all of a sudden?

[snoopsmom]

Hello all,

Here's my situation, my beagle snoop is 12yo and while he is aging was was not visibly ill. A few days ago he went outside and came back in showing signs of pain he was eating and drinking normally. I took him to the vet after a couple days as he wasn't eating as much and looked sick. They say he has renal failure and they are pressuring me to put him down. He stayed with them overnight on the drip and now he seems worse than before. I don't know what to do, is this normal to happen suddenly, and is not eating the sign to let him go? He is still drinking and responsive but he is not eating.

Thanks

[snoopsmom]

They said that he would be in pain from the renal failure. He is currently eating rice with plain chicken, veggies and a little vienna sausage to entice him to eat.

There is no bp on the paperwork, and the CREA has no result on test the line is blank.

They said his xrays showed tumors as well. Would any of those things affect him suddenly? He was running around the yard then he's ill within a few hours.

[tonyb286]

Hi. Don't do anything until you have access to a copy of the blood results. Once you have them, post them here so I can see what the numbers are like. Pay particular attention to creatinine, BUN, phosphorus, calcium, potassium and sodium levels. Also, have they done a urinalysis for specific gravity and protein leakage? And have they checked for any urinary infections? Have they undertaken a blood pressure check?

What fluids are being given - saline or lactated ringers? What length of course is planned for the IV fluids? It should be at least a week with intermittent blood testing to see what the numbers are doing.

It is not untypical for blood values to deteriorate during the first 3 days along with associated worsening of symptoms, but then they often improve beyond that. Fluid therapy is the best first course of treatment, so stick with it. It does take time and while it is worrying for you, it's worth doing. Once IV fluids have finished, you must continue with SubQ fluids at home. Talk to your vet about this as you will need guidance from them about how to undertake it. SubQ fluids should continue for at least 2 weeks and maybe longer depending on blood values.

If your dog rallies, then we can talk about other things that will be needed including diet changes, supplements and other measures. Get back whenever you need to and if you have any other questions.

Tony

[tonyb286]

Heaven knows why, but your initial post came through as a new post, so my response above is inappropriate. Sorry. The blood numbers are improving, which is great. The creatinine puts him in stage 3 of kidney failure, so a canned kd diet is going to be appropriate right now. Hills kd is among those you should be looking for.

Phosphorus is very high. This needs controlling. I would ask your vet for a phosphate binder ... aluminium hydroxide is the one I would advise.

The weakness in the hind legs are likely to be a direct result of muscle loss and/or neurological issues, associated with the kidney disease. Do the blood results show levels for sodium, potassium and calcium? Let me know.

Tony

[snoopsmom]

Hi Tony,

We saw a new vet and the new blood test results:

BUN 113
CREA 2.9
PHOS 11.7

Snoop is eating/ drinking almost normally and moving around on his own, still some weakness in his hind legs. I am visiting all my local pet stores today to find a good kidney diet.

[snoopsmom]

Yes the vet has given up on him, they said it did not matter what I fed him. I am currently looking for a different vet.
I stopped the pain meds and he is doing much better today, he slept through the night and he is walking and eating much more today. He is showing no signs of pain except when he is passing stool, and I can see he is constipated.
What should I feed him?

Thank you so much for your time and sharing your knowledge.

[tonyb286]

Without the creatinine test and result it's difficult to advise on food. I would however suggest, as a precaution, starting him on a kd specific renal food, such as Hills kd (canned not dry kibble). This can be quite unpalatable, so drizzle a teaspoon of organic honey or pure coconut oil over the top to encourage eating. Getting blood pressure checked remains crucial.

When you find your new vet (sooner rather than later) ask them to perform a full blood panel check including an SDMA test, a urinalysis for specific gravity and protein leakage, and a blood pressure check. If your dog is still not eating, ask the vet to prescribe Mirtzapine.

Once the results are in, let me know.

Tony

[tonyb286]

Hi. Right. Your vet clearly isn't checking for renal failure properly, as this cannot be done without a Creatinine result. Pain medication is advised only when there is signs of pain and usually in the final stages of the disease, because it will actually make the kidney disease worse ... and probably quite fast. Pain killers are loaded with by-products and toxins that healthy kidneys need to deal with. In kidney disease, the kidneys are already over-stressed and cannot cope with normal by-products and toxins from food and other things, so the pain killers will simply overload the kidneys (and therefore the dog's body and blood) with more toxins. There is a necessity to be judicial here, as the kidney disease and the tumors could be causing pain - so giving it (a pain killer) will help provide a shorter but better quality of life, while withholding it will ease stress on the kidneys and give all involved a chance at treating/managing the disease. The blood pressure test is still needed, as high blood pressure will also impact on blood flow through the kidneys and cause a more rapid deterioration. Reading between the lines, I feel your vet may have given up on your dog, and may be just treating the pain (anticipating a quick decline in health). Did he give you any diet advice? The food you are giving is very inappropriate for later stages of kidney failure. I would suggest you get a second opinion from a different vet, unless the road the current one is taking you down is the one you are contented with.

Tony

[snoopsmom]

Hello,
Here are some of the blood test results.

BUN/UREA>> 130 mg/dL
GLU=148 mg/dL
PHOS>> 16.1
EOS 0.01(LOW)
PLT 498 K/ul
MPV 8.6 FL (LOW)

I have only posted the items that are not within the normal range.

[tonyb286]

Hi. And what about blood pressure? This is really important. Another urgent question ... why is he on pain medication? That will almost certainly make the kidney disease worse. Can you check the results for Creatinine please ... if that's not high, then there's a question about the diagnosis. Phosphorus is way too high ... you should try controlling this in the diet for now, by feeding low phosphorus foods.

Tony

[snoopsmom]

Thank you Tony for your detailed response. It is chronic renal failure, and I was told his renal values from the blood tests were off the charts. I will request the copies to post here. He has improved since my first post, he ate some food and he is moving around. They gave him pain killers and famotidine to take at home.

[tonyb286]

Hi and welcome to our family of friends here. Firstly, all dogs on (drip) fluid therapy usually get worse before they get better. It takes several days and sometimes longer of IV infusion before the blood numbers start to improve. It's worth stating, that not all dogs improve, as sometimes the kidneys are just too damaged, but it's definitely worth giving this time.

You haven't stated whether this is Chronic or Acute renal failure. What has your vet told you?

The vets must have taken blood readings to come to their conclusion. Did they give you a copy of the results? If yes, please post them - if no, ask for a copy so you can post them.

If he isn't eating, they need to get him on an anti-nausea medication AND an appetite stimulant AND maybe also get nutrition into him via the drip. They also need to perform a blood pressure check, as high blood pressure is common in kd dogs and is very damaging (the kidneys will shut down faster without treatment for it).

Okay, There's lots more I could say, but I think that's enough for now. This is the first hurdle to overcome, if you can.

Tony

[tonyb286]

Please read my article here, if you have the time: http://www.infobarrel.com/My_10-Point_Plan_for_Dogs_with_Kidney_Failure