Kidney Disease

[SS Cressa]

Cressa was diagnosed with kidney disease back in October for her routine visit. She went in for blood work for her 6 month to check her level. The vet said they were getting worst. She is at stage 2 border line stage 3. He started her on meds for kidney disease and also kidney friendly pain meds for arthritis. We also started a kidney friendly homemade diet.

She is already 15 years and 2 months. Has anyone else gone thru kidney disease with their older senior? Did they act like they suffered?

Everything I read seems like it’s geared towards younger dogs that once you start medication and switch food they have years left. While that would be amazing! I’m just trying to figure out what to expect. 

She is still acting the same. Still has a healthy appetite, no nausea or throwing up, she demands to be included on all outings.

She does sleep more. She also needs helps climbing the stairs sometimes.
 

eta: had to correct the picture. It being upside down was driving me crazy

 

[D'Elle]

I am sorry to hear this. Kidney disease is no joke, but I am convinced that with the right care, which can be very complicated, many animals can live for years while having renal failure.

I don't have experience with this in a dog, but had a very beloved cat years ago who developed renal failure. After diagnosis he lived a pretty good quality of life for another 3 years. Not as great as it would have been without CRF, but pretty darn good. He was almost 18 when he died.  My care of him, though, was time consuming and relied on constant vigilance to his diet, his blood levels (he was tested monthly) and giving him subcutaneous fluids every day. I was very dedicated to his health and my life revolved around taking the best possible care of him.

I'm not saying it would be that way for every animal/person team. But I do think that if you want years more with her you will need to have her levels tested regularly and make adjustments in her care accordingly. there's a lot of information out there on this. I joined an online group back then for people with CRF cats, and the information I got there was invaluable to me, not to mention the support. The information I got from them saved my cat's life more than once when a well-meaning vet told me something that was inaccurate., or suggested a treatment that would probably have been fatal. You could find something like that group for dogs if you take a look. There's a great deal you can learn from other people's experiences with this.

Best of luck to both of you.

[SS Cressa]

Thank you. She is schedule for more bloodwork in June to check her levels again. 

 

She so far has outlived all of her playmates, and sibling. I feel blessed with everyday every day and she is still with me. I will definitely check to see about dog groups.

[GentleLake]

I'm so sorry to hear this about Cressa.

I have no prior experience with kidney disease in dogs, but Bodhi -- estimated age somewhere between 14 1/2 - 17, though I think he may be closer to the lower end -- was Dxed with mild CKF in early September of 2019 during a routine checkup. At the time he had some slightly elevated BUN, creatinine and NA/K ratio blood levels and some protein in his urine. Blood pressure was normal.

He's been raw fed since he came to me over 12 years ago. I was advised to make some minor changes to his diet -- no more bone (subbing ground eggshells for calcium) or egg yolks to reduce phosphorus intake and using some egg whites for easily digestible protein -- and to investigate acupuncture. She said that more frequent, smaller meals can help with nausea, so even though he doesn't seem to be having any problems with that yet I switched him from one to two meals daily. She also said I should be sure to make sure he drinks plenty of water. Being fed raw he never drank a lot (more moisture in the food), so I've been adding 1 1/4 cup filtered water to each meal.

I also started giving him a Kidney Support Compound that a friend who's a holisitic vet recommends. Also took him to a local holistic vet. acupuncturist and chiropractor. All 3 vets, btw, emphatically said to ignore outdated guidelines that recommend reduced protein diets, at least until late stages of the disease.

On his recheck 6 months later the BUN and creatinine levels (azotemia) had both increased (not good), though NA/K ratio and electrolytes were normal (good) and there was no protein in his urine (very good). Wasn't able to take him back to the holisitic vet then b/c of pandemic restrictions, but he added a Chinese herbal Rhemannia Eight Combination (Ba Wei Di Huang Wan (cheaper, btw, thru Amazon than my vet).

He's due for repeat bloodwork in August. Haven't had him staged yet but will consider then depending on the results.

So, that's where we are now. Mostly Bodhi seems OK. He was still actively doing his therapy dog visits before the shutdown. Definitely slowing down but not sure how much is due to aging (even at the lower age estimate he's the oldest purebred border collie I've had, soon approaching second oldest dog I've ever had, and I know what you mean about feeling blessed for every day) or how much CKD may be contributing. His appetite's still excellent and at least most of the time he doesn't seem to be nauseous, though he may have had a couple instances.

There is an online forum devoted to kidney disease in dogs -- https://groups.io/g/K9Kidneys I'm told from past references to it that there are tons of very experienced people there. I've joined but have to admit I haven't spent a lot of time on it yet, partly b/c of not wanting to read about advanced stage dogs that are really suffering. If there're any more increases in August I'm sure I'll begin following.

I'm in the same boat as you, not knowing what to expect and wanting to do the best for my boy. I'll do all I can for him as long as his quality of life is still good, but I won't let him suffer needlessly when there's no more I can do to make it better.

I hope we can keep in touch and share information going forward. Wishing you and Cressa the absolute best.

 

 

[SS Cressa]

I do have 4 water dishes throughout my house. I have also been adding water to her food. She gets fed 2x daily.

Im with you. I’m very much about quality of life vs quantity. 

My vet was going through her read outs which was hard for me to follow that is when I asked what stage is she at. Since when reading up it talked about stages not actually readings. 
 

My current check list is if she snubs food 4 days in a 7 day period. I feel like there should be more on the check list. So I will definitely join the group. I hate not knowing or being “prepared” even though I don’t think you can actually be prepared.

[GentleLake]

I only have one water bowl, but Bodhi rarely touched it before I added extra water. Vet felt he needed more so I started adding.

I always ask for copies of any lab work done for my records and so I can review them myself. In the past I've noticed certain things that were slightly off from reference ranges in both my own or dogs' labs. Usually the doc or vet is aware of it and perhaps watching (or not concerned about just once and would watch for later) but at least once I noticed something that my doc didn't and it made a difference. There are website where you can look for explanations. I always check them if I'm not sure about something and then also ask vet about it so I know exactly what I'm dealing with. The ppl on the K9Kindneys list seem to be pretty savvy w/ understanding what the results mean.

Staging CDK requires a different test from the ones my vet initially did. She's said when first Dxed that it was very mild but we could stage it then if I wanted to. Neither she nor my friend felt it would really tell us much more at that point so I opted to wait. She didn't mention it w/ the 1st follow up. I'll ask her (actually both of them) before the next one what they think and make a decision then.

 

[juliepoudrier]

My Pip, who will be 14 in July, was dx with early renal failure a couple of years ago. He’s kibble fed, so I immediately switched him to the lowest phosphorous commercial kibble I could find (FirstMate senior weight control).  The phosphorus isn’t quite as low as with the Rx diets, but he’s getting slightly lower protein and it’sa *high-quality* protein (vs most, if not all, Rx diets, which use corn as the main protein source). Thinking has definitely changed over the years and my preference is to slightly limit protein, but to use high quality protein, and to limit phosphorous. Pip’s bloodwork values have been holding pretty steady and I’m good with that. Eventually he may require fluid therapy, but even that isn’t a difficult undertaking. 
 

I have a friend who managed two elderly dogs with renal failure. I took care of them when she had to travel. She did homemade diets for both, tailored individually by a nutritionist. They both did really well for quite some time.

 I’ve had numerous cats who required management for CRF. Some went years on special diets and sub Q fluids. 
 

Most side effects can be managed. I always felt that as long as my pet still seemed to enjoy life then I’d do what I could to keep them happy and comfortable. 
 

J.

[alligande]

Our first border collie had kidney failure, unfortunately we only found out when it was very far gone, we had no clue there was any issue until he had a seizure. As kidney function was so far gone, we made the decision in conjunction with our vet to go for quality of life. So we opted not use an rx food as he hated it and I never asked what he ate when he was with my husband! He had 3 good months, we gave him fluids most nights but gave him the option to opt out, he hated needles so we were amazed how comfortable he was with the process. He never seemed to be in pain or discomfort, and for an old man remained reasonably active up to his last day. He passed peacefully in his sleep, he always slept beside me and I found him in the morning curled up like a sled dog, his normal position with his eyes closed. 

[gcv-border]

Good Luck with Cressa.

Like others, I have more experience with felines that have kidney disease. I never used Rx diets for them (against the vet's advice), but did pay attention to posphorus levels in the kibble, added water to their daily 2X feedings (which I do now for all my pets regardless of age) and gave subQ fluids. Both cats lived another 3 - 3.5 years of quality life until close to the end. One hint for subQ fluids if you ever go in that direction - warm the fluids in body temperature water. It is so much more comfortable for the animal. One cat would visibly relax, then go to sleep in my lap, when I started his alternate day subQ fluid administration. This cat had very high blood chemistry values for kidney disease when initially diagnosed, and was tested every 6 months. Each time, the vet would shake his head in disbelief that his values remained fairly stable for about 3 years. He thought that he would have been gone within the first 6 months after initial diagnosis.

I have one 13 year old border collie with values indicating beginning kidney disease. I will have to begin educating myself about the canine version.

[diane allen]

I just lost my 14 yr old BC to cancer; he's had kidney disease for at least three years.  He had some issues when it was first diagnosed, but essentially he was stable and had no symptoms recently. 

I contacted a vet nutritionist who was willing to work with me on a raw diet for him (a version of which he'd been on his entire life, with great success).  He had special recipes, different from my younger healthy dogs, and thrived on it.  He maintained a good weight (well, except for the last month or so...), his coat was great, and he was hiking up to five miles just a few weeks ago.

I have several supplements, which may be of interest to you.  All have been opened bottles, but if you're interested in trying any of them, you are welcome to them.  PM me (though I'm not sure how that works here these days....) and I can send you the list.

I hope your success is as good as ours was!

diane

[GentleLake]

@diane allen, I'm so very sorry to learn of your loss. We never have enough time with out dogs, but I'm encouraged to know that he lived so long and so well with kidney disease. Thanks for sharing that.

[beachdogz]

I lost my 13 year old girl Kylie to kidney disease in April.  She was diagnosed in July.  I believe she may have contracted it from Ehrlichia, but I cannot be positive on that.  My Vet gave her til December to live, so I got four bonus months.  She really had no symptoms except for urinating two or three times when let out.  I had two friends who also had dogs with kidney disease, so I knew a little about what would happen.  Both gave sub-Q fluids.  One lasted almost 2 years, but her quality of life would not be what I would want for my dog.  The other started sub-Q thinking she would also get 2 years;  she only got 2 months.  I believe it progresses at different rates for different dogs.  I had made the choice early not to do fluids.  I also made the choice early that the day she quits eating is the day we call the vet.  And so, from July to April I had a very normal, happy old dog.  She never missed a meal.  I fed her the commercial renal kibble, soaked, mixed with renal canned.  She also got a renal supplement and milk thistle and a pinch of baking soda.  Her numbers would go up and down (my vet told me that was not unusual);  eventually I quit doing the numbers -- it was making me crazy.  Every time they were good, it would give me false hope.  Then I would be devastated when they went back.  She also got Dasequin, Fish OIl and Galliprant for her arthritis.  She climbed the steps and played without showing visible pain.  I will tell you how mine ended.  On a Thursday evening, I noticed she was coughing a little.  Very little.  By Saturday, it had me worried enough to call the vet (why does everything happen on a weekend?)  I eventually found out that in the later stages, the kidney will release an enzyme that causes congestive heart failure.) By Monday, the coughing was getting worse. However, she was still playing with the puppies and was in good spirits.  Tuesday morning she barely ate (picked), more coughing,  and I knew this was probably the end.  But -- just in case -- I waited to see if she would eat dinner.  She totally did not.  This was a dog that never missed a meal.  And in two days, I could see a change in her eyes and her face.  She just looked so old and tired. Wednesday morning she asked me to call the vet.   So... I thought I was over this,  but now I am crying as I write it.  I am writing because in the end stages, I searched the internet trying to find any story as to how this really ends.  I'm pretty sure everyone's is different, but this is how mine ended.   I know Cressa is a very special dog for you, and my heart aches for you. 

[Sue R]

I am sorry to hear this about Cressa. 

To answer one of your questions, our Megan was diagnosed with Stage 2 kidney failure when she was 12 1/2 years old. She lived a very active and happy life for four more years and was not euthanized until she was 16 1/2, after barely two days of a steady physical decline and loss of her normal good appetite. 

When she was diagnosed, I did some research on the internet and with the help of a Yahoo group dedicated to diets for kidney failure dogs, I devised a partly raw diet for her that worked very well for her (her vet said that, "Whatever you are feeding her, keep doing it!). It consisted of raw ground beef (or poached chicken in the few short instances I did not have home-grown beef in the freezer), sticky rice (very low phosphorus), cooked egg whites, pumpkin, green beans, water, and supplements. She did lose some weight over the four years but just a few pounds, maintained a glossy coat, and led a very active life for a senior, logging up to four miles of walking each day. 

We never did use sub-q fluids at all, deciding in the beginning that if it came to that, that would be her time to go. I have never regretted the choices we made for her and she seemed happy and content for those four years, with just an occasional and temporary digestive upset. She experienced both a heat-related incident and also (in her last six months) a few smaller seizures (she'd never had a seizure in her life) but other than these few problems, she did extremely well. 

I hope that things go as well as possible for you and Cressa at this difficult time, and that you can both enjoy your time together. 

I am also sorry to hear about your loss, beachdogz. It is never easy. 

[SS Cressa]

@diane allen I’m sorry for your loss and thank you for sharing your experience. I have been doing her senior bloodwork yearly just so we do catch any concerns. I’m hoping to focus on palliative care so she isn’t suffering.

@beachdogz I’m so sorry for your loss. Thank you so much for sharing. I keep trying to mentally prepare myself but I know I’m gonna be really upset without her even with having Val and Parker.

@Sue R I’m hoping I have another year with her but a part of me doubts it. However I also didn’t think she would make it to 15 without meaning to sound morbid. Every day I wake up and she greets me I feel lucky. She is being fed a very similar diet cept it is cooked. Lean beef, green beans, white rice, squash or cabbage or cauliflower, egg whites, and garlic. I sometimes add apples. She loves it and my other dogs are jealous. 
 

We need to do more bloodwork to see what her levels are like. She has been needing me to carry her upstairs more and had some issues standing form a down position. I’m not sure if it’s kidney related, something new, or just with how humid it has been. Lately she also hasn’t been as thirsty. I wish she could do a 4 mile walk again. She has been limited to a 40 minute walk for at least a year now. But on a good note she is very much alert and wanting to be part of the fun. She just needs more help now. 
 

When she was 1st diagnosed I had noticed her drinking more water and her breath smelled chemically. She has always marked her territory so I haven’t noticed her peeing more.

[Sue R]

Bad breath was one of the symptoms we noticed in Megan. As a marker, too, I didn't notice any increase in urination. And she lost some weight without a decline in appetite or increase in activity. 

Best wishes for you both - as long as she is happy and you can manage her, it sounds like you will have some sweet times together. 

[SS Cressa]

Cressa had some bloodwork about 2 weeks ago to see how her kidneys were doing. The vet advised they were steady he was worried about her phosphorus level.

But I’m slightly worried I feel like this is mainly weather related but that is something out of my control.

The last two days Cressa has:

- Decrease thirst. I used to have to refill the water at least 2x a day. Lat couple weeks i just change the water since I like them having fresh water.

- Decreased appetite. She has snubbed her homemade food, and kibble. I have been giving her wet cat food currently so she has something in her since I know not eating can compound other ailments. I also gave her part of a sausage sub which she ate hungrily. 

- Constantly panting even though we have multiple A/C working.

-Snubbing her medication even the ones which look like treats or the ones coated in butter. 

- Acting sore or discomfort (panting, issues standing, favoring legs, etc)

I called the vet to see if he had any thing else we can do. I think the weather is impacting her joints which increase her discomfort making her not want to exists. Last week the weather was in the 90s this week it has been cool enough to wear coats at time and super humid other days. And I do realize I humanized her about not wanting to exists. 

[GentleLake]

Inappetence is a known symptom of kidney failure. I know many ppl w/ dogs who have kidney disease and are losing their appetites will feed them just about anything they'll eat just so they don't stop eating altogether.

Although my chow hounds have never lost their appetites when the weather's really hot, I know some dogs do. So that could be contributing. According to my vet making sure Bodhi's water intake is adequate is very important; not drinking enough will put additional strain on the kidneys. Is there some way you can get her to drink more? I add 12 oz. of water to Bodhi's meals twice a day. That's not going to help much if she's not eating, but could you try to give her some salt free broth?

I've noticed all my dogs panting off and on while the weather's been hot.

If she's not taking her meds willingly can you just pill her? I make sure all my dogs will let me give them pills so that if I ever have to give them meds when they're sick it won't be an issue. Better IMO to shove them down her throat than for her not to get them at all.

Have you eliminated any high phosphorus foods from her diet? Has your vet suggested any of the phosphorus blockers or is he thinking it's not high enough yet to warrant it?

I think it's pretty important not to anthropomorphize our animals when we're discussing behavior or symptoms. It can actually get in the way of effective communication with vets who may not understand exactly what you're describing. Simple observations of behaviors and symptoms without trying to label their meaning are usually more useful for them.

 

 

[SS Cressa]

I was giving her a kidney friendly homemade food that the vet approved of. It should be low in phosphate.

My sister gave me some raw green tripe. So I started feeding her wet cat food (bff omgravy!) and raw green tripe which she ate without issue finally last night. I did mix some low sodium bone broth with water for her to drink. I was hoping to add water to her tripe today to just help increase her liquid intake. Am planning on buying some green tripe for her now. I used to feed raw but it got too expensive for me. 

I was going to figure out how to give her the medications. She normally will take it but can be picky some days.

Im also will try to take her to a physical therapy dog place. They advertise as being able to assist senior dogs and help with pain management. I’m hoping they can help migrate the level of discomfort but need to call them to check.

[SS Cressa]

I have gotten her to take her medications again(yesterday and today!). She been eating green tripe happily. I give her some bone broth mid day so make sure she is getting enough liquids. She was acting like her spunky self this morning. 

[GentleLake]

Happy to hear she's eating and drinking again and having some better days. I understand this can be an up and down sort of illness.

I'd still recommend learning how to pill an unwilling dog if you don't already know how to do it. (There are plunger type things that can help if necessary.) IMO getting meds into a dog who needs them isn't optional. (Ignore this if you already know how. )

[diane allen]

Been there - so sorry you are too.

While I would *never* (oops....) recommend it, Hill's Canine KD (kidney diet) was a hit with my guy whenever he was off his regular homemade food.  Usually just one or two meals of it set him straight, and he'd be back to liking the better stuff.  At some point, it doesn't really matter what they're eating, does it, as long as they're eating?

Best of luck to you both.

diane

[GentleLake]

Speaking of food, I once was sitting a small poodle while owners were on vacay. She was an old puppy mill breeder rescue with various health problems. Don't recall if kidneys were one of them but was told she often wouldn't eat. Owner had told me that canned ravioli was the one thing she'd eat when she wasn't eating her regular food, or sometimes baby food.

Dunno if it would entice Cressa when she's not wanting to eat, but just wanted to share in case you'd want to give it a try.

[juliepoudrier]

Baby food (jars of meat) have been my go to fit ill dogs (or cats) for years. Often works when nothing else does. It’s what kept Pip going the last week of his life. 
 

J. 

[SS Cressa]

So this last week she started to snub food again and she was having some bloody stool for a couple days. I was able to get her to drink bone broth though. On Friday we ate some ramen bowl and Cressa beg for some. So she got some ramen broth, chicken, and noodles. Saturday she was eating bone broth with chicken. Today she ate some salmon with bone broth and also rice/egg whites/boil bacon/steamed chicken. She hasn’t had anymore bloody stools yet.

Hate seeing her act old. But I am glad she started to get back to her spunky old self.

Thank you for the suggestions. I thought I knew how to give pills but Cressa is pretty good regardless how far you toss it in at spitting it back out making me go rounds with her. 
Val and Parker I just hand them the pills and they greedily eat them. Cressa use to take them with cream cheese or butter.

[GentleLake]

I'm so glad you're finding things she'll eat. One note of caution: my vet said it's very important to limit salt intake. Most ramen noodle flavor packages are extremely salty. Can you maybe look for a less salty version or not use the flavor packets? If she really likes it and isn't eating otherwise maybe you could make a separate portion for her w/out the packet? Same with most canned fish and bacon. I know there is canned fish available w/out added salt. Again, maybe have some around just for her.

One of my dogs used to be like that with pills. I would swear she'd choke them back up even after she sometimes swallowed them. It can help to coat the pill with a little butter to help it go down (it also makes them harder for you to hold onto so it can take some practice). After getting the pill in hold her mouth shut with nose slightly elevated and rub her neck a little till the tip of her tongue comes out, indicating that she's swallowed. I read recently that lightly blowing on the nose (while holding her mouth shut) will make them swallow. If it's really a struggle, maybe get a pill plunger. They aren't very expensive and can help get the pill further down her throat. Following with a very yummy, most favorite treat if she'll take it (or giving the pill right before she eats) will help ensure the pill goes down. Tansy requires a daily pill and she's finally stopped being such a bitch about it, so there is hope. I wish we could just explain that we're not trying to torture them but are trying to help. <sigh>