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7 year old lab mix diagnosed with stage 4
Yesterday we received the heartbreaking news that our beautiful girl Brewer has chronic kidney disease. Her CREA was 6 (unfortunately I don't remember the phos or BUN) they sent her home on the k/d diet and phos binder and an aluminum hydroxide gel. I took her in initially because she was losing weight and drinking more water (I initially thought diabetes) other than a little more tired, she is her normal self. Eats her food, begs for food from our toddler, and drinks water. She is still interested in playing and going for car rides. My vet seems to think this could've been caused by lymes (she was treated for that 3 months ago)
They have my poor girl maybe 6 months, but she just still seems so normal it's hard for me to wrap my mind around that. My vet did not suggest any IV fluids yet, do you think I should call back and see if that would be recommended to bring the CREA down? So far our plan is to recheck blood in 2 weeks. Anything else I can do in the meantime to slow the profession down? I appreciate any and all suggestions, so glad I found this group. I'm just heartbroken over this, she is only 7
They have my poor girl maybe 6 months, but she just still seems so normal it's hard for me to wrap my mind around that. My vet did not suggest any IV fluids yet, do you think I should call back and see if that would be recommended to bring the CREA down? So far our plan is to recheck blood in 2 weeks. Anything else I can do in the meantime to slow the profession down? I appreciate any and all suggestions, so glad I found this group. I'm just heartbroken over this, she is only 7
Okay. Lots to talk about here ... first and foremost that UTI.
This is so very important ... did the vet do a Culture & Sensitivity test on your dog's urine BEFORE prescribing an antibiotic? If you aren't certain, ask them about it straight away and ask for a copy of the test results if they say they did do it.
The phosphate binder (aluminium hydroxide gel powder) is a good one and should help get control of rising phosphorous over several days, maybe a week or two.
Red blood cells in urine could be due to many things, but also the UTI. It is worth checking if the vet did a test for anaemia (low RBC test result would suggest it). The loss of red blood cells can cause anaemia and it will certainly need treating as a priority if it is evident.
What is the blood pressure medication prescribed? Is this for actual high blood pressure - or simply to help push more blood through the circulatory system/increase blood volume? Please ask about this if you are uncertain, as the type of blood pressure medication is different for each.
With a creatinine of 6 and BUN at 118, Brewer's health is seriously undermined. Personally, I would like to see him having IV fluid therapy for a couple of days - followed by SubQ fluid therapy you can give at home. Of course, this is a difficult decision, because things may take a turn for the worse while he is at the vets ... but at the same time, the IV fluids are the best and fastest chance of lowering these high values.
What food has the vet given/suggested?
It's good he's drinking water - please make sure it is filtered ft or bottled water, as this will have less sodium and chemicals in it.
I'll give you a link below to two of my articles on changing diet which you should find useful. Please have a read of them:
http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease
http://www.infobarrel.com/Changing_Diet_During_Canine_Kidney_Disease
That's probably enough for you to be thinking about right now. Get back with answers when you can.
Tony
This is so very important ... did the vet do a Culture & Sensitivity test on your dog's urine BEFORE prescribing an antibiotic? If you aren't certain, ask them about it straight away and ask for a copy of the test results if they say they did do it.
The phosphate binder (aluminium hydroxide gel powder) is a good one and should help get control of rising phosphorous over several days, maybe a week or two.
Red blood cells in urine could be due to many things, but also the UTI. It is worth checking if the vet did a test for anaemia (low RBC test result would suggest it). The loss of red blood cells can cause anaemia and it will certainly need treating as a priority if it is evident.
What is the blood pressure medication prescribed? Is this for actual high blood pressure - or simply to help push more blood through the circulatory system/increase blood volume? Please ask about this if you are uncertain, as the type of blood pressure medication is different for each.
With a creatinine of 6 and BUN at 118, Brewer's health is seriously undermined. Personally, I would like to see him having IV fluid therapy for a couple of days - followed by SubQ fluid therapy you can give at home. Of course, this is a difficult decision, because things may take a turn for the worse while he is at the vets ... but at the same time, the IV fluids are the best and fastest chance of lowering these high values.
What food has the vet given/suggested?
It's good he's drinking water - please make sure it is filtered ft or bottled water, as this will have less sodium and chemicals in it.
I'll give you a link below to two of my articles on changing diet which you should find useful. Please have a read of them:
http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease
http://www.infobarrel.com/Changing_Diet_During_Canine_Kidney_Disease
That's probably enough for you to be thinking about right now. Get back with answers when you can.
Tony
4 Comments
No culture and sensitivity test because when they checked the urine they did not see any WBC in the urine. They are sending out the urine to do a urine protein-creatinine ratio.
The BP med they gave me is Enacard. It's to help reduce the stress on the kidneys. No anemia seen in her blood work.
The BP med they gave me is Enacard. It's to help reduce the stress on the kidneys. No anemia seen in her blood work.
Okay. That is actually very bad veterinary practice. Essentially, the vet has prescribed an antibiotic (a medication that will further harm and/or stress the kidneys) without knowing whether it is the appropriate antibiotic to treat the UTI. AND ... the UTI is only suspected, because without a culture and sensitivity test, they can't know.
The point is, if there is no UTI, then giving the antibiotic is pointless - and will definitely do more harm than good. Remember that the kidneys need to filter all the by-product toxins out of the antibiotic compound as it's metabolised. This adds stress to the kidneys and more toxins to the bloodstream.
If there is a UTI, then the antibiotic given may be completely the wrong type of antibiotic. A C&S result lists the antibiotics necessary to kill the particular type of UTI. So, the vet is using guesswork, and as a direct result the infection may not be completely destroyed - which means it will grow and come back again in a few weeks time.
I think I might be changing my vet if I were you.
Tony
The point is, if there is no UTI, then giving the antibiotic is pointless - and will definitely do more harm than good. Remember that the kidneys need to filter all the by-product toxins out of the antibiotic compound as it's metabolised. This adds stress to the kidneys and more toxins to the bloodstream.
If there is a UTI, then the antibiotic given may be completely the wrong type of antibiotic. A C&S result lists the antibiotics necessary to kill the particular type of UTI. So, the vet is using guesswork, and as a direct result the infection may not be completely destroyed - which means it will grow and come back again in a few weeks time.
I think I might be changing my vet if I were you.
Tony
Thanks Tony, I have another appointment with a different vet on Thursday. For now I'll hold off on the antibiotic. Any advice on the BP medication?
As I suspected, Enacard is contra-indicated in canine kidney disease. Unfortunately, it will do the reverse and CAUSE stress on the kidneys rather than ease stress on the kidneys. I can understand why the vet has prescribed it, but there are much safer drugs (for use in renal disease) that essentially do exactly the same thing and cause far less stress on the kidneys.
These drugs basically open up the blood vessels so more blood can flow through the kidney organs. This helps maintain the compromised function they have, and certainly supports improved renal filtering. Unfortunately, they are a drug which also has to be broken down and metabolised and any by-product toxins then need to be filtered out and disposed of via urine. Some drugs cause stress on the kidneys and/or liver during this process, and others cause less stress, so vets should look into how the drug of choice is processed by the canine body.
My personal drug of choice would be Benazepril, but I am not a vet, so please discuss the options with your vet and then take your vet's advice.
It is also very important for a vet to keep a very close and regular eye on what is happening to blood pressure while on these types of medication. They should also explain the symptoms of low-blood pressure, so you are well prepared for any problems.
Tony
These drugs basically open up the blood vessels so more blood can flow through the kidney organs. This helps maintain the compromised function they have, and certainly supports improved renal filtering. Unfortunately, they are a drug which also has to be broken down and metabolised and any by-product toxins then need to be filtered out and disposed of via urine. Some drugs cause stress on the kidneys and/or liver during this process, and others cause less stress, so vets should look into how the drug of choice is processed by the canine body.
My personal drug of choice would be Benazepril, but I am not a vet, so please discuss the options with your vet and then take your vet's advice.
It is also very important for a vet to keep a very close and regular eye on what is happening to blood pressure while on these types of medication. They should also explain the symptoms of low-blood pressure, so you are well prepared for any problems.
Tony
Just an update, I received all her lab values
CREA- 6
Phos- 8.6
BUN- 118
Protein in urine- 7.1
Red blood cells in urine
Starting her on an antibiotic to treat possible UTI, and a blood pressure medication
CREA- 6
Phos- 8.6
BUN- 118
Protein in urine- 7.1
Red blood cells in urine
Starting her on an antibiotic to treat possible UTI, and a blood pressure medication
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