15yr Old Pekingese, Stage 3 Renal Failure...what now?

[Petey_Mama]

Hi Everyone,
My 15yr. old male, neutered, Pekingese, Petey, was recently diagnosed with Stage 3 renal failure.
He does have some other health issues as well. He has insulinoma (tumors in pancreas), as well as pulmonary hypertension (high blood pressure in the lungs due to "leaky" heart valve).
He was diagnosed with pulmonary hypertension around March of this year by a cardiologist. Since then we have had him on sildenafil with regular check ups and heart scans to monitor his progress.
During his latest check up his primary vet ran blood and urine and we discovered that he is in stage 3 renal failure and his kidneys are only working at about 20-30%.
Like most on this forum, I feel guilt for not having caught this sooner. The side affects of taking the sildenafil are similar to symptoms of renal failure so I fear that we may have lost a couple of months without realizing it.
I know that given all of his health issues my little guys prognosis is not great. But now I am at the point where I start to wonder where to go from here.
We have him on a home cooked, low phosphorous diet as he wouldn't eat the KD food (Canned or dry); lean ground beef, green beans, egg whites, pumpkin, quinoa, parsley.
And we also give him a high quality fish oil daily with his food.
Sometimes he goes a whole day without eating, he has the crooked walk/swagger down, and seems really depressed.
As it is, we have to keep him very calm due to the pulmonary hypertension, so we can't get him too worked up. Even if we could, he doesn't have much interest in playing. He sleeps most of the day and is up at night sometimes pacing and I fear that he is depressed.
I'm just hoping for some general advice, especially from anyone who may have some experience with this.
I know that no one can tell me what to do and I'll have to follow my gut, but given everything I've typed above, I would love any input on this matter.
Thank you so much.

[tonyb286]

Hi. Sorry for the late reply but I have been away for a short break, and I'm only now able to catch up on a long list of messages in my absence.

How is Petey? I'm hoping things have not deteriorated.

It seems there is a complex group of ailments, some of which I really cannot comment on, because I simply don't know enough about them. I can comment about the kidney disease, as that's something within my area of knowledge.

I think your current diet for Petey is good. If possible, try to feed tiny meals more frequently, so every 2 to 3 hours, so the total amount for the day adds up to the amount recommended for the size and breed of dog. These smaller meals help relieve stress on the kidneys.

Low phosphorous foods is key. If he won't eat the canned kd foods, try simple things like human-grade chicken and sticky white rice (glutenous rice). You could also re-try the kd food with something enticing on the top - just a teaspoon of organic pure honey or unsweetend unflavoured yogurt or cream cheese or pure coconut oil. If these don't work, then it's time to look at the anti-nausea medications you are currently using (if any). Please let me know.

Kind regards

Tony