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Old June 8th, 2007, 01:23 AM
seigle seigle is offline
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Kidney failure in dog - Answered by Dr. Lee

Hi Everyone.
I have a male dog, 12 years old.
During the last month or so, we saw that he drinks more than usual, and gives more urine than usual.
A few days ago we took him to the vet. He said it sounds like kidney problems.
We took blood checks. The vet said that according to the results he has 2/3 % kidney failure.

This is not my regular vet, so i would like to have another opinion, as to the percentage of failure, and if it might be caused from something else.

Attached are the blood results.

Do you have suggestions of what to do in such a case - i was advised to use a specific brand of dog food special for kidney problems.

Your help would be greatly appreciated!
Michelle.
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Old June 8th, 2007, 10:56 AM
jawert1 jawert1 is offline
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When my Pointer Simon had kidney issues (urine wouldn't concentrate), our vet put him on Hill's Prescription Diet c/d. Please make an appointment with your regular vet immediately and take those blood results with you. Your vet will likely recommend further testing, and possibly a special diet they can sell directly from their office, which I highly suggest you use. Normally I'm a huge fan of going with higher quality kibble or home cooked, but during my search for (IMO) a better quality than Hill's for Simon, I came up with next to nothing. He recovered quite nicely, though he wasn't in a failure state, and I suspect that by following your regular vet's advice, your pup will be ok. Good luck, please post back when you find out from your regular vet what's going on and what your course of action needs to be.
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  #3  
Old June 8th, 2007, 12:50 PM
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mummummum mummummum is offline
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I have a recipe or two which I'll put int the Dog Food - Recipe forum specifically for dogs with kidney disease and failure. I recall doing an internet search for a friend who has a dog prone to oxalate stones and was able to come up with a number of receipes in the 14-16% protein range.

Last edited by mummummum; June 8th, 2007 at 01:15 PM.
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Old June 8th, 2007, 02:23 PM
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Dr Lee Dr Lee is offline
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Good morning Michelle,

In taking a look at the blood work there kidney levels are high. Was a urine test performed? While the blood work is supportive of kidney failure, a urinalysis is usually needed to confirm the diagnosis. It may also help offer further treatment option.

Diet information
I will break this into two types of suggestions.... 1) prescription diets and 2) general recommendations with regard to holistic diets.

1) Science diet k/d is the diet for garden variety kidney failure. c/d would be useful if a pH problem is also present.

2) What is necessary in a kidney diet? Some of the general principles include a low protein diet (protein is cleared through the kidney and so the less the better) (a NO protein diet however cannot work, the body will start to break down its own muscle); also low phosphorus is important to relieve stress on the kidneys, and having a diet rich in omega fatty acids can help to improve kidney blood flow.


General kidney options
A couple new medications have become available and are nutriceudical. Azodyl is a great supplement which creates enteric dialysis (that is it pulls the urea out of the blood stream). How it works: a strain of lactobacillus bacteria which degrades urea nitrogen products. It is made from vetquinol. See the website www.vetoquinolusa.com Also Epikitin is a phosphorus binder which you can place on the food.(same company). Have had a few patients do well on this.

Further workup
In kidney failure there are many different underlying causes as well as secondary problems which need to be addressed. Causes range from idiopathic degeneration (old age), infections, inflammatory diseases, toxins (the recent food recall; also some chronic exposures can lead to chronic kidney disease – such as raisins and grapes), cancer, etc… Understanding what the underlying cause is may help to provide a more clear plan to help the doggie out.

Secondary problems include systemic hypertension and hyperparathyroidism. In light of the blood test, I am concerned about the parathyroid. I would recommend that you talk to your regular veterinarian about further options – blood pressure, further blood and urine testing, and diagnostic imaging (ultrasound and radiographs). At least a urinalysis and blood pressure...

The good news,
There are a lot of options. An answer of ‘your dog has kidney failure; here’s a bag of k/d” is not appropriate. If he/she was a human, the doctor wouldn’t say “you have kidney failure, don’t eat a lot of meat, and good luck”. There are so many ways of helping these guys out and sometimes to a normal life expectancy with great quality of life.
Hope this helps. Good luck.
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Old June 8th, 2007, 11:33 PM
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sugarcatmom sugarcatmom is offline
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Quote:
Originally Posted by Dr Lee View Post
Good morning Michelle,


Diet information
I will break this into two types of suggestions.... 1) prescription diets and 2) general recommendations with regard to holistic diets.

1) Science diet k/d is the diet for garden variety kidney failure. c/d would be useful if a pH problem is also present.

2) What is necessary in a kidney diet? Some of the general principles include a low protein diet (protein is cleared through the kidney and so the less the better) (a NO protein diet however cannot work, the body will start to break down its own muscle); also low phosphorus is important to relieve stress on the kidneys, and having a diet rich in omega fatty acids can help to improve kidney blood flow.

Hi Dr. Lee, thanks for being so generous of your time and knowledge, and welcome to the board! Although I don't currently have any pets with renal issues, I'm interested in what you think of some more recent theories that less focus should be put on the amount of protein consumed, and more on the quality of the protein. These references in particular caught my attention:
Part 1 NEW INSIGHTS AND TREATMENTS OF KIDNEY DISEASE
Part 2 MANAGING A RENAL CRISIS
Mythology of Protein Restriction for Dogs with Reduced Renal Function PDF

Also, at what point would you recommend subQ fluids?

Hope that you stick around here, it's actually not a bad place to be.
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Old June 9th, 2007, 11:44 AM
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Dr Lee Dr Lee is offline
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Originally Posted by sugarcatmom View Post
Also, at what point would you recommend subQ fluids?
Thanks for the links. I particularly enjoyed the last one. I have been to a couple of lectures on this as a myth with cats, but this is the first article I have read specifically for dogs.

As far as subQ fluids?
Obviously this is a case by case basis however there are a few guidelines. In RF cat patients, I will commonly consider subQ fluids when: appetite/attitude/overall well being declines, fluctuations in weight, if the creat/BUN is on the rise despite other medications/supplements, phosphorus levels are above 6. A lot of when to use is also based upon the client. I have some that are eager to start early and then some clients that want to euthanize once I mention SubQ fluids. There are so many options for RF patients now, and some clients will do anything and everything; however some will do Epogen injections but will euthanize at SubQ fluids and some visa versa. A lot of my goal is to figure how to make the patient as comfortable as possible with what medications the client will use.
I am very glad that there are a lot of websites out there to help clients understand the use and benefits (and dangers!) of at home therapies like SubQ fluids.

Again - thanks for the links. It is important try to dispell myths - it is funny how many of them there are in a scientific based setting like medicine. But having fallen for a few myself, it can be scary to trangress a myth. You keep telling yourself going a better direction will help the pet but all day want to throw salt over your left shoulder or something!
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Old June 9th, 2007, 05:27 PM
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sugarcatmom sugarcatmom is offline
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Quote:
Originally Posted by Dr Lee View Post
A lot of my goal is to figure how to make the patient as comfortable as possible with what medications the client will use.
It must be very frustrating sometimes trying to find that balance between what a client is willing to undertake and a therapy you know would benefit their pet. I certainly don't envy that aspect of vet med! With my own cat being diabetic, I constantly encounter people that are amazed someone would be willing to give an animal insulin injections twice a day for the rest of its life. For me it's a no-brainer, but I realize that isn't always the norm.

Quote:
I am very glad that there are a lot of websites out there to help clients understand the use and benefits (and dangers!) of at home therapies like SubQ fluids.
Although at the same time, there can be such a huge amount of info, some of it very conflicting, that I can see how people would get confused and overwhelmed by it all. It's still important to have a good relationship with your vet and to be able to work together sorting through it all. Which also makes me think that the best kind of vet is one who's eager to learn all throughout their career and doesn't just "close the gates" as soon as they're finished school. Kudos to you for being in that category!
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Old June 9th, 2007, 06:43 PM
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Dr Lee Dr Lee is offline
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Thanks. For the people that have been welcoming here - I am excited to hear everyone's point of view. It is nice to be able to discuss with pet owners outside of the room. It allows for a different perspective.
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  #9  
Old June 10th, 2007, 10:09 AM
seigle seigle is offline
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Thank you!

Hi Everyone!
Thank you very much for the responses and all the help.

mummummum-
I saw the recipe for home cooked food against kidney problems. Thank you very much for that!
What is the meaning of "14-16% protein range". How do i know whats the range my dog needs?

Dr Lee - thank you for the great answer! a urine test was performed. The only thing that the vet told me from that test is that there is no urine infection. He did add me any information regarding the kidney status.

Regarding the medicine - the vet did not say anything about medicine - just about the K/D food.
I thought that the main reason for the kidney was my dogs age (12) - but you say it might be connected to his parathyroid.
I will check this with my vet - but if this is true - what can be done about it?

Another thing - what is 'subQ'. I didn't get a chance to read the articles posted by sugarcatmom yet - but i guess i will get to it latter today.

Again - thank you so so much!!!

Have a nice week,
Michelle.
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  #10  
Old June 10th, 2007, 01:21 PM
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mummummum mummummum is offline
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Well Michelle I appear to have been labouring under the same misconceptions as many Vets and dog people. I encourage you to read the articles first ~ they are VERY informative and the last one goes far to question the common veterinary practice of reducing protein from the avg 24-26% (normal in kibble) to 14-16% range for dogs who have kidney issues, are prone to stones etc.

SubQ simply means subcutaneous (an injection just under the skin).
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