Sorry to hear of the loss of Cookie; I am sad for you. I am also dealing with a dog with Chronic Kidney Disease and would welcome guidance and advice. I am new to the forum and this is the first time I've posted here.
My pointer dog Courage was diagnosed with the early stage of CKD when he was at a dog shelter, after having been allegedly abandoned by his owners of 7 years at their vet's office. I adopted him with full knowlege that he probably would only have a year or two of quality life expectancy and I wanted to give him a loving home until his time comes. He is now 9 years old and I've had him faithfully on the prescription K/D diet and have been having my vet run urine tests and bloodwork on him and he's been doing pretty well until the past couple of weeks.
This week there was a change in him where he started refusing water and when this started, I took him to me vet and also began making homemade broth made from just water and the meat bone which he has been drinking for me. My vet gave me a thing of SubQ fluids and instructed me on how to use it (in case he needs it). 24 hrs ago the diarrhea started and my vet instructed me on bland diet of rice, using yogurt, and how to keep him comfortable since Courage was refusing the KD. This morning I found that Courage had vomitted the rice in his crate overnight and had an accident in his crate. Cleaned him up and got his crate cleaned up. He is stable and he is hydrated at present.
Today is Thansksgiving holiday and pretty much any grocery store or pharmacy I can think of is closed. However, our local target store and I think our local WalMart will open at midnight for the black Friday shoppers. I am trying to keep Courage comfortable and it seems like maybe he is starting the thing with either mouth or nasal ulcers because I found him scratching at his nose and it seems like he is trying to rub and scratch inside but can't get to it (because I suspect his nasal lining is irritated or inflamed. When stores open, I am wondering what else I can get him to help him stay comfortable? He hasn't had the mouth or nasal ulcers previously, but I think he's got 'em today because this morning he was rubbing his throat and nose on his bedding and he seems tender and irritated from my observation. I opened his mouth to examine him and his breath has a new acid smell that he hasn't had previously. I took his temperature this morning and he does not have a fever and is within normal canine temperature range; so I feel he's stable and not in need of emergency vet care at present. Since he didn't vomit the broth I gave him at lunchtime and he has managed to keep down the handful of K/D kibble I gave him then. Nonetheless, I do plan to call vet first thing tomorrow morning.
Courage couldn't keep down his blood pressure meds this morning with his tummy being upset (they are non-coated Rx pills), so I have just been keeping him quiet, clean, and keeping him hydrated with the homemade broth. Haven't yet needed the subQ since he is drinking the homemade broth and he did eat a handful of KD mixed in with the broth this morning.
I had a urine test done on him at the vets on Monday and he doesn't have a UTI. Blood tests show his levels are only slightly elevated; but his blood pressure was HIGH at 280-300 (the machine has a max of 300). Am wondering how to calm down the GI tract and calm what I suspect are some ulcer issues in nasal or throat until vet opens tomorrow morning? It seems like the yogurt and rice upset him, but he is keeping down the home made broth.
Sorry you and Cookie went through this. Courage wagged his tail when I brought him the broth and he pointed at a blue jay outside this morning; he's a bird dog who loves to point birds. He's moving slower and seems unhappy with himself over the diarrhea and accidents. This is a stoic and proud former field hunting dog who doesn't want to have accidents even though they are unavoidable. I am loving and accepting of the accidents; yet he seems embarassed even though I do not scold him in the slightest.
Vet's office opens at 8am tomorrow and I'm trying to keep Courage comfortable until then. At present his gums look good and he's hydrated. Just want to calm down what I think are nasal and throat ulcers and not sure of how to do that until tomorrow morning when vet will be back in office. I can't see any ulcers in his mouth; but I sincerely think they are in the nasal linings and in his esophagus (not sure how to spell that) based on the smell and based on his behavior or trying to scratch at his throat and nose.
Thanks for any guidance you or others may offer. please forgive any mispellings or if I've repeated myself since I was up every two hours last night taking out Courage due to the diarrhea; I didn't get much sleep since I was trying to keep him comfortable.
I do admire your taking in Courage with the knowledge of his condition. My close friends and family always used to ask- why did it have to happen to you and to her? My thought was always this- I'm so glad that she was mine rather than someone else's who might not have had the patience or the heart to deal with this...
Do you know what his Creatinine and BUN levels are? That will clearly tell you if his kidneys are worsening...
The biggest battle I faced with Cookie and I think many others did as well, going by their posts was with acidity. Please check that he does not have metabolic acidosis (blood test). if not, you can do the following for uremic gastritis and acidity:
Diet: timing and nature of food. Yogurt might have been acidic and triggered the acidity. I used to give her a rice gruel with jaggery (good for iron) and sweet potato (boiled and mashed). Multiple small meals were good- if she did not eat on her own, I would syringe feed her, just so that she was not on an empty stomach for more than 3-4 hours.
Gastritis: You must be giving him famotidine-pepcid? this can be given twice in a day, so please make sure he gets it in the evening.Cookie's acidity related vomitting was usually early in the morning, before i aggressively tackled the diet. There is something called Sucralfate which I found to be excellent for gastric ulcers. Give it at least an hour before you give the pepcid (both times of the day), because it works best in an acidic medium.
Let me know if these work- you should see some results in a couple of days...
Also, try cold milk - that might help alleviate the acidity somewhat...
I was so sorry to hear about Cookie.
Cookie was so fortunate to have you caring for her....without you, she would not have made it this far.
It is so nice of you to share your experience with others...it will help so many others who are struggling with this disease.
God Bless Cookie....her story will give hope to so many others......
Please accept my Heartfelt Sympathy for your loss.
Thank you, Connie...No matter how prepared we are for the final parting, it still is so difficult. The only thing I keep thinking is at least she did not suffer too much. Her worst was still to come , in terms of pain and suffering...She was a mere shadow of her old self in the end, but at least she was cheerful. Also, while a relatively pain free end is one of the biggest goals, I also think some of the things I tried, if I had commenced earlier, they would have kept her alive longer. I work in a biology based organization involved in finding new therapies for Diabetes and metabolic diseases and there is so much data on studies in canines for different indications, suggesting that there might be more hope in the future...
Thanks for your helpful ideas to help Pointer Dog Courage; I very much appreciated your help. Things changed dramatically and very rapidly overnight with Courage; it was very, very scary!
I rushed Courage to my vet Friday Morning because between 1- 5am his condition deteriorated so rapidly that nothing was working. It was like overnight while I was monitoring him and taking action to try to stabilize him, he was crashing anyway; none of the supportive measures were helping. By 5am, it seemed to me like Courage started going into shock; so I got ahold of the vet through the emergency answering service and they told me to bring him in immediately. My vet ran new blood tests on him and I was surprised to learn that his Creatinine was still at 1.8 (which is where it was on his 10/12/2011 blood test) and his Urea Nitrogen was still exactly at 32 (also same as 10/12 blood test). Bun Creatinine ratio was same as previous bloodwork at 18. Because the blood levels were the same as last month, vet felt that his rapidly advancing symptoms were not due to a kidney related crisis. Here's the surprising news:
On Friday' morning's blood test, Courage's s sodium was super low and his potassium changed in such a way that my vet suspected something called Addison's Disease!
She started Courage on an immediate IV, and in the IV she gave him injections of Cerenia (a med to tell his brain to stop vomitting), vitamin B12, Famotidine, and an antibiotic called Cefazolin. She gave him Predinsone and within 8 hours of him being at the vet hospital, it was like he was back to his old self...although a little on the tired side. What a relief it was to see Courage again wagging his tail. He was very happy to see me and was well enough to go home with me. Vet gave me these meds to take home: Metronidazole, Forti Flora Packets, Azodyl Caps, Prednisone for a few days) and Famotidine tabs.
Vet said prednisone is only for a few days because late next week, she wants to run an ACTH stimulation test on him and he'll need to be off the Prednisone for a few days so that when they run the test, that the prednisone won't cause a false test result for Addison's.
Today Courage seems totally fine. He was hungry and ate his prescription K/D kibble and he even brought his toys to me because he felt imrpoved enough that he actually wanted to play! What a change and what a relief because yesterday morning when I rushed him to the vet's, I was frightened for him because he deteriorated so incredibly fast. Vet says Addison's symptoms imitate other illnesses (including Chronic Kidney Disease) and he might have both conditions simultaneously. She suspects an Addison's Crisis is what happened over Thanksgiving.
Since Courage's blood test kidney numbers have been so stable for the past year and since they haven't really changed; his kidney disease is relatively stable and I think the K/D dog food has helped him.
Thank you for being so supportive with your advice for helpful supplements for Courage's food for his kidney disease and ideas to help keep aciditiy low. I think Courage will enjoy boiled and mashed sweet potatoes; I'll ask my vet about the Sucralfate that you mentioned.
Courage sends you happy pointer dog tail wags and he thanks you for your suggestions to help him feel better!
Again, I am so sincerely sorry about Cookie.