What to do now regarding recent CKD diagnosis

[marc22oys]

Just started looking online this past week about canine kidney failure after I was told my dog, a 4 year old american eskimo had the disease. I would like to get some information to help him lower his numbers and also be as happy and healthy as he can be for the time he has, which of course I hope is toward the longer time estimates that I have read. He had no symptoms of this prior to his recent routine check-up. I hoped he had some other problem like Addisons or Lepto which could be treated. After blood and urine tests and an ultrasound, my Vet concluded he had Glomerular disease, There was inflammation of the kidney. Dont know if this needs to be treated or is it only a result of the CKD? His numbers are as follows; Creatinine is 1.2, I think that is actually within normal range. Albumin was 2.4, low. Bun level was 43. The UPC level was very high at 16.8. The numbers confused me, Creatinine levels read Stage 1, while the UPC level is off the chart. He always ate a lot of chicken breast meat as treats and I stopped giving him this when told of the disease. He was however fine, running around, eating well, drinking and urinating normally right up to the Vets appointment. Then he had the test results and the Vet prescribed Hills G/D dry food for senior dogs, an Omega 3 capsule (600mg), Aminavast (300mg twice a day) and Benazepril (10 mg) to decrease stress on the organs and kidney. Since being on this routine, only approx 5 days, he is drinking heavily, urinating constantly and he eats very little, leaving most of the food in his bowl, hating the prescription diet food. How can I know this is the best solution? I want to get a second opinion and see if another Vet will conclude that the specific diet plan and medications are the way too go. I really want to give him high quality salmon and chicken as has been mentioned in this blog to help him eat more. Do the numbers say he can have this extra high protein at this stage? I think he is not in the CKD levels that would require a K/D diet or phosphorous binders, etc. He is young and I am hoping that his vitality, with no signs of the disease, lethargy, vomiting, loss of appetite (only until he switched his diet and has now started drinking/urinating frequently) will help him in the future be as healthy and happy as is possible. What else can I do? Feed him canned Hills G/D food instead? Can he have salmon and chicken with the skins as you suggest elsewhere to help him eat more food? I would appreciate some feedback or opinions for my particular case.

[tonyb286]

Hi. I thought I had replied yesterday to your post (maybe it was on another thread or maybe I was just dreaming it). If your vet is right about Glomerular disease (GD), then some of the symptoms could involve the same symptoms of Chronic Kidney Failure. However, other collective symptoms would be telling of GD, such as swelling of the limbs, heart rhythm disturbance, blue-purple skin colouration and swelling of the optic nerve due to high blood pressure.

Are these symptoms evident?

At 4yrs old, your dog would be considered very young to have CKD, which is why I am questioning that as a diagnosis - although the GD can lead to CKD - so nothing should be discounted at this stage.

I would suggest getting a second opinion from an alternative vet. My rationale for this is not that your current vet is incorrect in his diagnosis, but that a 2nd opinion (without advance warning of what the first vet has said) would either confirm or negate that diagnosis. The problem with a GD diagnosis is your vet may now be locked into a series of treatments that is inappropriate, if the diagnosis is actually something different. Also, if it is GD, then there would be an underlying cause - and the most likely are cancer, severe chronic infection or immune-mediated disease. So these need further investigation.

I would have expected the creatinine to be much higher with GD and with CKD, so this is puzzling. Low albumin can suggest many different illnesses and/or conditions, the most likely being pancreatitis (often the result of a high fat diet), internal parasites, poor quality low protein diets, severe liver disease, mange, internal blood loss, excessive IV fluid therapy ... and also chronic kidney failure.

So the difficulty is getting an accurate - and confirmed - diagnosis.

Assuming it IS CKD, then it is at a very early stage and a restricted low-protein diet is certainly not necessary. Lowing phosphorus in the diet cannot do any harm, so this is worth pursuing - but do we know whether phosphorus is abnormally high in the blood? What do the blood results say? It is certainly not worth starting a binder at this early stage just yet.

Frankly, any vet that advises a DRY DOG FOOD for dogs that have or may have kidney disease is very bad. I suggest using (for the time being at least) the canned versions you suggest. Don't feed chicken with the skin on until you know whether there is any pancreatitis or not - and only feed high quality proteins (human grade meats and poultry).

Hope that some of this helps.

Do let me know how things progress.

Tony