Renal Failure And Congestive Heart Failure

[kudzu]

My dog coughs/hacks like your's does which makes me think it is related to the kidney problem. Kidneys control the moisture in the body, which includes the lungs. The dryness in the lungs creates this cough. (I think)

This discussion has come up on the K9Kidney list in the past. This cough is not unusual in dogs with CRF. I don't know what the reason for it is. Keep in mind that renal failure usually causes neurological damage. Neuropathy is common. It could mild enough to not be noticeable or the effects so mild it is not thought to be related to CRF. Wish I could find the study again but they did EMG/NCV on dogs with CRF. (I think it was induced not naturally occurring.) Most of the dogs that appeared asymptomatic but the nerve studies showed signs of neuropathy. Many CRF dogs develop hind end weakness. Neurological damage related to renal disease does cause or exacerbate this. So my thought is that it is possible this could cause mild laryngeal, pharyngeal or esophageal problem that contributes to coughing in some dogs.

 

My dog's case was different. He had a polyneuropathy for many years. It effected his entire lower motor neuron system including his urinary tract leading to much urinary woes. He also had just one kidney, apparently born that way. Neurologist considered these two things unrelated. IM specialist speculated that the polyneuropathy & related urinary problems suspected of causing pyelonephritis at least once were the cause of his CRF. Two other vets actually felt it more likely the opposite. With evidence of urinary problems, low USG & proteinuria evident soon after adoption at 3 yo, they felt he had early decline in kidney function which caused the polyneuropathy.

 

The renal & neurological system are all so intertwined that it becomes almost impossible sometimes to know what is & is not causing what.

[kudzu]

IIRC, I read/heard some time ago that dogs don't absorb sub-q fluids as well as cats do, not that they resist it behaviorally. I don't know what that means, unless it just takes a longer time for absorption to occur. But at this stage I wonder if getting some IV fluids at the vet's would be a better idea.

I would be interested to know more about that. Have heard of vets saying sub-q's do not benefit dogs the way it does cats but there are so many of us with dogs that did benefit that this argument, whether true or not, does not seem reason enough not to try sub-q's. Certainly though you are right that IV fluids are necessary at times.

 

Holding good thoughts for Koda.

[Guest MorganKonaAlex]

The kidney specialist we saw at Angell Memorial said with a large dog it's hard to get enough SubQT fluids in a dog to make much difference. However, it made a huge difference for my Kona. We were doing SubQT 3 times a week at home. She started eating again and even went back on kibble after a while. She started playing again and acting much younger. After the first few weeks, we switched to doing subQT to twice a week. We got several months of quality time before she had some mystery problem that caused vasculitis and we had to let her go.

 

IIRC, I read/heard some time ago that dogs don't absorb sub-q fluids as well as cats do, not that they resist it behaviorally. I don't know what that means, unless it just takes a longer time for absorption to occur. But at this stage I wonder if getting some IV fluids at the vet's would be a better idea.

I would be interested to know more about that. Have heard of vets saying sub-q's do not benefit dogs the way it does cats but there are so many of us with dogs that did benefit that this argument, whether true or not, does not seem reason enough not to try sub-q's. Certainly though you are right that IV fluids are necessary at times.

 

Holding good thoughts for Koda.

[Guest meakah]

***UPDATE***

 

Well, I am back from the clinic...Koda is still there. We got a concrete answer immediately after taking x-rays of her chest. Her heart is ENORMOUS. Her trachea is being pushed into her ribs. She is in congestive heart failure. And this is likely what has caused her kidneys to start failing. The vet I saw today is the owner of the clinic and one I have known for over 20 years and so I feel relieved he is dealing with her right now. He is keeping her overnight to try and figure out her meds and I will pick her up tomorrow. So heart wrenching leaving her there. But the nice thing is that he just left her loose walking around the clinic so that will make her more comfortable and she has her bed to lay on when she wants to. I am hoping he will bring her into his house tonight too so that she is more comfortable through the night. My great dane is probably ripping my house apart right now because she gets quite anxious when Koda is not around...poor Tyah. I will post another update once I have picked her up tomorrow and have some more answers. We are obviously now dealing with more than CRF therefore this is going to be a tough battle between her kidneys and heart. Again, this is new territory for me so I would love to hear any words of advice/experience.... Thank you everyone for your kind words, they help a lot...

Edited January 10, 2011 by meakah

[KF_in_Georgia]

My first grey was miserable when she once was given sub-q fluids for dehydration (she'd been vomiting up food and water during the day). The fluids pooled below the skin in her chest and she couldn't lie down--couldn't figure out how to get her body down on the bed without hitting the sloshy part of her chest. She just stood on her feet for hours and whined miserably. She wanted to sleep, but was so uncomfortable when lying down. When she started swaying in exhaustion, I picked her up and tipped her over onto her side on a pile of pillows. She sighed with relief, but even then managed only a few minutes of sleep before she woke and got up again.

 

Her behavior scared me. I hadn't had a dog given sub-q fluids before, and I didn't know what to expect. Her behavior (and misery) scared me into worrying about bloat (esp. with the vomiting earlier in the day). I took her to the e-vet (not her favorite place--esp. at 3am). They diagnosed the sloshy problem correctly, but even they did x-rays to make sure she wasn't bloating too. It was more than 14 hours after the fluids were administered before she was comfortable enough to lie down and really sleep.

 

I know your girl needs fluids, but your vet might be aiming for a method of administering them that won't leave your girl as miserable as my girl was--especially if your girl needs a lot of fluids.

Edited January 10, 2011 by KF_in_Georgia

[Guest meakah]

That is awful to hear how hard the subq fluids were for your girl.

Unfortunately, now that we know we are dealing with congenital heart failure....too many fluids are a concern. And breathing is more important than her kidneys drying up. So it is going to be a battle trying to find that happy medium....hopefully one can be found so that she is happier and more comfortable.

[Remolacha]

When my Sugar's kidneys were failing and she needed fluids, the vet kept her all day one day and gave her IV fluids. No sloshing as the fluids went in slowly over several hours (she also had multiple heart problems). Unfortunately, it meant leaving here there all day, and mostly confined to her bed because of the IV. It's a tricky balance.

 

[NeylasMom]

I'm sorry you didn't get better news. I hope you're able to find a happy medium so her issues can be managed and she can return to her happy self.

Edited January 10, 2011 by NeylasMom

[AEB]

I'm so sorry. But I am glad they got you in today and you got an answer and that they are allowing her to be loose. I will keep you both in my thoughts.

[Batmom]

That is a low blow indeed, but I guess better than not knowing. Keeping up the prayers for your pupper, and sending a big bunch of hugs across the airwaves.

[Guest mcsheltie]

I am going to hope that this is actually good news. Now that they know the underlying condition they can get her system regulated.

[Guest Swifthounds]

[Guest meakah]

***UPDATE***

 

Well, I have Miss Koda back home. I picked her up after work yesterday and she was soooo excited to see me. The vet said she hadn't done her coughing/gagging the entire time she was there (besides her fit when we were taking chest x-rays) and so she figured all was good. But then Koda got super excited that I was there and totally went into her coughing/gagging fit. Sigh. So the vet sent me home with some codeine to administer as needed. And Koda is now on Benazepril and Lasix. The vet also recommended I consider Co-Enzyme Q10...anyone have experience with that? They gave her IV fluids Day 1 of her 2 day visit at the clinic and her appetite was good while there. I was told no big runs for a week (no dog park... ) and to just keep her quiet and keep a close eye on her. These next 2-3 weeks will be the test to see how she responds to the meds. Fingers crossed she responds well, otherwise....there is not much I can do for her. Also, she seems quite drowsy from the meds....is this normal? Will it wear off? Or is this going to be her from now on?

 

We also had an unfortunate accident on the way home from the clinic. I stopped at the drug store to pick up her Benazepril and when I came back out....I guess she had to go really bad and couldn't hold it....# 2..... Fun times. First time she has ever done that in my car. Poor girl. So I spent the next hour cleaning her up at home and then another hour at the car wash cleaning my car out in -30C....and then mega laundry from the bedding in the back. Ick.

 

I will update again if anything changes...

 

Thanks again for everyone's kind words. We truly appreciate it! I will be getting a diet for her asap so that I can start cooking because this canned prescription food is RIDICULOUSLY expensive and I cannot afford it. I started to add rice to it and Flax Oil along with her Salmon Oil. Hoping to get her to gain some weight....

Edited January 12, 2011 by meakah

[Batmom]

Glad she is home and will be keeping fingers crossed that she does well.

[MaryJane]

Hopefully she'll do well over the next few weeks.

 

As a note, you may need to be careful adding both salmon oil and flaxseed oil because they have "aspirin-type" effects in that they increase bleeding time. You might want to check with the vet to find proper dosages (or maybe someone on the forum knows).

[Guest Energy11]

Sounds like everything is on the right track! Good luck and lots of hugs and prayers coming your way! ;-)

[DesiRayMom]

Prayers for Koda......strength for you.

[robinw]

You've got a plan, and that's good

[Guest meakah]

Thanks everyone, I have a plan which is indeed a bit of a sense of relief.

Koda has been doing ok. But she definitely has diarrhea now. She has been sleeping very comfortably and I only had to give her codeine for her cough for the first time this morning. She ended up having the runs all over my house last night and peed. This is from a dog that has only had ONE accident in my house in the 7 years I have had her so she must be feeling off. The codeine seems to have nipped the cough so that is good. And she did a little happy dance outside this morning which is great...even though it is -30c. But the meds are definitely making her quite drowsy. But if that is the downfall to have a body that is more regulated...then it is probably a pretty acceptable one. Hopefully it is something where it is just her adjusting to the meds. Other than all of that, she is doing well and her appetite is really good. I have been adding the oil and rice to every meal and she is cleaning her bowl out each time. I am dropping her off at a friend's this evening for 4 days while I am at a conference and so I hope she does ok. They are her surrogate parents and love her very much and I sometimes think Koda loves them more than me... So I am sure she will be fine... I just spoke to the vet and she is prescribing some meds for her diarrhea as we speak so that should help too. She thinks it may be some stress colitis.

 

Thanks again for all the kind words and advice...I will update again if there are any changes....

Edited January 13, 2011 by meakah

[Remolacha]

I am glad to hear she is eating and feeling better (except for the runs ) She probably will be less drowsy after she adjusts to the meds, but right now you want her to be quiet, so drowsy is good

[Batmom]

I'm glad she's holding her own! Might consider backing off on the oil until her diarrhea has cleared up -- I know it provides calories, but if they're just shooting on thru ....

[Guest 2dogs4cats]

I just wanted to add that I have been using Tea Pills with Rehmennia for my 14 year old girl for about a week now and she is back to her normal self. No more coughing/hacking, no accidents, no peeing every 2 hours. It's been small miracle in a bottle for her. I know your pup has other issues besides the kidney, but just wanted to post if there are others that are having renal failure.

 

I don't know how long this improvement will last, because in the end the disease is fatal, but it has eased the syptoms for sure. I have heard that others have had good success with Rhemennia as well.

 

I wish you and your pup all the best!

[greyhead]

My vet highly recommends rehmannia!

 

About all that oil, though...that would tend to give her the runs, especially if she's not used to getting it. Especially with her having you gone for four days ahead and staying with friends, might it be good to back up a bit on that?

 

ETA: Oops, Batmom already said that!

Edited January 13, 2011 by greyhead

[Guest meakah]

Ya, I agree about the oil and didn't give her any this morning. I will let them add a bit if they want over the next 4 days if they are there to deal with the consequences. I have been giving her salmon oil with each meal for a few weeks so it is nothing new. But I did increase it by adding a bit of flax oil too so either that gave her the runs, or it is a bit of stress colitis. I am siding on stress colitis because she is a high anxiety dog and this wouldn't be the first time...plus she got sick in my car on the way home from the clinic on Tuesday evening after being there 2 days with no oil. But I agree that it is a good idea to back off on the oil until her diarrhea clears up a bit. Poor girl...one thing after another...

 

And interesting info on rehmannia....I will definitely check into that! Thanks!

 

How much rehmannia do you give? Are they pills?

Edited January 13, 2011 by meakah

[Guest 2dogs4cats]

Here's a link to the ones that I use:

http://www.chineseherbsdirect.com/jin-gui-shen-qi-wan-golden-book-teapills-min-shan-p-1955.html

 

My pup is 52 pounds and I started off with 3 pills twice a day (they are small and I just plopped them into her food.)

The next day I gave 4 pills twice a day and then 5. I stopped at 5 pills twice a day because she was back to her old self. She could take 6 pills 2x per day if the 5 were not enough. I think I will go to a maintenance dose after a month or so. So far, I have not seen any side effects.

 

She used to go out every 2 hours to pee, have accidents in the house and drink a lot of water (typical kidney disease). After a week of the pills, she is going out every 7 hours, no accidents, drinks regular amounts and has a great appetite.

 

I really don't know how the pills work other than increasing blood flow, I think? All I know is that she was at death's door, losing weight etc and now healthy!