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kidney disease uncovered by chf episode in dog
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kidney disease uncovered by chf episode in dog

My sweet 14 year old Pomeranian had an episode of Congestive Heart Failure 2 weeks ago.  He was treated successfully and responded well to the Lasix, etc.  However, when he had his follow-up work a few days later, his kidney levels were bad - over 11 phosphorus, high BUN and creatinine.  We took him to the hospital for hydration and the BUN came down to 87, creatinine a little above normal.  On follow up a couple days later his BUN was 140, creatinine 2.8, and phosphorus normal.  His behavior is less exuberant than normal.  He had a bit of vomiting yesterday, no diarrhea.  His appetite today and yesterday was not too good.  The one day he had the Mirtazapine  he was his normal self and ate well.  My vet said to come back in a month for blood work and keep doing what we were doing.  However, I am concerned that I should be doing more- particularly with his diet when he does eat well.  Right now, with a lowered dose of Lasix, his heart issues seem well managed.  

Is there some more aggressive treatment, especially in terms of diet?  
Is his outlook is so bad, doing anything more will be fruitless?
Is a month soon enough to keep a good eye on his kidney blood levels?

Thank you.  We want to keep our buddy as comfortable and happy as we can as long as we have left.  

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82861_tn?1333457511
Kidney failure is one of the most heartbreaking conditions to strike a dog and its owner because there really isn't much of anything that can be done to combat it.  By the time symptoms appear and are confirmed by lab results, too much damage has already been done to the kidney cells to arrest its progress.  Unlike the liver, kidneys are not able to produce new cells.  Once they're damaged and die, it's permanent.

The idea behind treating kidney failure is to slow down the damage and treat the symptoms - primarily nausea and vomiting.  If your dog continues to vomit and avoid food, by all means take him back and ask for something for nausea.  You may need to learn how to administer sub-q (under-the skin) fluid injections if your dog cannot stay hydrated on his own.  

While phosphorous is necessary for life, it is deadly to damaged kidneys so you need to feed a low phosphorous diet.  At some point, you'll need to add a phosphorous binder such as calcium (unless his calcium levels are already too high) or aluminum hydroxide.  These things bind to phosphorous and help sweep it out of the body before it can do further damage to the kidneys.  Calcium is easy to find in the form of unflavored Tums tablets.  I found aluminum hydroxide more difficult to find in a pure state without other ingredients.  It's a common active ingredient in over-the counter antacids.  If you can find Alternagel in your area, that would work well.  Check with your vet on dosing requirements.  It may be necessary to order it from a compounding pharmacy.  If you can keep the phosphorous levels down, the nausea won't be as bad.

As far as nausea meds go, you'll want to avoid Reglan (generic form is metaclopromide).  It works by increasing gastric motility and it was only somewhat effective for my dog in the early stages of kidney failure.  When she was in the deep late stages of failure, it caused terrible side effects.  Reglan is metabolized by the kidneys, and since hers weren't working it built up to toxic levels in her bloodstream.  Symptoms are extreme restless and shaking.  That reaction can be treated as an allergic reaction with benadryl.  I found that phenergan was the most effective and cheap nausea medication for my dog.  Many vets aren't aware that dogs can take phenergan, so your vet may have to send you to a pharmacy for it.

There is really no telling how much time your dog has left.  It's a tough act of heavy-duty nursing and attention to symptoms to keep your dog comfortable.  Like people, some dogs fight for every last moment of life and others quickly give in  There's no way to tell until you try.  Here is a link to what I found to be the best resource on managing kidney failure in dogs.  It explains lab results, medications and includes a tremendous amount of dietary information.  Take your time and read through it.  I'm sure you'll find some things there to generate a conversation with your vet.  Meanwhile, enjoy every moment you have with your dog.  You've obviously taken great care of your buddy for many years and I'm sure you'll continue now that he's in his final weeks and months.  Please keep us posted on his progress.  :-)
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82861_tn?1333457511
Might help if I pasted the link!

http://www.dogaware.com/health/kidney.html
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974371_tn?1364538460
Jaybay gave all good advice.  I'm dealing with that now in our 12 year old Greyhound.  Yes, you need to watch the phosphorus levels.  I am presently feeding Natural Balance Fish and Sweet Potato.  We are also using Pepcid twice a day.  You might want to ask your Vet about that.  
Oh man, stay away from Reglan.  Docs gave me that once for bad nausea after a surgery. I got very restless and had tremors. Doc pulled me off that right away.
Sounds like your Vet is pretty much on top of this.
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1623561_tn?1299944237
Thank you so much Jaybay and Margot.  I am sure I will come back here many times for info.  I've been so sad. It's good to be in a place where people know how you feel. Right now, Foxy had a great day, and I am trying to be grateful for every moment I have.  All dogs are so special, especially your own.  

By the way, no vet has suggested Reglan to me - but I am glad to have the info.  Foxy is already on Pepcid.  His appetite has been poor and, unfortunately, he is a dog who is used to holding out for the good food, and he is refusing to eat the more healthy stuff, so I am constantly worrying about his diet.  However, with Mirtazapine (sic?), he is very perky and has had a great appetite.  He has only come back from the hospital 4 days, so we will see.

I would like to start making food for him to make sure he is correctly nourished, however the veterinary staff thus far have been more concerned that I get him to eat than anything else.  I was advised only to try to stay away from processed food.  Perhaps, if he continues to hold his own, there is a little time to learn more about this.  Thanks again.
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942557_tn?1272698419
Purina has a prescribtion diet food for kidney function..My peke eats the Purina K.D. food and seems to like it.As far as lab work, My vet ran labs and then another set in 2 weeks.Then we waited a month to check again.Dont give up hope there is still alot of things that you can do to help your baby.I know it is hard when they dont feel well and we dont know what to do to help them.Your baby is very lucky to have someone like you to care for them and to try to help them like what you are doing.You will both be in my prayers.Please keep us posted
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The KD diet is prescription and merely a low-phosphorous and low-protein food.  For decades the theory was that protein should be avoided because it's hard on failing kidneys.  Dogs absolutely must have protein to maintain good nutrition, so what you're looking for is a more easily digestible form of protein.  You can achieve this goal by making the food yourself.  Check out the link I pasted above for lots of different recipes including phosphorous levels for various foods.  

I understand your vet's advice about getting your dog to eat anything at all.  Nausea is so bad with kidney failure that at some point, they have to eat something even if it's not the best thing for the kidneys.  I gave my dog a daily multivitamin to help with the malnutrition.  It was hard to find and I nearly went blind reading labels, but managed to find a senior dog vitamin with no phosphorus.   Since the urinary tract can be painful with kidney failure, I also kept her on Cranassure capsules to help with that.  It did seem to help and she had no more nighttime explosions of urine.

I know all this must sound completely overwhelming to you.  My experience was that each day was different - some better, some worse but the general direction was downward.  One day she would have a great appetite and the next she was vomiting and lethargic.  All you can do is treat the symptoms the best you can.  If it's caught early enough, kidney failure can be managed for years and the dog may die of something totally unrelated.  It all depends on the underlying cause and how much damage has been done before diagnosis.  Hang in there and keep us posted.  :-)

Give it a couple more days, and if your dog still shows no interest in eating, ask for some phenergan or cerenia.  Cerenia is so expensive I couldn't afford it, so went for the phenergan instead and it works wonders.  One of my dogs has a sensitive tummy and about every 6 weeks his guts make so much noise you can hear him across the room.  He totally stops eating and lays around in misery.  One phenergan pill has him back to normal in 15 to 20 minutes.  It's great stuff and very cheap.

One of the first things you could try is plain boiled dark poultry meat - legs are perfect.  Mix it 50/50 with cooked white rice and see if that will gain some interest.  Hard boiled egg whites are another good source of easily digested protein.  Use only 1 in 4 of the yolks since they're high in phosphorous but have lots of other great nutrients.  Your vet probably checked her calcium with the other labs, so ask him if it was normal.  If so, add a plain, unflavored tums tablet to her meal.

How's your pilling technique?  I got to where I was stuffing pills down my dog's throat several times a day.  Since she wasn't really interested in food I couldn't mix meds in with a meal.  Chica was also a master at working her tongue around the pill to spit it out while keeping the food.  LOL!  She didn't mind being pilled and I knew she got exactly what she needed.  I know it can look awkward, but if you move fast and get it past the hard palate it'll go right down before they know what happened.
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974371_tn?1364538460
Actually, and it is on a kidney diet, try green tripe.  I found it canned in PetCo.  It stinks but most dogs seem to love it and it is good for them.
There's some research that shows that Enalapril also helps kidney function in general in dogs, in addition to helping control blood pressure.  My Vet started our Grey on a low dose.

This is also off the boards.  There are some very knowledgeable people on there, so take what you can from it but always discuss your particular situation with your Vet.
At the beginning stage the best thing to feed are proteins that are at the top of the bio-availability chart, such as fish and eggs. These will put the least amount of strain on the kidneys. Mix these with sticky rice to bring the Phos content down further, while keeping the calorie count up. The rice adds some B Vits and other nutrients too. Take a look at nutritiondata.com. You will see that whole brown rice has something like (I am going off memory here...) 165 mg of Phos per cup. While sticky rice (the type you use in sushi) has 12 mg per cup. Balance with a therapeutic dose of Omega 3 and a vita/mineral supplement. When they get a bit farther along start adding a Phosphorus binder. When they get to end stage you need to restrict protein.



Here is some other links that may help off my Greyhound boards.  Excellent site.
http://www.dogaware.com/health/kidney.html
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1623561_tn?1299944237
Thank you all so much for the great advice.  I have been on dogaware site and now will make sure to read it more thoroughly.  I am very sad today because I have to go to work and leave my little buddy behind.  He comes with me when I am in the office and loves it, but today and many days this week he won't be able to come.  My husband will care for him - but I don't like to miss a day with him.

He is already taking Enalapril for heart function, so I'm glad to find out that it is good for kidneys.  He has taken pills very well with food until lately.  However, when I have to pill him, he fights like crazy, shakes his head, gags, etc.  I hate to put him through it.  He sometimes spit them out - his throat opening is so small, it's hard to get the pill down far enough.

Re: diet - I made some dark poultry meat and broth and am trying to find acceptable carbs to mix with it that he will like. I put potatoes in it with the broth of the soup and he accepted them after he has had his appetite stimulant.   I haven't tried sticky rice, but will look for it now.  He actually spits out individual grains of white rice I've tried with him.  He is very fussy, but so cute.  

Well - off to giving him meds and to work. Hopefully he will eat.  Thank you all again.
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974371_tn?1364538460
try sweet potato instead of the regular potatoes.
You may find sticky rick in an Asian market.  Some I know order it on line.
I give our Grey his pills in the small pill pockets twice a day and he eats them right down.
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What other meds is your baby on besides Enalapril.My Peke is on Enalapril, Vetmedin and lasiks.She also takes 1/2 a pepcid a day and Sulfracate.It helps her from getting ulcers from her meds.You could try getting some of the Nutri-cal and putting Foxy's meds in it.Also pumpkin is another way you could try.When my baby first went on her meds she did great and then she started spitting her meds out.I tried all kinds of things and since they have little mouths it is hard to pill her,But after a couple of weeks she got better about it.IWell i hope that Foxy is feeling better.Take care and God Bless
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1623561_tn?1299944237
Hello Chasha33,

Foxy is taking 1/4 Enalapril,1/4 Pepcid, and 1/4 Mirtazapine related to the kidney issue.  He also takes a bit of lasix (furosemide), and Vetmedin for his heart disease.  Enalapril also works on the heart issue.  His heart medicines are working fine.  Nutri-cal sounds so familiar - where would I find it?

How old is your Peke?  Has he been diagnosed long?  Do you do subcutaneous fluids?
The vet didn't suggest that to me yet.  I hope he continues to do well.

I will be trying all the food suggested here.  However, it seems as if I don't have enough time to do it all because of work.  It worries me.   I had to leave him to work yesterday and I hated to, but I think he was able to get a good day's rest with my husband there and he was very perky and happy when I got home. However, this morning he is nauseous again and doesn't want to eat.

I've had a hard time, of course, but a friend of mine with a young dog with kidney failure said she was the same way at first.-crying all the time, etc.  Now it is better.  

I so appreciate your interest.  God bless you and your Peke as well!
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942557_tn?1272698419
You can find Nuri-cal at most petstores like Petco ot Petsmart and alot of vets carry it.I know how hard this has to be for you.My peke Snowball is 12 years this all started  over a  year ago.I took her to the vet cause she had gained 8lbs in a few weeks.I didnt know what was wrong with my baby.Well  it took several weeks and lots of test and 3 different Drs and then they found out it was CHF and her kidneys.But her lab work would change every few weeks durindg all of this.Sometimes she was fine then her Bun and creatinine levels go up.Her lab work for her kidneys would look like a normal for her age then they would get high.When we found out what was wrong my vet did labwork and then waited 2 weeks after she started her meds to check again and then  waited a  month.My vet put her on the Purina KD and  I do feed her  KD to help cut back on her sodium intake.Cause restricting there salt helps prevent edema,ascites,and hypertension.Also KD has low protein and protein is hard for them to metabolize when they have kidney problems.Also the phosphorus in the kd is lower.With the kidneys and the CHF problems, Foxy needs a food that will help all of that.I also feed Nutro holistic.
I havnt had to do subq's on her But i did have to do them with my other Peke.Foxy seems to be a really lucky little guy to have you.I will keep ya'll in my prayers Take Care and God Bless
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1623561_tn?1299944237
Thanks so much Chasha,

I need to do something about food as I constantly worry I am killing him quicker - though he is eating homemade dark meat chicken soup with carrots and low sodium broth as well as hamburg.  Carbs are a problem and he won't eat pills without something he likes.  I am going to the vet tomorrow because he is coughing a bit more and I am worried his CHF is acting up.  I will ask more about food help then.  He is so fussy, I am not sure he will eat KD.  I am willing to cook though.  I will keep the forum updated.  I find any support I can get very helpful and restorative.
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462827_tn?1333172552
Here's 2 balanced recipes for Kidney disease........I know I have another one, but haven't found it , yet...I'll keep looking......Karla

LOW PROTEIN DIETS  
( Thanks to Lowchen's )

http://www.lowchensaustralia.com/health/diet2.htm

Low protein diets play a role in the treatment of several conditions, such as kidney disease, advanced liver disease, and some forms of dominance aggression.

[If your pet has been prescribed a low protein diet], but doesn’t like any of the commercial preparations, you might consider trying one of these home-cooked recipes.


EGG & POTATO DIET
(low-protein, low-phosphorous, high-potassium, normal sodium) for Dogs

1 egg, large, cooked

3 cups potato, boiled with skin

1 tablespoon chicken fat

( *THE (1 1/2) CALCIUM CARB AND THE 1/2 NuVET vitamin is correct for a dog under 10 lbs )

1½ calcium carbonate tablets (600 milligrams calcium)

½ multiple-mineral tablet

THIS IS ENOUGH FOR 1 DAY OF AN 18 POUND DOG'S NEEDS:

Provides 600 kilocalories, 15.1 grams protein, 18.5 grams fat. Supports caloric needs of an 18-pound dog.

Provides phosphorus at 53 percent, potassium at 322 percent, sodium at 114 percent of dogs daily needs.

TO reduce the Salt - take away the chicken fat....

***********************************************************
1/2 to 1 NuVET plus wafer per day for all dogs on home-made foods or commercial diets:
Order your NuVET here:  http://www.nuvet.com/81098
Tell them you are working with PET Nurse Marie and some home-made special recipes.  ( use Discount code 81098) when you call in : NOT sold in stores;   1-800-474-7044
************************************************************

NEXT -


CHICKEN AND POTATO DIET  ( LOW SALT )***************
(low protein low phosphorus, high potassium, low sodium) for Dogs

¼ cup cooked chicken breast

3 cups potato, boiled with skin

2 tablespoons chicken fat

1 ½ calcium carbonate tablets (600 milligrams calcium)

½ multiple vitamin-mineral tablet
( NuVET supplement vitamins)
SEE order link Above*

THIS is enough for a 22 POUND Dog per Day :

Provides 689 kilocalories, 18.9 grams protein, 26.8 grams fat. Supports caloric needs of a 21-22 pound dog
Provides phosphorus at 45 percent, potassium at 301 percent, sodium at 54 percent of a dog's daily needs.

PLEASE only use GRAIN free treats-
INNOVA EVO and WEllness CORE make a nice Grain free treat.
There is also a brand called NO GRAINERS - very good treats.


HOPE this helps - MUCH better than the Awful HILL's RX stuff...
YUCK - MOST dogs don't like the HIlls Rx or Science Diet.


BEST wishes...

Marie Peppers LPN MA
Ask the VET Nurse
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
******  The Calcium Carb. tablet is a regular Human "Tums
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462827_tn?1333172552
Two more:

Beef and Potato Diet

(Low-protein, low-phosphorus, high-potas­sium, low-sodium)

    6-7 ounces lean ground beef (raw weight), cooked please***

   3 cups potato, boiled with skin or without skin ...

    2 tablespoons chicken fat
1/8 cup of green beans ( canned with no added salt)

   1 1/2 calcium carbonate tablets (600 milligrams calcium)

    1/2 multiple vitamin-mineral tablet  NuVET ( Holistic and very safe)

Provides 737 kilocalories, 18.6 grams protein, 32.5 grams fat

Enough for : Supports caloric needs of a 23- to 24-pound dog

***************************************



Eggs and Rice Diet

(Low-protein, low-phosphorus, low-potassi­um, normal sodium)

2 egg, large, hard-boiled

2 cups rice, long-grain, cooked

2 tablespoons chicken fat
1/2 cup of green peas or yellow wax beans..

2 1/2 calcium carbonate tablets (600 milligrams calcium)

1/2 multiple vitamin-mineral tablet or powder ( SEE NuVET)

Provides 721 kilocalories, 15.2 grams protein, 31.4 grams fat

Supports caloric needs of a 23-pound dog



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82861_tn?1333457511
Regarding the pill issue, have your vet show you how to quickly "pill" your dog.  Once you get the technique right, you can pop it down his throat in a millisecond with no gagging or struggling.  It's important that he gets all his meds and that there's no question that he got them all down.  I know pilling can look awful, but if done correctly it's not at all traumatic for the dog.  I had to stuff so many pills down Chica's throat that as soon as she saw me coming with the bottle she just opened wide. :-)
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HI, I also have a precious black Pom of 14 yrs of age.  He has problems with his hips and has been doing fairly well until Jan 27th of 2011 when his companion of 14 yrs our darling 16 yr old toy poodle died.  they have been together since Shadow (Pom) was 3 mos old and Napoleon was 18 mos old.  they slept together, when every where together, even with us on vacations.  Napoleon suddenly developed lung disease of some kind in Dec and had to be put down on 1-27-11.  Since then Shadow has been going down hill.  He developed a growth h near his anal glad which had to be removed and due to a lung xray the vet found two nodules in Shadow's lungs.  He was put on Tramadol for the pain in the hips and every time he takes it he pants very heavily.  I cut the dose in half and it still is not doing the trick.  After the surgery he had a pain drug called Metacam and he threw up from that.  I too, cook all the food like chicken breasts and rice and carrots and sometimes beef shanks from soup.  He seems to have a good appetite but he is not nearly the funny and peppy dog he was.  I know what you are going through having to leave him to go to work.  I work part time at the local library and don't want to go and leave him either.  We adopted a little 8 yr old toy poodle (female) that was a rescue dog hoping that would help him forget about Nappy but although he seems to like her his zest for life seems gone.  It is so hard to see your babies sick, I hope that you can get your little Pom feeling better soon so you can feel better,believe me I suffer when the dogs are not well and still am grieving over that loving poodle.  Little Chucky Valentina seems to help the household feel a little better and she is so happy to be with us.  Please let us know how you and the dog are doing, I am praying for you.
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Hi Everyone,

I am so thankful for all your comments.  Blondie - I am so sorry to hear about the loss of your poodle and now, Shadow's illness. What you wrote is exactly how I am feeling.  Thanks for your prayers and good wishes.  I hope you will see Shadow perk up very soon.  

My little Foxy is doing okay.  He has had many good days since I first wrote.  Today, however, is one of the rare days when I had trouble with the pills.  He is throwing up a bit too - usually after drinking water.  He hasn't eaten well in the last 2 days.

The problem is - he is so fussy. He refuses to eat potatoes, spits out rice, etc.  He only is interested in protein - especially salty protein.    Normally, before he was sick, we would give his food and then wait and eventually he would eat it.  Now, he is not as likely to eat at all.  My vets say the most important thing is to keep him eating, so we have given him some of his favorites with the healthier meals to get him going.  That usually works, but not so well the last 2 days.  I wish they could make healthier food tastier.  I am hoping he will improve again, but know that, eventually, he will succumb.  

My vet is doing the kidney panel Monday - so Foxy has made it a little over 3 weeks since he was in the hospital.  I will ask the vet to give me a lesson on   how to pill him.  However, when he was in the hospital, they had a very difficult time giving him pills, but I am hopeful.  

Best wishes to you all and to your dog buddies.  I will continue to come back for your very helpful comments.  Thanks again.

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I lost my sweet sweet angel, Taylor one week today.  She was 16 1/2. I have children two young boys and was a grief counselor for years and am grieving like a baby. I'm do broken hearted, but want others to really know what all went on for others sake.  She was onLASIx(sorry for spelling I pad auto correct and children asking for me)and benzapril, and three other things. I truly feel the meds ran her kidneys into weakness and that's why she died. I wish I could turn back the clock.  Her murmur was bad the last few weeks, but I just think her meds were too much on her. Maybe Im Just sad and in the stage of denial still but I feel I could have done more
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Sorry. Lots of typing issues and spelling. It's hard through tears.  
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1832268_tn?1326819610
Hello TaylorMonroe....
I am so sorry that I was not able to reply to your post sooner.
It has been 6 months since I had my sweet little Yorkie euthanized because of Kidney Failure.
I still grieve for her and wish that I, like you, could turn back the clock.
I know that I had her euthanized too soon, and regret that I even found out about the Kidney Disease.
I will always wish that things would have been and gone differently...but...I cannot change what happened.
TwoBits was 15 years old, and she was ALWAYS by my side...every step of the way. She was always right beside me.
I would give anything to be able to change the way things ended, but unfortunately I know that is an impossibility.
I try to tell myself that her death, at my hand, happened for a reason.
And I tell myself that I am glad that she did not have to get any sicker before she died. But....that does not seem to change the fact that I feel like I could have done more for her, and I feel guilty about having her euthanized when I did. Still....life goes on, and I know that TwoBits would not want me to spend the time I have left, dwelling on the fact that she was sick, and I helped her to die a peaceful death. To dwell in the past, only robs us of the present.
I know I only ALWAYS wanted to do the best I could for her, and she knows it too.
I am sure your sweet angel Taylor knows that is what you only ALWAYS wanted for her.  
Both of you were so fortunate and blessed to be given 16 1/2 years together. The number of years she lived, is certainly due in part to the wonderful care you gave to her.
You did the best you could....without you in her life, who is to say what may have happened to her.
I know you feel that you could have done more for her....As we ALL DO...
Whether or not that is true, ( which I doubt).....the fact remains, that
NOBODY COULD HAVE LOVED HER MORE THAN YOU DO...!
And because of that fact alone, nobody could have, or would have, done more for her than you did.
She was right where she belonged....with you....for 16 plus.... wonderful years.
I know how much your heart is breaking....I also know that all the kind words in the world, can not, and will not, make you feel any differently about what happened to Taylor.
But I do want you to know that you are not alone in your thoughts.
I also want you to know, that you have come to the right place for support, as there are many wonderful people here, who understand your loss and grief.
Taylor was a very lucky girl, to live her life in the company of someone who loves her as much as you do.
God Bless her Beautiful Spirit and Soul...she is much loved.
Please accept my heartfelt sympathy and understanding....
Connie
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1832268_tn?1326819610
Ok...well due to the tears that were interfering with my typing abilities...after re-reading my post...what I meant to say was...

I am sure your sweet angel Taylor knows that you only ALWAYS wanted what was best for her.  

Dang Tears.....!  
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My sweet girl Missy who will be 16 in August was diagnosed with CHF almost a yr ago, she has been doing pretty well! The only meds she has been on is enalapril 1/2 tab twice a day. About a month ago I just noticed that she was coughing a little bit more and just not acting like her self, so I brought her to vet where she was diagnosed with 3rd stage Kidney disease. I have been reading all that I can about the disease and just crying. The vet put her on kd food ( that she ate up the first couple of days) and also 1/2 tab of pepcid twice a day.  But her appetite changes from day to day on what she will eat. I was using the pill pockets for her pills but some days she turns her nose up at them, it stresses both of us to give her the pills down her throat, will have to ask vet suggestions. She goes back to the vet for her 30 day blood recheck tomorrow. I fear she has lost more weight and feel like I should have called vet sooner to ask for more suggestions. I was trying to feed her the right food, but did occasionally just give her anything she would eat. I sure hope we get a good report tomorrow, some days she seems like her old self with energy and other days she seems to have trouble going up one step, so I carry her up or down the one step when I need to.
I love her so and want to do everything I can to help her. I am going to ask vet tomorrow about suggestions on home made diet for her or anything to get her to eat!

Melinda
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I am very sorry to hear about Missy. You must be devastated by this additional problem on top of the CHF. There may come a time fairly soon when you will need to consider things like I/V fluids and I would certainly suggest keeping her on the pepcid, as it will reduce the tummy upsets and encourage her to eat. It sounds like you have done an amazing job so far - and to have reached 16, Missy is an amazing dog. I'm sure you have already realised the prognosis for kidney failure is bad, as there is no cure, but if she is in 3rd stage then you still have a period of time with her, so just enjoy it as much as you can. Your vet sounds like one of the good ones, so keep him up-to-date with how Missy copes with things and certainly keep asking him any questions you have about her condition and how best to treat and manage the symptoms.

My heart goes out to you. I know from experience how difficult this is for everyone involved. Use this site for support ... there are lots of good, friendly and empathic people here. Tony
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I know, obviously you want to keep her on the diet food and not step away from it too far. But my feeling about her taking the pills is ANYTHING she might find irresistible in which to wrap the pills will do.
I mean, she would only be getting the odd morsel of non-diet-food a couple of times a day, I don't think that would do too much harm. If you get some hamburger meat/chicken breast/soft cheese/scrambled egg....whatever takes her fancy, about a marble-sized piece or a tiny spoonful, wrap her pill in that, let her sniff it, then make a big thing of giving it to her, get her to sit for it, etc, like it's a real treat....it might just slip down very fast!
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So, so sorry for your loss! I am sure that Taylor knew how much she was loved! I think when we lose someone that we love we always second guess ourselves but you must know that you did everything that you could and I am sure she knew that too. My heart goes out to you and your 2 sons!

My sweet girl is almost 16 and I am already besides myself, don't even want to think about the inevitable! I am praying that when it is her time that she just doesn't wake up one morning, so I don't have to make that dreaded decision.

Please try to take comfort in the love & joy that the16 years you had with your sweet Taylor!

Melinda
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We are back from vet's office, they did the blood recheck, will know results on Thursday. I was so worried that she had lost weight but she stayed the same. But the vet said, the healthiest food, KD or another low phosphorus would be best for her but the most important thing is to get her to eat ANYTHING!

The most important thing the vet said is, NO ONE is giving up on her. I like him so much, he is very understanding and just loves animals!

Sometimes she looks like her old self, she still likes to go outside too. But usually at night she is restless and looks up at me like mom, why can't you find something I like to eat or why can't you make me feel better. Or at least that is what I think her look means.

Thanks for your support and advice, it really means allot to know I am not alone!
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Ask your vet about including a little powdered eggshell in with your dog's food if you feed her something like egg or chicken breast (which are examples of "high quality protein foods")
Eggshell is pure Calcium Carbonate, and binds to Phosphorus. Also it just involves a pestel and mortar and a lot of "elbow-grease" to prepare it, is almost no-cost, and is additive free.
So that might mean she can eat some more palatable foods without the worry about the Phosphorus content. I would still be circumspect, however, and not go overboard with high-Phosphorus foods.

Also you can ask your vet about anti-nausea medication. It will be the Blood Phosphorus presumably,causing the nausea, causing her to lose interest in food.
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Thank you for the suggestions, the vet did say that we may add a phosphorus binder but he wanted to get results of blood work before he suggested to make any changes.
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Yes it would be important to know the results of her bloodwork first. If her blood Phosphorus is not elevated, there is less of a worry. Also you wouldn't want to get her Calcium out of balance, so see how that is before adding a Phosphorus-binder.
My dog was diagnosed with early-stage kidney failure last October. In her case the blood Phosphorus was not elevated. As a result I was very careful about adding Calcium Carbonate to any Phosphorus-containing foods. I did it sparingly if ever she had something like sea fish. Apart from occasional chicken breast and scrambled white of egg, the vet recommended "Fresh-water White Fish" as a possible OK food for kidney insufficiency. But I found that impossible to obtain. I added a little powdered eggshell whenever I gave her whole egg. (Yolks of eggs contain Phosphorus)

By the way if you add Calcium Carbonate do not give any medications about an hour each side. Calcium Carbonate hinders the absorption of medication.
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The vet just called, her BUN and creatine stayed about the same (that was a relief to hear) but her phosphorus is elevated, so he does want me to start administering a binder. He wants me to give her aluminum hydroxide (sp). I did not mention the powdered egg shell but will try to remember when I call him back later today.
I have been able to get her to eat chicken breast the last couple of days, I keep trying the KD food too but she doesn't show any interest.
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