Aa
Now has Kidney Disease, what questions should I ask the Vet?
Okay, My little 4 lb 10 yr old Yorkie has Heart Disease and now they determined he also has Kidney Disease. I don't know which came first so it is a double hard for me to handle, too much too fast.
I go in to tomorrow to see the Internal Med Vet about his kidneys and I don't know what to expect. What questions should I ask? What tests should I request? What am I to expect?
He had his BP taken last week and it was 120 mm Hg systolic. I was told it was good.
His counts are very high, the first count was 3 weeks ago, the 2nd last week, and the 3rd yesterday.
BUN: 184 - 169 - 244
Creatinine: 3.2 - 3.5 - 3.5
Phosphorus: 6.9 - 6.2 - 10.2
Between the 2nd and 3rd test I had him on homemade food of ground turkey, white rice, carrots, and sweet potatoes. Did that affect his count? He is now on Hills K/D canned or kibble soaked in water (he had his teeth removed 2 yrs ago). He seems to like it, if I hand feed it to him... so far.
He was treated for GI issues last year so when he started to have bloody diarrhea and vomiting I was worried it had returned. He is now on: Pimobendan (for heart), Metronidazole and Proviable for the diarrhea and vomiting and Alum Hydrox. for his Phosphorus issue. He was on Lasix for first 2 weeks but I stopped because his numbers were getting too high.
I am scared, sick to my stomach, I can't go to work because I start weeping. He still moves around stumbles a bit at times but sleeps most of the time. My baby hurts and I want to get all the info I can to help him. I have read a lot of your posts and have bawled uncontrollably at some thinking I can't do this, I don't know how you go on.
I go in to tomorrow to see the Internal Med Vet about his kidneys and I don't know what to expect. What questions should I ask? What tests should I request? What am I to expect?
He had his BP taken last week and it was 120 mm Hg systolic. I was told it was good.
His counts are very high, the first count was 3 weeks ago, the 2nd last week, and the 3rd yesterday.
BUN: 184 - 169 - 244
Creatinine: 3.2 - 3.5 - 3.5
Phosphorus: 6.9 - 6.2 - 10.2
Between the 2nd and 3rd test I had him on homemade food of ground turkey, white rice, carrots, and sweet potatoes. Did that affect his count? He is now on Hills K/D canned or kibble soaked in water (he had his teeth removed 2 yrs ago). He seems to like it, if I hand feed it to him... so far.
He was treated for GI issues last year so when he started to have bloody diarrhea and vomiting I was worried it had returned. He is now on: Pimobendan (for heart), Metronidazole and Proviable for the diarrhea and vomiting and Alum Hydrox. for his Phosphorus issue. He was on Lasix for first 2 weeks but I stopped because his numbers were getting too high.
I am scared, sick to my stomach, I can't go to work because I start weeping. He still moves around stumbles a bit at times but sleeps most of the time. My baby hurts and I want to get all the info I can to help him. I have read a lot of your posts and have bawled uncontrollably at some thinking I can't do this, I don't know how you go on.
Hi. Right, so at least now you know for certain. I know that may not be what you had hoped, but on the plus side it's a route to intervening and giving management to the best of your abilities. I think you have been amazing so far and have gone to incredible lengths to help Pepsi.
But you must also look after yourself too, because if you aren't eating and caring for yourself, how can you have the energy and determination to help Pepsi? I hope joining our group means you can get some good support ... but we can't be with you, so you must take care of yourself.
As for Pepsi, well, as you probably know, this illness has it's good and bad days and when bad days outweigh the good ones, you may have to think about the unthinkable. I don't think we are there yet though. My guess is the vet is "on the ball" and up-to-speed with Pepsi's conditions and the IV Fluids will certainly help the kidney disease, but only when the fluid volume in Pepsi's blood is under good control (otherwise he's right, it will adversely affect the heart condition).
As I said before, it's very much Catch 22 dealing with both of these conditions.
I am pleased you have switched from dry food to canned Purina NF. Dry foods are not good for kidney diseased dogs, mainly due to potential dehydration and the various chemicals used to dry and process it.
Yes, if you are already using filtered water ... that's excellent.
If you get the time, have a read of the article (link given above in prior post) about diet. There will come a time when Pepsi will almost certainly stop eating the Purina and that's when you need to be prepared for alternatives. The article points you in the right direction and gives some other useful info too. I would try feeding smaller amounts more often (about 4 times a day if possible), as this will help reduce the toxin build-up.
Pepsi still has a zest for life, which shows in how he's interested in what you might be doing on a day to day basis. Time may not be on his side, but while he enjoys a reasonable quality of life, there's still things that can be done to prolong your time together. Stay strong.
Tony
But you must also look after yourself too, because if you aren't eating and caring for yourself, how can you have the energy and determination to help Pepsi? I hope joining our group means you can get some good support ... but we can't be with you, so you must take care of yourself.
As for Pepsi, well, as you probably know, this illness has it's good and bad days and when bad days outweigh the good ones, you may have to think about the unthinkable. I don't think we are there yet though. My guess is the vet is "on the ball" and up-to-speed with Pepsi's conditions and the IV Fluids will certainly help the kidney disease, but only when the fluid volume in Pepsi's blood is under good control (otherwise he's right, it will adversely affect the heart condition).
As I said before, it's very much Catch 22 dealing with both of these conditions.
I am pleased you have switched from dry food to canned Purina NF. Dry foods are not good for kidney diseased dogs, mainly due to potential dehydration and the various chemicals used to dry and process it.
Yes, if you are already using filtered water ... that's excellent.
If you get the time, have a read of the article (link given above in prior post) about diet. There will come a time when Pepsi will almost certainly stop eating the Purina and that's when you need to be prepared for alternatives. The article points you in the right direction and gives some other useful info too. I would try feeding smaller amounts more often (about 4 times a day if possible), as this will help reduce the toxin build-up.
Pepsi still has a zest for life, which shows in how he's interested in what you might be doing on a day to day basis. Time may not be on his side, but while he enjoys a reasonable quality of life, there's still things that can be done to prolong your time together. Stay strong.
Tony
Got the news yesterday but could not post, had to first go through denial. I kept thinking past blood tests were wrong some how. That maybe he was just dehydrated or stressed, or even wished it was heart worm (curable). Got 1st Urinalysis, 2nd ultrasound (first was on heart, this one was on kidney and liver), 5th blood test and 3rd x-ray.
They wanted me to leave him there for his tests but I refused, he gets very stressed. So after each test they brought him back to me in the lobby. We were there over 6 hours.
Urine is diluted, high in protein.
BUN 224 - down from 244, 2 days ago
Creatinine 3.5 - same as 2 days ago
Phosphorus 4.2 - down from 10.2, 2 days ago
Good news, he gained a few ounces and Phos and BUN are down, also Creatinine is stable. Bad news it is definitely kidney disease.
Vet kept him on Alum Hydrox, I told her of my concerns. She said this is what they normally prescribe and it was a very low dose so I should have no worries. I asked about Epakitin, she said it was not reliable.
I asked about IV hydration, (she called it CoQ10?). She said at present he was not a candidate and when the time came that he would benefit from it she was concerned that with his heart condition, he could not take the stress. More than likely this will not be an option for him.
At present he is not nauseous so I did not ask about Cerenia or Azodyl.
He was eating Hills K/D kibble soaked in water so I bought the smallest bag they had and wouldn't you know it, he threw up in the car ride home and now won't touch the K/D kibble. Luckily I had a sample can of Purina NF and he seems to like it.
I have a Brita water filter/pitcher. Tony, is this what you mean about filtered water? I started using this for him, even rinse his dishes (no soap) and med syringes in it.
I read other posters about not going anywhere and now I understand, Pep's bed is under the coffee table so I have started sleeping on the sofa so I can keep an eye on him. I follow him when he goes into the kitchen to see if he is eating. He turns and looks at me like, "What are you doing?"
After days of this I realized this is not good for him or me (I have not eaten, I mean nothing, just water and juice for 4 days). Whenever I cook he would come into the kitchen and wait for me to "accidentally" drop something for him. I could not tolerate him looking at me in the kitchen cooking and begging for something so it was easier to just not cook. Yesterday I finally warmed up something in the micro and went upstairs to my room to eat. He can't make it up the stairs. When I came down 1/2 hour later, he was sitting at bottom of steps with ears perked, head cocked, looking for a treat. Sorry Pep's.
My mom lost her Yorkie-baby a few months ago so we talked and cried together. She suggested I take a few days off till I come to accept this.
They wanted me to leave him there for his tests but I refused, he gets very stressed. So after each test they brought him back to me in the lobby. We were there over 6 hours.
Urine is diluted, high in protein.
BUN 224 - down from 244, 2 days ago
Creatinine 3.5 - same as 2 days ago
Phosphorus 4.2 - down from 10.2, 2 days ago
Good news, he gained a few ounces and Phos and BUN are down, also Creatinine is stable. Bad news it is definitely kidney disease.
Vet kept him on Alum Hydrox, I told her of my concerns. She said this is what they normally prescribe and it was a very low dose so I should have no worries. I asked about Epakitin, she said it was not reliable.
I asked about IV hydration, (she called it CoQ10?). She said at present he was not a candidate and when the time came that he would benefit from it she was concerned that with his heart condition, he could not take the stress. More than likely this will not be an option for him.
At present he is not nauseous so I did not ask about Cerenia or Azodyl.
He was eating Hills K/D kibble soaked in water so I bought the smallest bag they had and wouldn't you know it, he threw up in the car ride home and now won't touch the K/D kibble. Luckily I had a sample can of Purina NF and he seems to like it.
I have a Brita water filter/pitcher. Tony, is this what you mean about filtered water? I started using this for him, even rinse his dishes (no soap) and med syringes in it.
I read other posters about not going anywhere and now I understand, Pep's bed is under the coffee table so I have started sleeping on the sofa so I can keep an eye on him. I follow him when he goes into the kitchen to see if he is eating. He turns and looks at me like, "What are you doing?"
After days of this I realized this is not good for him or me (I have not eaten, I mean nothing, just water and juice for 4 days). Whenever I cook he would come into the kitchen and wait for me to "accidentally" drop something for him. I could not tolerate him looking at me in the kitchen cooking and begging for something so it was easier to just not cook. Yesterday I finally warmed up something in the micro and went upstairs to my room to eat. He can't make it up the stairs. When I came down 1/2 hour later, he was sitting at bottom of steps with ears perked, head cocked, looking for a treat. Sorry Pep's.
My mom lost her Yorkie-baby a few months ago so we talked and cried together. She suggested I take a few days off till I come to accept this.
Hi. You may have already left ... so I'll wait for your return and an update. One thing worth mentioning that is very important for Pepsi ... you must also try to reduce all sodium (salt) intake. Sodium has detrimental effects on both the kidney disease and on heart disease, so this is something you can do that benefits both conditions. Unfortunately, sodium is in just about all manufactured dog foods, but it may also be in the dry food you are using, so look out for it. It's also in faucet (tap) water. Any water you use for Pepsi should therefore be filtered (not distilled) water - if buying this in bottled form, again, check for sodium additives (some add it, some don't). The best route is to use your own filtering system, but I realize this isn't always practical.
Tony
Tony
Thank you so much.
Pepsi has not had any urine tests, I will make sure to ask for that. He is presently taking Alum Hydrox as a phosphate binder, I think they gave him this one because of his history with GI issues. I stopped giving it to him once I saw it could be toxic and cause brain issues. I will ask today about EPAKITIN.
He is eating well, small amounts 3 - 4 times a day and mostly if I sit with him and hand feed it. He likes K/D kibble soaked in water.
He has not had a BM in 2 days (side effect of alum hydrox?). He urinates, last night he had a large urination that is bright yellow and smelly. Usually they are small and nearly clear. He uses pee pads so I check often.
I printed all past blood test results and doctor discharge notes to take with me. I leave in an hour. Wish Pepsi good news.
Pepsi has not had any urine tests, I will make sure to ask for that. He is presently taking Alum Hydrox as a phosphate binder, I think they gave him this one because of his history with GI issues. I stopped giving it to him once I saw it could be toxic and cause brain issues. I will ask today about EPAKITIN.
He is eating well, small amounts 3 - 4 times a day and mostly if I sit with him and hand feed it. He likes K/D kibble soaked in water.
He has not had a BM in 2 days (side effect of alum hydrox?). He urinates, last night he had a large urination that is bright yellow and smelly. Usually they are small and nearly clear. He uses pee pads so I check often.
I printed all past blood test results and doctor discharge notes to take with me. I leave in an hour. Wish Pepsi good news.
Hi. Earl has given you some good advice and there's not a lot I can add at this early stage. Your best friend has two very difficult and serious conditions, which make treatment of both at odds with one another. Treating the kidney disease ordinarily means withdrawing other major medicines and drugs, but in the case of heart disease, those drugs are needed to keep it under control. On the other hand, giving those drugs will actually put more stress on the kidneys, making the kidney disease deteriorate more quickly. It really is Catch 22.
I have seen dogs improve with higher blood counts, so hang on in there. A strict KD diet is crucial, either manufactured (like the Hills) or homemade - just work to guard against any phosphorus in the ingredients you use. Ideally, use only high-quality proteins (human grade chicken, for example) and guard against using any low-quality proteins.
Fluids are another priority. Canned Hills is better than dry foods of any kind. Homemade broths are great as they get additional fluids into your baby. If he stops eating, change the anti-nausea medication to something else (sometimes it's trial and error with this medication).
Have you read my piece on diet and KD? If not, it's here:
http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease
Okay. Let us know what happens at your vet. Fingers crossed for some positive news.
Tony
I have seen dogs improve with higher blood counts, so hang on in there. A strict KD diet is crucial, either manufactured (like the Hills) or homemade - just work to guard against any phosphorus in the ingredients you use. Ideally, use only high-quality proteins (human grade chicken, for example) and guard against using any low-quality proteins.
Fluids are another priority. Canned Hills is better than dry foods of any kind. Homemade broths are great as they get additional fluids into your baby. If he stops eating, change the anti-nausea medication to something else (sometimes it's trial and error with this medication).
Have you read my piece on diet and KD? If not, it's here:
http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease
Okay. Let us know what happens at your vet. Fingers crossed for some positive news.
Tony
Hi Persibaby,....Terribly sorry to hear about your 'Best Friend'. I will go ahead and mention some things until you hear from Tony. Not sure about time difference where you are vs. Tony in the UK.
First, since there are no teeth involved, you need to get a 60ml syringe from your Vet, or the Internal Specialist you're visiting tomorrow. The 60ml 'should' have ~3/16" orifice opening on the end so you do not frequent 'plug-ups' of the food. Second, you need a blender to blend the mixture of foods in order for it to 'pass through the small orifice' in the syringe. In the blender place the prescribed KD food, along with some vegetables(carrots, greenbeans, etc). Food intake is priority ASAP.
What questions to ask the Vet tomorrow?
1)What should I give for a 'Phosphate Binder'?(Example product is 'EPAKITIN')
2)What should I give for nausea and/or gastrointestinal maintence?(Example products 'CERENIA', 'AZODYL'........
3)What about IV hydration?
4)What about a 'thorough urine examination, including a 'Urine Culture'?(You didn't mention that urine tests were done??)
This should get your Vet's attention tomorrow, the you should hear from Tony.
The main thing is to get some steady food into him/her.. Multiple small meals throughout the day is best.
I wish you and your 'Best Friend' the best tomorrow.
Regards,
Earl
First, since there are no teeth involved, you need to get a 60ml syringe from your Vet, or the Internal Specialist you're visiting tomorrow. The 60ml 'should' have ~3/16" orifice opening on the end so you do not frequent 'plug-ups' of the food. Second, you need a blender to blend the mixture of foods in order for it to 'pass through the small orifice' in the syringe. In the blender place the prescribed KD food, along with some vegetables(carrots, greenbeans, etc). Food intake is priority ASAP.
What questions to ask the Vet tomorrow?
1)What should I give for a 'Phosphate Binder'?(Example product is 'EPAKITIN')
2)What should I give for nausea and/or gastrointestinal maintence?(Example products 'CERENIA', 'AZODYL'........
3)What about IV hydration?
4)What about a 'thorough urine examination, including a 'Urine Culture'?(You didn't mention that urine tests were done??)
This should get your Vet's attention tomorrow, the you should hear from Tony.
The main thing is to get some steady food into him/her.. Multiple small meals throughout the day is best.
I wish you and your 'Best Friend' the best tomorrow.
Regards,
Earl
I found his blood results from 3 1/2 weeks ago when he went to ER:
BUN: 109
Creatinine: 1.6
Phos: 7.8
In less than one month he has gotten worse fast...
BUN: 109
Creatinine: 1.6
Phos: 7.8
In less than one month he has gotten worse fast...
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