kidney disease uncovered by chf episode in dog

[rddugan]

My sweet 14 year old Pomeranian had an episode of Congestive Heart Failure 2 weeks ago.  He was treated successfully and responded well to the Lasix, etc.  However, when he had his follow-up work a few days later, his kidney levels were bad - over 11 phosphorus, high BUN and creatinine.  We took him to the hospital for hydration and the BUN came down to 87, creatinine a little above normal.  On follow up a couple days later his BUN was 140, creatinine 2.8, and phosphorus normal.  His behavior is less exuberant than normal.  He had a bit of vomiting yesterday, no diarrhea.  His appetite today and yesterday was not too good.  The one day he had the Mirtazapine  he was his normal self and ate well.  My vet said to come back in a month for blood work and keep doing what we were doing.  However, I am concerned that I should be doing more- particularly with his diet when he does eat well.  Right now, with a lowered dose of Lasix, his heart issues seem well managed.  

Is there some more aggressive treatment, especially in terms of diet?  
Is his outlook is so bad, doing anything more will be fruitless?
Is a month soon enough to keep a good eye on his kidney blood levels?

Thank you.  We want to keep our buddy as comfortable and happy as we can as long as we have left.  

[missysmomma]

The vet just called, her BUN and creatine stayed about the same (that was a relief to hear) but her phosphorus is elevated, so he does want me to start administering a binder. He wants me to give her aluminum hydroxide (sp). I did not mention the powdered egg shell but will try to remember when I call him back later today.
I have been able to get her to eat chicken breast the last couple of days, I keep trying the KD food too but she doesn't show any interest.

[ginger899]

Yes it would be important to know the results of her bloodwork first. If her blood Phosphorus is not elevated, there is less of a worry. Also you wouldn't want to get her Calcium out of balance, so see how that is before adding a Phosphorus-binder.
My dog was diagnosed with early-stage kidney failure last October. In her case the blood Phosphorus was not elevated. As a result I was very careful about adding Calcium Carbonate to any Phosphorus-containing foods. I did it sparingly if ever she had something like sea fish. Apart from occasional chicken breast and scrambled white of egg, the vet recommended "Fresh-water White Fish" as a possible OK food for kidney insufficiency. But I found that impossible to obtain. I added a little powdered eggshell whenever I gave her whole egg. (Yolks of eggs contain Phosphorus)

By the way if you add Calcium Carbonate do not give any medications about an hour each side. Calcium Carbonate hinders the absorption of medication.

[missysmomma]

Thank you for the suggestions, the vet did say that we may add a phosphorus binder but he wanted to get results of blood work before he suggested to make any changes.

[ginger899]

Ask your vet about including a little powdered eggshell in with your dog's food if you feed her something like egg or chicken breast (which are examples of "high quality protein foods")
Eggshell is pure Calcium Carbonate, and binds to Phosphorus. Also it just involves a pestel and mortar and a lot of "elbow-grease" to prepare it, is almost no-cost, and is additive free.
So that might mean she can eat some more palatable foods without the worry about the Phosphorus content. I would still be circumspect, however, and not go overboard with high-Phosphorus foods.

Also you can ask your vet about anti-nausea medication. It will be the Blood Phosphorus presumably,causing the nausea, causing her to lose interest in food.

[missysmomma]

We are back from vet's office, they did the blood recheck, will know results on Thursday. I was so worried that she had lost weight but she stayed the same. But the vet said, the healthiest food, KD or another low phosphorus would be best for her but the most important thing is to get her to eat ANYTHING!

The most important thing the vet said is, NO ONE is giving up on her. I like him so much, he is very understanding and just loves animals!

Sometimes she looks like her old self, she still likes to go outside too. But usually at night she is restless and looks up at me like mom, why can't you find something I like to eat or why can't you make me feel better. Or at least that is what I think her look means.

Thanks for your support and advice, it really means allot to know I am not alone!

[missysmomma]

So, so sorry for your loss! I am sure that Taylor knew how much she was loved! I think when we lose someone that we love we always second guess ourselves but you must know that you did everything that you could and I am sure she knew that too. My heart goes out to you and your 2 sons!

My sweet girl is almost 16 and I am already besides myself, don't even want to think about the inevitable! I am praying that when it is her time that she just doesn't wake up one morning, so I don't have to make that dreaded decision.

Please try to take comfort in the love & joy that the16 years you had with your sweet Taylor!

Melinda

[ginger899]

I know, obviously you want to keep her on the diet food and not step away from it too far. But my feeling about her taking the pills is ANYTHING she might find irresistible in which to wrap the pills will do.
I mean, she would only be getting the odd morsel of non-diet-food a couple of times a day, I don't think that would do too much harm. If you get some hamburger meat/chicken breast/soft cheese/scrambled egg....whatever takes her fancy, about a marble-sized piece or a tiny spoonful, wrap her pill in that, let her sniff it, then make a big thing of giving it to her, get her to sit for it, etc, like it's a real treat....it might just slip down very fast!

[tonyb286]

I am very sorry to hear about Missy. You must be devastated by this additional problem on top of the CHF. There may come a time fairly soon when you will need to consider things like I/V fluids and I would certainly suggest keeping her on the pepcid, as it will reduce the tummy upsets and encourage her to eat. It sounds like you have done an amazing job so far - and to have reached 16, Missy is an amazing dog. I'm sure you have already realised the prognosis for kidney failure is bad, as there is no cure, but if she is in 3rd stage then you still have a period of time with her, so just enjoy it as much as you can. Your vet sounds like one of the good ones, so keep him up-to-date with how Missy copes with things and certainly keep asking him any questions you have about her condition and how best to treat and manage the symptoms.

My heart goes out to you. I know from experience how difficult this is for everyone involved. Use this site for support ... there are lots of good, friendly and empathic people here. Tony

[missysmomma]

My sweet girl Missy who will be 16 in August was diagnosed with CHF almost a yr ago, she has been doing pretty well! The only meds she has been on is enalapril 1/2 tab twice a day. About a month ago I just noticed that she was coughing a little bit more and just not acting like her self, so I brought her to vet where she was diagnosed with 3rd stage Kidney disease. I have been reading all that I can about the disease and just crying. The vet put her on kd food ( that she ate up the first couple of days) and also 1/2 tab of pepcid twice a day.  But her appetite changes from day to day on what she will eat. I was using the pill pockets for her pills but some days she turns her nose up at them, it stresses both of us to give her the pills down her throat, will have to ask vet suggestions. She goes back to the vet for her 30 day blood recheck tomorrow. I fear she has lost more weight and feel like I should have called vet sooner to ask for more suggestions. I was trying to feed her the right food, but did occasionally just give her anything she would eat. I sure hope we get a good report tomorrow, some days she seems like her old self with energy and other days she seems to have trouble going up one step, so I carry her up or down the one step when I need to.
I love her so and want to do everything I can to help her. I am going to ask vet tomorrow about suggestions on home made diet for her or anything to get her to eat!

Melinda

[TwoBitsMom]

Ok...well due to the tears that were interfering with my typing abilities...after re-reading my post...what I meant to say was...

I am sure your sweet angel Taylor knows that you only ALWAYS wanted what was best for her.  

Dang Tears.....!  

[TwoBitsMom]

Hello TaylorMonroe....
I am so sorry that I was not able to reply to your post sooner.
It has been 6 months since I had my sweet little Yorkie euthanized because of Kidney Failure.
I still grieve for her and wish that I, like you, could turn back the clock.
I know that I had her euthanized too soon, and regret that I even found out about the Kidney Disease.
I will always wish that things would have been and gone differently...but...I cannot change what happened.
TwoBits was 15 years old, and she was ALWAYS by my side...every step of the way. She was always right beside me.
I would give anything to be able to change the way things ended, but unfortunately I know that is an impossibility.
I try to tell myself that her death, at my hand, happened for a reason.
And I tell myself that I am glad that she did not have to get any sicker before she died. But....that does not seem to change the fact that I feel like I could have done more for her, and I feel guilty about having her euthanized when I did. Still....life goes on, and I know that TwoBits would not want me to spend the time I have left, dwelling on the fact that she was sick, and I helped her to die a peaceful death. To dwell in the past, only robs us of the present.
I know I only ALWAYS wanted to do the best I could for her, and she knows it too.
I am sure your sweet angel Taylor knows that is what you only ALWAYS wanted for her.  
Both of you were so fortunate and blessed to be given 16 1/2 years together. The number of years she lived, is certainly due in part to the wonderful care you gave to her.
You did the best you could....without you in her life, who is to say what may have happened to her.
I know you feel that you could have done more for her....As we ALL DO...
Whether or not that is true, ( which I doubt).....the fact remains, that
NOBODY COULD HAVE LOVED HER MORE THAN YOU DO...!
And because of that fact alone, nobody could have, or would have, done more for her than you did.
She was right where she belonged....with you....for 16 plus.... wonderful years.
I know how much your heart is breaking....I also know that all the kind words in the world, can not, and will not, make you feel any differently about what happened to Taylor.
But I do want you to know that you are not alone in your thoughts.
I also want you to know, that you have come to the right place for support, as there are many wonderful people here, who understand your loss and grief.
Taylor was a very lucky girl, to live her life in the company of someone who loves her as much as you do.
God Bless her Beautiful Spirit and Soul...she is much loved.
Please accept my heartfelt sympathy and understanding....
Connie

[TaylorMonroe]

Sorry. Lots of typing issues and spelling. It's hard through tears.  

[TaylorMonroe]

I lost my sweet sweet angel, Taylor one week today.  She was 16 1/2. I have children two young boys and was a grief counselor for years and am grieving like a baby. I'm do broken hearted, but want others to really know what all went on for others sake.  She was onLASIx(sorry for spelling I pad auto correct and children asking for me)and benzapril, and three other things. I truly feel the meds ran her kidneys into weakness and that's why she died. I wish I could turn back the clock.  Her murmur was bad the last few weeks, but I just think her meds were too much on her. Maybe Im Just sad and in the stage of denial still but I feel I could have done more

[rddugan]

Hi Everyone,

I am so thankful for all your comments.  Blondie - I am so sorry to hear about the loss of your poodle and now, Shadow's illness. What you wrote is exactly how I am feeling.  Thanks for your prayers and good wishes.  I hope you will see Shadow perk up very soon.  

My little Foxy is doing okay.  He has had many good days since I first wrote.  Today, however, is one of the rare days when I had trouble with the pills.  He is throwing up a bit too - usually after drinking water.  He hasn't eaten well in the last 2 days.

The problem is - he is so fussy. He refuses to eat potatoes, spits out rice, etc.  He only is interested in protein - especially salty protein.    Normally, before he was sick, we would give his food and then wait and eventually he would eat it.  Now, he is not as likely to eat at all.  My vets say the most important thing is to keep him eating, so we have given him some of his favorites with the healthier meals to get him going.  That usually works, but not so well the last 2 days.  I wish they could make healthier food tastier.  I am hoping he will improve again, but know that, eventually, he will succumb.  

My vet is doing the kidney panel Monday - so Foxy has made it a little over 3 weeks since he was in the hospital.  I will ask the vet to give me a lesson on   how to pill him.  However, when he was in the hospital, they had a very difficult time giving him pills, but I am hopeful.  

Best wishes to you all and to your dog buddies.  I will continue to come back for your very helpful comments.  Thanks again.

[blondie699]

HI, I also have a precious black Pom of 14 yrs of age.  He has problems with his hips and has been doing fairly well until Jan 27th of 2011 when his companion of 14 yrs our darling 16 yr old toy poodle died.  they have been together since Shadow (Pom) was 3 mos old and Napoleon was 18 mos old.  they slept together, when every where together, even with us on vacations.  Napoleon suddenly developed lung disease of some kind in Dec and had to be put down on 1-27-11.  Since then Shadow has been going down hill.  He developed a growth h near his anal glad which had to be removed and due to a lung xray the vet found two nodules in Shadow's lungs.  He was put on Tramadol for the pain in the hips and every time he takes it he pants very heavily.  I cut the dose in half and it still is not doing the trick.  After the surgery he had a pain drug called Metacam and he threw up from that.  I too, cook all the food like chicken breasts and rice and carrots and sometimes beef shanks from soup.  He seems to have a good appetite but he is not nearly the funny and peppy dog he was.  I know what you are going through having to leave him to go to work.  I work part time at the local library and don't want to go and leave him either.  We adopted a little 8 yr old toy poodle (female) that was a rescue dog hoping that would help him forget about Nappy but although he seems to like her his zest for life seems gone.  It is so hard to see your babies sick, I hope that you can get your little Pom feeling better soon so you can feel better,believe me I suffer when the dogs are not well and still am grieving over that loving poodle.  Little Chucky Valentina seems to help the household feel a little better and she is so happy to be with us.  Please let us know how you and the dog are doing, I am praying for you.

[Jaybay]

Regarding the pill issue, have your vet show you how to quickly "pill" your dog.  Once you get the technique right, you can pop it down his throat in a millisecond with no gagging or struggling.  It's important that he gets all his meds and that there's no question that he got them all down.  I know pilling can look awful, but if done correctly it's not at all traumatic for the dog.  I had to stuff so many pills down Chica's throat that as soon as she saw me coming with the bottle she just opened wide. :-)

[Misfits4Me]

Two more:

Beef and Potato Diet

(Low-protein, low-phosphorus, high-potas­sium, low-sodium)

    6-7 ounces lean ground beef (raw weight), cooked please***

   3 cups potato, boiled with skin or without skin ...

    2 tablespoons chicken fat
1/8 cup of green beans ( canned with no added salt)

   1 1/2 calcium carbonate tablets (600 milligrams calcium)

    1/2 multiple vitamin-mineral tablet  NuVET ( Holistic and very safe)

Provides 737 kilocalories, 18.6 grams protein, 32.5 grams fat

Enough for : Supports caloric needs of a 23- to 24-pound dog

***************************************



Eggs and Rice Diet

(Low-protein, low-phosphorus, low-potassi­um, normal sodium)

2 egg, large, hard-boiled

2 cups rice, long-grain, cooked

2 tablespoons chicken fat
1/2 cup of green peas or yellow wax beans..

2 1/2 calcium carbonate tablets (600 milligrams calcium)

1/2 multiple vitamin-mineral tablet or powder ( SEE NuVET)

Provides 721 kilocalories, 15.2 grams protein, 31.4 grams fat

Supports caloric needs of a 23-pound dog

[Misfits4Me]

Here's 2 balanced recipes for Kidney disease........I know I have another one, but haven't found it , yet...I'll keep looking......Karla

LOW PROTEIN DIETS  
( Thanks to Lowchen's )

http://www.lowchensaustralia.com/health/diet2.htm

Low protein diets play a role in the treatment of several conditions, such as kidney disease, advanced liver disease, and some forms of dominance aggression.

[If your pet has been prescribed a low protein diet], but doesn’t like any of the commercial preparations, you might consider trying one of these home-cooked recipes.


EGG & POTATO DIET
(low-protein, low-phosphorous, high-potassium, normal sodium) for Dogs

1 egg, large, cooked

3 cups potato, boiled with skin

1 tablespoon chicken fat

( *THE (1 1/2) CALCIUM CARB AND THE 1/2 NuVET vitamin is correct for a dog under 10 lbs )

1½ calcium carbonate tablets (600 milligrams calcium)

½ multiple-mineral tablet

THIS IS ENOUGH FOR 1 DAY OF AN 18 POUND DOG'S NEEDS:

Provides 600 kilocalories, 15.1 grams protein, 18.5 grams fat. Supports caloric needs of an 18-pound dog.

Provides phosphorus at 53 percent, potassium at 322 percent, sodium at 114 percent of dogs daily needs.

TO reduce the Salt - take away the chicken fat....

***********************************************************
1/2 to 1 NuVET plus wafer per day for all dogs on home-made foods or commercial diets:
Order your NuVET here:  http://www.nuvet.com/81098
Tell them you are working with PET Nurse Marie and some home-made special recipes.  ( use Discount code 81098) when you call in : NOT sold in stores;   1-800-474-7044
************************************************************

NEXT -


CHICKEN AND POTATO DIET  ( LOW SALT )***************
(low protein low phosphorus, high potassium, low sodium) for Dogs

¼ cup cooked chicken breast

3 cups potato, boiled with skin

2 tablespoons chicken fat

1 ½ calcium carbonate tablets (600 milligrams calcium)

½ multiple vitamin-mineral tablet
( NuVET supplement vitamins)
SEE order link Above*

THIS is enough for a 22 POUND Dog per Day :

Provides 689 kilocalories, 18.9 grams protein, 26.8 grams fat. Supports caloric needs of a 21-22 pound dog
Provides phosphorus at 45 percent, potassium at 301 percent, sodium at 54 percent of a dog's daily needs.

PLEASE only use GRAIN free treats-
INNOVA EVO and WEllness CORE make a nice Grain free treat.
There is also a brand called NO GRAINERS - very good treats.


HOPE this helps - MUCH better than the Awful HILL's RX stuff...
YUCK - MOST dogs don't like the HIlls Rx or Science Diet.


BEST wishes...

Marie Peppers LPN MA
Ask the VET Nurse
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
******  The Calcium Carb. tablet is a regular Human "Tums

[rddugan]

Thanks so much Chasha,

I need to do something about food as I constantly worry I am killing him quicker - though he is eating homemade dark meat chicken soup with carrots and low sodium broth as well as hamburg.  Carbs are a problem and he won't eat pills without something he likes.  I am going to the vet tomorrow because he is coughing a bit more and I am worried his CHF is acting up.  I will ask more about food help then.  He is so fussy, I am not sure he will eat KD.  I am willing to cook though.  I will keep the forum updated.  I find any support I can get very helpful and restorative.

[chasha33]

You can find Nuri-cal at most petstores like Petco ot Petsmart and alot of vets carry it.I know how hard this has to be for you.My peke Snowball is 12 years this all started  over a  year ago.I took her to the vet cause she had gained 8lbs in a few weeks.I didnt know what was wrong with my baby.Well  it took several weeks and lots of test and 3 different Drs and then they found out it was CHF and her kidneys.But her lab work would change every few weeks durindg all of this.Sometimes she was fine then her Bun and creatinine levels go up.Her lab work for her kidneys would look like a normal for her age then they would get high.When we found out what was wrong my vet did labwork and then waited 2 weeks after she started her meds to check again and then  waited a  month.My vet put her on the Purina KD and  I do feed her  KD to help cut back on her sodium intake.Cause restricting there salt helps prevent edema,ascites,and hypertension.Also KD has low protein and protein is hard for them to metabolize when they have kidney problems.Also the phosphorus in the kd is lower.With the kidneys and the CHF problems, Foxy needs a food that will help all of that.I also feed Nutro holistic.
I havnt had to do subq's on her But i did have to do them with my other Peke.Foxy seems to be a really lucky little guy to have you.I will keep ya'll in my prayers Take Care and God Bless

[rddugan]

Hello Chasha33,

Foxy is taking 1/4 Enalapril,1/4 Pepcid, and 1/4 Mirtazapine related to the kidney issue.  He also takes a bit of lasix (furosemide), and Vetmedin for his heart disease.  Enalapril also works on the heart issue.  His heart medicines are working fine.  Nutri-cal sounds so familiar - where would I find it?

How old is your Peke?  Has he been diagnosed long?  Do you do subcutaneous fluids?
The vet didn't suggest that to me yet.  I hope he continues to do well.

I will be trying all the food suggested here.  However, it seems as if I don't have enough time to do it all because of work.  It worries me.   I had to leave him to work yesterday and I hated to, but I think he was able to get a good day's rest with my husband there and he was very perky and happy when I got home. However, this morning he is nauseous again and doesn't want to eat.

I've had a hard time, of course, but a friend of mine with a young dog with kidney failure said she was the same way at first.-crying all the time, etc.  Now it is better.  

I so appreciate your interest.  God bless you and your Peke as well!

[chasha33]

What other meds is your baby on besides Enalapril.My Peke is on Enalapril, Vetmedin and lasiks.She also takes 1/2 a pepcid a day and Sulfracate.It helps her from getting ulcers from her meds.You could try getting some of the Nutri-cal and putting Foxy's meds in it.Also pumpkin is another way you could try.When my baby first went on her meds she did great and then she started spitting her meds out.I tried all kinds of things and since they have little mouths it is hard to pill her,But after a couple of weeks she got better about it.IWell i hope that Foxy is feeling better.Take care and God Bless

[Margot49]

try sweet potato instead of the regular potatoes.
You may find sticky rick in an Asian market.  Some I know order it on line.
I give our Grey his pills in the small pill pockets twice a day and he eats them right down.

[rddugan]

Thank you all so much for the great advice.  I have been on dogaware site and now will make sure to read it more thoroughly.  I am very sad today because I have to go to work and leave my little buddy behind.  He comes with me when I am in the office and loves it, but today and many days this week he won't be able to come.  My husband will care for him - but I don't like to miss a day with him.

He is already taking Enalapril for heart function, so I'm glad to find out that it is good for kidneys.  He has taken pills very well with food until lately.  However, when I have to pill him, he fights like crazy, shakes his head, gags, etc.  I hate to put him through it.  He sometimes spit them out - his throat opening is so small, it's hard to get the pill down far enough.

Re: diet - I made some dark poultry meat and broth and am trying to find acceptable carbs to mix with it that he will like. I put potatoes in it with the broth of the soup and he accepted them after he has had his appetite stimulant.   I haven't tried sticky rice, but will look for it now.  He actually spits out individual grains of white rice I've tried with him.  He is very fussy, but so cute.  

Well - off to giving him meds and to work. Hopefully he will eat.  Thank you all again.