Hi Nancy.
The suspension format of aluminium hydroxide (suspended in a liquid) does have a bad taste, and most owners use a syringe to put it in their pups mouths, just so they can't refuse it. The gel powder form (available without prescription from http://www.thrivingpets.com/) has no taste or smell and is added to food. Not sure what your vet is charging for the alum hydroxide, but if it's very costly through your vet, you can always try getting it direct from ThrivingPets instead (if cheaper).
If the chicken stew is Hills KD then it's absolutely fine and will already be low in sodium and phosphorus.
The vet's veggie + protein diet sounds fine. The best veg is green beans (the lowest in phosphorus), but the mixture given sounds okay. When using chicken, make sure you buy thighs (they are the lowest in phosphorus) and that the poultry is intended for human consumption, as that means it will be high-quality protein content.
It might be worth downloading and printing off some of my nutritional data sheets (available at my website at www.tonyboothwriter.com), as these contain an easy to reference list of the best meats, poultry, fish, pulses and vegetables for kd dogs and you can mix and match according to need.
Good luck and do keep me updated with how things go.
Tony
Hi Tony, me again....
so yeah.... I got my Vet in agreement for the aluminum hydroxide phosphate binder.
You were mentioning that they make a gel powder that has no taste and no odour?? Do you know exactly what it is called and is it a white powder or gel? My Vet was talking about Rx vitamins phos-bind and said that it is a white powder of aluminum hydroxide . but she said that it can alter the taste of food so I am thinking this is not the one you were referring to ?
Thanks again ..
Nancy
Hi Tony,
Thanks for both your messages... That is shocking about the Epakitin.... Glad I know the reality though!! After I got the product I was looking at it and was wondering about the calcium in it. I am absolutely going to somehow get the alum. hydroxide in the gel powder. As soon as I read your response, I called my first vet back and am awaiting a phone call back. I said that I was requesting it. Hopefully that will work.
I agree that the vomiting could have been that I stopped the Omeprazole . Today, I find Chance is a lot more fussy and refusing some of her favourite things so I started that back up thinking that she must be feeling nauseated.
The chicken stew I was referring to is by Hills KD canned ( sorry I was unclear) ..They have the original and also a chicken stew. I am assuming that they are both okay to give??
When the second Vet talked about home cooking yesterday he said that we can make a meal by combining good quality protein and vegetables / carbs. He said for 1 cup of food we should use 1/3 cup cooked good quality protein like salmon filet, boiled chicken... chop it fine and combine it with 2/3 cup of different kinds of cooked and pureed veggies like carrots, peas, broccoli, cauliflower, butternut squash, green beans, pumpkin, sweet potatoes etc. He said we can cook all the veggies together , puree them measure out 2/3 cup and add that to the 1/3 cup finely chopped protein. Does this sound right to you?
Not sure I will start home cooking right away but would like to know your thoughts as home cooking is something I might soon need to try.
Thanks a million !!!!
Nancy
Hi Tony,
So I did not see your last reply when I sent you my last reply....
Thanks for your suggestions about rotating and smaller meals. I will do this.
So we gave Chance the Epakitin last night for the first time and a few hours later, she threw up. Not sure related to this but is aluminum hydroxide phosphate binder easier to digest ?
Also, Can we rotate the kd canned food i.e. the original one night and the chicken stew etc the next ? Also, she seems to prefer right now her Royal Canin mature consult canned food can we rotate this as well ? or is Kd much better for her right now?
Big hugs to your fur kids and Chance sends you a big hug back !!!
You are her guardian angel,
thanks,
Nancy
Hi Tony,
I got the second opinion and he agreed that Chance requires a phosphate binder. He said we should keep her on the Fortekor and phosphate binder and discontinue the rest like glucosamine, aventi ks, fortiflora, gabapentin and omprazole etc. as he feels those 2 items are the most important and the other meds can worsen her kidneys. He put her on Epakitin.. ( chitosan and calcium carbonate powder ). I know you said that aluminum hydroxide is better. ??? Now I am wondering about this.
He also talked about home cooking and the advantages of this as you have mentioned
Thanks,
Nancy
Thank you so much for getting back to me so quickly.
We actually are getting that second opinion tomorrow and I will absolutely mention the phosphate binder. and I forget to tell you that Chance's ALT is a little elevated. So given that she just started Fortekor this past week, I will take your suggestion and get some milk thistle for her. I only noted the elevated ALT by asking for a copy of her test results. My Vet had not told me that.
I also have been reading your articles which I find very helpful. They are so well written and full of great helpful advice.
Your diet article mentions the benefits of giving a CKF dog Green Tripe...do you think I should also try that for Chance? In addition to the Hills KD with honey, coconut oil and cabbage.
Take Care,
Nancy
Hi Tony,
So my Vet is now talking about quality of life and doing the "right thing" for Chance and saying things like "I hate to say that she is 15 cause some dogs live healthy to 17 but she is 15 "... I am not there yet. We are getting a second opinion form another Vet in the next couple of days.
So Doogan was on KD canned food and then we went onto home cooking. We bought that powder that you add to food for vitamins and minerals ( Hilary's blend Renal supplement) but he hated it ..the smell is very strong . If we wanted to start home cooking for Chance how would I do this..? So just to confirm Hills KD canned is not better in terms of protein and phosphorous levels compared to Royal Canin Mature consult canned?
Thanks,
Nancy
Hi Tony,
So just got some more blood work done on Chance, my 15 year old with chronic kidney disease. It appears that she has slipped up to stage 3.
Her blood results as of 2 days ago are... creatinine 262, urea 20, phosphorous 1.7 and her BUN 20.4.
Her protein in her blood work was normal but she is a bit anemic.
We just brought another sample of urine to have a protein test done on it.
Would love to know your thoughts.
She has been eating Royal Canine Mature consult canned dog food for a few years now when she was first diagnosed with chronic kidney issues.
We have tried the omega supplements but they give her diarrhea but I do give her a bit of salmon or sardines once a week. She is on aventi ks nutritional support, glucosamine chondrotin pills for arthritis , a probiotic, metronidazole for her bowel issues and the vet is thinking about putting her on Forticor...which Doogan was on. (our beagle that passed away in December 2015).
Thanks as always,
Nancy
Hi. Sorry you need to be here, but welcome anyway. This is more likely (but not necessarily) acute rather than chronic kidney problem, simply due to your dog's age. For now, it actually doesn't make much difference, as the treatment is exactly the same. If it's acute, your dog will recover and not continue to suffer the ill-effects of a degenerating disease, which sadly is what happens in chronic variants of kidney disease. I am curious about why your vet wants to "open her up" - there's absolutely no reason for this so do not allow them to do it, unless they suspect there is something other than kidney disease happening.
Your dog needs to be on IV Fluids - and I'm assuming that's what she is getting while at the vet's. Once that treatment has finished, you need to begin SubQ fluid therapy at home - a treatment that you need your vet to instruct you on.
New blood tests will be needed in a week's time to see if the fluid therapy has had any effect.
Your vet should also perform a urinalysis checking for protein leakage and any infections. They should also perform a blood pressure reading.
If this is acute kidney problems, then there will be a reason for it and that's usually something your dog may have eaten (including human medicines, household or garden chemicals, and other such substances). If it is chronic, then it may have been happening for many months and even some years, even though symptoms have only now started to show.
Hope this helps. Do let us know how things go.
Tony
I guess I was in the wrong group. Rosie had closed pyometra. That's what was causing her kidneys to fail. Vet saw it too late. She was already too weak for surgery. She died this morning.
Well, according to the vet today, she's not in a very good state. If she gains strength tomorrow, they might have to open her up. If not, then it's just a matter of time before Rosie passes on. It's all happening waay too fast.
Hi. Just signed up on this group. Came back from the vet today. Brought our 6-yr old Lhasa Apso, Rosie for confinement. A week and a half ago, she just lost her appetite and was very lethargic and quiet. Then after 5 days, she seemed to get better on her own and started eating again. She also seemed active again. After two days, it was back to no eating with constant urination, drinking and vomiting. It just seemed so sudden.
Long story short, the first vet we brought her to conducted a blood test. BUN 13.5 (normal 2.9-10.0), creatinine 175.26 (normal 44-150), SGPT 35.2 (normal 10-109). I don't know what these numbers mean but when we transferred her to another vet (another story), we were told that she has kidney problems and that it's irreversible. She's confined at the clinic now for the next three days but we aren't sure yet what kind of kidney disease she has. There's chronic and there's acute right? We're just very worried and confused at this point. I hope we find out for sure what she has. I've been reading the posts here about kidney disease and it seems like it's something that most dogs won't live through and I feel very very sad. And guilty for not being with her now. I guess I'm here to find a little support. Rosie is our first dog. I didn't think one could be this emotional over a pet. It's no different from children.
Hi. I am new to the group. I have a 12.5 year old Shelty who has been diagnosed with early chronic renal failure about a month ago. I don't know the numbers but the vet said that he has given her a newer test which shows failure sooner. Her blood pressure was good. She is drinking a lot and regurgitating water a lot the last few days. She is now on a kd diet and taking Epakitin. The vet said that I should start giving Pepcid if Fleecey is doing a lot of vomiting. I assume that he means this regurgitating. Does that make sense? Thanks.
Hello Eric. Yes, creatinine 5.2 is suggesting final stages even at diagnosis. I think the fluids wouldn't have worked, probably because there was too little kidney tissue remaining. The disease destroys the organs bit by bit until there's not enough left to complete any level of function.
Again, I am very sorry for your loss.
Tony
Hi. I am so sorry for your loss. Please accept my sincere condolences.
The loss of a pet dog is like no other loss. It runs very deep in many people (in my opinion, in the best of people). Our dogs are our friends, family, companions and confidants. More, they are at our side for most of their lives. They share our days, our adventures and our love and devotion. It is therefore no wonder we miss them so much when they have to leave us.
The big problem with kidney failure is it is firstly incurable. We can try our best to improve the function of the kidneys or make the work they need to do less stressful on health, but we cannot stop it. Second, unless we have an ultra-sound done every week, we cannot truly know how much of the organ remains functioning. In the end, the kidney may be struggling to work with perhaps only 10%-20% of tissue remaining - and that means a dog will decline rapidly, regardless of what a vet or an owner might do. In humans, there is both dialysis and (for some) transplantation ... but this is neither practical nor affordable for most dog owners.
Guilt about ending our best friend's suffering is a very common experience. But I believe you did all you possibly could and chose to help your best friend in the only way (and the right way) when the usual kidney management protocols stopped working. There is no need and no cause for guilt, but I do empathise and understand how and why you feel that way. If you can, try to remember what a wonderful life you gave her. Remember the happy times (that ultimately far outweighed the final days of her life). She was lucky to have had you as her owner - and you were lucky to have shared her life with her.
I hope the coming days and weeks see your grief start to subside. And we are here to talk to, if you need us.
Tony
Hey all. On Valentine's Day I lost my Yorkie, Lili she was 12. She was diagnosed 10 months ago with early stage 3. We did a lot of effort to safe her, but she didn't response well for any treatment given. Her last blood work from 2/13/15. Creatine 4.6, BUN 130, phosphorus 16.1. Last four days suddenly she got very sick, bad breath, no eating, barely drank water, strong seizure and paralyzed on the left side, she didn't want to be touched at all, she started pooping with blood, slept nonstop, lost balance too. We decided to help her with that suffering and we put her to sleep on Valentine's Day. I still feel guilty of that decision and question myself maybe I didn't do enough to safe her.
How you all deal with a loss?
Thanks, Eric.
I am not sure how to join the group. I did set up a user and password but I'm not sure I joined the group. My five year old yorkie is in kidney failure, probably from eating chicken jerky her whole life. She was diagnosed May 2015 right before her fifth birthday. After an initial round of IV's, Azodyl twice a day and Science Diet K/D dog food she did well for about three months and then she was readmitted for more fluid treatment. Now it seems she is admitted for 3-4 day intervals about once every six weeks. She is back again today. Her BUN levels were 52 today and she has refused food for two days. She weighs 4 pounds and is like my child. I know she is frightened to death. I cannot imagine my life without her. I am glad I found this group.
Hi Nancy.
Dry dog food has NIL water content, other than water that is added. But the important point about all dry dog food is it is always always always less nutritious than a good quality canned dog food. Dry food also generally contains far more bad things ... more preservatives, more colourants and more chemicals. All these things can lead to kidney failure - and they certainly are not good for a dog that already has kidney failure. So, my advice, never feed any dog with dry food, not ever. It was designed for human convenience at the expense of dog health.
Raw diets are actually interesting. They have become more popular in recent years, partly due to dog owners feeling that manufactured dog food has a variety of health concerns. Owners are also getting told how it is a more natural diet for dogs, whose ancestors were of course wild wolves. But all of this is only part of the truth. Dogs today are very different from their ancestors. Multiple breeding techniques have caused extreme changes to domesticated dogs. Could we call a Pug a wolf today ... NO ... so why should we expect him to eat a diet a wolf would choose.
There are lots of other issues about raw dog food ... mainly about quality of the meat, how and where to store it and whether it has enough nutritional value on its own. In most cases only the highest quality sourced meats are suitable as a raw diet for dogs, and this can be very expensive to obtain. It must be stored in a spotlessly clean cold area, such as a fridge, and must be used within a specified time (as with all meats). More importantly, all meats develop bacteria over time, and the bacteria can be more harmful to humans coming in to contact with it than the dogs that are eating it, so this must also be considered when storing raw foods. And as for nutritional value ... it's usual for raw diets to have various vitamins and other supplements added, as this is necessary to maintain good health of the dog.
Raw diets are a complex issue. Generally speaking, I advocate raw diets as a healthy choice, but only if it is started at a young age and if the meat obtained is of the very highest quality. I would strongly suggest you read up on the subject - just Google raw diets for dogs, and you'll find lots of information.
Onto other matters ... at 15, Chance is an elderly dog and some muscle and weight loss is expected. However, it would be interesting to see what the current blood values say, so I would certainly get a repeat test done as soon as you can. It may be that she has moved into stage 3 by now, in which case some tweaking of the diet will be necessary.
Tony
Hi Tony,
I'm back. Since we lost our precious Doogan, I have been off the site trying to get through all the grief and my depression. He sure did take a huge space in our lives and heart.
Thanks for answering me about Chance and the Aventi KS, omega 3 and vitamin e.
Chance's weight at present is 20.7 kg which is 45.5 lbs.
You mention that you could help with appropriate doses of omega 3 and vitamin e ??
Also, I have been thinking more and more about the diet we feed our fur kids. When Chance was diagnosed with chronic stage 2 kidney disease a couple of years ago, we were told to take her off of Fromm dry food ( which we always added water to) and at our Vet's recommendation, we put her on Royal Canine Mature Consult. ( Mixing dry with canned). We add a lot of water to it and mix it all up with her Aventi KS . She loves it. Her values were just re-checked in November 2015 and they had come down slightly. She just turned 15 in December and is part Husky part lab. We do find that although her values have come down a bit which was good, she appears to have lost lean body mass and is very boney. She also has arthritis and is on monthly cartriphen injections and daily UBASPORT advanced joint care (Glucosamine and Chondroitin sulphate.
What is your thought about Royal Canine Mature Consult? It is very pricey and I have heard not very good things.
AND we are thinking about getting a young healthy dog and I am very stressed about about what to feed him. Lots of people say that Orijen is excellent--high protein and grain free but it is dry food. They say to add water to it. Others told me to go to the raw diet as it is high in protein and moisture. I know that All dry dog food is only 10% moisture . We don't want to feed raw as our neighbour's dog was eating raw food and died from bone fragments. I really need help. I have had 2 dogs with kidney issues ( one acute and one chronic) and for many years, they both ate Fromm dry with water added to it. Can you suggest anything ?
Thanks ,
Nancy
Hi. A mixture of good news and bad news then, but mostly good. The poor walking and ability to stand is usually connected with muscle wastage and/or neurological pathways being destroyed. Your vet may have ideas on supplements to help - if not, come back and ask the group for ideas. Glad you managed to join okay ... I know MedHelp don't make it a very easy route, despite me constantly asking for them to simplify things.
Tony
Hi Tony! I finally figured out how to join the group...I've been reading the links you have sent me today and I just want to thank you for the information. It has alleviated some of my stress regarding my dog Buzz. For those in the group, Buzz is a 16 year old Bichon who was diagnosed with stage 4 kidney failure. I thought I only had a few days left with him and I was in a state of shock and panic but all the information I've received from Tony has been more than helpful. Buzz has been having a difficult time standing up and walking. I've been having to carry him to his water bowl and to his wee wee pad since its been far too cold out for him. Today, when I left for work I left Buzz in his bed tucked with a blanket and when I came home for lunch I was happy to see that he had left his bed, gone to the bathroom (pooped normally), and was looking for food! While I know his kidneys will not be back to what they used to be, I am just glad to see that his appetite has not decreased. He is still sleeping an awful lot, very lethargic, but still tries to get up and figure things out for himself. Like I said in my initial post, he has the heart of a champion. I have a follow up appointment with his vet on Thursday to figure out his care as his kidneys aren't the only concern, I'm also worried about his ability to walk and just his quality of life. Thank you again Tony for this forum and the information.
Nancy, I just saw this post and I want you to know that we all know what you are going through. I had to have our Shadow put to sleep just a few weeks ago because of his rapid descent into Stage 4 kidney failure, and I still wake up each morning thinking I'd better get up and get him out for his walk. The hole they leave is amazingly huge. You did everything you could for Doogan and then some. Just know that we are with you.
Cheryl
Hi Tony,
I feel so lucky to have "met" you with all your compassion and knowledge.
So I was going to finish up Doogan's omega 3 capsules. Chance is twice his size. Then I will buy salmon oil as you suggest . I already looked for it and found a brand named Grizzly. Have you heard of this?
Re the Vitamin E ... Is there a special dose for the dog's weight for this as well ? Do I purchase this at my vet? I wonder why no one told me about vitamin E for my Doogan?? Have you heard of the Aventi KS supplement that she has been taking for the past couple of years ? I wonder if there is vitamin E in that?
In your opinion for a chronic stage 2 do you think the omega is a good idea ?
Truly,
Nancy
Hi. These are the hardest of days - and nights - as many of us know only too well. It takes time. I just wanted to add a brief bit of info as you mentioned starting giving Omega-3 to Chance. The best and cheapest Omega-3 is actually pure salmon oil (you only need give about half a teaspoon, so a standard bottle of about a litre lasts forever. The pills are fine, but usually a bit expensive, and omega-3 must be given according to dog size and weight as overdose can actually occur. Perhaps the most important thing about all Omega-3 is that it inhibits the absorption of vitamin E, which makes it essential you also give chance a Vitamin E supplement. You can buy these specially for dogs in capsule form.
Reagrds,
Tony