Chronic Kidney Failure in Dogs User Group

[tonyb286]

If anyone wishes to join the Group (your input and participation will be appreciated) or anyone that has a dog with Chronic Kidney Failure and wants information, advice or support ... please click the following link: http://www.medhelp.org/groups/chronic_kidney_failure_in_dogs

Tony

[anmllvr]

Tony....Thank you so much for getting back to me.  Dickens has another vet's appt. this coming Wednesday.  I will post the blood panel results to you then.  Enalapril was prescribed the very first time the vet said he had kidney disease.  He said to give him one pill per day.  I didn't know enough to ask him if it's for high blood pressure.  Also, the vet didn't say he's at stage 2, I found that on the internet...I will ask about all these things on Wednesday.

[tonyb286]

Good. The blood results from the point of diagnosis will give the stage of kidney disease. Armed with those results, we can proceed from there. Just for information ... The Enalapril (often a good choice for kidney disease to increase blood flow through the kidneys) can induce additional inappetence, so temporarily discontinuing the drug in dogs with enalapril-associated anorexia and then re-administering a lower dosage after the appetite returns is usually successful. The dosage can be increased back to the desired total daily dose after two to four weeks.There's lots that can be done, if it is stage 2, to help prolong life and quality of life.

Tony

[anmllvr]

Thank you Tony.  Question for you...Along with the new results this coming Wednesday, would it be helpful to give you the initial results??

[tonyb286]

Yes definitely. Comparisons are good, for one thing, but it would also help see what stage things were at at the point of diagnosis ... along with any other abnormalities in the blood/urine panel.

Tony

[anmllvr]

Hi Tony.

Got the blood panel results back on Dickens.....Don't know if it makes any difference, but Dickens is 13 1/2 years.

I'm going to start out with the blood panel results first taken on November 17, 2016.  Needless to say, this is going to be long.

ALB          3.4
ALP           53
ALT           38
AMY          1502
TBIL           0.3  
BUN           74
CA             10.3
PHOS        8.5
CRE           1.8
GLU            91
NA+            146
K+               4.7
TP               6.4
GLOB         3.0
Suffix     QC    OK
               HEM 0  LIP  1+
               ICT 0

Results from Feb. 17, 2016

ALB             3.0
ALP             117
ALT               30
AMY             1507
TBIL             0.2
BUN             69
CA                10.6
PHOS           8.1
CRE              2.0
GLU              94
NA+              146
K+                 6.0
TP                 5.7
GLOB           2.6

Suffix             QC  OK
                       HEM 0  LIP 0
                       ICT 0

Also wanted to tell you that for some reason, Dickens has gone from 29.5 lbs to 31 lbs in the last 3 months.  No idea why, but it sounds good to me.

The vet didn't prescribe anything else.  As a matter of fact, he was pleased that things have not progressed any further.

Get back to me when you can.

Donna

Oops, forget to tell you that the enalapril..is being given to enhance blood flow through the kidneys (just as you had suggested).

[tonyb286]

Hi Donna.

Okay, I've looked at the comparable blood results. The first thing to say is your dog has pancreatitis (I'm fairly certain about that). The pancreas can become inflamed, often due to high fat diets or (exacerbated) by obesity or endocrine diseases such as hypothyroidism. It can also be caused and made worse by certain medications. While this is a painful illness, pain-killing medications are often damaging to the kidney disease and can make the pancreatitis worse. Therefore my earlier comments remain justified.

Is your dog considered overweight for his breed and size? If not, have you been feeding a high-fat content diet prior to Dickens getting kidney disease? If neither of these are relevant, then your vet needs to discount hypothyroidism by having a T4 blood test undertaken.

In the meantime, a reduction in fat content in the diet is crucial - and this may even correct the pancreatitis over a couple of weeks. The muscle spasms you mentioned earlier could be partly due to pancreatitis, although I suspect the slightly increased potassium level may also be contributory.

Higher than normal potassium is not very unusual in kidney disease, but it is important to discount other potential causes - including kidney or urinary tract stones. An ultra-sound and white blood cell (WBC) count will help identify if stones are a problem.

Phosphorus is also too high. Dogs acquire phosphorus directly from food, and normally (in healthy dogs) any excess is excreted through the kidneys. In kidney disease the kidneys are damaged and cannot excrete excess phosphorus, which then acts like a toxic substance in the blood. Reducing phosphorus intake is therefore important (check all the foods you may be feeding, including treats, for phosphorus content). The additional way of controlling it is to introduce a phosphate binder. The best I suggest is aluminium hydroxide, which your vet can supply.

The creatinine has crept up very slightly and this puts your dog on the border of stage 2 to stage 3 kidney failure. Protein restriction is now advised. You can either home-cook (choosing the right ingredients) or continue with a specialised kidney specific manufactured CANNED dog food. Hills kd is one of the better ones, but there are many others too.

I would leave him on the Enalapril for now, as that should help things a little. But definitely consider stopping the Rimadyl and Tramadol, as these will affect the kidneys and potentially make the pancreatitis worse.

Okay. There are quite a few things in my message that you need to talk to your vet about, so I'll leave you with them for the time being. Please get back if you have questions and/or after you have spoken with your vet.

Tony

[anmllvr]

Thank you so much, Tony.  I will address a few things right now.  I was shocked when you said that Dickens has Pancreatitis.  The vet never mentioned that..............Dickens is a big Cocker Spaniel.  When diagnosed with kidney disease, he only weighed 29 1/2 lbs.  The vet is very pleased that he's gained weight and is up to 31 lbs......All of our dogs have been on a very fine and highly recommended low fat diet for a good 3 years......The canned dog food that he is getting is the Hills k/d that you mentioned.

Would you care to expound on what I can expect given the stage that the kidney disease is in??  AND, is the weakness in his rear legs exaserbated due to the kidney disease?
(Before you answer that the vet has said for at least the last year that his back legs are weak and that he might very well have arthritis is them.)

Thanks Tony.  You are a God sent.

[tonyb286]

Hi again. The hind leg weakness could be congenital, but really only if it's always been there since he was a young dog. How old is he now? Muscle weakness is a fairly typical sign of neurological and mineral abnormalities associated with kidney disease. I would be surprised if it didn't have a direct correlation, but it could equally be arthritis or a combination of both conditions.

When you say he's a big Cocker ... do you mean just big for his breed or too big for his breed? In other words, overweight? If overweight, then gaining weight is not a good thing, as it will adversely affect the pancreatitis.

It's curious that he's got pancreatitis if he's been on a low-fat diet for 3yrs. The blood result that points directly to it is the amylase, which has been consistently high on both blood results. I would raise this with your vet and please let me know what he suggests (cause, diagnosis and treatment/management advice).

Tony

[anmllvr]

I just joined your group about 1 week ago.  My boy, Dickens (Cocker Spaniel) was diagnosed with Kidney Disease 3 months ago.  After going online, it looked as though he was Stage 2 after getting the results of the blood panel.
He is on a special kidney food, plus is taking Enalapril, plus Rimadyl for the pain.  Yesterday he was put on Tramadol for the pain, also.  Up until today, he has been eating very well and drinking his usual amount of water, plus urinating and pooping as he always did.  Today is the first day that he really didn't want to eat his Rx dog food.  So, I got special canned food prescribed by the vet and he did eat a little more.  Recently, he has started shaking.  Primarily in his hindquarters.  There has been  several times in  the last 3 days where he could not get up on his own.  He is getting a little hunched looking.  (Not all the time).  He doesn't want to sleep in my bed anymore (and must say, I really miss him).  He seems to prefer sleeping on a hard service...................Because all of this is so new to me, I'd like to know if other people have experienced these same things with their dogs.  I don't know what to expect.......I'm afraid because I see him going downhill.  I know this is a deadly disease and, at some point, I will have to make the decision to let him go.  But, until then, I need to know if there's anything else I can do to give him perhaps a little more quality in his life and to keep my boy happy.

[tonyb286]

Hi. I would really like to see the blood results. Can you copy them here? If it is Stage 2, then special renal food is NOT appropriate (yet). I would add that dry dog foods are never appropriate, so avoid them at all costs. Canned foods are okay, as long as they are of the highest quality, have low phosphorus and low sodium content ... but more about that later.

Is the Enalapril for pre-existing high blood pressure - or is it being given to enhance blood flow through the kidneys?

Do NOT give Rimadyl. This will make the kidney disease worse.

Tramadol is another problem ... it should only be used in very low doses for dogs with kidney disease and only used for the period of time it is absolutely necessary.

I will comment more after seeing the blood results, but for now you might want to have a read of my article on diet here:

http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease

Tony

[tonyb286]

Hi. I regret to say 5 years is unlikely. Most dogs with CKD can be maintained if the diagnosis is caught early and effective management and treatment undertaken, but for maybe 2yrs at the very most. The kidney disease is progressive and terminal. Without good management, the time is hugely reduced to sometimes maybe only a few days, occasionally weeks or months. I'm sorry that maybe isn't what you were hoping for. On the plus side, you are doing the right things and it's clearly having a positive effect. I'm post two links to articles written by me that I think will help you ...

http://www.infobarrel.com/My_10-Point_Plan_for_Dogs_with_Kidney_Failure

http://www.infobarrel.com/Changing_Diet_During_Canine_Kidney_Disease

Please take your time to read them and then come back and ask any questions you may have.

Tony

[Charliebrownerickson]

Hi. My dog Charlie Brown(10yr old yorkie/Shitzu and the love of my life) was diagnosed with kidney disease on October 6th after I had blood work done to make sure he was healthy enough to get some lower front teeth pulled. The vet called me and told me the terrible news. His blood was way off the charts, showing a BUN score of 127 and a CRE score of 2.9. The vet gave him a life expectancy of 2mo - 2yrs, which broke my heart. I immediately put him on a KD diet, ordered a new water filter, and kidney gold drops. I started breaking his meals down into 3 per day with water added, and encouraged him to drink before bed and in the morning when he woke. When I took him back for repeat blood work three weeks later(October 26th) his blood work improved substantially. His BUN score fell to 67 and his CRE score fell to 2.16. This made me very happy. That day I started him on the Kidney gold drops and plan to get repeat blood work done on Nov 16th. I have been giving him egg whites as a treat(and to put the kidney gold drops on). He seems to be doing well, except that his trembling has increase. It has happened once in awhile over the last few years, but it seems to be increasing substantially. I love my dog more than anything and obviously want him to live as long as possible as long as hes not in major pain. I really don't know what my question is, I just really want someone to tell me that he could live another 5 years if taken care of properly. Given that hes on a KD diet, should I be giving him any vitamins or supplements?   Any response to this would be appreciated!!

[tonyb286]

Hi. You're very welcome. I think there's a real chance of getting this under control, but it's going to take a lot of work. I do think you need to pay some attention to reducing protein - the kidneys just can't process them and are releasing them back into the bloodstream, causing more toxaemia. Keep trying the kd food ... even adding things like a small amount of probiotic or natural honey that many dogs enjoy. Sub-Qs will help bring the toxic levels down, and then it's a question of keeping them down with diet changes and supplements. You probably know, this won't cure the kidney disease ... but once stable, it may provide many months (very occasionally, even years) of additional time and an improved quality of life during that extra time.

Tony

[Debsbrett]

Thank you Tony. Our Max won't touch the tinned k/d or the dry even moistened with chicken stock. The vet suggested a mixture of hamburger and rice and to try giving her a teaspoon every half hour to see if she could keep it down. She LOVED it! It is now 8 pm here and she has had about half a cup in total of this mixture. She has kept it down and so far no diahrea. The meds I gave her was Fortekor 2.5 mg. 1 tablet once a day for 14 days. And also Metoclopramide 10 mg. 1/4 tablet one every 8 hours for 7 days. Really strange earlier when I went to take my daughter's friend home, Max didn't want me to leave and almost wanted to come with me. When I came home she wagged her little tail and then wanted beside me on the couch in her usual spot and we fell asleep for a nap. She is now resting comfortably. I will mention the possibility of infection (urinary) and also more flushing of her system. Sub Q. Will keep you posted. Thank you so much.