Possible Kidney Issues

[Guest Gingy]

Lucy is my 4 year old grey who I've had for about six months now, and a week and a half ago she started drinking excessive amounts of water (3 bowls in the afternoon) and peeing in the house. We took her to the vet, who checked her urine, that was fine, and did some blood work. Her creatnine level was 2.3 as of last Friday. The vet thought it could be an early infection of some sort so she gave her some antibiotics and also gave her subcutaneous fluids.

 

Two days after the vet visit she started drinking less and peeing less, no accidents in the house now. We brought her back for a checkup today and they ran her bloodwork again, and her creatnine was up to 2.4. I believe all the other levels in her bloodwork were normal. The vet was concerned and sent me home with an IV bag and i'm supposed to give her fluids 2x a week for a month and bring her back to check her bloodwork again.

 

I've read through the greyhound health info about the creatnine levels being higher than normal in greyhounds and searched the forums here and saw that some people's grey's have really high levels but that's normal for them. The vet we go to is listed on my adoption group's website and they seem to know greyhounds pretty well (from what I can tell). My question is does it seem like overkill to be doing the fluids, should i seek out a second opinion, or does that sound pretty normal? It's my first dog in a long time so i'm new to the whole medical thing.

[CaliforniaGreys]

When you say that the vet checked her urine, do you know exactly what he did? Do you know if he cultured the urine? I don't have a lot of experience but have been through kidney and UTI issues more than I care to remember. I don't understand the fluids. As for the drinking a lot, she should be drinking 1oz per 1lb of body weight

Edited November 7, 2008 by cbudshome

[Guest Gingy]

I don't think they cultured the urine, they didn't check her urine at all today. Her drinking is back down to normal like she was when we got her, but it was so bad last week she was just peeing clear all the time.

[CaliforniaGreys]

I don't think they cultured the urine, they didn't check her urine at all today. Her drinking is back down to normal like she was when we got her, but it was so bad last week she was just peeing clear all the time.

You would know if they cultured because they send it out to the lab and it takes a couple of days to grow the culture. Sometimes, the UA comes back with no bacteria and then when they culture they find a UTI. Did they tell you what the goal was and why subq fluids? As for her Creat level, if the vets know Greys, they'll know where that should be and the reasons if it's elevated.

[Burpdog]

They need to culture the urine.

 

Did you change food or water or treats the week she was drinking so much?

 

What is her BUN? How are her teeth?

[greyhead]

We have a five year old grey with early kidney disease. I'll share what I can with you.

 

We took her to the vet, who checked her urine, that was fine, and did some blood work.

 

The most important urine check for kidney function is the USG, urine specific gravity? Was that included in this workup? This is a measure of how well the kidneys are concentrating waste into the urine. One wants the number higher rather than lower, and the range of normal is very tight, and it doesn't change with being a greyhound.

 

You also need to check BUN, the amount of urea nitrogen in the blood. It climbs along with creatinine if the kidneys are troubled. (Creatinine can also elevate from muscle loss if there has been any weight loss, which is the main reason greyhound values tend to be higher than other breeds.)

 

Her creatnine level was 2.3 as of last Friday.

 

This is high enough to be interesting -- higher than our dog's, actually. The problem with norms in general is that they address the values found across a group of individuals (dogs or greyhounds in this case), while you're dealing with a single individual. Any given value may not be normal for your dog even if it is considered to be "within greyhound norms." If your individual dog is not functioning well at a given value, it really doesn't matter that many or most other dogs might.

 

An example from a different realm to illustrate: Human norms say it's normal for a person to lose 25 to 100 hairs per day from his/her head. But if a given person usually loses 25 and then starts losing 50 or more per day, they may very well be hypothyroid. On the other hand, a person with a thick head of hair may routinely lose 100 hairs per day and be perfectly healthy.

 

Excessive drinking and peeing, such as you describe, was the first sign we had that our grey might have a problem. Also leakage, which the vet at first was thinking was old age. (Five is old?! I don't think so!) We retested in a month, after using Missing Link, and his BUN and creatinine were back to the high end of the normal range. As well, his thirst/peeing decreased and no accidents. Lately he had another accident and we retested, and his BUN is 34, his creatinine is 2.2, and his USG is 1.016 (low). We now have him on a relatively high-protein food at 32% (Wellness Core Low-Fat) and an herbal supplement from Chinese medicine called rehmannia. Our vets have seen very good results with that, and I'll be glad to tell you how to acquire it if you ask. In any case, behaviorally he is improved -- more energy, longer walks, less thirst.

 

It does sound kind of early to be starting sub-q fluids, but I'm not aware of everything your vet is thinking. On the other hand, twice a week isn't excessive. It is the case that fluids don't cure kidney problems. Rather they just keep the furkid properly hydrated so that they don't develop even more problems from being dehydrated. I would be concerned, though, that extra fluids may mask his true kidney values when you retest. In other words, a more dilute blood sample will show a lower percentage of BUN and creatinine than a less dilute one will. So when you retest, you might want to avoid injected fluids for at least two or three days. At least discuss it with your vet.

 

Food is important in this condition, and the new thinking for treating kidneys is not to switch to a low-protein food early in the disease, because that just causes other problems. Rather, it's important to have enough very high-quality protein.

 

I'd be really interested in knowing whether the USG was tested and, if so, what the value was. If it was tested, your vet probably is knowledgeable about kidney disease. If it wasn't tested, well, maybe s/he knows a bit less. But apart from blood work, how well the kidneys are concentrating the urine is the tell-tale sign.

 

Can't say if you need a second opinion. The way I have come to evaluate vets is how willing they are to research and learn about things they haven't had much experience with. I'd recommend that you get to know the issues in testing and treating for kidney function yourself, bounce your findings off your vet, and see how he or she responds. And ask questions until you yourself understand what things are important and why.

 

I'll be happy to share more, but I don't want to snow you with more than you need to know at this point. Just don't be afraid. You can handle this, and your Lucy can still have a good life.

 

Mary, and Shane the kidney kid

Edited November 7, 2008 by greyhead

[Guest Gingy]

I don't know the BUN, I also forgot to get copies of the test results while I was there so i'm going back monday to get them, i was so stressed out I forgot that and all the specific questions to be asking.

 

No food, water or treats changed when she started drinking a lot. The vet said every other level in her bloodwork was normal, the only thing she saw as abnormal was the creatnine level. Her teeth are in good shape, front ones are a little worn down but no other issues. The vet didn't explain things at all, she would talk fast and pretty much leave so I had to interrupt her to get a word in. She said that with a creatnine level so high she felt she needed to treat it and that's why she was giving the sub-q fluids, but she told me that was the only thing off.

 

Lucy is doing really well now, and started drinking/peeing normal after 3 days of antibiotics, which is why I got a little suspicious about why I need to be injecting her with fluids twice a week.

[Guest Greensleeves]

I just lost a dog to kidney failure. If I had a dog--ANY DOG--with a creatinine of 2.4, I would get an ultrasound of the kidneys ASAP, and speak to a specialist about dietary changes and supplements that may help support the kidneys. I know we say that greyhounds can have higher-than-average creatinine values, but to my mind (and to the specialist who treated Nelly), 2.4 is dangerously high. I wish more than anything that we'd known to worry when Nelly's creatine was "only" 2.3. We didn't start treating her until she was at 4.1, and by then it was pretty much too late.

 

Sub-cu fluids can't hurt, and are almost the only thing that can be done to support a dog with kidney problems (IV fluids at the hospital are another option, but you're probably not there yet). If you can start treatment now, you can help slow further damage to the kidneys, and prolong the time that the creatinine can stay at these lower levels.

 

It's important to know, *if* there's a kidney problem, whether it's acute (caused by toxins or an infection) or chronic. Acute kidney disease can be recovered from. Chronic kidney disease requires life-long treatment.

 

If your girl is fine, wonderful. But trust me: if there IS a problem, you want to catch it fast, when there's a chance to help her. You don't want to go through what we just did.

[Guest ss556]

Alan has glomerularnephritis or protein losing nephropathy, kidney disease. His creat. is 2.4 or more. He was diagnosed 2 yrs ago. You have to know the BUN (blood) and get a Urine Protein Creatinine Ratio (urine) to see if he has protein in his urine. He is on several medications daily, forever. He also had his blood pressure checked and it was very high. So maybe you can get that checked as well. Alan had two ultrasounds which showed about 30% of kidney function. So, some tests are required and should be done and possibly repeated. He is well managed with the above, and with diet. Good luck and update when you can.

[Guest Gingy]

Thanks for everyone's input and info!

 

The more information you guys gave the less it seems like the current vet knows what should be looked at. I made an appointment with another vet just to see what their view is after reading the responses for early next week , and i'll definitely mention ultrasounds, blood pressure, and the urine protein creatinine ratio, since we didn't have those done yet. If she has kidney disease i want to find out now rather than the "wait and see for a month" approach the current vet is on since it sounds like time is of the essence with treating it.

 

 

[Guest Greensleeves]

The way the vets explained the sub-c/IV fluids for us was not just to help avoid dehydration, but also to help support the kidneys by flushing the toxins through the system, since compromised kidneys don't function well on their own. "We're replacing quality with quantity," as my vet kept telling us.

[greyhead]

The way the vets explained the sub-c/IV fluids for us was not just to help avoid dehydration, but also to help support the kidneys by flushing the toxins through the system, since compromised kidneys don't function well on their own. "We're replacing quality with quantity," as my vet kept telling us.

 

Looks like we're both right, Stephanie! The following is a great web page from WA State U. on sub-q's for canine kidneys. It has lots of pictures of how to administer them, which should really help if Lucy is going to need them.

 

http://www.vetmed.wsu.edu/ClientED/dog_fluids.aspx

 

Fluid given under the skin, subcutaneously (SQ), is absorbed into the blood stream and can be used to correct or prevent dehydration. The most frequent disease for which fluids are given is chronic kidney failure. Dogs with chronic kidney failure pass large amounts of urine and may not feel well enough to drink enough to prevent dehydration. The dog owner may give subcutaneous fluids a few times a week to supplement the water the dog is drinking in order to prevent dehydration and help flush waste products through the kidneys.

 

Sounds like Gingy has a good plan. A second opinion could be a good thing.

 

Mary