Renal Failure

[Rbchound]

My redbone coonhound, Wilma, is only 4 yrs old.  After a week of vomiting and 2-3 days of not eating or drinking I decided to bring her to an emergency vet.  The blood tests showed chronic renal failure.  I then took her to my regular vet this morning after an evening of IV fluids at the emergency vet.  She is going to be there for another 48 hours of fluids and then another blood test tomorrow afternoon.  She was diagnosed and treated for lime disease about a year ago.  She is my life and I spend almost all my free time with her.  When I brought her to the vet this morning she was in good spirits, active, and rehydrated.  I am fearing for the worse and hoping for the best.  Can you offer any advice?

[Rachel4thAve]

To everyone who has just received a diagnosis of kidney (renal) disease or failure from the vet:

My 14 1/2 yr old shepherd/rottweiler mix, Morgan, was diagnosed 2 years ago with advanced chronic renal failure. She seemed to be deteriorating rapidly and we expected to lose her within 6 months until, in total desperation, I got brave and stopped listening to the vet's advice to put her on prescription 'low-protein' diet food (we tried Hills KD and several others) + phosphate binding pills plus other meds. Instead I researched a TON on sites like DogAware and started Morgan on a raw food, high-quality protein & low-phosphorous diet plus daily supplements which I'll list below. It's not the most convenient at first, the food's pretty gross, the cost is about £40 per month for the food, and another £25 for the supplements, but my dog turned around straight away with this diet, both in her behaviour and her blood BUN and creatinine levels. Now her blood work is down to nearly normal, she loves to eat, doesn't drink any more than normal, and with her bright eyes and shiny coat most people think she is several years younger than she is. I'm in London, UK, but from NYC, so I know that there are alternative suppliers of the products I us - just be sure to research all ingredients.

Every day, my 27kg (59lb) Morgan eats the following: From Nature's Menu dot co dot uk (not *******!) the Chicken&Tripe complete dinner. Defrost two individual "meal" packs and mix with 1/2 teaspoon of eggshell (which I save from our breakfasts, then wash, let dry out, and grind into fine powder in a cheap coffee bean grinder I got off Amazon - once a month I make a batch. It's pure calcium carbonate, the same stuff you may be buying from your vet only without any manufacturing additives). Also mix in a big spoon full of plain yogurt or good quality probiotic powder. I use a teaspoon of Green Vibrance powder, which is the best but unless you can buy in bulk it's very pricey (then again, I haven't had a vet bill in 14 months!). Also mix in 100mg of CoQ10 (get these in capsule form from a human health food store, open up, and pour the powder into the food. If your dog is elderly like mine and suffers from arthritis, also pick up from the healthfood store (or I order everything from amazon): Turmeric (500-720mg), Green-Lipped Mussel extract (I use Musselflex 500mg, which I have to crush as it's not a capsule), and Thorne Research Arthroplex for Canines (2 capsules). Mix all together very well along with at least a cup of water (filtered unless you know your tap water is excellent - in London it's not) then divide into 4 small meals spaced throughout the day (keep the rest sealed in the fridge - it smells a bit. If your dog has trouble with upset stomach (eating grass, vomiting) I give Mo a 75mg tablet of Ranitidine (generic ingredient in Zantac).

Here's the last bit, which I'm a strong believer in: everyday I give Morgan about 8oz or so of raw green tripe, which I buy in frozen chunks from the Nature's Menu website. This stuff is foul. I keep it and the rest of her food in a small freezer only for the dog (£60 at Argos). I can only handle it with rubber gloves, never open the bag in the house, and toss the frozen chunks into her bowl out in the garden, but she will never refuse it, no matter how low her appetite ever becomes. It's naturally calcium-phosphorous balanced and is hugely nutritious - in the wild, this is the first part of the prey that the dogs eat. Even if you don't do any of the other supplements (except you must always add the crushed eggshell!) the green tripe is seriously important. Anyway, my vet, husband and friends have been urging me to post this info around, given what a miracle it's been for Morgan's CRF and general health. I can promise that I'm not some wacko - it's just that I did SO much research and experimentation with all the prescription diets, alternatives, home-cooked meals, etc. on the market in hopes of keeping my best girl with me as long as possible...Now that I've discovered a routine that's working so well, maybe we'll get another 14 yrs together :) Best of luck to all of you and yours, Rachel

[Jaybay]

I'm dealing with the same problem, only my dog is much older - well over 13.  There really isn't much you can do for failing kidneys other than try to protect the remaining function for as long as possible.  The best tools you'll have are your own hands:  make homemade dog food that is as low in phosphorus as you can make it.  Calcium and aluminum hydroxide are great phosphorus binders and should be added in the form of a Tums or an Alu-Tab twice a day.  In my experience, those have been the two most important items in my doggie renal failure tool box.  :-)  You'll also need something for nausea, but if your vet prescribes reglan (metoclopromadine), be aware that reglan is metabolized in the kidneys.  If the kidney damage is too great, the reglan can't be processed and a toxic dose will result.  Symptoms are restlessness, trembling, shaking, and fast pulse and respiration.

Pepcid should also be given to deal with the high acid levels that go along with renal failure.  Another beware:  some dogs (like mine) totally lose their appetite after taking pepcid long-term.  It's just something to keep an eye out for since getting dogs with bad kidneys to eat is a huge problem.  Even if the food they eat isn't the best for them, they MUST eat something.

If necessary, your vet can show you how to inject sub-cutaneous fluids at home if your dog can't stay hydrated on its own.

Here is a link to a 40 page article written by a woman who dealt with a dog in renal failure for many years.  I have to say this article has been more helpful to me (and my dog!) than what I learned from the vet.  Don't get me wrong - my vet is just fabulous, and we need him for testing and other meds.  It's the day-to-day maintenance that this article helps with.  Lots of different recipes to try and lists of foods and their phosphorus values.

http://www.dogaware.com/kidney.html

Look through the past 3 weeks of postings on this forum and on the Ask a Vet forum.  There have been several people posting about renal failure lately and lots of good discussions for you to read through.

Are you and your vet pursuing further testing for the underlying cause of the renal failure like Addison's Disease or an infection?  I know that can get expensive, but it can obviously make a difference if the cause of the renal failure is known and treatable.