Kidney Levels, Hills K/d Diet, And Sleeping Incontinence

[Guest ElizabethB]

New to Greytalk here. We just adopted our first greyhound two weeks ago and are already going through some medical confusion and issues. Our sweet boy Watson is age seven, and the adoption agency advised that he was in perfect health. He’s a bounce, and a calm easygoing sort who has adjusted easily to everything during the transition (behavior-wise).

 

The problem is that when we brought him home, we noticed sleep-based incontinence. We watched it closely, and see now that he leaks in his sleep when he 1) has a full bladder and clearly it is time to go out and 2) when he is at his sleepiest (around noon and then again at night).

 

It is almost as if he is so dead asleep in those moments that he does not realize he needs to pee. When I wake him up to "tell him" (because I know that it is time), he is happy (but not desperate) to go out, and he pees right away, and when we come back in it does not happen again right away, even if he goes right back to sleep.

 

He does not have incontinence or marking issues otherwise. We have also tried restricting water intake after 7:00 PM.

 

We took him straight to our vet in those first days. She ruled out an infection and thyroid problems. She also gave us Panacur and Metronidazole because his stool was soft and his gas was bad. This was in his first 4 days with us (so I suspect it was partially related to food transition).

 

What concerns us is that she is saying his kidney values are high: BUN 39 and Creatinine 2.9.

 

She is advising that they next step is to react to these high levels by changing his diet (specifically, moving to the Hills k/d). We are disappointed in this option – for the last few days we’d been trying to get him stabilized on what I would like his regular diet to be from here moving forward - a combination of Blue Buffalo Wilderness canned and LiveSmart kibble (only the latter for now because that is what he was on in the shelter), and a bit of cooked chicken that we are also using for treats. We are also adding to his evening meal glucosomine powder, an omega 3 supplement, and a bit of plain yogurt. (The vet advised us to ditch the yogurt immediately due to the kidney issue ...).

 

I asked the vet about Proin (or something similar) for the incontinence, and she said that they do not recommend this if the kidney levels are high.

 

Apologies for the length of this post. I just hate that the vet seems to be saying that we cannot make an attempt to solve the incontinence problem without getting him stuck on a crappy low-protein Hills diet when we had such high hopes for feeding him better quality food.

 

When I mentioned to her that I was suspicious of the Hills food, she advised that Purina and Royal Canine also have kidney formulas.

 

As a new Greyhound mom, am I wrong to be concerned? Are these kidney levels truly high for greyhounds?

[Feisty49]

I'm no expert but the info I have from my adoption group is that Creatinine for a Greyhound should be between 0.8 and 1.6. I have no info on normal BUN stats. Actually, from the info I have, a Creatinine stat of 2.9 would be high for any breed of dog.

 

Regarding food: The more you read on here the more you'll find that there is a contingent of us (me included) who don't think that high-end kibble is necessarily the best. Annie Bella, my grey, had bad diarrhea while on Blue Buffalo kibble. As a matter of fact, all high-end kibbles I tried gave her diarrhea. If it were me, I'd follow my vet's advice regarding food and address the type of food you want to feed your pup after Watson's health issues are fixed.

Edited May 2, 2012 by Feisty49

[sweetdogs]

Welcome! Hiya Watson!

 

Here is an article on greyhound kidney issues you might find helpful.Greyhound kidney issues If you have a copy of his bloodwork results, you'll see the range given for BUN & creatinine.

 

I'm not a fan of prescription foods but a lot of people swear by them. I think for kidney issues, it's easier, healthier & cheaper to prepare food at home. Hopefully Watson doesn't have kidney disease but a sneaky urinary tract infection that antibiotics can take care of.

[MaryJane]

Sometimes a greyhound can get an acute kidney condition resulting in elevated values and eventually they might become "normal" but, then again, they might not.

 

I would suggest doing a "kidney" diet, either homemade or commercial, and see where the values are in a few months.

 

You didn't mention whether you had a "first catch" urinalysis done. If you haven't, then you should get the specific gravity and the protein level in the urine so you know the baseline. If there is protein in the urine, you can get the dipsticks that check for protein and monitor it yourself on the first morning specimen every few days - I used to do this for one of my dogs. If protein was in the urine then I would cut down on the amount of protein in his food. With my angel Onyx, I fed him a home-made kidney diet that I was able to adjust easily to increase or decrease the protein levels.

 

 

edited to add .... the urinary incontinence could be due to the kidney issue and if you get that under control, the incontinence might stop ...

Edited May 2, 2012 by MaryJane

[GeorgeofNE]

My last dog probably lived three years longer than he might have because he was put on K/D.

 

There was no change in his vitality, his coat, or his energy. What it did do was keep his kidney issue under control. Is it the IDEAL diet for a normal healthy dog? Probably not. But if your dog may have a kidney issue, it's certainly worth trying I think!

 

My dog's creatinine runs high (2.1 or 2.2) but his BUN is totally normal. That's one of the indicators for vets who know that Greyhound chemistry can be different. If the creatinine is high but the specific gravity is normal and the BUN is normal, then it's probably just a normal reading for that particular dog.

[Batmom]

I'd ditch all the supplements and try either the prescription KD (I prefer the canned but YMMV) or a homeprepped diet with a similar low-salt, minimum-protein profile. Nothing to lose, lots to gain.

[tbhounds]

Ah - MaryJane beat me to it-- you really need to check the first a.m. urine's specific gravity. Ideally the urine should be more concentrated in the morning--1.030 or higher would be wonderful- meaning the kidneys are able to concentrate the urine.

Has your vet ever run a urine culture? Sometimes these guys even respond to antibotics despite a negative result.

I believe it's because whille the urine may not have active bacteria floating about the within the bladder may contain the bacteria. It's also believed that antibotics have an anti inflammatory effect.

I would also without a doubt have your hounds blood pressure checked- all so often overlooked diagnostic test.

Like MaryJane I believe if you get the kidneys happy I would bet the incontinence will resolve.

[greyhead]

We have a hound with leakage like yours. (Creatinine 2.2, specific gravity 1.012, small amount of protein in urine.) We get by by using a belly band at night, with an incontinence pad attached, and by using kidney food. Royal Canin Medium (not low) Protein Renal kibble. And if we try to change the food, we get increased volume of leakage. (We've experimented with that twice.) On that food the overnight leakage is just a spot most of the time. We do enliven the food with a gravy made from a tablespoon of Wellness canned food and a little water.

 

He's also low-positive for Lyme, which can affect kidney function, so we're going to treat for that. We resisted use of Proin because it's dangerous to some dogs, and I didn't like the way he looked after one dose. This should all be manageable, for our dog and for yours. Best luck!

[Guest ElizabethB]

I cannot thank all of you enough for your replies. This is an extremely helpful forum.

 

We've had Watson on the Hill's k/d diet (exclusively) since Friday, and the pee leakage has seemed to miraculously stop - none visible since Sunday. I have my fingers crossed that the need to keep him on a kidney diet will not be long-term (we'll see after another round of bloodwork in a few months). If that proves to be the case, I'll gradually move to a home cooked kidney-friendly version over the next few months.

 

His poo softness is the only pressing concern right now. It is not diarrhea per se (not liquid), but is soft like pudding. But, despite this, at the same time, he's put himself on an impressively rigid poo schedule of twice a day, about 30 minutes after each meal. No accidents in between so far at all.

 

When we visited the vet in that first week, I mentioned that his stool was soft (not as bad as now) and he had a moment of bad gas right there in the vet's office. She put him on a round of Panacur and Metrondinazole. He's finishing up his last pill of the latter today. Plus, once we determined the kidney issue (last week), she suggested I take him off yogurt and give him a round of fortaflora instead. We are doing this.

 

The gas has almost completely stopped. For the diarrhea, could it be that he just needs more time to adjust to that k/d food? I'll admit that I did move to it pretty cold turkey (because of all the confusion during that first two weeks about what we could/should be feeding him).

 

His energy level, coat, and general behavior all point to signs that he feels fine otherwise. He's starting to get a little more brazen and bold (in harmless ways) and less timid - the personality coming out has been interesting.

 

Again, thanks for all your kind thoughts and words of support!

 

Karen (and Watson)

[tbhounds]

K/D is high in fat--many dogs will have soft stool and/or become gassy while on it.

[Burpdog]

Did they culture the urine?

[Guest ElizabethB]

They did indeed test the urine for infection (none found).

 

As for the soft stool, I visited the vet with a stool sample yesterday and they got back to me this morning with news that he has hookworms. They're giving us a second round of Panacur.

 

I'm pleased that it was at least something that they could nail down - but ... I haven't yet read all the threads on these boards about how bad hookworms can be, so I might be speaking too soon.

[NeylasMom]

Can you find out what the specific gravity was on the urinalysis, and whether there was any protein in the urine? That will be helpful in determining if this is in fact kidney disease and the stage. More information on staging and diagnostics here: IRIS staging of CKD. You will also want to find out what his phosphorus level was on his blood work.

 

Managing chronic kidney disease can be a bit challenging. I suggest you really educate yourself. This site is probably a good place to start.

 

A few basics:

 

- The thinking now is that a low protein diet isn't needed and may actually be detrimental until the later stages of the disease. What's of paramount importance is phosphorus levels. With your numbers and symptoms, I'd say you're looking at end stage 2/early stage 3, and you may not need that lower protein yet. The problem with the K/D is that while it does give you the lower phosphorus you need, it also restricts protein. So a home cooked diet, or a regular kibble that naturally has lower levels of phosphorus may be a good option as well.

 

-There are a few supplements that can really help bring his numbers down - primarily a good quality purified fish oil and a supplement called Azodyl. You can get the latter online rather than from your vet but you need to make sure you get it from a reputable seller who will send it wtih freezer packs. We saw my cats creatinine and BUN drop notably after 2 weeks on Azodyl, but most importantly his phosphorus dropped from a dangerous level ot a COMPLETELY NORMAL one. He has been doing so much better since then.

 

-If you see inappetance or nausea, you'll want to start a daily antacid like Pepcid or Zantac.

 

-DO NOT restrict water access in a dog with kidney disease. The extra water is required to clear out the toxins, which is what causes them to feel ill. Limiting water can cause your dog to get sicker and go off his food, which can start a nasty downward spiral. When Cisco (my cat) was diagnosed, I added water bowls throughout the house, including one in the bedroom so it was easier for him ot access overnight. I also started cleaning his litterbox twice a day rather than once. Of course, with a dog the trade off is more visits outside. If you have a way to set up a dog door, or teach him to use an indoor potty system, now might be the time to start training with that. There are diaper options, but one of the latter is more comfortable for human and dog I think.

 

I hope that helps some. If you can find out those extra values, that would be helpful.

Edited May 10, 2012 by NeylasMom