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Stage 3: 10 year old American Eskimo
My 10 year 3 month old American Eskimo has been diagnosed with CRF Stage 3. His Creatinine levels are 4.5, and BUN is 68. Our vet has put him on IVF, but he continues to vomit sometimes. He is peeing after day 1 of IVF, and I'm pretty much desperate for any way for him to recover. It seems like a nightmare. He seemed completely fine two weeks ago, and now his condition has deteriorated so quickly. His blood work a week ago was CRE 1.4 and BUN 14. No idea what happened in a week. Please help, Tony. I've read your threads, and I don't know what to do. Also, I'm in India, and though our vet has asked us to keep some faith for the next few days, I'm not sure how much longer I can see him suffering. It's extremely hard coming in terms with the possibility of losing him, and we are ready to do anything to make him better.
Hi. I agree. This is becoming critical. I am not sure if your vet can get it, but if he can - your dog needs erythropoietin - this is a hormone produced by the kidneys, but with kidney disease the hormone is not produced. A supplement of erythropoietin is therefore needed, as it is necessary for the body to produce red blood cells - it's the lack of red blood cells that is causing the anaemia, and the anaemia will only get worse over time.
Talk to your vet about it straight away. If that's not possible, then a transfusion will help in the short term ... but getting hold of the hormone will prove more successful over the longer term ... and hopefully, long enough to get the kidney disease under control.
Tony
Talk to your vet about it straight away. If that's not possible, then a transfusion will help in the short term ... but getting hold of the hormone will prove more successful over the longer term ... and hopefully, long enough to get the kidney disease under control.
Tony
3 Comments
Hey Tony. Our vet also recommended the same hormone, and has been administrating it to him. His blood work just came in today:
CRE 2.89
Blood urea 60
BUN 28.02
Hb 5.8
Neutrophil 86
Lymphocyte 12
RBC 2.27
MCV 83.2
MCH 25.8
PCV 18.9
The vet says that anemia should be the main concern now, and in addition to the hormone suggested by you, he has also put Iron in his IV Fluids and has given us an Iron and Folic acid tonic to orally feed him. He still has no appetite and doesn't eat at all, so our vet has prescribed 'Proctin' to build appetite. He does seem a little more active, not like his usual self, but better than how he was two days ago. The vet also says that since his kidney disease came about so rapidly, it is quite possible that it is 'acute' and not 'chronic'.
CRE 2.89
Blood urea 60
BUN 28.02
Hb 5.8
Neutrophil 86
Lymphocyte 12
RBC 2.27
MCV 83.2
MCH 25.8
PCV 18.9
The vet says that anemia should be the main concern now, and in addition to the hormone suggested by you, he has also put Iron in his IV Fluids and has given us an Iron and Folic acid tonic to orally feed him. He still has no appetite and doesn't eat at all, so our vet has prescribed 'Proctin' to build appetite. He does seem a little more active, not like his usual self, but better than how he was two days ago. The vet also says that since his kidney disease came about so rapidly, it is quite possible that it is 'acute' and not 'chronic'.
Hi Tony,
The vet is asking us to consider a blood transfusion. We are not entirely convinced that it is a safe process. The vet says that they will perform cross-matching but not match blood type with the donor.. should this be a big concern? What is your opinion on blood transfusions in this case?
The vet is asking us to consider a blood transfusion. We are not entirely convinced that it is a safe process. The vet says that they will perform cross-matching but not match blood type with the donor.. should this be a big concern? What is your opinion on blood transfusions in this case?
Hi. I think the anaemia is a real concern and anything that helps has got to be a worthy risk. A transfusion is only a temporary fix, but if things are still at critical stage, then it's worth it, I'm sure. Cross-matching is essential and it's also important that the donor dog is in excellent health. Most donor dogs are what is known as universal donors, a bit like human blood donors. There are 5 different blood groups in dogs, and only one of them is considered universal donor type. There's a handy and concise bit of info here:
https://www.petfinder.com/dogs/dog-health/dog-blood-donor/
Tony
https://www.petfinder.com/dogs/dog-health/dog-blood-donor/
Tony
He is very lethargic. Keeps sleeping all day. The vet gave him D-25, which he said is equivalent of 25 gms of sugar, but that didn't help with energizing him too much. We are very scared. His heart is beating fast. He vomited only three times compared to 19-20 times the days before this, but he keeps digging holes to vomit in, and covers them up.
The vet says hopefully we wont need to do transfusion, but he really needs to start getting his haemoglobin up really fast.
The vet says hopefully we wont need to do transfusion, but he really needs to start getting his haemoglobin up really fast.
Tony, he is getting weaker by the minute. He didn't vomit as much today, and even defecated a little. We are scared his anemia is getting worse. The vet has been putting Iron in the fluid solution, and has given us tonics: Dex Orange and Sharkopheral (not sure about the spelling). He also has given him a haemoglobin booster shot. He's suggested transfusion.
We live in a small city in India, and I don't trust blood transfusion here - plus there is a possibility that we can't find any donor dog. He has never had an appetite, and has always been fed by hand for the past 10 years. So, we fed him very tiny amount of Royal Canin's Gastrointestinal food today and yesterday, the Renal one wasn't available and will come soon.
We live in a small city in India, and I don't trust blood transfusion here - plus there is a possibility that we can't find any donor dog. He has never had an appetite, and has always been fed by hand for the past 10 years. So, we fed him very tiny amount of Royal Canin's Gastrointestinal food today and yesterday, the Renal one wasn't available and will come soon.
Hi. Okay, first about SubQ fluids ... it may seem scary, but really it's only because it's unfamiliar to you. After the first couple of times doing it, you'll find it's easy and becomes part of your daily routine. The reason SubQs are important, is they can be done by you (someone your dog trusts) and they can be done at home (so minimum stress). Stress really affects kidney disease, so keeping it to a minimum helps. Anyway, have a think about it.
The vomiting is perhaps likely to be from either too much water (even small amounts every hour would be enough) or from the toxins in the gastric tract. The toxins will flush out a little with the IV/SubQ fluids over time. For now, Mirtzapine is worth trying, as it will help with the vomiting and encourage proper eating too.
The water you are giving ... give filtered water only, not water from the tap/faucet, as that can have chemicals in it that may cause issues.
The low haemoglobin means your dog is anaemic, and this can happen with kidney disease. This may be the result of inappetence, but there are lots of other potential causes too, so your vet needs to consider them and investigate.
The creatinine puts your dog in stage 3 kidney disease. This means protein restriction is important. The ideal food would be a canned kd dog food, such as Hills kd. If he refuses to eat it, try drizzling a teaspoon of organic honey or pure coconut oil over the top. You could also mix a little cooked egg white in it and a desert spoon of cooked chopped green cabbage (the latter will help treat and prevent stomach ulcers, which is another possibility for the low haemoglobin).
I notice phosphorus isn't in the blood results. Please about this.
Tony
The vomiting is perhaps likely to be from either too much water (even small amounts every hour would be enough) or from the toxins in the gastric tract. The toxins will flush out a little with the IV/SubQ fluids over time. For now, Mirtzapine is worth trying, as it will help with the vomiting and encourage proper eating too.
The water you are giving ... give filtered water only, not water from the tap/faucet, as that can have chemicals in it that may cause issues.
The low haemoglobin means your dog is anaemic, and this can happen with kidney disease. This may be the result of inappetence, but there are lots of other potential causes too, so your vet needs to consider them and investigate.
The creatinine puts your dog in stage 3 kidney disease. This means protein restriction is important. The ideal food would be a canned kd dog food, such as Hills kd. If he refuses to eat it, try drizzling a teaspoon of organic honey or pure coconut oil over the top. You could also mix a little cooked egg white in it and a desert spoon of cooked chopped green cabbage (the latter will help treat and prevent stomach ulcers, which is another possibility for the low haemoglobin).
I notice phosphorus isn't in the blood results. Please about this.
Tony
1 Comments
It's probably worth mentioning that both sodium and potassium and are a little low. These two minerals need careful balance, as they are involved in neurological pathways in the canine body. If they remain low, they may start causing muscle tremors or even seizures, so have a word with your vet about it and ask about cautious supplementation. Both can be improved with diet too, although some kd foods are low in sodium, which won't provide the extra that's needed right now.
Tony
Tony
Hi Tony! Thanks a lot for getting back and all the help :)
So, his blood results are out:
Haemoglobin: 5.4
Blood Urea: 126 mg/dl (The guy forgot to get the BUN value, and I'll update you as soon as I get that)
I checked up, and BUN is roughly half of Blood Urea, so assuming BUN is around 58-59.
CRE: 3.48 mg/dl
Protein: 5.40 gm/dl
Albumin: 2.85 gm/dl
Sodium: 135 MEq/L
Potassium: 2.3 MEq/L
The doctor has given him an haemoglobin shot today, and said he is going to continue fluid therapy for a couple of more days. Too scared to continue SubQ fluids :(
We don't mind giving him IV fluid treatment for as long as it is required.
He drinks water, but vomits it. Spoke to vet about Ondanestron, and turns out he has already been giving that to my boy, but it hasn't really been helping to control the vomiting bit. That's the most worrisome part for us. He vomits too much, in spite of all the meds and treatment.
He keeps asking for water, so we give him small amounts every 15/20 minutes. It induces vomiting, somehow. The vet has asked us to try giving him rice water or boiled egg, but he refuses to eat. He has prescribed half a tablet of Rubenal (Dietary complementary feeding stuff) twice a day, but he vomits everything. What would you recommend to tackle this issue?
Thank you so much for all the support :)
So, his blood results are out:
Haemoglobin: 5.4
Blood Urea: 126 mg/dl (The guy forgot to get the BUN value, and I'll update you as soon as I get that)
I checked up, and BUN is roughly half of Blood Urea, so assuming BUN is around 58-59.
CRE: 3.48 mg/dl
Protein: 5.40 gm/dl
Albumin: 2.85 gm/dl
Sodium: 135 MEq/L
Potassium: 2.3 MEq/L
The doctor has given him an haemoglobin shot today, and said he is going to continue fluid therapy for a couple of more days. Too scared to continue SubQ fluids :(
We don't mind giving him IV fluid treatment for as long as it is required.
He drinks water, but vomits it. Spoke to vet about Ondanestron, and turns out he has already been giving that to my boy, but it hasn't really been helping to control the vomiting bit. That's the most worrisome part for us. He vomits too much, in spite of all the meds and treatment.
He keeps asking for water, so we give him small amounts every 15/20 minutes. It induces vomiting, somehow. The vet has asked us to try giving him rice water or boiled egg, but he refuses to eat. He has prescribed half a tablet of Rubenal (Dietary complementary feeding stuff) twice a day, but he vomits everything. What would you recommend to tackle this issue?
Thank you so much for all the support :)
Hi. Yes, vomiting can occur and deterioration is typical, but persistence will pay off. Stay with the fluids. Ask your vet if he can get hold of Ondanestron, as it's the fastest acting anti-emetic for dogs and should stop the vomiting within 8hrs. Beyond that, I would also suggest prescribing Mirtzapine, as this will help your dog eat normally, improve their mood and reduce anxiety.
The weakness is probably partly due to muscle loss, typical in kidney failure. This can be assisted with diet changes. Please make sure you post the blood results as soon as you get them.
Don't forget to ask your vet about continuing with SubQ fluids after the IV fluids have finished.
Tony
The weakness is probably partly due to muscle loss, typical in kidney failure. This can be assisted with diet changes. Please make sure you post the blood results as soon as you get them.
Don't forget to ask your vet about continuing with SubQ fluids after the IV fluids have finished.
Tony
Also, he wants to go outside to the yard and seems a bit restless? I think its probably because he has been throwing up. Does the deterioration you mentioned during the first few days include such vomiting?
Hi Tony! Thank you so much. I posted this on another thread as well, but I'm posting it here again, just in case you miss seeing that one. Kind of desperate right now for any help.
Our vet administered intralipids to him on Day 2 and Day 3. He is still vomiting, and although our vet is giving him anti-vomiting injection, it doesnt seem to help much. He vomits a little bit about 4-5 times a day, and its white foamy stuff (Sometimes yellow). Last night, he urinated a little on his bed. That said, he urinates about 3-4 times a day and quite a bit, that oo.
He drank water by himself today, but he's getting very weak. His hind legs are weaker and he gets tired easily, even after walking some steps. His vital stats are normal, as per our vet. His blood test is tomorrow, and we are hoping that the reports are good.
But, it's today that is worrying us the most. He has already vomited about five times since the morning, and it's mostly yellow thick mucous-y stuff. I'm assuming it is bile. Very worried about whether he will make the night. Hoping for some miracle to make him better :(
Our vet administered intralipids to him on Day 2 and Day 3. He is still vomiting, and although our vet is giving him anti-vomiting injection, it doesnt seem to help much. He vomits a little bit about 4-5 times a day, and its white foamy stuff (Sometimes yellow). Last night, he urinated a little on his bed. That said, he urinates about 3-4 times a day and quite a bit, that oo.
He drank water by himself today, but he's getting very weak. His hind legs are weaker and he gets tired easily, even after walking some steps. His vital stats are normal, as per our vet. His blood test is tomorrow, and we are hoping that the reports are good.
But, it's today that is worrying us the most. He has already vomited about five times since the morning, and it's mostly yellow thick mucous-y stuff. I'm assuming it is bile. Very worried about whether he will make the night. Hoping for some miracle to make him better :(
Hello and welcome to our family of friends here.
It is not untypical for things to deteriorate in the first few days of fluid therapy. But, it's also very common for blood levels to start improving beyond that, so stay with it. Fluid therapy is the best first line of treatment, so you are doing the right thing. It may take several days to a week for IV fluids to have an impact and start to bring the creatinine particularly down. BUN may also improve pver this time, but even if it doesn't, don't worry excessively, as diet changes will help in the longer term.
The next thing you will need to do is prepare for continuing with fluid therapy at home AFTER a week or so of IV fluid therapy. Your vet will need to advise and teach you how to give SubQ Fluid Therapy, using Lactated Ringers. This should then continue for at least another two weeks and maybe longer depending on what happens to blood values.
I am also sending you a link below to one of my articles designed for first time diagnosis of kidney failure in dogs. Please read it and make sure you follow it up with your vet:
http://www.infobarrel.com/My_10-Point_Plan_for_Dogs_with_Kidney_Failure
Tony
It is not untypical for things to deteriorate in the first few days of fluid therapy. But, it's also very common for blood levels to start improving beyond that, so stay with it. Fluid therapy is the best first line of treatment, so you are doing the right thing. It may take several days to a week for IV fluids to have an impact and start to bring the creatinine particularly down. BUN may also improve pver this time, but even if it doesn't, don't worry excessively, as diet changes will help in the longer term.
The next thing you will need to do is prepare for continuing with fluid therapy at home AFTER a week or so of IV fluid therapy. Your vet will need to advise and teach you how to give SubQ Fluid Therapy, using Lactated Ringers. This should then continue for at least another two weeks and maybe longer depending on what happens to blood values.
I am also sending you a link below to one of my articles designed for first time diagnosis of kidney failure in dogs. Please read it and make sure you follow it up with your vet:
http://www.infobarrel.com/My_10-Point_Plan_for_Dogs_with_Kidney_Failure
Tony
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