Appetite Stimulant Suggestion? Moderate Kidney Failure: Won't Eat

[WHanson12]

Our 14 year old Molly has recently been diagnosed with moderate kidney failure, plus she is very prone to pancreatitis, which she is currently recovering from another serious episode due to the accumulation of toxins in her blood stream related to her kidney failure. It has been a hellish couple weeks for all of us--especially her. Anyway, she has always been a very picky eater & now with her kidneys failing, her appetite is even more depressed. Molly also has osteoarthritis in multiple joints so she is also taking those usual meds: Gabapentin, Tramadol, Rimadyl, etc. The vet prescribed Mirtazapine (a human drug, I believe) which caused Molly to experience body tremors, severe neurological

twitching & severe mental deficiency (she would stare off into space--completely unaware--horrible!). My husband's research revealed that Mirtazapine should NOT be given with Tramadol, as it can also cause seizures when used together!!!!!

 

So, does anyone have any good experience with an effective appetite stimulant, either an Rx or a homeopathic one? The vet said she does not know of any other ones, other than an injection of vit B12.

 

I will be checking GT on Facebook soon for the chronic kidney disease thread mentioned on a different topic thread here.

 

Any suggestions would be Greytly appreciated. Still don't know for sure that Molly will recover from this, although she improved some today. But the vet said once we get her kidney values down some (with all the fluids I've been giving at home), I/we will have to give Molly subQ fluids 3 times a week (500-1000 cc per) for maintenance of her kidneys... Molly already hates to see me & my husband coming to her together--sucks so much!!

 

Thank you!

[kudzu]

Subcutaneous B-12 injections greatly helped a cat & a dog of mine with renal failure. Fortified B-12 complex, available at livestock supply stores, is what I used for my dog. Also used acid reducers. Ranitidine (Zantac) and, to a larger effect, nizatidine (Axid) both have prokinetic qualities that can help boost appetite in some circumstances. Axid seemed to improve my dog"s appetite where other drugs failed. He had reduced GI motility related to a neurological disease. Renal failure can both increase acid production & reduce motility so perhaps that is why the Axid helped more.

 

A different drug, metoclopramide, helped with appetite in a couple of my dogs. Metoclopramide is both a prokinetic & an antiemetic, so can help with both reduced motility & nausea which can increase appetite.

 

Mirtazapine also has antiemetic qualities and, I think, is in dogs with renal failure. Had not realized it could cause problems when combined with tramadol. Sorry that happened but thank you for sharing that info.

[greyhead]

Hi, we have a kidney dog too. We usually feed Royal Canin renal kibble (used to be called MP for Medium Protein, now called formula A), and we coat it with a gravy made of Hill's ZD and water. But when he's feeling off, the gravy is too rich, so we just moisten the kibble with water. When they're having a bad time, food that's too smelly is nauseating or at least off-putting. When he doesn't want to eat at all, we can usually jump-start him with the rotisserie chicken from Costco. (We start with the legs as dark meat is said to be best for kidney conditions.) If that's not handy, we might tear off pieces of bologna. And sometimes he needs some vanilla yogurt (not low-fat, no aspartame) instead of food. Basically, the vet said that when it comes to not wanting to eat at all, use anything you can. (But no onions, of course.)

 

ETA: This is my second kidney-failure animal, and both have involved sub-q fluids at home. A vet in Baton Rouge started my kidney cat off with 1cc of B-12 given through the injection port of the drip line with the fluids, and I totally swear by it. My greyhound responds well to it too, as did my IBD greyhound. About once a week I go ahead and substitute a shot of B-complex; fluids wash out all the B vitamins, so they can all use supplementation, though B-12 is the most critical.

 

It's a roller coaster, but you can do this. Just remember that after a down is an up!

Edited October 13, 2015 by greyhead

[tbhounds]

Pepcid.

[WHanson12]

Kudzu: Thanks so much for your response. Due to Molly's propensity for developing pancreatitis, she has been on Pepcid & Reglan (metoclopramide) every day (once daily) for years. When Molly was at the vet today for repeat blood work, the vet administered some vit B12 through an acupressure point on her nose. I didn't see how this was done nor do I know how much B12 Molly actually received (I did not get to speak to the vet today). When you administered the B12 to your dog subQ, what was the dose you gave? I'll never use Mirtazapine again!!

 

Greyhead: Thanks so much also for your response. I'll look into the kibble diet you feed your kidney dog, but the Costco rotisserie chicken is not an option for Molly, as it is way too greasy (same with dark meat fowl) & will cause a pancreatitis episode. Unfortunately with the complication of the pancreatitis factor, I have to be very careful what I feed Molly--nothing too rich or fatty (you know--the good tasting things!!). Do I understand you correctly that you administer a shot of B12 complex in the subQ fluids once a week for your kidney dog or is it a separate injection? What is the dosage & do you have to purchase the B vitamins from the vet or have an Rx for it to purchase it elsewhere? Thanks for your encouragement & suggestions. Getting Molly to eat is a real challenge (frustrating too) many days, but those days when she is spunky & tries to chase that squirrel, are the reward for my persistence with her TLC. Our Molly is a red Girl too like the one in your photo! Beautiful! I'm technologically challenged, otherwise I would post a pic of Molly... ;o}}

 

tbhounds: Thank you for responding also! I greytly appreciate your info!

[Dawnnziggy]

We lost our first grey to kidney disease. We gave her Ensure, a half a bottle a day. We had her for 2 more years! I don't know if that will bother her other issues. It was a rough time for us so I understand what you are going through. I am sorry and I hope she gets a lot better!

[WHanson12]

We lost our first grey to kidney disease. We gave her Ensure, a half a bottle a day. We had her for 2 more years! I don't know if that will bother her other issues. It was a rough time for us so I understand what you are going through. I am sorry and I hope she gets a lot better!

Thanks so much for your reply & for the helpful info. What flavor of Ensure did your Grey like? Did you have to mix it in with her food or did she drink it plain?

I'll have to check into whether that will aggravate her pancreatitis issues or not, but it's worth looking into, as she has lost 12+ pounds over the past year! Did you have to administer subQ fluids at home to your kidney Grey Girl too? Thank you also for your good wishes & empathy to us...

[WHanson12]

Molly is fighting for her life especially this week when she's been at the vet daily for IV fluids in an attempt to bring down her pancreas & kidney values. After my husband & I administered 1 liter of subQ fluids per day for 5 consecutive days at home, her kidney values & pancreatitis indicator has gone up significantly! As with a lot of Greys, Molly gets VERY stressed going to the vet, much less staying there all day--breaks my heart to leave her there, but this is our final hope to help her through this. As far as I know at this time, her bloodwork will be re-checked this Sat. & if those values haven't gone down, my heart breaks already... Getting old sucks, whether we have 2 or 4 legs. It has almost been a year since we lost our previous Grey Girl, Mae, to an aggressive lymphoma that would not respond to any chemo protocol.

Please keep Molly in your good thoughts & prayers--thank you to all.

Subcutaneous B-12 injections greatly helped a cat & a dog of mine with renal failure. Fortified B-12 complex, available at livestock supply stores, is what I used for my dog. Also used acid reducers. Ranitidine (Zantac) and, to a larger effect, nizatidine (Axid) both have prokinetic qualities that can help boost appetite in some circumstances. Axid seemed to improve my dog"s appetite where other drugs failed. He had reduced GI motility related to a neurological disease. Renal failure can both increase acid production & reduce motility so perhaps that is why the Axid helped more.

A different drug, metoclopramide, helped with appetite in a couple of my dogs. Metoclopramide is both a prokinetic & an antiemetic, so can help with both reduced motility & nausea which can increase appetite.

Mirtazapine also has antiemetic qualities and, I think, is in dogs with renal failure. Had not realized it could cause problems when combined with tramadol. Sorry that happened but thank you for sharing that info.

Kudzu: Thanks so much for your response. Due to Molly's propensity for developing pancreatitis, she has been on Pepcid & Reglan (metoclopramide) every day (once daily) for years. When Molly was at the vet today for repeat blood work, the vet administered some vit B12 through an acupressure point on her nose. I didn't see how this was done nor do I know how much B12 Molly actually received (I did not get to speak to the vet today). When you administered the B12 to your dog subQ, what was the dose you gave? I'll never use Mirtazapine again!!

Hi, we have a kidney dog too. We usually feed Royal Canin renal kibble (used to be called MP for Medium Protein, now called formula A), and we coat it with a gravy made of Hill's ZD and water. But when he's feeling off, the gravy is too rich, so we just moisten the kibble with water. When they're having a bad time, food that's too smelly is nauseating or at least off-putting. When he doesn't want to eat at all, we can usually jump-start him with the rotisserie chicken from Costco. (We start with the legs as dark meat is said to be best for kidney conditions.) If that's not handy, we might tear off pieces of bologna. And sometimes he needs some vanilla yogurt (not low-fat, no aspartame) instead of food. Basically, the vet said that when it comes to not wanting to eat at all, use anything you can. (But no onions, of course.)

 

ETA: This is my second kidney-failure animal, and both have involved sub-q fluids at home. A vet in Baton Rouge started my kidney cat off with 1cc of B-12 given through the injection port of the drip line with the fluids, and I totally swear by it. My greyhound responds well to it too, as did my IBD greyhound. About once a week I go ahead and substitute a shot of B-complex; fluids wash out all the B vitamins, so they can all use supplementation, though B-12 is the most critical.

 

It's a roller coaster, but you can do this. Just remember that after a down is an up!

Thanks so much also for your response. I'll look into the kibble diet you feed your kidney dog, but the Costco rotisserie chicken is not an option for Molly, as it is way too greasy (same with dark meat fowl) & will cause a pancreatitis episode. Unfortunately with the complication of the pancreatitis factor, I have to be very careful what I feed Molly--nothing too rich or fatty (you know--the good tasting things!!). Do I understand you correctly that you administer a shot of B12 complex in the subQ fluids once a week for your kidney dog or is it a separate injection? What is the dosage & do you have to purchase the B vitamins from the vet or have an Rx for it to purchase it elsewhere? Thanks for your encouragement & suggestions. Getting Molly to eat is a real challenge (frustrating too) many days, but those days when she is spunky & tries to chase that squirrel, are the reward for my persistence with her TLC. Our Molly is a red Girl too like the one in your photo! Beautiful! I'm technologically challenged, otherwise I would post a pic of Molly... ;o}}

[greyhead]

We give 1cc of B-12 with each fluid administration, which is 200 to 400 ml, usually daily. That's the same amount we gave our 12-lb cat, so I imagine he could take more, but 1cc syringes are what we have on hand, But you can easily ask for or buy 3cc syringes too.

 

They can also be given as a sub-q shot apart from the fluids, but they sting a little, so it's easier on the dog to get it in the fluids after a pocket of clear fluids has been built up to cushion the blow, so to speak. With our prior GH, who needed B-12 but not sub-q fluids for his condition, the vet did give us skinny 25g needles to use when administering directly under the skin since the network of nerves across their shoulders and backs is even more extensive than in a cat! In WA state and on all the internet sites I looked at, a prescription is needed, or you get the vet to order you a bottle. (They usually just have one bottle in stock for their own use.)

 

Our Costco also frequently has bags of white meat that has come from their unsold rotisserie chickens, and white meat is much less greasy than dark. But I can see where the whole chicken seems very greasy for a pancreatitis situation. That really complicates things, doesn't it! Sometimes we've used canned a/d from the vet to tempt him to eat when nothing else was working, and we keep some on hand just in case, but it's pretty rich. We've found that Milk Bones can be very tempting when the dog is hungry but regular food is too smelly (nauseating), and often a medium-size one or two will jump-start him to go ahead and eat soon after.

 

Hoping and praying that all will be well. Please keep us posted!

 

ETA: They get a faster response if you syringe water into their mouths, and we do this when he's really dehydrated. It takes the sub-q fluids hours to be absorbed and become effective. A vet told me that water by mouth is as effective as IV fluids, and both are effective at much lower quantities than sub-q's. We asked the vet recently for an irrigation syringe for the task, as it has a curved end that goes easily between the teeth and onto the tongue area. There aren't any quantity markings on the syringe, but it's not very large, and we give about 1/3 to 1/2 of it at a time, repeating at 15-30 minute intervals. As long as it's plain water, you can't cause pneumonia even if it goes down the wrong pipe. It has been a very helpful thing for us, so I thought I'd mention it.

Edited October 15, 2015 by greyhead

[XTRAWLD]

I'm sorry to hear about her recent battle. My experience with appetite stimulants are below: For the record, table scraps were NEVER refused! In fact, for the most part, if it started on my plate, he'd be interested!

 

Forti Flora which is a probiotic has some sort of smell that makes dogs want to eat whatever it's put on. I don't know if it would work for you, but one package (powder form and simply sprinke it on food) is about a buck or a box of 30 for a month for about $30 (I got it at the vet). I'm not sure if it is acceptable to use with her issues so check first, but I gave a package to Kasey in the morning and evening meals.

 

He also quite liked Ensure or Boost. I never noticed it to cause any stool issues but only gave him a half bottle at a time. Half in the morning, half in the evening. In the very least he had SOMETHING getting in him.

 

Kasey was also given a prescription of Mirtazapine. I'm really on the fence with it's effectiveness. His first try seemed to work, but when we used in again a few weeks later, it seemed pretty ineffective. He also hated the taste and you'd swear I was killing him when I was administering it to him (orally in liquid form).

 

Also last but not least, we tried a canned food, which he never usually got, and that was a pretty big deal, so he was excited to eat that. He had Royal Canin Gastro Intestinal High Caloric food.

 

It does suck when they don't want to eat and you can start seeing them slide down hill. Thinking about you and good luck.

Edited October 15, 2015 by XTRAWLD

[greyhead]

Just thought I'd try to quantify how much water needs to be given orally to keep these guys hydrated. The vet told me 1/2 cup per hour, which is 120 ml. When Molly comes home, maybe you can help her this way. We also find that appetite comes back within an hour or two of getting fluids into our boy, so however you get it done is good.

[brandimom]

Please check with a holistic vet as our gh had kidney issues and we took her in once a month for an oxygen treatment (don't know what it was called) but his method delivered oxygen to her kidneys.

[WHanson12]

Sorry to all that I have not provided an update sooner, but most of my time is spent on Molly's care at home. Molly's blood work last week did not produce good results or a good prognosis for her. After 3 days of IV fluids at the vet, her kidney values were slightly higher, but her pancreatitis indicator (PSL--a fairly new test that is a more accurate diagnosis of pancreatitis) sky rocketed to 8x what it was the previous week. At this point, there is not much more we can do other than keep her comfortable. We are administering subQ fluids daily to keep her hydrated, but it is very difficult to find food that she is willing to eat. I'm trying everything (that isn't too fatty) from grilled fresh salmon, boiled hamb or ground turkey, turkey baby food, some of her favorite canned dog food, bone broth (which she will not eat), etc... Very frustrating to get her to eat. It has also gotten very difficult to get her to take all of her meds in the Cheez whiz; half the time I have to shove them down her throat. I'm also feeding her Ensure daily, which sometimes she will drink on her own, other times I syringe it into her mouth. I've added vit E 400 IU twice a day in an attempt to dissolve the possible stones she has in her very inflamed gallbladder & biliary duct (not a total blockage there), but that may take more time than Molly has. The vet believes that this gallbladder issue may be what's caused the pancreatitis episode, which is unrelated to her severe kidney failure now. My husband & I are preparing ourselves as much as is possible to make that final, difficult decision to let Molly go, as it may come at any time. But as I'm sure you all know, there is no way to be 100% prepared to accept & make that decision; however, we won't let her suffer for our own selfish needs. Molly is eating fairly well today (compared to other days), but we try not to get our long term hopes up. We are closely monitoring her quality of life every day. Thank you to everyone for your replies, suggestions & prayers--we appreciate all of them. Wendy

[tbhounds]

I'm sorry to hear Molly hasn't improved. Pancreatitis is very painful-has your vet ever suggested giving her a low dose narcotic --a small dose of buprenex may help her feel more comfortable. Buprenex can be administered sub lingually (under the tongue) so, there's no painful injections given.

[WHanson12]

I'm sorry to hear Molly hasn't improved. Pancreatitis is very painful-has your vet ever suggested giving her a low dose narcotic --a small dose of buprenex may help her feel more comfortable. Buprenex can be administered sub lingually (under the tongue) so, there's no painful injections given.

 

Molly's 2 vets on her recent case have not suggested this at all. I have come to the conclusion today after Molly's primary" vet called to check on her after being out-of-state for a week, that she (both vets actually) has given up on us, as she gave me the standard "quality of life speech" that you give to a pet owner who has not been through this before (making such a difficult decision to let your pet go). Apparently she has "forgotten" that she put our lymphoma Grey girl to sleep about a year ago! I thought she knew us better than that--she should. I'm not sure this vet will help us any more with things that we want to try for Molly before making that final decision... We know Molly VERY WELL & will know when the time has come... Thanks for your suggestion Tbhounds. We will certainly consider it, although Molly is on Tramadol & Gabapentin & more. Does Buprenex wack out a Grey at all or have a sedation effect? Molly has had very bad reactions (being wacked out, not all there, hallucinating maybe?) to Mirtazapine while she's been on Tramadol. Don't want her to experience anything like that again.

[tbhounds]

Ghs can react to buprenex as it is a narcotic but, many hounds can "handle" it better than say morphine. Buprenex has a very wide dosing range. In your case I would use a very low dose given every 6-8 hours. IMO Tramadol really isn't strong enough (personally I find Tramadol a joke) and increasing the dosage just makes these guys act adversely-panting , pacing......

I would try 0.1mg/10lbs every 8 hours to see if she becomes more comfortable (that's a very low dose). If she's more comfortable she may be more inclined to eat. If she handles that dose there's a lot,of room to increase the dosage. I would discuss medications with your veterinarian -be frank with your vet-he/she should be willing to sit down and discuss a reasonable treatment plan. Together you can decide which medications to try or discontinue.

Please keep us posted <3

[WHanson12]

Thank you to all for your suggestions & personal experiences, as well as your prayers & good wishes. My husband and I had to say goodbye to Molly yesterday. Her quality of life was declining even more & she let us know that she was tired of fighting. Molly was set free in a calm, peaceful & loving environment, at home, with the assistance of a house call vet. Molly adopted us for 10 wonderful years & was the poster Girl for the Greyhound breed with her intelligence, sweet, sweet disposition (not a typo or stutter), & beauty--the entire package. She leaves a huge, painful void in our hearts, family & home, as many of you Grey lovers have experienced also. But we find comfort in knowing that she is running free & fast now, in a better place with her best Grey friend, Thumper, & in the care of my husband's Mom, "Grandma Muffin," (who loved to share bites of her muffins with our Grey girls!), & also knowing we will see her again... Wendy

[MP_the4pack]

 

I'm sorry

 

[greyhead]

I'm so sorry to hear this. I hope warm memories of Molly will comfort you, along with knowing that you did all you could.

[tbhounds]

I'm so,sorry to hear of the passing of your beloved Mollly -I do hope she's enjoying a bit of a muffin now <3

[Batmom]

I'm so sorry to hear of your loss.

 

Godspeed, special girl. Your people loved you and will miss you forever.