Heatstroke can indeed cause acute renal failure, although it is unusual. Dehydration is the underlying problem, so intensive fluid therapy is the right course of treatment. Bringing the creatinine down fairly rapidly is the key to retaining the health of the kidney organs and kick-starting them to function properly again. However, IV fluids may not be enough on their own and I would expect there will be a need to continue with SubQ fluids at home afterwards (ideally with lactated ringer solution).
I understand this is all very costly. But it is also the only way to proceed, if you want to have any chance of improving the situation for your dog.
There will be questions you need to ask after the initial run of treatment is complete, but at the moment the important thing is to get the fluid therapy. You might ask about continuing with SubQs, as they will need to teach you how to undertake this at home - possibly for several weeks, with at least 2-weekly blood tests during this period.
Did they undertake a Culture & Sensitivity test on the urine? This test is the only way of ensuring the right antibiotic is identified for the particular strain of UTI ... if indeed there is a UTI (quite common in kd dogs). Giving generic antibiotics (which is what many vets do) is pointless, as the antibiotic may not be the right one for the job and the UTI will consequently just return again and again.
You might also ask to receive copies of all the blood and urine testing that has been (and will be) undertaken. These are extremely useful for comparative purposes, but also to see if anything else is happening that we can help you with.
How old is your dog?
Hi. Great news that the creatinine levels are falling. That's the priority. When the kidneys are affected and undermined by whatever caused this acute reaction (probably the heatstroke), then providing treatment is undertaken quickly, they can make a full recovery. However, so much depends on how much organ tissue has been damaged in the process. Kidney organ tissue does not replenish itself, so once it is destroyed, it is lost forever.
The question therefore is hard to answer, because nothing will be known until the creatinine levels are brought back to a normal level and the fluid therapy stops. At that stage, the creatinine could begin rising again - and if it does, then it's likely this may have developed into chronic kidney disease. But that's not a likelihood, just a risk.
It's a case of fingers crossed for a positive outcome. There are of course very important lessons to be learned from this experience - the big one being hydration and access to lots of fresh clean water at all times, but more so when out in hot weather. If your dog is particularly active when out, it is also useful to calm him down by keeping him on a leash - which will help prevent overheating and consequential dehydration.
Let me know how everything goes.
Hi. That's really very positive news. The fact that creatinine keeps falling is excellent and gives rise to a good outcome. I wouldn't worry too much about eating behaviour just yet (the vet can give nourishment I/V or by tube if absolutely necessary and just to keep him going). He won't want to eat while the toxins are "active", as it produces large amounts of nausea and acid reflux. The vet might want to give some anti-nausea medication, although equally they may not want to complicate the situation with additional meds just yet.
I think the next couple of days will see further falls in creatinine and your dog's appetite should then return.
Fingers crossed for you both that this horrible episode ends with more good news and that the creatinine stays within the normal range over the coming weeks (after fluids have finished).
Hi. The SubQ Fluids will continue to flush out toxins, hydrate and help lower creatinine further. They are standard for renal treatment after IVs have finished and have proved to be effective and beneficial in many cases. The period of SubQs depends on what happens with creatinine levels, but usually a period of between 6 weeks and 3 months is sufficient with blood testing every two to four weeks.
The type of fluids are equally important. Assuming that sodium levels in the blood are within normal range and not below normal range, then the solution used should be Lactated Ringers. This is the closest to natural canine body fluids and is what's known as a balanced fluid. Saline solution is often prescribed, but that is inappropriate for kd dogs (unless sodium levels are below normal).
Before bringing your dog home, please make sure the vet undertakes a comprehensive blood pressure check. Dogs with kd tend to have high blood pressure, and that adversely effects the kidney disease. Treatment is usually required - the appropriate medication also indirectly helps force more blood volume through the kidneys, thus removing more toxins and helping the remaining organ tissue improve its filtering ability.
Diet is going to be crucial to ongoing care. I would suggest starting with a canned kd prescription food such as Hills kd. This is low in phosphorus (a very influential element in kidney disease) and it also has high-quality proteins compared with the low-quality of most manufactured dog foods.
Having mentioned phosphorus ... what is the current serum phosphorus of the blood tests showing? If they show it is high (or approaching the border between normal and high), then I would start a phosphate binder. The best of these is aluminium hydroxide. Chat to your vet about starting this, if appropriate.
It may help you to start reading-up on some aspects of canine kidney disease, and particularly diet changes. There is a whole raft of my articles available on my website at www.tonyboothwriter.com or you can access them through inforbarrel.com
Fingers crossed for continued good news.
Great news. To help aid eating, you can drizzle a teaspoon of organic (pure) honey on the top of the kd food, which improves the taste and makes it more appealing. Or, try adding a tablespoon of chopped cooked green cabbage (I know, sounds crazy), but actually it adds two important things to help kd dogs ... fermentable fibre is one, and cabbage is also a natural preventative for stomach ulcers. KD dogs tend to develop ulcers easily (due to high acid levels in the stomach).
If eating remains a problem, try to find either pure coconut oil (again just a teaspoon drizzled over kd food) or some natural (nothing added) green tripe. The green tripe stinks like hell when you cook it (I use a microwave), but dogs usually love it and it is full of nourishment for them. Again, just crumble a small amount on top of the kd food, as an appetiser.
Okay. Hopefully you won't need any of those things, but just in case.
Let me know how things go.
Great news. I would suggest (if your not already doing it) only using human grade chicken, as this contains high-quality proteins - and only use chicken thighs, as the dark chicken meat has much less phosphorus than white chicken meat. Also, it's best not to buy pre-cooked chicken, because it will probably be sprinkled in salt (too much sodium is not good for dogs with kd).
Fingers crossed things work out over the next week or two on the SubQs. You are doing all you can for now. It would be good to get him on the Hills kd canned soon, but I think the vet is spot-on that the absolutely chicken is fine for now. Eating is half the battle, even if it's not the perfect choice of food long-term.