End stages of Kidney Failure

[PHolsten522]

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....

[tonyb286]

Hi. Okay. 3 days fluids is not enough. She needs more over a longer period, at least a week - followed up by Sub Q fluids you can give at home. If she is still on Proin, ask your vet about stopping it. This drug is indeed given for spay incontinence, which is common, but it should not be started and then ignored - it needs assessing a) whether it is working; and b) whether it is needed.

We could talk about the foods you are trying, but right now I think that is pointless. The important thing here is fluids and while the vet is giving IV Fluids, they can also give nourishment at the same time.

Next, your vet needs to prescribe Mirtzapine for your dog. This is excellent at lifting any depression and anxiety, and also treating the nausea and inappetence associated with the kidney disease and toxin production. Once started, this drug can help improve eating very quickly.

Blood pressure check remains a critical thing to get done.

High quality meats and poultry are important with any dog that has kidney disease (high quality means meats and poultry you would buy to eat yourself, not any designed as pet food). In addition, small amounts at regular intervals (rather than one or two large meals) help reduce stress on the kidneys. Fatty meats like lamb, beef and pork are good, as long as there's no pancreatitis. Stop all other foods and treats for the time being. The alternative is to use a kd manufactured canned diet, such as Hills kd, and drizzle a small amount of organic honey (just a teaspoon) or pure cocnut oil over the top to encourage eating. If you can get your hands on some frozen green tripe at a good pet store, this is also a food many kd dogs will eat even when they turn their noses up at other things.

Enough to be getting on with there ... let me know how you get on.

Tony

[mcfur]

Hello, I came across this board and would love some insight! I have a 13 year old dog who was diagnosed with CRF on February 2, 2016. The lab test showed Creatinine of 6 and Urea of 271 mg/dL. She was put on Cerenia for nausea, tramadol for pain, sub-q fluids (she weighs 12 pounds, we are giving her 250 ml daily), and kidney friendly food, which she refused. The only thing I got her to eat was cooked chicken breast. As of 2-10-16 she has refused all food (was eating very very little before that). She had her blood tested again on February 10, 2016, Creatinine had dropped from 6 to 3.5, but Urea increased from 271 to 279. She is currently at the vet getting IV fluid therapy, and we will find out today what her new numbers are. I wonder if it's worth trying to keep her alive, am I just prolonging her suffering? She had a fever as well, I am not sure if that can be due to CRF? She is not having a good quality of life, not eating, not active (only gets up to lay in a new spot or to urinate). I love her sooo much that I don't want her to suffer, and want to do what is right. Any suggestions for me? She is not throwing up (which may be due to taking Omeprazol and Cerenia), has not had stool since February 5, 2016. Thank you!

[sadiesmygirl]

My vet who put her on Proin did no test what so ever when putting her on Proin. No blood test, no urine test, no blood pressure check. Nothing. She was drinking excessively and peeing excessively at that time and had begun wetting herself whenever she was asleep. I was told her incontinence was due to being spayed. They did not moniter her after the Proin. When we took her for the second opinion she did the urine test. I was told there was no urine in her urine. She did the 3 days of IV fluids with her numbers only rising. I was told she has chronic kidney failure. After she was diaganosed  I read up on it. She has had signs for months. She has begun to flinch when ever I touch her, but she doesnt cry..never has. She is not a vocal dog. No barking or whining. But I think she is in pain. I have not been given any kind of pain meds for her. I have been told this is not a painful way to die. But she looks like she is starving to death. She has eaten at most 6 ounces a day for last 5 days.

[tonyb286]

Hi. The problem here is I can't tell just how bad things are without a copy of the blood test results, a blood pressure check,  urinalysis (for specific gravity and protein leakage) and a reason why Proin is still being given (assuming it is). It's worth noting that Proin should never be given without the dog having a blood pressure check, so I hope this was done at the start of this treatment. There are more natural remedies for incontinence, which I personally prefer.

And talking about blood pressure, this is something that needs doing, as high blood pressure is common in kd dogs and simply makes things a whole lot worse.

The priority here is to get the blood numbers down, if possible, and that means IV Fluid Therapy using Lactated Ringers fluid. This is the only chance I believe you and your vet have of making a difference, but it is not guaranteed to work (if the kidneys are too damaged, for example). The fluid therapy needs to be intensive and treatment will involve veterinary care for several days. The blood should be tested at Day 3 to see if any change has occurred.

Sometimes, things can deteriorate very quickly. It is then when euthanasia may be considered appropriate. "When is the right time?" is a hard question. Your dog will tell you (sounds crazy, but believe me it isn't). She will give you a glance that says, I've had enough, it's time to go. It's the hardest thing to witness, but it does happen.

I'm intrigued about what your vet has said about the kidney failure. Have they said it is ACUTE or CHRONIC. Acute forms of kidney failure can be due to several things, including genetics, access to poisons, anti-freeze, human medicines, etc. If caught early enough (and it's not a congenital problem), the disease can often be treated.

Chronic renal failure occurs slowly over months and even years and tend to affect older dogs. An acute form of renal failure can develop into chronic renal failure if it isn't effectively treated at the outset. Poor dental hygiene and poor quality foods and treats contribute to kidney disease - as indeed do some manufactured pet foods (particularly dry kibbles).

Hope this helps.

Tony

[qwertywestberg]

I really have no clue I just wanted to say that I am so sorry about your dog.

[JanisM13]

Sorry you're having such a hard time getting to the kidney
forum...YOU CAN COPY AND PASTE YOUR POST...

If you look to the right you will see a box with "RELATED
FORUMS" click on the "GROUPS" and this should open
right up to "CHRONIC KIDNEY FAILURE IN DOGS"
Click on that forum and re-post( paste your prior post)
in here. Tony does live in England so there's a bit of a
time difference but he will check this forum and see your
post there for Sadie... I am sure Tony or others there
can offer help as well as information you need.
I AM SO VERY SORRY your girl is going through this
PLEASE DO NOT let her cross over until you talk with
Tony.

Jan

[TeddysGrievingMom]

I see these posts are all old and am not sure you still monitor... but IF you do, I have a couple questions.  My Coton de Tulear started becoming lethargic and not eating two or three weeks ago.  His breath has been bad for a few months, but I thought it was due to the tarter on his teeth.  He is 8 years old and usually very playful.  When these things occurred quite suddenly I had a "Mom's intuition" and took him to the Vet.  The Vet was concerned and did a full blood workup and said it was "very bad", he was in "full kidney failure" and has given him 7-10 days to live.  So I'm assuming Teddy is in the 'final stages'.  Does anyone know what the next week will bring?  What can I expect?  I found out this morning and the pain is unbearable, he sleeps most all day and night, but WILL still wag his tail and eat chicken, bacon and all the other things he wants (I figure let him go out with a happy belly).  Will he start vomiting, have seizures, etc?  I've read some horrible "endings" and if that's what's ahead, I want to weigh my options of what I put him through vs. how much quality life he has left.

[tonyb286]

Please join the CHRONIC KIDNEY FAILURE IN DOGS User Group today here on MedHelp - then re-post your question for full support and info. Thank you. Tony

[sadiesmygirl]

I cant figure out how to join. My boxer is just turned 4 in Nov. I found out 2 weeks ago she is in end stage kidney failure. I am devastated. I took her to vet in May because she was drinking and peeing excessively and had begun wetting in her sleep. They didnt do any test. They told me it was because she had been spayed at 6 months. They are the ones who spayed her and told me it was time. They put her on Proin. She stopped peeing in her sleep, but in Sept. began to lose weight and throw up. They told me to crush the proin and change to a no grain food. It worked and she stopped throwing up. But she continued to lose weight. I took her back 2 weeks ago and was told she has kidney failure. Her bun was 202 and creatinine 8.6. They sent me home telling me she would die in a couple months. I went for a second opinion. They looked at the numbers from my old vet and said she also had pancreatitus. They kept her 3 days on IV fluids and sent her home with s/c fluids, meds, and special diet. We went back last Tuesday for blood test. She has only gotten worse and new vet said I will have to put her down this coming week. I look at her and cry. She looks so sad and she wants help. She had lost 25 to 30 pounds and this is the most awful thing I have dealt with. She is eating but only about a half a can a day now for last 3 days. I am so mad that the vet I had been using never ran any test on her till it was too late. I keep thinking if they had checked her blood or urine in May we may have caught it early enough to prolong her life. I cant figure out how to tell when it is time to end her suffering. She is only 4 and she keeps trying. She gets up about 3 times a day to drink and potty. She is wetting herself at night. I get up and check her at least twice and change her bedding. She is week but like I said she gets up 3 times a day, drinks, potties, and today was a good day, she ate alittle twice. I hate thinking if putting her down but I hate the idea of her suffering. She has never been a vocal dog and still isnt. I dont know if she is in pain. How can I tell?