Slow progression of kidney failure

[gretchensmama]

My 14-1/2 year old German Shepherd mix was diagnosed with kidney failure last summer.  She has been on several medications for high blood pressure (enalapril & amlodipine), another for pain (tramadol) and for occasional pancreatitis and nausea, I have recently been giving her Pepcid AC.  Apparently we caught it fairly early, as she is doing fairly well and has even survived a 3 month trip to Florida in an RV.  She goes through occasional bouts of not eating for a few days, but then will eat - somewhat selectively - quite normally for a few days.  I can't get her to eat the prescribed diet of K-D dry and canned, so we tried the kidney regimen provided by Purina.  This is not to her liking either.  Since last summer, she has lost about 10 pounds (from 51 to 41).  Rather than continuing to give her the prescription diet, I cave in and give her what she will eat.  She has gradually gotten weaker in her back legs and does a lot of sleeping...she's quite deaf, so she sleeps VERY soundly.  She's always in close proximity to either me or my husband and becomes anxious when we get out of her sight.  
A lot of the posts I've read described the quick downward spiral of dogs that have been diagnosed with kidney failure.  Are we just lucky that it was caught in the early stages of the disease?  I know that the outcome will be the same whether it takes days, months or more, but is this typical for an early diagnosis?  I don't know what stage of failure she's in, but when the time comes, I'm hoping I have the courage to allow her to leave us with dignity.  She's been too good of a friend for me to see her in pain. We got her at the Humane Society when she was only a year old (+/-) and she's been the absolutely best dog I've ever known.  
From the comments I've read in the forums, I know what lies ahead, and although it frightens me to consider her future, I'm thankful for the information that has been discussed.

[gretchensmama]

Thanks for your input regarding Gretchen's situation with kidney failure.  I don't know how old or what breed your dog is, but am wondering if that may have been a factor in it's recovery.  Gretchen has always been a picky eater and the prescription diets literally make her turn up her nose and walk away.  When I have been able to get her to eat it, she may go 2 or 3 days, then refuses it. We haven't tried the Royal Canin variety, but I'll check with my vet to see if she can get some. I'm willing to give another brand a try, of course.  She's been eating her regular food quite well the past few days and even though it might not be the best thing for her, it makes me feel better to know that she isn't starving to death. I gave her some of the prescription food mixed with chicken yesterday morning and she threw it all up about 15 minutes later...it was also mixed with the binder that my vet gave us, so that didn't make it down either!  It's frustrating, so I'm just treasuring the times when she acts like her old self.
I've also read in previous posts, about a drug called Azodyl.  I plan on asking my vet about it when I ask about the Royal Canin prescription diet.  We'll see what happens next - and thanks again for your encouragement.

[ginger899]

Kidney Failure comes in "stages". If it's caught in the very very early beginning stages, then treatment and diet can stabilize kidney function. It's "incurable" of course (meaning that kidneys cannot repair themselves, like some organs can -like the liver) -so usually, by the time kidney failure is diagnosed, 75% of kidney function is lost. So all there is to work on is the remaining 25%. It's a question of getting that 25% to stay that way for as long as possible. It can be "managed" like that, but full function can never be restored.

Now most dogs won't show many symptoms at all until the nausea starts, and they go off their food. By that stage usally they are past the early stages. I was just lucky in that my dog's early symptoms were obvious. She started drinking more, and she never was a heavy drinker, so I really noticed it. Also I was lucky because she shares a bed with me, so the wetting the bed thing was blatantly obvious!
But with some dogs, the owner may not notice those early symptoms. If they already do drink a lot, for example, or if they spend most of their time outside, or stay in the yard or garden a lot (so their increased peeing gets missed)
Sometimes little "leaks" mght be attributed to something else....such as "getting older" or even "spay incontinence" or even a mild UTI.

But if the kidney failure is found at a late stage (as many are) things are different, and there is often not much time, and of course, no going back.
Then the only thing that can be done is medication to ease symptoms for as long as possible, and at the end, the kindest thing to do is to have them put to sleep, as their bodies fail utterly.

I KNOW you did the right thing with Tracy. She was at a very late stage. It was through no fault of yours (any more than it was MY fault when my other dog developed Prostate cancer and he was at late stage, and in the end I had to have him put to sleep) Yes I had a lot of "what-ifs" as well (what if I'd had him neutered when I first got him, age 10 months or so) But the fact is he had a lovely happy life, and that life was one of the best a dog can have.
I honestly don't think your Tracy would have swapped a moment of her life for anything else.

[2sad2dal]

Why reading this post gives me reafirmation I could have saved Tracy? Her only bloodwork we ran in years and her last too had everything lethal almost out the scale but still; reading this i know there was something i could have done; no use beating myself up now; this is exactly that "feeling" I was posting before I felt all over me while i was terminating her suffering; vet said we did not caught her in the earlier stages but vet also said she could have "maybe" get stable if we would attack the decease that very night of March 27; only 4 days later, "I decided" to put her down out of "love"...well it still hunts me this decision..it does not go away; it breaks me in half every time i think of it and what no.
My recommendation to you G, do whatever you need to do for your companion, even if you are told there is not much to be done; there always is; look at my own posts here; read the pain I am in and many others because we were convinced ourselves there was nothing to be done; I have spoken with a vet since Tracy went; she have told me it all always depends on how much the owner is willing to sacrifice, economically, which i did not and now i regret it sooo much...do your best even if you are convinced you need to do your worst..once those drugs are pushed in only in 4 seconds or so, there is nothing you can be done then..then you will be for God knows how long just like me, wondering what if.

[ginger899]

Kidney Failure does NOT always have to be a death sentence just waiting to happen, no matter what their age. Mine was diagnosed with very early-stage Kidney Failure last October, after I noticed she was drinking more water, and had started to wet her bed quite often (otherwise she seemed very well!)
Her Creatinine and Blood Urea Nitrogen were both slightly elevated, but she had no elevation in blood Phosphorus, which was a plus.
So immediately the vet started her on ACE inhibitors. (Benazecare 5mg) Immediately I started her on a Prescription diet (Royal Canin Prescription Renal diet both canned and dry food) and was very strict about it, only allowing her what the vet said might be OK for her in moderation (that was egg, and chicken breast and small amounts of certain vegetables, like potatoes, green beans, spinach, greens, and carrots) That was all she got. NO treats except tiny pieces of apple, and bits of her kibble.
What we had to consider was any food which had the potential to produce what is called "nitrogenous waste" (which ailing kidneys cannot filter, and this waste ends up in the bloodstream, causing other symptoms such as lethargy, nausea, anorexia etc) And also any foods with high Phosphorus content (this isn't so vital if the Blood Phosphorus is not elevated)


Now the end of the first month, the vet re-ran her bloodwork, and found her Creatinine and BUN had come down slightly. It was encouraging. The next month, they had come down to the borderline of "normal" and "elevated"....in February they had come down to "upper normal"....and 2 weeks ago, the vet said they were both now absolutely normal, and if he had seen that bloodwork witout knowing the history, he would have had no reason to suspect any Kidney issues at all! We hope she will stay stabilized like that for quite some time to come. The trend is positive.

So what I'm saying is caught early there is REAL HOPE!  But the treatment and diet should be started immediately with no wavering.
Phosphorus-binders such as Calcium Carbonate or Aluminium Hydroxide may be prescribed (or if Calcium Carbonate should be used, you can make your own for no cost, from powdered eggshells!

It's partly the excess Phosphorus (which most protein foods and many other foods contain)which can make them nauseous. If that is kept under control, their appetite will be better. Look for low Phosphorus options when adding any vegetables or anything to her diet food. There are lists available online of how much Phosphorus foods contain.

Unfortunately, the Kidney diet foods are rather bland (although I must say the Royal Canin smells quite nice to me)....and some dogs are not so keen on them. Mine, being very food-oriented -I had no problem with at all. She ate the food very happily.
To add variety to her canned and dry food, I also add some cooked green beans or carrot or potato as well sometimes.

[MaxMabi]

Bless your heart. I know nothing about what you are going through, other than I know what it is like to have your best friend be sick, and YOU are their reason for hanging on. Warm hugs from me and Wet Kisses to Gretchen from Max & Mabi. AND bless you for rescuing her and giving her a wonderful life.

M&M's Mom.