Renal Failure, Pancreatitis, Liver Function going Down

[karen_arriaga]

Hi Tony, My Dog Zoey shih tzu 10 yrs old was diagnosed with kindey failure (Chronic on Acute) on Thursday 04/27/2017. I never knew she had a kidney disease and now feel horrible that i never recognized it or took her in to get checked. She has always been a picky eater so her picking and choosing when to eat didn't concern me much until she began to lose weight rapidly. Within a matter of a week her weight went down dramatically. She has always had food allergies, skin allergies which they think is environmental as well. When she was younger she had crystals in her urine and now has dry eyes. My poor baby to say the least has always been fighting something. So when she would throw up I would chalk it up to it being her allergy then changing her food. Anyway currently her creatinine is at 7, it was 10 when i first took her in. Her BUN was 155. She was in the animal emergency for 6 days on IV all that did was lower her kidney level to 7. I should also mention she was severe anemic with 11% red blood cells. She was given a transfusion and now only slightly anemic but stable. They released her and said make her comfortable pretty much there was nothing else they could do. Her primary vet decided to try her for two more days - which he increased the fluids a little more then what the ER had her at. After two days i was told last night her kidney is at 7, i cant remember what her BUN was or any other number because at that point i was told she now has pancreatitis and her liver is going bad as well. They are releasing her today with me and told me to take her home, make her comfortable at home and she can either pass on her own or i can bring her in after a few days to be put down. I am having a hard time with this whole thing and felt it came on quickly. I am guessing there is nothing else i can really do at this point but try to keep her comfortable. They are sending her home with subq fluids but was told thats just going to buy me days especially now since she is having issues with her other organs. Would you also agree there is nothing left to do? I know you are not a vet but seem to be well informed in this.

[tonyb286]

It's the hardest of things we do for our beloved pets ... allowing them to leave us when the time is right. I have been there too many times in my life - and each time is as hard as the first time. But, we do it for all the right reasons, and certainly not for ourselves.

Just try to enjoy what time you have.

Give her whatever she wants, when she wants it. You cannot do anymore.

Thinking about you.

Tony

[tonyb286]

Hello and welcome to our User Group. I am very sorry you have had this recent news, which must be both a shock and very alarming. I feel your vet has done all the right things. Fluid therapy is the first line of treatment, in an attempt to flush out the toxins and get creatinine specifically more towards stable. Unfortunately, the success of fluids relies on the health of the kidney organs themselves. Once they are severely damaged, no amount of fluids will improve things beyond the level that is reached.

In addition, of course, there are the other complications you have mentioned. The anemia is a big one. The blood transfusion was the right approach in my opinion, but this is only a short-term measure. In normal circumstances, once the creatinine is brought down, a vet can concentrate on other issues (such as the anemia), and attempt to stabilize them one by one or collectively.

Sadly, I believe the kidneys may be just too damaged to improve the prognosis, which means it is unlikely any intervention will really improve things from here onwards. To obtain a real idea of how things are, your dog would need an ultrasound scan. This would detail how much kidney organ tissue remains and whether there is any chance at all of any improvement (with diet changes, medications and good management - and assuming the other issues could be resolved). However, the decision is difficult, because you may not want your dog to be prodded and poked around even more. I don't envy your situation or this decision, but I do empathize greatly.

The SubQswill help your dog, so I would continue doing them. They will help make her feel more comfortable, but only for a short time. You could also consider undertaking more IVs, but do you want to risk her passing while not at home? Probably not.

I wish I could say something that would be helpful. Sadly, I do get the impression that the kidneys are just too far compromised - and further rapid deterioration is likely. I cannot and will not even attempt to advise what you should do. But I am here to offer support and information, should you need it, and I'm happy to try and answer any further questions you may have.

Kind regards

Tony

[karen_arriaga]

Thank you Tony I appreciate you getting back to me. I have to admit that I agree in terms of her not being able to recovery (her organs). She isnt eating, she drinks water and urinates but that is about it. I look at her and she seems tired and I felt guilty for taking her back to her primary vet to try again but I wanted to know I exhausted all options. I am completely devastated as she is my first dog who has been with me 10 1/2 years. I am bringing her home tonight and going to try and give her the best weekend possible with car rides and trips to the park even if it is to just lay in the grass and feel the sun. She loved the park. I was told she doing the subq fluids is pretty much prolonging the inevitable and at times i feel like i am submitting to the subq for my own personal reasons. She has been prodded and poked so much in the last week i am feeling bad about taking her home to do the same once a day. So i am stuck on whether i let her become weak and sleepy to pass on her own or try to hydrate her in the little ways i can by poking her at home too. I feel that would make her feel betrayed that I am also doing this to her in her place of comfort. :(