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Not A Great Follow-Up Vet Appointment


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Diana was diagnosed with kidney disease 3 weeks ago, so the vet put her on Hills k/c and told us to come back in 3 weeks for follow-up bloodwork.

Well.... Her BUN went from 66 to 40, but her creatinin barely budged. I'm pretty bummed, but we'll keep working on it. I made the mistake of mentioning to the vet that we had her on part Hills, part home-cooked. He was NOT happy. I tried to fill him in that I'd done research and wasn't feeding her pizza and ice cream, but he was SUPER busy so we didn't get to have a discussion. He did ask me to call back and keep in contact with him on food, and her condition. They were having a rabies clinic that day and we were supposed to come in before it started, but people came an hour early. It WAS A ZOO!!! We were so rushed I didn't even get the bloodwork printout from him, or buy another back of the nasty Hills food. He actually brought the results out to me outside where we were trying to stay out of the way.

I'll get the printout out tomorrow. How quickly should levels drop, and by how much? She's been eating great and really looks good.

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1) it would be helpful for us here to know what her creatinine was and is, along with reference ranges for the BUN and creatinine. I know you don't have it right now but as soon as you can get it, post it. Greyhounds run high in those values anyway so she might not have as big a problem as originally thought.

 

2) if your vet discourages a home-cooked diet for a kidney dog, find a new vet. Any doctor who won't provide information in line with the client's needs is useless, IMO. Our vet copied several pages from a book on home cooking for kidney issues for us. I have never met a dog that will eat the Hill's kidney diet. If she truly needs a kidney diet, home cooked is the only way I would go.

I also think it was pretty rude of this dude to basically pay zero attention to you when you're a paying client with an appointment. He should take as much time as needed to explain things and provide information. The people that came for a rabies clinic can wait until their actual scheduled time, just as you came at your scheduled time. Rude.

Kristin in Moline, IL USA with Ozzie (MRL Crusin Clem), Clarice (Clarice McBones), Latte and Sage the IGs, and the kitties: Violet and Rose
Lovingly Remembered: Sutra (Fliowa Sutra) 12/02/97-10/12/10, Pinky (Pick Me) 04/20/03-11/19/12, Fritz (Fritz Fire) 02/05/01 - 05/20/13, Ace (Fantastic Ace) 02/05/01 - 07/05/13, and Carrie (Takin the Crumbs) 05/08/99 - 09/04/13.

A cure for cancer can't come soon enough.--

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1) it would be helpful for us here to know what her creatinine was and is, along with reference ranges for the BUN and creatinine. I know you don't have it right now but as soon as you can get it, post it. Greyhounds run high in those values anyway so she might not have as big a problem as originally thought.

 

2) if your vet discourages a home-cooked diet for a kidney dog, find a new vet. Any doctor who won't provide information in line with the client's needs is useless, IMO. Our vet copied several pages from a book on home cooking for kidney issues for us. I have never met a dog that will eat the Hill's kidney diet. If she truly needs a kidney diet, home cooked is the only way I would go.

I also think it was pretty rude of this dude to basically pay zero attention to you when you're a paying client with an appointment. He should take as much time as needed to explain things and provide information. The people that came for a rabies clinic can wait until their actual scheduled time, just as you came at your scheduled time. Rude.

He wasn't trying to be rude. I wanted out of there too! It got crazy. Cars lined up, vets going car to car giving vaccinations, dumb people getting their dogs out when they shouldn't. They don't normally schedule any appointments on clinic day, but he really wanted a reading on her so he snuck us in. We'll do a real consultation over the phone, we just couldn't that day.

 

I'll definitely post the levels as son as I get them. I guess I'm just disappointed that I didn't get "Great job, keep up what you're doing" lol!

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So I can't help on how quickly values drop but was curious as to what you were doing for the homemade part. We have a kidney dog too and she hates the food.

See some of my previous posts. I think one of them is entitled "HELP quick!" LOL

Lots of GTers gave great advice, and sites for more info. Dogaware was very helpful to me.

 

Basically we're doing pasta and/or rice. Sweet potato, 1/4 c fatty hamburger or chicken thighs and/or egg white per meal. Low-sodium chicken broth, fish oil, ground eggshell. I need to add a supplement but haven't settled on one yet that's low phos. I cook up a batch about every 5 days. She loves it. I sneak in the Hills when I can, dry or canned. She'll eat some of it if it's mixed in with the good stuff. Oh, and we put her on all distilled water. We have well water and I know it's full of minerals and stuff.

 

He weight maintained over the past 3 weeks, so I'm pretty happy. She's been dropping weight for a while, prior to diagnosis.

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Yes to what krissn said. Studies show that home diet is actual best for kidney disease, even better than prescription foods if you do it right. So if your vet doesn't know this and is discouraging cooking, I'd be concerned and find a vet who knows. Unless maybe he thinks you are doing randomnessin the foods without any research, and he should still ask you that first. (On a side note, have you found the site dogaware.com? Tons of info and nutritional values for kidney diets, both commercial and home-cooked.)

Cathy & Calvin (DOB 9/18/13). Always missing my angel Robin (Abdo Bullard).
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Would your vet be happier if you had conculted with a veterinary nutritionist and had a diet designed for your dog?

https://www.petdiets.com

Probably not. I'll check it out.

Yes to what krissn said. Studies show that home diet is actual best for kidney disease, even better than prescription foods if you do it right. So if your vet doesn't know this and is discouraging cooking, I'd be concerned and find a vet who knows. Unless maybe he thinks you are doing randomnessin the foods without any research, and he should still ask you that first. (On a side note, have you found the site dogaware.com? Tons of info and nutritional values for kidney diets, both commercial and home-cooked.)

Dogaware is awesome. I'll explain to him more on the phone that I'm not just winging it. It would've helped if the levels proved me out, but again, I don't know how quickly levels change.

Anybody know how long it takes to see progress?

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Noticed that you are doing "fatty" hamburger ... think instead about doing a lean hamburg. Pancreatitis can be a concern with excessive fat in the diet.

I'll look into that. From what I've read, extra fat in the diet of a kidney-compromised dog is a good thing, as they need the calories. We're also doing chicken thighs, with skin, for the extra fat. But - her meat content is only 1/2 c per day.

 

Is Pancreatitis something that develops along with kidney disease, or a separate condition?

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Would your vet be happier if you had conculted with a veterinary nutritionist and had a diet designed for your dog?

https://www.petdiets.com

I'm not sure where you are, but University of Pennsylvania does individualized diets; I haven't worked with them on that but my other experiences with them were stellar.

Beth, Petey (8 September 2018- ), and Faith (22 March 2019). Godspeed Patrick (28 April 1999 - 5 August 2012), Murphy (23 June 2004 - 27 July 2013), Leo (1 May 2009 - 27 January 2020), and Henry (10 August 2010 - 7 August 2020), you were loved more than you can know.

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I'll look into that. From what I've read, extra fat in the diet of a kidney-compromised dog is a good thing, as they need the calories. We're also doing chicken thighs, with skin, for the extra fat. But - her meat content is only 1/2 c per day.

 

Is Pancreatitis something that develops along with kidney disease, or a separate condition?

 

 

It's a separate condition and can be very serious. It appears (not 100% sure) that greyhounds might be more susceptible to pancreatitis with a fatty diet. If weight gain is occurring, I might suggest cutting back on fat and substituting with extra carbs like rice/veggies. You want some fat but, not dripping in it ....

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With chronic kidney disease, the creatinine may not (and often doesn't) drop. I'm usually happy if it stays stable. Chronic renal disease is progressive and irreversible, so those values will gradually and eventually increase with time and age. If she's feeling good, eating well, and maintaining her weight, those are all good signs.

Jennifer &

Willow (Wilma Waggle), Wiki (Wiki Hard Ten), Carter (Let's Get It On),

Ollie (whippet), Gracie (whippet x), & Terra (whippet) + Just Saying + Just Alice

gtsig3.jpg

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With chronic kidney disease, the creatinine may not (and often doesn't) drop. I'm usually happy if it stays stable. Chronic renal disease is progressive and irreversible, so those values will gradually and eventually increase with time and age. If she's feeling good, eating well, and maintaining her weight, those are all good signs.

Oh - cool! Thanks for that! The BUN dropped, which I believe indicates fewer baddies left that the kidneys are trying to kick out.

 

I picked up some Neo brand canned, and I'll try that as an add-in, alternating with the Hills canned, because I'm not 100% confident in my home-cooked yet. I'm not going to bother buying any more prescription dry food. I can barely sneak any of it in.

 

DH is crude about such things, but as he said "A year of having her eat well and fell good and be happy is better than 2 years of her starving and feeling miserable". We're going to give her the most appropriate diet we can, but she needs to eat. Wasting is a horrible thing to see. When my other grey had hemangiosarcoma, I put him on mostly home-cooked (different) and he did well for a year past what the vet said he'd live, and he didn't waste away. He got to leave at his time, but never suffered.

 

My friend visited my house tonight when I was mixing up Diana's food. Pasta cooked in no-sodium chicken broth, sweet potatoes, chicken thighs, cooked eggwhites, and ground eggshells, then more broth added in. She said "Heck I'd eat that!". The eggs came from her chickens, so I know they're what is now called "organic'. Used to called home-raised.

Edited by sobesmom
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I'd try explaining to your vet that Diana won't eat the prescription food and that you've done your research on a home-cooked diet that meets a lot of the same nutritional criteria (low phosphorus, lower, high quality protein, etc). A good vet should respect and work with you, or at least offer you some options to consider. I can't imagine that he would insist that you keep feeding a food she won't eat. If you just don't feel like your vet is willing to work with you, maybe it's time to consider finding a vet you're more comfortable with. As long as my kidney patients are stable and doing well clinically, I usually recommend bloodwork every 3-4 months.

Jennifer &

Willow (Wilma Waggle), Wiki (Wiki Hard Ten), Carter (Let's Get It On),

Ollie (whippet), Gracie (whippet x), & Terra (whippet) + Just Saying + Just Alice

gtsig3.jpg

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