What Stage Kidney Failure Does My Dog Have?

[mydogsaremylife]

Hello. My 11 year old yorkie was diagnosed with kidney disease a month ago, but I am confused about his lab work.  His creatinine was 1.3 (still in the normal range), but his BUN/Creatinine ratio was 45 (high).  His phosphorous and potassium are also high (phos 6.6 and pot 6).  Is this Stage 3?  He has other health issues as well, high blood pressure (2 meds daily) and has survived two torn ACLs (at age 6 and 7) and had a tumor removed from one of his anal sacs just after Christmas of 2012.  He is my little miracle dog, but has been having lots of upset stomach the past few weeks with some vomiting.  The vet put him on aluminum hydroxide last month.  Did he need to be on this?  Could it possibly be causing the upset stomach?  I am taking him back to the vet later today for a re-check.  

[DarbiesMom]

This is fantastic news! With our little Yorkie feeling better, as Tony said, that's 1/2 the battle. It's amazing when you can get over that hump and your pup will help you very much from here. I hope your vet reconsiders administering Cerenia again as that seemed to be a core issue. Let's hope the good appetite continues as he gets stronger each day!

So happy you found the help you desperately needed in this forum. So many beloved pets have extended their lives not only in time, but most graciously, in quality of life. I always felt that if Darbie's health should turn when the inevitable may not be avoided, I will be so grateful knowing Darbie was not abandoned, but given a fighting chance with Tony's help and our wonderful friends.

What a blessing!

Fondly,
Lynne & Darbie:)

[mydogsaremylife]

Thanks Tony and "Sammie's Mom" for the encouraging words.  It's great to know that the diet changes and med adjustments CAN work and that, with luck, I will have my little guy around for many more months.  Trust me, having lost his brother just four short months ago, I am treasuring each moment with this one and know full well how blessed I have been to have these dogs in my life.  I just hope I bring them half the happiness that they have brought me!  I will post again after the next blood work is done.  Words don't quite sum it up, but THANK YOU to both of you and all the others on this forum.  The support and information you provide is priceless.  

[DogBlog]

So happy you are seeing an improvement.  You learn to savor every moment they are doing well......not to worry about the inevitable.  I had my Sammie with  me for MANY more months than I expected and learned to enjoy when she did well.  All the little improvements are great....Sammie was the same!!  Keep doing what you are doing.

[tonyb286]

Great news. I'm pleased things are starting to work and symptoms are settling down a little. This is half the battle won. Keep up the good work. The next bloodwork results will be interesting, but don't expect too much at this early stage ... any downward result should be considered encouraging. Keep us informed. Tony

[mydogsaremylife]

Hello all.  I am so happy to report that my little guy has been doing GREAT the past few days.  I lowered the dosage of the aluminum hydroxide, but was still seeing the head jerking a day later so I stopped the Cerenia.  That worked.  About 24 hours after his last dose, there were no more head jerks.  I also did some research on the internet and found several instances of pet owners reporting having similar reactions with Cerenia (even death in a couple of cases where an injectable version was used) so I will think twice before giving it again.  The Pepcid I had been giving him previously seemed to be working, but the vet wanted me to use the Cerenia to see if we couldn't get his appetite revved up.  It's been a great few days -- no head jerks, still good appetite, no upset stomach, AND he is beginning to use his injured rear leg again -- not fully, but he is starting to gingerly put it down when he walks.  I want to attribute this turnaround in him to the sub-q fluids he's been getting every other day for a little over a week now. It really seems to have pepped him up and I am so elated to see this change in him!  I have e-mailed my vet to give her the update and I imagine she will want to re-check his bloodwork in a few weeks.  Keeping my fingers crossed that all continues to go well -- I know we can't stop the inevitable, but it's sure nice to have this reprieve for however long it lasts.  Thank you all again for your comments and guidance.  I am absorbing all of it.    

[DarbiesMom]

Kay,

When Darbie was at her worst, I followed thru with plain organic yogurt. Leap of faith,  Darbie gets Azodyl  w/yogurt  in her dish. When her meal is done , she actually waits for the "tums" My guess is , Mandy may need 1/4 of the tablet ( smashed ).

For Darbie, pan"fried" chuck steak ( semi raw) was a better option than 80/20. I have used this, too...Darbie was OK, but Mandy is your Baby:)

Please know that Darbie gets Sub Q IV fluids every day.

It is so important for pet's parents to understand and study these blood analysis on vet's visit....REQUEST A COPY and be one step ahead of what could be a roller coaster.

Kay, stay in touch...Each pup has a special key:)

Fondley,

Lynne & Darbie

[Kaymbsc]

Thanks, Lynne. I really appreciate all the detail in your response.

Does Darbie get anything else for acid besides Tums? Does she/has she had a problem with acid, vomiting and/or ulcers?

I wonder if ground beef, 80% lean, would work as well (for my Mandy) as flat iron chuck steak.

You've had such good results with Darbie, I want to try mimicking your plan, scaled down, of course, for a 12-pound dog

Thanks again,

Kay

[DarbiesMom]

Hi Kay!

Darbie is a female lab-mix and finding the right portions was a constant experiment. As much as she loves chicken, her stool gets loose, so the chuck steak has been great. My market sells "flat iron chuck steak" which looks like 4" squares, 1/4"  thick. The meat pan fries ( with a hint of unsalted butter) within minutes. At below "medium rare", it should be very tender. I usually cut what I need at the time of her meal, discarding gristle.

Darbie gets 1/2 c KD kibble soaked in a splash of unsalted chicken stock and water.; 1/2 can of KD STEW; 2 TBS yogurt ; 6 (1/4") cubes steak. Her supplements go in her dish= 1ea. Azodyl, Fish Oil, Cranberry soft gel, CoQ10 (30mg),Glucosamine. After each meal, she gets a Tums ( assorted Berry) which has helped a lot with any gastro issues.

When Darbie was solely on KD prescription foods she lost a lot of muscle strength in her legs.  Adding the bits of high quality protein as advised by Tony has not only made Darbie stronger, but also proved her numbers could go down!

Stonyfield Organic makes YOBABY Vanilla which is packaged in 4oz cups.I enjoy their low fat plain, so Darbie and I can share a 32oz tub:) Tony has advised us all in prior posts to be wary of lactose intolerance, so please keep that in mind:)...I hope this is helpful!

Best of Luck to everyone during this journey...This forum is a blessing and it does take a lot of research and TLC...But, you will be rewarded:)

Fondly,
Lynne and Darbie

[Kaymbsc]

Thanks, Lynne.

You mentioned Darbie gets semi-rare chuck steak mixed in her meal with plain yogurt, too. What proportions are you using?

I've tried tons of different human foods with Mandy; I regularly roast organic chickens for her, cook organic ground beef (80% lean), cook organic eggs, human baby food, and bunches of other things, but until we tried the K/D beef stew, it was a struggle to get her to eat.

We haven't yet tried chuck steak nor yogurt.

Since we know Mandy likes at least some of what you're feeding Darbie (the KD Beef & Veg stew), maybe Mandy's palate is similar to Darbie's. So I'd like to replicate (in smaller portions, of course) what you're giving Darbie to see if Mandy likes it, too. If you wouldn't mind sharing your recipe, that would be great. Thanks again!

Kay

Kay

[Kaymbsc]

Hi there. Just one comment about the K/D food. My girl Mandy wouldn't eat it, either. Then I read Lynne's comment about the Hills k/d Beef & Vegetable stew which apparently is something new this year. So even if your Yorkie won't eat the KD canned food (because the original is bland and blah), if he hasn't yet tried the new Beef & Vegetable stew flavor, it might be something he likes. Mandy loves it, but she wouldn't touch the other KD stuff.

Good luck. I know what a struggle it is to find food that they'll eat.

[DarbiesMom]

Hi there:)

I'm so hoping your little yorkie is finding a balance....This is such a difficult time when figuring out this disease as well as other complications that arise. Please update on his aluminum hydroxide intake....I hope you saw positive results with a change of dosage.

Darbie went thru a horrible time with food association w/ sickness....I hope you find a nice menu that can stay. It means so much overall.

Best of wishes to you:)

Lynne and Darbie

[DarbiesMom]

Hi Kay,

I'm catching up a bit since being away for a few days...Excellent news that Mandy is receptive to the KD Stew! This was a great turning point for Darbie as I knew she was getting nutrition from a KD source and supplementing human grade protein ( Darbie is thriving on bits of semi rare chuck steak mixed in her meal with plain yogurt too...She's a lab-mix. Her legs got so strong as did her overall happiness! )

Wishing you a healthy journey! There is hope and Mandy will benefit from all your love:)

Fondly,
Lynne & Darbie

[tonyb286]

Interesting about the aluminium hydroxide. Aluminium can store in the nerve tissues when excessive amounts are present, which may be causing the twitching. That could certainly be the culprit and explain what's happening. Fingers crossed for a good weekend ... let us know how things go.

Tony

[mydogsaremylife]

Hello all.  So my vet said she thinks the head jerking (which is still happening sporadically as well as some front leg jerks) is due to the increased dose of the aluminum hydroxide.  My dog had been taking one capsule twice a day with food and she had increased that to two capsules twice daily.  So the vet said to go back to the original dose of one capsule twice a day.  We will see if that gets rid of the jerking movements.  As for the KD canned food, my dog just will not eat it.  He is just very picky about what he will eat and I have definitely found Tony's article to be true -- he associates certain foods with feeling sick.  What he does eat, he eats fairly well, so he sounds like Kay's picky eater, Mandy.  Thanks for the info on the green tripe also and how Mandy has responded to it.  I may end up ordering some for him and am only hesitant because of the size of the minimum order.  I guess if he didn't eat it, I could offer it to my neighbors for their dogs.  I want to say thanks again to everyone on this forum.  You have all been so helpful and supportive and I sincerely appreciate it.  Going to see how my little guy does over the weekend and hope to have a GOOD update to post next week.  

[tonyb286]

Hi. That's fabulous news. Hope she continues to woof it up. Every dog is different and every stage of this dreadful illness presents us with challenges to overcome. The fact that Mandy is now eating is down to your own perseverance ... so well done to you. Things may change again in time, but for now, it's great news.

Tony

[Kaymbsc]

Lynne, I'm so glad you mentioned the Hills k/d beef & vegetable stew. Because of your comment, I went to my vet and got some today, and I'm THIRLLED that Mandy scarfed it up. She really liked it!

Thank you!

Kay

[Kaymbsc]

Yes, I was happy with the order and the tripe supplier. They delivered exactly as promised. Does my CKD dog Mandy eat it? Yes, she nibbles at it, but she isn't crazy-in-love with it. But my other two dogs are.

Mandy's appetite has been very poor, so I'm not surprised she's not wild over it. It's hard to get her to eat anything. BUT, just today I read on this forum that someone else suggested Hills Prescription Diet canned K/D Beef & Vegetable Stew. So I went to my vet and got some (only available from a vet), and Mandy scarfed it up. I have to say, it even smelled good to me! So I was thrilled to see her eat with enthusiasm.

In Tony's article "How Diet Affects Dogs with Chronic Kidney Disease"

http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease

Tony writes

"There is also a psychological element to dogs not eating when they have chronic kidney failure. Because a dog experiences nausea as part of the illness, they commonly associate feeling sick with the last food they ate. Many dog owners feed their dogs much the same food, day in, day out, so it is little wonder a dog suddenly refuses to eat it. In his mind, he is thinking 'this is making me feel sick, so I'm not going to touch it.'  "

That's pretty much been the case with Mandy. So I keep switching up her foods, and when I find one she readily eats, like the Hills K/D Beef & Vegetable Stew -- WOW! That's just so exciting.

[tonyb286]

Hi. I haven't heard of any symptoms of that nature with Cerenia. I did a quick look-up and found this though, which is something worth noting:

"A light meal or snack before dosing is recommended; prolonged fasting before administration should be avoided. Cerenia tablets should not be administered wrapped or encapsulated in food as this may delay dissolution of the tablet and consequently the onset of the effect."

After looking even deeper, I discovered that a very small number of dogs in trial studies with the drug have developed Otitis/Otorrhea (less than 2% of dogs in the study). This could be the answer to the head jerking, as the condition refers to a middle ear infection with a slight discharge. I would certainly raise this with your vet, as they may not be fully aware of this potential effect.

It may, of course, be something completely different (such as an allergic reaction to something else or a neurological symptom), so I would certainly suggest your vet considers what may be happening (particularly if you see it happen a third time or more).

Hope this helps.

Tony

[mydogsaremylife]

Hi Tony,
Yes, that certainly is coincidental that your dog developed a limp also.  I'm so happy to hear that he is doing better as I can fully relate to having to watch them so carefully when they are in this state.  My little guy is still hopping around, no weight bearing yet.  I have a question about the Cerenia -- has anyone reported any negative side effects from it?  Since starting it two days ago, my dog is eating better which is great, but last night he was sitting next to me on the sofa and out of nowhere his head starting jerking, as if with a nerve twitch.  It only lasted a matter of seconds, but it happened again this morning and it is rather scary to watch.  He seems as alert as ever afterwards, but of course, this is worrisome.  I have a call in to my vet to see what she has to say.  Sometimes it seems that every day brings a new problem, but I am grateful for every moment with him.

[mydogsaremylife]

Hi Kay.  Thanks for the link for the second supplier of green tripe.   Were you happy with the order you received from the other supplier? and is your dog eating it?  Appreciate your feedback.

[Kaymbsc]

So sorry to read about your dog. You mentioned that you read about someone ordering tripe from Atlanta -- that was probably me. I'm also on the US east coast -- in SC. I've also found you can get tripe from another east coast supplier:  http://www.blueridgebeef.com/BRB-Complete.html.

Best wishes!

Kay

[tonyb286]

Hi. As if by coincidence - and maybe in sympathy - my own dog had a bad limp last week, which also couldn't be surgically corrected. So I've had a whole week of him limping - and me worrying about him limping, as he's getting on in years. Although it's been a tough week, with me making sure he didn't jump up at me or on furniture or climb up or down any stairs ... I'm pleased to say the limp is much improved.

I hope your best friend's limp also repairs quickly.

Have you tried drizzling a small amount of honey (all natural) on his KD food? It's worth trying. Also, if you can get hold of some rice bran, this will help him gain some weight and aid his CKF blood levels too. After a couple of days of taking Carenia, he should start eating better - but if not, ask the vet for an alternative. With nausea, it's a case of different dogs need different remedies, and sometimes it's just trial and error until you find the right one.

Tony

[mydogsaremylife]

I took my little guy back to the vet last Thursday for the re-check.  The x-rays show his right rear leg does have an CCL tear, but the vet said she cannot do surgery because of his kidney issue.  She said the tear will heal itself eventually although probably not as well as with surgery.  As of this morning, he still will not put weight on it, but he does hop around and the leg doesn't seem to bother him.  The vet also checked his blood pressure and it is running around 180 which is "normal" for him.  He had lost another 3/4 lb and the vet said his gums looked dry so she gave him sub q fluids and sent me home with a bag and directions to give to him every other day.  She said to start Cerenia also as this will help with his nausea and appetite.  She said no point in doing the ultrasound at this stage, that we need to just focus on the kidneys right now, BUT, that if I really wanted the ultrasound done, she could schedule it.  My poor little dog has been such a trooper and doesn't seem to be in pain and that is my goal -- to keep him comfortable.  When the day comes that I can see "that look" in his eyes, I will do what I must.  Meanwhile, the fluids do seem to be making a difference.  He seems to have a little more energy and his appetite is a little better.  My only big issue now is that he still refuses the KD, even the tinned type, and I need him to eat.  So I continue to prepare his meals, giving low phosphorous dishes.  Mostly chicken thighs.  I want to try the green tripe and saw where someone on the forum had ordered it from Atlanta, GA.  I will check into that as I also live on the East Coast in Virginia.  Thank you Tony and Lynne for your reassuring words and guidance.  God bless you both and your lucky animal companions!

[DarbiesMom]

Sounds like your little guy has so much going on...As do you.

It's hard to hear  animals suffering...It's so much more difficult to hear their Moms or Dads desperately looking for answers and hope. It's heartbreaking to be in that space...I've been there several times.

My very best to you.

Fondly, Lynne & Darbie