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1916673 tn?1420236870
WELCOME one and all to the Chronic Kidney Failure in Dogs Group
I hope you will join this Group and become a valuable and active member. Through this Group, we can help each other with suggestions, advice, support and information about this dreadful disease and how best we can manage treatments for our best friends. As a starting point, please have a read of my article on diet at: http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease

I have tried my very best to put as much useful information as possible in this piece, but if your questions and concerns are not answered in the piece, please start a thread and post your comments. To help track your thread, please head it with the name of your dog.
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1832268 tn?1326819610
Thanks for inviting me to join the group Tony...!  This is a much needed group, and you are the perfect person to be the administrator of this group. You are a blessing to so many people who come here to seek advice and support.  Best Wishes my dear friend..
Connie
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1916673 tn?1420236870
Thanks Connie. I'm hoping the Group gets a good foundation of members, because the collective source of support and information will prove invaluable. Like others, I am continually reading information and new research about canine CKF and this Group should be a good way of passing on these things and inviting the valued opinions of all interested parties.

Of course, you are the person who first supported me when BB was diagnosed ... so this Group has been made possible through your kind words, compassion and friendship. I'm sure I've said it many times, but here's an official THANK YOU to you.

Tony x
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8335135 tn?1397683000
Thank you for the invite.  Very happy this was created. The stories in this group will help all that are going through CKD with their furbaby.

I am forever grateful that I found this site by accident- really has helped me tremendously.

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462827 tn?1333172552
Hi Tony!!!  I'M IN!!!!   Karla
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1916673 tn?1420236870
Yeaaahhh ... I feel happy! Thanks for joining. :)
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974371 tn?1424656729
I still can't figure out how to join!!!
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8168842 tn?1396917249
Thank you for inviting me to this group! You, Connie and numerous others have supported me through the horrible loss of my Riley, and have helped me cope with my guilt and broken heart :( Thank you all for your love, kind words, helpful advice, and shared experiences. Hopefully, we can all get through it together!
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1916673 tn?1420236870
Hi. Thanks for joining. I'm hoping the family of friends here can help others going through what many of us have already gone through. Your support is greatly appreciated. Tony
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1916673 tn?1420236870
Bump ... !
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Avatar universal
Not positive if I've joined (also having trouble bookmarking blog); but hope I'm in.  First time I've been back in a few weeks since I had to put Teagan to rest.  To be honest I hope to NEVER need to refresh myself on the terrible disease.  But, you all gave me such comfort when Teagan left me.  I hope to keep reading posts to keep up with you all.
Doris
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1916673 tn?1420236870
Hello Doris. I agree, it would be much better if this User Group wasn't needed, but as this dreadful disease affects one in every three dogs over the age of 12 yrs, I think it very much is needed - and people here are very supportive and kind hearted, despite their experiences and losses.

Thank you for joining us.

Tony
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Avatar universal
Absolutely.  Great to have a source of information when we're not sure what to do to help our fur kids.  Have a great 4th all.
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1916673 tn?1420236870
Hi Doris. I was just checking the member list and find you didn't sign up. This is an open Group, so you don't need to be a member of it to join in discussions. It would of course be great if you did join though, as then you will receive the occasional updates from me and others into your Watch List.

MedHelp don't make joining as easy as I would like, but if you check the buttons at the top of the page (usually on the right hand side) you should see Join This Group. If so, just click on it.

Tony
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1916673 tn?1420236870
Hi Doris. I was just checking the member list and find you didn't sign up. This is an open Group, so you don't need to be a member of it to join in discussions. It would of course be great if you did join though, as then you will receive the occasional updates from me and others into your Watch List.

MedHelp don't make joining as easy as I would like, but if you check the buttons at the top of the page you should see a + sign. Click on it to join the Group.

Tony
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1916673 tn?1420236870
The + sign is in white and below the main MedHelp logo.

Tony
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Avatar universal
Must be blind.  All I can see is the  "watch"icon which I've clicked .  Also can start a new group but not join your group.  When I get home in a couple days will try with my laptop.  Maybe I'm not seeing the join "+" option with my iPad.
Weird....
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1916673 tn?1420236870
Ha, well, I don't know if you know how you did it or not ... but you are now a member. Welcome to the User Group.
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1916673 tn?1420236870
Bump!
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10507306 tn?1410655754
Hi Tony, thanks for inviting me to join the group. Yes she is young to have this disease her brother was younger when he passed, I had a feeling something was wrong she had a few wet accidents at night she never had before I was taking her in to have her teeth cleaned & told the doctor I wanted her to have a blood test done, he called and asked me to come in that he couldn't clean her teeth. When I got there that's when he told me the bad news, he has been her Vet since day one.

By reading all the post from the others has helped me & given me support on what to feed her & other information I didn't know.

Peggy
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7622073 tn?1409088858
Peggy:

I just read your story about your baby.  I'm sorry you are going through this.  I truly believe the reason I had an additional 8 months with my baby is because I followed the advice on this blog.  Tony is amazing and will provide his feedback on food, exercise, etc.  You can read most in previous blogs and he has written some wonderful articles.

We are all here for you.  When I had to make that horrible decision just last week, I turned to the members here for support and understanding.

We will remain with you for support.

Regards,
Charlene
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9214378 tn?1408885184
I know you're in good hands if you should need any advice. Please make every effort to provide Tony with as much information you can.

We will be here:)

Fondly,

Lynne & Darbie
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1916673 tn?1420236870
Welcome Peggy. I'm pleased you have joined and I know you and your best friend will benefit from being here. Homework for Day One ... have a read of my article on diet and kidney disease through this link:

http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease

It is a comprehensive account of how diet affects CKF dogs, what changes can be made to improve quality and longevity of life - and a few other important suggestions on management. Once you have read through it, you will probably have questions, so please ask for answers.

Also, at the same time, can you let us know what you are feeding now (be as comprehensive as possible and include all things, including treats). And when were the last blood panel tests done? Do you have the results? If yes, please report them in your post.

Finally, this is a dreadful disease. It can be unpredictable. Many dogs have their good days and their bad days, and while the good outweigh the bad, I think it's worth doing what we can to make them even better for our best friends (and the owners that love them so much).

I'm sure we can help you achieve the most precious thing in the world .... more time to share adventures and experiences and love with your dog.

You are now part of the 'family' here and I welcome you.

Tony
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Samantha is a nearly 18 year’s old bichon frise and was diagnosed with kidney failure on Oct 2.  She has good days and bad days.  Sam has been on daily IV fluids since Oct.  She takes zantac, vitamins, cranberry, denamarin and anti-phosphorous medicine twice daily.  She has lost considerable weight and lately has become disinterested in food.  I am supplementing her little intake of food with nutrical.  That's the bad news.  The good side is that she sleeps through the night has never had an accident in the house and does not appear to be in any pain though I am not really sure.  Like others I want her to just go to sleep when it’s time though I know that probably won't happen.  I am not sure how much longer she can live with such little food intake.  I take her to the vets for bloods on Thursday.  What should I ask?
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1916673 tn?1420236870
Hi. I'm sure you don't need me to say it, but at 18 yrs of age, she is a very elderly lady and you have done incredibly well to reach this stage with her. It strikes me you are doing pretty much all you can. at this point, though I would urge you to have a read of my article on CKF and diet, which you will find here (it may help with a few useful food ideas):

http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease

Has your vet discussed IV Fluids with you? This will almost certainly help, as rehydration and flushing of toxins is of paramount importance. Blood count details can be very helpful in assessing the stage things are at and whether anything can be done to truly make a difference, so please post back with BUN, Creatinine and Phosphorus levels in particular.

Sadly, not many CKF dogs go peacefully in their sleep. They are more likely to suffer a massive heart attack, as organs start to shut down. It is a hugely difficult and traumatic decision whether and when to consider euthanasia, which only owners can make with guidance and advice from their vet. Let's assume we are not there yet with your fur baby and keep our fingers crossed for the blood results. Either way, we are here for you - and will be here for any questions you may have or any worries you might want to let us know about, as well as ongoing support today, tomorrow and for as long as you need it. You are not alone and you are now part of our expanding family of friends.

Stay strong. Tony
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I am so happy to have found a group that can help me navigate my beloved Bruno's diagnosis of CKF  I am devastated to think I will lose my sweet pup earlier than I ever imagined.  He is at stage 4, with Lyme disease the likely cause.  Would love more input on diet. I read Tony's article which was very informative. Bruno is on enalapril Pepcid and just finished doxycycline  for the Lymes .  Thanks for being a great resource  for dog owners facing this tough diagnosis!
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1916673 tn?1420236870
Hi and welcome to our family of friends. Is the Lymes now under control? How old is your dog? What are you currently feeding Bruno? When was his last blood tests undertaken and do you have the results for BUN, creatinine, phosphorus and calcium? And finally, did your vet take your dog's blood pressure?

Sorry for so many questions, but just so we have some background info to work on.

Tony
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Thank you so much for responding! Just having another resource is so reassuring!He has finished the course of antibiotics for the Lymes-vet said we will retest in 4 months .  He is mixed breed rescue dog-he will be 8 in August.  Blood levels:  BUN-83  creatinine 6.5  phosphorus 5.8  urine/protein ratio 4.1  this blood test was Mid-May. I am feeding him white rice (sometimes a little quinoa-he doesn't seem to like that much!) ground beef, and a bit of KD canned food from the vet.  He has lost 12 lbs (but he's very bushy so we didn't notice!) he looks like a small border collie.  Random vomiting is what brought us to the vet.  Vomits maybe 2-3 times a week now.  Has some diarrhea  that we gave him 2 courses of Metronidazole .  Per my readings here I have switched him to filtered water .  Bruno has been acting pretty frisky with some days where he just hides from us -I assume that's when he isn't feeling well. .  I adore this dog and am heartbroken thinking I may lose him sooner than later :(  Any tips/input are greatly appreciated Tony! Thanks so much! Amy
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1916673 tn?1420236870
Hi. Those blood levels are really not too bad ... I've seen much worse, so there's lots of good potential to work on. Is the ground beef human grade - i.e. what you would buy to cook for yourself? If not, then it probably has a lot of additives and beef is also traditionally high in phosphorus. It would certainly be better to alter the diet a little, paying as much attention as you can to high quality protein (versus low quality protein) and foods that are low in phosphorus. Tinned kd food is good, because although it has protein, it's usually high quality protein, and low in phosphorus. Salt is another issue, and I'm pleased you are using filtered water as that will prevent him getting too much via that source.

White rice is fine. I would switch occasionally to sweet potatoes, just to get extra carbohydrates in him. It's a bit of a myth that dogs don't actually need carbohydrates, because kd dogs need to get energy and nutrition from either fatty foods (so always keep the skin on if cooking chicken for him) or from carbohydrates. Protein is a dog's natural food, but low quality protein (as in most canned and dry dog foods) cannot be processed by the kidneys when they are damaged, so his just adds to the toxin build-up.

The goal now is to get BUN below 60 and creatinine to 4.5 or less. Currently, your dog is (I would say) in Stage 3 of kidney failure. The phosphorus is just within normal values, at the high end of normal, so that's great ... and it makes it a perfect time to add a phosphate binder. A binder will help keep the blood levels under control, but a binder can only be introduced when the phosphorus level is normal. Have you spoken to your vet about this?

Finally, I would consider adding (pure) salmon oil to the diet. This will help get him some omega-3 fatty acid in a nutritional way, which has lots of benefits in managing this disease.

You might also want to think about adding some probiotics (there are several specially formulated for dogs with kidney disease). It is debatable whether probiotics succeed, but there have been some positive feedback from owners. Others suggest the good bacteria cannot survive beyond the stomach, which makes it pointless ... but I'm not entirely convinced.

And ... Just in case you haven't read it, here's a link to my article on diet and kidney disease in dogs ...

http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease

Tony
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Hi Tony!
It is human grade ground beef and I was doing some white meat chicken but after reading your article I will switch to dark meat with skin.  I have been giving him a 1000 mg fish oil capsule with his breakfast--better to just switch to straight oil--or break it open and sprinkle on his food? This is why this forum is invaluable--I would never have known to suggest to the vet to put him on a phosphorus binder but I can totally see the benefit of that! I will talk to the Vet on Monday and see if he can prescribe that (any name or is a generic ok?)
Bruno also really loves raw veggies--carrots, green beans--is it ok to include in his meals or just continue tossing them to him as treats? He still is into his Milk Bones and I'm not sure they are the "nutrient-dense" foods he should be eating right now.  Any other packaged treat suggestions? We are in the US (Chicago) --gathering you are in UK but not sure.  We have another dog-purebred Golden who is 12 with arthritis- and I never thought she might outlive Bruno! Bruno gets very stressed at groomers so have decided to just forgo that in order to make his life as stress-free as possible.  His hairy coat hides his weight loss anyhow.
Again--THANKS for your input!! Amy  
PS-Hasn't had his BP taken--due at Vet end of month for progress report.  I'll have it checked then.
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1916673 tn?1420236870
Hi Amy. Phosphorus binders need to be prescribed carefully. Your vet probably knows what to look for (should do, anyway). Basically there are a few types. The most common is Aluminium based. Magnesium based binders should be avoided in kidney disease. There are also calcium based binders, that should be only used when calcium is low in the blood, but never used when calcium levels are high.

Raw veg are good in small quantities, but do some research because some vegetables are very high in phosphorous. This is a link to the things to be wary of ... certainly the top 20 here should be avoided if possible:

http://nutritiondata.self.com/foods-011121000000000000000.html?maxCount=191

Fish oil is fine, but salmon oil is the richest source of omega-3 and therefore the best you can get for Bruno. Always buy PURE salmon oil with nothing added to it. All fish oils are actually quite high in phosphorus, but the advantages outweigh the disadvantages. It's also a reason why very small amounts should only be given.

I'm not sure what's in Milk Bones? Is there a breakdown on the pack?

Tony
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Rocky....my old boy of 14 (turning 15 in November)

Ok, finally figured out where the button was on this page to join. I'm in!
Found the liquid salmon oil in small bottle with dropper, a couple of drops to Start him off in the morning and see how he does, begun giving him a little egg in the morning with his KD and feeding him three to 4 times a day his SD Hills KD canned, a vitamin and his MLM joint medication. He is bit more spry. Doctor visit in a week for his first blood test in over 2 years, opted not to have him vaccinated any more as vet suggested we not do it as his last rabies vaccine was last year and it was a 3 year span rabies vaccine.

Any suggestions for canine toothpaste, his breath is smelling mighty rank!
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1916673 tn?1420236870
Hi. Sounds like you have things under good control. I've never heard of salmon oil in a small bottle or needing a dropper. Are you sure this is PURE salmon oil? Can you see any ingredients on the bottle? Just checking to make sure there are no additives, colorants or other preservative chemicals.

I agree completely about no more vaccinations ... these would seriously and adversely affect the kidney disease.

As for toothpaste ... you need to know it may or may not be his teeth that's causing the odour. The bad breath smell is far more likely to be the toxins in the stomach causing the smell. However, poor dental hygeine is an indicating cause of kidney disease (if not the most common reason for it happening), so daily teeth brushing is recommended. There are lots of doggy toothpastes available and they are all equally okay to use. You could also try using things like Dentistix and/or Tropiclean FreshBreath which work to soften tartar and plaque making it easier to remove.

The blood results are going to be very important and will indicate how far the disease has gone. Do you or your vet have the prior results for comparison?

Tony
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Before Rocky died I had purchased Grizzly Salmon oil on Amazon.com. It is hard to find, can only be shipped in US. The smallest bottle came with a pump and a screw top with a dropper for 39 bucks a bottle, He was worth the expense. It also comes in huge containers which are refills. The contents stated pure wild salmon oil, it did have extract of Rosemary and the labels says provides Omega 3, Omega 6, and Arachidonic fatty acids. I had been giving this to him with his meals to get his appetite up along with adding chicken broth to everything he ate to give him more moisture. This kept his appetite up and his coat a bit better, he ate well until the night before the day he died. Supposedly a pump was what a very small dog should consume. He never got to point of lapping up the full pump.

We also used the beef flavored toothpaste, although he always bit me, he hated brushing his teeth and they always bled.

The last tests Rocky had were over two years old before the change in vets, we could not find the reports at home. Our new vet only requested the last set of tests for comparison from the vet we had in New Mexico.  All I remember is the creatine levels were abnormally high last time (I wrote down 8.01 and 21 BUN). His levels were just slightly above normal three years ago respectively. The female vet had him tested every two months back then, he was stuck quite often back then as they were trying to determine why his stomach was getting distended and if he had cushings ( like our other rat terrier) or kidney failure.

Now getting back to normal. Time has a way of helping to heal the void left by Rocky. The other two dogs miss him and our male chihuahua emulates Rockys patterns. The dogs are determining their order in the pack as Eocky was small but the alpha dog.
Smog
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1916673 tn?1420236870
Hi. Yes, pure salmon oil can be hard to get hold of. I just wanted to check it wasn't the dreaded essential oil type, which are full of bad things for dogs. Here in the UK it's easier to buy, but darned expensive. Luckily most dogs only need a small amount each day for it to be beneficial.

Sound like things are settling down there for you and a new pack order is being created between you and your other two best friends. It's hillarious how chihuahuas always seem to think they are the size of bulldogs and often assume the dominant role, and even try to dominate human owners, if they can get away with it.

Tony
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Hi Tony,
I have to take my female ChiWeenie tomorrow to the vet for her three year old checkup, yes, she is getting her baseline blood work, her first full work up. I want to ensure Daisy and Rusty have their baseline testing done early on.

You are spot on about the attitudes of Chi's, they are too big for their britches, easily corrected with a firm "NO".  Yes, the family dynamic is changing and Rusty is coming out as the Alpha, thankfully I took him for dog training which has helped tremendously!

Sharon
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1916673 tn?1420236870
Hi Sharon. It might be worth trying (tricky with small dogs) to catch some urine prior to your vet visit. Urinalysis can often detect kidney failure about 9 months before it starts to show in bloods. It's something I do each year now. It adds to the annual check-up cost, but that extra 9 months could prove invaluable, should either of my dogs ever develop kd, as management could begin so much sooner.

Tony
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Hi Tony, thanks for the info. I spoke to the vet tech. Capturing was an ordeal. But...it SURE beats having it extracted from the Chi's, they are nervous as it is and then throw in -- going to the vet. It's all peals of vocal angst once we enter the vet's parking lot.

It is worth the peace of mind.

Sharon
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My 7 year old Beagle was suddenly diagnosed with stage 3/4 CKF. He appeared to be fine one day and began to vomit. Took him to the vet for what I thought was gastro. upon exam, his xray showed enlarged kidneys. Blood work revealed creatinine around 779 with high urea and high phosphorous. Albumin was 22. They put him on IV fluids for a few days. Creatinine came down to 370. Sent to another vet hospital for an ultrasound which showed enlarged  kidneys with no mass. Put on IV fluids there plus antibiotics and stomach coater plus a phosphorous blocker. Vomiting stopped. Creatinine has not improved still around 400. Albumin has gone down to 14. He is alert with a great appetite. Still on IV . Has bp around 180-200. Now on 2 bp meds. Also a anticoagulant due to the increased risk of blood clots due to dropped albumin.  They say he has glomeurlonephritisis not tubular. And are concerned about the albumin being so low. They want to start him on an immunosuppressant as they feel his issue is autoimmune. I am terrified and want to help him but unsure I am doing the right thing.
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1916673 tn?1420236870
Hi. I read your other post, but this one has more information, which is very useful. I think you are doing everything right so far. I have been unable to get online recently due to a major computer crash, so perhaps you would be kind enough to update me with how things are right now. Then I can comment more. It's great that your vet has tested for and found high BP, as this severely adversely affects kidney disease - so treating it is a real priority. Tony
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Hi Tony,
Thank you so very much for answering me. Doogan, my Beagle, is home from having been hospitalized for about 2 weeks. We have learned how to do the Sub Q fluids finally with a lot of practice. He is on lots of medications; 2 BP meds, 2antibiotics, anti-acid, anti-coagulant and an immunosuppressant.  We have switched his food to KD canned, which he loved initially because he was starving and had lost weight but we are having trouble last couple of days. Also, we put 2 phosphate binders onto his food and mix it all together with a bit of water to make a gravy. He has been eating no problem actually barking for his food until last night.
The vet had told us to make a few meatballs prior to feeding him and put his pills inside. This has been also working well but the last couple of days, he dropped the meatballs and ate it more slowly and got the pills and crunched on them .I am assuming leaving a bad taste. Also we have been trying to add the Omega 3 but the capsule is huge and yesterday he actually chewed it up not impressed. All this to say, this has made him go off his food and now he won't eat KD canned. Not interested at all. Spits it out. I have consulted with another Vet who told me that we should NOT have been giving him his pills with the KD canned for this very reason . Some vets have  suggested that we switch him to KD dry or Royal Canine renal canned but Royal Canine is not as good a food for CKF with a protein of 35 instead of 14. And the KD  DRY although he loves it, is not as good as the wet stuff.  I now don't know how to give him his pills or what to feed him. Any thoughts? I am desperate. This whole treatment plan has been working so far. His BP has come down to 150 from 220 (systolic), his kidney values are slowing coming down as well as the protein ratio. But now we are at a huge roadblock.
Thank you for your help
Nancy
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Hi Tony ...I should have told you that that the KD canned food we have been giving Doogan is the Original.
What about the KD canine chicken and vegetable stew or the KD canine beef and vegetable stew?
I forgot to include this with my above reply to you.
Thanks again,
Nancy
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1916673 tn?1420236870
Hi Nancy. Yes, try the other canned varieties. Canned is much much better than dry as it gets some hydration into the system. I don't understand why vets are suggesting dry foods for CKF dogs and never will. There is evidence that dry dog foods dehydrate dogs and actually can cause kidney disease over a long period. But more importantly, it also contains lots of artificial colorants and flavorings, which all produce toxins - the last thing a CKF dog needs. Try drizzling a little organic honey (just a teaspoon) over the top of the food, as this may help improve the taste (kd dog food is fairly bland to a dog) and encourage eating. Also, feed very small amounts - ideally, split into 4 or more tiny meals per day and don't give extra food even if Dougan asks for it. The smaller amounts cause less toxins, less acid in the stomach, are easier for the kidneys to cope with and usually improve regular eating as there are no associated ide effects. Try putting the pills inside a small amount of soft or hard cheese - or revert to the old fashioned way of putting them to the back of Dougan's throat, closing mouth and stroking the underside of the chin/throat until he swallows. Hope this all helps. Tony
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Hi Tony,
Thank you so much for your  information, knowledge and time. I really appreciate it.
We had Doogan back for a follow up appointment. As mentioned earlier, he has been on 2 bp medications one which is Forticor.  These 2 drugs have helped to lower his BP but the Forticor can affect the electrolytes which is Doogan's case. His potassium is increasing.Presently, it is 6.5. So now they have stopped the Forticor medication in the hope that it was the drug doing this to him and not his failing kidneys. Prior to him going on the drug, Doogan did not have any shaking /tremors but since his potaasium is increasing he shakes a lot. Again reflective of it being the drug. I PRAY.
His BP will be monitored and the other BP medication will be adjusted.
BUT they have also told me to STOP all commercial dog food even KD as all kidney food is high in potassium. They gave me 2 recipes of which we made one last night and he is not impressed. My Doogan has to eat . He has lost weight and I am terrified that this is the last attempt at stabilizing him before he is deemed palliative as the vet said that rising potassium is not good. Do you know . I can share the recipes with you if you would like. .. But would like to know what to do now
Thanks,
Nancy

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1916673 tn?1420236870
Hi Nancy.

Proper internal levels of potassium are very important to your pet's well being. When a pet’s kidneys fail, its body potassium levels rise. This problem, called hyperkalemia causes generalized fatigue, nausea and an irregular, slow heartbeat that can be life threatening. However, when pets with advanced kidney disease loose their appetites, their blood potassium level can fall dangerously low.

So, it's very likely the rise in potassium levels is directly related to the kidney disease. I don't entirely agree with your vet about withdrawing the specialised kd canned food, as that has the right balance of high quality proteins in reduced amounts together with low phosphorus. I think it may be the case that getting the kidney work blood numbers under control with the appropriate diet will in fact improve the potassium levels .... while any food containing the wrong type of protein or which is high in phosphorus will in fact make the potassium levels worse, because it will make the kidney blood values worse.

This is of course a complicated scenario of symptoms, so I should add your vet knows more than I do (in theory) and you should take their advice above my own - but also you should ask questions from them and get satisfactory and logical answers. For example, ask whether the recipe they gave you is low in phosphorus and that they contain high-quality proteins and not low in proteins (as that advice is only recommended in early stages 1 and 2 of kidney disease).

Hope this helps.

Tony
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Hi Tony,
Just to give you an update on Doogan.
So he has been off the Forticor drug for a couple of days now and his potassium went back into the normal range. They have also stopped the immunosuppressant drug as he now has a kidney infection and have changed the antibiotics he has been in order to treat this.
His creatinine is back up to 700 and albumin was at 15 last night. They told me he is at risk for a blood clot anytime. We do have him on anticoagulants. He once again is on iv to try and bring the values down as they think they spiked as a result of the infection as they had come down last week. The ONLY thing he will eat is the KD DRY so we put lots of water and add his phosphate binders to make a gravy. For some reason this is the only dog food he will continue to eat.We have tried so much . I do worry about the kibble as we have read your articles. but are at a loss as he won't eat anything else so to compensate we are adding water to it and he is on IV there and will receive his sub q fluids at home.  Thoughts ?
Thanks for all.,
Nancy
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1916673 tn?1420236870
Don't worry about the kd dry food for now - it's not going to have any dire effect in the short term and if he eats it, that's more important than getting him to eat canned food. Adding water to the dry is good (always leave it to soak for about half an hour if you can). I think, for now, you and your vets are doing all the right things. If he gets over this stage, then we can concentrate on tweaking things a little - but priorities are important - so lets see where he is in a week's time. Heart disease and CKD are a difficult combination to manage, as what helps one often antagonises the other, so it's all about treating the symptoms on the day.
Tony
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hi Tony,
Doogan is back home again. creatinine ..800 albumin 15 and potassium 7.7  they are rising despite our efforts to bring them down. He has a lot of muscle wasting and is weak. . we are doing sub q fluids twice a day now , still giving his meds and phosphate binders by a 6 ml syringe into his mouth for what it is worth and hand feed him. At this time, the vet said it is a matter of time and feed him whatever he wants. Do u agree with this. He loves little cubes of chopped apples and other fruit that we used to give as snacks and I am thinking of boiling some extra lean ground beef for him with rice but feel so guilty as I know these are not good for his values and feel like I am rushing him to the grave.thanks,
Nancy
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Hi Tony,
It's Nancy again. Sorry I know I am bombarding you with lots of questions. I meant to ask you something else in my above post. As you know, we are giving my Doogan Sub q fluids now twice daily. I just realized that in the Lactated Ringers there is potassium. His potassium levels are going up... is this bad to be administering fluids that contain  more potassium ?
Thanks again,
nancy
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1916673 tn?1420236870
Hi Nancy. First things first ... yes, I kind of agree with your vet, feeding whatever he will eat is more important just now. The energy it gives is vital, so nutrition over the right nutrition is the priority. Obviously, if he will eat other foods that are better for his kidney disease, then that's good, but any food intake is more important for now.

Lactated Ringers subQ are an electrolyte balanced fluid, so yes there will be some potassium - actually, the right amount for a dog's daily needs. Lactated Ringers are usually the best fluids for a kidney disease dog and much better than the alternatives (such as Saline). However, when potassium is rising, saline is actually a better option (given at 0.9%), as it accentuates the excretion of potassium. Talk to your vet about this.

Hope this helps.

Tony
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Hi Tony,
Thank you so much for the reassurance and information. Went to Doogan's vet today and they agreed for us to try the sodium chloride 0.9%. instead of the lactated ringers. We will give it a try .
Just making sure that this is ok with his high blood pressure ? sodium chloride is saline right?
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Hi Tony,
It is me Nancy yet again.... I feel so VERY confused.
Ever since my Doogan began this awful journey a month ago, I have been trying so hard to follow  what the experts say to do in the hopes of giving my Doogan a fighting chance. So here is the thing. As mentioned earlier, we have been giving lactated ringers for a month. I read what you wrote about it but have also read very conflicting opinions about this..giving lactated ringers to an animal with severe renal disease. So when I read this it terrified me. We talked to his vet today who agreed for us to try the nacl if we want to but she said that really the minute amount of potassium in the ringers is not making my Doogan sicker. She did talk a bit about his hypertension and the nacl. When you read about nacl the potential side effects can be  scary and yet when you read about the ringers given to renal insufficiency animals that is scary too. What is up with all the controversial information on this. My god it's exhausting and terrifying as the last thing I want to do is worsen his situation by trying to help. I have not missed a day in 1 month for fluid hydration but I am skipping today in the hopes that I can make more sense of this. I really need help. I feel desperate and more confused than ever.
Thank you a bunch
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1916673 tn?1420236870
Hi Nancy. I am not in the slightest bit surprised you are confused. There is a lot of conflicting and confusing information both on the internet - and sadly, from some vets too (not yours, actually, but some). There is also a lot of information that is just simply wrong or not checked by anyone, and once it's "out there" people believe it as factual, even though sometimes it's a lot of rubbish.

The big problem with a dog with kidney failure is there is often more than one illness going on at the same time. In Doogan's case, he has high blood pressure too (not that uncommon in kd). In humans, salt is a concern with anyone that has high blood pressure. However, sometimes we forget how different dogs are to us (anatomically and biologically). In fact, they do not suffer from the same problems with salt and there is no current scientific evidence that salt impacts on blood pressure in dogs whatsoever. Interestingly, dogs do not even have taste buds to detect salt, which leads some to believe it has no significance in what they taste or search out for food instinctively.

However, salt does have some impact on kidney disease, but to a very minor degree. Much depends on the electrolyte blood work. As potassium is high in current tests, I would still err on the side of giving saline rather than lactated ringers and then switch to lactated ringers once the potassium is back under good control. While on saline, your vet will want to maintain a reasonable check on blood results for any rise in sodium levels, but I think it is unlikely this will occur.

The fluids are the best remedy and the first step in getting the toxins under control and blood values (creatinine, BUN) to fall back down. I hope what I have explained is reassuring and you can get back on track, knowing you are doing all the right things.

Tony
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Hi Tony,
Thank you very much.
Today is a sad day.... Early this morning my Doogan had a bad seizure when trying to get a drink of water. Now he can't stand, walk or anything.Lifts his head in recognition of us but puts it back down.
We are having him put to sleep today. And I can't stand my guilt. I feel like I have failed him. I have taken a month of work, spent $12000.00 to try and save him and have tried meds, diet change sub q's and 3 hospitalizations.
I feel like I have killed him with the sub Q's cuz even though his potassium was rising,I continued with the lactated ringers. I feel my guilt will destroy me as he only just turned 8.
We love him beyond imagine .
Thank you for everything.
Nancy
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Hello Nancy. I am very sorry. It is very easy (in comparison) for me to sit here and type responses to members on this site. I try my very best to pass on good information and advice, regardless of circumstances. I consider it is always up to the owner to decide if and when a dog is too ill to continue the fight against this dreadful disease. The owner is in the situation, not me, and therefore I believe they know far better than anyone else when the right time has come. More than that, I also believe a dog knows when its time has come - and that is often clearly evident to an owner.

No one can say you didn't do everything humanly possible. These decisions are always very difficult, sad, traumatic and guilt-ridden. But, do not feel guilty, as you have no reason to feel that way. You certainly have not killed him with SubQs - fluids, regardless of type, are the first line of defense for a kd dog - but not all dogs respond, because the illness sometimes has just taken hold too much.

Doogan has been lucky to have you share his life and has known huge amounts of love, care, devotion and adventures too. This sad end of his life is only a small part of the life he has enjoyed. A life you gave him. If he could, he would thank you from the bottom of his heart.

Run free Doogan.

Tony
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Hi Nancy, just wanted to let you know that you are  not alone as we have all experienced this disease and the unbelievable grief that ensues when our beloved dogs and cats pass. Thinking of you !
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Thank you so very much  
Our hearts are so very broken. It all happened so fast it's like a terrible dream and I wake up  to praying that it's not real but it is. My Doogan is gone forever.
After Doogan's first seizure  he couldn't walk or stand on his own. We thought maybe with time he would come back and continue the fight but instead, he just lay in our arms needing support for his head. After a few hours passed, I gave him so water and his favourite a few little cubes of apples which he ate. Again, the hope built up in me that he was regaining some strength. Another hour passed and we tried again to stand him to no avail. He just stared at us with sad eyes and heavy breathing. I again attempted more water and he took a sip and had a second seizure in my husband's arms. The Vet said she thought he might have had strokes given his inability to recover. There was no return for him and we had to end his suffering only now to leave us suffering the worse emotional pain. To think, that just a month ago we were walking and running with him and playing ball out the back. The Internal medicine Vet said that his kidney issues were glomuleur not tubulour and that it was not a toxic event. They were certain of this and kept repeating this to us each time we said..." but he didn't get into anything." They" think" he had an autoimmune illness such as ameloidosis or something like it. They also say that he probably had symptoms long before they were made known to us ...keeping them hidden from us and it's only when he toxins became so high that he started to vomit. I don't know what it was but he was taken too early from us and I miss him dreadfully. The past month has been all about fighting so hard to save his life and now it's all over and I am lost.
We have a just turned 15 year old husky/lab mix, Chance,  who I saved years 14 years ago off the highway. 3 years ago she was diagnosed with stage 2 chronic kidney issues. We changed her diet at that time to Mature consult canned and Dry...We have added daily Aventis KS to her food and we fill her water bowl more than half full of water at each meal as she doesn't drink.. Given everything going on with Doogan, we just had her values checked and they have come down a bit. She has bad arthritis and we give her Cartiphen injections once a month and glucosamine daily which helps her. Doogan used to play with her while respecting her limitations or just cuddle up next to her on their beds.  His bubbly loving  infectious personality was contagious to us and Chance and kept her young at heart. Now the house is so very quiet.
I will start giving Chance Omega 3 pills as no one had told me to do this. Given Chance's age , we have been trying to prepare for the inevitable but never did we prepare for Doogan. Instead we always thought what a great age difference. When  Doogan is alone one day, we will get another and he can be the mentor as Chance has been to him. Life is so very cruel.
This forum has been so helpful with the knowledge, emotional and practical support from people who truly "get it all". Thank you.!!!!!
In future, when our future fur kids go for their annuals, we will be insisting that they have yearly blood work and urines done. Yes the cost will be higher but honestly it is worth it because if we had caught this terrible illness earlier, perhaps  we could have had more of a fighting chance with our precious boy who was robbed of so much life yet to be lived. And boy, did he know how to live life to the fullest enjoying every moment with his happy go lucky huge spirit.
We love you Doogan !!!

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Thank you from the bottom of my very broken heart !!!!
I wish we could all personally meet as I feel there is a friendship like no other . No need for explanations...just complete and compassionate understanding.
Thank you !
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1916673 tn?1420236870
Hi. These are the hardest of days - and nights - as many of us know only too well. It takes time. I just wanted to add a brief bit of info as you mentioned starting giving Omega-3 to Chance. The best and cheapest Omega-3 is actually pure salmon oil (you only need give about half a teaspoon, so a standard bottle of about a litre lasts forever. The pills are fine, but usually a bit expensive, and omega-3 must be given according to dog size and weight as overdose can actually occur. Perhaps the most important thing about all Omega-3 is that it inhibits the absorption of vitamin E, which makes it essential you also give chance a Vitamin E supplement. You can buy these specially for dogs in capsule form.

Reagrds,

Tony
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Hi Tony,
I feel so lucky to have "met" you with all your compassion and knowledge.
So I was going to finish up Doogan's omega 3 capsules. Chance is twice his size. Then I will buy salmon oil as you suggest . I already looked for it and found a brand named Grizzly. Have you heard of this?
Re the Vitamin E ... Is there a special dose for the dog's weight for this as well ? Do I purchase this at my vet? I wonder why no one told me about vitamin  E for my Doogan?? Have you heard of the Aventi KS supplement that she has been taking  for the past couple of years ? I wonder if there is vitamin E in that?
In your opinion for a chronic stage 2 do you think the omega is a good idea ?
Truly,
Nancy
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1916673 tn?1420236870
Omega-3 is good for all dogs. It has some good and beneficial properties in it. Yes, there is a fairly strict Vit E and omega-3 regime according to the weight of each dog. Let me know what Chance weighs and I'll work out the dosages for you.

Aventi KS seems to be a good Vit B12 supplement, as well as some probiotic elements. Always give this with food and keep to the maximum feeding guidelines of the manufacturer, according to weight of the dog.

Tony
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Hi Tony,
I'm back. Since we lost our precious Doogan, I have been off the site trying to get through all the grief and my depression.  He sure did take a huge space in our lives and heart.
Thanks for answering me about Chance and  the Aventi KS, omega 3 and vitamin e.
Chance's  weight at present is 20.7 kg which is 45.5 lbs.
You mention that you could help with appropriate doses of omega 3 and vitamin e ??
Also, I have been thinking more and more about the diet we feed our fur kids. When Chance was diagnosed with chronic stage 2 kidney disease a couple of years ago,  we were told to take her off of Fromm dry food ( which we always added water to) and at our Vet's recommendation, we put her on Royal Canine Mature Consult. ( Mixing dry with canned). We add a lot of water to it and mix it all up with her Aventi KS . She loves it. Her values were just re-checked in November 2015  and they had come down slightly. She just turned 15 in December and is part Husky part lab. We do find that although her values have come down a bit which was good, she appears to have lost lean body mass and is very boney. She also has arthritis and is on monthly cartriphen injections and daily UBASPORT advanced joint care (Glucosamine and Chondroitin sulphate.
What is your thought about Royal Canine Mature Consult? It is very pricey and I have heard not very good things.
AND we are thinking about getting a young healthy dog and I am very stressed about about what to feed him. Lots of people say that Orijen is excellent--high protein and grain free but it is dry food. They say to add water to it. Others told me to go to the raw diet as it is high in protein and moisture.  I know that  All dry dog food is only 10% moisture . We don't want to feed raw as our neighbour's dog was eating raw food and died from bone fragments. I really need help. I have had 2 dogs with kidney issues ( one acute and one chronic) and for many years, they both ate Fromm dry with water added to it.  Can you suggest anything ?
Thanks ,
Nancy
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Nancy, I just saw this post and I want you to know that we all know what you are going through.  I had to have our Shadow put to sleep just a few weeks ago because of his rapid descent into Stage 4 kidney failure, and I still wake up each morning thinking I'd better get up and get him out for his walk.  The hole they leave is amazingly huge.  You did everything you could for Doogan and then some.  Just know that we are with you.

Cheryl
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Hi Cheryl,
I am so sorry for your loss as well. By the way, I love the name Shadow and ShadowNose. The loss is HUGE. These fur kids are so very special. We love them so much ( more than words can say) and  we want to do the best for them and give them every fighting chance possible. Kidney disease is a horrible disease!!!
With the thought of one day getting another dog, I am struggling with  what to feed him. There is so much debate over what to feed dry( with water added to it) vs wet( canned) vs raw. Which company and why. My God .
I guess I am still questioning how my Doogan got so sick with acute end stage kidney disease and am wondering if diet at all played a role.
Thanks for the support,
Nancy
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Hi Tony! I finally figured out how to join the group...I've been reading the links you have sent me today and I just want to thank you for the information. It has alleviated some of my stress regarding my dog Buzz. For those in the group, Buzz is a 16 year old Bichon who was diagnosed with stage 4 kidney failure. I thought I only had a few days left with him and I was in a state of shock and panic but all the information I've received from Tony has been more than helpful. Buzz has been having a difficult time standing up and walking. I've been having to carry him to his water bowl and to his wee wee pad since its been far too cold out for him.  Today, when I left for work I left Buzz in his bed tucked with a blanket and when I came home for lunch I was happy to see that he had left his bed, gone to the bathroom (pooped normally), and was looking for food! While I know his kidneys will not be back to what they used to be, I am just glad to see that his appetite has not decreased. He is still sleeping an awful lot, very lethargic, but still tries to get up and figure things out for himself. Like I said in my initial post, he has the heart of a champion. I have a follow up appointment with his vet on Thursday to figure out his care as his kidneys aren't the only concern, I'm also worried about his ability to walk and just his quality of life. Thank you again Tony for this forum and the information.
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1916673 tn?1420236870
Hi. A mixture of good news and bad news then, but mostly good. The poor walking and ability to stand is usually connected with muscle wastage and/or neurological pathways being destroyed. Your vet may have ideas on supplements to help - if not, come back and ask the group for ideas. Glad you managed to join okay ... I know MedHelp don't make it a very easy route, despite me constantly asking for them to simplify things.

Tony
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Hi Tony,
I'm back. Since we lost our precious Doogan, I have been off the site trying to get through all the grief and my depression.  He sure did take a huge space in our lives and heart.
Thanks for answering me about Chance and  the Aventi KS, omega 3 and vitamin e.
Chance's  weight at present is 20.7 kg which is 45.5 lbs.
You mention that you could help with appropriate doses of omega 3 and vitamin e ??
Also, I have been thinking more and more about the diet we feed our fur kids. When Chance was diagnosed with chronic stage 2 kidney disease a couple of years ago,  we were told to take her off of Fromm dry food ( which we always added water to) and at our Vet's recommendation, we put her on Royal Canine Mature Consult. ( Mixing dry with canned). We add a lot of water to it and mix it all up with her Aventi KS . She loves it. Her values were just re-checked in November 2015  and they had come down slightly. She just turned 15 in December and is part Husky part lab. We do find that although her values have come down a bit which was good, she appears to have lost lean body mass and is very boney. She also has arthritis and is on monthly cartriphen injections and daily UBASPORT advanced joint care (Glucosamine and Chondroitin sulphate.
What is your thought about Royal Canine Mature Consult? It is very pricey and I have heard not very good things.
AND we are thinking about getting a young healthy dog and I am very stressed about about what to feed him. Lots of people say that Orijen is excellent--high protein and grain free but it is dry food. They say to add water to it. Others told me to go to the raw diet as it is high in protein and moisture.  I know that  All dry dog food is only 10% moisture . We don't want to feed raw as our neighbour's dog was eating raw food and died from bone fragments. I really need help. I have had 2 dogs with kidney issues ( one acute and one chronic) and for many years, they both ate Fromm dry with water added to it.  Can you suggest anything ?
Thanks ,
Nancy
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1916673 tn?1420236870
Hi Nancy.
Dry dog food has NIL water content, other than water that is added. But the important point about all dry dog food is it is always always always less nutritious than a good quality canned dog food. Dry food also generally contains far more bad things ... more preservatives, more colourants and more chemicals. All these things can lead to kidney failure - and they certainly are not good for a dog that already has kidney failure. So, my advice, never feed any dog with dry food, not ever. It was designed for human convenience at the expense of dog health.

Raw diets are actually interesting. They have become more popular in recent years, partly due to dog owners feeling that manufactured dog food has a variety of health concerns. Owners are also getting told how it is a more natural diet for dogs, whose ancestors were of course wild wolves. But all of this is only part of the truth. Dogs today are very different from their ancestors. Multiple breeding techniques have caused extreme changes to domesticated dogs. Could we call a Pug a wolf today ... NO ... so why should we expect him to eat a diet a wolf would choose.

There are lots of other issues about raw dog food ... mainly about quality of the meat, how and where to store it and whether it has enough nutritional value on its own. In most cases only the highest quality sourced meats are  suitable as a raw diet for dogs, and this can be very expensive to obtain. It must be stored in a spotlessly clean cold area, such as a fridge, and must be used within a specified time (as with all meats). More importantly, all meats develop bacteria over time, and the bacteria can be more harmful to humans coming in to contact with it than the dogs that are eating it, so this must also be considered when storing raw foods. And as for nutritional value ... it's usual for raw diets to have various vitamins and other supplements added, as this is necessary to maintain good health of the dog.

Raw diets are a complex issue. Generally speaking, I advocate raw diets as a healthy choice, but only if it is started at a young age and if the meat obtained is of the very highest quality. I would strongly suggest you read up on the subject - just Google raw diets for dogs, and you'll find lots of information.

Onto other matters ... at 15, Chance is an elderly dog and some muscle and weight loss is expected. However, it would be interesting to see what the current blood values say, so I would certainly get a repeat test done as soon as you can. It may be that she has moved into stage 3 by now, in which case some tweaking of the diet will be necessary.

Tony
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I am not sure how to join the group. I did set up a user and password but I'm not sure I joined the group. My five year old yorkie is in kidney failure, probably from eating chicken jerky her whole life. She was diagnosed May 2015 right before her fifth birthday. After an initial round of IV's, Azodyl twice a day and Science Diet K/D dog food she did well for about three months and then she was readmitted for more fluid treatment. Now it seems she is admitted for 3-4 day intervals about once every six weeks. She is back again today. Her BUN levels were 52 today and she has refused food for two days. She weighs 4 pounds and is like my child. I know she is frightened to death. I cannot imagine my life without her. I am glad I found this group.
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1916673 tn?1420236870
Hi. Yes you have joined the group. There has been a huge problem with chicken jerky (mainly originating from China but sometimes packaged selling from USA) for several years. I think I wrote about it about 5yrs ago on some of the dog sites. You and your vet should report the problem to the FDA (as they are still investigating it and gathering data).

Okay. Kidney disease can start out as acute - but then develop into chronic kidney disease. This is because a large amount of organ tissue is destroyed during the poisoning. In a dog so young, there is the chance of recovery as long as it is caught early enough and not too much of the kidneys become destroyed. I suspect, in this case, the kidneys have been severely compromised - which means this is now a chronic condition.

Can you ask your vet for the blood and urine test results from the point of diagnosis. They should have these on their records (unless you have them in your possession). Please post these results for me to look at.

Can you then also post a full set of the latest results. I am particularly interested in creatinine, phosphorus, potassium, calcium, sodium, PVC and haemoglobin. But if there are others, please just post all of them (remember to put the unit of measure after each one).

Next, has your vet done a blood pressure check? If not, it needs doing.

Has there been a recent urine sample test for specific gravity, protein leakage and any infection. If not, this also needs doing.

Is the Science kd diet you mention the Hills canned variety?

If she is refusing food, please ask the vet to prescribe Mirtzapine. This should help improve nausea, appetite and anxiety all at the same time.

Tony
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Hey all. On Valentine's Day I lost my Yorkie, Lili she was 12. She was diagnosed 10 months ago with early stage 3. We did a lot of effort to safe her, but she didn't response well for any treatment given.   Her last blood work from 2/13/15. Creatine 4.6, BUN 130, phosphorus 16.1. Last four days suddenly she got very sick, bad breath, no eating, barely drank water, strong seizure and paralyzed on the left side, she didn't want to be touched at all, she started pooping with blood, slept nonstop, lost balance too. We decided to help her with that suffering and we put her to sleep on Valentine's Day. I still feel guilty of that decision and question myself maybe I didn't do enough to safe her.
How you all deal with a loss?
Thanks, Eric.
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Hi. I am so sorry for your loss. Please accept my sincere condolences.

The loss of a pet dog is like no other loss. It runs very deep in many people (in my opinion, in the best of people). Our dogs are our friends, family, companions and confidants. More, they are at our side for most of their lives. They share our days, our adventures and our love and devotion. It is therefore no wonder we miss them so much when they have to leave us.

The big problem with kidney failure is it is firstly incurable. We can try our best to improve the function of the kidneys or make the work they need to do less stressful on health, but we cannot stop it. Second, unless we have an ultra-sound done every week, we cannot truly know how much of the organ remains functioning. In the end, the kidney may be struggling to work with perhaps only 10%-20% of tissue remaining - and that means a dog will decline rapidly, regardless of what a vet or an owner might do. In humans, there is both dialysis and (for some) transplantation ... but this is neither practical nor affordable for most dog owners.

Guilt about ending our best friend's suffering is a very common experience.  But I believe you did all you possibly could and chose to help your best friend in the only way (and the right way) when the usual kidney management protocols stopped working. There is no need and no cause for guilt, but I do empathise and understand how and why you feel that way. If you can, try to remember what a wonderful life you gave her. Remember the happy times (that ultimately far outweighed the final days of her life). She was lucky to have had you as her owner - and you were lucky to have shared her life with her.

I hope the coming days and weeks see your grief start to subside. And we are here to talk to, if you need us.

Tony
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Tony, Thank you so much for all your kind words and support.  I appreciate it and it means a lot to me.

It is still hard for me to accept that she is gone. Now I am asking myself, what if my vet was wrong about her condition giving her couple of days.  

Can you tell anything about her last blood work. The numbers are above.

I wish I found that website earlier so maybe we could extend her life a bit longer.

And I don't understand why some vet doesn't want to treat that disease. I saw three different vets in Chicago and only one suggested to try treatment.

Thank you,
Eric.  


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1916673 tn?1420236870
Hi Eric. Well, that's a hard question to answer, because all dogs with this disease are so very different and while some do rally with good management, others simply don't no matter what might be tried. One thing I can say is that early stage 3 is not what the bloods tell me ... it looks to me like very late stage 3 or even early stage 4 (final stages). The phosphorus was very high, which means a phosphorus binder would have been needed to control more and more toxins being produced. She may have rallied with extensive IV fluid therapy, which would have needed to be undertaken at the vets for several days, followed by SubQ fluids given by yourself or the vet at home. A complete diet re-think would also have been needed. The point I'm trying to make is it would have been very intensive and very expensive to attempt, and with no guarantee of success. In the end, you made the decision along with your vet's advice, and rather than second-guess what management and treatment might have achieved, be contented knowing you and your vet feel you did the right thing at the right time - and more importantly, you did it to help prevent further suffering.

I know how hard it is. But try to think about the years of happy times you both shared. Times that you supplied.

Tony
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Hey Tony. Thank you again for all the support.

About four weeks before the Valentine's Day we took her to the vet for blood check up and at that time her creatine was 5.2
I don't recall the rest blood work. We immidietly started IV fluids for three days, 10 hours per day.
After the three days IV fluids we did a blood work again and the vet said it didn't go well as she planned. She said continue medication, diet and SubQ fluids at home, every day 100 ml. So we did it for almost four weeks, every day but it didn't help to flush out her toxins. She got really sick four days before Valentine's Day. And Lili was 7 lbs.  

Thank you.
Eric
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I am slowly letting her go but still feel guilty that I didn't put her to the hospital. I just didn't want her to suffer more. Last four days she was so poor and uncomfortable.
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1916673 tn?1420236870
Hello Eric. Yes, creatinine 5.2 is suggesting final stages even at diagnosis. I think the fluids wouldn't have worked, probably because there was too little kidney tissue remaining. The disease destroys the organs bit by bit until there's not enough left to complete any level of function.

Again, I am very sorry for your loss.

Tony
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Hi.  I am new to the group.  I have a 12.5 year old Shelty who has been diagnosed with early chronic renal failure about a month ago.  I don't know the numbers but the vet said that he has given her a newer test which shows failure sooner.  Her blood pressure was good.  She is drinking a lot and regurgitating water a lot the last few days.  She is now on a kd diet and taking Epakitin.  The vet said that I should start giving Pepcid if Fleecey is doing a lot of vomiting.  I assume that he means this regurgitating.  Does that make sense?  Thanks.
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1916673 tn?1420236870
Hi and welcome to our Group. The test is likely to be the SDMA test. While that is very good at picking up kidneys issues early, it is not in itself a diagnostic test. Your vet will still need a full blood panel test, a urinalysis and a blood pressure check. Do make sure these are done. If she is indeed in early stage kidney failure, then a kd diet is inapproriate and could make things slightly worse. The important thing here is to get the blood test results, as we can then advise properly about diet and other management measures.

Tony
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Hi. Just signed up on this group. Came back from the vet today. Brought our 6-yr old Lhasa Apso, Rosie for confinement. A week and a half ago, she just lost her appetite and was very lethargic and quiet. Then after 5 days, she seemed to get better on her own and started eating again. She also seemed active again. After two days, it was back to no eating with constant urination, drinking and vomiting. It just seemed so sudden.

Long story short, the first vet we brought her to conducted a blood test. BUN 13.5 (normal 2.9-10.0), creatinine 175.26 (normal 44-150), SGPT 35.2 (normal 10-109). I don't know what these numbers mean but when we transferred her to another vet (another story), we were told that she has kidney problems and that it's irreversible. She's confined at the clinic now for the next three days but we aren't sure yet what kind of kidney disease she has. There's chronic and there's acute right? We're just very worried and confused at this point. I hope we find out for sure what she has. I've been reading the posts here about kidney disease and it seems like it's something that most dogs won't live through and I feel very very sad. And guilty for not being with her now. I guess I'm here to find a little support. Rosie is our first dog. I didn't think one could be this emotional over a pet. It's no different from children.
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Well, according to the vet today, she's not in a very good state. If she gains strength tomorrow, they might have to open her up. If not, then it's just a matter of time before Rosie passes on. It's all happening waay too fast.
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I guess I was in the wrong group. Rosie had closed pyometra. That's what was causing her kidneys to fail. Vet saw it too late. She was already too weak for surgery. She died this morning.
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1916673 tn?1420236870
I am truly very sorry to hear that. Run free Rosie. :(
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1916673 tn?1420236870
Hi. Sorry you need to be here, but welcome anyway. This is more likely (but not necessarily) acute rather than chronic kidney problem, simply due to your dog's age. For now, it actually doesn't make much difference, as the treatment is exactly the same. If it's acute, your dog will recover and not continue to suffer the ill-effects of a degenerating disease, which sadly is what happens in chronic variants of kidney disease. I am curious about why your vet wants to "open her up" - there's absolutely no reason for this so do not allow them to do it, unless they suspect there is something other than kidney disease happening.

Your dog needs to be on IV Fluids - and I'm assuming that's what she is getting while at the vet's. Once that treatment has finished, you need to begin SubQ fluid therapy at home - a treatment that you need your vet to instruct you on.

New blood tests will be needed in a week's time to see if the fluid therapy has had any effect.

Your vet should also perform a urinalysis checking for protein leakage and any infections. They should also perform a blood pressure reading.

If this is acute kidney problems, then there will be a reason for it and that's usually something your dog may have eaten (including human medicines, household or garden chemicals, and other such substances). If it is chronic, then it may have been happening for many months and even some years, even though symptoms have only now started to show.

Hope this helps. Do let us know how things go.

Tony
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Hi Tony,
So just got some more blood work done on Chance, my 15 year old with chronic kidney disease. It appears that she has slipped up to stage 3.
Her blood results as of 2 days ago are... creatinine 262, urea 20, phosphorous 1.7 and her BUN 20.4.
Her protein in her blood work was normal  but she is a bit anemic.
We just brought another sample of urine to have a protein test done on it.
Would love to know your thoughts.
She has been eating Royal Canine  Mature consult canned dog food for a few years now when she was first diagnosed with chronic kidney issues.
We have tried the omega supplements but they give her diarrhea but I do give her a bit of salmon or sardines once a week. She is on aventi ks nutritional support, glucosamine chondrotin pills for arthritis , a probiotic, metronidazole for her bowel issues and the vet is thinking about putting her on Forticor...which Doogan was on. (our beagle that passed away in December 2015).
Thanks as always,
Nancy
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1916673 tn?1420236870
Hi. Forticor (Benazepril) is a good idea, as it will help widen blood vessels and improve blood flow to the kidneys. There is of course a downside too, insofar as your vet will need to keep a very close eye on what's happening to blood pressure, to make sure it doesn't fall rapidly; and it will add some toxins to the blood load, although most of this medication is filtered by the liver - so it would be advantageous to add some Milk Thistle to the supplements list, just to add some protection to this organ.

At stage 3, you now need to restrict protein and (more importantly) phosphorus even more. Royal Canine  Mature has about 25% protein on a dry matter basis, which is now too much. The aim for protein is to get it down to about 12%. Phosphorus content is about 0.6%, which is acceptable for early stage kidney failure, but again this is now really too much for Chance.

That said, the protein and phosphorus content of Royal Canine Mature is about the same as the best alternative renal foods, such as Hills kd.

So, the question is whether to continue with it or look at the next alternative, which is probably home cooking. But that presents its own set of problems ... time and effort, getting the ingredients right and ensuring sufficient vitamins and minerals are provided.

Is Chance on a Phosphate Binder (sorry, without back reading I don't know)?

I'm wondering what is in the ks nutritional support? Could that be contributing to the problem? Is there a reason you decided to give this?

The anaemia is not uncommon in kd dogs, but it does need dealing with otherwise it will worsen and become a major health concern. Has your vet done an erythropoietin test? This is the first thing needed, as it will help identify whether it is this abnormality that's causing the low red blood cell count. If it isn't, then you are safe to give a medication such as Aranesp (darbepoetin alfa), which will help correct the anaemia. You can also use a supplement form of this, from Thriving Pets. Just ensure the erythropoietin test is done first and discuss the options and testing with your vet before proceeding.

Tony
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Hi Tony
Thanks for getting back to me so quickly with so much valuable info as usual.
So Chance is not on a phosphate binder at the moment as her phos levels have been in the normal range although slightly going up. 1.72 mmol/L ( range is 0.81-2.20). A few months ago (end of May) it was 1.53 and December 2015 phos was 1.31 mmol/L.
The Aventi Ks powder is a  nutritional supplement promoting normal kidney function  is made  by Candioli and she has been on it for a few years now..since she was first diagnosed with kidney disease. My Vet suggested this. Ingredients are :
per 2 gram scoop : (she gets 3 scoops per day as she is about 43 lbs.
Fructooligosaccharides
Lactobacillus acidophilus
Vitamin C 100mg
B12 200 mcg
Folic Acid 4mg
Vitamin B6 10mg
Citrus bioflavonoids 100mg
Enterococcus Faecium
I will ask about the anemia test and start her on Forticor and milk thistle.
My Vet just also started her on 100 mg Gabapentin per day (at night) to help with pain management as she has been restless , panting and some pacing on and off through the night. No longer able to sleep in our bedroom with us as she has done all her life.
My Vet says this drug is ok for Kidney Disease in low doses unlike steroids and other pain meds. I just looked it up however and found that it is excreted solely  through the kidneys and can cause toxicity.Now I am scared to give it. She just started this week has been on it for 3 nights.
Chance is also on fortiflora probiotic as she had Giardia a few months ago with lots of explosive diahrea that has taken weeks to get over. She was treated with Metroindazole which she is still taking and Fenbendazole for 5 days.  Every time we try to stop the Metroindazole she gets diahrea in the house and falls in it as she is weak in the back end from arthritis. She is also taking 2 tablets a day of glucosamine Chondrotin and a cartriphen injection monthly.
Thanks,
Nancy
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me again...
I forgot to mention that Chance is also on Omeprazole anti-acid  and her blood serum protein was normal but her urine protein test is slightly going up. 0.4 (reference range is 0.0-0.2). A month ago it was 0.3.
Thanks again,
Nancy
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1916673 tn?1420236870
Okay. Most of the meds are fine, as far as I am aware. Of course, all meds tend to be dealt with through the kidneys, so it's a Catch 22 scenario. I would certainly start a phosphate binder now(ish). There is growing evidence that starting one early is better - and I would tend to opt for aluminium hydroxide, if your vet agrees to it. The problem in delaying it (old school idea) is that parathyroid hormone starts to cause issues and calcium starts to be drawn from bone and teeth, because the body tries to get the balance between phosphorus and calcium right. But rising phosphorus just keeps causing the problem, so the body draws more and more calcium from bones and teeth, until hyperkalaemia occurs to compound things. More info on this in my Phosphate Binders article, which is available on my website.

Tony
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Hi Tony,
So my Vet is now talking about quality of life and doing the "right thing" for Chance and saying things like "I hate to say that she is 15 cause some dogs live healthy to 17  but she is 15 "... I am not there yet. We are getting a second opinion form another Vet in the next couple of days.

So Doogan was on KD canned food and then we went onto home cooking. We bought that powder that you add to food for vitamins and minerals ( Hilary's blend Renal supplement)  but he hated it ..the smell is very strong  .  If we wanted to start home cooking for Chance how would I do this..? So just to confirm Hills KD canned is not better in terms of protein and phosphorous levels compared to Royal Canin Mature consult canned?
Thanks,
Nancy
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1916673 tn?1420236870
Forget about protein restriction. It really isn't nearly as important as phosphorus right now. As long as the protein you give is human grade meats, that will be fine. I would stick with Hills kd ... add a teaspoon of honey or organic coconut oil and a tablespoon of cooked and chopped green cabbage, and see if he takes it. Great that you're getting a 2nd vet for an opinion ... please, please mention the phosphate binder. It's so important.

Tony
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Thank you so much for getting back to me so quickly.
We actually are getting that second opinion tomorrow and I will absolutely mention the phosphate binder. and I forget to tell you that Chance's ALT is a little elevated. So given that she just started Fortekor this past week, I will take your suggestion and get some milk thistle for her. I only noted the elevated ALT by asking for a copy of her test results. My Vet had not told me that.
I also have been reading your articles which I find very helpful. They are so well written and full of great helpful advice.
Your diet article mentions the benefits of giving a CKF dog  Green Tripe...do you think I should also try that for Chance? In addition to the Hills KD with honey, coconut oil and cabbage.
Take Care,
Nancy
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1916673 tn?1420236870
Green tripe is good, because most dogs are very happy to eat it, so if I were you I'd hold that back and use it only when Chance refuses to eat her normal day-to-day food (sadly, that time will come at some stage).

Thanks for your very kind comments about my articles. They are written purely to help dog owners (and their dogs) just like yourself. If they help, then that's all the reward I need.

When using the honey, coconut and green cabbage ... as additional supplements to the Hills kd ... I would rotate them one after the other. So, coconut one day, then cabbage another day, and then honey on day 3. This may keep Chance interested in them and prevent her getting bored with the smell and taste.

In addition, and if it is practical, try feeding several smaller meals more often during the day. This will help reduce the stress on the kidneys and also help reduce nausea.

Do let me know what your 2nd opinion vet says.

Take care - give Chance a hug from me.

Tony
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Hi Tony,
I got the second opinion and he agreed that Chance requires a phosphate binder. He said we should keep her on the Fortekor and phosphate binder and discontinue the rest like glucosamine, aventi ks, fortiflora, gabapentin and omprazole etc. as he feels those 2 items are the most important and the other meds can worsen her kidneys. He put her on Epakitin.. ( chitosan and calcium carbonate powder ). I know you said that aluminum hydroxide is better. ??? Now I am wondering about this.
He also talked about home cooking and the advantages of this as you have mentioned
Thanks,
Nancy
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1916673 tn?1420236870
Epakitin is rubbish. Sorry, but there's no point me saying anything less blunt. It has two ingredients, as you rightly mention ... calcium carbonate (the worst there is, because it has less workable calcium than calcium acetate and is likely to cause hypercalcaemia in due course) and chitosen, which has been shown to act very poorly as a binder ingredient (comes from shellfish).

On the plus side, you can start using it and have another blood test done in two weeks time and then see what - if any - impact has been made on serum phosphorus and general demeanour. If as I suspect there has been none or very little, then mention aluminium hydroxide again. If he won't provide it, then get a 3rd opinion from a more informed vet.

I think discontinuing the Omeprazole is fine at this stage ... but be aware it may need re-starting if Chance starts to refuse food due to nausea.

Home cooking is a good consideration, but hardly necessary just yet unless you want to go down that road. A very good quality canned dog food is fine, as long as it is low in phosphorus and sodium. Low protein isn't necessary yet.

Tony
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Hi Tony,
So I did not see your last reply when I sent you my last reply....
Thanks for your suggestions about rotating and smaller meals. I will do this.
So we gave Chance the Epakitin last night for the first time and a few hours later, she threw up. Not sure related to this but is aluminum hydroxide phosphate binder easier to digest ?
Also, Can we rotate the kd canned food i.e. the original one night and the chicken stew etc the next ? Also, she seems to prefer right now her Royal Canin mature consult canned food  can we rotate this as well ? or is Kd much better for her right now?
Big hugs to your fur kids and Chance sends you a big hug back !!!
You are her guardian angel,
thanks,
Nancy
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1916673 tn?1420236870
Hi Nancy. 2nd message ... we are chasing each other. Ha, ha.

I've already commented on Epakitin. All binders suffer from being rather unpalatable, unfortunately. However, alum hydroxide can be obtained as a gel powder and put in food, which tends to make it easier for dogs. It's also tasteless, so no nasty odours.

I'm curious about Chance throwing up ... and I'm wondering if this is because the Omeprazole has been stopped. Something worth mentioning to the vet, if Chance repeats this again tomorrow.

Is the chicken stew homemade or a bought product? The ingredients of the Royal Canin Mature include Protein: 9% - Fat content: 5.5%, but it doesn't say what the protein source is. In most kd specialised canned foods, the protein is high quality (much needed) rather than the low quality in some products (and something bad for the kidneys). You could telephone the manufacturer and ask them about that. The fat content may be of concern too, because some kd dogs become prone to pancreatitis (inflamed pancreas). It's something to be aware of and something worth checking through regular blood testing.

Rotating these three different foods is I think a safe option just now, while working out changing blood values. However, some dogs react to different food sources by vomiting or getting loose stools - so if either happen, it may be worth reverting to homemade or the kd canned.

Tony
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Hi Tony,
Thanks for both your messages... That is shocking about the Epakitin.... Glad I know the reality though!! After I got the product I was looking at it and was wondering about  the calcium in it.  I am absolutely going to somehow get the alum. hydroxide in the gel powder.  As soon as I read your response, I called my first vet back and am awaiting a phone call back. I said that I was requesting it. Hopefully that will work.
I agree that the vomiting could have been that I stopped the Omeprazole . Today, I find Chance is a lot more fussy and refusing some of her favourite things so I started that back up thinking that she must be feeling nauseated.
The chicken stew I was referring to is by Hills KD canned  ( sorry I was unclear) ..They have the original  and also  a chicken stew. I am assuming that they are both okay to give??
When the second Vet talked about home cooking yesterday he said that we can make a meal by combining good quality protein and vegetables / carbs. He said for 1 cup of food we should use 1/3 cup cooked good quality protein like salmon filet, boiled chicken... chop it fine and combine it with 2/3 cup of  different kinds of cooked and pureed veggies like carrots, peas, broccoli, cauliflower, butternut squash, green beans, pumpkin, sweet potatoes etc. He said we can cook all the veggies together , puree them measure out 2/3 cup and add that to the 1/3 cup finely chopped protein. Does this sound right to you?
Not sure I will start home cooking  right away but would like to know your thoughts as home cooking is something I might soon need to try.
Thanks a million !!!!
Nancy

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Hi Tony, me again....
so yeah.... I got my Vet in agreement for the aluminum hydroxide phosphate binder.
You were mentioning that they make a gel powder that has no taste and no odour?? Do you know exactly what it is called and is it a white powder or gel? My Vet was talking about Rx vitamins phos-bind and said that it is a white powder of aluminum hydroxide . but she said that it can alter the taste of food so I am thinking this is not the one you were referring to ?
Thanks again ..
Nancy
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1916673 tn?1420236870
Hi Nancy.

The suspension format of aluminium hydroxide (suspended in a liquid) does have a bad taste, and most owners use a syringe to put it in their pups mouths, just so they can't refuse it. The gel powder form (available without prescription from http://www.thrivingpets.com/) has no taste or smell and is added to food. Not sure what your vet is charging for the alum hydroxide, but if it's very costly through your vet, you can always try getting it direct from ThrivingPets instead (if cheaper).

If the chicken stew is Hills KD then it's absolutely fine and will already be low in sodium and phosphorus.

The vet's veggie + protein diet sounds fine. The best veg is green beans (the lowest in phosphorus), but the mixture given sounds okay. When using chicken, make sure you buy thighs (they are the lowest in phosphorus) and that the poultry is intended for human consumption, as that means it will be high-quality protein content.

It might be worth downloading and printing off some of my nutritional data sheets (available at my website at www.tonyboothwriter.com), as these contain an easy to reference list of the best meats, poultry, fish, pulses and vegetables for kd dogs and you can mix and match according to need.

Good luck and do keep me updated with how things go.

Tony
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Hi Tony,
Thank you so much for the above information. I had a conversation with my Vet who agreed that Chance should be started on a phosphate binder --the aluminum hydroxide one.
Early Wednesday morning, Chance began to have really bad diarrhea and then she would not eat  her breakfast and vomited. She became weaker and frail really fast so we went to the Vets. She was dehydrated and her values were up a bit more so they hospitalized her with IV fluids and meds. She stopped wanting all foods. Friday they started her on an appetite stimulant she began to eat some things but refuses most. And she won't take pills by mouth and becomes aggressive if you really try to force her mouth open.  She continues to have bowel problems and had an u/s of her abdomen which showed that she has inflammatory bowel plus she has a UTI. They are treating her now for that as well but things don't look good. We are waiting for some news from the Vet as I write this to you with such desperation and sadness. I will keep you posted and wanted once again to say thank you.
Nancy
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1916673 tn?1420236870
Hi Nancy. Sorry things took a downward turn. This is the way with this disease ... good days and bad days ... I know it can be heart-wrenching.

Sounds like a couple of things started to get out of control there. The UTi is an important one, because it does make pups feel dreadful. I'm hoping they did a culture and sensitivity test, rather than just guess which antibiotic to treat it with. Now, this is quite important, UTIs and kidney disease ... the antibiotic needs to be given for a longer period than normal, so at least 20 days. The dose should also be lower than normal. The lower dose helps protect the kidneys a little and the longer time period for the course ensures the infection is treated.

Tony
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Hi Tony,
I have an update for you.....
We had an abdominal u/s done on Chance and she has colitis(inflammatory bowel) hence all the diarrhea for the past 3 months. She is on Tylosin for that.She also had that nasty UTI--- they did a culture and she was put on the appropriate antibiotics. Both those things were treated and she has responded well to that however, her kidney values have worsened. Presently,  Creatinine 285, Urea 42, Phosphorous 2.8 and Bun 42. She has been hospitalized with IV fluids for 2 days last week  which did bring down her values to creatinine 283, urea 20, phosphorous 1.8 and Bun 20.4 . But she comes home and they have crept up to the above present values. Now we are giving sub Q fluids. The main issue...she has gone off food a few days ago so we literally are trying everything to get her to eat something. Sometimes 20 different things and then all of a sudden she eats a small amount of something new. She is on Famotidine 20 mg daily and an appetite stimulant and Forticor. I have to force the Famotidine and appetite stimulant down her throat and she really protests. We have been luckty to get the other things in at night when she eats a bit. For the phosphate binder, that is a tough one cuz now she is not eating . And when she eats it is only protein...a bit of roast beef, ham steak  etc. At least a few days ago, she was eating some macaroni or crackers or cereal but now not at all. Just protein. So we are now trying to get amphogel into her via syringe after eating something. But everything is a struggle and she is getting weaker. The end is very near and we are scared. Just wanted to give you an update and see if you had any thoughts on this.
Thank you,
Nancy
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1916673 tn?1420236870
Hi Nancy. I'm really sorry. Yes, this horrible disease catches up eventually, and at which stage everything tried seems to fail. It is incredibly frustrating and saddening.

Tylosin is good remedy for kidney dogs with diarrhoea, as it by-passes the kidney so doesn't overload them with additional toxins and by-products from being metabolised.

The antibiotics would have undermined the kidneys though, because they produce large quantities of by-products, which if they can't be dealt with by the kidneys they just end up in the bloodstream. It's a Catch-22 scenario ... but the infection is f course better being dealt with. I'm assuming the antibiotic course has finished now?

The IV fluids were the right course of action - and SubQs for at least a month to 6 weeks, maybe more, is essential.

If the values are creeping up again, are you sure the amount of SubQ fluids are the right amount? If not, let me have Chance's weight and the type of fluids being used and I'll calculate it for you.

I understand the desire to get anything into her, food wise, and it is frustrating not to be succeeding. Of course, anything with higher amounts of phosphorus will impact on the kidneys, as you know, so it is best to avoid them if at all possible. Very simple things in very small amounts (can't stress that enough) are often the answer. As well as unusual things to entice - such as organic honey or pure organic coconut oil (just a teaspoon drizzled on the top), rare proteins such as kangaroo and ostrich (expensive but worthwhile trying as Chance may not have smelled or tasted them before), and you could also try adding a desertspoon of organic natural yogurt or even cottage cheese to the mix on a temporary basis.

The other thing worth trying (if your vet hasn't tried prescribing it yet) is Mirtazipine. It can be a miracle cure for inappetence for many kd dogs - but not all - with a 50/50 success rate. The advantage is it deals with 3 problems in one tablet, so always worth giving it a go. It can take a week or so to have an effect, though many report success after just a day.

Other than that, my guess is you are taking things day by day. And that's a good way to deal with things. There does come a point when nothing really works ... I hope you and Chance aren't there yet. Stay strong.

Tony
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Hi Tony,
Thank you for your response.
Yes we are taking it literally day to day.
Chance's weight fluctuates between 19.8 - 20 kg.
I have looked at your article on diet, phosphorous and meal ideas. They seem wonderful I just wish she would eat some of that. She used to LOVE chicken, salmon, veggies etc but has gone off all of that. Unfortunately, sometimes we try literally 20 different things and finally she will take a few bites of something but it has become a 24/7 job taking care of her. I'm not complaining  don't get me wrong just feeling exhausted myself. Sometimes all we get into her is a few macaroni, cereal, crackers or a tiny bit of rice. Then all of a sudden she will eat roast beef slices (thinly). It makes no sense and then out of the blue she will eat something that she had stopped eating altogether  but she will only eat tiny tiny amounts. I know it's not good but she likes rice, water and a tiny bit of ham. We are so at a loss . Yet interesting enough, she has not yet lost weight but definitely muscle mass. Perhaps it is water retention from the sub q fluids.--Lactated ringers. She is on the appetite stimulant that you mentioned--Mirtzapine and Fanoditine.( Pepcid Ac) and Cerenia and Forticor. and her tylosin antibiotics. Also, because she is not eating much, we are mixing the aluminum hydroxide powder with water and using a syringe to get it in her .
Today, she ate some plain greek yogurt where as before she would even look at it. Just a week ago, she was eating salmon and chicken and all kinds of things. It sure is stressful. I will try those tricks you suggested above like the coconut oil, honey etc.
Thanks for all and will keep you posted.
Nancy and Chance
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1916673 tn?1420236870
You are doing fantastic job. I know it's exhausting and very stressful, both emotionally and physically. I've 'been there' and don't envy you at all. But, hopefully, Chance will rally once the fluids, phosphate binder and Mirtzapine take effect - fingers crossed.

Tony
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Hi Tony,
Hope that you and your fur kids are okay...
We have been really busy with Chance and wanted to give you an update.
Mid August given her age, symptoms and  stage of kidney disease we were told that Chance was palliative. Lots of conversations took place around euthanasia but we did not feel ready for this. We opted for comfort care instead.
Chance is presently taking Famoditine, Mirtazapine, Tylosin (for her inflammatory bowel), Fortekor, Cerenia ( 5 days on and 3 days off) and Gabapentin once daily for pain management. We are giving her probiotics before her meals and the phosphate binder (white powder--aluminum hydroxide )after her meals. We give both these via syringe with a tiny bit of water to mix it up. .We are giving daily sub q fluids for her hydration using plasma lyte and due to her bad arthritis we have to assist her with 2 bowel movements morning and night as she cannot be independent any more. She also gets a vitamin b12 injection weekly. Although my Vet has said that the treatments are for comfort care and not curative, I am going to request more blood work as we are curious as to where things are at--even though they have said in a way  that we are in a sense wasting our money and continue to remind us that she is palliative.
For her diet, she has some good days and some not so good days. We are rotating foods.
We evaluate her daily and try to keep her as comfortable as possible. We continue to look for signs that her time has come but we don't yet see it. We see her loving eyes looking back at us some days they look sadder -but these are the days that she doesn't feel so good. We are trying to maintain her dignity as best we can . She deserves this. She is such an angel !!!!
Thank you !!!!
take care,
Nancy
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