Hailey's Kidneys Are Failing---She's Only 8 :(

[JerseyGirlInOz]

A couple months ago I posted about Hailey developing incontinence. The regular vet diagnosed her with a mild UTI and spay incontinence and put her on DES. She assured me that the the results of the urinalysis did not indicate any kidney involvement.

 

She responded well to the DES, but she started losing weight rapidly so I took her to the greyhound vet for a blood test. Her creatine, urea and white blood count were all really high, indicating that her kidneys are in fact failing. I am shattered---and still trying to get my head around the very dire prognosis. I'm trying to come to terms with the fact that it can't be reversed, but want to do everything I can to at least stabilize her and keep her feeling well for as long as I can.

 

Has anyone else had kidney disease in a relatively young grey? What steps did you take with treatment, diet, etc?

[JJNg]

I'd consider doing a consultation and ultrasound with an internal medicine specialist. The high white count may indicate an infection, and a kidney infection can cause acute kidney failure that may be at least partially reversible. But if this is the case, it would need to be addressed asap for best results.

 

What are her actual bloodwork numbers? What was her urine specific gravity (concentration), and did she have protein in her urine? How is her appetite?

 

If she does have permanent, chronic kidney disease, management would include a special diet that is low is phosphorus (easiest to do with a prescription diet like Hill's k/d or Purina NF, but some people choose to home-cook), as well as meds to address any particular secondary effects, like electrolyte abnormalities, high blood pressure, protein in her urine, etc.

[tbhounds]

Did you check for lepto? At our clinic here in NJ we have had 2 positive cases already this fall. I would also check for Lyme--need to rule out Lyme nephritis.

[racindog]

No advice/experience but adding my prayers to her treatment plan!

[Wonder]

Do they have Lepto and Limes in Australia?

 

Mo- post the bloodwork values.

 

I'm so sorry you are going through this. I hope the vet is wrong and it's just an infection and can be treated. Hugs to you my friend

 

Just thought of something, I would check with OSU. Fill out a consult here and upload her bloodwork.

https://greyhound.osu.edu/consultationservice/index.cfm

[Trihounds]

Sorry you are going through a rough patch with Hailey.

 

While not a grey, we had a kidney cat that we treated for about 2.5 years post diagnosis. The general program is similar between the species and at least with a feline, it was a bit of a roller coaster. Blood values had to be checked regularly and we had good days and bad days. Towards the end, even with increased subQ fluids, we couldn't keep our boy flushed of the toxins and had to say goodbye.

 

Hoping you find it isn't something chronic and that you have found the issue in time. Good luck.

[duncan41]

My 8 year old is in the same situation but with an entirely different cause. Best tests are ultrasound and cystocentesis for UA, culture and UPC, Lepto and PCR for tick borne disease. Those results should either give you the answers that you need.

 

But before you do that, it would help tremendously if you could copy and paste the blood test results here (including the reference ranges), then others could be more specific with their advice.

Edited October 2, 2012 by duncan41

[Batmom]

I'd consider doing a consultation and ultrasound with an internal medicine specialist. The high white count may indicate an infection, and a kidney infection can cause acute kidney failure that may be at least partially reversible. But if this is the case, it would need to be addressed asap for best results.

 

Ditto. The high white count almost always *does* indicate an infection.

 

My Gidget had an acute kidney failure incident at age 4, before I adopted her. Took @ a year, year and a half for her bloodwork to normalize, but it did.

 

My Joseph has chronic kidney disease, confirmed by ultrasound at 7. He is 9 now. The disease appears to be progressing slowly in his case. He feels well 99% of the time and has little in the way of symptoms.

[JohnF]

Not in a Grey but I have had it with 2 Borzois. One age just 5 and the other (distantly related) at only 8. I also had it with my last dog but she lived to 14 with it for about 18 months so it was an old age and drug influenced thing.

 

What I can tell you is that every dog is different in how they progress with the disease and you need to think about treating the dog rather than the lab numbers.

 

My 5 year old declined rapidly and was PTS within the month. Then 8 year old took a couple of months. It's a horrid disease and once they stop eating for good then you have about 3 weeks of quality life left. Once they stop drinking then it really was time to let them go yesterday. I let them go to the Bridge before that quality of life equation went below zero and they get seizures on top of everything else. If you talk to a human kidney sufferer without dialysis you'll know it is the kindest way.

 

Treatment aims to remove the load on remaining kidney function, flush away the toxin build up, correct the calcium/phosphorous balance, reduce acid production and stomach soreness, and encourage the eating of anything they will by a steroid boost.

 

The people at this place were incredibly helpful and understanding when my last dog was in trouble with CRF. They'll need you to post the latest lab results to join. http://pets.groups.yahoo.com/group/K9KIDNEYS/

 

There is a good article in the Diseases tab at http://www.dogaware.com

[Rickiesmom]

I agree with many posters above - get her to an internal medicine specialist as fast as you can.

[Guest Amba1027]

We lost my parents first grey to kidney failure when she was 8. Unfortunately by the time she started showing symptoms it was too late to do much of anything. It was only about a week after we found out that we had her PTS. I think you've gotten some good suggestions above. I wish you luck and hope things turn out ok.

[Jiffer]

My angel Atlas, who was 12 at the time, was diagnosed with early Renal Failure in Oct '11.

 

The vet had us immediately put him on Fortekor, and asked that we give him Omega oils daily, plus a high quality kibble (we put him on a 70% home cooked plus 30% kibble). Within a couple of weeks, we saw a complete turn around. He had more energy and was back to his old self. It was amazing.

Our story didn't end well, however, his RF was actually a symptom, and not the problem, and it turns out he was developing CHF which was hidden behind a murmur he had for years. We missed it at every vet check until November 2011 when it was discovered. We had our big boy until early January when his heart couldn't handle it anymore and we had to lead him across the bridge.

 

My parent's shih-tzu was also in RF for several years and did amazingly on Fortekor. They also switched her diet to a kidney diet. She was 16 when she passed.

 

Worth checking into for sure, esp in a hound so young.

[Guest Vers]

Please ask your vet about calcitriol, or find a vet who has experience with it. It's been mostly used for dogs with CKD, but I have a cat with kidney disease who, so far, is staying symptom-free on it and I am amazed by it. I also changed to low phosphorus, low sodium canned food.

 

Here's a start on reading about calcitriol: http://www.veterinarypartner.com/Content.plx?P=A&A=558&S=0&EVetID=0

http://www.zzcat.com/CRF/calcitriol/

 

I am very sorry you're facing this with your hound, but will hold hope that there's help.

 

And anyone with cats that have kidney disease -- not all vets are familiar with its use with cats, but they are out there. My vet says that since she's been prescribing it over the past four or five years, cats are not dying of kidney disease.

[JerseyGirlInOz]

Specific Gravity on the urine was 1.025, and presence of blood was Moderate (80).

 

These are the results of the bloodwork:

 

GENERAL BIOCHEMISTRY SPECIMEN : SERUM

Sodium 152 mmol/L (138 - 158) Protein 45 g/L (45 - 62)

Potassium 4.1 mmol/L (3.5 - 5.8) Albumin 24 g/L (23 - 34)

Na/K 37.1 Globulin 21 g/L (21 - 32)

* Chloride 119 mmol/L (100 - 115)

* Bicarb. 19 mmol/L (22 - 28) GGT 3 U/L (1 - 10)

* Urea 44.4 mmol/L (3.6 - 10.4) Alk Phos 22 U/L (10 - 120)

ALT 25 U/L (5 - 80)

* Creat. 712 umol/L (95 - 166)

CK 244 U/L (50 - 400) AST 48 U/L (10 - 80)

* Amylase 2156 U/L (180 - 1300) Chol. 5.3 mmol/L (2.8 - 6.2)

Lipase 26 U/L (< 70) Calcium 2.49 mmol/L (1.75 - 2.50)

Phosphate2.10 mmol/L (0.80 - 2.10)

 

Preserved Glucose 4.9 mmol/L (3.3 - 6.7)

 

SERUM INDICES (Clear/+/++/+++/++++)

Icterus index Clear

Lipaemia index Clear

Haemolysis index Clear

 

 

 

GENERAL HAEMATOLOGY

* Red Cell Count 6.92 x 10 ^12 /L (7.40 - 9.00)

* Haemoglobin 178 g/L (190 - 215)

* Hct 0.51 L/L (0.55 - 0.65)

MCV 73 fL (65 - 78)

MCH 26 pg (21 - 26)

MCHC 351 g/L (320 - 370)

Reticulocytes 0.5 % 35 x 10 ^9 /L

White Cell Count 5.7 x 10 ^9 /L (3.5 - 6.5)

* Neutrophils 87 % 5.0 x 10 ^9 /L (3.0 - 4.5)

Band Forms 0 % 0.0 x 10 ^9 /L (< 0.2)

* Lymphocytes 9 % 0.5 x 10 ^9 /L (0.8 - 1.9)

Monocytes 4 % 0.2 x 10 ^9 /L (0.1 - 0.7)

* Eosinophils 0 % 0.0 x 10 ^9 /L (0.1 - 0.6)

Basophils 0 % 0.0 x 10 ^9 /L

Platelets 237 x 10 ^9 /L (200 - 500)

 

FILM MORPHOLOGY: Red cells show occasional polychromasia .Leucocyte

morphology is normal. Platelets: Adequate .

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 

After 4 days of IV fluids they were able to get her urea level down to 24, I took her back for a follow-up a week later, and her level had crept up slightly to 27 so they did 2 more days of fluids. They also put her back on amoxy, although this is the 3rd time and I'm beginning to think that whatever's there is resistant. The vet said that if the infection hasn't cleared by Friday she would do a culture.

 

I took her in for follow-up bloodwork today, but the vet was in surgery so I have to wait for the results. In the meantime I got copies of all her labs and am sending them through to an infectious disease specialist, but I can't actually get in to see her until next week.

[JerseyGirlInOz]

Do they have Lepto and Limes in Australia?

 

Both are extremely rare, but I will mention these to the specialist.

 

 

I'm so sorry you are going through this. I hope the vet is wrong and it's just an infection and can be treated. Hugs to you my friend

 

 

Thanks, Kari, that means a lot to me. I'm trying to stay cautiously optimistic, but this is killing me. She's my hound.

[tbhounds]

Amoxicillin? Honestly, I think it may be time for a change in antibiotics. Possibly, Baytril? This sounds like pyelonephritis?

[NeylasMom]

I'm with JJng on the possibility of infection and next steps. Even if you cant find a cause, I might consider treating prophylactically with Doxy or Baytril, but I would get the U/S and test for lepto and TBD if you have them in your area or anywhere you've been.

 

So sorry you're dealing with this. I do think the WBC count is potentially a promising thing here, will keep ky fingers crossed for you. If it helps, Neyla had an acute kidney failure episode around age 5. I thought she was going to die, but while we never found the cause she recovered and lived until osteo took her at nearly 12 as you know. I believe she did have compromised kidneys from it, but it didn't affect her until her pamidronate treatment for osteo, which is known to also potentially compromise kidneys. So it is possible for her to recover from this and have a "normal" life if its not chronic kidney disease.

[rascalsmom]

I'm so sorry to hear of this, Mo. Not having clear answers is so hard.

[gazehund]

Please ask your vet about calcitriol, or find a vet who has experience with it. It's been mostly used for dogs with CKD, but I have a cat with kidney disease who, so far, is staying symptom-free on it and I am amazed by it. I also changed to low phosphorus, low sodium canned food.

 

Here's a start on reading about calcitriol: http://www.veterinar...58&S=0&EVetID=0

http://www.zzcat.com/CRF/calcitriol/

 

I am very sorry you're facing this with your hound, but will hold hope that there's help.

 

And anyone with cats that have kidney disease -- not all vets are familiar with its use with cats, but they are out there. My vet says that since she's been prescribing it over the past four or five years, cats are not dying of kidney disease.

 

My kidney girl was a candidate for calcitorl but IIRC not all dogs are? One of the values needs to be within

normal range again if I am remembering this correctly. I managed Pearl for 3 years. She did very well. Good

luck to you.

[Guest Downtownhoundz]

I'm sorry you're going through this. I have no advice regarding kidney illness, just sending gentle hugs and warm wishes your way...XXOO

[NeylasMom]

Mo, if it does turn out to be CKD, we've had a lot of success with Azodyl and fish oil for Cisco (the cat). When he started vomiting more frequently, we also added in Pepcid, but then switched to Zantac and have had better results with that (supposedly Zantac can help with potential constipation issues, whereas Pepcid will not, which is why we switched - Pepcid is more commonly used).

[Guest Scouts_mom]

Just wanted to tell you my experience with kidney failure in Greys. My Lizzie was 8 when I adopted her (she had been abandoned by whoever owned her before). When I took her into the vet for a well-pet visit, I had blood work done to get a baseline. She seemed perfectly healthy to me, so I was shocked when the vet reported that she had serious kidney problems. We did an ultrasound to try to figure out what was going on and discovered that she had a birth defect--very small kidneys--a size appropriate for boston terriors, not greyhounds. She was put on the kidney diet and various drugs letting her have another year. Up until the last month she still seemed healthy and was certainly very happy. The vet said her kidneys were just worn out..

[JerseyGirlInOz]

Thanks so much for all the support and suggestions. I have an appointment with the infectious disease specialist on Tuesday, which can't come soon enough for me, since the bloodwork the greyhound vet did on Wednesday showed her urea levels went up again (to 36.5) and her creatinine is up to 763, which is even higher than when she was first diagnosed. I feel so %#@& helpless

Edited October 6, 2012 by JerseyGirlInOz

[mychip1]

So sorry to hear you are going through this.....my thoughts and prayers are with you.

[NeylasMom]

Keeping my fingers crossed for tomorrow.