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675347 tn?1365460645

Early stage renal failure. Advice appreciated

My Misty was diagnosed today with very very early stage renal failure. I was aware she had started drinking more than usual, and in spite of the vet reassuring me the quantity of water she was taking on board was still in the "normal" area for a dog her weight, I knew that something was wrong.
Her urine test showed no abnormality, but her blood test showed Creatinine slightly raised, and urea also. Sufficiently for the vet to give that diagnosis.
He did say we have caught it at a very early stage. There is no elevation in her Phosphorus levels right now.
He has put her on ACE inhibitors (one a day) which will improve blood flow to the idneys,and an antibiotic, to see if that will  completely eliminate any subtle presence of infection (although her white blood cell count was not elevated)
She as also been given Royal Canin prescription Renal diet (canned and dry kibble)

She is acting very fit and well,  eating well, no other symptoms, she doesn't know anything is wrong with her!

This is right out of my league, I know little about Kidney Failure, am reseaching of course, and am doing everything the vet advises. But please, I would appreciate any advice (particularly diet-related) from anyone who has experience with this.

She likes the (notoriously unpalatable) Royal Canin Renal dry food, which I am introducing gradually over the next few days, at the beginning alongside her regular food. She wolfed it down! So that's a good start.
But I need to know, apart from that, what else can I and can't I -give her?
I am aware low protein is the key....but would she be allowed ANYTHING else at all? Are, for instance, vegetables not allowed...or egg white? or tiny pieces of apple....or saltfree wholemeal bread, etc (which is the best thing to wrap her tablets up in to get her to swallow them!)

Any advice would be much appreciated,
Ginger
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Avatar universal
Stay with it Ginger.  I have reserached and researched for many hours and I think what you are doing is right.  The Royal Canin and a little added "good protien" is what I have come up with.  We are in early diagnosis with a 12 year old Westie.  So far his energy is absolute.  I am hoping the leaking, water drinking and blood elevations will lessen over time. BTW, Dr. Dodd recently recommends The Honest Kitchen Preferrence with a small amount of added "good proteins"  and you know what they are.  But why not just stick with what you are doing now?
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Avatar universal
Stay with it Ginger.  I have reserached and researched for many hours and I think what you are doing is right.  The Royal Canin and a little added "good protien" is what I have come up with.  We are in early diagnosis with a 12 year old Westie.  So far his energy is absolute.  I am hoping the leaking, water drinking and blood elevations will lessen over time. BTW, Dr. Dodd recently recommends The Honest Kitchen Preferrence with a small amount of added "good proteins"  and you know what they are.  But why not just stick with what you are doing now?
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675347 tn?1365460645
COMMUNITY LEADER
Blessings Rachel! And to Morgan, and may she continue to flourish and be well. Green tripe is notorious for being disgusting, but dogs do love it.
Your food routine sounds wonderful.

It's weird -re-visiting this thread I started when I was worried about Misty way back in September 2011. Oh boy -even though she peed the bed at that time, and drank too much water....she was a lovely healthy-acting girl who raced about chasing frisbee and dog-trotting for miles each day, defying her age....and those days were so incredibly happy.
Memory Lane -hey?

I wish Morgan well. She is well-loved, and has a k9 gourmet chef to look after her! My blessings.
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Avatar universal
To everyone who has just received a diagnosis of kidney (renal) disease or failure from the vet:

My 14 1/2 yr old shepherd/rottweiler mix, Morgan, was diagnosed 2 years ago with advanced chronic renal failure. She seemed to be deteriorating rapidly and we expected to lose her within 6 months until, in total desperation, I got brave and stopped listening to the vet's advice to put her on prescription 'low-protein' diet food (we tried Hills KD and several others) + phosphate binding pills plus other meds. Instead I researched a TON on sites like DogAware and started Morgan on a raw food, high-quality protein & low-phosphorous diet plus daily supplements which I'll list below. It's not the most convenient at first, the food's pretty gross, the cost is about £40 per month for the food, and another £25 for the supplements, but my dog turned around straight away with this diet, both in her behaviour and her blood BUN and creatinine levels. Now her blood work is down to nearly normal, she loves to eat, doesn't drink any more than normal, and with her bright eyes and shiny coat most people think she is several years younger than she is. I'm in London, UK, but from NYC, so I know that there are alternative suppliers of the products I us - just be sure to research all ingredients.

Every day, my 27kg (59lb) Morgan eats the following: From Nature's Menu dot co dot uk (not *******!) the Chicken&Tripe complete dinner. Defrost two individual "meal" packs and mix with 1/2 teaspoon of eggshell (which I save from our breakfasts, then wash, let dry out, and grind into fine powder in a cheap coffee bean grinder I got off Amazon - once a month I make a batch. It's pure calcium carbonate, the same stuff you may be buying from your vet only without any manufacturing additives). Also mix in a big spoon full of plain yogurt or good quality probiotic powder. I use a teaspoon of Green Vibrance powder, which is the best but unless you can buy in bulk it's very pricey (then again, I haven't had a vet bill in 14 months!). Also mix in 100mg of CoQ10 (get these in capsule form from a human health food store, open up, and pour the powder into the food. If your dog is elderly like mine and suffers from arthritis, also pick up from the healthfood store (or I order everything from amazon): Turmeric (500-720mg), Green-Lipped Mussel extract (I use Musselflex 500mg, which I have to crush as it's not a capsule), and Thorne Research Arthroplex for Canines (2 capsules). Mix all together very well along with at least a cup of water (filtered unless you know your tap water is excellent - in London it's not) then divide into 4 small meals spaced throughout the day (keep the rest sealed in the fridge - it smells a bit. If your dog has trouble with upset stomach (eating grass, vomiting) I give Mo a 75mg tablet of Ranitidine (generic ingredient in Zantac).

Here's the last bit, which I'm a strong believer in: everyday I give Morgan about 8oz or so of raw green tripe, which I buy in frozen chunks from the Nature's Menu website. This stuff is foul. I keep it and the rest of her food in a small freezer only for the dog (£60 at Argos). I can only handle it with rubber gloves, never open the bag in the house, and toss the frozen chunks into her bowl out in the garden, but she will never refuse it, no matter how low her appetite ever becomes. It's naturally calcium-phosphorous balanced and is hugely nutritious - in the wild, this is the first part of the prey that the dogs eat. Even if you don't do any of the other supplements (except you must always add the crushed eggshell!) the green tripe is seriously important. Anyway, my vet, husband and friends have been urging me to post this info around, given what a miracle it's been for Morgan's CRF and general health. I can promise that I'm not some wacko - it's just that I did SO much research and experimentation with all the prescription diets, alternatives, home-cooked meals, etc. on the market in hopes of keeping my best girl with me as long as possible...Now that I've discovered a routine that's working so well, maybe we'll get another 14 yrs together :) Best of luck to all of you and yours, Rachel
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2 Comments
Hi Rachel.  How is your dog doing? I would like uotknow more about the diet you are giving you dog.
Hi TOOMundo,
Rachel4thAve hasn't posted since 2014. It's possible he won't be back. This is quite an old thread. I hope you find some advice for your dog's diet.
Avatar universal
Hi everyone.
My 13.5yr-old Pomeranian Sunshine just died yesterday. I keep wondering if there is something else I couldve/ shouldve done. He had end stage renal disease and congestive heart failure. I was just reading about all the treatments you all went through - ours happened v v fast. We ran a battery of tests last month because he drank water at all hours of the day and night, urinated a lot, and was incontinent. Nothing was noted about his kidneys. They said this breed often had issues with pancreas. But several days ago, I noted diarrhea, then bloody stools.  A couple of nights ago, his breathing was labored, he would not move, was too weak to eat or drink - so I hand cupped water so he could sip it. I took him to the vet yesterday. She was not sure she could give him fluids subq, so she sent me to a referral hospital. They rushed him into an oxygen chamber to address the respiratory distress - and after a cardiac ultrasound, confirmed his CHF status. His renal numbers were off the charts. They recommended euthanasia "here and now." The toughest decision for me to make,especially since he was still alive looking at me. Not a sound. Not a bark. I held him closely in my arms and lap as they adminstered the dose. My heart hurts today. He will be cremated tomorrow.  I hope someone else's dog lives today. Bring a little Sunshine into all your lives. ~Katie
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Avatar universal
Small correction I meant subcutaneous fluids not i.v. Just learning these words.
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Avatar universal
Ginger, please know in your heart that you are such a great fur mom. I am so sorry to hear about your Misty.  
I relate so much to your posts.  On top of everything, my baby has a mouth infection and has to go in for dental surgery (9 teeth extraction even though i clean her teeth every night!) and a lower breast lump removal if i can get her kidney numbers down. I am terrified, but your posts give me some strength. Take care. Misty was very lucky you were her person and fought so hard for her.  My best to you, FM.
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675347 tn?1365460645
COMMUNITY LEADER
As far as her kidneys were concerned, my Misty did extremely well. In early February (2012) her bloodwork was taken again, and the vet found her elevated Creatinine and BUN had come right down to within "normal" parameters. She continued to be fit and well, healthy and happy. Her bloodwork was done again end of March, and the vet said if he hadn't known her history he could not have suspected she had any kidney issues at all.
She underwent surgery for breast lumps -sailed through it. Was still fit and well. Her kidney values remained healthy.
Unfortunately in late May 2012 she was diagnosed with Hemangiosarcoma, and succumbed to it in 2 weeks.
I miss her dearly. She was one of the best Souls I have ever known.
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Avatar universal
Thank you ginger for posting this. I cry every night because My 13year old chi also was diagnosed w crf sept 2012. No big warning just her mouth was dry.  It pained me to put her on science diet k.d. Because i had her on a holistic diet.  I don't even buy organic chicken for myself but I bought it for her. The good part she is doing well on the science diet and the ingredients is mostly water so it's not too junky.

She is also a treat lover so we use the liver flavored glucosamine tablets instead of cookies now. Just have to find one they really like that the vet says is ok.

Giggamo ask your vet if doing I.v. Fluids is an option.  We got her Bun # down by over half by doing that for a week. (4 sessions). The vet tech can do it or you can get a kit from them.  If you catch it early and dedicate yourself my vet said he got extra years doing the I.v. Hope this helps.
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Avatar universal
HI I just found this post because I was looking for answers to dog kidney disease. My 13 years old chihuahua was just diagnosed with kidney disease and I am having hard time coping with her sickness. Its sad to watch your baby sick and there is nothing that you can do to fix it. I am doing everything to make her comfortable. She is not showing any distress sign at the moment. The only thing showing is excessive drinking and urinating, more coughing than usual. She loves to eat and now we have to put her on low protein prescription diet. I don't know what treat to give her because I don't want to make matter worse for her. Dr has not put her on any new medication. she has already been taking enalpril and vetmedin for her heart problem. Should I be concern and ask another dr? How long will she live? I don't want her to suffer. How do I know if she's in pain or not. Im not even sure what I want from writing this. I guess I needed to talk to someone about it. By the way how is your dog doing?
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1 Comments
My dog is going through the same thing. I saw your post was from 2012. I hope things went well for your dog. I'm so devastated, and was looking for some help on this forum. My dog is on the same things your dog was.... Do you have any advice?
675347 tn?1365460645
COMMUNITY LEADER
I'd just like to add another update...
We went for her blood test the other day and it is GOOD NEWS. Her Creatinine and Urea nitrogen have both come down a lot! The levels are now at the borderline of "upper normal"
The vet and I decided to keep her on her tablets (Benazecare -ACE inhibitors) for the next 3 months and see what happens. He said it won't do her any harm.
She is now drinking much less water than she was drinking when she was diagnosed. Also she hasn't wet the bed for ages.

I'd like to take the opportunity to say that if anyone has a dog who suddenly starts drinking more than usual, no matter how fit and well the dog might seem...do take it to the vet for a blood test. If early stage kidney failure is caught early enough, and treated well, there is positive hope.
(There can be many reasons why a dog starts to drink more, kidney failure being one of them. But always run it past your vet)
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1832268 tn?1326816010
I just wanted to take the time to say...."Thank-You" ....for giving so much of your time to help so many of us....you are amazing....Connie
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675347 tn?1365460645
COMMUNITY LEADER
Thank you Karla, and Margot.
I HATED the idea of her eating that processed food which contains "animal proteins" (not specified) and "animal fats"....corn gluten... I was shuddering at the very thought...
Yet the vet nutritionist had no axe to grind. She wasn't selling me the food. She didn't work for Royal Canin. She did say it had excellent results with stabilizing kidney function. And apart from that I am a great one for "gut feelings"...and when I observe Misty's energy levels since being on the food they have been even BETTER than before. I must say I might have to put an emotional reaction to her diet change on hold....
What you see is what you get...?
OK so the meds might have something to do with it.
But I feel things are looking quite good right now, so I don't want to rock the boat too much.

We spent an hour in a beautiful Church today. Kind of by accident as a big storm came up on our walk, and we dashed in there for refuge, and the rain came pelting down, with thunder and lightning. Misty went right to the altar and lay down for a break, and I felt she would be looked after......for now anyway.....
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974371 tn?1424653129
You have a lot of good info but I can add a little. When our Grey was diagnosed with renal disease, I was overwhelmed with all the info.  Of course, my Vet recommended the Science Diet ID.  I am not a fan of that food. I contacted Jean Dodds and we discussed foods.  She said make sure the food is low in phosphorus and recommended Wellness, I think it was. In the mean time, I was checking the Natural Balance and Evo canned food (the canned Evo after the cancer diagnosis) Anyway, I started feeding the Natural Balance Fish and Sweet Potato, which Dr. Dodds said was fine.  He has done well on that and he was also put on daily enalapril to keep the pressure down in the kidneys. Of course, he is over 12 years old now.  He was maintaining and eating the Natural Balance well but then we had the cancer diagnosis.  :-(  You might want to check on those foods. She did tell me to make sure of the protein source and make sure the diet is low in phosphorus.  Hope all goes well
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462827 tn?1333168952
Thanks for the update Ginger...Please, keep them coming.....I for one, am following them.....Also, I'm praying for both you and Misty......Take care, Karla
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675347 tn?1365460645
COMMUNITY LEADER
I'd just like to add an update in case it is of any help to anyone else whose dog has been diagnosed with early-stage kidney insufficiency ("failure" seems a rather harsh word to use for the very early stages!)

Misty is even better than usual right now. I spoke to a veterinary nutritionist. She put my mind at rest re: the Royal Canin Renal diet. And I have to admit it seems to suit Misty. She has had very good energy on it (2 weeks now)
The nutritionist did however, say that a little high-quality protein such as boiled chicken or fish or eggs with a few vegetables wouldn't do much harm at this stage.
Misty had no blood phosphorus elevation at her test. However I add a pinch of powdered eggshell to her food if she has anything OTHER than the Royal Canin diet. To "mop up" any phosphorus which will stress the kidneys. The nutritionist agreed with that. She did mention it wasn't the small amount of protein that was the problem, so much as excess phosphorus in her diet which could be hard for her kidneys to process.

She is still on the ACE inhibitors (no side effects at all) and continuing the month-long Amoxycillin course.
She now sleeps through the night without either wetting the bed -or diapers! Great! That means I don't have to get up before dawn to go potty!
And -she is drinking far less water.
And more importantly -she seems so very fit and well, with energy which is almost paranormal for a dog her age. Bless her.

All maybe good signs. She is due for another blood test mid November. Fingers crossed.
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675347 tn?1365460645
COMMUNITY LEADER
Thank you Connie.
I won't keep posting here now, unless there is something interesting to report. But I found the nutritionist online. She's not exactly very near me, but not too far away. I just googled "veterinary nutritionist" and then my area, and got through to this lady's vet practice. I liked the sound and "feel" of the place, and her work, etc, so am going to consult with her tomorrow morning.
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1832268 tn?1326816010
Ginger....!
That sounds like a wonderful idea....!
I don't think we have anything like a veterinary nutritionist around Northern Minnesota....!
Lucky Misty....!  Having guidance with her new diet will be a big help.
I will be sure to check in once in a while to see how things are going for you both....Until then....Best wishes for both of you....Connie
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675347 tn?1365460645
COMMUNITY LEADER
No, there's no regulation against them or anything, it's just that I don't see them here in pharmacies, there are other products instead, like Rennies, etc... trouble is, the other products don't just have Calcium Carbonate, but other additives I'd be unsure about giving her.

She does seem to be drinking SLIGHTLY less today again. That's not my imagination as I measure her water. She got up to 800ml a day (28lb dog) which was  WAY more than she's drunk all her life especially as she does have some "wet" food too. Yesterday she drank 480, today about 500 so far. She won't take on much more now because it's late evening and she doesn't drink after about 11pm(!) dunno why!?

Anyway I've decided to cut to the chase, and stop myself having to carry the world on my shoulders. I have booked a consultation with a veterinary nutritionist, who is also a practicing veterinarian. She has the knowledge I need to be able to really trust what to do.
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1832268 tn?1326816010
Ginger....I'm SO glad to hear you don't spend your entire day at the computer..!
And even better, I'm glad to hear Misty is just going with the flow, and probably enjoying her new and exciting menu...!  Ground eggshells are easy, a mortar and pestle really grinds them into a fine powder. You mentioned you cannot get Tums....?  Why not...?  Are they regulated by presciption only...?   Tums are available over the counter here in the U.S........HMMMM...what's up..?
Thanks for such and uplifting report on Misty....Have a great day...Connie
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675347 tn?1365460645
COMMUNITY LEADER
Oh Connie....I can never rest until a problem is cracked wide open! I have been known to stay up all night to solve something before I can sleep!
But I know -this can't be solved in a day or two. It's something I will learn more and more about each day.
I don't sit at it all day though. We run around the countryside most of the daylight hours!

Anyway...very interesting update....
I started adding ground eggshells to her food (to act as Phosphorus-binders) I am told that because she had no Blood Phosphorus elevation when she was tested, that isn't so important at this stage....But I did it anyway. I didn't think it would do any harm.

Well, I gave her a 1/4 teaspoonful with her breakfast food (about a half-pound weight) and the same with her dinner (same weight) And tonight I look at her water dish, and can see that today her water consumption was HALF the amount she was drinking before. (she has been drinking water like it was going out of fashion for weeks)
Now I don't know if that really means anything yet. I might be speaking too soon. But there is a definite change tonight
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1832268 tn?1326816010
Hi Ginger....
I've been thinking that as long as she is Happy and Ok with the Kidney Diet dog food, let her have it...I mean, it doesn't sound very good to us, but if she is OK with it, then take some comfort in that. As long as she is more than Happy to gobble it up, it will give you some time to do your research, and you can relax alittle, knowing that she is OK with the food.
I do know what you mean about the confusion of proteins and the renal diet.
There seems to be growing evidence, that protein does not accelerate the progression of the disease, as much as Phosphorus does.  
Some studies even suggest that Dogs with Renal Failure may need more protein in their diets....!
All the inconsistancies about this disease, drive a person crazy.
So many people find out about their dogs kidney failure when the disease is fairly well progressed. This forces many of us to have to make hurried decisions about diets, medications, tests, etc.
You found out early, so you do have some time to figure out the best plan of action.
Do yourself and your dog a favor, and take a little breather....get away from the computer tomorrow...and enjoy your dog...!
Connie
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675347 tn?1365460645
COMMUNITY LEADER
Connie, thank you very much. I didn't feel my answer to your survey question was very useful really. I know you need more answers yet from more people who have had this problem with their dogs.

I think I have been trying to do "too much too soon" the last 3 days, and got tied up in knots, as I expected the answers I sought to be fairly cut-and-dried. But -as I am learning, Kidney Failure has so many different stages, and responses to those stages re: diet and medication etc. And the solutions are not all just there on a plate.

Yes she is fortunate that this was discovered early. The vet sad that too and said it was good that I pushed for a blood sample even though even HE didn't think her water drinking was excessive (but I know my dog! And I know when somethng is different about her)
Of course, the only thing that can EVER be done with KF is hopefully "plateau out" at the stage the dog is at when the condition is first diagnosed. And keep that going as long as possible before full renal failure happens.

She likes the Royal Canin diet food. No problem. Both the canned and dry variety. I have her at about 80%/20% (R.C. to her old food) by today. Her energy levels are spectacular. Her general condition and fitness -wonderful. Her appetite -great. I've noticed a very slight weight gain on the new food, but she looks fine, and that's probably because I haven't got the portion measures right yet (she won't complain!)
But she is still drinking lots of water, as before. I keep thinking -if we really really stabilize her, surely her heavy drinking will ease up a bit?

Anyway, this is a learning curve and I am working at it.
I'm aproaching the point where I'm wondering if adding a phosphorus-binder (Calcium Carbonate in the form of ground egg-shells as I can't buy "Tums" here)...might help a lot, so she can have some protein foods like chicken or fish in moderation.
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1832268 tn?1326816010
Hi Ginger....
First, may I say that I am so sorry to hear that your dog has kidney insufficiency starting. But you are fortunate that it was caught early.
Also, Thank-you for your response to my post about a possible survey.
As you are discovering....this disease requires many difficult decisions by the pet owner....it is overwhelming.
I wish I had some definitive answers for you.....but the reality is, you will have to decide.
Have you tried the new food yet....maybe you dog will be ok with it.
You could Mix it half and half with her regular food for now, until you can come up with a plan you are comfortable with.
Also you could check into www.b-naturals.com They have a kidney diet you might be happier with...
Wow...your work is cut out for you....! If I can do anything to help you with your research let me know.......Connie
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