Aa
Please Help!! Chronic Kidney Failure with Inflammatory Bowel Disease
Hi Tony
I'm desperate for any advice that could help my beloved dog 'Tattoo'. Tattoo is an english staffordshire bull terrier, currently 10 years and 8 months old.
Tattu has been diagnosed with chronic kidney failure AND inflammatory bowel disease. The problem we are having is the battle between the 2 diseases because any diarrhea flare up, injures her kidneys further. In November 2015, Tattoo had a bout of bad diarrhoea, we took her to the local vet and they put her on antibiotics and IV fluids for 12 hours. They did this because her creatinine was high (I'm unable to get the numbers for this particular test) but after fluids her creatinine returned to almost normal 'apparently'.
I saw an internal medicine specialist who diagnosed Tattoo with chronic kidney failure and inflammatory bowel disease. Whilst there is no evidence of the inflammatory bowel disease, there is evidence of kidney disease which unfortunately was caused by the bout of diarrhoea. Until 10th January 2016, her creatinine value sat at 220 (Australian numbers), she was eating well, drinking well, loved life and could hardly notice that she was ill. But the internal medicine specialist advised that she should go on the Royal Canin hypoallergenic diet to fix her acid reflux and settle her gut BUT the change to the new diet (even though I weened her on it slowly over 2 weeks before giving her 100% of the diet) made her SO sick - she is still in hospital now.
So between 10th January and 26th January, she had been 100% on the hypoallergenic diet for 2 weeks. From the beginning she had bloating, flatulence and it didn't seem right but we kept trusting in the medicine specialist. On 23rd January she began to get diarrhea, it got worse over 3 days until eventually she chose not eat. She NEVER doesn't eat, she loves food, so I took her straight to the emergency hospital where she was admitted and put on IV. She had lost 300 grams within 3 days. On admission her creatinine was 290 (up from 220). On discharge, her creatinine had come down to 180, expected to rise back to 220 (after 24 hours of fluids). BUT on discharge, she had a breathing attack, her throat had swelled up due to excessive panting whilst in hospital and she was rushed back into ICU for sedation and prednisalone. A few hours later I was able to be re-introduced with her without her getting too excited. By the time we got home, she still had diarrhoea and wouldn't stop drinking. I called the hospital and advised that she had diarrhoea, seemed dehydrated, very weak, she was hard swallowing and had blood in her stool (she had never had that before) and they said as long as she is drinking and eating, and her creatinine had come down to 180, then there is nothing to worry about. The blood in stool cleared up, but all other symptoms persisted.
1 week after being discharged, she could hardly walk and she was telling me there was something wrong, she had lost SO much muscle, was SO weak and flat, then the joints in her hind legs started to swell and became obviously sore.. She continued to 'hard swallow'. I took her to the local 24 hour vet and whilst we were there, she began to bring up white foam, I saw a bit come outside her mouth, so I pulled it out for her and it was the size of a cricket ball, so thick and so sticky that I had trouble washing it off my hands. This happened twice, then she seemed to feel a bit better but still very weak. The next morning, she was much more weak, the joints in her hind legs had become so sore that she couldn't walk, it was awful!! I took her back to the local vet and he put her on IV fluids (2 bags), at this time she was just laying on the floor, so sick and still hard swallowing (I think she was trying to get that mucus up but it wouldn't come up), her creatinine came back at 595, I was devestated!!! The vet carried Tattoo to the car and directed us to go straight to the specialist at the hospital. Upon arriving at the hospital, her usual specialist was not there, so we had to see another one, he offered us to put her to sleep, my heart broke because she was fine 2 weeks before. I said no, so he admitted her on IV fluids (it was so hard to leave her there that night because I was worried she would get stressed again but I had no choice). Then her specialist arrived the next morning and told me that she hasn't given up hope. She said Tattoo had bounced back and was looking bright and able to walk around. She said that Tattu was very sick though and needed to stay in hospital, but after 24 hours on the fluids her creatinine had come down to 280. The next day it came down to 240. BUT the next day, it went up to 340 on fluids, then the next day it was 350, then the next day (today) it was 350 so the specialist is going to start taking her off the fluids.
I must help her, but I don't know how. There is no limit to what I will do for her so if you have any advice, please share it with me. The hardest thing about Tattoo's kidney disease is the inflammatory bowel disease (if that's what she has??). Because on both occasions that she got diarrheoa which caused the injuries to her kidneys, was due to a diet change. So I'm limited on what she can eat, the only thing I know she can tolerate is cooked chicken and sweet potato but she has been on this diet for months now, it's the only thing that settles her diarrhoea. The good thing is that she loves food and she's eating and drinking well in hospital, but I'm so scared what will happen once she comes off the fluids.
What can I do to help her?
A bit of history below:
Tattoo has never had a problem with health, except a TPLO surgery on her right hind leg and she suffers from anxiety, particularly separation anxiety.
BUT 8 months ago (June 2015), Tattoo was diagnosed with a high grade mammary carcinoma with vascular invasion. She underwent surgery and 1 course of chemotherapy (5 sessions of doxyrubicen) and was confirmed to be in remission by November - she handled all treatment well and was her usual bubbly self.
BUT, during chemo she caught kennel cough. I took her to so many vets and none of them could tell me what was wrong. Through my own research I realised in was kennel cough, but by that point she had developed a cough which on 2 occassions was so bad that she fainted (it was SO scary), the cough then turned productive and at this point I found the medicine specialist who diagnosed her with pre-exisitng chronic bronchitis (this was evident on her CT scan when testing for cancer) and she said the kennel cough exaserbated it. She gave her doxycycline and the cough went away. Now, the biggest problem and the cause for her hospitalisation is the battle between her gut and kidneys. Any help or advice that you can give will be forever appreciated.
Thank you.
I'm desperate for any advice that could help my beloved dog 'Tattoo'. Tattoo is an english staffordshire bull terrier, currently 10 years and 8 months old.
Tattu has been diagnosed with chronic kidney failure AND inflammatory bowel disease. The problem we are having is the battle between the 2 diseases because any diarrhea flare up, injures her kidneys further. In November 2015, Tattoo had a bout of bad diarrhoea, we took her to the local vet and they put her on antibiotics and IV fluids for 12 hours. They did this because her creatinine was high (I'm unable to get the numbers for this particular test) but after fluids her creatinine returned to almost normal 'apparently'.
I saw an internal medicine specialist who diagnosed Tattoo with chronic kidney failure and inflammatory bowel disease. Whilst there is no evidence of the inflammatory bowel disease, there is evidence of kidney disease which unfortunately was caused by the bout of diarrhoea. Until 10th January 2016, her creatinine value sat at 220 (Australian numbers), she was eating well, drinking well, loved life and could hardly notice that she was ill. But the internal medicine specialist advised that she should go on the Royal Canin hypoallergenic diet to fix her acid reflux and settle her gut BUT the change to the new diet (even though I weened her on it slowly over 2 weeks before giving her 100% of the diet) made her SO sick - she is still in hospital now.
So between 10th January and 26th January, she had been 100% on the hypoallergenic diet for 2 weeks. From the beginning she had bloating, flatulence and it didn't seem right but we kept trusting in the medicine specialist. On 23rd January she began to get diarrhea, it got worse over 3 days until eventually she chose not eat. She NEVER doesn't eat, she loves food, so I took her straight to the emergency hospital where she was admitted and put on IV. She had lost 300 grams within 3 days. On admission her creatinine was 290 (up from 220). On discharge, her creatinine had come down to 180, expected to rise back to 220 (after 24 hours of fluids). BUT on discharge, she had a breathing attack, her throat had swelled up due to excessive panting whilst in hospital and she was rushed back into ICU for sedation and prednisalone. A few hours later I was able to be re-introduced with her without her getting too excited. By the time we got home, she still had diarrhoea and wouldn't stop drinking. I called the hospital and advised that she had diarrhoea, seemed dehydrated, very weak, she was hard swallowing and had blood in her stool (she had never had that before) and they said as long as she is drinking and eating, and her creatinine had come down to 180, then there is nothing to worry about. The blood in stool cleared up, but all other symptoms persisted.
1 week after being discharged, she could hardly walk and she was telling me there was something wrong, she had lost SO much muscle, was SO weak and flat, then the joints in her hind legs started to swell and became obviously sore.. She continued to 'hard swallow'. I took her to the local 24 hour vet and whilst we were there, she began to bring up white foam, I saw a bit come outside her mouth, so I pulled it out for her and it was the size of a cricket ball, so thick and so sticky that I had trouble washing it off my hands. This happened twice, then she seemed to feel a bit better but still very weak. The next morning, she was much more weak, the joints in her hind legs had become so sore that she couldn't walk, it was awful!! I took her back to the local vet and he put her on IV fluids (2 bags), at this time she was just laying on the floor, so sick and still hard swallowing (I think she was trying to get that mucus up but it wouldn't come up), her creatinine came back at 595, I was devestated!!! The vet carried Tattoo to the car and directed us to go straight to the specialist at the hospital. Upon arriving at the hospital, her usual specialist was not there, so we had to see another one, he offered us to put her to sleep, my heart broke because she was fine 2 weeks before. I said no, so he admitted her on IV fluids (it was so hard to leave her there that night because I was worried she would get stressed again but I had no choice). Then her specialist arrived the next morning and told me that she hasn't given up hope. She said Tattoo had bounced back and was looking bright and able to walk around. She said that Tattu was very sick though and needed to stay in hospital, but after 24 hours on the fluids her creatinine had come down to 280. The next day it came down to 240. BUT the next day, it went up to 340 on fluids, then the next day it was 350, then the next day (today) it was 350 so the specialist is going to start taking her off the fluids.
I must help her, but I don't know how. There is no limit to what I will do for her so if you have any advice, please share it with me. The hardest thing about Tattoo's kidney disease is the inflammatory bowel disease (if that's what she has??). Because on both occasions that she got diarrheoa which caused the injuries to her kidneys, was due to a diet change. So I'm limited on what she can eat, the only thing I know she can tolerate is cooked chicken and sweet potato but she has been on this diet for months now, it's the only thing that settles her diarrhoea. The good thing is that she loves food and she's eating and drinking well in hospital, but I'm so scared what will happen once she comes off the fluids.
What can I do to help her?
A bit of history below:
Tattoo has never had a problem with health, except a TPLO surgery on her right hind leg and she suffers from anxiety, particularly separation anxiety.
BUT 8 months ago (June 2015), Tattoo was diagnosed with a high grade mammary carcinoma with vascular invasion. She underwent surgery and 1 course of chemotherapy (5 sessions of doxyrubicen) and was confirmed to be in remission by November - she handled all treatment well and was her usual bubbly self.
BUT, during chemo she caught kennel cough. I took her to so many vets and none of them could tell me what was wrong. Through my own research I realised in was kennel cough, but by that point she had developed a cough which on 2 occassions was so bad that she fainted (it was SO scary), the cough then turned productive and at this point I found the medicine specialist who diagnosed her with pre-exisitng chronic bronchitis (this was evident on her CT scan when testing for cancer) and she said the kennel cough exaserbated it. She gave her doxycycline and the cough went away. Now, the biggest problem and the cause for her hospitalisation is the battle between her gut and kidneys. Any help or advice that you can give will be forever appreciated.
Thank you.
Yes, it is very difficult. Thank you for your kind wishes.
I don't have copies of all the tests right now (I will get them) but I do know the answers to some of your questions:
Creatinine is 350
Phosphorous is 2.8
BUN (I'm not sure but it's not as alarming as the creatinine level apparently)
Blood pressure is normal
Live urine test showed no protein leakage, no infection (I'm not sure of specific gravity)
She is not anaemic
Pottassium: Was low on admission but is now normal after fluid therapy
Her blood levels did come down with fluid therapy, but just not down as far as they were. So she already had chronic kidney disease, creatinin sitting at 220 but after this bout of diarrhoea it caused a further insult to her kidneys and her creatinine was 595 on admission to hospital, her creatinine has only come down to 350 after 5 days of fluid therapy.
She had an ultrasound: there was no sign of obstruction or tumors and no difference in the size or shape of her kidneys (the specialist said the damage is too microscopic to see)
I have submitted the form to the nutritionists at Davis University in California who are currently putting together a customised diet for Tattoo.
The specialist says to me "don't look at the blood level numbers, look at the dog". Tattoo is eating well, drinking well, going for 4 walks per day whilst in hospital. The specialist says that kidney disease doesn't kill dogs, they die if/when they stop eating which of course is inevitable as the disease progresses. Example: The specialist has patients with creatinine levels of 600's and are still eating and live a good quality of life, but then she has some dogs with creatinine levels of 400 that won't eat.
Whilst Tattoo is still so food motivated, I'm committed to trying to delay the progression of the kidney disease as much as possible. She was very sick on admission to hospital, but she's bounced back so well and I know she wants to live.
If you can think of anything else I could be doing, please let me know. I'll get in touch with Kathy Lulabelle also. I'm very grateful for your support.
I don't have copies of all the tests right now (I will get them) but I do know the answers to some of your questions:
Creatinine is 350
Phosphorous is 2.8
BUN (I'm not sure but it's not as alarming as the creatinine level apparently)
Blood pressure is normal
Live urine test showed no protein leakage, no infection (I'm not sure of specific gravity)
She is not anaemic
Pottassium: Was low on admission but is now normal after fluid therapy
Her blood levels did come down with fluid therapy, but just not down as far as they were. So she already had chronic kidney disease, creatinin sitting at 220 but after this bout of diarrhoea it caused a further insult to her kidneys and her creatinine was 595 on admission to hospital, her creatinine has only come down to 350 after 5 days of fluid therapy.
She had an ultrasound: there was no sign of obstruction or tumors and no difference in the size or shape of her kidneys (the specialist said the damage is too microscopic to see)
I have submitted the form to the nutritionists at Davis University in California who are currently putting together a customised diet for Tattoo.
The specialist says to me "don't look at the blood level numbers, look at the dog". Tattoo is eating well, drinking well, going for 4 walks per day whilst in hospital. The specialist says that kidney disease doesn't kill dogs, they die if/when they stop eating which of course is inevitable as the disease progresses. Example: The specialist has patients with creatinine levels of 600's and are still eating and live a good quality of life, but then she has some dogs with creatinine levels of 400 that won't eat.
Whilst Tattoo is still so food motivated, I'm committed to trying to delay the progression of the kidney disease as much as possible. She was very sick on admission to hospital, but she's bounced back so well and I know she wants to live.
If you can think of anything else I could be doing, please let me know. I'll get in touch with Kathy Lulabelle also. I'm very grateful for your support.
1 Comments
Please keep looking out for Kathy's response on the Fb page. I'm sure she'll be able to advise more than I can. On the face of it, the fluid therapy seems to be having a positive effect, which is good. When a vet says no dog dies of kidney disease, that's nonsense, as there are so many complications to it including organ failure elsewhere, metabollic and hormone inballance, etc. The priority here is to bring the numbers down to near normal and alter diet accordingly. Hopefully, Kathy will consider the options and let you know how to achieve this, despite the other conditions.
I had a thought ... if you are on FaceBook, please consider going to https://www.************/groups/211455130573/ as this is a very useful and informative group. Ask to join, and then copy and paste your message to me above as a new message within the group. If you know how to Tag, please tag it for Kathy Lulabelle.
Tony
Tony
1 Comments
The missing address entry is Facebook followed by a full stop and com ... MedHelp don't like it being entered.
Hi. I am very sorry for your experiences. It must be extremely difficult, both for you and Tattoo. These are a complex group of illnesses, some of which I have little knowledge on. While I can offer help with the kidney disease, the other conditions are outside my general knowledge and make it difficult to advise, simply because anything I say would or could adversely affect these other conditions.
I do think the more serious conditions here are the kidney disease, the chronic bronchitis and mammary carcinoma (apparently in remission). Unfortunately, these three conditions are intertwined and treating one will almost certainly affect the others, not necessarily in a good way. So, a vet needs to decide whether it is appropriate to treat them all at the same time, or to concentrate on the most problematic (at this time). It's a question of priorities.
Clearly, she is very ill and (sadly) may not recover. It would be useful to have full details of the tests that have been undertaken, if you can post them. Creatinine, BUN, phosphorus, calcium, potassium blood levels are crucial for diagnosing kidney disease (and the stage of the disease). An SDMA test would also help. It is also important to have a blood pressure reading (the vets must have done one, so just ask for it from their records). A urinalysis has probably also been done - can you ask them for the results of specific gravity, protein leakage and whether any urinary infection is present.
Fluids are certainly the first line of defense and treatment with kidney disease. The problem is, if blood numbers do not come down with fluid therapy, then the kidneys may simply be too damaged. Once the kidney organ tissues fall below 25%, there simply isn't enough of the organs remaining to maintain life. Xrays and a kidney scan would help identify the size and shape of the kidneys.
I'm not entirely convinced about the hypoallergenic food, but I'm also reluctant to advise anything about it. I think the input of a canine nutritionalist is needed ... someone that can advise a suitable hypoallergenic food that is also low in phosphorus and has adequate high quality protein (but not in excess of 12%).
A complete review of all the medicines Tattoo may be on is needed, and a continuance of only those medicines that are absolutely necessary. The reason is ... any medicines will produce toxins and by-products as a metabolic process, and this will cause the kidney disease to deteriorate. If a particular medicine does not appear to be helping or isn't crucial, it should be stopped.
I don't know whether what I'm saying is helpful or not. I wish I knew more about the other conditions.
Regards
Tony
I do think the more serious conditions here are the kidney disease, the chronic bronchitis and mammary carcinoma (apparently in remission). Unfortunately, these three conditions are intertwined and treating one will almost certainly affect the others, not necessarily in a good way. So, a vet needs to decide whether it is appropriate to treat them all at the same time, or to concentrate on the most problematic (at this time). It's a question of priorities.
Clearly, she is very ill and (sadly) may not recover. It would be useful to have full details of the tests that have been undertaken, if you can post them. Creatinine, BUN, phosphorus, calcium, potassium blood levels are crucial for diagnosing kidney disease (and the stage of the disease). An SDMA test would also help. It is also important to have a blood pressure reading (the vets must have done one, so just ask for it from their records). A urinalysis has probably also been done - can you ask them for the results of specific gravity, protein leakage and whether any urinary infection is present.
Fluids are certainly the first line of defense and treatment with kidney disease. The problem is, if blood numbers do not come down with fluid therapy, then the kidneys may simply be too damaged. Once the kidney organ tissues fall below 25%, there simply isn't enough of the organs remaining to maintain life. Xrays and a kidney scan would help identify the size and shape of the kidneys.
I'm not entirely convinced about the hypoallergenic food, but I'm also reluctant to advise anything about it. I think the input of a canine nutritionalist is needed ... someone that can advise a suitable hypoallergenic food that is also low in phosphorus and has adequate high quality protein (but not in excess of 12%).
A complete review of all the medicines Tattoo may be on is needed, and a continuance of only those medicines that are absolutely necessary. The reason is ... any medicines will produce toxins and by-products as a metabolic process, and this will cause the kidney disease to deteriorate. If a particular medicine does not appear to be helping or isn't crucial, it should be stopped.
I don't know whether what I'm saying is helpful or not. I wish I knew more about the other conditions.
Regards
Tony
You must join this user group in order to participate in this discussion.
You are reading content posted in the Chronic Kidney Failure in Dogs Group
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
