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Kidney Failure in my dog...
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Kidney Failure in my dog...

My Deke is 12.5 years young and a Lab/Ridgeback mix.  He was diagnosed with beginning kidney failure about 1.5 years ago and was on the kidney diets since then.  He recently got weak in the rearend and his appetite decreased so in for labwork we went.  BUN: 131, creatinine: 11.2, phos.: 7.3.  After 2.5 days on IV fluids (just days, not nights), his numbers did not get better.  Vet said there's nothing we can do.  This was November 29 and she said he had 24-48 hours left.  Well, he is walking on his own now, wagging his tail, and growling at the mailman.  He is drinking but refuses all food and I have tried almost everything.  I am starting to see the weight loss (he's originally 90 pounds and very healthy - not fat at all).  He last ate about 1/4 cup chicken on Wednesday AM.  I syringed in about 5 TB of baby food today and he has not vomited since Tuesday.  I don't want to just give up on him but my vet is unable to tell me anything else.  Any advice?  Does anyone recommend going to an internal medicine vet at this point? .
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675347_tn?1365464245
My dog was diagnosed with very early stage renal failure about 7 weeks ago, she is doing extemely well, but I am always aware of her kidney weakness now, so I am learning fast about kidney failure, what it can do, and what foods are best. I have a heck of a lot more to learn yet. But some little tips -things I have discovered -I can pass on to you.

I have learned that the elevated phosphorus in the blood counts for a lot when it comes to nausea and vomiting. If it s possible to lower that at all, it can definitely help them to keep food down.
I would recommend to try him with white rice with low sodium (or no salt at all) chicken broth. That is simply water in which chicken has simmered. A little grated carrot or a few green beans can be added if liked. Plus one Omega 3 oil capsule, broken open and stirred into the food.

Another good Omega-3 containing food is a scrambled egg, lightly scrambled, with a little potato or sweet potato. To make the potato even ore tasty-smelling, you could put it under the grill until browned. I know my dog loves that, and the smell is appetizing.
Cook the egg only in olive oil. Sunflower and many other oils contain Omega 6 which is best to avoid. Olive oil contains only Omega-9, which is pretty neutral as far as kidney function goes.
Now, the important thing to go with this is a good pinch of powdered eggshell. The eggshell is pure Calcium Carbonate, and Calcium Carbonate helps "bind" phosphorus in the system.
The correct "dose" of powdered eggshell would be one half-teaspoonful to one pound of food. It isn't necessary to use it if the KD diet or another diet food like Royal Canin is used, but if any other protein-containing, or phosphorus-containing food is given, then it might help.

Wash eggshells, dry them brittle on top of a stove or oven but don't cook them (they smell pretty foul if you allow them to cook! You would have to hae your windows open for a week! I made that mistake once!)
Then grind them very very fine with a pestel-and-mortar, or anything else which does the job. (I don't have a pestel and mortar so ground mine in a sturdy dish with the hard wooden handle of an old kitchen ladle)

I know your boy is in late stage failure, but if his nausea can be controlled, he has a better chance of eating well, and avoiding malnutrition. Try him with small amounts at a time.
Also you could speak to your vet about prescribing anti-nausea drugs.

As I said, there is so much I do not now about KF, and a lot to learn yet, I can only help a bit with the things I have tried and find useful, so hopefully someone else will help us out here and give you some good advice.

It sounds to me like he is not ready to leave you yet. So all the best and good luck. Live one day at a time.


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675347_tn?1365464245
....By the way, my dog eats Royal Canin Renal diet, and they do a wet version (canned) It does smell quite good, and my dog loves it. I was thinking your dog might find that a bit easer to eat and a little bit tastier perhaps than any dry kibble?
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1924744_tn?1322847970
Thanx for all that.  I was cooking the low protein/low phosphorus diet but he stopped eating that on Saturday.  I then tried just boiled egg, then chicken breast, then scrambled egg, his treats, cheese, then peanut butter (an old favorite of his).  I don't care what he eats at this point, as long as he is not starving.  He either ate them once and then not again or refused all together.  He is NOT vomiting but just doesn't seem interested in any foods.  I will try the sweet potato in a few minutes and that's probably the last food I haven't tried.  
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1832268_tn?1326819610
Thanks for helping Dekesmom...Connie
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1924744_tn?1322847970
A big no to the sweet potato...I may go down to the pet store to see if they have Nutri-cal...saw that mentioned in another post.  And I have tried all sorts of canned food, usually the expensive better ones like Blue Buffalo but he won't even try Alpo at this point.  I wonder if a phosporus binder or other things would help him to feel better, enough so as to eat.  He looks interestedly at the food but then sniffs it and turns away.  My poor lil guy....
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1832268_tn?1326819610
Dogs seem to like stinky food....I have read that others will feed them something called green tripe...?  You might check into that when you are at the pet store.
Also ...could you give a quick summary of the meds or supplements that your dogs is currently taking...?  Have you tried SubQ fluids...?  
This info may help others with some new suggestions for you.
Thanks,
Connie
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675347_tn?1365464245
He's feeling sick, isn't he? That's why he can't face food. His body wants it but his appetite can't handle it.
Has the vet given him an anti nausea drug? Or an appetite stimulant?
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1924744_tn?1322847970
We were doing subqs every week until this last crisis.  We were just instructed to do a liter a day and will be picking up azodyl tonight from the vet.  Deke's not on any supplements and hasn't been for a while.  So we plan on using Tums, Azodyl, and maybe an appetite stimulant like Remeron.  
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675347_tn?1365464245
Yes Tums are a good idea. They are Calcium Carbonate too, so will help mop up any phosphorus (which many foods contain)

I thought about honey. Dogs often love it, and it is neutral as far as affecting the kidneys. It won't upset him. That is if he is interested in eating it. Honey on buttered toast might tempt him? Can't do any harm. And there is a lot of goodness in honey
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1872406_tn?1320893991
Dear Dekesmom,

Here is basic  list of the medication that the vet will (need to ) put Deke on:
Azodyl
ACE inhibitor
Antacid for acidity (pepcid)
Anti-nausea (either Ondansetron or metoclopramide). The latter is more effective as a sub-c injection
Phosphorous binder- I would go for an Aluminium based phosphorous binder rather than a calcium carbonate, - over the long term, calcium tends to deposit and the Al binders are also good for lining the stomach and intestine.  Something called Epikatin is also supposed to be good, but I did not have the time to try it...
Sucralfate: if acidity becomes a problem, this is something I would highly recommend.
Iron supplement that he can handle
Based on his haemoglobin levels, you might need to go for erythropoetin injections. Erythropoetin is synthesised in the kidney, so this deficiency is a big reason for anemia. The epo injections did not help Cookie much, but please do try with Deke.

In addition, please start supplements as soon as yo can : Vit E, CoQ10 and L-Carnitine are beneficial for CKD. Particularly the last, which helps with the muscle wasting due to  uremia.
The unfortunate things is it takes time for the effects to start kicking in, so it is better to start early...
Please syringe feed him if he wont eat on his own. Whatever he can eat on his own is a bonus, but you have to ensure that there is some food (the ight sort) is going in. The shocking fact is that of all deaths among pets with CKD,, >80% are because of either euthanasia or malnutrition. And i know from my experience with Cookie, that the biggest cause of suffering is the gastritis and nausea. With aggressive treatment, you can I think at least control these symptoms. Oh, and CoQ10 is available as a water additive, that also may clear his breath a little and help him taste better...

Cookie pulled it out till her Creatinine levels hit 18 (BUN stayed low becuase of diet control and Azodyl) and I like to think that she did not suffer too much - except of course for the inability to do the things she liked.... and she died of a cardiac arrest- probably due to hypoxia of the heart caused by her severe anemia...I wish I had started all this a year earlier than I did, even when she was clinically normal and she may have been with me for some more time...
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1832268_tn?1326819610
I am so glad to hear that you have a plan...my thoughts and prayers will be  with you....You are in good hands with Cookiesmum and Ginger....Connie
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1916673_tn?1388595391
Hi. I put a message for you in the first thread last night, which you may not have seen. I have returned to this new thread today to see how Deke is doing - and to offer what little support I can to you. Cookiesmum gave a comprehensive reply, which I think puts the treatment into a nutshell. It's a brilliant reply, which I have actually saved to my PC for the future, should it be needed. TwoBitsMum mentioned green tripe, which most dogs will eat because it stinks but is full of nutrients. I tried this with my BB and it was in the end the only things she would eat before she stopped taking anything at all. Green tripe is generally available at pet stores and comes in a frozen block, which can then be cooked as needed (I tended to microwave as it was simple and easy to do, about 6 minutes on half power).

I sincerely hope Deke is a little better today. Please keep posting when you can. We are all thinking about you and your Deke. Tony x
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1924744_tn?1322847970
Thanx for all the input and well wishes so far.  We have decided to take a palliative approach with Deke and just keep him comfortable at home.  I tried the azodyl last night five times and he continued to spit it out.  I even tried syringing some water in after pushing the pill in to get him to swallow - which he did...but as soon as I let his mouth go, here comes the pill!  I give him sucralfate in case of ulcers and torbutrol for any pain he may be having, and he does swallow the tagament to reduce any acid.  He stopped eating on Tuesday so I don't think anything will help at this point.  He still drinks a bit of water and has not vomited since Tuesday.  I'd rather not torture him by shoving pills down his throat several times a day.  My mother-in-law - a great woman - does hospice care nursing and I am going with that philosophy.  When someone is too sick to keep going, they often stop eating and just start to fade away.  All you can do is respect them and keep them comfortable.    
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1916673_tn?1388595391
You and your Deke are in our thoughts. Give him an extra cuddle from me. Tony x
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1832268_tn?1326819610
Thinking of you and Deke, today and in the days to come.
You know your dog best....
If Deke is refusing the food and treatments, then you are doing the right thing. Keep him comfortable...give him lots of hugs,tell him how much you love him, and tell him he is the best friend in the world.
My thoughts and prayers are with you both.
Connie
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462827_tn?1333172552
I'm thinking about you both, too.....I hope you enjoy each other today.....Hugs & kisses from me, also.......Karla
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1868280_tn?1320169073
May Go Bless You, I know the pain you are going through and the true love you have for your dog Deke. He knows your love for him and he will always be a part of you. Deke is your family and I add could not had a better friend than you Deke's Mom. You should know you did everything right and your love and his love with for you will last on forever.

Mark
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Avatar_m_tn
Try GREEN TRIPES. One place to get them is greentripe.com. My boy has KF and is super picky. Green Tripes does it !
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