My dog has Chronic Kidney Disease.

[Skyegy]

Okay, I need to know what to expect now.

A year ago on August 15, 2012, I lost one of my shih tzus to kidney failure.she was 12 years old at the time. Not much meds were given to her because when we had her checked to the vet, they said she needs 3days IV fluids. It was that severe. She had to be confined in the hospital. So we made the decision to allow it, could have probably been the worst decision I have made since it made her sad. And the 3rd day when I was allowed to take her home, on my way to the vet, the hospital told me she went unconscious. After minutes of trying to bring her back, she passed. And it broke my heart, because she died without me beside her.

So the real purpose of this thread though is because of my other shih tzu dog, he was the mate of the one that passed a year ago. Last August, he showed signs of stiffness and could not move for days and we sent him to the hospital. The vet said he'll be fine, but in between the bones of his spine, the fluids are depleting, due to old age. They could not give him steriods because of a problem with his heart. The vet suggested therapy. We did not go through with that because his spine healed by itself. He can now run around the house!

Along with the xray, he had an echocardiogram to get his heart checked, it was because his heart had murmurs and it had an abnormal shape from the xray. He had findings there of a heart disease, something with an enlarged ventricle. And he is not allowed to get tired, the vet suggested that his heart problem is still manageable without the medicine. So, he will not prescribe any at that point.

The vet also carried out a blood test. Unknown to us all, the blood test came out fine except for that one thing, his kidney was below normal, and the vet suggested to let him drink more water. 2 weeks after, his kidney function starts falling exponentially, he had to be given nefrotec. 4 weeks after that, he had to be given subcutaneous fluids every other day, unfortunately though, 2 weeks after that, the vet said his kidney is failing and one of the things they suggested is to have him on IV fluids for 3 days just like our previous shih tzu, but they wont do it because he has heart problems which might cause even bigger problems. So subqs were prescribed on a daily basis instead. He is also on a renal diet. Along with a prescription of an antacid and nefrotec.

by the way, he is being taken care of by a group of 3 doctors.

Earlier, I had problem administering the subq fluids. And it broke my heart because before, i would not have problems with giving him the shots. Right now it seems that he does not want to get better anymore. He ate very little, but would still take his meds. I have read around the internet that he might already be on a stage 4, ending stage and we cant do much about it anymore.

I have accepted that he wont be with us for long. he has the same situation as our previous shih tzu. And she died without any signs of pain, she just dropped dead. I am afraid he might just do the same for the next few days. 12 years of my life was full of love from them afterall.

So I was thinking earlier, are subqs really helpful for them? Am I right into thinking that he might not live long enough? Should I stop the subqs instead because it is stressing him out? Would it be more comfortable for him? I want him to live the rest of his remaining life without the thought of hospital and needles, and stress. I want him to play around the house instead. i just want to know how you guys, vets and dog owners alike, would handle this situation. sorry for the long post, i just thought maybe you guys should know the entire story.

[sugarcatmom]

Sorry about the kidney disease. I know how you feel as my cat has had ailing kidneys for over 3 years now.

Originally Posted by Skyegy

So I was thinking earlier, are subqs really helpful for them?

SubQs can help them feel better by flushing out toxins and maintaining better hydration.

Originally Posted by Skyegy

Should I stop the subqs instead because it is stressing him out?

Instead of stopping, maybe experiment with different ways to help him accept the fluid administration. A few things I found made a big difference with my guy:

• The type of fluids. For instance, I'm not sure why, but he much prefers Lactated Ringers over PlasmaLyte. The PlasmaLyte would make him squirm like crazy and it was a challenge getting the required amount into him. With the Lactated Ringers, he just sits and purrs, sometimes even falls asleep. Might have something to do with the ph or the electrolyte balance that caused the PL to sting. Ask your vet for a different brand or type of fluid to see if that helps.
  
• Do you warm the fluids first? Even room temperature subQs will feel cold and weird, so heating them up a bit first in a sink of very warm water is preferable.
  
• The gauge of the needle can be a big factor. Most vets seem to hand out the fat 18 gauge harpoons like it doesn't matter, but you can get finer needles (check out home medical supply stores - as a bonus, they'll probably also be cheaper). I like the Terumo 21g Ultra Thin Wall (UTW) ones (the higher the number, the thinner it is). More comfortable going in and the flow is still quite fast. 22g is also okay but the flow is a touch slower and if you have a squirmer, the faster one might be a better choice.
  
• Make sure when you're giving fluids that your pup is in a comfy spot, hopefully even a little bit sleepy (like after some exercise and a meal). If you have someone who can help you, have them give your pup treats and/or gentle pets while you man the IV line. Give lots of praise, even if you can't get the whole amount in.
  
• Eventually some pets will start to associate the fluids with feeling better and be more accepting of the procedure. Give it some time and see if that's the case with your guy.

Good luck! Whatever happens, your dog knows you love him with all your heart.

[Skyegy]

Thanks for the response. I did ask our vet if he could use the smaller needle, he prescribed the gauge 21 we were using a 19 before. We tried it; we successfully placed the needle, but as we open the fluid flow, he went crazy and cried all over the place. Which was odd because he didnt have a problem with the fluid before, just the pricking. We couldn't do it then, and our vet told us to take a break from injecting the fluids and just make sure he drinks a lot of water.

It was a problem, because now, not only does he not eat his renal diet anymore, he is also a bit lifeless, unlike before when he sees us, he will jump up and down, now he just stares at us.

Any suggestions as to how we can encourage him to drink more water? I placed chicken broth on his renal diet and he does eat it. But he doesnt eat the entire bowl. I place clean fresh filtered water on his water bowl but he does not drink that often anymore. As of now, i am trying the ice, and he loves it. pretty much everybody here in the house have been giving him extra attention because we think he would give up soon.

[sugarcatmom]

Originally Posted by Skyegy

but as we open the fluid flow, he went crazy and cried all over the place.

Do you warm the fluids first? What type of fluids are they?

As for the renal diet, I personally think it's totally the wrong thing to feed an ailing animal and probably makes kidney disease worse. Lack of appetite can be a huge problem for pets in renal failure, so feeding them a largely unpalatable low-protein food doesn't help. The most important thing is that they eat! My cat with CKD eats a mostly raw diet augmented with high quality (ie NOT prescription) canned. He hasn't lost any weight and always eats with gusto. The key is that the protein source be highly digestible (which automatically excludes plant-based protein, which is what's found in renal diets). Here is a link worth checking out: http://healthypets.mercola.com/sites...and-liver.aspx

[MaxaLisa]

SubQ;s are very helpful for kidney disease, but can be bad for heart disease, which makes it a difficult situation

Have they made sure that there is no tick disease, like lyme disease?

Diet is huge, and I would recommend a home prepared diet. Because of the kidney disease, I would use one put together by a nutritionist, like Sabine Contreras (that is who I use).

I am sorry that you are facing this, it is so difficult

[Skyegy]

Thanks guys for replying and offering advice. Our vet has advised us to stop the subqs for the meantime as it is stressing him out. We also stopped with his renal diet because he went on a hungerstrike for 2 days. He did not eat anything just drank water. And he shrunk immediately. We got scared and so we stopped his royal canin renal diet and gave him pure, unprocessed, unsalted, cooked organic ground sirloin instead. He even eats better than me now! Haha. he ate up two bowls once we gave it to him the first time, he must have been so hungry!

He has been eating beef for a week and a half now, but he started to not eat again. I think he is just too picky and he just got fed up with it. I honestly dont know what to feed him next. I thouht he would stick to beef forever. But I guess I was wrong.

To know that sugarcatmom's cat has had ckd for 3 years and still surviving is giving me hope. Thanks. We did warm the subqs before. I think he is just too stubborn now. That he doesnt want anything to do with his meds or maintenance.

To MaxaLisa, in his most recent general checkup which was a week ago, the vet did not diagnose any tick disease.

[MaxaLisa]

Kidney disease can cause stomach upset, which will frequently cause the dog to not want to eat.

Beef I'm guessing is high in phosphorous, which may speed the disease process - hard to tell without numbers and knowing all of the diet, which is what I use a nutritionist for.

The yahoo groups, K9 Kidney Disease, and another one K9 Kidney Diet, may be helpful.

Good luck!