Kidney Failure / Congestive Heart Failure

[Brandysmom2008]

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    : (

[caroed]

hello,  just  found this site last night,  so wish I had seen it  weeks months  back,  
my conner cairn terrier,  has CHF ,collapsing trachea , and now  early stage kidney failure, the vet said there was nothing to do but keep in him comfortable, that was it,  I had taken him in cause he was  vomiting, and I thought was constipation she said no was  diarrhea , gave meds  for that  he is straining so hard, meds  worked,  he seemed almost back to normal, I had made arrangement to let him go,  but canceled after he seemed better over Fri, Sat and part of sunday,  then he stopped eating again,  it is now wed, he is still straining to go, it went from almost  normal back to thin liquidy, still drinking  some but no where near as much as he was, and loosing weight. he is getting 4 lasiks a day 2 morning and night along with 1 1/2  pill for heart each time, plus remidahl for pain no mention was made about cutting or stoping the lasiks

[tonyb286]

Hi. Thank you for your post. I agree, your vet is one of the good ones, so hang on to them. They do seem to be treating the kidney failure as a priority, because (as you may know) IV Fluids are not good for the CHF. It's a balancing act, but with the BUN being very high, I can understand why they have gone ahead with IV Fluids in an attempt to bring the BUN back down.

Antibiotics is another problem in kidney failure, because of the toxins produced as a bi-product of this treatment. But again, it's important to treat any UTIs, so (again) someone has to decide which is a priority at any point in time. This will always depend on how each condition progresses ... or when they improve or deteriorate.

Regards

Tony

[Old_Dog_Caretaker]

Just stumbled on this thread in my google search "fluid therapy for dogs with kidney failure and congestive heart failure".

My 16 year, 8 months rat terrier currently is at the vet's on IV therapy in an attempt to bring down his BUN (140+). I have done sub-q fluid therapy twice weekly for the past month. My dog is not in pain and he is an excellent patient who tolerates his meds and treatment well.

He has not experienced the vomiting some have mentioned. I don't know if that is because he gets Sucralifat (sp) 3X daily. It coats his digestive tract. I get it thru goodrx.com affordably.

My vet will not do a dental because of the risk of anesthesia now. Therefore, we do pulse antibiotic therapy, only now is simply is daily antibiotics (clavomox rotated with orbax). That vastly improved my dog's quality of life as he would get chronic prepucitis/UTI's.

I commend my vet for going the extra mile with this dog but we both recognize that we are in the final stages and want my best buddy as comfortable as possible. I hope this information helps.

[tonyb286]

Hello and welcome to the forum. I think you have the measure of both these conditions - and I also think you have done amazingly well to help your best friend achieve the age he has with such a zest for life. I cannot praise you enough. You are absolutely right in everything you say ... there is a real dilemma between treating these two serious and life-threatening conditions. In a younger dog, compromises are common, as it depends which illness needs the priority treatment at any particular time. At 16, there are many other complications, and I actually think quality of life is the only real priority.

I reckon there is a day-by-day assessment to make, as you probably know. And you are spot-on ... you know your dog better than anyone else ... and when you feel the time is right to cease any particular medication, then that's the time to do it (though you probably would be wise to have a discussion with your vet beforehand, just so you know what to expect). There are also some medications that need to be tapered off, rather than stopped immediately, so whatever you decide, just plan it as carefully as possible.

One thing you could do is get a full blood panel undertaken along with a full urinalysis done, as these combined will let you know what degree of kidney failure is present (if any). This obviously would help in deciding whether or not to withdraw the CHF meds.

Tony

[cgul]

These posts have been so helpful! My Shiba Inu will be 16 in August and was diagnosed with mild CHF last April. At the time, the vet warned about the "long term effects" on kidneys of heart meds, but we agreed that long-term for a 15 year old dog was not really a concern. My boy is so hearty and happy. He has terrible arthritis in his back legs but powers through it if it means playing or going for a walk. Since being on enalipril and vetmedin, his coughing and breathing have improved significantly.About three months ago, he started vomiting and refusing his pills (Trust me, I tried EVERYthing). The vomiting would last a day or two then go away for weeks at a time. We had another episode last week that lasted a few days, so we went to the vet. I got the same thing as far as what to do. "You know, he's in his 90s now... we can run all these tests, but..." I appreciate her honesty, so we just put him on amoxicillan (sp) and Metacam and continued heart meds. His appetite came back after a couple days, and he has been eating and playing like a kid again. This morning--more vomiting. I really think after being on heart meds for a year, his kidneys are failing. He is my kid and my best friend, and I'm waiting for the vet to call me back. After reading all of these posts, I think the best thing for him is to just stop the heart meds and give the kidneys a break. I know it means his CHF will progress faster, but everything I've read said that CHF is not necessarily painful, just difficult in other ways. Kidney failure can cause painful stomach cramping and loss of appetite. I'd rather spend my last months or weeks with him quietly, letting him eat whatever he wants, until the time comes. Forcing all these meds on him just doesn't seem right any more. Again, I am so grateful people took the time to write about their own furkids. It really helps. For those wondering if they made correct decisions, I say that if you love(d) your pet, you most certainly did. I don't think there's any right or wrong answers. We give them a good quality of life, including the end of it. That sure beats would they would have faced without us. Despite all the well meaning advice, you know your pet better than anyone and they know you. I honestly believe they tell us stuff, as my dog is telling me now.

[tonyb286]

Hello. I am so very sorry. Dot's kidney disease was truly compromised and complicated by the CCF. It was always going to be an uphill struggle to treat both of these conditions with any success. Seizures are a strong indication that things had deteriorated quickly and to a point of no return. Although it is heartbreaking, at least Dot is at peace now. No more suffering or stress. She will always have a safe place in your heart and memories.

Please stay with us on this forum if you want or need to talk about her and share some of the wonderful things you did together. My heart goes out to you during this very difficult time.

Run free Dot.

Tony