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  1. #1
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    Default Devastating News

    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????
    Sue, Prince (B&T, DOB: 28/09/2001) & Lucy (Tri, DOB Unknown)

  2. #2
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    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.

  3. #3
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    Default Am not expert in kidney issues but...

    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.

  4. #4
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    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

    Karen

    Ruby - my stunning soul mate who defies the odds every day
    Charlie- my angel at heart and devil at play


  5. #5
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    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
    Pat B
    Atlanta, GA

  6. #6
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    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.
    Joyce - Proudly owned & loved by

    BellaMia (Aug. 30, 2012) My Beautiful Ruby Milo (Jan. 20, 2014) My Handsome Tri
    Sydney (
    April 16, 2000~April 4, 2012) Always and Forever In My Heart

  7. #7
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    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
    Pat B
    Atlanta, GA

  8. #8
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    So sorry. no advice either. but wanted to say that I'm thinking of you and Prince
    Gus(blenhiem) Pippin(tri) DJ(ruby)

  9. #9
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    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
    Pat B
    Atlanta, GA

  10. #10
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    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.

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