Aa
Winnifred
Hi Everyone, glad to have found this group. My almost 14 year old Westie was diagnosed with kidney disease in October of 2014. After being treated for a UTI and leptospirosis her numbers dropped into the normal range in late December. However numbers in February were elevated again so I have done a diet change and will be getting more blood work done in the next few weeks so can post all the numbers at that time. My question for today is if anyone knows if tremors and paralysis are a side effect of anything that may be going on with her kidneys? She is still eating well and last BUN was around 25 but she has gradually ( over the last 2 years ) developed tremors that are now quite bad. They used to only occur when she was standing still but in the last few weeks she has fallen a few times while trying to have a bm and now while we walk she will have a few tremors and her whole body seems to short circuit for a second and sometimes her back legs give out and sometimes they don't. This only lasts for a few seconds and it is not painful or scary for her ( yet ) and she resumes normally within 5 seconds. But It is horrifying for me as I know there is something terribly wrong. I have googled the symptoms countless times but have come up with nothing. Hoping someone has some advice or suggestions....vet says it could be a variety of things so taking matters into my own hands as I am not ready to say goodbye to my sweet girl. Thank you.
Hi. My big concerns here are with the creatinine and phosphorus, which are both extremely high. Normal (Canada uses mmol/l as you know) creatinine is 44-138, so 313 is 200% higher than the maximum range of normal. Phosphorus normal is 1.0 to 2.0, which makes Winifred's reading at 185 absolutely huge - can I just double check you aren't missing decimal point in that somewhere? I note you say it's within normal, so I'm hoping you meant to put 1.85.
If the phosphorus is only 1.85 then now's a good time to introduce a phosphate binder, yes. Talk to your vet about it. In the meantime, a small amount of chopped cooked cabbage or rice bran in the diet will help. These are fermentable fibers, and they can assist in dealing with excess phosphorus and prevent stomach ulcers forming too.
There are always trade-offs when using a phosphorus binding agent, as there are many side-effects that can arise. We really have to deal with priorities here, and managing the kidney disease is THE priority, regardless of side effects at this stage.
The creatinine level puts your dog in the middle of stage 3, by my reckoning, so it may be an uphill struggle getting the numbers under control - but it's definitely worth a shot at doing. Dealing with the creatinine is a real priority too, because high levels can be caused by something called hypovolemia, which means a decrease in blood volume. Dehydration and heart issues can also cause a rise in creatinine. High blood glucose, vitamin C supplements and certain antibiotics can falsely raise the creatinine ... so given the recent leptospirosis treatment, that may indicate a cause, not just the kidney failure.
I think the best thing right now is to maintain a strict diet regime on KD food, and guard against anything else you might feed that contains low-quality proteins, phosphorus and artificial preservatives, chemical enhancers and colorants. I'm a little concerned about the "herbal remedy" you are using - what is this? My concern relates to most herbal remedies being littered with bad things, but once you let me know I can investigate further.
After a couple of weeks of being on the KD diet (strict KD diet), then it would be wise to have more bloods taken and tested. We need to see if the levels start falling back a little, particularly the creatinine.
If you are concerned about the leptospirosis, have your vet perform a Complete Blood Count or CBC, a biochemical profile, and a urinalysis. These will indicate increased white blood cell count, low platelet count, and sometimes anemia in the CBC if leptospirosis is still present. This may be confirmed by dilute urine, positive for protein, and evidence of inflammation in the urinalysis. It is not however wise to do "another round" of antibiotics, as this may further stress and damage the kidneys, particularly if leptospirosis is actually not indicated.
I would tend to consider adding some potentially useful kidney disease supplements at this stage - perhaps pure salmon oil, unflavored and unsweetened probiotic and maybe Azodyl, as well as using a little Milk Thistle to protect the liver.
I think that's probably enough for now. Let us know how things go.
Tony
If the phosphorus is only 1.85 then now's a good time to introduce a phosphate binder, yes. Talk to your vet about it. In the meantime, a small amount of chopped cooked cabbage or rice bran in the diet will help. These are fermentable fibers, and they can assist in dealing with excess phosphorus and prevent stomach ulcers forming too.
There are always trade-offs when using a phosphorus binding agent, as there are many side-effects that can arise. We really have to deal with priorities here, and managing the kidney disease is THE priority, regardless of side effects at this stage.
The creatinine level puts your dog in the middle of stage 3, by my reckoning, so it may be an uphill struggle getting the numbers under control - but it's definitely worth a shot at doing. Dealing with the creatinine is a real priority too, because high levels can be caused by something called hypovolemia, which means a decrease in blood volume. Dehydration and heart issues can also cause a rise in creatinine. High blood glucose, vitamin C supplements and certain antibiotics can falsely raise the creatinine ... so given the recent leptospirosis treatment, that may indicate a cause, not just the kidney failure.
I think the best thing right now is to maintain a strict diet regime on KD food, and guard against anything else you might feed that contains low-quality proteins, phosphorus and artificial preservatives, chemical enhancers and colorants. I'm a little concerned about the "herbal remedy" you are using - what is this? My concern relates to most herbal remedies being littered with bad things, but once you let me know I can investigate further.
After a couple of weeks of being on the KD diet (strict KD diet), then it would be wise to have more bloods taken and tested. We need to see if the levels start falling back a little, particularly the creatinine.
If you are concerned about the leptospirosis, have your vet perform a Complete Blood Count or CBC, a biochemical profile, and a urinalysis. These will indicate increased white blood cell count, low platelet count, and sometimes anemia in the CBC if leptospirosis is still present. This may be confirmed by dilute urine, positive for protein, and evidence of inflammation in the urinalysis. It is not however wise to do "another round" of antibiotics, as this may further stress and damage the kidneys, particularly if leptospirosis is actually not indicated.
I would tend to consider adding some potentially useful kidney disease supplements at this stage - perhaps pure salmon oil, unflavored and unsweetened probiotic and maybe Azodyl, as well as using a little Milk Thistle to protect the liver.
I think that's probably enough for now. Let us know how things go.
Tony
Hi Tony ( and others ),
Thank you for the info. Unfortunately her numbers have risen again. Her BUN is now 29.8, and creatinine 313 , phosphorous is high but in normal range at 185 mmol/l and same for calcium at 2.75. Total protein is within normal at 68 g/l. ( is there a way to convert these numbers to the numbers everyone else uses ? I am in Canada and think we use different measurements). From what I can tell she is in late stage 3. I started her back on 1.25 mg of prednisone a day and this has improved the tremors significantly. She no longer falls but still has regular tremors while she is awake. I know prednisone is not great for the body but feel I don't have a choice as her quality of life is much better while medicated. We still walk daily and she is still happily chasing squirrels in the yard, but does sleep a lot.
I have her on a diet of KD and white rice, and add about 1/4 cup of beef or chicken to her food each day. She loves it and eats 3 times a day ( but would eat more if I would let her ). She's drinking about 2 cups of water a day, so that is within in normal range. She is also on a herbal remedy of liquid drops and greens, she gets this sporadically as I am not great with the consistency but it is suposed to be a 3 week blood and kidney cleansing method.
I guess my question is what else can I do to extend her life or improve kidney function at this point ? Are IV fluids necessary if she is not dehydrated? Is there anything I can do to lower her BUN or creatinine? It is also interesting to note that after a 10 day round of antibiotics for leptospirosis in December her BUN dropped to 11.9 and creatinine to 159 ( from around the same numbers as above). But a few months later she was back up to the same levels. Wondering if I have anything to loose by doing another round. Perhaps the virus was not totally eradicated.
Anyway any thoughts or tips would be great. Thanks so much for your time.
Thank you for the info. Unfortunately her numbers have risen again. Her BUN is now 29.8, and creatinine 313 , phosphorous is high but in normal range at 185 mmol/l and same for calcium at 2.75. Total protein is within normal at 68 g/l. ( is there a way to convert these numbers to the numbers everyone else uses ? I am in Canada and think we use different measurements). From what I can tell she is in late stage 3. I started her back on 1.25 mg of prednisone a day and this has improved the tremors significantly. She no longer falls but still has regular tremors while she is awake. I know prednisone is not great for the body but feel I don't have a choice as her quality of life is much better while medicated. We still walk daily and she is still happily chasing squirrels in the yard, but does sleep a lot.
I have her on a diet of KD and white rice, and add about 1/4 cup of beef or chicken to her food each day. She loves it and eats 3 times a day ( but would eat more if I would let her ). She's drinking about 2 cups of water a day, so that is within in normal range. She is also on a herbal remedy of liquid drops and greens, she gets this sporadically as I am not great with the consistency but it is suposed to be a 3 week blood and kidney cleansing method.
I guess my question is what else can I do to extend her life or improve kidney function at this point ? Are IV fluids necessary if she is not dehydrated? Is there anything I can do to lower her BUN or creatinine? It is also interesting to note that after a 10 day round of antibiotics for leptospirosis in December her BUN dropped to 11.9 and creatinine to 159 ( from around the same numbers as above). But a few months later she was back up to the same levels. Wondering if I have anything to loose by doing another round. Perhaps the virus was not totally eradicated.
Anyway any thoughts or tips would be great. Thanks so much for your time.
Hi ... and welcome to our family of friends. Yes, tremors are very likely to be directly connected to her kidney failure. There can be other reasons, such as an underlying primary or secondary condition, particularly neurological tumors, but your vet will almost certainly have investigated that already (if not, it's worth asking him about it). As you probably already know, when the kidneys are not performing well, the various functions the canine body relies on them for are also undermined. Over time, this affects muscle tissue, neurological pathways and other major organs. It is likely the tremors are being caused by a failure of some pathways associated with muscle stability. Essentially this could be a breakdown of the messages sent from the brain through the spinal cord and down to leg muscles.
Vitamin D plays a major role in producing tremors in kidney failure. And in turn, the absorption of Vitamin D relies on calcium. Too much or not enough calcium in the canine body will disrupt the absorption of Vitamin D. So, have your vet look at the levels of calcium in your best friend's blood sample. If there's too little, they can prescribe a suitable supplement. If there's too much, you can alter the diet to restrict calcium intake. During this process, it is essential to keep an eye on the relationship between the levels of both calcium and phosphorus ... so double-check with your vet about this to ensure things remain stable.
A phosphorus binder would be useful at this stage, but the phosphorus level needs to be stable before you can introduce one. Again, something to discuss with your vet.
If you are not yet using Milk Thistle as part of the diet, I would also consider adding this, which has some good properties and will help deal with some of the symptoms.
A couple of useful articles from me you might want to read:
http://www.infobarrel.com/Supplements_Useful_For_Kidney_Failure_Dogs
http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease
Hope this helps.
Tony
Vitamin D plays a major role in producing tremors in kidney failure. And in turn, the absorption of Vitamin D relies on calcium. Too much or not enough calcium in the canine body will disrupt the absorption of Vitamin D. So, have your vet look at the levels of calcium in your best friend's blood sample. If there's too little, they can prescribe a suitable supplement. If there's too much, you can alter the diet to restrict calcium intake. During this process, it is essential to keep an eye on the relationship between the levels of both calcium and phosphorus ... so double-check with your vet about this to ensure things remain stable.
A phosphorus binder would be useful at this stage, but the phosphorus level needs to be stable before you can introduce one. Again, something to discuss with your vet.
If you are not yet using Milk Thistle as part of the diet, I would also consider adding this, which has some good properties and will help deal with some of the symptoms.
A couple of useful articles from me you might want to read:
http://www.infobarrel.com/Supplements_Useful_For_Kidney_Failure_Dogs
http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease
Hope this helps.
Tony
I do not know about a connection to tremors but dogs will shake/shiver for different reasons. Sometimes, weakness, pain, nausea. My westie could not support herself to squat for a bm her last two days and would shake and fall when trying. Hope you all can figure it out soon, for both your sakes. Do you give anything for possible arthritis? Just a thought. Good luck
I hope your Westie Girl is feeling better. This is a very grey area with elderly dogs. I always feel less is more until you truly understand your pup's blood work. Please review Tony's articles. My Darbie Girl loves & trusts him....I will always!
Have great faith!
Lynne & Darbie:)
Have great faith!
Lynne & Darbie:)
sorry to hear of your baby's struggles. I don't know anything about tremors. My dog who had CKF did get very week in her hind end and we would have to carry her in and out. Our forum guru, Tony, is on a much needed break for a couple of weeks but when he returns he might have something to add. In the meantime, he has written many great articles on CKF and has posted them on this forum. Maybe there's some help in those!! Best wishes!
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