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End stages of Kidney Failure

Hi Everyone..... This is one of the most difficult things I've ever had to deal with. My beloved Gypsy is dying of kidney failure. Gypsy is a Jack Russell Terrier and she turned 18...yes 18...on Christmas Day.

It's just so hard to know when it is "time." I prayed and prayed that she would give us one final parting gift and die on her own in her sleep...but she is SUCH a fighter and refused to surrender to this thing. We keep her comfortabel with sub-q infusions daily, Calcitriol, Aluminum hydroxide and novox. One day she seems bad and then the next day she is up and climbing a full flight of stairs and getting on the sofa by herself! Other days she can barely stand.

She sleep most of the time but today she has been shivering almost uncontrollably. I finally wrapped her in a warm blanket and held her for a while and she stopped shivering...she is asleep now.  This is GUT WRENCHING. I know that you are all thinking that "OMG...she is 18...she's had a long life...put her down" but if you knew Gypsy... well she was spry as can be until she had to have surgery in November for a tooth abcess... She was under anesthesia way too long and developed acute pancreatitis (she also came back almost blind because the stupid vet didn't moisurize her eyes and she developed corneal ulcers)...She recovered from that (still can barely see) but then her kidneys started failing and haven't improved since.

She is skinny as a rail now....will only eat a bite or two occasionally (I supplement with Nutrical).. I read about how people look into their dogs eyes and "know." That hasn't been the case with me yet. I look into her cloudy eyes and just see a fighter who only wants to be with me.

My question.....How do you KNOW when it is time? AND, is there ANY chance she will just fall asleep and not wake up...or is everything I'm doing for her (infusions, etc) stopping that from happening?

Please help me....
103 Responses
441382 tn?1452810569
That's how it was with my Katie.   I kept hoping she would just go to sleep one night and not wake up, but she was stuck to me like glue and one morning she jumped up from laying down and came and stood by me.  I asked her what was up, like I always did, and when I looked into her eyes I just knew.  Hoping I was wrong, I asked "wanna cookie?" and got absolutely NO response.  I knew.  My husband was shopping in town and I grabbed my cell and called his cell and said "hurry up and get home, Kate's dying."  He got home and she was laying on the floor with me and her poor nose and her lips were very cold.  We called the vet to come out to help her go, but while he was on the phone with the vet she licked my hand, I told her she was the bestest girlie that ever lived, and then she died.  I'm crying all over again writing this.  I miss her SO MUCH every day!  I can't seem to get over her.  I had NEVER been so attached to a dog and even though I knew she could not have beaten it, it still doesn't help.  But you will know.  You will know beyond a shadow of a doubt.  I don't know how to tell you that you'll know, but you will.

Ghilly. Sorry fo your loss..i know 3 years later. I hope you are at peace with Katie's passing. You are lucky to have a chance to say goodbye the ways she did. She really loved you.  I am dealing with the same thing right now and ironically my dog is named Gilly. I dont know if I was mean to find this or not.  Perhaps this is a message from her that she will be ok. I just dont want to let her go.  She is a good girl, a fox terrier mix..maybe a lil Jack Russell.  I thought I would have many more yeas with her only being 14.5.... I guess life is never predictable.
1989182 tn?1327016716
its never an easy choice, i worked in a clinic and i saw many people faced with what you are faced with now... i have also had to make the choice with my own pets.. i had a cat who was dying of kidney failure... i didnt know what the right time was either even though animal medicine was my feild... but after a lot of soul searching i decided that when his suffering out wieghed his quality of life then it was time to go.. unfortunatly there is nothing much you can do in animals with late stage kidney failure... and it can be quite uncomfortable to have, it causes pain and nausea. because the blood is becomein g toxic to the body. there is always the chance that she will die in her sleep, she will die adventualy no matter what you do... the question (and i dont mean to sound cruel) the question is whats best for her. not what best for you, its hard but you have to really look at her with all the love in your heart , and ask is her life mostly suffering or does it still have an exceptable amount of pleasure... when the situation is terminal i usealy let go when they no longer eat, aniimals cant tell you how they feel but i think not eating is a good indicator... im so sorrry for you, its so hard everytime.. i just hope that i didnt come across to cold
1832268 tn?1326816010
I am sorry to hear about your dog.
To answer your question about whether or not the supportive measures you are giving your dog, will stop her from dying in her sleep, the answer is no.
The things you are doing, are merely supportive, they only make her feel more comfortable.
Eventually as the kidneys start to shut down...the toxins will build up in her system. These toxins will make her more nauseated, she will vomit more, may have more diarrhea, her breath will start to smell very bad, she may start to stagger, shiver, or tremble. She might act confused or disoriented. She may develop mouth ulcers, and also ulcers of the G.I. tract..you may see blood in her stools. She will become more lethargic, and want to sleep for many hours. She will start to urinate less. She may have seizures, or she may go into a coma, and die peacefully.  We would all want them to die peacefully in their sleep, but this is not always the case.
I have read many peoples posts on kidney failure in their dogs. Most people say that when their dog stops eating, The time is near.
Watch for increasing signs and symptoms.
I pray that she will go peacefully in her sleep, but if this is not the case, I am sure you will know when it is time to let her go.
My heart goes out to you.... ( My lovely little yorkie..TwoBits had kidney failure. I sure do miss her.)
Give your dog lots of hugs and kisses, and tell her she is the best dog in the world.
1916673 tn?1420233270
Oh my, I am so sorry. Reading your post and the subsequent posts from Ghilly, hyenakiss and Connie had tears rolling down my eyes (again). I lost my beautiful lurcher BB to this devastating illness in late November. It is heartwrenching to hear what you are going through, particularly as it brings what happened to BB and our 'family' all back. I can tell you that kidney disease can fool you into thinking things are ok for a while, as there are good and bad days, but sadly the bad days become more common and eventually there are only bad days with no good ones. I would agree with what others have said, once a dog stops eating completely, the time is very close (probably two or three days at most).

And although it might be hard to believe, but yes, somehow our best friends do tell us when they want to go. Heaven knows, it's the worst thing to see in a dog's eyes, but that's what my girl did - it was a look I would never want to see in a dog ever again. Utterly heartbreaking. And when your Gypsy gives you that look, you will know she wants you to help her to go. My heart goes out to you and your girl ... I just wish there was something more positive I could say to ease the pain. Big hugs, Tony
Avatar universal
hi we lost our gorgeous yorkie in march ,mia was her name she was 12 2 wk before ,she ,was playing 48 hrs before the end ,but it was horrendous ,she had 4 seizures in 48 hrs 2 mild 2 very bad ,the last one was it ,and i still didnt want to take her to the vets ,but i stroked her head and all of her scull was moving and her jaw started clicking ,it broke our hearts on hind site we should have took her when she had her first ,to let go ,but the vet gave her some tablets hopefully to stop the seizures but it didnt help,she was such a poorly girl and we will miss her forever ,and little milly who is 11 misses her 2 ,but you will know the right time it wont be easy ,but please think about your girl and not what you want bless you both
Avatar universal
hi we lost our gorgeous yorkie in march ,mia was her name she was 12 2 wk before ,she ,was playing 48 hrs before the end ,but it was horrendous ,she had 4 seizures in 48 hrs 2 mild 2 very bad ,the last one was it ,and i still didnt want to take her to the vets ,but i stroked her head and all of her scull was moving and her jaw started clicking ,it broke our hearts on hind site we should have took her when she had her first ,to let go ,but the vet gave her some tablets hopefully to stop the seizures but it didnt help,she was such a poorly girl and we will miss her forever ,and little milly who is 11 misses her 2 ,but you will know the right time it wont be easy ,but please think about your girl and not what you want bless you both
Avatar universal
I am going thru this tonight, Sadie is in final stages, throwing up, diarrhea, but still wags her tail when I come home, so happy to see me.  She loves sleeping with me, I pray every night God will take her peacefully, but not yet, I'm putting in a call to the vets now to see if its time, if I can stop crying long enough.  I hate kidney failure.
Avatar universal
Guys, i am sitting in my office reading all your heart wrenchign experiances and i just want go back home to my Jerry boy... a month  back he was al normal and suddenly in the last wek or so stopped eating..,. he lost weight gradually in about 4-6 months and developed a lump near his ribs.. the doc said this could be a lymph node welling and not malignant...
Yesterday we had his blood tests done and and his creatine is 14 way high.. which mean sign of ill functionaing kidneys... its been 3-4 days since he has been lethargic , sleeping al the itme.. rarely peeing... not passing stool except for watery droplet here and there and not eating at all..i dont know if its the right time or not.. a dog whose only motive in life was eat eat and eat.. the scooby doo kinds.. i cant watch him sinking like this... he is a 11yr old pariah and i know for a fact that dialysis and treatment like that would only delay the inevitable.. which in a dig s life span would be a couple of months of suffering.. i dont want to see him sufer.. i am a strong guy.. who doesnt cry.. but a tear just roled down my eye and type this
6796332 tn?1384888064
goining thru this now..just lost my rescue dog.she passed in her sleep..I just pray Titus goes same way..throwing uo...little blood in stool today..my heart is breaking
1832268 tn?1326816010
Hi Weedogsmum,
I know it will be difficult for you to write about your dog, but, could you
Tell me more about Titus. Do you know what stage he is in...?
Is he eating a kidney friendly diet...? Do you have him on any medications?
Tell me about your rescue dog...did she also die from kidney failure..?  How long ago?
I am so very sorry. My heart hurts for you. It is so difficult to watch our loved ones leave us. Please accept my heartfelt sympathy.
My thoughts are with you ,
Avatar universal
I just lost my dog yesterday to kidney failure I'm so heartbroken it was awful! Constant puking, not eating, I'm so sad I don't know what to do :(
1832268 tn?1326816010
Hi Donna5928,
I'm so sorry for your loss. I know how much you are hurting right now. I know that you are like most of the rest of us in this dog community. We love our dogs, they are part of our family. When they die, it is a huge loss.
True love is a bond with something, it has no boundaries, it is not something that is exclusive to humans. I feel bad for both the animals, and the people in this world who never experience that.
I wish I had some good advice to help you overcome your grief, but the truth is...you just need to allow yourself to grieve...know it's ok....and never feel the need to have to explain yourself to people who don't understand what you are feeling.  
It has been 2 years since I had my Twobits euthanized.(Because of kidney failure)  I still grieve for her. It took me a very long time to get past crying all day long.  Grief is a long road to walk. It will take time. Others can walk it with us, but no one can walk it for us.
Now, speaking of walking....you may find it helpful, to go to your local shelter, and volunteer to walk dogs. The exercise and the doggy companionship, will help you relieve some of your stress. (and the dogs)  It is something nice you can do for yourself, and at the same time honor your beloved dog, by helping one of her own kind.  In a strange way, it may help you feel connected to the dog you have lost. ( I have done it in the past, and it helped me. )  If you don't have a shelter, perhaps you have a neighbor or friend who would let you walk their dog?   Give it a try.
I wish I could be of more help, if you need someone to talk to, you know where to find me...!  
My thoughts are with you during this difficult time. Please accept my heartfelt sympathy.

1832268 tn?1326816010
vihsyaj.....I just read your post.....how are you doing...?
Avatar universal
My heart hurts tonight as I read your stories. Thank you for sharing... It helps. I learned last week that my beautiful, loving shar-pei , Richie is in palliative condition for kidney failure. I pray he stays comfortable until it's his time... I hope he goes peacefully, at home.
Avatar universal
My heart hurts tonight as I read your stories. Thank you for sharing... It helps. I learned last week that my beautiful, loving shar-pei , Richie is in palliative condition for kidney failure. I pray he stays comfortable until it's his time... I hope he goes peacefully, at home.
Avatar universal
I am so sorry for all of you and understand your pain.  My 11-year-old Bailey has been diagnosed with kidney failure.  She started a few months ago with a UTI and protein in her urine that continued to elevate.  Now her BUN and creatinine are elevated and she just recently became symptomatic.  My husband and I are having such a difficult time.  As a lot of you share, we are giving her SQ fluids and her appetite has severely declined over the past week.  We, too, don't know if she is currently suffering and do not want to be selfish in just keeping her alive for our sake.  Our vet was blunt earlier in the week stating she probably has weeks to a month to live.  We love her so much!!  This is gut wrenching.  Thanks to all of you and this blog.  We are not alone.
Avatar universal
Hi, we are in a similar situation with our Bearded Collie, Shana. She has Congestive Heart Failure and is now in Kidney failure. She is 16 and has had 4 litters in her life but like Gypsie, she is a fighter. However, we were up all last night with her as she had diarrhoea and was very distressed all night. She is now sleeping soundly. She can't stand up since yesterday and I was thinking like you but after communicating with a lovely vet on 'Just ask', I agree with him that it would be kinder to end her suffering. Shana was also doing pretty well until last October when she had an anaesthetic to remove a polyp from her womb. She bled a lot afterwards and has never been quite the same since.
We are most likely taking her to the vet tomorrow to end her suffering. So sad. I wish you all the best with Gypsy. Anna
1916673 tn?1420233270
Hello. I think you have arrived at the right decision regarding Shana, sorry to say. She is an elderly dog and things are likely to deteriorate rapidly, which means she will be suffering as time goes on (when I say time, I mean days or possibly weeks, but not months).

It is a heart wrenching decision to make, and only you can make it. You know your dog better than anyone else. Most people don't think dogs can communicate their feelings, but I totally disagree with this, because they talk to us with their eyes. When Shana gives you 'that look', you will know, even though it will break your heart to recognize it.

My heart goes out to you. If tomorrow is the day ... then so be it. Shana would thank you, if she could, for being so brave and for taking her suffering away. You are in my thoughts. Tony
Avatar universal
Beautifully written! I lost my beautiful Husky last month to other reasons but I am here as I am watching my snowy, an American Eskimo, who I rescued last year (now 13 1/2). This pain is so real. I do not want her to really suffer. She has licked the fur off of her legs. I just bought her a little girls long-sleeved crop top cotton hoodie to cover her front legs. I have put coconut oil on them to relieve the itching as she cannot get to them. I also put it on the inside of the one ear that bothers her. I learned to use this from my chiropractor. (I am a chronic Lyme patient and and have dry skin issues.) her tremors and shaking has gotten really bad and that worries me.

She has not had seizures or the vomiting. I do not know about the stools as it is hard for me to go outside due to my disabilities. However, I would know as she would have diarrhea on her hairy hind end. She has started to be unsteady on her legs. I had to make the difficult decision last month with my 13 year old Gus and know I will have to with this precious little one. She sleeps closer and closer to me every night.

All the posts here are making me cry. My heart goes out to each and every parent here!
Avatar universal
I lost my very first dog, the dog I grew up with from age 8 to 24, from kidney failure. He was 16 when he died. It was only 3 1/2 months from diagnosis until when I took him to be euthanized. That was back in 1980. He was a happy boy until the end. He just stopped eating and drinking. I took him for his last walk before taking him to the vet. I could not stop crying for so long. My hormones were crazy as I was a month and a half from giving birth to my first born. He was a colicky baby so I decided that if i was going to be up with my son, it was time to get our first "new family" dog. As it turned out, Brady was born the same day as my son! Brady helped ease the loss of Kutzi (Kutya in Hungarian means "dog".). It was a new beginning for this new young family but no dog could replace my beloved companion!
1916673 tn?1420233270
Hi. I am sorry your best friend is going through this. I think it is wonderful that you gave an older dog a chance at some happiness, and I guess you probably did so knowing you may not have a huge amount of time with Snowy. You don't mention what Snowy is suffering from? The licking and itching could be so many things and I don't want to second-guess an inappropriate response. Perhaps you would tell us. Tony
Avatar universal
I feel for all of you.  To the person inquiring about the itchiness- in humans when your blood phosphorus is high, itchiness is a symptom ang with the shaking/tremors.  My dog suddenly staryed rubbing her chin in her paws a few days ago, desperately.  And her ears are red.  Have been using oil of oregano pet ear drops and Melissa's aloe for pets.

  Right now I am staying up with my beloved Lulu, a 14.5 year old Staffordshire Terreir and my best friend.  She is the sweetest, funniest and adoring dog I have ever known.  She was diagnosed with stage 3 in November,  most likely due to daily use of metacam for arthritis.
I started cooking for her and giving her supplements and she was doing well until this afternoon.
All of a sudden she was twitching more in the face and front paws and looked dopey, hard to stay focused.  But she ate all her food and went to the washroom normally.
She is fighting a UTI too right now though and having some accidents.
Before bed I gave her some blueberries and then as a special treat, popcorn.  She really wanted the popcorn but she seemed like she was having trouble staying awake to eat it.
Then I took her outside to the washroom and when I brought her in she collapsed from a bad seizure.
She has been sleeping since and only opened her eyes a few times-  two more if those times brought on two more seizures.  It is so sad that I don't know if I will be able to look into her lovely eyes again as her illness seems ready to take her away.
It is so sudden, she had such a good day yesterday and I was sooo happy.  Now I'm in shock.  I need her to live for my parents to see her on Saturday. I am too numb to process this, my life revolves around her.
1916673 tn?1420233270
Hello. Hoping Lulu is okay. I would say, if she is still eating, then half the battle is won for now, even though you are clearly aware that time may not be on your side. There will come a point when Lulu looks at you and says the words, 'Im ready.' Hearbreaking as it is, it's your last responsibility to her to prevent further untreatable suffering. I am not there, so cannot say whether that time is rapidly approaching, though I fear it may be.

You are both in my thoughts. Tony x
Avatar universal
Sent by SweetBeauty808 Jan 31, 2014
Hi Jay,
I've been reading your tips and comments on this topic and it breaks my heart with all the stories, and at the same time given me some good advice.  Yet I am puzzled with the situation I'm in and the direction I will be heading with my dog.  My just turned 3 yr old lab was tested Lyme positive back on dec. 26.  No full panel blood was taken at the time though the vet said she was going to do that. My dog was given doxycycline and pain meds.  She was throwing up everyday and we went back to the er to get sucralfate for possible ulcers and an anti-nausea...still no bloodwork.  2 weeks later, my dog had complete leg lameness, wouldn't get up and was vomiting on herself on her bed. We take her to the vet who finally does full panel and we are rushed to the er vet for fluids.  Come to find out now 3 weeks later, my dog is diagnosed with esrd.  Yet there's a twist, somehow her cells are attacking her own body.  So not only I am dealing with that, we have an underlying problem.  She is then hospitalized for a whole week and I went to see her 2x daily. I  was so disappointed at the care and I could really go on about that,  but we ended transferring her out to a top university vet hospital.  She was then hospitalized there for 3 days but because further I could only see her for an hr 1x daily.  I feel like I abandoned her, but at the same time, maybe that's why she decompensated.  finally was told that her prognosis is not good and had three options.  To euthanize her, care and comfort at home, or tubes in her vein and her urethra.  I took care and comfort at home.  Since then she is still here with us today being a week later.  We took her back in for lab work two days ago and her bun went up 2 points at 246 her phosphorous has gone a little lower at 4.9 and her anemia went up from 19% to 20%. Her kidney shows at least half kind a looks good and the other half doesn't.  Her rine of her kidney is gone, but her kidney is slightly a little bigger that kidney size, so it hasn't shriveled like in so many stories I read.  It made me happy, but now, she's not drinking as much as we've been told she is severely dehydrated and with ulcers in the mouth.  I feel like I'm on a roller coaster. Making all kinds of food for my lucky water as she enjoys one thing one day and another a different day, and then for the first time, not really eating yesterday. But everyday she pushes herself on a jog/ run for about 25 minutes and everyday going outside then coming in, she shakes like crazy. Mi put my heating blanket on her to stop her shake.  With the food, yesterday she would only eat turkey dogs.  I understand that the vet wants her on the kd formula in which she eats a t times, but I feel so lost. I don't know how much time I have with her, I don't know how to keep her steady on a particular food in which I find myself boiling eggs, dark meat chicken, and ground turkey and hotdogs everyday.  The egg whites she did enjoy and she was eating 9 egg whites a day!  Now to none.  She now has fluid therapy under the skin, taking pepsin, enalapril, anzemet, decreasing on the prednisone, and on lactate ringer solution with a,ledozapine.  She's my beautiful dog and her same litter brother lays by her everyday.  I feel lost and am in tears everyday please help guide me through this.  With the wrap around autoimmune on top the kidney disease, the docs and I are just in a puzzle, and though they would like a biopsy, I don't think my poor a a scooby Dee will make it out.  
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