CHF and Renal failure shi/poo 8 pounds

[giovanni_lou]

CHF diagnosis 7/2012
placed on Enalapril 2.5 mg twice daily
Lasix 12.5 mg twice daily
9/2012- I reduced lasix to 1/2 tab twice daily
5 vet visits in between then and now and not once was renal disease mentioned to me as a possiblity and no labs were drawn.
Emma- My girl- seemed fine, gained her energy back, lost the fluid weight and was eating..
11/2013- I notice Emma is loosing too much weight but still energetic.
Vet says try new food and if it continues we can check labs for potential kidney problems.
I make her turkey burger and rice daily...she loves it...gains a couple ounces.
4/2014 Emma went to another vet to have labs drawn to see if she was healthy enough to undergo anesthesia for a dental
RENAL FAILURE
BUN, Creatinine, Calcium and phosphorus all extemely elevated
New vet says
Vetmedin, Benazapril and supplements
Old vet says
stay on the enalapril, lasix and give Sub Q fluids every day
I read enalapril and lasix combo causes renal failure

Emma begins vetmedin on 4/11/14 as well as 1/4 tab lasix...she is now coughing like crazy since the new vet did two manual exams on her trachea to illicit the cough response...prior to that NO cough for about 8 months.
NOW..DIARRHEA from the vetmedin...I stopped it this morning 4/14/14
I am so freaked out...what do I do?????
My girl seemed fine and now she is losing her appetite, decreased energy, cough and diarrhea.
can someone please advise???
thank you so much,
CG

[giovanni_lou]

thank you so much for your concern.
I am about to try a third vet for another opinion but still just very confused.
I hope to make my sweet girl as comfortable as possible and wish I would have known sooner about the medications that cause renal disease.
thank you again

[giovanni_lou]

Now that we are aware of the renal failure there will NOT be anesthesia for a dental. She was having trouble eating but the teeth are the lease of our concerns at this point.
Metvedin absolutely caused diarrhea as she is no longer dealing with that but is now getting dehydrated.
fluids SQ started this morning
back on Enalapril and lasix at lower doses but those are the medications that protected her heart and yet caused renal failure....
so confused
One vet offers phosphourus binder the other does not
one vet says yes to fluids and the other says it will kill her
just looking for any helpful information.
thank you

[LoveMyBostons]

I'm sorry to hear that. Unfortunately, the medicines that treat CHF eventually cause kidney failure. The same thing happened to my Petie.

I'm sorry that your vet didn't explain this to you. I hope that you can find a vet that you trust and together you come up with the best treatment plan for your dog.

[amielynn24]

You shouldn't just start and stop Emma on pills just because they are upsetting her stomach, or making her sleepy. There might be an underlying problem - maybe it's her disease giving her diarrhea, etc.  Also Enalapril and Benazapril are ACE inhibitors.  They help control hypertension as this can be elevated when dealing with CRF.  

I'm a little confused why your vet would suggest a dental surgery and anesthesia when your dog's immune system is down - heart and kidney failure are two serious diseases... especially at her age.  I certainly wouldn't consider putting my sweet dog under anesthesia when she was battling kidney disease unless of course it was absolutely necessary.  

Coughing can indicate a heart murmur and with CHF it's possible that your doggy developed one.  

What are you feeding her now?  Is she drinking enough water?