I'm confused about the IV fluids issue (ringers). I was getting mixed messages during Darbie's treatment. There was a time, prior to April 17, when Darbie started a routine IV treatment. When the Azodyl started, they had me stop the IV for 2 months. Although I questioned this, the attending vet said "not necessary". I spoke with the receptionist up front ( who is very experienced ) and she stated" it wouldn't hurt". I purchased a bag of Ringers, but abstained thinking after 2 months on Azodyl, they were looking for results. Her next appt was June 12 and her #'s proved higher. I was dismayed as we were heading out to Cape Cod for 2 weeks and came home ( Darbie was very sick in the first week ) with her #'s very elevated, though I was anticipating this ( we did everything under heaven and earth to reboot her.)
My brother's concern was congestive heart failure. I often wonder why there was no medium ground between April-June where the vets could have advised minimal ringers to avoid Darbie's body from entering stress? Are they experimenting? By now, you'd think they left the sandbox...
I am grateful now as Darbie is comfortable, but was there more harm done than good... Her vet appointments are coming sooner than later.
Hi Lynne. The subject of Azodyl is one strongly debated amongst researchers in the field. When it first started to be used (mainly in kidney failure cats) in 2010-2011, some were suggesting it was a wonder-drug. But, I'm not so sure ... it is essentially a probiotic, and an expensive one at that. David J. Polzin, DVM, PhD, DACVIM said in his research paper presented at a conference in 2011 (Probiotic Therapy of Chronic Kidney Disease):
'... a considerably more comprehensive research project, though still with some limitations, as is always true. 32 dogs with moderate kidney failure were randomly assigned to treatment with Azodyl or a placebo. They were otherwise treated identically according to a standardized algorithm for managing kidney disease. They were evaluated in terms of comprehensive bloodwork, body condition, and owner perception of quality of life and 7 time points from 1 month to 1 year after the start of the study. No significant difference in any measure was found between the groups at any time point.'
This study suggested there was no actual effect of Azodyl on these dogs. It was of course a small study - but nonetheless of some interest. The supplement was also given at twice the manufacturer’s recommended dose (so if there was going to be some effect, it would almost certainly have shown, and the drug was given in capsule form, as there was some doubt that powdered variations could pass through the enzymes of the stomach.
The Azodyl manufacturer's website suggests lower BUN levels should show after 2 weeks, but if not, certainly after 4 weeks. Consequently, if the BUN levels have not reduced using Azodyl after 4 weeks, we can say the supplement definitely isn't working in Darbie's case.
While probiotics have proved to have some beneficial therapy on chronic kidney failure dogs, it would potentially be just as viable to give about a tablespoon of unflavored natural yoghurt or other natural probiotics than spend money on so-called superdrugs.
With regard to your brother's concern about congestive heart failure ... what brought him to this concern? There is some concern about giving additional fluids when a dog is in congestive heart failure because one of the treatments would be to reduce fluid accumulation, particularly in the lungs. It is one reason diuretics are commonly given. However, if a dog has both congestive heart failure and chronic kidney failure, there must be a balance of management/treatment between the two serious illnesses. Not treating one in preference for the other could be fatal - because the other illness will deteriorate. The best person to assess and advise is of course your vet, but if you feel Darbie is not getting good support from your vet, now's a good time to change to another one - and always make sure you get to see the senior vet at the practice, not some newly qualified and inexperienced vet or one that is still an undergraduate.
After reviewing hundreds of posts throughout these CKD forums, it seems there are no two vets that think alike. It's incredibly difficult for pet owners to grasp hold of a treatment plan as it is forever changing. I trust Darbie's overall demeanor on a daily basis as her general health guide. Like many on these forums have said...The dog will let you know.
The delivery of Azodyl is recommended 1 hr before meals. As Darbie refused to take pills hidden in treats, I have been hiding them in her meals. She loved the whole milk plain yogurt with a drizzle of raw honey, but later got sick and turned against everything. She's a bit like an elephant that way...She never forgets!
It was within that first week in Cape Cod when Darbie's health was declining. She refused food and water, and when she drank she vomited waves of water. That's when my brother ( medical field ) witnessed how sad Darbie was. Darbie was very lethargic and panting rapidly. Not knowing to what degree her organs were effected due to the CKD, his concern was potential fluid buildup compromising stomach, heart and excess toxins. We honestly felt Darbie wasn't going to get thru the following days, but she rallied back with a strict regimen. Although her July #'s were worse, I'm hoping the daily fluids, Azodyl, renal diet/ with supplemented good quality protein will show improvement in her blood work. She seems very content and I am grateful!
Hi Lynne. You're right, your dog will let you know. They somehow have an amazing ability to communicate their desires and feelings, despite not speaking our human language. I think there's also a hint of intuition from owners, who truly know their dogs better than anyone else. And maybe even some form of sixth-sense - a direct and unique pathway between owner and dog, particularly when things are bad.
Aside from that debate ... I'm pleased Darbie is contented ... long may she continue this way (with your excellent support, management and love).
I realize the Purina NF is "meat by products" ( oxymoron, isn't it? ), but at this time it helps her thrive in small amounts, with minimal KD kibble, good quality protein, and certain veggies and fruit. I have memories of my mother "cooking" a separate meal for the dogs, which is very similar to most new age holistic dog diets. I realize how sad over the years that many of us got so caught up in the convenience to feed our dogs canned /dry food. In this new world, we all seek short cuts...Compromising our own health as well as our canine companions.
I totally agree. In the early years we really weren't told the bad things about manufactured dog food - and in truth, even the manufacturers probably had no idea whether the ingredients were good or bad. As time went along, we all became complacent and tended to rely on tinned food for convenience, and then came (much worse for dogs) dry food. The internet has been the great educator, with such a mass of information available to us all. We are now at a stage where we have so much information available, it's like trying to find a needle in a haystack when looking for the facts.
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