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.  

[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!

[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

[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!

[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]

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]

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.