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    : (

[Brakemill]

Thanks for replying again Tony!

Dot deteriorated and ended up having seizures so obviously my little girl isn't with me any more. Our vet came to our house and put her to sleep.

It was very traumatic and I hope that I didn't leave it too long. I had decided that if she didn't eat the following day then I would have to do something but the decision was made for me really.

Heartbroken

Thanks again

[tonyb286]

Hi. Ok, it's good that you have a diagnosis. After you speak to the Internal Med please come back and let us know what is said. The BUN is of great concern. It's extremely high. Alum Hydrox as a phosphate binder is good, but not necessarily the best or most appropriate. I'll comment more after you get back to us. Also, Metronidazole is an antibiotic for bacterial infection - presumably this has been given for a limited course only, maybe there are signs of infection or tooth decay, which has the vet think there's an issue with the intestines, thus creating the mucous-stools? Proviable is a supplement much like some probiotics, which is intended to assist the digestive tract and intestines.

When you say kidney food ... what is it and has it been supplied by the vet? Either way, please give the name and whether it is dry food or canned.

Please consider joining our User Group ... the CHRONIC KIDNEY FAILURE IN DOGS user group. It is a useful forum specialising in this disease.

Hope to see you as a new member in due course.

Tony

[pepsibaby]

Thank you Tony. I did go to ER and had another blood test. He now has definite Kidney Failure. Phosphorus is up so they prescribed Alum. Hydrox, Creatinine is 3.5 (same as week earlier), the BUN is now 244, up from 169 week before. He is on kidney food only. And now taking Metronidazole and Proviable in addition to the Alum. Hydrox and Pimo.

I finally had someone tell me the truth and not skirt around when I asked about his kidneys. I have appt tomorrow with Internal Med. to advise on his "severe azotemia".

He has lost his "sparkle", he walks slowly and doesn't seem interested in anything. Only thing that sparks him are car rides and sitting outside.

[tonyb286]

Hi. CHF is not really my area of speciality, so I'm hoping others will respond to your concerns. I just wanted to say that being told to wait 3 days for your regular appointment is probably not helping you, because I can tell you are extremely concerned and anxious about the night time events. If you become concerned, just go to the ER ... you know your dog better than anyone and your worries are very real. This is a serious condition, so if you think emergency intervention is needed (or even just some reassurance for yourself), then I wouldn't hesitate. Better to be safe than sorry.

Tony

[tonyb286]

Hi. She's probably not eating due to toxin build-up in her stomach. You could try giving a suitable anti-nausea medication, which should encourage her to eat. Not eating is typical of kidney failure. It's because the toxins make dogs feel sickly - and like all of us, if we feel sick, we don't want to eat anything.

The deterioration is likely to continue, I'm sorry to say. You are truly caught between a rock and a hard place. Helping one problem will almost certainly cause the other to get worse. I would tend to treat the kidney failure as a priority, but only because it is in stage 3, which gives you a chance of controlling it (albeit for a short time).

While she is interested in "pottering about" and has a reasonable quality of life, I think the time is approaching but not necessarily here yet. It really is a day-by-day assessment you need to make, along with any advice your vet might give you. In the end, you know her better than anyone, so you will know when that time has come.

My thoughts are with you.

Tony

[Brakemill]

Thank you for replying Tony
Things have deteriorated since I posted as she's not eating at all now albeit only 2 days but cant see her regaining her appetite. Consequently, the only tablet she takes ie frusemide she hasn't had for 2 days and I'm not prepared to fight with her to take it.
She had some diarrhoea yesterday and was incontinent  - this is not her at all! And I'm so sad to say that I do think she has that look in her eyes!!? She is still pottering about - mainly to check where I am.
My heart is breaking as I write this because I suppose I know what happens next.....