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4th stage renal failure in my dog
I have a nine year old lab  "Sandy Grace".  She is in fourth stage renal failure-Of course she has seen her regular vet for fluids-ultra sound revealed she has one kidney which is failing.   Creatine was 13-subs at home-now using hollistic and homepatic treatment.  Recently more bad days than good.    I am giving her ice chips which seem to work better for her than lapping.  Pedialyte ice is also better.  She throws up until she staggers and falls-I am continuously trying to hydrate her and giving her baby food-At times, she is able to keep it down,  other times the vomiting is horrible.  She continues to try for us, and we are fighting so hard for her-LIke others, I tuck her in at night (she sleeps on the loveseat with her "bankie" covering her).  I am sleeping in the den with her so I can give her support throughout the night.  Neither of us are getting much sleep.  I have her spoiled now with hand feeding other than her baby food, and I hold her plate while she licks it up.  I am using a recipe of egg yellow / whites, honey, and whole yogurt with a touch of dry powdered milk.  This works sometimes.  Sandy Grace is not ready to leave us-she continues to try-we try for her twenty-four hours a day.  Is there any over the counter medication that I can give her that will help with her vomiting?  We love her so much and she loves us so much-my husband and I feel like we will know when she is ready to go.  We went to grocery store yesterday to  buy more food supplies and liquids for her, when we got home, there she was looking out the window-barking for us to hurry and come inside-you open the door and there she is  - -so excited, still wagging her tail for us.  What can we do, this is our baby, she is so, so sweet-I know her days are numbered, but she is just not ready to leave. Help.    Aggieone
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82861 tn?1333457511
Your story breaks my heart as I lost my 14-year-old dog, Chica, to this exact disease on January 4.  The vomiting is so awful to watch in the end as it just goes on and on and on...  

There are many anti emetic meds to try.  Has your vet not prescribed anything?  Reglan (metoclopromadine) is a very cheap medication, unfortunately, it is also metabolized in the kidneys, so a too high dose results in toxic levels in the blood.  My husband and I discovered that completely bypassing the GI tract by using reglan injections worked much better in the end.  Chica didn't get the extra pyramidal side effects (extreme restlessness, shaking and trembling) from the reglan injections that she got from the oral meds.  Our vet drew up a dozen or so prefilled syringes, and we administered them just under the skin at the back of the neck.  If you're already doing sub-q fluids, this won't be any different.

I take phenergan myself for constant nausea, and discovered late in the game that dogs can also take phenergan.  It didn't work quite as well as the reglan, but at that point we tried anything we could get our hands on.  Over the counter Dramamine for motion sickness can be tried as it is metabolized in the liver - got that info from an ER vet nearby.  Benadryl is also something of an anti-emetic, and can be given at 1 mg per pound of the dog's weight, but I doubt it will be very effective in the face of this kind of vomiting.  Worth a try though.

Another thing that helps is calcium - lots of it.  I was giving Chica 2 Tums a day during her last couple of months.  The calcium binds to phosphorus which is deadly to those in renal failure.  As you already know, nothing can cure this disease, so all you can do is manage the symptoms as best you can.

If you can stand it, check out the several journal articles I wrote on my profile here at Med Help regarding Chica and our "adventure" with end-stage renal failure.  You and your husband are doing the same things we did, and your Sandy Grace sounds like the exact same temperament as our Chica.  She never did give it up either, which made it so much more difficult to make the decision.  It's all in my journal though.  I just can't bring myself to rewrite the story.  :-(
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82861 tn?1333457511
Just checking in to see how things are going.  I hope you've had some kind of "sign" to help you with your decision.  :-(
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Thank you so much for your caring and informative response.  The TUMS help!   My vet and the specialist that we took Sandy Grace to wanted us to put her down since her numbers were so high.   But, we knew in our hearts that Cissy (we call her Cissy because she has an adopted brother "Charleston Hershey" who is also a lab that we got from rescue . . .his nickname is Bubber and Sandy Grace is Cissy) was not ready to leave us.  She is not in pain, but most uncomfortable with the throwing up.   She is doing better with this since I am giving her tums.  Cissy weighs around 95 pounds, so I am disolving four tums in water and administering by a syringe.  I know this is short lived, but she finally accepted some shredded chicken that I had cooked for her.  Her mom and dad are fighting so hard for her and I know we will have to make that decision very soon, but honestly she is not ready yet.  I read your journals and I cried for Chica, you and your husband.  Jerry (my husband) and I feel your pain as we are living it.  We have shared so many special times with Cissy and Bubber.  We love primitive camping, the beaches, and any outdoor activities that we could include our babies in.  We are having the hardest time letting go, but I pray that we will know when to stop.  She is drinking water, eating some of the chicken; so as long as she is willing, wagging her tail, able to go outside and enjoy, we will continue the fight.   My family and friends are supportive, but now they want us to let go.  How can I make that decision as long as she is fighting?     Well, it is time to give Cissy her Tums, thank you so much for your concern and we shall keep in touch.  aggieone
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82861 tn?1333457511
Bless your hearts.  Yes, I know exactly what you all are going through, and it's the worst thing I've ever been forced to deal with where one of my animals is concerned.  I'm so glad she's doing a bit better with the Tums.  Did your vet give you anything at all for the nausea?  If not, MAKE HIM!  I totally agree with your decision to wait a while longer, so do everything you can to keep her as comfortable as possible.

The way renal failure is supposed to work when it's Time, is that the toxins build up so high in the blood that they cross the blood-brain barrier.  When that happens, the dog loses its personality and really isn't "there".  Well, that's the textbook case.  It never really happened with Chica.  She just got slower and slower and finally stopped eating the last couple of days, but her personality was still intact. She still knew us and her pack mate, Maggie.

Please speak with your vet about having some sedation on hand before you take Cissy in.  If she's going to be like Chica, the last thing your baby will know is going to sleep with you and your husband by her side.  Had we not done that for Chica, she would have tried so hard to do her usual routine of sticking her nose out the window and barking at everyone along the way.  Neither one of us could have handled that.  Of course, hubby being the big fat baby that he is, I was the one who had to give Chica her last pills.  I'm choking up again just thinking about it, so I'll stop this line of thought...

We also arranged for private cremation and return, so ask about that ahead of time if you want to go that way.  Chica was the 2nd dog we've had cremated (my husband just can't deal with back yard burial) so I figure when it's my turn, they'll all just go in the box with me.  :-)
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Cissy (Sandy Grace) is much worse from mid yesterday to present.  She is still drinking some, but not enough to count-has not urinated since early this morning.  Syringe feeding and medications is hopeless now as she will not swallow and work with me; everything just runs back out the side of her mouth I put it in, I bathe her each time and she loves that.  She is ready to go now and we must help her .  Like Chica, she still has her wonderful personality, but she is so weak. Sandy has always cleaned herself like a cat, always loved it  when you brag on how beautiful she is, she is having accidents now and she knows it, she is humilited when I have to wash her bottom.  I can't let this go on any longer.   Our vet is coming out tomorrow at 11:00 a.m. to help her go easily.  He will  slightly sedate her first.  She will be on her loveseat with her head resting in my lap as that is her favorite way to spend time with her mommy.  I know this will be more than I can stand, but I promised her faithly after her stay in the hospital that I would not put her back in my car unless it was for fun.  Cissy has always loved her daddy a little more than me, I was her next pick so I love it when husband is away at work and I am alone with my babies as they are all mine.    I have been her primary caregiver since December 23, so she has been my baby, and daddy the next in line.  If I am in another room she is looking for me.  She is not attempting to walk now as she is so weak, so I find myself laying down with her just to hold her.  We do that anyway, but now it is feeling her  breathing and cherishing her even more.  We will need your thoughts and prayers tomorrow morning,  I hope I am strong enough to do this for Sandy Grace.

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82861 tn?1333457511
I hardly know what to say.  :-(  You have done everything you can for Cissy, and I completely agree with your decision on timing.  Thank God your vet is coming to your home - not all of them can, or will, do that.  Do try to remember that first and foremost, you are ending suffering.  It's true that you are doing her a big favor by helping her ease gently from this horrible sickness.  She will never have to be sick or vomiting or soiled ever again.  You WILL have the strength to see this thing through as long as you remember that you're actually helping her.  I know you're in for a long, miserable night tonight, and all of you are in my prayers for peace.  Please check back in when you can.  
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Thank you so much for your sincere and caring words.  Cissy just threw up and each time gets worse,   I can tell she is so sore from throwing up.  She is still accepting water and Pedialyte, but very little.  She has given up now.  I plan to hold her throughout the night to talk to her and tell her it is O.K. to go.  My family wanted to be here to support us tomorrow morning, but you know, Cissy would not want that, she is a daddy and mama's girl so it will just be the four of us:  daddy, mommy, Sandy and Charleston.  I know I am doing the right thing, but it is so hard
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158939 tn?1274918797
I am so sorry for all you are going through.  I know this is so hard.  I had to go through a really rough death with mine a few months ago.  He looked so scared until I held him then he just looked relieved and let go.  It will be so good for you and your husband to be there with her tomorrow.  

Reassure her and tell her how much you love her but let her know that you don't want her to hurt any more.   I had Buster's favorite toy which I put in his paws then petted his head and told him how much I love him and all of the good times we've had until he was gone.  You are strong enough to do this - Cissy is counting on that.

Hugs and prayers for you, your family, and Cissy tomorrow.  Angles will be waiting for her.
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172023 tn?1334675884
I am so very sorry to hear of what you are all going through.  How courageous of you and your husband to make this difficult decision to help Cissy over the Rainbow Bridge with all her loved ones beside her.  

It is so hard.  I am still tearing up to remember the beloved dogs we've said goodbye to in the past.  

I will say a prayer for Cissy and your family and keep you in my thoughts.  I hope that you and your family can heal together during this very difficult time.  

Many hugs and good thoughts.

-Peek-
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274158 tn?1276350787
I am so sorry your going through this. You and your husband gave her a great life and I know she knows that too. You have done everything you could do plus more. She knows and thats why she let you know when she was ready. Just be with her and everything will be okay. It's going to be hard at first but time will heal you and your family. My prayers are with you and your family during this hard time.
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82861 tn?1333457511
Just wanted to let you know I'm thinking of and praying for you all this morning.  I know how awful the "countdown" is, and find myself glancing frequently at the clock today.  I hope Cissy had a fairly quiet night last night too - for her sake as well as yours and your husband's.  Prayers headed your way from west Houston.
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165308 tn?1323190145
I am so sorry for the pain you are feeling right now.  Remember, it is because of your deepest love for your Cissy that you are able to let her go.  Please know that you are doing the right thing for her, she will leave this world with dignity and will be waiting for you in the next.  I am sure that she is thankful for the choice that you have made.  I had to put my Tiffy down in December, and it was a very difficult time, somehow, though, we manage to make it through. God will be there with you making you strong and ready to take Cissy to a special place.  Remember, she will always be alive in your heart.  No one is ever truly gone when they have been truly loved.  My prayers are with you.
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Sandy Grace is gone now.  She left on her own at 4:45 yesterday morning.  Our prayers were that she would go on her own.  I was holding her when she left.  The worst night we had together, I finally gave up the attemp of giving her any liquids what so ever around 2:00 a.m.  I held her while she threw up time and time again, as she was so weak she could not stand on her own.  My last words when she  vomited  for the last time were, Lord have mercy on her.  She left us just after that.  I called my vet early that morning to tell him Sandy had left on her own, and he said that was the best thing that could have happened.  Soon, I will share with all of you her last minutes, but I just can't right now.  Cissy was a big yellow lab with a heart of gold.  The biggest brown eyes you have ever seen.  Our home seems so empty without her.  First time, we came back in the door and she was not there to greet us.  I feel so alone without her right now.  I see her all over our house, As exhausted as I was,  I could not sleep last night, I kept waking up to check on her.  Did I try to keep her too long, was I selfish?   A million thoughts are in my head and heart now,  trying to sort through them.  I have relived her death thousands of times.  I feel myself pulling away from Bubber (Charleston Hershey) as I have nothing to give right now.  I love Charleston as much as I love Cissy, but I can't seem to be mama to him right now.  He needs love and support too in his grief for his sister.  My husband is lost without his baby.   We have a lot of support  in our family and friends, but we feel so alone without Cissy.  She loved her "bankie",  when she was able to still stand and walk, she would hold her tail up to maintain the blanket, when she laid back down, she still had her bankie.  If she wanted the blanket off, she would drop her tail and keep walking until it fell.  How many times I have relived those moments with her bankie.  Oh what a personality she had.  Sandy Grace smiled a lot-I have a picture of her smiling,  I will send when I can get my head together--that is how I want to remember her, smiling-but right now,  I can't seem to think of anything but the  last six weeks that she has been through.  Could I have done anything else,   Will be back in touch to share more, I have found new friends who know what we are feeling right now, and there is no words to tell you how much we appreciate your caring and the support .  Aggieone
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82861 tn?1333457511
Oh boy, now you've got me crying right along with you.  Both of you did everything right with Cissy - never doubt that.  I prayed so hard for God to take Chica and spare us from making the decision, but it didn't work out that way.  I have a confession to make about Chica too.  She had a blankie that she loved and did the same thing with it that Cissy did.  Those two sure sound like soul mates don't they?  Hopefully they've found each other now.  But back to the blankie.  In the first days after losing Chica, I had to go through the ritual of cleaning up all the signs of sickness.  Cleaning the food bowls and putting them away, doing laundry, vacuuming up all the hair she lost during the last couple of weeks.  But when it came to her blankie, I just couldn't wash it.  I folded it up and keep it in my closet.  Every so often I'll take it down and smell it, and it's like having her back if only for a moment.

I understand why you've backed off from Bubber as well.  Sometimes grief makes us go into our shell, just like an injured snail or a turtle.  For Bubber's sake, just give him a pat here and there and let him know you're still there.  The great thing about dogs is you don't have to talk to them.  They know how you're feeling.  

Grief is an odd thing in animals.  When we lost our first dog, Travis, it upset our cockatiel more than it did Chica.  Petey Bird grew up with Travis and worshipped him.  He followed Travis around the house, shared his food bowl, cleaned his whiskers.  They were really best buddies.  After a few days with Travis out of the house, Petey stopped singing.  That was almost 5 years ago, and that bird has yet to utter one peep of any of his old songs.  

Give it time hun, and let yourself cry as much as you need to.  It's so hard in the beginning to try to forget the sickness and remember the healthy, fun times, but it will come.  God bless you and your husband for being such great parents to Cissy.
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165308 tn?1323190145
Cissy is in peace and you did everything right for her, right up to her last minute...What you are feeling is very normal..I still ask myself if I did everything for my dog before I had to put her down...You (and me) have to let this go.  Just from hearing your words you were the best mom and Cissy was very blessed to have you.  Yes, it hurts a lot and it will for a long time.  I just had a little crying jag thinking of my Tiffy a while ago.  It takes time to get those last moments out of your head, but soon they will be replaced with the wonderful memories of days gone by.  You are grieving right now, so go easy on yourself.  We are all here for you.  Cissy is no longer suffering and I am sure she is saying "thank you" for the wonderful life you have given her.  May God bless you all at this difficult time.
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274158 tn?1276350787
I just wanted to let you know that I am thinking of you and your family. You did everything tight and she thanks you for that. My prayers and thoughts are with you during this emotional time.
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Reading my journals for the last six weeks-will provide some of the highlights when I can, but now I just can't.  Hopefully, this will help  somone else recognize the symptoms of kidney failure in their babies. I cannot express to all of you how much your comments mean to us right now. Not sure we could make it without you. It is so hard.  Aggieone
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165308 tn?1323190145
We all know the feeling of losing a beloved pet...we are always here for you. Hang in there and take it one day at a time...that is all you could do right now.
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82861 tn?1333457511
Yes, everyone here helped me through Chica's illness and death more than they may realize.  It still comforts me to look back every so often and read all the kind words from so many people.  You aren't alone in this by a long shot!  :-)

How about a little distraction?  I assume you're in Texas based on your screen name.  My husband and I live in west Houston, and have been here for nearly 30 years.  Yeah, we're getting old!   When we first met in the mid 80's, we spent nearly every summer weekend camping and fishing on the beach on the far west end of Galveston island.  Talk about primitive camping!  During those years, that end of the island was nearly deserted - nothing like what you see there today.  Our dogs loved the whole camping routine, but once we bought a boat (actually, a series of 4 over the years) the camping ended much to the relief of my back.  

Where do you two like to camp?  We've made a few trips more recently to Guadalupe State Park and Pedernales State Park, but we've gotten old enough now to seriously consider an RV instead of hauling the tent and everything else.  I don't need much, and I can stand the heat, but really need something closer to a real bed than we can rig up in the tent.  

My neighbor recently spent 10 days out at Big Bend.  Wow!  The pics are awesome, and primitive doesn't begin to describe the conditions.  Apparently that's the only kind of camping available in that vast park, and dogs aren't allowed so we babysat his 120-lb Lab, King, during that time.  King is just another member of our family and we take custody of him frequently when his dad has to travel on business.  When Chica was still with us, I would take both our dogs and King on walks through the neighborhood, and we literally stopped traffic.  Here I am with 3 times my body weight in dogs, and they just trotted along beside or behind just as nice as you please.  I always got such a kick out that!  Particularly when King's dad gets dragged down the street when he tries to walk his own dog.  LOL!  It's all in the attitude.  :-)
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172023 tn?1334675884
Please know that you are in our prayers out here in Calfornia.   I hope that you can come to find some peace and joy in your life soon.  
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