Kidney Disease

[Guest Greensleeves]

Hi, all... I haven't been around much since we lost Whistler to cancer last summer. Unfortunately, we have more bad news: Nelly is in renal failure. Apparently the search function isn't working, or I wouldn't have started a whole new topic! What I'm looking for is information on what worked for you, what helped your dogs, at what numbers they seemed "sick," etc. Really, *anything* you can share would be helpful.

 

Nelly's creatinine was 3.2 three months ago, and was 4.2 earlier this week. I don't have her BUN or her other numbers. When she saw the internal medicine specialist on Thursday, he seemed to think she was too sick to even be walking around... but our regular vet is much more optimistic about the numbers (the specialist said she probably had 25% kidney function, but our regular vet said "we start to see numbers like that at about 75% kidney function.") We just don't know! The specialist (who is a wonderful doctor who really worked with us to save Whistler) gave us options but felt that having us get as much water down Nelly was the best/easiest current option (along with Pepcid to settle her stomach). Our regular vet suggested subcutaneous fluids and IV fluids. Since it was a late Friday afternoon, and the clinic is closed on weekends, we opted for the sub-cu fluids, and we're returning tomorrow for three days of IV therapy (she'll come home at night).

 

Nelly is a solid, consistent girl who will eat *anything,* and has never, in 7 years, left a single crumb behind in her food dish. Last week she started declining a cookie at bedtime, and by Friday, she was refusing her meals. It's scary how fast she's started to feel bad.

 

Other things the specialist suggested were a phosphorus binder (Epakitin); we got some from our vet, but nobody seems to know what the dosage is (Nelly is 70lbs), so we can't start that yet. He also suggested Metaclopramide (sp?) for nausea (but she's not vomiting, so our vet didn't think it was necessary yet), and he told us to look into something called Calcitriol--but it looks like we need some more exact numbers before we can start that, so we'll have to get through the next round of fluid therapy before we think about testing her again. He also mentioned bicarbonate, but again, we don't know what/how much/where to get it/when to give it.

 

Arrrgh! This is really frustrating and scary--not knowing how sick she is or if we'll be able to do anything to help her. The ultrasound showed that her kidneys are only about 1/2 the size they should be (probably a birth defect), and as a result they're aging much faster than a normal dog's would. So we know that time is limited (she's only 8), but we'd like to know what we can do to hit this as aggressively as we can, to make the most of the time we do have with her.

 

Thanks so much for anything you can tell me!

 

(Nelly sends Nellahugs to all her Greytalk friends )

Edited August 17, 2008 by Greensleeves

[Guest greyscot]

Hi,

So sorry about Nelly. I know how you feel as I am going through this with one of my dogs (a non grey). However, my vet advised a renal diet which he supplied. He told me this can double the lifespan and more of renal dogs. It is a wet food but I believe it also comes in dry form. Hill's make it - Hill's prescription diets K/D and also Royal Canin renal diet. I'm in the U.K. so I can only tell you about what is here but I suspect you have similar if not the same. Epakitiin is used here also, the dosage should be on the container, which also has a measuring spoon supplied. I will say my dog hates the renal diet and this is common so it can be a battle getting them to eat it.

Give Nelly a hug from me.

[Guest Scouts_mom]

 

This sounds very similar to what happened to my Lizzy a few years ago. She also was born with very small kidneys. I don't remember what her BUN and Creatine numbers were, just that they were very bad--my vet said she should be dead or at least very vary sick. We put her on the kidney diet (Science diet KD) which she didn't like. Purina also makes a kidney diet that she liked much more. She lasted for about 6 months on the diet, then she began to go down hill quickly. We were going to start her on some of the medicine you mentioned, but her kidney's stopped completely before the Vet got the medicine and I had to let her go. I remember we didn't start her on the medicine earlier because they had extensive side effects, might not have helped at all, and she seemed to be doing okay.

 

I am so sorry this is happening to Nelly.

[Guest greytbookert]

I'm sorry to hear of your troubles with Nelly, our Mama Ro's kidneys are failing but she is just slightly over 14, so things are a bit different for her. What really helped me understand and provide some sort of "control" on my part was this link.

 

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

 

There is tons of information in there and if you take time to digest what it says, it will help you get your arms around what you are dealing with. I know it helped me tremendously after I read it over three or four times

Edited August 17, 2008 by greytbookert

[Guest MZH]

So far, it sounds like you've been given good suggestions. I'd be careful about reducing protein too much; that's the first things the kidney diets do. They lose muscle mass and feel more awful than they need to. Low-phosphorus foods is the way to go. Unfortunately, most of the high protein foods are high phosphorus. There must be lower phosphorus, higher protein foods around that she will like.

 

One good thing to give is egg, IIRC. I know my cats and one dog who've had kidney problems liked the Purina better than the Hill's kidney food. There are other choices too.

 

There are lists of low phosphorus foods on the Internet as well as a canine kidney diet list, believe it or not. You'll find lots of feeding help out there.

 

The sub cu fluids at home will do her a lot of good. That alone will make her feel much better.

 

Keep the faith. Nelly may have plenty of time left yet.

 

Marcia in SC

 

 

 

 

[CaliforniaGreys]

Prayers for your girl! I have a girl who has kidney disease and has had it for almost 2 1/2 years now. She's on the Hills KD, both dry and canned. It does need to be a low protein and a low phosphorus as well. My girl is also on Enecard and has been doing very well. Dr Bill Feeman has a great post on here about kidney diets needing to be low in protein and phosphorus. If you can't locate it,pm him.He's always happy to help with info and suggestions

[Guest MZH]

Prayers for your girl! I have a girl who has kidney disease and has had it for almost 2 1/2 years now. She's on the Hills KD, both dry and canned. It does need to be a low protein and a low phosphorus as well. My girl is also on Enecard and has been doing very well. Dr Bill Feeman has a great post on here about kidney diets needing to be low in protein and phosphorus. If you can't locate it,pm him.He's always happy to help with info and suggestions

 

Does your girl have glomerularnephritis? (The Enacard tipped me off.) We had a hound with undiagnosed-for-3 years GN. We gave him Enalapril early on but stopped it when the BP went down. No one told us we needed to keep it up or that he had GN! (I should have known better and looked it up.) He made it to 10 and a half but he had two terrible rounds of Lyme disease, which may have caused or hurried his GN downfall.

 

I'm so happy your girl is doing so well for so long!

 

Marcia in SC

[Guest charmsmom]

My cat lived 2 years with renal failure. Sub-q fluids and Metaclopramide will definitely help. They will quell the nausea and stimulate her appetite, so she won't have to get to the vomiting point. Renal failure is manageable and, yes, your girl will have good days and bad days, but she'll have lots of time. Give her high-quality proteins, high-quality treats, and high-quality LOVIN'!

[CaliforniaGreys]

Prayers for your girl! I have a girl who has kidney disease and has had it for almost 2 1/2 years now. She's on the Hills KD, both dry and canned. It does need to be a low protein and a low phosphorus as well. My girl is also on Enecard and has been doing very well. Dr Bill Feeman has a great post on here about kidney diets needing to be low in protein and phosphorus. If you can't locate it,pm him.He's always happy to help with info and suggestions

 

Does your girl have glomerularnephritis? (The Enacard tipped me off.) We had a hound with undiagnosed-for-3 years GN. We gave him Enalapril early on but stopped it when the BP went down. No one told us we needed to keep it up or that he had GN! (I should have known better and looked it up.) He made it to 10 and a half but he had two terrible rounds of Lyme disease, which may have caused or hurried his GN downfall.

 

I'm so happy your girl is doing so well for so long!

 

Marcia in SC

My vet never said that she did. He has her on the Enacard because it helps with poor kidney fuction, at least that's how I understood it. Misty is 10 and so far, her blood work every 6 months has come in good.Isin't there a difference between kidney failure and kidney disease? In Misty's case, we caught it very early.

[greyhndz]

I'm sorry you and your sweet pup are having to face this. The "dogaware" website is, I agree, a wonderful resource!

 

Sub-Q fluids are probably one of the most important treatments you can give Nelly. The dogs tolerate it very well, and it doesn't take long to run the fluid in every 24 hrs. The improvement will show in her bloodwork, but more importantly, in the way Nelly feels.

 

I've also been dealing with kidney disease with my iggy Lexi, so have recently been down this road. The Encard (enalapril - which you can get for $4 at Target, Walmart, etc.) not only helps to decrease the amount of protein lost in the urine, it also lowers blood pressure, which improves blood flow to the kidneys. For some types of renal disease, a low-to-moderate protein diet is important, but this is mainly for diseases (like glomerulonephritis) that result in a large amount of protein in the urine (as in Lexi's case). More important is phosphorous restriction, and for Nelly, phosphorous binders.

 

Several prescription kidney diets are out there, but I have to tell you -- read the labels. They're horrendous and not at all palatable. It really isn't hard to home cook a kidney diet, based upon how much protein, phosphorous and how many calories the vet feels she should have. Marcia is right about egg being the best protein source -- that and cottage cheese. Those are the most bioavailable (digestible) sources of protein. The problem I found was that everything I home cooked for Lexi, she lost interest in very quickly, so varying the diet was helpful. The dogaware website has formulas and recipes that will help. I also have some recipes and a formula that I'm happy to send.

 

Feel better soon, Miss Nelly!

[Madeara]

anther great group with loads of information and help

 

http://pets.groups.yahoo.com/group/K9KIDNE...group&slk=4

 

http://pets.groups.yahoo.com/group/K9Kidne...group&slk=3

 

[Guest charmsmom]

One more thing...when you do run the fluids sub-q, it would be a good idea to warm the fluids in some warm water in the sink. While fluids are wonderful, room temp fluids can feel COLD and make her miserable during infusion. But be sure you warm ONLY the fluids and don't get the infusion kit wet.

[Guest Greensleeves]

Thanks, everyone. I'm slowly making my way through all the links and feeling very overwhelmed.

 

Nelly's been at the vet's since 8 am, and they only just now called to tell me they were unable to do the IV because her veins kept collapsing and/or her blood kept clotting and clogging the tube! I don't know why they didn't tell me any of this in one of the three times I called today to check on her! Now she has to go back for three *more* days of this! Assuming they can even get it to work tomorrow. They did some sub-cu fluids and think that that should help them get a better vein tomorrow (these very people have IV'd her plenty of times before).

 

Argh.

[Guest charmsmom]

I know it's tough...but as mentioned in the other thread, dehydration can make veins hard to get. Go ahead and run the subq fluids and get those into her and maybe they'll have better luck tomorrow. Once they *get* a vein, maybe they'll be smart and leave her catheter in.

 

Try to relax and not get overwhelmed. Yes, it's kidney disease, but it's manageable. Besides...you have all these fabulous GTers to help you. They've never let me down! {{{{hugs}}}}

[greyhead]

Hopefully, things will get more manageable when she's hydrated; the blood will thin out and the vein will become available. So do give her lots of water now.

 

We have a 5 year-old greyhound with recent early kidney failure and an 18-year-old cat who has been getting along fine with it for two years, with special handling. The dog is on a high-protein diet (Wellness Core Low-Fat) because he can't handle grains. But his phosphorus level is within normal limits, and he's not losing protein through his urine. The school of thought we're following is the one that says don't reduce the protein in the diet too much or too early in the disease, because it causes other problems that then harm the kidneys even more.

 

Despite the high-protein food, we pulled the dogs numbers back to the high end of the normal range just by adding Omega-3's to the food! It's easy to do, and it's not something we just pulled out of the air; our vet and others have seen beneficial effects on kidney disease from Omega-3's.

 

Hang in there. It's overwhelming at first, but if you all can get Nelly through the initial rough patch, she may do well for a long time. (Our last cat, for example, with CRF -- chronic renal failure -- lived 5 years post-diagnosis, using mostly just sub-q injections.)

 

Mary

 

Thanks, everyone. I'm slowly making my way through all the links and feeling very overwhelmed.

 

Nelly's been at the vet's since 8 am, and they only just now called to tell me they were unable to do the IV because her veins kept collapsing and/or her blood kept clotting and clogging the tube! I don't know why they didn't tell me any of this in one of the three times I called today to check on her! Now she has to go back for three *more* days of this! Assuming they can even get it to work tomorrow. They did some sub-cu fluids and think that that should help them get a better vein tomorrow (these very people have IV'd her plenty of times before).

 

Argh.

Edited August 19, 2008 by greyhead

[Guest suzye]

I'm sorry to hear about Nelly's illness. Kidney disease is scary and frustrating. I second the suggestion on those yahoo groups. I am a member of K9KidneyDiet thanks to a kind soul on greytalk (not sure which thread I found it in). Jazz was diagnosed on Oct. 14, 2007 (adverse event from Deramaxx). I've been treating her aggressively with a low phosphorus home-cooked diet and daily subcutaneous fluids. Just to give you an idea of what's possible, her creatinine has ranged from 3.2 to 4.2 (it has gone up and down) over the last 10 months. For me the home-cooked diet is the most work -- I'm constantly boiling chicken and trying to buy it on sale (the boneless, skinless, non-broth injected stuff is hard to find and not cheap). By doing all this you can improve the quality of life.

 

If you feed the RX food try to supplement with egg whites for more protein, unless the diet needs to be low protein (my dog's diet is not). Be careful as those Rx diets are loaded with fat. Alternagel is a much better phosphorus binder than Epakitin. K9KidneyDiet has info on phos binder dosage.

 

 

Edited August 19, 2008 by suzye

[Guest Tigonie]

Poor Nelly, and what a horrible shock for you.

 

Our Emma was diagnosed with early renal failure. We caught her kidney disease early, due to some abnormal blood test results on a routine screening. We also did the ultrasound to confirm that was the issue. We tried her on Purina NF food, and she liked it, so we've stuck with that. We also give her 10 MG of Enalapryl twice a day. It's a $4 prescription for 30 pills at your regular pharmacist. Our vet told us bananas are good for her, so I frequently give her part of a banana as a treat (and to hide the pill sometimes). She gets very little if anything else for a treat (maybe just occasional crumbs that he kids drop).

 

We have not done subq fluids for Emma yet, though I used to for our old cat, before he died. It's not hard to do, because you just need to get the needle under the skin--you don't need to hit a vein or anything, so the technique isn't very difficult.