Kidney failure, how to make Nora (puppy) comfortable

[AkemiTW]

My puppy (12 years) has heart failure which is currently managed and now she had kidney failure. Dr.says the creatinine is not that high because she has lost a lot of her muscle mass. She walks, likes to go for wagon rides and car rides. My partner and I would like to do anything in our power to help her heal, feel better.
BUN/UREA = 108 mg/dL (H*) 7 - 27
CREA = 2.1 mg/dL (H) 0.5 - 1.8
BUN/CREA = 51
SDMA = 78 ug/dL (H*) 0 - 14
when I checked online this looks like stage 4. Her urine is clear

she feel vomitish and want to know if Cerenia is okay at this stage? I syringe feed Mirclevet high calorie diet and not even sure if that makes her feel bad. On top of that I make 1:1 (rice, carrot, beans): (boiled egg, chicken). I add parsley as well/

please help us make it better for our girl Nora

[metaylor]

Cerenia will help with the nausea. As far as the high calorie food, that is probably too rich. I would feed boiled rice, and boiled chicken or ground lean beef. Beef or chicken baby food would be good, too.
The heart failure and high BUN are tough together. The high BUN would be helped with sub Q fluids, but would likely add stress to the heart failure.