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661200 tn?1225486613

Kidney Failure / Congestive Heart Failure

I have a 15 yr old female Pekeapoo who was diagnosed with congestive heart failure 8 yrs ago.  She has been on Digoxin (sp?) 3 X a day, Furosemid 3X and Enalapril 1 X.  Took her in for a health screen last nite.  Bloodwork/Urine finds bad.
BUN - 140    Creatinine  3.1   Phosphorus  8.8  Calcium  13.3
Doc says she is going into kidney failure because of the Furosemid and want me to cut back to 2x daily.  However, this will fill her lungs back up, start her coughing and possible serious heart failure.  We have a follow up on Thursday.

I am scared to death - what should I expect or what symptons should I be on the phone to the Vet for?  She looks fine on the outside.  How much longer does she have?

I'm not ready to let her go    : (
60 Responses
82861 tn?1333457511
Oh, I am so terribly sorry for you both.  I think it's time to face the fact that your peke is at the end of her life.  As you now know, treatments for one problem often contradict the treatment for another - as with the furosemid.  Even worse, there isn't a darn thing to do for kidney failure other than treat the symptoms as best you can.  Once kidney cells are destroyed, they cannot regenerate like other organs such as the liver can.  

When kidney failure reaches the last stages, you will notice a marked increase in nausea and vomiting and probably urinary accidents as well.  The nausea is from the toxins remaining in the bloodstream that the kidneys can no longer filter out.  

To maintain as much function as possible, add calcium to the dog's diet.  If you aren't an experienced "piller" now, you will be very soon.  Get some plain over-the-counter Tums - they are nothing more than calcium, but be sure to read the label to be certain there is nothing else included.  Give a half a Tums twice a day.  The calcium helps sweep out phosphorus from the body which is deadly to failing kidneys.  

Also add a cranberry preparation like CranAssure.  I used both Tums and CranAssure on my dog who died of kidney failure, and it did make a difference - particularly in the early stages.  The Cranassure helps sweep debris from the urinary system and the extra vitamin C is also helpful.

Hydration is extremely important, and yet another contrasting issue with congestive heart failure.  The kidneys need the extra water, but it may worsen the CHF symptoms.  

You may want to consider preparing your own dog food to keep as much phosphorous out of her diet as possible.  Most prescription dog foods for kidney failure are merely low protein.  The idea being that protein is metabolized in the kidneys; therefore, a low protein diet is necessary.  Studies over the past few years negate this idea.  It's not so much the protein that is the problem, rather that a more digestible form of protein is needed.  Scrambled eggs (with about 1/2 the yolk), yogurt, dark poultry meat and rice are some good options.  You'll probably want to add a low or no-phosphorus vitamin supplement as well whether you use a commercial prescription diet or make your own food.

Ultimately, nausea and vomiting will take over your dog's daily life.  The cheapest medication for nausea is reglan (generic name metoclopromadine).  While it is very effective, it is also processed in the kidneys and can cause some wild side effects like extreme nervousness and severe shaking.  Benadryl can take care of the side effects if this happens.  In my experience, once the kidneys reach the point of being unable to process oral reglan, the injectable version got around that problem.  I'm just glad my husband was able to do the injections at home.  :-)

I know I just bombarded you with a whole lot of information, and I hope you'll speak to your vet about how to balance treatment for the CHF and kidney failure as best you can.  Comfort measures are the best that can be offered now, and you'll need to know exactly what those are.

God bless you.  The next weeks and/or months aren't going to be easy, so enjoy the time you have left. :-(
661200 tn?1225486613
Thank you for that information

/me wipes the tears away
I gotta go hug a dog.......

82861 tn?1333457511
    I know.  I've been through it.  :-(
661200 tn?1225486613
An update - Brandy and I went back for a follow-up yesterday and got some good news!  Her kidney levels dropped significantly!  Still high, but better.  She is breathing deeper and her eyes are watering.  She is not peeing as much too.  I thought she might have lost more weight, but she actually gained an ounce (not much but for a 6.2lb dog, its alot!)

I now have to cut back her Lasix at 1X a day to half of her normal dose.  I'm a lot nervous about this with her CHF.  But I can give her a dose if she has an episode.

Her favourite toy is an old sock.  She hasn't wanted to play with that for over a month.  Last nite, she pulled it out of the basket and wanted to play.  I cried happy tears on that!

I love her sooo much!
462827 tn?1333172552
I meant to reply to your original message, but never did...I'm sure excited about your good news...Makes for a good day, too, doesn't it? This very situation has happened to my little guy.  By rotating his lasix, I have been able to cut his elevated kidney levels in half. His at one time were also in the very high range, but they are HALF of what they were, now. I didn't actually cut any dose out, I rotate....One day he gets his 3, next day 2, next day 1 & then I start over....This has worked for 6mos., now....He is due his 3mo. bloodwork in 2wks. and we'll go from there...Just wanted you to know that your not alone. I'm glad you and your baby are having a good day....I understand, completely!!!!!!Karla
82861 tn?1333457511
Well that news makes for one Happy Halloween!  Congratulations on the great news!  :-D
661200 tn?1225486613
Well, it's been 4 weeks and not alot of progress has happened.  3 weeks ago, she was completely taken off her Lasix.  She has done well with this.  She did have an episode that scared the **** out of me.  We went on our daily walk.  She got overly excited.  When she got to her first pee spot, she squated and then went all flat out and passed out.  I ran her back home and gave her a dose of Lasix.  She was quite disoriented for about an hour, but then was ....ok.She has been gaining weight and her skin lesions (from her skin being posioned from all the medication) are lessening and her BUN levels have improved immensly.
But.... went back for a check up last nite, excited that she seemed heavier and healthier, only to find ou ther BUN levels had almost doubled and she was severly dehydrated.  She lot 1/2 lb (for a 7lb dog, that's alot)
Long story short, now we are on a weekly subcutaneous fluid therapy, still off the Lasix.  I don't know how I can get her anymore fluids - she's on a kidney diet that I mix with chicken broth and has water bowls all over the house.  She is tinkling fine.
Remember that she will be 15 in January.  I am taking it 1 day at a time.  I am scheduled for a hysterecemy on the 18th and want her on my bedside during recovery.

Anyone have any additional ideas I can do for hydration?  Anyone going thru the same thing?

I am scared to death
Brandysmom  : {
462827 tn?1333172552
If your feeding Dry food (Kidney diet), switch to CANNED. Canned will help immensely with hydration. Also, make sure the chicken broth is low/or No Sodium. Sounds like your doing a great job with her.....Good luck with your surgery and give Brandy a kiss from me.....Good luck, I wish you both well!         Karla
661200 tn?1225486613
Thanks Karla - she is on prescription canned KD food.  I heat it up in the microwave for 10 secs and add low sodium chicken broth.

Thanks for the encouragement!  We begin our thrice weekly trips tomorrow!  Oh yea.... and I sooo ready for my surgery!

All the commercial broth's have onions and garlic in them, they are toxic to dog and cat's kidneys, make homemade.
Should read "broth's have onions and garlic"
82861 tn?1333457511
You are really doing a great job with the heavy nursing duties.  I remember this time last year taking it day by day with Chica.  It's so hard to believe that energetic, clown of a personality is now gone.

Balancing CHF and failing kidneys is like walking on razors over a shark-filled tank.  I really am amazed Brandy has made it this far.  That's a testament to your excellent nursing.  Best of luck with your surgery.  I hope it's going to be done laparascopically.  Mine was the open hyst and WOW did it knock me for a loop!
Avatar universal
Hi Brandy,

I put my 15 yr old down yesterday. CHF and then the kidneys were failing. I worry that I didn't do enough and that my vet didn't try harder to save him. He said since he couldn't
give more lasix there was nothing to do. He never mentioned trying to get liquid other ways.

Bogart was breathing very heavy yesterday and had a heart rate of 220. His gums were gray. But he slept thru the night prior to and was not listless. He was struggling to breathe but I think something more could have been done like you are doing.

What is Brandy's heart rate? Are her gums and tongue bright pink still?

Bogart was diagnosed 60 days ago with MILD CHF. Put on all the drugs. I'm saddened that he didn't last longer. What went wrong? I did the research right away and had too much faith in the drugs -- which is so unlike me. But, I have a heart condition and the drugs work fine for me.

I am so sorry now that I didn't do the herbs along with the drugs. Check into them if you
haven't already.

Looking for answers..
Jane from Chicago
661200 tn?1225486613
I'm so sorry to hear about Bogart, Blye.  Brandy was first diagnosed with CHF 8 years ago.  I thought she had a cold as she kept coughing all the time.  Her heart rate started going out of this world and it was then that I decided to take her to the Vets.  See, she was my Mother's dog and me and my husband have always been Cat People.  They are usually self-sufficient and, needless to say, I really didn't know what to look for in a sick dog.  Once we got to the vets, she was quite bad off.  Dr Howard (whom I will forever be indebted to for saving her life) had to give her nitroglycerin pills to jolt her back.  After many days of EKGs, ultrasounds, bloodwork, we started our daily reigm of meds.  One of her Dr's was a holistic vet.  She actually did not recommend anything because of her condition.  So you needn't worry that you could have done more herbally.  Even her groomer said she thought Brandy would have passed 3 years ago - can't believe she's still hanging on  : )
Her current sleeping breath rate is usually around 16 - 24 breaths per minute.  Dr. Howard said to be alarmed if it gets higher than 36 BPM.  Her gums and tongue are still pink, but the whites of her eyes (that you normally don't see - that the Peke in her) are bloodshot red.
Don't know when the next bloodwork will be scheduled.  I assume after the new year.  The Dr. has assigned his Vet Tech to be my personal 'doctor' that I don't like.  He cannot (or will not) answer any questions I have - like why are her eyes blood red.

Blye, I know this is not much solace for you, but our situation has been building for 8 years.  Lucky for you, Bogart didn't have to suffer all the tests and meds for a long period of time.

You are in my prayers.
Carole and Brandy
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