Early stage renal failure. Advice appreciated

My Misty was diagnosed today with very very early stage renal failure. I was aware she had started drinking more than usual, and in spite of the vet reassuring me the quantity of water she was taking on board was still in the "normal" area for a dog her weight, I knew that something was wrong.
Her urine test showed no abnormality, but her blood test showed Creatinine slightly raised, and urea also. Sufficiently for the vet to give that diagnosis.
He did say we have caught it at a very early stage. There is no elevation in her Phosphorus levels right now.
He has put her on ACE inhibitors (one a day) which will improve blood flow to the idneys,and an antibiotic, to see if that will  completely eliminate any subtle presence of infection (although her white blood cell count was not elevated)
She as also been given Royal Canin prescription Renal diet (canned and dry kibble)

She is acting very fit and well,  eating well, no other symptoms, she doesn't know anything is wrong with her!

This is right out of my league, I know little about Kidney Failure, am reseaching of course, and am doing everything the vet advises. But please, I would appreciate any advice (particularly diet-related) from anyone who has experience with this.

She likes the (notoriously unpalatable) Royal Canin Renal dry food, which I am introducing gradually over the next few days, at the beginning alongside her regular food. She wolfed it down! So that's a good start.
But I need to know, apart from that, what else can I and can't I -give her?
I am aware low protein is the key....but would she be allowed ANYTHING else at all? Are, for instance, vegetables not allowed...or egg white? or tiny pieces of apple....or saltfree wholemeal bread, etc (which is the best thing to wrap her tablets up in to get her to swallow them!)

Any advice would be much appreciated,
Ginger

[Ghilly]

Oh my goodness, I am SO sorry to hear this!   Thank goodness it is the early stages where medical intervention can REALLY make a difference!

This link is wonderful!  http://www.2ndchance.info/homemadediets.htm    
I had a friend who had a puppy born with juvenile kidneys, meaning as he grew, his kidneys would stay the size of a young puppy and eventually not be able to support his body size.  We used the recipes in this link and he actually lived four years before his way-too-small kidneys went into total renal failure and he had to be euthanized.  Home cooking was a Godsend for that puppy, so you might want to consider it for Misty.  Also, he was a large breed dog (border collie/collie cross).  Misty is a small girlie, no?  So her body size will be in your favor in this.  PLEASE post updates to let us know how she is doing and know that you will both be in my thoughts and prayers.

Ghilly

[ginger899]

Oh Ghilly, thank you very much.
I will check out that link right now.
At the moment I DO home cook half of her food (for instance she has either chicken/ Tuna/Salmon/white fish/rabbit/beef....(which she's not allergic to) plus a little veg. usually carrot/green beans/cabbage/peas. As well as her Holistic Dog Kibble (which she has been on for years and thrived on as far as I can see)
She also has a small slice of apple in the evenings, which she loves, and occasionally a very small piece of wholemeal toast.
I don't add salt or any seasonings to her food.

My thing is this....the Royal Canin Renal diet sounds ok...and she seems to like it. But although this all she's supposed to have SURELY there must be other food she is allowed, OK maybe not protein-rich stuff, but perhaps veggies or carbs (maybe in the form of a little potato, wholewheat pasta or brown rice?) or anything that would be safe to add to her food in small amounts to give her some variety.
That's what I'm working on right now.

She, by the way is acting like an extremely fit, active, and happy girlie.
Thanks. Bless you

[Ghilly]

You're very welcome!  :)

You can also Google "Home cooking for dogs with kidney failure" and you'll find OODLES of links with great recipes!  The kidney failure section in the article I posted is a little more than halfway down the page where it explains what you need to have more of or less of in a renal diet.

I'm so glad to hear that she's doing so well and is apparently oblivious to her condition.  She is so adorable!  It's awful to think of any of them having something like this to deal with.  She is very lucky that you are her dogmom because I know you will go to the ends of the earth for her.  :::hugs:::

Ghilly

[ginger899]

Well, thank you, I'll check that article out hat you wrote. But where is it exactly? Could you give me the URL?

Subconscously, of course, it's very tempting to start treating her like a "sick dog" But I have to stay on top of that, and not do. She is very sensitive to any changes. Yesterday, for example I found myself thinking "she's going to need this....or that....and I'd better be careful....and watch out for any signs and symptoms.....etc" And you know what? I caught her staring in an almost "guilty" way at me, and not wagging her tail, and kind of creeping a little bit in the kitchen, all the while watching me, as if she'd done something wrong!
She could "hear" my thoughts, and pick up on my feelings, worries, and mood! Clever girl. But it means I will have to re-think how to think.
I immediately switched to normal mode took her in the orchard where she chased fallen apples I threw for her -and was quite herself again.

[ginger899]

O...M...G help please!
I'm either trying to do too much too quickly, or trying to do it all when I'm tired, but am in a nutrition minefield right now. I have spent 5 hours researching nutritinal requirements for dogs in early stage renal failure, and got a list about as long as my little finger (which isn't very long!) of foods that are ok, and those that are not!
Plus I'm getting a LOT of conflicting information online about protein/phosphorus contents of foods....whether protein should be restricted in early stage (or not)....high fat (??) foods seem to be recommended(!?)....I NEVER fed my dog fats I didn't need to!.....

And though I want to trust the prescription diet, as the vet has told me this is the perfect balanced food for early stage renal failure, and really WILL make a difference to keeping her urea/creatinine levels low right now, and prevent phosphorus in the blood...
Listen to the ingredients in the food I suddenly have to give her!

(NO high-quality protein amongst the first 4 ingredients, just corn, animal fats (ok -like WHAT animals???) -and corn gluten....and then the first protein is "Soya Protein Isolate" followed by "hydrolyzed animal proteins" -like what the HECK are they? ....beet pulp....preservatives and antioxidants (completely unspecified!)
OK there are some good-sounding things in the food too.

But after feeding her a good wholesome, well researched and healthy diet for years now, plus home cooked food, and staying away from junk dog food completely because I don't trust it and wouldn't go near it with a barge-pole....I suddenly WHEN SHE IS SICK LIKE THIS have to start feeding her JUNK again?

I know the nutritional content as far a proteins and phosphorus in the prescrition diet is supposed to be well balanced and precisely what she needs to stay as well as possible for as long as possible, and hopefully, to hold at bay the later stages of real disease for as long as we can.....
but I don't trust ingredients like these.

Like I said I am in a minefield of mixed-up information when it comes to home cooking her complete diet. I don't know exactly what to do. I'm scared of NOT giving her the prescription food....and I'm scared of GIVING it to her!
Phew! Sorry to vent like this!

[TwoBitsMom]

Hi Ginger....
First, may I say that I am so sorry to hear that your dog has kidney insufficiency starting. But you are fortunate that it was caught early.
Also, Thank-you for your response to my post about a possible survey.
As you are discovering....this disease requires many difficult decisions by the pet owner....it is overwhelming.
I wish I had some definitive answers for you.....but the reality is, you will have to decide.
Have you tried the new food yet....maybe you dog will be ok with it.
You could Mix it half and half with her regular food for now, until you can come up with a plan you are comfortable with.
Also you could check into www.b-naturals.com They have a kidney diet you might be happier with...
Wow...your work is cut out for you....! If I can do anything to help you with your research let me know.......Connie

[ginger899]

Connie, thank you very much. I didn't feel my answer to your survey question was very useful really. I know you need more answers yet from more people who have had this problem with their dogs.

I think I have been trying to do "too much too soon" the last 3 days, and got tied up in knots, as I expected the answers I sought to be fairly cut-and-dried. But -as I am learning, Kidney Failure has so many different stages, and responses to those stages re: diet and medication etc. And the solutions are not all just there on a plate.

Yes she is fortunate that this was discovered early. The vet sad that too and said it was good that I pushed for a blood sample even though even HE didn't think her water drinking was excessive (but I know my dog! And I know when somethng is different about her)
Of course, the only thing that can EVER be done with KF is hopefully "plateau out" at the stage the dog is at when the condition is first diagnosed. And keep that going as long as possible before full renal failure happens.

She likes the Royal Canin diet food. No problem. Both the canned and dry variety. I have her at about 80%/20% (R.C. to her old food) by today. Her energy levels are spectacular. Her general condition and fitness -wonderful. Her appetite -great. I've noticed a very slight weight gain on the new food, but she looks fine, and that's probably because I haven't got the portion measures right yet (she won't complain!)
But she is still drinking lots of water, as before. I keep thinking -if we really really stabilize her, surely her heavy drinking will ease up a bit?

Anyway, this is a learning curve and I am working at it.
I'm aproaching the point where I'm wondering if adding a phosphorus-binder (Calcium Carbonate in the form of ground egg-shells as I can't buy "Tums" here)...might help a lot, so she can have some protein foods like chicken or fish in moderation.

[TwoBitsMom]

Hi Ginger....
I've been thinking that as long as she is Happy and Ok with the Kidney Diet dog food, let her have it...I mean, it doesn't sound very good to us, but if she is OK with it, then take some comfort in that. As long as she is more than Happy to gobble it up, it will give you some time to do your research, and you can relax alittle, knowing that she is OK with the food.
I do know what you mean about the confusion of proteins and the renal diet.
There seems to be growing evidence, that protein does not accelerate the progression of the disease, as much as Phosphorus does.  
Some studies even suggest that Dogs with Renal Failure may need more protein in their diets....!
All the inconsistancies about this disease, drive a person crazy.
So many people find out about their dogs kidney failure when the disease is fairly well progressed. This forces many of us to have to make hurried decisions about diets, medications, tests, etc.
You found out early, so you do have some time to figure out the best plan of action.
Do yourself and your dog a favor, and take a little breather....get away from the computer tomorrow...and enjoy your dog...!
Connie

[ginger899]

Oh Connie....I can never rest until a problem is cracked wide open! I have been known to stay up all night to solve something before I can sleep!
But I know -this can't be solved in a day or two. It's something I will learn more and more about each day.
I don't sit at it all day though. We run around the countryside most of the daylight hours!

Anyway...very interesting update....
I started adding ground eggshells to her food (to act as Phosphorus-binders) I am told that because she had no Blood Phosphorus elevation when she was tested, that isn't so important at this stage....But I did it anyway. I didn't think it would do any harm.

Well, I gave her a 1/4 teaspoonful with her breakfast food (about a half-pound weight) and the same with her dinner (same weight) And tonight I look at her water dish, and can see that today her water consumption was HALF the amount she was drinking before. (she has been drinking water like it was going out of fashion for weeks)
Now I don't know if that really means anything yet. I might be speaking too soon. But there is a definite change tonight

[TwoBitsMom]

Ginger....I'm SO glad to hear you don't spend your entire day at the computer..!
And even better, I'm glad to hear Misty is just going with the flow, and probably enjoying her new and exciting menu...!  Ground eggshells are easy, a mortar and pestle really grinds them into a fine powder. You mentioned you cannot get Tums....?  Why not...?  Are they regulated by presciption only...?   Tums are available over the counter here in the U.S........HMMMM...what's up..?
Thanks for such and uplifting report on Misty....Have a great day...Connie

[ginger899]

No, there's no regulation against them or anything, it's just that I don't see them here in pharmacies, there are other products instead, like Rennies, etc... trouble is, the other products don't just have Calcium Carbonate, but other additives I'd be unsure about giving her.

She does seem to be drinking SLIGHTLY less today again. That's not my imagination as I measure her water. She got up to 800ml a day (28lb dog) which was  WAY more than she's drunk all her life especially as she does have some "wet" food too. Yesterday she drank 480, today about 500 so far. She won't take on much more now because it's late evening and she doesn't drink after about 11pm(!) dunno why!?

Anyway I've decided to cut to the chase, and stop myself having to carry the world on my shoulders. I have booked a consultation with a veterinary nutritionist, who is also a practicing veterinarian. She has the knowledge I need to be able to really trust what to do.

[TwoBitsMom]

Ginger....!
That sounds like a wonderful idea....!
I don't think we have anything like a veterinary nutritionist around Northern Minnesota....!
Lucky Misty....!  Having guidance with her new diet will be a big help.
I will be sure to check in once in a while to see how things are going for you both....Until then....Best wishes for both of you....Connie

[ginger899]

Thank you Connie.
I won't keep posting here now, unless there is something interesting to report. But I found the nutritionist online. She's not exactly very near me, but not too far away. I just googled "veterinary nutritionist" and then my area, and got through to this lady's vet practice. I liked the sound and "feel" of the place, and her work, etc, so am going to consult with her tomorrow morning.

[ginger899]

I'd just like to add an update in case it is of any help to anyone else whose dog has been diagnosed with early-stage kidney insufficiency ("failure" seems a rather harsh word to use for the very early stages!)

Misty is even better than usual right now. I spoke to a veterinary nutritionist. She put my mind at rest re: the Royal Canin Renal diet. And I have to admit it seems to suit Misty. She has had very good energy on it (2 weeks now)
The nutritionist did however, say that a little high-quality protein such as boiled chicken or fish or eggs with a few vegetables wouldn't do much harm at this stage.
Misty had no blood phosphorus elevation at her test. However I add a pinch of powdered eggshell to her food if she has anything OTHER than the Royal Canin diet. To "mop up" any phosphorus which will stress the kidneys. The nutritionist agreed with that. She did mention it wasn't the small amount of protein that was the problem, so much as excess phosphorus in her diet which could be hard for her kidneys to process.

She is still on the ACE inhibitors (no side effects at all) and continuing the month-long Amoxycillin course.
She now sleeps through the night without either wetting the bed -or diapers! Great! That means I don't have to get up before dawn to go potty!
And -she is drinking far less water.
And more importantly -she seems so very fit and well, with energy which is almost paranormal for a dog her age. Bless her.

All maybe good signs. She is due for another blood test mid November. Fingers crossed.

[Misfits4Me]

Thanks for the update Ginger...Please, keep them coming.....I for one, am following them.....Also, I'm praying for both you and Misty......Take care, Karla

[Margot49]

You have a lot of good info but I can add a little. When our Grey was diagnosed with renal disease, I was overwhelmed with all the info.  Of course, my Vet recommended the Science Diet ID.  I am not a fan of that food. I contacted Jean Dodds and we discussed foods.  She said make sure the food is low in phosphorus and recommended Wellness, I think it was. In the mean time, I was checking the Natural Balance and Evo canned food (the canned Evo after the cancer diagnosis) Anyway, I started feeding the Natural Balance Fish and Sweet Potato, which Dr. Dodds said was fine.  He has done well on that and he was also put on daily enalapril to keep the pressure down in the kidneys. Of course, he is over 12 years old now.  He was maintaining and eating the Natural Balance well but then we had the cancer diagnosis.  :-(  You might want to check on those foods. She did tell me to make sure of the protein source and make sure the diet is low in phosphorus.  Hope all goes well

[ginger899]

Thank you Karla, and Margot.
I HATED the idea of her eating that processed food which contains "animal proteins" (not specified) and "animal fats"....corn gluten... I was shuddering at the very thought...
Yet the vet nutritionist had no axe to grind. She wasn't selling me the food. She didn't work for Royal Canin. She did say it had excellent results with stabilizing kidney function. And apart from that I am a great one for "gut feelings"...and when I observe Misty's energy levels since being on the food they have been even BETTER than before. I must say I might have to put an emotional reaction to her diet change on hold....
What you see is what you get...?
OK so the meds might have something to do with it.
But I feel things are looking quite good right now, so I don't want to rock the boat too much.

We spent an hour in a beautiful Church today. Kind of by accident as a big storm came up on our walk, and we dashed in there for refuge, and the rain came pelting down, with thunder and lightning. Misty went right to the altar and lay down for a break, and I felt she would be looked after......for now anyway.....

[TwoBitsMom]

I just wanted to take the time to say...."Thank-You" ....for giving so much of your time to help so many of us....you are amazing....Connie

[ginger899]

I'd just like to add another update...
We went for her blood test the other day and it is GOOD NEWS. Her Creatinine and Urea nitrogen have both come down a lot! The levels are now at the borderline of "upper normal"
The vet and I decided to keep her on her tablets (Benazecare -ACE inhibitors) for the next 3 months and see what happens. He said it won't do her any harm.
She is now drinking much less water than she was drinking when she was diagnosed. Also she hasn't wet the bed for ages.

I'd like to take the opportunity to say that if anyone has a dog who suddenly starts drinking more than usual, no matter how fit and well the dog might seem...do take it to the vet for a blood test. If early stage kidney failure is caught early enough, and treated well, there is positive hope.
(There can be many reasons why a dog starts to drink more, kidney failure being one of them. But always run it past your vet)