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Sue.k
21st July 2011, 10:50 PM
Hi Everyone, I havent been on in a good while but I could really do with some help, I have just found out that my presious Prince has kidney failure and hasnt got long, I have to make the decision on what to do. I really cant bare to see him like this, its all happened in the space of 4 weeks. I noticed he wasnt eating his food so I thought he just didnt like it so I changed it, I then thought that maybe it was his teeth. I brought him to the vet this morning and the news was just unreal, I cant come to terms with it, he has lost so much weight and is just lying around the place, he is on my lap now as I type this and the only thing moving are his eyes. The vet said it would be kinder to him if he was pts, this is all happeing too fast, has anyone else gone through this, how did he get kidney failure, what causes it????

Piper
22nd July 2011, 12:07 AM
So sorry to hear that! I can't answer your questions but I just wanting to offer support. IMO If he is suffering I would put him down. I know that's so tough but if there is nothing they can do then you shouldn't let him go through it any longer than necessary. My thoughts are with you.

GraciesMom
22nd July 2011, 12:16 AM
Just want to be here to support you and so many here have had to make these tough decisions. My heart goes out to you and Prince. I know that I would be devastated.

Karen and Ruby
22nd July 2011, 12:20 AM
I don't have any advice as I haven't been through anything like this but wannted to say I'm thinking of you and little Prince!

You are in my prayers xxx

Pat
22nd July 2011, 12:23 AM
I'm sorry to read your news. Yes, I have had dogs with kidney disease/kidney failure - three dogs in the past and one current dog (almost 14 years old) who have had kidney disease. It appears that your boy is about ten years old? Does he have heart disease? Is he on any meds such as heart meds or any NSAIDS for arthritis, etc. When is the last time that you ran blood chemistry before today? Do you have a copy of the current blood chemistry report? Was a urinalysis done and do you have those results? If you had copies of all of the tests, I would be able to stage the kidney disease and I'd have a better idea of the prognosis.

Here are some basics, and I'll try to keep it simple. There are several kinds of kidney disease (the three most common are chronic kidney insufficiency caused by aging organs or heart disease or other systemic disease such as hypertension; glomerulonephritis which is when the kidneys leak protein which causes nephrons to die and which can be autoimmune; and acute kidney injury which can be caused by toxins, drug reactions and various other things and which can in turn lead to chronic kidney insufficiency. There is also JRD - juvenile renal dysplasia - which is caused by kidneys that are not properly formed at birth. We had a member here lose a young Cavalier from JRD.

There are absolutely treatment options that can either reverse kidney disease or allow the disease to become stable and pretty well controlled. But it takes a commitment from the owner in concert with working with a vet who is committed to trying treatment options. Many (most?) vets will simply give up especially with a senior dog or cat, so often the owner must be very proactive if he/she decides to attempt treatment. There is absolutely nothing wrong with an owner making a decision not to attempt treatment because of the financial commitment or the effort involved, etc. It is a perfectly valid decision to let a beloved pet go. It is also my experience (through being a member of and a moderator of the yahoo K9KidneyDiet group which has several thousand members) that vets in the UK are almost always reluctant to agree to some basic treatments that are done routinely in the US such as allowing clients to administer subcutaneous (subq) fluids at home.

There is a terrible thunderstorm going on here so I'm going to post this and then type a second post so that I don't lose what I've already composed. More will appear in a few minutes.

Pat

Sydneys Mom
22nd July 2011, 12:39 AM
Sorry about your terrible news. Like others before me, I have no advice, just wanted to wish tor the best and offer my prayers and support.

Pat
22nd July 2011, 12:50 AM
With chronic kidney disease, the failing kidneys become less and less able to clear toxins from the blood. Symptoms are subtle (and blood chemistry is normal) until the kidneys are functioning at about 25% capacity and then you start to see the classic signs of anorexia, nausea, vomiting, lethargy - basically the dog just feels really awful - just as you describe Prince. This is because of the toxins that have failed to be removed by the kidneys through the urine. (This is one reason to do regular monitoring urinalysis and blood chemistry especially for senior dogs.) With acute kidney disease, something hurts the kidney functioning quickly and severely, and the dog displays the same symptoms as above.

The blood chemistry values that you want to see in particular are creatinine (directly measures kidney functioning), BUN or blood urea nitrogen which indicates dehydration, and phosphorus. High phosphorus is generally what causes dogs to feel nauseated, anorexic and just plain horrible. Phosphorus is normally eliminated through the kidneys, but the failing or injured kidneys cannot clear this mineral. Urinalysis will show protein loss through the kidneys (glomerulonephritis or protein losing nephropathy - PLN) and will show infection (which could cause acute kidney injury) and other things. Urine specific gravity measured by urinalysis is a value that shows exactly how well the kidneys are concentrating urine. (I have a digital refractometer at home where I can measure my dogs' USG on a routine basis.) Kidney disease shows on the USG long before it shows in blood chemistry and long before there are any symptoms which is why routine urinalysis can be very helpful. The blood chemistry results, particularly those three values I listed, will help the vet to stage the disease (there is an IRIS staging chart that is used internationally by vets - and I can give a link). Staging the disease gives a clue about prognosis. Generally early stage will show milder symptoms but this isn't always the case, esp. when the phosphorus is sky high but the creatinine isn't terribly high.

If the blood chemistry values can be lowered through treatment, the symptoms can dramatically get better and stabilize with continuing treatment.

If the kidney disease is acute, one would want to rule out pyelonephritis (kidney infection - not to be confused with UTI). That can be diagnosed by ultrasound, and the vet would start major antibiotics along with the other supportive treatment. The other rule-outs for acute kidney disease are leptospirosis and tick borne diseases - so one would run those tests. Acute kidney injury can also be caused by NSAIDS - rimadyl, metacam, etc., so one would stop those drugs to see if the injury would improve. Heart meds can also be implicated, especially furosemide and digoxin, so that must be considered.

I have made long posts in the past about this to Misha the Pooh and Janice among others, so you could search for those posts. I'm posting this and will write another about treatment options.

Pat

pippa
22nd July 2011, 12:57 AM
So sorry. no advice either. but wanted to say that I'm thinking of you and Prince :hug:

Pat
22nd July 2011, 01:34 AM
Treatment - Rule out lepto, tick borne diseases and pyelonephritis - if these diseases are a factor, administer appropriate antibiotics. If a PLN is diagnosed, start enalapril or benazapril which helps with the protein loss.

Supportive treatment to alleviate symptoms:

Depending on blood chemistry results - consider hospitalization for an IV fluid flush. This flushes out the toxins and lowers kidney values listed earlier which in turn helps resolve symptoms. (Think of "poor man's dialysis.")

Subq fluids can also be given but they generally aren't as fast acting as an IV flush because they are given more slowly. Often subq fluids are given at home to follow up - on a regular basis usually for the life of the pet. When done correctly and purchased from a medical supply company, this is quick, easy and inexpensive and animals (especially small dogs and cats) tolerate this well. I gave subq fluids daily for one and a half years to my Cavalier (Capers), and I am currently giving every other day subq fluids to my 13+ year old Polly (Shih Tzu) who is in very early chronic kidney disease. Polly's disease was caught quite early, in Jan of this year, before any symptoms, by routine urinalysis and follow up blood chem. Starting treatment early can make a huge difference in outcome. She will be on subq fluids for the rest of her life, which could be years. In the US, clients give subq fluids at home routinely. I do not know why UK vets are so resistant to this, but they are. (For people with cats with kidney disease, see Tanya's UK Feline Kidney Disease site - it is a wonderful resource.)

Diet change - is paramount in controlling symptoms and in quality and quantity of life. A low phosphorus, moderate protein diet must be fed. This can be through commercial kidney diet or home prepared diet. My Polly is eating commercial kidney kibble, but often dogs with serious symptoms will not eat commercial kidney diet because it is not very palatable and they already feel nauseous. Home cooked diet is very useful in these cases. Commercial kidney diet is very high in fat so if a dog is prone to pancreatitis, a home prepared diet is best as it can address both issues. Polly has done well on commercial food for about 7 months.

Phosphorus binder - this is given immediately after meals to help bind the phosphorus in the gut and remove it so the kidneys have less phosphorus to remove through the urine. Aluminum hydroxide is the most effective binder. It is fairly inexpensive.

Drugs are given for nausea (reglan, pepcid, lots of other newer drugs that I haven't used) and also to coat the stomach and prevent ulcers (carafate, sucralfate). These help the dog to feel better, esp. until the diet change and fluids can help the kidneys to better clear the toxins and the kidney disease to improve.

Supplements - certain supplements will help lower creatinine and can also help with PLN kidney disease - notably omega 3 fish oils, CO-Q-10. B vitamins are given to help with anemia.

I can elaborate on my dogs (two recovered and did well, dying years later of unrelated causes; one did not respond to treatament and was euthanized - he had acute kidney injury, likely pyelo, and we just couldn't turn it around; and little Polly is doing very well - one would not know that she has chronic kidney disease).

Kidney disease is completely overwhelming when you are blindsided by it and know nothing. If you already have a background, it is much easier to address. Just like MVD, early detection and knowledge are key. Specialty care and/or a cooperative vet are also essential. Again, there is no "right or wrong" decision about electing to pursue treatment or deciding to release your pet peacefully, and individual situations can be very different. Because I have had successful outcomes, I'll likely always pursue diagnosis and treatment. You can't predict success or failure - my Capers should not have lived, and he did very well. On the other hand, I did everything possible for my beloved Nominee and spent thousands of $ (no insurance) and lost him very quickly.

My thoughts and prayers are with you and Prince.

Pat

Zumie05
22nd July 2011, 02:17 AM
I truly am sorry for this situation. Two years ago I lost my Rottweiler due to kidney problems also - we thought his anorexia and lethargic behavior was because he was home sick (he was at a different house for several weeks when symptoms began) and by the time we had him at the vet his kidney's were just not salvageable...it was awful.

I am so glad you guys were able to get to the vet and have time to weigh your options, I had one hour to decide what to do with my boy. He was pts at only 3 years old.

Blondiemonster
22nd July 2011, 02:21 AM
So so sorry. Im glad pat wrote what she wrote and i hope you will be able to get him treatmemt if thats what you want... We r all here for you!

mishy
22nd July 2011, 02:52 AM
My heart goes out to you I like many on this board have been faced with the decision to have my beloved cavalier pts. You have got a shock, I knew for a couple of weeks that the day was approaching but it didn't make it any easier when that day came. Read over your first post again especially the way you describe Prince lying on your lap. I'm sure you don't want him to suffer on and have no quality of life. Talk to the vet later on today and if there is no treatment available be strong and do the most loving thing you can do for Prince - let him go.
Whatever decision you make everyone on the board is here to support you.

BrooklynMom
22nd July 2011, 06:17 AM
I too have no advice...but I just wanted to say that I am thinking of you and I am so sorry the you and your cav have to go through this. Sending prayers your way.

Sue.k
22nd July 2011, 10:41 PM
Thank you all so much for your support and advice. We had to let Prince go earlier this evening, there was nothing that could be done for him, the vet said they could hook him up to a drip for the weekend but we would have to face this in a few days time anyway. He was just too sad, it was killing me to see him like that, he wasnt happy at all, he was starving to death also because he had no interest at all in food which was just not him, he would normally inhale some tuna but he wasnt even interested in that. I miss him so much already but i do really feel I done the right thing for him, I have had him since he was 12 weeks old and I just know he wasnt happy, it was like he was depressed. I am a bit worried about Lucy, will she miss him, will she be crying for him? She is deaf and Prince was her ears for her, do dogs grieve? Pat, thank you so much for all the information you posted, it was much appreciated.

gamefanz
22nd July 2011, 10:49 PM
I am so very sorry for your loss. I'm sure Prince is at peace now and he is happy:hug: My thoughts going out to your family and to Lucy:hug: I hope Lucy will be ok.
Becky

Blueroses
22nd July 2011, 10:51 PM
My heartfelt sympathies in your sad loss today. :(





I wish I had not posted about my happy day today now, Im sorry

Love my Cavaliers
22nd July 2011, 10:53 PM
I am so sorry. At least he is at peace now even if your heart is not yet. I hope Lucy will be o.k. I imagine it will be difficult for her. Run free Prince!

mishy
22nd July 2011, 11:23 PM
So sorry for your loss Sue, my thoughts are with you.

Nicki
22nd July 2011, 11:31 PM
So terribly sorry, catching up now - this is just tragic. You did the most loving thing for Prince, a very hard decision to make but as you said, he wasn't happy and it was the kindest thing to do - it sounds like your vet was very wise and gave you the appropriate advice.

I haven't read all the way through but I'm sure Pat will have told you that it is very hard to pick up in the early stages, so please do not feel guilty that you may have missed anything.


Perhaps when you feel up to it you would like to start a post "in memoriam" and I'll move these posts across.



I'm sure Lucy would have known that Prince was very poorly, my dogs have always known this, so although she may be a wee bit confused, she will adjust. Try to keep her in routine as much as possible, feeding and walks at the same time - this will help you too.

She will find it hard managing with deafness when she was used to a hearing companion - Rupert found that adjustment difficult - so you will need to be extra aware of her, maybe time to start teaching her hand signals if you have not done so already. In the house and garden deaf dogs manage very well, you just need to be extremely careful when you are outside - I'm sure you know all this anyway.



Take care - we are all thinking of you at this sad time.

Desrae
23rd July 2011, 12:56 AM
I'm so sorry about Prince. It must have been such a harrowing decision, but you did the right thing. Run free Prince.
Your girl will grieve, I think that dogs grieve like we do. You'll be there for her and she for you.

Jasper and Holly
23rd July 2011, 07:39 AM
So sorry you had to let him go but you did the right thing even though it's heartbreaking. My heart goes out to you.

pippa
23rd July 2011, 12:43 PM
So sorry, my thoughts are with you and Lucy. You did what was right for your boy xxx

Margaret C
23rd July 2011, 01:27 PM
At the end making the decision to let them go is the last act of love we can show our precious dogs.

I am so sorry for your loss.
RIP Prince

Cathy T
23rd July 2011, 05:04 PM
I'm so sorry to read about Prince. Letting him go sounds like the kindest thing you could do for him. I'm sorry for your loss :(

Sue.k
23rd July 2011, 10:12 PM
thank you all so much for your kind words. Today has been so difficult without him, I just keep crying. Lucy woke early this morning and she was crying also, she never normally does this, my heart is just broken. I am sure it will get easier but I really cant imagine how it will, I love Prince so much, he was the best. I know i done the right thing for him, he is happy now.

GraciesMom
23rd July 2011, 10:50 PM
No words ever seem to be enough. Wish I could give you both a real hug! Prince will always be waiting at the bridge..

mommytoClaire
24th July 2011, 06:44 AM
I'm just catching up on posts also, and was so sadden to get to the end of this with the decision you had to Jairo. Having had to make that decision just a couple weeks ago for Claires companion, my Nash, I know full well how painful it is.My heart and thoughts are with you as you adjust to a different life, and try to overcome your grief. So very sorry about your boy.

Sandrac
24th July 2011, 06:55 PM
So sorry to hear that you have had to give Prince his wings. His memory will stay in your heart forever.:hug:

Tania
24th July 2011, 07:25 PM
I am so sorry for you and Lucy, my heart goes out to you both.:hug:

lovecavaliers
24th July 2011, 08:46 PM
So sorry for the loss of your sweet Prince. May he rest in peace. I hope you find some solace in the happy memories you have of him and that you did the ultimate unselfish act, by setting him free from his pain. Again I am so sorry.

Spangly
24th July 2011, 09:24 PM
I am so very sorry for your loss. Sending you and Lucy our love, take care of one another. Run free Prince.

susandavis1
24th July 2011, 10:11 PM
I am so sorry for your loss. Run free sweet Prince

Janice
24th July 2011, 11:46 PM
I have only just seen this :(

It was me who had the pup, Reuben, who had the JRD. It was discovered during a routine castration operation December 2009 and he went rapidly downhill during the next week. Finally he was in at the vet to have a large lump drained that came up on his neck from constant injections while being flushed out, and the vet rung on Boxing Day and said that his levels were back from the lab, and were higher than they were to start with.
So failing having him flushed out every week, she recommended he be pts. So we decided there and then as he was already under a light anesthetic for the drain, it would be kinder to do it at that time.
He was 10 months old :(

I still feel guilty that until we discovered it, how ill had he been feeling?

I know how you feel and you have done the very best you could do.

Reuben will meet Prince at Rainbow Bridge and Prince can look after my puppy. x

Pat
3rd January 2013, 05:42 PM
More kidney info - but mostly about chronic kidney disease.

Pat