If anyone wishes to join the Group (your input and participation will be appreciated) or anyone that has a dog with Chronic Kidney Failure and wants information, advice or support ... please click the following link: http://www.medhelp.org/groups/chronic_kidney_failure_in_dogs
Bumping this to the top ... six members so far, let's see if we can't get into double figures. 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. Click here to go straight to the User Group page: http://www.medhelp.org/groups/chronic_kidney_failure_in_dogs
I just found out today my dog's labs were elevated. Creatintine is 2.8 and Bun level is 77.
They started my love on Azodyl and a prescription k/d diet. Recheck in a month. ( Which will be next Tuesday July 22)
I am in shock as I just found out bringing her in for a senior check up and had blood drawn for a dental. Now vet is telling me right now a dental would be risky.
I hope I can help others and get support. I love my dog like my own child. It is breaking my heart.
She is 14 vet said her heart and basic exam was excellent for her age. She is spunky and eats well but I do see her sleep more. Which could be age related.
After getting the results they starting her on the Azodyl twice a day and a prescription diet. I am not crazy about the food but she eats it well. I do add safe vegetable and have made treats from the dog food baked in the oven. She shows no signs, she goes potty outside, she drinks, she eats, but the vet is concerned she is high risk for a dental which she needs badly. She is Shih Tzu and has had her teeth done every two years since about the age of 9.
I want her to have the dental but with the vet telling me it is risky I am torn. I am trying a holistic treatment for her teeth which is not helping. It works great on my younger dog who has pearly whites. But she needs a good cleaning and I fear I am between rock and hard place. Do I do the dental and risk her life or let it be? I know the bacteria from dental decay is not good for her either.
I am also interested in some home made cooking diets. I am sorry this is so long. I keep reading and still have so many questions. I will let everyone know if her levels do go down next week.
Hi. I would have to be completely honest and say, given her age and her kidney failure, and given that she has had (presumably) good dental care up to two years ago - I would forget about the dental work. It is true that according to some sources, bad dental hygiene is a major contributor to kidney failure. However, once a dog is in kidney failure, stress can be even more damaging. And that's without the high risk that anaesthetic will introduce. You are indeed torn between a rock and a hard place, I know, but right now I would concentrate on the highest priority - which is to keep her blood levels as close to normal as possible.
Others will hopefully add their opinions, comments and suggestions.
Thanks for replying. All feedback is helpful. I am bringing her next Tuesday for repeat lab work and hoping it has gone down. I will go from there. The last visit I had a new vet in office as my regular vet was on vacation.
I did request him for this visit. I feel more comfortable with him. I am leaning toward not doing the dental work. The vet did say she would be high risk.
If I can keep her happy, eating, playing, and doing what dogs do in life, I think that would be the best.
Does anyone have suggestions on diet to entice her more? She will eat the prescription diet but has her good and bad days. At 10 lbs the vet doesn't want her to lose more weight. I will bring that up at vet visit also.
Hi. I just read your discussion about having dental work done for your dog with kidney disease. I am going through similar issues except mine has developed a gum infection. He just finished his round of antibiotics but his lymph nodes are still swollen. Im afraid he might need teeth extractions because he seems very uncomfortable.
Through Adozyl and a low protein and phosphorous I have been able to keep his creatine and BUN normal (He's @ Stage 2 and 15 yo with a heart murmur)
The vet told me that it was risky. However, I feel that maybe I should go ahead and do it since it seems his quality of life has diminished. I want him to be comfortable more than anything...I am scared and torn.
I was wondering what your decision was. Did you have it done?
I just joined! I loved your responses, Tony, on other CKF threads, so when I saw that you had your own user group I went there ASAP. My Sippie is a mixed rat terrier who was found on the streets and then had languished for months in an Oxford, MS, USA, shelter when we found each other about ten years ago. Her first name is Miss :-). Sippie recently and suddenly entered Stage 4 of her kidney disease. I am watching and waiting to see when the time comes that it is better to put her down than to keep her alive and suffering.
Hi there. I have a min pin (Maxine) or Max, she will be 13 and has been diagnosed with stage four renal kidney failure. She has been going downhill since Monday where she wouldn't eat and then finally wouldn't drink. She had diarrhea and frequent urination. We had camped on the weekend prior and coming home on the Monday I took her into our vet as she has a couple of growths on her and the one she had been licking and it had seemed to grow in size, red, angry looking. We had blood work done and it was then she was diagnosed with the kidney failure. They said her kidneys had already shut down 75%. She is very tired and any little bit of walking has her heartbeat elevated. They said her red blood cell count at that time was 26 percent. We took her home with some canned K/D. She ate the recommended three quarters of the can but Tuesday wouldn't eat or drink anything and the runs and throwing up started. She is very tired and just wants to sleep. Thirds day morning we took her back to the vet and they put her on the fluid IV to try and flush her systems and get fluids into her. We picked her up yesterday morning after being on IV for two days. She wouldn't eat the K/d dry food, but the vet had said she ate a bit of it on Friday. She drank quite a bit of water on Saturday and I fed her wet little Caesars food. She loved it. Today I'm having a hard time getting her to drink but she will continue to eat the little Caesars. She had no BM yesterday but today I got her outside and she has the runs. She continues to just lay in her kennel. She is very tired. Last night she wanted to lay beside me on the couch. We've been carrying her to go to the bathroom and hand feeding her. Any effort for her to walk causes her heartbeat to speed up. She is also shivering so I keep blankets covering her. She has always loved to be under blankets. I realize that we will eventually have to make a decision. I don't think she is in pain but she is not feeling good. She looks at me with her eyes I'm not sure if it is the look or not. It's almost the look that yes she loves me but she isn't feeling very good. The vet gave her an anti nausea injection yesterday and said it will last for 24 hours. They did blood work yesterday and her red blood cell count is now 15 percent which is way worse than what was originally thought. The vet was worried about the diarrhea and thinking that she may have cancer as well which could be attributed with the two growths she has. One on her hind leg and the other on her front chest. We now just noticed another one between her two nails on her back paw. My question is regarding fluids. Do we keep taking her in to get the fluid Iv or is our poor girl simply had enough and just try and make her as comfortable as we can? I was looking through family photos yesterday as a talented person we know is doing a pencil sketch of our girl. Every family outing she has been with us and every life event. It's so hard to deal with this. We love her so much and don't want to let her go and don't want her to suffer. I love how this coommunity all comes together and is so supportive. Could really use some kind words right now. Thank you so much.
Hi. Everything you have said about symptoms are connected with the kidney disease. The lumps could be cancerous, but I have to say they may not be, because old dogs get lumps just like old humans. Sometimes they are cancerous, sometimes not. In a way, these are secondary to the kidney disease, which needs to be the priority for now.
I am always surprised when vets put dogs with CKF on dry dog food. This really is not good. Canned kd food has less additives, colorants, blah, blah, but more importantly, it's 80% water - so this kind of food is another way of getting fluids in your Max. She needs fluids more than anything right now, to help flush the toxins out. But importantly. she needs the right fluids. You should be doing Sub-Q fluids at home. Talk to your vet about this. This will reduce the stress on Max, meaning she won't need to keep going to the vet. Stress needs to be avoided, as it will make the kidney disease deteriorate.
About the fluids ... your vet should be adding various things to the fluids, even if you do it at home. The additives will depend on Max's latest blood results. If there are deficiencies in some minerals and electrolytes, your vet needs to prescribe additives to the fluid (they can be injected into the bags you get). Just make sure your vet does this, as it will help Max.
Next, one anti-nausea injection won't do the job. You need to get your vet to prescribe a suitable anti-nausea medication to give every day. This is urgent, because without it, Max will continue to refuse food.
Food is important right now, but the right food is equally important. Caesar is not kd food. It is high in the wrong things, like phosphorus, which will further damage the kidneys. I totally understand you are trying anything, and if she eats it, then that's good, because it gets nourishment in her. But while it might seem like an answer for today, it isn't a good resolve for tomorrow or the day after. The other thing about food is to try and feed much smaller amounts, maybe five times a day. Smaller amounts of food will upset the stomach less and have a chance of staying in her digestive tract long enough to get some benefit from it - smaller amounts of food spread out over a day also reduce the amount of toxin by-products produced, so the kidneys don't have to work as hard.
On diet, please read my article, the link is here:
Max almost certainly has nonregenerative anemia and your vet needs to treat this, otherwise the red blood count will continue to fall. This is urgent.
Also, has your vet checked Max's blood pressure. Dogs with CKF often have high blood pressure, which also causes the kidney disease to worsen fast ... so if her blood pressure is high, this needs treating too.
That's probably enough for now. Let me know how things progress and if you get your vet to take more of a pro-active role in diagnosing other symptoms and treating them.
I've put this as a second post underneath my initial post above, because it's quite important. Treating low red blood cells count in canine kidney disease is tricky. Sometimes it works well and gives a dog's internal systems extra time to correct the problem themselves, and other times it fails and makes things worse. I tend to believe, it is a worthy risk given the fatal alternative, but that's just me. The corrective medicines are sold as Epogen, Betapoietin or Eporel, these compounds encourage your pet to produce red blood cells and so combat the anemia. Because these compounds were engineered for humans , dogs eventually cease responding to them. But they often do raise the pets PVC for a time. There is a danger in giving this product. When the pet's immune system decides to attack human erythropoetin as a foreign protein, it not only destroys the human erythropoetin that was given - it also destroys the pets natural erythropoetin. So it can make the anemia even worse. It should only be used as a last ditch effort.
Whether you want to encourage your vet to try this is really a decision only you can make. The alternative is to hope the kidney disease is improved enough and quickly enough to resolve the red blood cell count, but that seems unlikely, from the symptoms you have described. Max is on a downward spiral ... and intervention is the only potential remedy, in my opinion. The kind of intervention is a very hard decision to make.
Thank you Tony for the info. Max will drink a little water today and is still urinating. She refuses to eat the K/D this includes canned, dry and I even tried hand feeding her the dry that I had soaked in water. Even tried chicken broth mixed in. She does love watermelon though, she always has. So maybe I will try some of that. I'm thinking that while she loved the Ceasar's yesterday that could be what gave her the diahrea. She vomited yesterday too. Today she is still sleeping a lot, but she did get out of her kennel to walk to the water bowl. I continue to carry her outside to go to the bathroom as we have a lot of stairs and it is too much exersion on her little heart. I will get a copy of the blood work values. Last night she walked from the kitchen into the living room and wanted me to pick her up to lay beside me on the couch. I covered her up in her favorite blanket and she slept there all night. I will keep you updated. Thank you so much. There is so much info and not entirely sure what to do. Food and hydration are so important at this critical stage and the anti-nausea for sure. I'm not ready to give up with her, she is my baby. :(
Sadly, Ruby Tuesday lost the battle and I had to help her out of this life on Friday. She refused all food and water for 5 days and in spite of a daily Ringers subcut bolus AND Ambrotose, she did not get any better. When she stopped wagging her tail and barely managed to walk over to me, I knew I had to say goodbye. My heart is broken.........:-(
Hi. So sorry to hear about Ruby. Sometimes, no matter what we do, it's not enough. Goodbyes are so hard, I know. You did all you could. My sincere condolences. If Ruby could say it, she would say a huge thank you for loving her, caring for her and enriching her life with adventures.
So sorry for your loss. We are going through this right now and it is so hard to accept an illness that is terminal. ((((Hugs)))) Hoping you find comfort in knowing that Ruby is now in doggy heaven playing with all the other happy dogs. I know its no consolation, but friends on community and off have had so much faith and encouragement and have been so loving and kind and tell us to remember her and all the good times. Truly man's (& woman's) best friend. Bless you.
Hi Tony, I got the lab results, don't quite understand what they mean, but there are a lot of figures with astericks beside them so I'm sure its not good. I'll post here two readings one from June 8, 2015 and one from June 13, 2015. I went to the vet and both are busy but will get back to me shortly on what Max can eat her anemia and some anti-nauseau meds. She ate the watermelon! She is drinking water and has not thrown up or had the runs (so far) today. She even walked out onto the deck (a short distance) and enjoyed a bit of sun. She is in her kennel now and lays a foot away from me while I type at the kitchen table. Here are her lab results:
June 8, 2015
ALB 23 25-44 G/L
ALP 28 20-150 U/L
ALT 59 10-118 U/L
AMY 1296 200-1200 U/L
TBIL 5 2-10 UMOL/L
BUN 42.9 2.5-8.9 MMOL/L
CA 2.25 2.15 - 2.95 mmol/l
PHOS 2.43 0.95-2.13 MMOL/L
CRE 319 27-124 UMOL/L
GLU 7.3 3.3-6.1 MMOL/L
NA+ 138 138-160 MMOL/L
K+ 4.7 3.7-5.8 MMOL/L
TP 46 54-82 G/L
GLOB 23 23-52 G/L
QC OK HEM 0 LIP 0 ICT 0
JUNE 13/2015 (After receiving fluids IV for two days)
QC OK HEM 0 LIP 0 ICT 0
Also a couple more figures.... I'm thinking this one is her red blood cell count. June 8 it was 26.0 and June 13 it was 14.8 (HCT). They circled this as well: WBC June 8 it was 16.4 and June 13 it was 30.7.
Hi. Thank you for typing that little lot ... must have been a pain to do. Let me take a look at the relevant figures and get back to you. At first glance, the kidney levels don't look dreadful and not nearly as bad as I was first thinking. I've certainly seen much worse. But, I realise the kidney levels are only part of the story ... the white cell count and red cell count are more relevant here, I think. It's late now in the UK, so I may have to get back to you tomorrow, hope that's okay.
Yes, that will be fine. Thank you. I am going to see if she will try and eat some hamb/rice mixture... will try and teaspoon. The vet has some anti-nausea meds, not sure of the name... will post when I get it. There are two meds and not sure what they are for. But any help is so worth a try to make her feel comfortable. :)
Hi. Fairly typical of me ... I couldn't leave it ... so here I am. Firstly, the good news is that most of the blood levels are absolutely normal. It's a bit tricky sometimes, because the normal v abnormal levels are slightly different in the US to the UK, because labs do the work in a slightly different way - so it all took a little double-checking on my part.
There are some very interesting results, however, which need attention. First, the white cell count is about 100% above normal, which means there's an infection somewhere. It's more than likely it will be a urinary tract infection, which is common with kidney disease, but your vet can confirm it. It needs treating. Antibiotics are not ideal in kidney disease, but needs must.
Next, the red blood count is actually high, not low, according to my understanding. And this is very likely due to dehydration. This makes fluid therapy much more important. If I were you, I would ask about starting Sub-Q fluids at home. This wouldn't be forever, but just long enough to get your dog rehydrated and it will help flush toxins too.
The usual indicators of kidney disease when it's out of control, include high BUN (blood urae nitrogen) and creatinine. The levels you have given me show BUN to be just within normal limits, but creatinine is high (upper limit is normally 138).
It's more than likely the kidney disease is causing the high creatinine. Get the kidney disease stable, and the creatinine will reduce.
Phosphorus is just above normal. This can be reduced further by maintaining a good kidney specific dog food diet. Once it's within normal limits, you should ask your vet about starting your dog on a phosphorus binder.
Amylase (AMY) is just slightly high. This may be due to the kidney disease, but equally it could be a blip, because amylase can alter suddenly due to a variety of day-to-day events, including food intake. I think your vet has identified this as indicative of anaemia, but I'm not convinced, given the other readings.
One of the levels that is very high is TP - this stands for total protein. Proteins are very hard for kidney disease dogs to process, which is why the TP is showing so high. The answer is to reduce the protein intake dramatically - again, this means keeping to a strict kd tinned diet - or devising a very low protein home cooked diet - or only using high quality proteins, such as human grade chicken.
A lot of information, I know, but hope it helps you decide on some management interventions.
It's hard for me to give an opinion. Age 15 many people would not choose to go down the surgery route with their dog. But my girl had a half breast-strip age 14 and completely bounced back from that! (Something else -quite unrelated to the breast issues or the successful surgery came and took her in the end.)
If you do decide to have his teeth extracted, ask the vet to be especially careful with him, and to put him on fluid support during the surgery. That is iportant with kidney issues. The anesthetics themselves according to my own vet, are safer than they used to be and less stressful for older dogs.
Then he will need good nursing care and support afterwards. You can expect he will take a little longer to recover than a 4 year old would. And at first may be off his food because his gums may be too sore to enjoy eating. But careful nursing will help.
Thank you Tony. Our Max won't touch the tinned k/d or the dry even moistened with chicken stock. The vet suggested a mixture of hamburger and rice and to try giving her a teaspoon every half hour to see if she could keep it down. She LOVED it! It is now 8 pm here and she has had about half a cup in total of this mixture. She has kept it down and so far no diahrea. The meds I gave her was Fortekor 2.5 mg. 1 tablet once a day for 14 days. And also Metoclopramide 10 mg. 1/4 tablet one every 8 hours for 7 days. Really strange earlier when I went to take my daughter's friend home, Max didn't want me to leave and almost wanted to come with me. When I came home she wagged her little tail and then wanted beside me on the couch in her usual spot and we fell asleep for a nap. She is now resting comfortably. I will mention the possibility of infection (urinary) and also more flushing of her system. Sub Q. Will keep you posted. Thank you so much.
Hi. You're very welcome. I think there's a real chance of getting this under control, but it's going to take a lot of work. I do think you need to pay some attention to reducing protein - the kidneys just can't process them and are releasing them back into the bloodstream, causing more toxaemia. Keep trying the kd food ... even adding things like a small amount of probiotic or natural honey that many dogs enjoy. Sub-Qs will help bring the toxic levels down, and then it's a question of keeping them down with diet changes and supplements. You probably know, this won't cure the kidney disease ... but once stable, it may provide many months (very occasionally, even years) of additional time and an improved quality of life during that extra time.
Hi. My dog Charlie Brown(10yr old yorkie/Shitzu and the love of my life) was diagnosed with kidney disease on October 6th after I had blood work done to make sure he was healthy enough to get some lower front teeth pulled. The vet called me and told me the terrible news. His blood was way off the charts, showing a BUN score of 127 and a CRE score of 2.9. The vet gave him a life expectancy of 2mo - 2yrs, which broke my heart. I immediately put him on a KD diet, ordered a new water filter, and kidney gold drops. I started breaking his meals down into 3 per day with water added, and encouraged him to drink before bed and in the morning when he woke. When I took him back for repeat blood work three weeks later(October 26th) his blood work improved substantially. His BUN score fell to 67 and his CRE score fell to 2.16. This made me very happy. That day I started him on the Kidney gold drops and plan to get repeat blood work done on Nov 16th. I have been giving him egg whites as a treat(and to put the kidney gold drops on). He seems to be doing well, except that his trembling has increase. It has happened once in awhile over the last few years, but it seems to be increasing substantially. I love my dog more than anything and obviously want him to live as long as possible as long as hes not in major pain. I really don't know what my question is, I just really want someone to tell me that he could live another 5 years if taken care of properly. Given that hes on a KD diet, should I be giving him any vitamins or supplements? Any response to this would be appreciated!!
Hi. I regret to say 5 years is unlikely. Most dogs with CKD can be maintained if the diagnosis is caught early and effective management and treatment undertaken, but for maybe 2yrs at the very most. The kidney disease is progressive and terminal. Without good management, the time is hugely reduced to sometimes maybe only a few days, occasionally weeks or months. I'm sorry that maybe isn't what you were hoping for. On the plus side, you are doing the right things and it's clearly having a positive effect. I'm post two links to articles written by me that I think will help you ...
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