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Havanese, 13 years old, acute kidney failure outlook, creatine 4.4 ->1.7 ->3

Hi there,
My beloved dog Lucky was diagnosed last Weds with an acute episode of kidney failure.  His creatine was 3.1, BUN 128, and ALT (liver enzyme) 130.  No major visible damage to kidneys, minor signs of chronic kidney disease in an ultrasound but they said nowhere near end stage chronic kidney disease.  After 2 days of fluids and a brief treatment with antibiotics (which they discontinued when culture came back negative) his creatine was down to 1.6, BUN of 74 and they sent him home on a kidney diet.  He still seemed a bit lethargic and ate a bit less at each meal than usual, so we went in for a recheck today (one week after admission) and his creatine was back up to 3, BUN down to 67, but ALT up even higher to 175.  We now have SUBQ fluids to administer every 24 hours.

1.  Has anyone had a dog improve after an initial decline and then resurgence in Creatine? (He was tested after a meal.)
2.  Is there anything I should ask my vet to test for that could be causing the acute episode?
3.  Any treatment tips?

Thank you everyone.  
Aimee
1 Responses
1916673 tn?1420233270
Hi. I'm assuming you have exhausted every possible cause of this acute attack? Commonly these include human medicines, chemicals used in the house and/or the garden, certain toxic plants (some dogs will still eat them), very poor quality dog foods. Other causes include various parasites including Lyme Disease and Lepto (tick and flea bites). Sometimes, it is also congenital, though I would rule this out owing to your dog's age. Dehydration is another significant cause of high BUN and creatinine. Does your dog drink enough? Are you feeding a wet diet (canned is better than dry foods as it contains 80% moisture)? Some antibiotics can also falsely raise creatinine levels, so it could also be that now the antibiotics are finished it may take a week or two for things to settle down again. A re-test in 2 weeks would certainly be worthwhile. High blood glucose and excessive vitamin C supplements can also cause high creatinine levels to occur. I would be interested in the SubQ fluid dose (to see if it is accurate for your dog) ... can you let me have your dog's weight please? Given the possible liver enzyme abnormality, it may be worth using Milk Thistle as a supplement (this will help protect the liver). Other than that, I would say try to keep to a kidney diet for now and see where things are in 2 weeks time when you repeat the blood testing.
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