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Avatar universal

End stage renal failure

Hi I'm new to this forum and stumbled onto it while looking for help with my dog not eating. I have a 15 1/2 year old toy poodle named Chloe. She was my daughter's Christmas present in 1994 but has really become my dog over the years. I have noticed Chloe not eating as much and losing weight but attributed it to her advanced age and problems with arthritis. We had her at the Vet's office 3 months ago and he told me she was in pretty good health for her age with the exception on a slight decrease in kidney function and suggested putting her on KD. She has always eaten dry dog food but did not like the KD and I started mixing it with chicken broth to try to get her to eat better. When that failed, I started trying out different foods. They didn't work much better. After a trip to the Vet on April 12, the Vet called and said Chloe was in end stage renal failure. I saw a different Vet from the one I had seen before. She told me her creatinine level was at 6 and wanted to get it down to 3 so they kept her for a couple of days. I told them she would not eat the dry KD so they put her on canned KD and gave her some IV treatments. When I called to check on her they told me her level was down to 4 and let her go home. I went to pick her up and was given a very expensive bill along with a case of KD. The Vet also told me she had some loose stools and gave me pills for that with the recommendation that she take them twice a day. When I got her home I fed her the KD which she ate a little of and then the pill for the loose stool. She started to heave and I took her outside and she staggered, fell, and vomited. She didn't have any more loose stools so I did not give her any more of the pills as they made her so sick. The following day I again offered the KD but she refused to eat it. I called the Vet and she gave me a prescription for canned Royal Canin. She has only eaten small amounts of that and in fact it has taken 2 days to eat 3/4 of one can. She is not drinking as much water either. Has anyone had any luck with a diet I found on line consisting of ground beef, white rice, egg, and white bread slices? It is breaking my heart to see her starving to death. We have given her thin sliced turkey that I'm sure is not good for her since it is processed just to get her to eat something. Of course she readily eats that. I have read many heartbreaking stories on here and as hard as it will be for me, I know I will do the humane thing and put her down once she is unable to hold anything down. This disease seems hopeless and I am very sad.
205 Responses
Avatar universal
I don't have any suggestions on what you can do, all I can say is to try everything possible for her and don't rush into anything.  If you do end up putting her to sleep you will at least know there was absolutely nothing else you could do, which will help alot.  Good Luck, let us know how shes doing.
Avatar universal
Thanks I will. I went home for lunch a little while ago and was encouraged to see that the small amount of Royal Canin I put in her bowl this morning had been eaten and that she had been drinking her water. I put more food in her bowl so hopefully she will do better with smaller amounts during the day. I also noticed that she had tinkled on my carpet but I just couldn't be mad at her.
Avatar universal
Why is one food better for her than another?  Does it help her kidneys more than her regular food?  Would human food (meat) be harmful?
942557 tn?1272698419
Nutro holistic is a really good food and they usually really like the taste of it.You can boil some chicken and then use the broth and pour on some rice.Also you can use veg-all.You want to feed food that is 17% or lower in protein if you are concerned with the crenatine.Sometimes when my baby turns her nose up to her food i pour a little chicken broth on it,But i really try to limit her meat intake due to it having high protein levels.I know its hard to try to get them to eat food they dont want,Even though its what is best for them.I had to put my little girl on special food for her weight and kidneys.She weighed 26lbs about a month ago and she is a Pekingese.She has lost 2lbs so far and needs to lose about 6 more and then she will be back to her normal weight.She went blind overnight and started eating all the time and when i took her to the vet due to her vision lose and weight gain we found out about her kidneys.What stage is your baby in ?I will keep you to in my prayers.May God Bless You both.
Avatar universal
I will try the chicken broth and rice. I'm desparate for her to eat. The Vet only told me she was in end stage renal failure and didn't say what level. I will have to ask about that. She called me last night to check on Chloe and told me I needed to stick with the food that was prescribed for her. Since Chloe's hind legs are weak and she can no longer get up and down from the sofa without assistance, I have been putting her bedding down on the floor so that her food and water are easily accessable to her. She has always been a private eater and does better with her food when no one is around. It takes her a long time of sniffing and walking away before she will actually take a bite of food. Last night I took her out to go to potty before bedtime and her hind legs kept giving out on her and she kept falling. This morning she was walking better. It's so sad to watch her going down hill like this. Thank you for your prayers.
Avatar universal
The prescribed food is lower in protein and puts less stress on the kidneys. Also so much of human food has too much sodium.
Avatar universal
It is very hard to watch them go down hill, especially when walking is a problem.  Ours had Cushings, and had good days where she would roll in the snow, and the next day we had to carry her outside.  She wasn't limited to what food she could have, that must make it a lot harder for you and her.  
942557 tn?1272698419
Sometimes i pour a little chicken broth over my Pekes NF food to get her to eat it,But i do have to be careful as to not give her to much.Cause of having to watch the protein levels.It is hard to get them to eat food when they dont want it or dont like the taste.I really wish that there was more that i could say or do to help you,I will keep both of you in my prayers.If you need to talk i am here.Take care,Chan
Avatar universal
Thank you for your prayers. We are now into day 2 without Chloe eating a bite. I keep her bedding near her food and water bowls hoping she will eat something. I put out fresh food and water this morning before I left for work. She did drink some water, but has sniffed her food a few times and walked away. If she hasn't eaten anything by the time I get home this evening, I am going to try making a recipe I found on line that comes from Hills that is supposed to be suitable. It consists of ground beed, white bread, hard boiled egg, and white rice. Hopefully this will tempt her to eat. I am so frustrated and worried.
1254306 tn?1270995813
As I read your post, it brought up so-ooooooo many vivid memories of just 10 months ago with our sweetheart Sami (she was the larger, sable & white one).  She was 10 1/2 years old when we finally after 1 week of unbearable misery I put her down.  She was diagnoised with renial kidney failure in September, 2008.  She ate the Science Diet K/D wet dog food.  At first she would eat 1/2 can at each feeding, plus a little bit of dry K/D 2x  per day.  She remained pretty stable for a year.  She did go through boughts of no eating many times.  Sometimes I would give her a little bit of Science Diet Mature wet dog food since it was the closet thing to K/D.  Then last May, she quit eating anything.  The only time she would eat is if I would hand feed her little chuncks of the K/D wet dog food.  Sometimes I would lay by her and talk to her as I fed it to her.  She went from being 45 lbs to being 14 lbs in the end.  You could literally put your hands around her waist and overlap them.  

With her legs giving out it sounds like you are definitely in the end stage of the renial kidney failure.  I would have to hold Sami's hind end up the last week whenever she would go outside to do her business.  Our vet did blood work and told me it was just a matter of days.  I prayed and hoped everynight I laid with her that she would just go in her sleep.  No such luck.  Each morning she would raise her head and perk her ears as if nothing was wrong, even trying to wag her tail.  Her gums were so pail from being malnourished and she emitted an odor that the vet told me was toxins her kidneys were unable to process.  So finally I had to do the only humane thing and my dad and I took her to the vet and I held her until she finally drew her last breath.  It is so heartbreaking and I feel so sorry for you.  Those furry little friends give us so much with their life, that even in the end they try to please!!!!

Will she drink water if you dip your fingers in it and let her lick your fingers?  

Don't beat yourself up or even try to second guess yourself.  Only you know what is the best for her.   My feeling is the quality of life outweighs the quantity.  Be prepared.  the bond between you and her sometimes is so strong, that it makes them hold on even longer than their bodies will allow.  Remember, they don't want to leave us, as much as we don't want them to go.

If you need someone to talk to, we are all here.

God bless,
veryworriedmomdad,  Patty
Avatar universal
Well said.
Avatar universal
Thank you for your post. I was so much at my wit's end wanting Chloe to eat that I used a recipe I found on line that Hill's put out. She ate a little of it last night, but this morning she wolfed it down and I even put a bit more in her bowl so that was encouraging to me just to see her eating something. She will drink her water still, but probably not as much as she should be. She also likes bits of apple. I am holding on to her as long as I can.
Avatar universal
Spoil her rotten, and enjoy day.
942557 tn?1272698419
I am so glad to hear that she is eating a little.I will keep you both in my prayers.Take care.
1256099 tn?1269541834
Whats her BUN level?
82861 tn?1333457511
Kidney failure is one of the hardest things to accept in our pets.  We lost our dog Chica to kidney failure in January 2008.  She was sick for a good 6 months and showed no symptoms until it was too late.

Here are some kidney failure facts I learned along the way:

1.   There is no cure.  Period.  Once kidney cells die, they are gone forever and the body cannot make more like say, the liver.

2.   That means you want to preserve what kidney cells remain.  Use plain Tums once or twice a day as a supplement.  They're pure calcium and calcium binds to phosphorus and sweeps it out of the body.  Phosphorus is deadly to kidneys in failure.  There is in expensive product called Azodyl that accomplishes the same thing, but I found the Tums to be much more effective.  If you don't know how to "pill" your dog, have your vet show how to do it quickly and easily.

3.  On diet, your dog will suffer from malnutrition sooner rather than later if you stick with a KD diet for long.  It's not so much that you want to limit all protein, but rather find a more digestible form that is low in phosphorus.  Dark poultry meat (boiled, no seasoning) is a good cheap form of acceptable protein.  Scrambled eggs are also good, but use only half the yolk or less as the yolks are high in phosphorus.  Your vet should be able to provide you with low-phosphorus dog food recipes.  One popular one is to use high-fat, cheap hamburger meat.  Brown it thoroughly, drain thoroughly and mix in plain cooked white rice.

4.  If your dog isn't able to stay hydrated, offer low sodium chicken broth - anything to keep fluids up.  You may have to learn how to give sub-q (just under the skin) injections to supplement hydration.

5.  Once a dog is actually in end-stage kidney failure, it's more important to get him to eat anything - even if it's on the No list - rather than nothing.  The calcium in the Tums will help a great deal to keep nausea and vomiting down in addition to saving what kidney function remains.  Avoid organ meats as they're very high in phosphorus.  Add plain white rice for carbohydrates to any dark poultry meat or hamburger.  Plain yogurt is also a good choice to mix in or offer by itself.

6.  Kidney failure causes nausea and vomiting because the toxins normally filtered by the kidneys are now in the bloodstream.  There are several medications that can help.  Cerenia is expensive, but effective.  Most vets rely on reglan tablets, but beware.  Reglan is metabolized in the kidneys and it doesn't take long to build up to a toxic dose.  The symptoms aren't pretty.  The dog staggers around shaking and trembling, unable to sit still, eyes spinning in their sockets, panting, etc.  Benadryl at 1 mg per pound of the dog's weight will stop the symptoms.  We did find that reglan injections did not produce this reaction.  Sometimes all you have to do is bypass the GI tract to avoid side effects with meds, and this was one of those times.

Phenergan is a very cheap medication that not many vets even know about as a very effective anti-nausea agent.  It worked the best on our dog once we learned she could take it.  I have crhonic nausea myself and always have phenergan on hand.  When any of my dogs get into a nauea and barfing episode, 12.5 milligrams knocks it out within 15 to 20 minutes.

7.  The idea is to keep your dog as comfortable as possible, and as long as possible.  That means calcium supplements, homemade boiled foods, vitamin supplements (read labels for phosphorus content - senior vitamins have little to no phosphorus) and most important, anti nausea meds.  Don't expect your dog to keep up with regular mealtimes.  Keep offering food in small amounts several times a day.  Same goes for water.  Some dogs like various flavors of Gatorade better than plain water, or even ice cubes, so experiment a bit.

8.  Believe me, you will know when it's time to say goodbye.  Once the toxins in the blood reach high enough levels to cross the blood-brain barrier, you probably won't even be able to get a response from your dog.  Copious vomiting and dry heaving usually occur by then because no medication can keep up with the toxins.  It's more heartwrenching than I can say to have to make that last trip to the vet, but still the kindest thing you can do for your suffering friend.  Meanwhile, treasure every good moment that happens in every day.  You'll probably find that your dog will cycle back and forth from good to bad several times in any given day.

Feel free to write any time.  You aren't at all alone in this.  :-)
942557 tn?1272698419
I just wanted to check on your baby and see how she was doing.I hope that she is eating a little better for you today.You two are in my prayers ...May God Bless You.
Avatar universal
Thank you so much for the advice. I am definitely dreading the day when she does start to get really sick. This is such a cruel disease. One of my sisters had to put her dog down because of renal failure so I know what is coming. In the meals I prepare for Chloe I have crushed up Tums. She eats but not much. Some days she sort of staggers around and other days she looks perky and almost back to normal.
Avatar universal
Thank you for your concern. At the moment Chloe seems to be doing alright though not eating as much as I would like to see her eat. I am taking her back to the vet tomorrow to check her levels. I will post again once I hear what the vet has to say. I really appreciate your prayers. Blessing to you.
1254306 tn?1270995813
I wish I would of stumbled upon this site back last year when I really needed it.  I searched the internet high and low and only found information that made me second guess myself.  Your information would have been useful knowledge.  The vets in are small town are good, but seem to be limited in knowledge sometimes.  I had asked for any recipes and got nowhere.  

Feel good knowing your giving her the best care!!!  We've all been through this before and will be there for you.  (Lord knows a non-animal lover does not have a clue to what you are feeling or dealing with!)  It's good to have people who are compassionate on your side.  And we all are!!!

Keep us informed.
patty
942557 tn?1272698419
If you are concerned over her not eating enough you can use Nutri-cal.Your vet or a local petstore should carry.It really helps as far as keeping them from not getting weak and gives them the nutrients they need.It is highly palatable and most really like the taste of it.I will keep both of you in my prayers.May God Bless You.
Avatar universal
Thank you. I will ask about the Nutri-cal. Chloe is at the vet now for a check-up so I will post when I get the results.
Avatar universal
I received a call from the vet and she told me Chloe's creatinine level had gone up from 4 to 5. She suggested a suppliment that she is going to order for me called Azodyl. Is anyone familiar with that? I am certainly going to give it a try. She has also ordered another suppliment that I forget the name of to sprinkle on food. Hopefully these will help.
82861 tn?1333457511
Azodyl serves the same function as the calcium in Tums, and helps to remove phosphorus from the body.  I remember using the powdered stuff on our dog's food as well, but can't remember the name of it either.  It didn't take too long before Chica refused to eat anything it touched.  The azodyl was pretty expensive as I recall, and it just didn't make one bit of difference with Chica for the month she was on it.  I went back to Tums only and she did better.  Hopefully your Chloe will have a better response.

How is Chloe doing as far as nausea and vomiting are concerned?  I pray she doesn't have that part of it too badly.  
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