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question about kidney disease

Hi, my dog Phoenix is in Stage III renal failure.  I had her tested about 3 months ago, she is going to be tested again on Saturday.  She was diagnosed last October and the vet said 3 months to a year for life expectancy.

Phoenix stopped eating in January, at which time she went on SQ fluids 2x a week, along with Pepcid AC and Maalox to bring down her blood phosphorous.  This turned her around bigtime.  She gained 4 pounds, got her appetite back, etc.

Now, she is very lethargic (although is still VERY happy to go for a ride in the car) and eating less and less. She won't even eat chicken.  I am basically feeding her whatever she will eat (stale bread and donuts this week, cat food last week). She has lost 2.5 pounds in the last 3 weeks.  She is still drinking water, has diarrhea frequently but no vomiting.  She is 13 years, 10 months old and is a Redbone Coonhound mix. She should weigh 62 pounds but only weighs 50.

My question is this: how close to the end does this sound to you? (I know I should just wait for Saturday's bloodwork, but hey.)

Peggy
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1916673 tn?1420233270
Hi. Well, those anti-nausea meds should be doing the job. I had to laugh about the green tripe incident - and I'm also really pleased she ate it. There are so many good nutrients in green tripe, it can only do her a world of good. Fingers crossed for a repeat performance tomorrow. Have a good evening. Tony x
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Avatar universal
She takes Pepcid AC 20mg and 500ml of Maalox Extra Strength 3x a day.

Just to make a liar out of me, she ate half a can of green tripe last night. I could tell she didn't like it, but Tully was gobbling it down and she didn't want him to have hers. Something to say about being the Alpha...
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1916673 tn?1420233270
Hi. I do know it can be exhausting and frustrating, but this is probably a relatively short term thing, so stay brave and just keep doing what you're doing. I remember going through this dreadful process and virtually jumping for joy when my girl, BB, ate anything at all - though this was towards the last few days of her all too short life. I even gave her my sirloin steak straight off my plate at one point, which she took one bite of, then refused the rest.

Without checking back through the thread ... is Phoenix on an anti-nausea medication? If not, I would ask your vet to start it. It will encourage her to eat more and - importantly - a wider variety of foods. If she is already on anti-nausea meds, ask your vet about changing to something that may work better.

As always, you are in my thoughts. Stay strong. Tony x
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Avatar universal
I feel your pain!  Daisy stopped eating after her hospital stay and only wanted cat treats for days.  I bought new dog food, smaller bite version and she ate that for a few days.  She was very particular, one day she loved chicken, the next she hated it... a day later, she loved pork then hated it.  The only thing I advise about the meat sauce is the acid in the sauce could cause nausea and reflux.  Just be sure she's keeping it down.  Right now, you don't need to focus on feeding her the right things, just get her to eat.  Have you gotten any nausea medicine for her?  I know when I'm sick, I don't want to eat either.  Daisy responded well to the Cerenia injections we gave her - the first round... then 2 weeks later, they did nothing for her and we ended up losing her that following weekend.  

Grieving is the toughest part - trust me!  People say it gets easier with time, but there are still days that I BAWL my eyes out and miss her.  I saw a beagle the other day and lost it.  I cried the entire drive home.  I swear I 'saw' her face this morning as I was leaving for work - she was sitting at the top of the stairs as I closed the door.  Your mind will play tricks on you for a long time.  But she will always be with you.  

Keep us posted about your baby.  Stay strong for her :)  She needs you more than ever now!  
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Avatar universal
Thanks, Tony, for your long and thoughtful post.  We started Phoenix on the KD special diet food back in October and she would not touch it, even mixed with tuna juice, which she normally goes apeshit over.  I got some green tripe last weekend (third try with it) and she totally ignores it.  I think she is the only dog on the planet that doesn't like the stuff.  :(  The vet said that at this point, keeping her alive by any means outweighs the kidney friendly benefits of any food I might try.  She said if she doesn't eat she wouldn't last more than 2 weeks.  When she was healthy she weighed 68 pounds. She has lost 20 of that. So, yeah, I feed her whatever she wants whether it is good for her or not, because at this point it almost doesn't matter any more, sad to say.   She actually ate 2 cups of spaghetti with meat sauce yesterday.  It was fairly astounding.  Some days all she wants is carbs, other days only raaw meat will fit the bill. It is exhausting, quite frankly, to offer her 7 or 8 different things only to have her turn everything away.
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1916673 tn?1420233270
Hi. Yes, weight loss is quite dramatic with KD and seems to happen all of a sudden, though of course it just becomes more noticeable after a time and actually happens fairly gradually. You could do to try and increase the calorific content of her diet. This is quite complex, because it is essential to keep her on a low phosphorous and low protein diet (to prevent further damage to the kidneys), while still aiming to give an adequate amount of protein and more calories so she doesn't lose more weight. Eventually, it will make no difference what you feed - as it will by then be more important to get her to eat whatever she will eat just to acquire some energy - but for now, the above regime is worthwhile following, if you can. There are lots of manufacturers now making special tinned foods for kidney failure, so it's worth having a closer look at some of these and aim to give the one a) she enjoys eating; and b) one with a higher calorie per ounce content.

Most of these special diets are low (some virtually zero) phosphorous and lower than normal protein, but their actual calorific measure differ across each product, so it's definitely worth looking into. Another good source of calories and very suitable for KD is green tripe (not the white tripe variety that is eaten by some humans). Green tripe is ordinarily given to racing dogs and is exceptionally high in calories and nutritional values. It also stinks like hell ... particularly the frozen blocks you can buy from some pet food stores, which need to be cooked before serving ... but I have yet to meet a dog that doesn't absolutely adore green tripe.

Green tripe also contains some amazing amino acids, oils and probiotics that can help aid digestion and prevent the sickly feeling many KD dogs suffer from (due to the toxin build-up). Green tripe is also rich in vitamins and low in phosphorous.

Tony
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Avatar universal
She is still drinking, eating less on the days where she is due for fluids. Yesterday she ate 2 milkbone flavor snacks, a few bites of spaghetti and a little caesar canned dog food. She was very tired yesterday and was not her perky self.  She gets fluids today and will gradually improve to a peak on Friday/Saturday. I took her little sweater off to wash it yesterday since it was so nice out and she is horrifying to look at. She is so skinny you can see all her ribs.  :(
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Avatar universal
I agree with Tony!  My vet was so excited that Daisy wanted treats, that she ate too many too fast and threw up on the car ride home.  How is she otherwise.. drinking?  eating?  

My heart breaks for you, but sounds like you have support here. I wish I would have found this forum for guidance, advice, related stories before I lost Daisy.  
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Avatar universal
Good to know..
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1916673 tn?1420233270
Hi. That's good to know. I would advise not letting Phoenix overindulge, as this could make her become ill quite quickly (because more food all at once just means more toxins are produced and not dealt with, because the fluids won't always flush them out). So, small amounts more often is the way to go. For example, instead of six milkbones all at once, give the same amount an hour or half an hour apart. Tony
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Avatar universal
I can definitely tell when the fluids wear off.  They increased her fluids by 50% and she was doing really well (also tripled the amt of Maalox) and then the vet tech on Tuesday didn't read the chart and only gave her the old amt, which I didn't catch until Saturday. So, given the additional fluids, her appetite has increased a lot. The new dog makes a difference, too.  I offered Phoenix a  small Milkbone which she refused, so I gave it to Tully. Phoenix ate six of them after that.  ;^) So, she is much better than she was a couple weeks ago. Thanks for asking about my baby.
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1916673 tn?1420233270
Hello again. How have the last couple of days been? Hope they've been good ones for you and Phoenix. Tony x
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Avatar universal
Oh, no. I am giving her all the love, if not more, than before.  The new dog is not needy at all (and his time will come).
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Avatar universal
Glad to hear she is doing a bit better.  It's a roller coaster ride that's for sure.  One good day, 2 bad days, one good day, 2 bad days is how it seemed for Daisy at the end.  I hope you continue to love on her as much as you can, and spend time with just her more than she's spending with the new dog.  Don't let her think that you're trying to replace her just yet :)
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1916673 tn?1420233270
Hi again. It's good to know things are going fairly okay, though I think you are becoming prepared for the near future - I hope so at least, because sadly, it is inevitable. On the plus side, you are getting some wonderful days with Phoenix and the addition to your family is no doubt giving both you and Phoenix some extra enjoyment. It's lovely that they sleep together (maybe you'll supply a pic of this for us all to see and go "awe" to). The extra food she is taking should give her some extra energy ... all great news ... and the increased iv fluids will hopefully flush out some extra toxins. Fingers crossed these good days continue for as long as possible. Tony x
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Avatar universal
Looks like none of the comments I made via my phone made it here.

Phoenix's BUN went from 138.5 in Jan to 140+ (I did the quick test, so it doesn't measure over 150).  The creatinine went from 7.9 to 8.2, which the vet said was not a huge change.  They increased her fluids to 300.  The vet thought she had a month or 2 based on how happy and bouncy she was at the vets. (the fluids from the previous visit had obviously kicked in). She went for a quarter mile walk and was happy. Based on the vet's assessment, I picked up a rescue I had been looking at for a while. She loves him and is eating more because she doesn't want him to have it (which I had hoped would happen!) He is 5 and very laid back and she sleeps with him during the day now on occasion.  The chicken she didn't want for the past 3 days she gobbled down when I offered it to him.  Same with milk bones. She has not wanted one in over 6 months. She ate FIVE of the little ones since he was getting some.  So, I think that in between the fluids she is tired and doesn;t have much of an appetite, but perks back up with the fluids.  I am also supposed to give her up to 3x the amt of Maalox I had been giving her.  She seems improved over when I posted last.  Thanks everyone for asking about my girl.
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1916673 tn?1420233270
Hi. You have done extraordinarily well to get her to this stage, but from what you have told us, I imagine the time is very close now when you will need to make a decision. No one can tell you when that time has arrived - except your own dog. She will give you a look when she is ready to go. When you get that look, you will understand.

I'm hoping the vet has given some reassuring news, following the bloodwork, though I rather feel that may be unlikely. Either way, please let us know in due course. As for feeding ... at this stage, give her whatever she wants and is prepared to eat. If you can get hold of it, green tripe (tinned or frozen, the latter you need to cook), mixed with a tiny amount of boiled white rice, often does the trick. It's highly nutritional and despite the stink of green tripe, just about all dogs absolutely love it.

You are in my thoughts. Tony
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Avatar universal
How is your little girl doing after the weekend?  Any updates from the bloodwork?
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462827 tn?1333168952
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Avatar universal
At this point, love on her and let her know how special she is to you.  I'm sorry :( it's horrible saying goodbye esp when they love you so much for their whole lives.  
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Avatar universal
I think I will try some tuna juice mixed with water.  Tuna juice was always irresistible (though no longer interesting over her kibble anymore).  :(
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Avatar universal
From your comments it seems Phoenix is closer to the end than I thought.  A month or two ago she would eat pasta, or I would add it to chicken broth and some canned dog food and make a shake in the blender.  Now, even the most enticing morsel she turns away in disgust.  We managed to get her to eat maybe 5 tiny pieces of steak (steak!!) today, but the gusto is definitely not there. Last week all she would eat was stale bread or stale donuts. Forget dog food of any kind. MAYBE some canned cat food, but only a few tablespoons. I will be interested to hear what the vet says on Saturday (if she is still with us then). I actually check to see if she is still breathing in the middle of the night (she sleeps next to me).  Ugh.
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Avatar universal
That no longer works.  
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Avatar universal
I wish. She won't even eat the canned food in the little cans.
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