Don't give up on Zeus just yet. You need to talk to your vet about possibly doing a kidney flush. A flush would require I.V. infusions of fluids. Some vets suggest that you leave your dog for a couple of days, so they can push the fluids through. If you think that Zeus would be OK with that, then it might be something you could consider. If Zeus would not be comfortable with that, then you might be able to bring him in for one day, take him home at night, and then bring him in again the next day. Extra fluids may help stabilize the kidneys, and help flush out some of the toxins that have accumulated. I know that some people have stated that after a kidney flush, their dogs seem to do worse...so discuss this "option" with your vet.
In the meantime, I see that you have started SubQ's. That will be helpful, but it may take a few days to notice any difference.
Now, honestly, given the fact that his blood values were not within the normal range, I am surprised that your vet went ahead with the dental procedure.
Were they aware of his kidney condition before the dental cleaning...?
Was the anesthesia safe for a dog with compromised kidneys...?
You mentioned that your dog was given antibiotics...do they think that perhaps the high blood values are due to an infection...and not kidney related...? You may want to have his blood values checked again, a week or two after the antibiotics are done, and you have been doing SubQ's.
Long story short....you may be able to lower his blood values, and he may be able to live comfortably for months to a year or more. All dogs are different, and respond to treatment differently...so...you know your dog best, and you will just have to use your best judgement.
To start with, be sure to get him on salmon oil..get him some meds to aid his comfort...such as anti-nausea meds, anti-ulcer meds, and a good phosphorus binder. You vet can help you with these, and the cost is actually pretty inexpensive. The best thing you can do at this point, is fluids, fluids and more fluids. So...SubQ's are great...! Keep them up..!
My thoughts are with you at this difficult time...Give Zeus a hug from me.
I forgot to mention 2 very helpful websites...listed below...
Both of the above websites, are LOADED with information, and K9Kidneys group has tones of support from others, who are going through the same thing. Check these websites out, when you have a chance to do so. You won't regret it...!
Thank you so much for responding! I am grateful for the info and for the support and understanding.
The dental - I don't think they did the blood work until he was already under. So they did not know until it was too late. I wish they had done that differently, but I cannot blame them. I told them he was healthy. I did not know he had kidney problems. And the first time they mentioned elective bloodwork, I said there was no need because he was not sick. I did tell them the morning of the surgery to go ahead and do bloodwork if they saw any reason to. Thank God I did that! But I don't think they did the tests until later. (I did ask her after the fact if the meds given during the dental could have caused this spike in his disease and she said not the meds, but the stress.)
Anitbiotics - He was on those to make sure the dental could not have caused any infections. He had plaque under the gums and the doc was worried once she saw his bloodwork about him trying to fight any potential infections in his state. He definitely had kidney disease before the dental. I can see that in hindsight. I just did not know it at the time.
Flushing - I think that is what we have been doing all weekend from home?? I have been pushing a liter and a half of fluid spiked with B-vitamins through him every day and I am pretty sure she said that would be flushing him out hopefully? He is going in this morning for new bloodwork.
Meds - I have him on a phosphorus binder now and I will ask about the other meds. He also take a supplement for dogs with renal problems and I ordered Azodyl, but I cannot figure out if it is okay to give that with the Pepcid AC in the morning or not. Both say to give them an hour before he eats. Does anyone know if they can be given together or if the Pepcid kills the probiotic thingies?
Food - the biggest problem right now is feeding. I am trying so hard to get anything in him! If he stabilizes, does that get any easier?
Thank you SO MUCH for caring. I am scared and feel very alone with this and very exhausted.
I forgot to mention that he was anemic after the dental, too, but we cleared that up.
Also, I will go order him salmon oil now! Is there any specific brand you recommend?
We just got back from the vet and his creatinine has come down a little, but not nearly what the vet had hoped. It is now 5.0, down from 5.8. His BUN is 87. And his anemia has returned.
She gave me a prescription for nausea - thank you for telling me to ask for that. And we are going to try Enalapril again, but at half the dose as before. And we changed from PepcidAC to Prilosec which is a little stronger to help with the stomach stuff.
Zeus ate some hamburger and rice this morning and the vet seems to be okay with that for now.
She is keeping him on a liter of subQ fluids per day.
And I just ordered some Salmon oil.
If there is anything I am missing or any other feedback, please let me know! She said we could try EPO for the anemia, but it is $350 and I am already $1,000 into this will little savings left, so I said, "Let's try all these things first." I think if the anti-nausea stuff helps enough and he gets eating again, that should help with the anemia, right?
Thanks, again, for any help or support you can lend. It means a lot to me that I can come here.
I'm always so sorry to hear another kidney failure story. It's a hard, hard thing to deal with. Please don't feel guilty that you weren't aware Zeus was sick. I didn't know my dog was in kidney failure either until it was too late. Most animals hide illness because it marks them as prey, and some of our dogs are just too good at it for their own good.
The biggest issue with discovering your dog is in kidney failure is that it usually is too late to do much by the time you find out. Unlike the liver, once kidney cells die, they can't be regenerated. You can only work with what's left. You and your vet are on the right track treating the nausea and working on nutrition. What you're looking for are low phosphorous foods, and that means mostly high-fat meats: cheap, fatty hamburger, dark meat poultry, that sort of thing. And NO organ meats like liver. They're loaded with phosphorus. At some point though, it's a victory getting your dog to eat anything at all. Definitely spend time with the dogaware link. I learned a whole lot there.
If Zeus can stay hydrated on his own, then you may not have to keep on going with the sub-q fluids. That's just one of those individual things. If you can control the nausea, that's half the battle. Since nutrition is so out of whack on a kidney failure diet, look into senior dog vitamins with low or even no phosphorus added.
Mostly you're looking at heavy-duty nursing over the next weeks or months. I didn't realize how focused I'd become on my dog's every move until after she was gone. It was worth all the stress and anxiety and I couldn't have done anything differently. We kept her pretty comfortable for several months right up to the last couple of days. It's a rough ride, but we'll try to help you through it.
Thank you for the support and all of the great info. Like you mentioned, I already feel myself getting lost in Zeus' illness and monitoring everything about him all the time. It is all so complicated.
Here is what he is on...
Prilosec for stomach stuff
Aluminum hydroxide for phosphorus
These kidney support suplements: http://amzn.com/B005CBTV3O
Metoclopramide for nausea
And Enalapril for I am not sure what
Salmon oil is on the way
Plus, he will be staying on SubQ fluids - a liter a day
I am afraid to add a vitamin because I no longer have any clue about what might interact with what.
I feel bad pumping him full of so many chemicals. Especially when he is not eating very much. But all of these things are necessary, right?
Thank you for responding. I really appreciate hearing from you and I am sorry for your loss, too.
Good Morning Melissa,
It sounds like you and your vet are working well together, to ensure that Zeus is given the best possible care.
It is nice to see that some of his blood levels have come down a bit. The SubQ's will be a big help. It is important to remember, that you cannot cure the kidney disease, nor can you bring it to a complete halt. The goal here, is to help the kidneys do their job, so you can slow down the progression of the disease. The meds, diet, and SubQ's will help with all of that.
To answer your question on Enalapril...it is a vasodilator. Enalapril is used for heart disease, high blood pressure, and kidney failure. It helps to relax the blood vessels, thus increasing flow to the kidneys. Many dogs with kidney insufficiency, will also have high blood pressure. I am guessing that this is the reason your vet has prescribed Enalapril. Especially when you consider Zeus's history of a stroke. Talk it over with your vet, or call them and ask. It will make you feel better, knowing exactly why the med is prescribed
The dogaware website has loads of info...I urge you to look at it, if you have any spare time. I know that taking care of Zeus requires a lot of your time.
I also know how you feel about pumping all of those pills into him. I felt the same way when TwoBits was going through this. It is stressful for us, and I would imagine it is stressful on the dog too.
Don't beat yourself up, for not catching this disease sooner. It is normal for most of us. Typically a dogs kidneys are 75% destroyed, before any symptoms start to become obvious. Like you, I just thought my dog was getting older, and starting to lose control over her bladder. Because of my experience with my own dog, I now recommend that all senior dogs should have annual blood testing to assess kidney and liver functions.
You are doing a wonderful job, you are providing the best care you can.
I would like to add, that if you are not providing distilled water for Zeus, you may want to add that to his diet. Distilled water is easier on the kidneys. If you find that he does not like the distilled water, try mixing it half and half with his regular water.
Best wishes Melissa...Hugs to you and Zeus.
Thank you so much for the info and support, Connie. I feel so lost and so scared right now. I have definitely studied that site and many others. And I would give anything to keep him here with me happy and healthy and well. But I know now that is not an option. So now it is a balancing act. His arthritis is getting worse. I can tell he is sometimes uncomfortable. And it breaks my heart when he does not eat. But he does still enjoy walks and playing with his rope. So I just hope and pray that I will let him go at the right time and not keep him in pain for my own selfish reasons. I just can't believe I am losing him. I can't believe this is happening. I would give anything to make it stop but I can't.
I was in the same place you are, 2 years ago. It's tough. The best thing you can do, is to just try to take it one day at a time. Dog's in kidney failure will have good days and bad days. If he is still feeling well enough to go for walks and play with his rope, then that is a good thing.
I know you feel bad when he won't eat...my thought is, if he is refusing to eat kidney diet food, then give him whatever he wants...if he will eat it, be sure you also get him to eat the phosphorus binder at the same time.
You could ask your vet for some carafate, it is an inexpensive med that you can get in liquid form. It forms a coating over any ulcers he might have, and helps them to hopefully heal. Ask your vet about it. You can also ask your vet about adding B vitamins and a iron supplement to possibly help with his anemia.
You mention that Zeus has arthritis...the salmon oil may also help with that..!
Stay strong Melissa...you are doing all you can...Zeus is lucky to have you taking care of him.
Thinking of you both...and praying that both of you will have a good week.
Thank you for caring, Connie. It really does comfort me.
Zeus had a great day yesterday. He ate a little better. He had not thrown up in over a week. The anti-nausea stuff seemed to be a good thing. He had tons of energy and was very active.
I re-started the enalapril yesterday at half dose. I gave it again today. I also switched him today from PepcidAC to Prilosec. He had energy today, went for two walks, played with his rope. He did not eat a ton, but he ate.
But then he started to barf. He has been throwing up all afternoon and evening. Many times now. At least 6 times, maybe more.
I know that he is dying and I am no longer interested in prolonging his life, but I cannot stand the thought of him suffering. If there is anything I can do to stop the barfing or make him more comfortable, please tell me. Should I give him more fluids? Should I stop the various meds? What would make him more comfortable?
I am heartbroken, but I am ready to put him to sleep if that is the only way for him to not suffer and not starve to death. But his tail is still up and wagging even now. So I don't know what I am supposed to do.
I love him so much. I am so sad.
We have a vet appointment on Friday afternoon for a recheck and bloodwork. What should I do until then? How do I keep him comfortable? If he does not eat tomorrow or keeps barfing, I think I will say goodbye on Friday. That is unimaginable to me. But I can't watch him suffer. If I do have him put down, should I bring my girls in to that appointment so they can see he has passed on?
I hate this so much.
Thank you, again.
By "girls", I mean my other two dogs.
Connie has said it right, there are always good days and truly rough ones with kidney disease. The hardest thing in the world is to watch our best friends go through this, but while there's a quality of life, we just have to keep going as best we can. The fact that Zeus has had some great days when he is eating (even just a little) and even has the energy and motivation to play, means the time for decisions has not yet arrived. When bad days outweigh the good ones, then maybe the worst of decisions need to be considered.
For now, like Connie has suggested, forget the 'right' foods - just give Zeus whatever he will eat, because the energy he gets from it is more important. You might try easy to digest things like cooked chicken and rice, or even better, a little cooked green tripe (it stinks, but dogs absolutely love it). Mix the phosphorus binder in with it.
You and Zeus are in my thoughts.
Thank you so much for this note, Tony. I really appreciate the support.
Zeus has been eating boiled chicken and rice or hamburger and rice for the past week or more. He also ate a little of his prescription food each day. He never ate enough, but some each day. I tried feeding him green tripe a week ago and he would not eat it. But I had mixed it with his prescription kidney food. Maybe I will try it alone today.
He threw up all night, but stopped about 4 hours ago. I think he is empty. When should I try feeding again? He is drinking on his own. Plus, I will give fluids soon.
Hi. If you can get his anti-nausea meds in him, I would then feed him about 15-30 minutes afterwards, because this will give the meds time to calm his stomach and he will then feel like eating more. The trouble with dogs suffering from kidney disease, is they start associating the yulky sickly stomach with the food they are eating (they don't know they have kidney disease of course and can't therefore understand why they feel sickly). Once they associate a particular food with the bad feeling, they refuse to eat it (at least for several days until they forget which food it was), so it's probably better to switch to another food if he goes off one thing - and then maybe try it again after 3 or 4 days.
When to feed him ... well, little and often, and to be honest, if it were me, whenever he will eat.
You are doing a great job. If Zeus understood what you were doing for him and if he could say it, he would be thanking you every minute of every day.
I know how hard this is for you. As you say, it is a balancing act. You know Zeus best, you are the only one who really knows if he is doing OK or not.
I think the best indicators of his well being, are not the symptoms and the Numbers that result from his lab work, but rather....the way he behaves.
If he still wants to go for walks, play with his rope, eat, and drink on his own, then I think he is dealing with his condition, perhaps better than you think he is.
However, as I have said...You know him best. You are the best person to make any final decisions.
You say that you have "re-started" the Enalipril. Has he not been taking this med for a few days....? Did you ask the vet exactly why this med is being given...? If not, be sure to ask about it on Friday. As you have mentioned, it is a balancing act. If Zeus was not taking this med for a few days, and he was not throwing up...but now, you re-started, and he again is throwing up, then...maybe, this med might not be right for him...? Ask your vet which of his meds are metabolized through the kidneys, and if there are any alternative meds you can try...?
I know all this "Med" stuff can be so frustrating, and discouraging...a person can't help but wonder if they are doing their dog any favors.
This is such a difficult place for any dog owner to have to be in. My heart goes out to you Melissa. I understand that you may be tired of asking your vet so many questions regarding Zeus's care, but any good vet, will know that it is because you truly love your dog, and only want what is best for him. Any vet that truly understands, will not be offended by your questions. I also feel that the more informed you are, the better decisions you will make.
I know you are wondering about whether or not it is time to let Zeus go...my thoughts on that are....if you have any doubt about it, then now is not the time.
I think you will KNOW when Zeus has had enough. You will see it in his behavior,and you will see it in his eyes
As far as bringing your girls with to the vet appointment...? Again...that's a personal decision you need to make. I can tell you that I did that once. I took Twobits with me, the day I had her companion euthanized. I often wonder if it was a good idea or not. I think it is one of those things, that we will never really know.
One final thought Melissa....when you are at the vet's office, ask him to explain some of the end stage symptoms that you can watch for. TwoBits, had bloody stools, extremely bad breath, she would shiver/tremble, she slept almost all the time, and I noticed that she had a slight stumble when she would walk. Her behaviors where starting to change...she was no longer the tenacious little terrier that blessed my life for 15 wonderful years. According to the "numbers" she was only in Stage 3 of the disease. It is because of those "numbers" that I still wonder to this day, whether or not I made the right decision at the right time...so, don't focus solely on the "numbers" .... I have learned that the "numbers" can only tell you how well your dog's kidneys are doing...they do not tell you how well your dog is doing. Your dog cannot tell you either, but he will show you.
This is such an emotional time, and it is hard not to let your emotions guide you, but do your best, to let your own observations be your guide, not your emotions. Observe Zeus...I think that is the best way to listen to him.Take a deep breath...Observe how Zeus is doing...don't absorb your own emotions. ( I know it is easier said than done.)
Stay strong Melissa...you are doing the best that you can. Trust yourself, the way that Zeus trusts you.
I think Tony is right...wait until the bad days start to outweigh the good days, before you make any final decisions.
Hugs to you, Zeus, and the "girls"
Thinking of you all...I hope you all have a good day today.
That makes sense about the food. Humans are the same. I got sick after a meal at my favorite Chinese restaurant two years ago and I have never been back.
I agree that feeding small frequent meals makes sense, but I do not know how to make that work with the meds. His anti-nausea drug and his phosphate binder both say to give twice a day before meals. I am afraid to feed him other times now after what we went through last night. So today I only fed him twice. He ate both times. So far, the food has stayed down. I can hear his tummy making awful sounds right now, though, so I am always on edge. Praying it stays down. He ate hamburger and rice both times. Probably not enough to sustain him, but a decent quantity by recent standards. Probably a total of 3 - 4 cups between the two meals. He also ate a little scrambled egg.
Thanks, again, for telling me to hang in there. He had a short walk today and some playtime with his rope. So if he can keep his dinner down, this will have been a good day for him. Last night, I thought sure the good days were over.
I really appreciate the support,
Thank you for all of your helpful observations and suggestions. Yes, Zeus was on Enalapril right after he was diagnosed. He vomited several times in 2 days, so I took him off it. Then he only barfed one time in the next 10 days. My vet suggested I put him back on at half dose a few days ago and then last night happened. So clearly that med is not a fit for him. And, yes, it is metabolized in the kidneys.
I agree about the numbers thing. Zeus' numbers are horrible and have been since he was diagnosed two weeks ago. But he has gone on walks everyday and played every day and he does not have those other symptoms you mentioned. So I will try to forget about the numbers.
I am so sorry you went through this with your baby, too. :(
Thank you for your kind wishes. They are a comfort.
Happy Thanksgiving from a fellow Minnesotan,
Hi Melissa. You are working things out really well and doing exactly what you need to do. Clearly, the meds were the issue, so raise it with your vet and get him to swap it for something else. It's often trial and error, because so many things are not tolerated with kidney disease. So far, he's doing really well though and the fact he's eating anything is good, even in little bits.
Hoping you have had a good night with him.
I have only been on this forum for a week now. I have a 10 y/o Yorkie. She is in late stage 3 - early stage 4.
KD was diagnosed only by fluke. We were testing her urine for a UTI, and that's when they found out that she was not concentrating her urine, and something else, I forget. Blood work was done and it was officially diagnosed. This was about a year ago (?). She was immediately put on a kidney friendly diet, and most of the meds listed below. So we got her early in this disease.
She is on benazepril for blood pressure - it was twice as high as it should have been.
Epakatin powder to bind phosphorus.
Plavix - she had a terrifying neurological event a few weeks back, which has left her back end a little weak, particularly her left leg. I did not get an MRI done, so we don't know exactly what happened.
And I have got some generic Pepcid compounded (her dose is so tiny, that I could not just buy it OTC.)
and omega 3 gel caps that I pierce and put in her food (I think that is what is in salmon)
She has her good days, and bad days. On the bad days there is a lot of wretching (nausea), so she wont eat, and very tired. On the good days, she is practically normal...yapping at nothing, etc. She is on Renal LP with ground beef added, and water. It takes her a while, but eventually she will eat it, then she gets a treat. When she completely stops eating the Renal diet, I will start feeding her the scrambled eggs, dark meat poultry etc. But for now, I will stick with what she is supposed to be on. Also, her breath is horrific.
Last Saturday, she didn't want to get out of bed at all. She stayed there for 9 hours straight. I was sick with worry. But she has since rallied. I guess that is the way it is going to be.
I cannot get sub Q fluids into her. She absolutely freaks and squeals when I do it, and when the vet tech does it (so I know it was not just me doing it wrong). I worry about her hydration level. Fortunately, she is not vomiting and losing fluids that way. I am going to call the vet now to see if getting her fluids with IV will be of any use. Might help with flushing out the toxins. I dunno. Might be not worth bothering her, stressing her out.
I had her little brother's (same parents) urine tested and it came back just fine. But you can bet I will watch him like a hawk.
I am very sorry Zeus has become part of this forum. It sounds like you are getting good advice. I have picked up some pointers, like the Pepcid idea and eventually the dark poultry meat, eggs, etc.
Keep it up Melissa.
Jane and Tasha
Whooops.................I HAVE her little brother, not had (past tense !!)
jane and tasha
Thank you for the much needed positivity. I am definitely glad he is eating some. But how do I get him the other nutrients he needs? He is not eating enough. Is there a way to get more nutrients in him somehow besides what he willingly eats? Or will he start to eat more at some point? Because otherwise won't he starve to death?
Zeus is doing well today. Thank you SO MUCH for giving me perspective and letting me know he would have better days. I was so scared the other night.
I hope you and your pups are well,
I am so sorry your dog has this crummy disease, too. But I am happy for you that they caught it sooner than we did with Zeus. It sounds like you are managing pretty well if you are a year in and your baby is still having good days! After Zeus was diagnosed, I had hoped I would have that long with him. The diagnosis was just 2 weeks ago and I have adjusted my thinking to just be grateful for each day.
Thanks for sharing your story. I wish you and Tasha more days of energy and playfulness.
I talked to my vet regarding giving Tasha a "kidney flush" - to me that just means hooking her up to IV for the day to try and reduce the toxins in her blood. But, she thought maybe the stress of being at the vet attached to an IV outweighed the benefit. She suggested a pre/post biotic called Azerol (I am sure I spelled that wrong). It might help to reduce toxins. Tasha will not allow me to force fluids orally and certainly not sub Q. For a tiny yorkie, she is very head strong and uncooperative when she wants. That is a terrier for you.
So far today, she is acting perfectly normal, except perhaps really not wanting breakfast - but she did eat it. The vet reminded me about giving Tasha anything fatty as she had Pancreatitis in the summer. We do not want that to happen again. That will be the end.
I am doing my best to keep her comfortable. Running all suggestions I read here past my vet. I know you and all of the others are doing all you can too. Not much else we can do. It is so sad.
Jane and Tasha.