will show as mmol/L, mg/dL or similar.
The high calcium is common in kidney disease (may also be common to spleen issues, not sure), and often relates to calcium being drawn out of the bones and teeth. This is caused by abnormal parathyroid hormone. The recommended treatment (something your vet may want to consider) is Calcitriol therapy.
I am surprised not to see a BUN level in the blood results. This is one of the 3 crucial tests for kidney disease.
Did they test for urine and bladder infection (UTI)? Again, this should be done.
Did they test blood pressure?
High blood pressure is common in kd dogs and causes a rapid deterioration in kidney failure.
Tony
The high calcium is common in kidney disease (may also be common to spleen issues, not sure), and often relates to calcium being drawn out of the bones and teeth. This is caused by abnormal parathyroid hormone. The recommended treatment (something your vet may want to consider) is Calcitriol therapy.
I am surprised not to see a BUN level in the blood results. This is one of the 3 crucial tests for kidney disease.
Did they test for urine and bladder infection (UTI)? Again, this should be done.
Did they test blood pressure?
High blood pressure is common in kd dogs and causes a rapid deterioration in kidney failure.
Tony
Hi Tony. Thanks for your quick response. The values I have emailed are exactly as it is stated on the printout, the mmol/L are in one column with reference values I.e urea ref value 3.1 -10.1 mmol/L Baillies value 32.8.
I'm quite confused by all of these figures to be truthful.
The urine sample which gave a Protein creatinine ratio Baillie 0.8 (ref value <=0.5) was taken 10 weeks before the blood test and to my knowledge they haven't run another urine test to compare the two.
I'm going to take a urine sample in on Monday and ask for a repeat creatinine to be done.
Reading the blood values I posted,to me would suggest that my dog shouldn't be alive as they are so high but nothing could be further from the truth and the results appear at odds with how Baiillie actually is!
She has a really good appetite, much better now she is on the renal food and her water consumption is going down from 3 bowls per day to about 1.
They did test her blood pressure and told me it was high (not how high)and have prescribed Benazacare 10 mgs daily to help with that and the protein leakage or so I'm told?
She is also taking 2 mgs of Incurin as she started to become incontinent and this has helped greatly in that.
To my knowledge they haven't tested for any UTI's but at the moment I have started her on a course of Doxycycline which I'm not sure if this will help.
Is the urea level I posted not the BUN or should I be requesting something else?
I have as of today started to decrease her Tramadol and hopefully soon she will be off it all together.
Is there anything else I should be asking the vet to do... One of them does have a habit of turning the conversation around to euthanasia and giving them authority in my absence-which kind of upsets me, and with me going away in September leaves me feeling uneasy when my friend will be looking after Baillie.
I'm quite confused by all of these figures to be truthful.
The urine sample which gave a Protein creatinine ratio Baillie 0.8 (ref value <=0.5) was taken 10 weeks before the blood test and to my knowledge they haven't run another urine test to compare the two.
I'm going to take a urine sample in on Monday and ask for a repeat creatinine to be done.
Reading the blood values I posted,to me would suggest that my dog shouldn't be alive as they are so high but nothing could be further from the truth and the results appear at odds with how Baiillie actually is!
She has a really good appetite, much better now she is on the renal food and her water consumption is going down from 3 bowls per day to about 1.
They did test her blood pressure and told me it was high (not how high)and have prescribed Benazacare 10 mgs daily to help with that and the protein leakage or so I'm told?
She is also taking 2 mgs of Incurin as she started to become incontinent and this has helped greatly in that.
To my knowledge they haven't tested for any UTI's but at the moment I have started her on a course of Doxycycline which I'm not sure if this will help.
Is the urea level I posted not the BUN or should I be requesting something else?
I have as of today started to decrease her Tramadol and hopefully soon she will be off it all together.
Is there anything else I should be asking the vet to do... One of them does have a habit of turning the conversation around to euthanasia and giving them authority in my absence-which kind of upsets me, and with me going away in September leaves me feeling uneasy when my friend will be looking after Baillie.
Hi. Benazacare is actually a form of Benazepril, which is a good treatment for high blood pressure. It's something that needs careful monitoring, because they need to get the dose right - too much and the blood pressure will fall too dramatically; too little and it will remain in the high zone. Both of these are not good for kidney failure. So, they need at least weekly blood pressure readings ... along with tiny changes in dosing to reach a high end of normal level (no one expects it to become within normal levels, particularly given that a dog going to the vet office will likely increase blood pressure just by the stress of it).
While creatinine is measured sometimes in the urine, your vet needs to ensure there is a blood reading taken for creatinine too. This tends to be more accurate.
Urea is just urea - BUN is blood urea nitrogen.
With regard to water ... try to give filtered water (bottled) as tap water has too much sodium, chlorine and other nasty elements, which could adversely affect electrolyte levels.
Calcium is towards the extreme upper level of normal. Without re-reading back, if your dog isn't on a phosphate binder - she needs to be on one. The binder also should not be a calcium-based binder (as calcium is already high).
One of the problems with calcium is, it depends where it's coming from - it can be coming from her bones and teeth, as kidney disease causes parathyroid hormone to draw calcium from these sources. This can also mean that calcium may actually seem high, when it may actually be low - and the way of correcting this is to use a medication called Calcitriol. It may be worth asking about this.
It is very unwise to give an antibiotic without knowledge of the type of infection - or indeed, if there is any infection at all. Your vet should perform a culture and sensitivity test on the urine, which will help determine a) if there is a urinary tract infection (UTI) and b) which antibiotic will effectively treat it. Giving the wrong antibiotic - or giving an inappropriate dose (kidney disease demands lower doses for longer) - simply means any infection will re-occur. The other problem is, if there is actually no infection, the antibiotic will make the kidney disease worse - bearing in mind the kidneys have to deal with the by-products of such medications.
Tony
While creatinine is measured sometimes in the urine, your vet needs to ensure there is a blood reading taken for creatinine too. This tends to be more accurate.
Urea is just urea - BUN is blood urea nitrogen.
With regard to water ... try to give filtered water (bottled) as tap water has too much sodium, chlorine and other nasty elements, which could adversely affect electrolyte levels.
Calcium is towards the extreme upper level of normal. Without re-reading back, if your dog isn't on a phosphate binder - she needs to be on one. The binder also should not be a calcium-based binder (as calcium is already high).
One of the problems with calcium is, it depends where it's coming from - it can be coming from her bones and teeth, as kidney disease causes parathyroid hormone to draw calcium from these sources. This can also mean that calcium may actually seem high, when it may actually be low - and the way of correcting this is to use a medication called Calcitriol. It may be worth asking about this.
It is very unwise to give an antibiotic without knowledge of the type of infection - or indeed, if there is any infection at all. Your vet should perform a culture and sensitivity test on the urine, which will help determine a) if there is a urinary tract infection (UTI) and b) which antibiotic will effectively treat it. Giving the wrong antibiotic - or giving an inappropriate dose (kidney disease demands lower doses for longer) - simply means any infection will re-occur. The other problem is, if there is actually no infection, the antibiotic will make the kidney disease worse - bearing in mind the kidneys have to deal with the by-products of such medications.
Tony
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