Bloodwork And Urine Show Kidney Problems

[Guest greykat]

Well, here an x-ray starts at @ $35, so your ultrasound will probably be more, but hopefully not much more if it is needed.

 

Hmm... sounds like we should move to Illinois!

[MaryJane]

An ultrasound for a heart murmur in one of my greys cost about $500 in Boston at Angel Memorial. They did quite a few captures of data. No anesthesia was used.

[Guest greykat]

An ultrasound for a heart murmur in one of my greys cost about $500 in Boston at Angel Memorial. They did quite a few captures of data. No anesthesia was used.

 

Okay. While painful, that is still 1/4 of the cost of the MRI. I'll hope ours is a little less than that (I know Boston can be more expensive then DC for certain types of things), but I won't keel over if I hear $500. I paid way too much for his emergency surgery when he fractured his foot (it was actually a laceration, and they discovered the fracture as they went to do the surgery), so I'm unfortunately used to being price gouged. The emergency clinics around here are just ridiculously expensive.

 

I'll cross my fingers for a decent place/price for the ultrasound.

[greyhndz]

... Not good. The latest sample is as bad and probably a bit worse, from what I can make of it.

I didn't ask for all the numbers, just what I knew was of concern. And she pointed out a new one I hadn't seen as a red flag before...

 

The problem with getting lab results from a non-clinician is that they're not being interpreted for you, and the tendency is for you to look at numbers and think the worst. I do not see anything of grave concern here.

PH 6 (up 5.5 from last time) Not significant. Still within normal range.

Specific Gravity 1.05 (up from 1.041 last time) Means the urine is slightly more concentrated - likely reflects his hydration status -- that is, whether he's taking in adequate fluids

Protein 3+ again This needs to be evaluated with a urine protein creatinine ratio; a dipstick by itself cannot confirm proteinuria or kidney disease. A UPC is the test of choice for this purpose.

Bilirubin 1+ again Likely insignificant. A very common finding in male greyhounds, and with normal liver function tests and serum bilirubin, I would disregard this.

RBC 4-10 again (see below)

And she pointed out that calcium oxalate crystals were listed as "many" (this is probably the cause for the small number of RBC. Does brings up the question of bladder stones. But again, given the high SG, that means the urine is very concentrated, so these results are relative; the microscopic urinalysis (not dipstick) might look very different if he were a bit more hydrated.)

The only other thing was that "budding yeast" went down to none again (said "rare" last time), but I have no idea what that even means or if it matters at all. Really not of significance. Rules out a fungal infection in the bladder. Rare yeast buds could just be contamination.

 

What now? I hate waiting until tomorrow to talk about the results, although I have a feeling he's just going to say it's time for an ultrasound (which is essentially what he told me when I dropped off the sample yesterday- if the results stay the same, ultrasound).

 

It's reasonable to discuss getting an U/S - I just don't think the vet has enough information to say that Max has "kidney disease". The essentials (which should be part of the basic workup that the vet should have done by this point) would be the urine culture, urine protein creatinine ratio, repeat chem profile to recheck BUN/creatinine, serum albumin, phosphorous, etc., and if these remain abnormal, an ultrasound. If the vet is questioning bladder stones, again, an ultrasound would be the next step.

 

I did more reading yesterday, and I have to admit everything seemed rather bleak and scary. Do I have something irreversible on my hands? Is Max actually feeling pain or anything from this? What should I be prepared to hear?

 

I honestly have not seen anything in these labs that sounds bleak, or seems to point to a bad prognosis. Again, your vet (and you) does not have enough information at this point to make a diagnosis. I hope he does talk with Dr. Couto to get some guidance.

 

But I think the healthiest thing for *you* at this point is to "put down the laptop"! You're scaring the heck out of yourself by looking at numbers, reading about kidney disease, and in the process, assuming the worst. The BUN/creatinine values you've posted recently really don't seem to be high enough to either assume kidney disease, or even affect his appetite. However, infection, pain, etc. can certainly make him not want to eat. Again - more info needed!

 

If you're not feeling secure in your vet's knowledge base, or feel as if he isn't accessible, see if you can have Max evaluated by an internal medicine vet, who does have the knowledge to give you a diagnosis and a plan. Let a savvy vet explain to you what's going on, and don't try to figure this out by yourself.

 

When all else fails: chocolate!

Edited June 25, 2009 by houndznigz

[Guest greykat]

... Not good. The latest sample is as bad and probably a bit worse, from what I can make of it.

I didn't ask for all the numbers, just what I knew was of concern. And she pointed out a new one I hadn't seen as a red flag before...

 

The problem with getting lab results from a non-clinician is that they're not being interpreted for you, and the tendency is for you to look at numbers and think the worst. I do not see anything of grave concern here.

PH 6 (up 5.5 from last time) Not significant. Still within normal range.

Specific Gravity 1.05 (up from 1.041 last time) Means the urine is slightly more concentrated - likely reflects his hydration status -- that is, whether he's taking in adequate fluids

Protein 3+ again This needs to be evaluated with a urine protein creatinine ratio; a dipstick by itself cannot confirm proteinuria or kidney disease. A UPC is the test of choice for this purpose.

Bilirubin 1+ again Likely insignificant. A very common finding in male greyhounds, and with normal liver function tests and serum bilirubin, I would disregard this.

RBC 4-10 again (see below)

And she pointed out that calcium oxalate crystals were listed as "many" (this is probably the cause for the small number of RBC. Does brings up the question of bladder stones. But again, given the high SG, that means the urine is very concentrated, so these results are relative; the microscopic urinalysis (not dipstick) might look very different if he were a bit more hydrated.)

The only other thing was that "budding yeast" went down to none again (said "rare" last time), but I have no idea what that even means or if it matters at all. Really not of significance. Rules out a fungal infection in the bladder. Rare yeast buds could just be contamination.

 

What now? I hate waiting until tomorrow to talk about the results, although I have a feeling he's just going to say it's time for an ultrasound (which is essentially what he told me when I dropped off the sample yesterday- if the results stay the same, ultrasound).

 

It's reasonable to discuss getting an U/S - I just don't think the vet has enough information to say that Max has "kidney disease". The essentials (which should be part of the basic workup that the vet should have done by this point) would be the urine culture, urine protein creatinine ratio, repeat chem profile to recheck BUN/creatinine, serum albumin, phosphorous, etc., and if these remain abnormal, an ultrasound. If the vet is questioning bladder stones, again, an ultrasound would be the next step.

 

I did more reading yesterday, and I have to admit everything seemed rather bleak and scary. Do I have something irreversible on my hands? Is Max actually feeling pain or anything from this? What should I be prepared to hear?

 

I honestly have not seen anything in these labs that sounds bleak, or seems to point to a bad prognosis. Again, your vet (and you) does not have enough information at this point to make a diagnosis. I hope he does talk with Dr. Couto to get some guidance.

 

But I think the healthiest thing for *you* at this point is to "put down the laptop"! You're scaring the heck out of yourself by looking at numbers, reading about kidney disease, and in the process, assuming the worst. The BUN/creatinine values you've posted recently really don't seem to be high enough to either assume kidney disease, or even affect his appetite. However, infection, pain, etc. can certainly make him not want to eat. Again - more info needed!

 

If you're not feeling secure in your vet's knowledge base, or feel as if he isn't accessible, see if you can have Max evaluated by an internal medicine vet, who does have the knowledge to give you a diagnosis and a plan. Let a savvy vet explain to you what's going on, and don't try to figure this out by yourself.

 

When all else fails: chocolate!

Thank you SO much for your thoughtful reply. I promise to put down the laptop and snuggle with my buddy (who finally stopped crying after he ate his dinner).

 

I'll be sure to get the vet to talk with me tomorrow. He said he called Dr. Couto before, but that he was out of town or something. I'll be sure to push for that, too, since Dr. Couto knows his greys.

 

We do have a vet we've turned to w/ "grey" issues. They are over an hour from here, but they are highly respected and see tons of greys (our local adoption group promoted them from day 1). We took our Reiger there, and they were the ones who found the "snowstorm" in his lungs. We went back to them to have him euthanized. They are knowledgable and kind and compassionate. I really do like our local vet for a lot of reasons, but in the end, I know he isn't really grey savvy. I feel fine going there for routine exams and shots and tests, and even bandage changes and broken toes, but grey-specific issues make me always want an expert opinion. For that, I'll gladly drive 1 1/2 hours to see the best.

 

I'm thinking of giving Max some Metacam again when he seems to be in discomfort. Since stopping it didn't change his urinalysis results, and since other posts have made me think Metacam isn't harmful for kidneys unless given for a truly prolonged period of time (treating chronic arthritis on a daily basis for many months, etc.), I don't think it should hurt him while we're waiting for this leg to heal.

 

Since so many kind folks are sending best thoughts and prayers, can you include wishing that his splint can come off in a couple weeks? It's been WAY too long, and this poor guy deserve to run again and go up to our bedroom. I can use all the help I can get. It's been SUCH a long journey.

 

Off to snuggle with my sweetie... Right now he's on his favorite spot on the couch, looking as normal as can be. Just the way I like him.

 

THANK YOU again!!! "See you" folks tomorrow after I've talked w/ the vet. I'll think good thoughts in the meantime...

[Guest LindsaySF]

I agree with Jordan.

 

If he really is in pain I would give him the Metacam. It should be fine (for the reasons you listed).

 

Best of luck with Max!

 

[greyhndz]

I agree with Lindsay's agreement. A dose or two of metacam will likely not make a difference, and when you weigh the small risk with the importance of keeping Max out of pain, I, too, would give it to him. Have you tried tramadol for his pain? Maybe the vet needs to reassess his pain management plan and find something that will work a bit better for Max.

 

I hope tomorrow brings you the answers you need, and a plan!

[Guest greykat]

Thanks, ladies!

 

Max ate most of his food this morning (I need to pick up other exciting canned food today, so I used just dry food and milk...he's such a milk-lover)! I was so happy to see him eating first try!

 

I am going to give him Metacam this morning since he is still favoring his leg (not blatant limping, but still). Hopefully that will make him feel all fuzzy and comfy while I'm away at work.

 

I'll write again after I talk with the vet...

[Guest greykat]

Okay, I talked to the vet this evening. He said the tests did not include UPC or urine culture. He said he wouldn't recommend doing a UPC unless some of the values normalize (I think he was mentioning the crystals and was saying the results wouldn't be helpful or meaningful or something). He said he wants to reduce the crystals via change in diet, then we can see if a UPC or urine culture is in order. At least, I think this is what he meant. Really, I'm the worst with this stuff. I get confused with all the terminology and am not 100% sure if I understood his reasoning.

 

Here's what he did say. He doesn't really think it's kidney disease (at least not yet until he gets more info). He is wondering if there are stones in the bladder causing the bleeding. He also mentioned proteinuria and crystaluria (??). I don't know- I'm reading my scribbles. He said he wants to eliminate the calcium oxolate crystals and see if that stops the bleeding. He wants to figure out the best diet, and he said he's waiting to hear back on that (and I guess on their take on the results in general), from OSU. Dr. Couto is gone until the 29th, so he emailed the greyhound center at OSU to get their feedback. Hopefully if he hears from them tomorrow, he and I will talk diet.

 

He also said we could move up the x-ray of the foot (due at 4 weeks on July 7, but he says we can do it this Tuesday instead at 3 weeks) so we can do an abdominal x-ray at the same time. I think he wants to see if there is anything evident in that (maybe a stone?). He said we could then look at an ultrasound if it seems like it would be more helpful. And he was saying if it is a stone, that this type of stone (calcium oxolate?) would need to be surgically removed.

 

Anyway, he was also clear in saying that he doesn't know right now and that more tests are certainly in order. Oh, and I asked about UTI. He doesn't think that because he said the urine would have a strong smell and Max would be peeing everywhere (Max hasn't had accidents in this house...possibly ever) and I think he said WBC would be high, too.

 

I talked it over with my husband, and we feel comfortable with the vet's approach. Especially since he's trying to get a second opinion and advice from OSU. I appreciate his humbleness and willingness to learn.

 

I also asked about the fact that last year's results were very similar, and what does that mean. He looked at those to compare, and he sounded surprised that this wasn't investigated further last year (remember, the other vet got and told me the results). Apparently, the notes in the file even said the other vet was going to consult w/ the one I see, but then the notes stopped and my vet says he doesn't recall ever being asked about this). I liked that he admitted that was a problem (since I certainly think it is), and I'm glad I'm dealing exclusively with this vet now.

 

I get a good feeling from him. He is doing research, he wants to find out what's causing these abnormal results, but he also doesn't feel there is reason to panic or rush on a number of tests at once. He said he feels that if Max were in a bad situation and had kidney disease (or advanced KD) that he would be really anemic, and his iron levels are fine.

 

So, diet change (possibly starting tomorrow if he hears from OSU on a recommendation), x-ray next week, and then retesting and possibly an ultrasound, depending on what we find with the x-ray.

 

Hope this sounds okay to you experts. If he weren't talking to OSU, I would worry that I need to be seeing a grey expert, but I feel like the best advice will probably come from them, and he really seems to be open to learning.

 

He ended our conversation by saying that I should feel free to ask any questions (since I was already keeping him on the phone to ask all of my questions) and if he doesn't know the answer, he said "we'll find it."

 

And how's Max today? He's great. Ate right away for both meals, and he was chipper and wagging his tail and trotting in the yard. My husband actually thinks all my worrying may have been affecting him and maybe that was why he was so weird the past couple of days w/ food and mood. In a way it makes sense- he was fine until I got the test results, and then my worry went into high gear (lots of mood swings and crying lately), and that's when Max started crying more and ignoring his food. Today I felt better, and so does he. Hmm... maybe we're just super connected.

 

Okay, going to put down my laptop again so I can stay positive and focus on my sweetie!

 

Thanks to all of you, and especially to Jordan for bringing me back to normalcy. *hugs*

Edited June 26, 2009 by greykat

[greyhndz]

Normalcy? What's that?

 

I'm going to respectfully disagree with your vet on several points. (BTW, if you can PM me your e-mail addy, I can send you articles that are too long to post on the forum) After reviewing the veterinary literature, here's the general consensus (this is mostly applicable to human medicine as well):

 

Any proteinuria requires some type of follow-up, at the least a urine recheck in about 2 weeks. If 2-3 samples continue to show proteinuria, further evaluation is warranted. (Or, if the protein on dipstick is high -- such as Max's 3+, the vet should consider testing after just one repeat U/A.)

 

Complete urinalysis (including microscopic) is essential, and your vet did that. But urine culture is also indicated. There are two tests to confirm presence of protein: SSA, which is a special urine test that a vet can either run in their own lab or sent to an outside lab, depending upon how their in-house lab is set up. And UPC. Crystals in the urine wound not affect the presence or quantitation of protein; however, RBC or leukocytes (white blood cells, indicative of inflammation or infection) may indeed skew the results. I don't know that 6-10 RBC would make a significant difference because that is a small amt - the lab could probably answer that question. But would those few RBC cause 3+ protein? I can see 1+ but the literature suggests that 3+ protein mandates investigation (SSA or UPC, the latter being an accurate quantitation). The veterinary literature also recommends a sterile bladder tap (cystocentesis) for a reliable, uncontaminated specimen.

 

Lower urinary tract diseases, such as UTI, stones, crystals, can result in proteinuria, but I would have expected the micro to have shown leukocytes (inflammation or infection) or bacteria (infection) were that the case. Also, remember that the SG of 1.050 is very high. The urinalysis might look quite different were it less concentrated. Also, concentrated urine and/or inadequate fluid intake contributes to crystal or stone formation. It would be helpful to aggressively hydrate Max (perhaps by subQ fluids) and repeat the U/A and micro exam to see how it changes.

 

Definitions: proteinuria - presence of protein in the urine. Crytalluria - presence of various types of crystals in the urine. Hematuria/blood; pyuria/leukocytes; bacteriuria/bacteria. As far as UTI not being present if no odor is detected, I can't find any literature to support that -- certainly not in human literature. It's one of those things where, if there's unusual odor, great - that's a sign to make note of. But lack of odor does not at all rule out infection. A good, properly-obtained urine specimen for culture does. And not every dog becomes incontinent, especially if their fluid intake isn't adequate. And not every dog with UTI will have either fever or elevated WBC.

 

Calcium stones may well show up on a plan abdominal film, and it doesn't hurt to take a look. Depending on the UPC, you may still be looking at an U/S.

 

As far as whether stones in the bladder need to be removed, I still have study that part of the literature. I'd like to see Max aggressively hydrated to see if the stones or crystals pass spontaneously.

 

Here's a snip from a study on managing crystals/stones:

Previous research by Stevenson et al⁴⁹ has shown that, at least in healthy dogs, a reduction in both dietary calcium and oxalate will give the lowest risk for CaOx formation as assessed by RSS. Thus, the treatment diet was formulated to provide controlled levels of both calcium and oxalate. It was also designed to contain a relatively low level of protein and moderate levels of fat and sodium, with the purpose of reducing urinary calcium excretion. It was produced in a canned format that delivers a high level of dietary moisture, with the objective of increasing urine volume as demonstrated in a previous study by Stevenson and associates.⁵⁰ Feeding this diet to the stone-forming dogs resulted in significant increases in moisture intake and the production of more dilute urine with a lower calcium concentration. Thus, the diet appeared to meet the aim of reducing urinary calcium concentrations, which could be attributed to decreased calcium excretion, increased urinary dilution, and reduced dietary calcium intake. Urinary oxalate concentrations were also lower in both groups when fed the treatment diet. Since dietary intake and urinary excretion of oxalate were similar to baseline, it is likely that the reduction in urinary oxalate concentrations was the result of urinary dilution....

 

 

Conclusion

 

The results of this study indicate that hypercalciuria and hyperoxaluria are important factors in the formation of CaOx uroliths. Since the stone-forming dogs excreted more calcium despite a lower dietary intake, it is suggested that they might hyperabsorb calcium from the intestinal tract. This study has highlighted the importance of urinary calcium and oxalate in CaOx formation and has identified several dietary components (sodium, potassium, calcium, and phosphorus) that may influence disease risk. It has also demonstrated the ef�fectiveness of dietary intervention and showed that a diet that increased moisture and sodium intake and reduced calcium and potassium intake reduced the risk for CaOx formation in the majority of affected dogs.

You know, the adage in medicine is that you don't look at the labs, you look at the patient. And you treat the patient, not the labs alone. If there's a significant abnormality, repeat it. If it stays abnormal, you investigate it but don't assume the worst. Keep the lines of communication open. Write down your questions. Write down what you've researched. I have a feeling you're bringing more data to the table that your vet is! Don't hesitate to disagree with his plan in a respectful manner. And remember that you, too, can contact the other Greyhound Clinic vets as OSU for guidance.

 

I'm delighted to hear that he snorkled down food tonight. I hope mom did the same, and also sampled a little "adult beverage".

 

Jordan

 

 

 

 

 

 

[Guest LindsaySF]

I agree with Jordan (again ). Especially these points:

 

The urinalysis might look quite different were it less concentrated. Also, concentrated urine and/or inadequate fluid intake contributes to crystal or stone formation. It would be helpful to aggressively hydrate Max (perhaps by subQ fluids) and repeat the U/A and micro exam to see how it changes.

 

As far as UTI not being present if no odor is detected, I can't find any literature to support that -- certainly not in human literature. It's one of those things where, if there's unusual odor, great - that's a sign to make note of. But lack of odor does not at all rule out infection. A good, properly-obtained urine specimen for culture does. And not every dog becomes incontinent, especially if their fluid intake isn't adequate. And not every dog with UTI will have either fever or elevated WBC.

I had a cat with urinary crystals, he would get UTI's at the same time. His urine never had a strange smell and he was not incontinent. They found blood in the urine but no bacteria, they assumed a UTI anyway and gave him antibiotics. He did get better from the UTI.

 

Finny eventually needed surgery for the crystals. But before surgery we did a diet change and hydration first, only when that didn't work and he still kept getting blocked with crystals did we do surgery. Surgery should always be a last resort.

 

I would give Max antibiotics and try a diet and water change before any other invasive (or more expensive) procedures.

 

 

 

~Lindsay~

 

 

Oh, forgot to mention, I had a very hard time getting a urine sample from Finny (it's much harder with cats). They ended up doing several sterile bladder taps to get urine samples. It was quick and he didn't seem to be in pain at all. If you are at all worried about the accuracy of the urine sample I would go with a bladder tap.

[Batmom]

Well, everybody including the literature can go ahead and smack me, but unless the dog has other symptoms, I would still treat for a presumed UTI. Cheap, generally harmless, and based on my experience, often works.

 

Oh, and I asked about UTI. He doesn't think that because he said the urine would have a strong smell and Max would be peeing everywhere (Max hasn't had accidents in this house...possibly ever) and I think he said WBC would be high, too.

 

None of my UTI dogs have ever had smelly urine nor have they peed in the house. Sometimes not even excessive urinary frequency. Sometimes WBC, sometimes not.

 

You can get crystals due to UTI and in normal urine that isn't tested promptly.

[MaryJane]

It sounds like the vet has a reasonable plan of action and I would probably go along with what he says. I think others on the thread have good points but, I don't think that I would change what your vet plans to do. I would get a timeline from your vet so that you can get a idea of when he expects this to be resolved.

 

The protein in the urine is a concern but as he says it may not be indicative of a kidney problem (at least not yet). It doesn't appear that there are excessive "waste products" in the blood yet which would be highly indicative of more serous issues with the kidneys (although, the creat was a little high). There are quite a few reasons that the kidneys "spill protein" into the urine and he sounds familiar with these.

 

Crystals seem to be a likely suspect here with possible stones being the problem may fit the symptoms. This could cause blood in the urine from the irritation. There may or may not be bacteria in this type of condition, sometimes bacteria results from the irritation and sometimes bacteria is the cause of changing the environment and aiding the production of crystals.

 

I think his idea to change the diet is good - I assume that he will be changing the mineral composition of the diet and maybe adding things that might be able to dissolve existing stones although, this is not always successful and might need surgery to remove.

 

It sounds like your vet is "doing all the right things", he seems knowledgeable, he's researching the subject, and he's planning to talk to Dr Couto.

 

 

 

 

 

[Guest greykat]

Thanks, everyone! I didn't hear from the vet today, and I assume it may be that he didn't hear from OSU yet. They are closed by now, so I'll call in the morning.

 

I appreciate the continued feedback and details- I realize there is some debate on what might be best, and I respect everyone's opinions and expertise/experience. For now, I want to do what Mary Jane is suggesting by confirming a clear timeline with my vet. And he didn't rule out a culture or UPC. In fact, I'm sure if I said I want it anyway, he'd be okay w/ it. Possibly also w/ treating for UTI, although since Max is asymptomatic for the most part (he's been a finicky eater this week, but all else seems normal, including elimination of all types), I don't know that we need to try that just yet.

 

I am most curious about a diet change at this point. The more I'm reading what Jordan wrote and just the plain old word "calcium"...Max gets lots of calcium in his diet. We've often given him milk in with his dry food, and that was in part because we assumed that wasn't harmful (given how many greyhound people recommend cottage cheese and yogurt as good add-ins for digestive issues). One of our dogs once snuck a drink when we weren't looking, and we quickly realized how much they all love milk. So we would often add it when he would lose interest in his dry food.

 

How damaging could it be for us to have given him milk? I feel so bad. I will certainly hope that changing his diet dramatically will be helpful to him. I really just want to be sure he's comfortable (since greys are so stoic, it's hard to know when anything may be bothering them). He's seriously been so seemingly healthy in all normal ways (good appetite, good poop, peeing enough but not too often/too much, drinking, but not gallons or anything, sleeping well...) until just this past week, and that's only his on and off interest in his food. Before he hurt his toe, he was active and fun-loving and spunky. We call him our puppy because you'd think he's 3, not nearly 10.

 

Anyway, I didn't add milk tonight, although I still don't have canned food (and I am now stumped until I know what diet I'm supposed to start). The only excited dog-approved additive I could think of was a spoonful of peanut butter. Max was happy with my decision.

 

So I'll let you know as soon as I get to talk to the vet about the diet plan. Goodnight everyone, and thanks again!!

[Guest greykat]

Hey everyone!

 

Talked to the vet, and he said OSU folks said they don't have much experience w/ dogs w/ calcium oxalate crystals. He is going with the Royal Canin Urinary SO diet for 4 weeks, and then we'll re-test to see if the crystals are reduced or gone. We also have the x-ray scheduled for Thursday at 6pm, so hopefully we'll know something then (if there are stones). Apparently the folks at OSU said the x-ray seemed like a good idea.

 

I printed several of Dr. Stacks articles on diagnostics, blood tests, and hypothyroidism, the greyhound gang page on kidney disease, and I copied parts of what several of you wrote about experiences, suggestions, and reading (I edited nicely so it simply shows repeated recommendations and reasons for UPC, urine culture, treating for UTI, bladder taps, hydration, etc., so he can read the essentials instead of my trying to articulate it all), and I printed the review of my current dog food, and I listed the treats and additions we make to his food (in case the milk products have been contributing). I just wanted to give him as much info as possible. I went over there to pick up the new diet, and I chatted with him and dropped off the printouts. He was happy w/ it (especially the details on all the things Max eats), and laughed and said he has his homework for the weekend. I mentioned that I wasn't sure which info would be helpful, but since I've been reading and chatting and all I thought I'd share what I could with him. He said he prefers an educated owner who cares and wants to learn more, and he says this helps us keep an open dialogue so we can help Max. I was very happy talking with him and am excited to start this diet. Oh, and when I gave him the kidney papers and said "I don't know if it's a kidney issue or not, but..." he said he really doesn't think it's his kidneys. While I realize he and I both know we won't know until all tests are done, it was reassuring to hear him say that. I know crystals and stones aren't great, but they sound like they may be easier to deal with than kidney problems. Anyway, we shall see what the verdict is...

 

Max is in good spirits today. He ate a full meal this morning (added peanut butter again), and when we got home from our outing, he was wagging and practically skipping outside. Now he's passed out by my side. SOOO CUTE!

 

I'm so happy, and I'll keep you all posted as we begin the diet transition and get the x-ray results.

[Batmom]

Doubt if the milk would cause a problem like this, unless he has an oddity in terms of calcium metabolism. Glad to hear your pupper is feeling well!

[Guest greykat]

Doubt if the milk would cause a problem like this, unless he has an oddity in terms of calcium metabolism. Glad to hear your pupper is feeling well!

That's what the vet said, too, when I mentioned it today. Which is a relief for me, obviously- never want to think you've been hurting your dog! Probably a relief for Max, too, since he does LOVE him some milk. ;P

[Guest greykat]

Woohoo!!! Just fed Max- 2 cups old food, 1/2 cup Royal Canin Urinary SO, and a spoonful of the wet Royal Canin Urinary SO w/ some water. He danced as I brought it to him (haven't seen him that psyched in awhile), and he SCARFED it!!! Hooray!!!! Hope he continues to love it. We'll be transitioning over for the next week and a half or so. Maybe he somehow knew it would help him?!

 

Very happy tonight! All seems quite normal in our happy little home.

[Guest greykat]

No major update- just wanted you to know that Max continues to gobble his new diet (3 meals in a row now). He's been acting like himself, he let me work on his nails w/out a fuss, and he did a bit of training, too (he's getting really good at "leave it"). I still have fingers and toes crossed that he can get his splint off this week. Then he'll REALLY be able to get back to normal. And come upstairs...which means I get to go back upstairs, too!!!

 

Hope everyone had a great weekend!

Kat

[Guest Energy11]

Greyt news! I like the Royal Canin prescription diets! ... A lot better than the Science Diet. Goldie is on Royal Canin Renal MP. Have a GREYT week! D

[Guest greykat]

Greyt news! I like the Royal Canin prescription diets! ... A lot better than the Science Diet. Goldie is on Royal Canin Renal MP. Have a GREYT week! D

Yes! I can't believe how excited he's been to eat. He continues to do little dances of excitement as soon as he hears the spoon hit the sink and he knows I'm about to walk the food down to him. He even walks over to the dish later and licks it- even though it's beyond empty.

 

Yes, things are going well. Countdown to Thursday...can't wait for the x-rays. Hope both give us good news!

 

[Guest greykat]

Good news: Max had an abdominal x-ray, and there was no evidence of bladder stones. He also looked clean everywhere else (for whatever you can make from an x-ray, anyway). We will keep on with the diet and retest after 4 weeks.

 

Bad news: Max's foot x-ray shows healing, but SLOW healing. 4 more weeks w/ the splint. But the vet really does think that will be it (the healing is considerable, which is great! his little body is trying really hard).

 

One thing I started noticing today (first day Max is 50/50 on the new diet)- this new food is supposed to increase water intake and urination. Which is fine, except... Max normally goes 8-9 hours w/out going out while we're at work. He had to go pretty badly when I got home today, and each time we go out, he pees A LOT. I'm going to try to start coming home at lunch each day so he only has to go 4 hours at a time. I really hope the diet is temporary...

 

Luckily, he always has access to tons of water. We use the Drinkwell fountain, which holds about 2 gallons of water. Just so long as he doesn't drink it all in one day...

[MaryJane]

Glad to hear the x-rays look good!

 

Sorry to hear about the peeing ... can you get some of those "pee pads" and leave them on the kitchen floor - would he use them?

[Guest greykat]

He doesn't have access to the kitchen- actually, he has been restricted to the family room and hallway (where the water is) the entire time he's been in the splint. I could buy some pee pads and put them in the family room (accessible but not in any path he normally walks). I don't know if he'd use them- he's never in the past. Good idea, though! Certainly worth a try.

 

Actually, this is really bothering me now. We got back from the vet a little after 7. We waited for him to calm down, then we fed him, and I took him out after 8. He peed a lot again. And he's been panting a lot in the past couple hours (on and off) and keeps drinking. I just took him out about 20 mins ago, and he peed a river (must have been a whole minute or so), then we walked a bit (hoping he'd poop), and then he stopped and peed again. As soon as he came back in, he drank a bunch more. If this is what kidney problems do, WOW! That's awful. But I could say w/ certainty that he was NOT doing this before the diet change. I literally think he drank about 3/4 or more of a gallon of water so far today. Poor guy. I'm nervous to go to the full diet later next week. Yikes!

 

Any advice from anyone who's done this type of diet before? I don't want to limit his access to water at all because he clearly wants/needs it.

 

Hmm... tonight will be interesting. I'm envisioning needing to get up at least once during the night to help him outside.

 

Well, wish me luck! Buy hey, I should be happy about the clear x-ray, right?! No evident bladder stones and no other abnormalities. Abdominal x-rays do make me nervous- last year, Reiger went for hing leg x-rays, and one of them caught part of the chest. That's when they found the "snowstorm" in his lungs and we had to put him to sleep w/in a week. So, they definitely make me nervous. It was nice not to get any surprises today.

[MaryJane]

It didn't sound like you had this problem when you were adding in 1/2 cup ......

 

It sounds like the urination became an issue when you went to 1 cup of the royal canin -- can you check with the vet to see if you can do 3/4 cups and see if it helps to make it more manageable.