Young dog with kidney failure

[meesh34]

Hi all, I just found this blog and it looks like a great group with some incredible knowledge and experience. My Chow/ACD mix has kidney failure. He was diagnosed back in Oct. but has never really had any symptoms until he started vomiting this week. He mostly vomits his dinner at 4am, we thought he was keeping his breakfast down but threw up again this afternoon. He is on Royal Canine renal food, he wouldnt eat the other brands. He still has an appetite but his bloodwork this week was double from Oct, BUN:88, Creatine: 8.o and phosphorus: 8.2. Our vet really doesnt seem to know what to do with him, they recommended giving him Aluminum Hydroxide as a phosphate blocker, he is on analypril and a blood pressure med as well. We started pepcid for his nausea. Is there anything we can do for his diet? Is it time for the subQ fluids? Im not sure he would handle the needle very well, and doesnt seem distressed at all but is slowly losing weight. Thanks for any advice you can give. Hes only 6 and is my foster failure and is breaking my heart :(
Michelle

[tonyb286]

Hi again Michelle. I utterly understand and empathize with your concerns. Sadly, there is a point when the bad days outweigh the good ones and, regardless of what we try, nothing seems to have an effect on blood levels. All I can suggest is ... keep trying, for now. He seems generally contented if he still wants to go out and is quite perky, despite the lethargy and vomiting, so I don't think he's quite 'there' yet. He will tell you when he's had enough, so just be ready for when that day comes. I would rotate foods he seems to be eating - so day 1 maybe kd diet with yogurt and honey, day 2 human grade chicken with salmon oil and rice, day 3 green tripe with potato and rice and a little boiled cabbage - or your best combination of these high grade (low) protein low phosphate mixes. Fingers crossed, his numbers will start coming down a little. Tony x

[meesh34]

Thanks Tony, we have been giving him the kidney diet with a bit of his old food, as he wont eat it without. Hes lost interest in chicken and rice, but I will try the honey as well. We have been giving him pepcid twice a day and will try the phosphate binder again. We are doing the IV fluids at home daily, but with his numbers continuing to climb the vet doesnt think its making a difference. I just dont want him to suffer as it seems hes close to the end and the vet said hes probably really uncomfortable although aside from vomiting and being a bit lethargic hes still perky and wants to get out for walks.
Michelle

[tonyb286]

Hello Michelle. Yes, those are very high figures. I would urge you to restart kd diet and try to make it palatable with additions such as honey, plain yogurt, etc. He needs the phosphate binder - or if the vet says it isn't appropriate, add a tablespoon of chopped boiled cabbage to his food each day or rice bran if you can get hold of it. If he won't eat the kd diet then green tripe would be my first choice, then human grade meats with boiled white rice. All given in very small amounts four to six times a day. The fluids will be helping and without them he may not flush the toxins out, so you should be doing this at home to save on vet costs. I would also suggest some B12 vit supplements. If he starts turning his nose up at food on a regular basis, then add some anti-nausea meds to the mix.

I hope intervention gets the blood levels down. It may take a few days to have any real effect. The important thing here is to try by-passing the kidneys as much as possible, so we need to introduce nitrogen-trapping things to the diet. Cabbage is good at doing this in a natural way - and it helps with any ulceration of the stomach too - but too much can give diarrhea, so be cautious.

Tinned mackerel are a good source of omega-3 - as is salmon oil (pure variety) - which help add useful fatty acids to the diet.

Hope this helps.

Tony

[meesh34]

The bloodwork is not encouraging, BUN 177!!, Creatine 8.4, Phos 13.8 all up from not quite 3 wks ago, so the vet doesnt think the fluids are doing much for him. They wont tell us its time but I dont want him to suffer, and the vet indicated that even though he seems almost normal, he probably feels pretty awful. I dont want to get to the point where he has a seizure, or worse. Any advice on if this is the time?
thanks
Michelle

[tonyb286]

Yes, kidney specific food is commonly unpalatable, but obviously much better than the standard variety because of the low protein low phosphorus and being high in other minerals. You can try adding a tiny little bit of pure honey to it (dogs often love this natural wonder food) or even plain yogurt, if he enjoys it. Both are good for kidney failure dogs.
The other alternative (apart from green tripe, which I won't bore you with again) ... is any human grade meat, including chicken with the skin on. These have lots of protein, but it's high quality protein, which is fine ... only trouble being it doesn't have the mixture of vitamins and minerals the kd diet food has.

Tony

[meesh34]

Thanks Charlene! we tried chicken and rice for him but after a couple of days he wouldnt touch it,and he was still throwing up so the food seems to be what he will eat right now. Tony, we are decreasing the regular food, hoping to get down to almost none but it smells so much better than the KD diet that we might need to keep a handful in there.
Thanks! Michelle

[DogBlog]

Michelle:
Good to hear Rufus is having some good days.  My Sammie could never tolerate the KD diet.   Tried it several times and it always made her sick.  Cook for her now and she's doing better on that.

Prayers and doggie hugs!!

Charlene

[tonyb286]

Hi Michelle. That's good news. I know it's saying the obvious, but try increasing the renal food a little maybe every couple of days and reducing the high protein food by an equal amount. This will be better for Rufus, and he will tell you where his tolerance level is for eating the kidney food v normal food. The problem is while he may be eating the old food now (which is good as it gives him energy and calories), it will cause more toxins to be produced, which in turn will add more stress on the kidneys. The IVs won't rid all these toxins, and eventually it is the toxins that will do the most damage. It's all a bit of a balancing act and we just have to try and deal with the priorities as best we can.

Much love

Tony x

[meesh34]

Sorry not to update sooner, I cant get on here at work (old browser version) and things have been busy. Good news is we tried adding Rufus' old food to the renal diet and hes been eating for three days pretty consistently! its a grain free high quality but also high protein food, but at least hes eating something. The fluids seem to be helping and hes still on the BP med and pepcid, we took him off the renal med after talking with the vet and the phosphate blocker...back for blood work this week and we will see where we are at. Thanks everyone!
Michelle

[Fitmaltesemom]

Sending you healing prayers. My 15 year old Maltese was diagnosed with severe kidney failure in early April. So far he is eating the KD can food and drinking fluids. His kidney levels are back to normal. However, this Saturday he goes in for a blood test. Not sure what to expect.

I do wish you the best and know that you have a lot of support on this forum.

Hugs,
Elsa

[tonyb286]

Hi Michelle. Yeah, that's not untypical ... some good days, some bad ones, and the objective is to try and aim for more good than bad. When the bad days start stacking up, then decisions have to be made. It could be the IVs are taking time to have an effect. This can be slow, and sometimes it just means increasing the frequency of them and seeing if it helps. The balance between giving fluids, trying different foods, adding anti-nausea medication, all take their toll - but sometimes perseverance pays off.

Hope tomorrow is better.

Tony

[meesh34]

Thanks....this am we are right back to not eating and he threw up a ton this morning, lethargic, obviously not feeling well. Its hard to gauge and feels like we are postponing the inevitable. i guess we will recheck his numbers and see if the IV is making a difference and go from there.

[tonyb286]

Hi. What great news that is. It made me smile when I read it this morning. It just goes to show, sometimes the fluids take time to 'kick in'. Fingers crossed this good day continues into tomorrow and again the day after. If he's eating the renal diet, that will really help too. It will give him some energy and make him feel so much better.

Well done to you. Give Rufus a huge cuddle from me.

Tony

[meesh34]

After we gave him fluids last night, this am he perked up and was hungry, of all things he ate the renal food today and has been keeping it down. He seems back to semi normal, and thought we know it wont last its a step forward. We were planning to recheck his numbers in a week to see if therIV was helping. Thanks for everything all of you!
Michelle

[AmbertjesMom]

Michelle, it saddens me to hear this. I hope from deep in my heart that Rufus is just having one of the bad days. You're both in my thoughts.

[tonyb286]

Hello Michelle. I think between you, you and your vet are doing all that's possible for Rufus. I totally understand your thinking process, and apart from perhaps doing a blood test to see how his BUN, creatinine and phosphorus levels are doing with the IV fluids - I can't offer much more by the way of suggestions right now. I'm sure you are already trying to feed whatever you can - and don't worry too much about protein right now - if he'll eat something, just let him have it. Have you tried hamburger (no additives), just plain cooked and cooled. Some dogs will take this. Worth a try.

Please keep me informed. I think it's worth giving it two or three days, just to see if anything changes, and then maybe if you think the time has come to make that decision, so be it. You are there and you are the only person that can decide. I know this is hard. Stay strong.

Tony x

[meesh34]

We started the IV fluids last week, so far hes not improving. The vet suggested an appetite stimulant, so we gave him that and the pepcid but he still wont eat anything. I wish i could say something positive, and the vet didnt have any other ideas. SO I think if hes still not eating in a couple of days it may be best to let him go. Hes obviously in alot of discomfort even thought hes not showing it other than vomitting. thanks all of you for your well wishes.
Michelle

[boomersmomma]

I will be thinking of Rufus.  I hope everything turns out alright.

Best,
Kirsten

[tonyb286]

Hi. I'm so sorry he has had a turn for the worst. I truly hope your vet can offer some way through this. Sometimes it's not the end, but a bad day ... this disease tends to have it's severe ups and downs. You are in my thoughts and I'm just hoping for some good news. Rufus really needs IV fluids straight away (if you haven't already begun this) to flush the toxins out. This must be incredibly stressful for you and I'm sure between you and your vet, you will come up with the right answer ... which ever way things go. Please let us know what happens. Tony x

[DogBlog]

Michelle:

We are all saying prayers for you and Rufus.  Hopefully, the vet will be able to help!!

Regards,
Charlene

[meesh34]

After barely eating yesterday he wont touch anything at all now. last night he at two treats but no food, chicken, rice, even the tripe. he threw up some thick bile this am, we have a call into the vet but it feels like we are nearing the end. He doesnt appear to be suffering but is really lethargic and I imagine feels nauseous etc. thanks for all your help, Michelle

[tonyb286]

Hi Michelle. I would always go with what your vet says. I am not a vet and therefore cannot and should not give preferential advice. I would suggest you use the phosphate binder as prescribed. I might have given a bit too much information previously and caused concern where there really is no need for any. Aluminum can be dangerous in prolonged use. However, being blunt, your dog will not have prolonged use because you can expect to prolong life by a certain degree using kidney failure management, but not to provide many years of life (sadly). So, the phosphate binder will help reduce phosphate in the short term, and once under control, you might then try to introduce things like cabbage and rice bran to keep it within normal values.

Hope that helps and sorry if I caused you to question the value of phosphate binders.

Tony

[meesh34]

I read about 1/3 of your article last week and havent been able to get back to it...i will tonight. We are doing human grade chicken with the skin. i just bought some salmon oil and found a can of green tripe to try, also got samples of a dehydrated all natural veggie and fruit grain free food that the store recommended instead of the rice. Im still not sure I understand about the phosphate binder, the vet definitely recommended it without a second thought to how high his numbers are...it sounds bad for him, anything aluminum, so Id prefer to do the cabbage, would that produce a similar effect?
Thanks! Michelle

[meesh34]

Thank you Lynne! I need to find more time to check in here and read everyone's posts. I hope Darbie is doing well! Michelle