I think my Pepsi baby is near end... he has fought it well.

[pepsibaby]

I have not posted for a few months. My little Yorkie was dx with kidney and heart failure April 2014. He took a turn for the worst very quickly and I thought many times that it was the end but he always pulled through. His numbers were so high the vets were surprised he could recover (258 BUN and 3.5 Creatinine). I was able to get it down to 98 BUN, 1.6 Creatinine. I am diligent about him ONLY eating kidney canned foods or kidney dry soaked in water (he loves Royal Canin). Snacks are apples, pears, vanilla wafers, and glutin free animal cookies (Glutino brand I found is the best). He can't seem to gain weight, still between 4 lbs 1 oz and 4 lbs 8 oz. He use to be nearly 7 lbs.

Last few weeks I noticed his head started bobbing, usually first thing in morning and would go away as day progressed. Last few days the head bobbing progressed to his entire body having tremors. They were only occasional then go away. Today the tremors will not go away. At first they were small shivers and I thought he was cold so I put on his sweater. Now he falls over from the tremors.
He can't drink water because his head will not stay still. He gets subq every other day and is not scheduled for today but I gave him the fluids. His body absorbed it within an hour.
I also gave him a mirtazipine to see if this would help. I was worried because one of the possible side effects of mirtazipine is serotonin syndrome with shaking. He did experience the shakes when I first gave it to him in May but subsequent times it did not affect him so I gave it a try. He ate and seemed alert except for not being able to drink.

He is not one to sit in my lap, not a cuddly lap dog, but today he kept close to me and would nap when I held him. The tremors went away when I held him on his back. He is presently sleeping and has slight shivers. They are like contractions, his entire body contracts and then calms down. I read this happens to some kidney failure dogs. I just hope tomorrow is better. I have the phone number of a vet that makes house calls to help him cross over the rainbow bridge.

[tonyb286]

Hi. Okay. The tremors are (very) likely to be the result of either a breakdown of nerve tissue (one of many neurological symptoms of progressive canine kidney disease) - or an imbalance of electrolytes and minerals in the blood. Get your vet to undertake a fairly urgent comprehensive blood test which must include potassium, calcium, sodium, phosphorous, creatinine, magnesium, amylase, WC and RBC. The results will tell you (and me if you post them) whether there is an imbalance that can be corrected with supplementation and/or diet alteration.

I don't particularly like the idea of SubQs being given every other day. Has the vet given any reason why it's not prescribed on a daily basis? You do have to be careful not to overdose, so based on your dog's weight of 1.8kg alone, you should conservatively be giving about 100 cc per day. That could be increased to 125 cc assuming there are no heart or circulation issues. Also, the solution fluid should be lactated ringer, not saline solution.

Tony

[Gracie4804]

Gracie's head bops were the worst during her Addisonian crisis....and whole body tremors.  She was also vomiting often. Her electrolytes were so far off. She continued to have the head bops the next couple days, so the ER vet suggested it was residual neural effects from her electrolytes being so far off.  I know bloodwork for electrolytes isn't too costly since we were having it done every week.

Best wishes to you and your little Pepsi.

[Gracie4804]

Hi!

I'm not sure if my Gracie has exactly what your Pepsi has, but she also started having tremors and falling over during her Addisonian crisis/kidney failure a little over a month ago. The went away following 3 days of IV fluids, but came back when her acute kidney failure turned into chronic kidney failure a week later.  Even after we had her on another 3 days of IV fluids, the tremors remained. The vets put her on Tramadol and muscle relaxants thinking it was her back pain....that just made things worse.  They prescribed her anti seizure meds thinking it was a possible brain tumor. I never started her on the antiseizure meds because the tremors started to improve. She then had another set back because the vets did not give her her DOCP shot for her Addison's in time. Her electrolytes were off which caused her tremors to return.

We are still dealing with the tremors, but Gracie seems to have adapted to them a bit....she stands a bit wider to brace herself. I'm hoping that the tremors will again improve. If your Pepsi is still eating, I don't think he is anywhere close to the end.  I know Gracie is far from it

[pepsibaby]

Thank you, I will have to ask vet about Cushings and Addisons when I call them Monday (if they are open).
I gave Pepsi 50 cc subq every 6 hours yesterday and the head bopping has slowed, still there but not as bad. I notice his tremors when he is sleeping, they come with every breath he takes. I took him to ER 2 days ago thinking he was having difficulty breathing. Xrays showed chest was clear and nothing obstructing airway. He did not have bad head bops yet so I did not mention it to them. The head bops most when he is standing and goes down his entire body, like waves. His body kind-of bounces till he looses balance and falls. He does have a bad back.
I think he ate because I gave him mirtazipine - an appetite stimulant, anti depressant. I syringe fed him this morn, he won't wake up. I guess he is tired from all of the tremors and falling yesterday.
Sad thing is he is loosing his eye site too. He doesn't walk much bc he bumps into things. I carry him outside. I wonder if he fell or bumped into something and hurt his head causing the head bops? Family say to accept he is old and it is time. I just don't want him to be in pain and suffer. I want to make sure he is pain free so he can go comfortably.