Chica - Renal Failure

[Jaybay]

Dr. Cheng,  can't thank you enough for the information you provided about Chica's renal failure.  We just got back home, and I'll run it by our vet on Monday.  The frst couple days of our week-long trip were pretty rough on Chica.  Frankly, we were wondering if she was going to die before the week was out.  I had just started giving her a Tums (for the calcium) twice a day the night before we departed.  By the third day, she was really perked up - not her old self, but interested in things going on, and eating well again.  The worst problem was having to carry her up 14 stairs every time we took her out!  What would you recommend for arthritis pain?  She just can't seem to tolerate the Deramaxx any longer, and I suspect she'd be a lot perkier if she didn't have so much leg pain from the TPLO going on.

I did a whole lot of reading on renal failure diet, and it appears that right now the most important thing is to keep her eating - even if it isn't the greatest stuff for her kidneys.  She got really tired of the ground beef, rice, boiled egg diet after 10 days, so I switched out the beef for ground pork and dark meat chicken.  Much better on the appetite with that.  I guess variety really does count!

I'm guessing she is just going to have some fairly good days, and some really awful days before she dies.  This is just the worst part of having pets.  :-(

[Jaybay]

In the past 7 days we've seen a great deal of improvement!  I've backed off the reglan dose to either 1/4 or 1/2 of the initial prescribed dose that became toxic with really good results.  After discontinuing Pepcid for the most part (I know she still needs it) her appetite got much better and Chica continues to gain weight.  She's had many periods of normal activity, and only one round of vomiting.  Two Tums per day seems to be enough calcium for now, and we've ordered Alu-tabs as a calcium alternative since her calcium was already high.  Still continuing the potassium supplements and will retest everything next week to see where we're at.

I've discovered it's more important to get her to eat ANYthing at all even if it isn't the best for kidneys.  So far, roasted dark turkey and chicken is her favorite - a nice, easy alternative to add to rice and bread crumbs, that is also very low phosphorus.  

I can't say the expensive supplements from the vet did a darn thing - azodyl and epakitin powder.  I've totally discontinued the azodyl and cut the epakitin by 1/3.  We'll see how her labs look in a few days.

So far, we haven't needed to do sub-q fluids as she's drinking fine on her own.  It's backed off to more normal amounts as well.  

I know her improvement may not last long, but at least she'll probably be OK through the holidays. :-)

[Jaybay]

Oh, I know the end grows near.  I just want to keep her as comfy as possible until it comes.  Thankfully, this condition doesn't seem to be painful so much as just miserable with the nausea and vomiting.  I would never put an old dog of her years (and temperament) through a lot of treatment that will just make her more miserable.  I'll check around for a holistic vet in my area - since I'm in Houston, there will no doubt be plenty to choose from.  Many thanks!  :-)

[Aleda M Cheng, D.V.M., C.V.A]

Hello again Jaybay!  If you have been following the Pet Health Forum regularily, and I know you have, you will read about a lot of sad stories involving kidney disease.  As I have written before, chronic kidney disease really doesn't have a cure and only palliative treatment is helpful.  
The only "cure" for kidney disease for humans is with a kidney transplant.  Kidney transplants are performed in veterinary medicine on very rare occasions but are unbelievably expensive.  At the University of Penn. they are performed on cats but the selection process is rigorous.  The cat has to be healthy in every other way, with no diseases of any kind except failing kidneys.  You must also adopt the cat who donated the kidney.  In dogs it is much less successful.  Dogs rarely meet the necessary requirement for kidney transplant, so it can really only be considered experimental at this time.   This could change in the future.

As for your dog, as I mentioned before a holistic vet could prescribe helpful herbal medication for her, for her kidneys and for the leg pain.  I would contact a holistic vet.  The web site for locating a holistic vet is : American Holistic Veterinary Medical Association.