Early stages of chronic kidney failure

[beth235]

Hello I’m just wondering if any one can offer any advice please. My little boy Charlie who will be 13 in October has been diagnosed in the early stages of chronic kidney failure. He’s had a blood and urine test. He’s my world Iv has him since 8 weeks so I’m heartbroken. The vets have recommended to put him on the specific renal diet along with the pronefra supplement. Iv heard such conflicting advice. Some say this. Others raw. Ideally I’d prefer to keep him on his ljwb/ Lilly’s . He loves his food. Atm he’s not showing signs other than tiredness ( but he is nearly 13) and I feel like he’s drinking a little more. He’s been on loxicom since February for starting with arthritis. Does any one know if there is a link with this and kidney failure- again Iv read mixed stuff :s just really don’t know what’s the best route any help please would be appreciated! I just want to wrap him up .

. Thanks

 

[Bellasophia]

Hi...I went through this with my heart girl..






so ,difficult times ahead..brace yourself.

..you need a vet you can work with...

...get the dog on whatever food he will tolerate..give whatever they like..( he’s 13) .and then,.if there are days when they refuse food,I used to give hills a/ d cans ,high calories,low volume,easily digested.

now here comes the vet part...( given the age of your boy,this will be a last straw..)
I was shown how to give a sub cutaneous drip...saline ,rehydration,to help dilute the toxins in the bloodstream...I believe this gave my girl several extra months,and she felt better in this relief timescale.

note..we did this at home.

.....keep your expectations real.
you are living on borrowed time,but try to make it quality time.

The day I realized it was no longer working for my girl ,I booked her in for her last day.
That morning I took her to my bedroom and we had a long chat...I told her it was ok to leave me.We were all there..my new pup was serious,he laid by her side,quiet as a mouse( a first for him) and she lifted her head ,she just knew and she passed on....no vet visit.
I repeat ,my life dog ...who does that?

summary...,..kidney issues don’t resolve,but you can squeeze a bit of extra time...
just keep your focus...this is what is best for your dog..don’t try to prevent the inevitable and do what’s best for your best friend.

 

[Pearlsacarolsinger]

I'm afraid that when you first get your pup you know that in roughly 13yrs, depending on the breed, you will have to make *that* decision.
He has had 13 good years with you. If you trust your vet follow their advice, if you don't trust the vet, find a different one. Whatever you do do NOT try to hang onto the dog because you 'just can't bear to let him go'. Keep him as comfortable as you can until the time comes when he is not comfortable, then prioritise quality of life over quantity and do the right thing by the dog, upsetting as it will be for you, be the responsible owner that he needs.


If he is only in the first stages, it doesn't sound as if the end is imminent yet, so enjoy the time you have left with him and make sure that he does too. It is very sad that dogs don't live as long as us but unfortunately, it's a fact of life.

 

[ihatework]

Try the renal diet, my old lab did very well on it in early kidney failure for his final couple of years. It was his hind end that finally got the better of him!

 

[beth235]

Hello I’m just wondering if any one can offer any advice please. My little boy Charlie who will be 13 in October has been diagnosed in the early stages of chronic kidney failure. He’s had a blood and urine test. He’s my world Iv has him since 8 weeks so I’m heartbroken. The vets have recommended to put him on the specific renal diet along with the pronefra supplement. Iv heard such conflicting advice. Some say this. Others raw. Ideally I’d prefer to keep him on his ljwb/ Lilly’s . He loves his food. Atm he’s not showing signs other than tiredness ( but he is nearly 13) and I feel like he’s drinking a little more. He’s been on loxicom since February for starting with arthritis. Does any one know if there is a link with this and kidney failure- again Iv read mixed stuff :s just really don’t know what’s the best route any help please would be appreciated! I just want to wrap him up .

. Thanks

Thank you for the responses. I just feel like I’m getting different advice of everyone I’m so confused as to what route to go down

 

[Redders]

I’m sorry you have had this diagnosis, it must be a bit of a blow. Sadly in older pets, chronic kidney disease is common and a lot of older pets have it without owners knowing anything about it.
a really good resource is the IRIS kidney disease website. They created all the stages and recommended management protocols depending on what stage an animal is at. They do a lot of research and it is the go to resource for vets to help with diagnosis and management. They also have an owner section, and it may help you develop your understanding of the condition and aid in your decisions. As always there is a lot of information on the internet and a lot of opinions, but the IRIS page is all fact.
There is no ‘treatment’ as such for kidney disease. The aims are to support the kidneys and manage clinical signs with a good monitoring schedule so you can track the disease and tweak management.
when I diagnose kidney disease in pets, I go through everything with owners, I’ll go through the essence of what I discuss about the points you have mentioned in case it might help you, but bear in mind this is generic and I obviously don’t have any of your pets history etc.
Diet:
The main stay of managing kidney disease is diet. The special formulated diets pay meticulous attention to the level of proteins and electrolytes to ensure they kidneys aren’t over loaded and to help manage electrolyte/micronutrient/element imbalances, whilst still being a complete and nutritious food. I always recommend this as part of the treatment. HOWEVER. It is also important for the pet to have a good quality of life. The food isn’t going to reverse the disease process, only attempt to slow it down. If the pet doesn’t like the renal food and refuses to eat it after an appropriate transition period from normal food, and loses weight and is miserable on the food - that isn’t a good quality of life. So the option in that case is to accept that we aren’t ‘managing’ the disease, but we are supporting the pet to have good days rather than longer not so good days. I would counsel against raw diet for kidney disease
Metacam:
All NSAIDs are filtered by the kidneys and can be hard on the kidneys - in a well animal who is well hydrated, these effects are negligible, but they can cause issues. It’s why in older pets I recommend blood and urine tests before starting on Metacam and why we recommend routine monitoring of pets on it long term. The guidelines state in kidney disease (early stage) Stop nephrotoxic drugs IF POSSIBLE. HOWEVER, again, it comes down to quality of life. I advise owners that we can try other pain relief that doesn’t rely so much on the kidneys (Paracetemol, gabapentin, librela, different NSAIDS that may be more selective and so not so kidney heavy) but if these don’t provide the relief needed for that pet to be comfortable, then it’s the same question of quality of time over quantity of time, and do we accept that staying on metacam MAY reduce the quantity of time, but that time would be much nicer for the pet (no pain). I have some older pets with kidney disease on metacam because the other pain relief options just didn’t cut it, and they are on metacam with full informed consent of the owners.
equally I don’t hold metacam to ransom of blood and urine tests. Those things cost money, and not everyone has that. So I go through the pros and cons and explain to the owner that we can start it, but they must accept that we are doing it blind and it may exacerbate underlying kidney disease, or it might not, but I can’t make any promises either way.

I hope you manage to find some resources that help you in your decision making and you and your pet have many good days ahead.

 

[Umbongo]

Generally by the time an animal has clinical signs of kidney failure, there is only about 25% renal function left and this will continue to decline. There is no treatment....only supportive care.

The most important thing is diet. Veterinary renal diets are proven to extend the life of "most" animals in kidney failure. They need a diet that is much lower in phosphorus, protein and sodium than other foods. I would give it a try. Animals in kidney failure can feel quite nauseous due to the toxins in their bloodstream, and you may need to keep swapping between brands and flavours. Some animals may need anti-nausea medications or appetite stimulants later on.

If you don't go for a renal food then you can add phosphate binders, which extract phosphate and excrete via faeces rather than go via the kidneys. But this needs to be discussed with your vet and should ONLY be given if they have high phosphate levels. Not all animals have high phosphate, especially in the early stages.

Hydration is important, so always having fresh water available, wet food, and adding extra water to food can help. You can also give sterile saline under the skin (again discuss this with your vet).

Extended use of NSAIDs such as loxicom can lead to or worsen kidney failure, and all older animals should have a blood test before being prescribed it, and should continue to have regular re-checks. That being said you also need to factor in quality of life, and your dog needs to be comfortable. Speak to your vet about perhaps adjusting the dose, or adding in some different drugs. Other types of pain relief and/or joint supplements can sometimes control the pain without the loxicom, or allow you to give lower doses.

The kidneys play a role in the regulation of blood pressure, and an animal with kidney failure can have high blood pressure. This should be regularly checked, as prolonged high blood pressure can lead to other problems such as blindness. Ensuring the animal is not suffering from hypertension, and medicating if they are, can also help to slow the progression of kidney failure.

That all being said, you have to take in to account how happy your dog is for the time they have left. I had a cat with kidney failure (very common in cats). I started him off with renal diets but he hated them and stopped eating. I also gave him sub-cut fluids sometimes but again he wasn't a fan. He also had low-dose metacam for arthritis. In the end I just fed him what he wanted and continued his pain relief. He was happy, comfortable and went on for another 5 years. He was always a very people & food orientated cat. He became very fussy with his food in the last few months but did continue to eat. The day he didn't greet me in the morning and stopped eating was the day I said goodbye to him.

There is a lot of contradicting info on the internet. I would also second the IRIS website
http://www.iris-kidney.com/education/what_pet_owners_should_know_ckd.html

Sorry to hear you are going through this, enjoy the time you have left xx

 

[beth235]

Hello I’m just wondering if any one can offer any advice please. My little boy Charlie who will be 13 in October has been diagnosed in the early stages of chronic kidney failure. He’s had a blood and urine test. He’s my world Iv has him since 8 weeks so I’m heartbroken. The vets have recommended to put him on the specific renal diet along with the pronefra supplement. Iv heard such conflicting advice. Some say this. Others raw. Ideally I’d prefer to keep him on his ljwb/ Lilly’s . He loves his food. Atm he’s not showing signs other than tiredness ( but he is nearly 13) and I feel like he’s drinking a little more. He’s been on loxicom since February for starting with arthritis. Does any one know if there is a link with this and kidney failure- again Iv read mixed stuff :s just really don’t know what’s the best route any help please would be appreciated! I just want to wrap him up .

. Thanks

Thank you everyone for putting time into such great help it’s really appreciated. My vet mentioned keeping Charlie on his usual diet aslong as I used the binder. Although he was much more keen on the renal diet he said if I did both I could keep feeding him treats and his usual fruit and veg. Would you say overall the renal diet is the best option ? Iv read a lot and people often say it’s not palatable. He’s not fussy!! But I dont want him on a bland diet he loves his food. Thank you very much. Iv attached his bloods of abyone has any experience!

 

[beth235]

Thank you everyone for putting time into such great help it’s really appreciated. My vet mentioned keeping Charlie on his usual diet aslong as I used the binder. Although he was much more keen on the renal diet he said if I did both I could keep feeding him treats and his usual fruit and veg. Would you say overall the renal diet is the best option ? Iv read a lot and people often say it’s not palatable. He’s not fussy!! But I dont want him on a bland diet he loves his food. Thank you very much. Iv attached his bloods of abyone has any experience!

Iv checked the website out really helpful. Thanks ?

 

[AmyMay]

You’ve had some excellent advice on this thread. Redders is a vet, and has given you a very comprehensive reply, which I’d be inclined to follow.

 

[Redders]

Umbongo is also a vet and has given some great advice too.
I won’t comment on blood tests because they should always be interpreted alongside the animal with the urine results and with full knowledge and involvement in the case.
regarding the renal diet, I would always try it. There are several brands to try now and they will all vary in palatability so one may not be liked, but another may be. Royal Canin, Purina and Dechra are three from the top of my head, there are others but I don’t know them without looking them up. The vet nurses are excellent with nutrition and the vets can refer you to them for an appointment to discuss switching over food slowly and also discuss phosphate binders if you decide to go down that route.
if you try them and he doesn’t like them, well, at least you know you tried, if he likes them, then great!
It’s all about balancing managing the disease progression alongside allowing your pet to live a normal and happy life.

 

[brightmount]

My Yorkie was diagnosed with kidney failure 2 years ago. He was 13. I put him on Fortekor, it totally turned his life around, I wish I had found it years before. From being sick every morning, and only picking at his food, he became ravenous and managed to put on some weight. He’s way more energetic! He’s now 15, and I took him to the vet last week to get advice about his teeth, and my vet reckons he’s in excellent shape with another 1-2 years in him, and worth risking an anaesthetic to do a dental.

I also feed him a renal diet. My favourite was Hills k/d+mobility stew, but you can’t get that at the moment. k/d stew without the mobility bit is still available. I’m giving omega 3 for his mobility. My dog can’t tolerate metacam. If he’s in pain I give him one-eighth of a paracetamol and/or one-quarter of an amitriptyline.

 

[Birker2020]

Hello I’m just wondering if any one can offer any advice please. My little boy Charlie who will be 13 in October has been diagnosed in the early stages of chronic kidney failure. He’s had a blood and urine test. He’s my world Iv has him since 8 weeks so I’m heartbroken. The vets have recommended to put him on the specific renal diet along with the pronefra supplement. Iv heard such conflicting advice. Some say this. Others raw. Ideally I’d prefer to keep him on his ljwb/ Lilly’s . He loves his food. Atm he’s not showing signs other than tiredness ( but he is nearly 13) and I feel like he’s drinking a little more. He’s been on loxicom since February for starting with arthritis. Does any one know if there is a link with this and kidney failure- again Iv read mixed stuff :s just really don’t know what’s the best route any help please would be appreciated! I just want to wrap him up .

. Thanks

sorry to hear Charlie's diagnosis.

Our beagle aged 14 had this, we didn't realise that's what it was as we were waiting on the blood test results. She'd not eaten or drunk for a number of days but she was on some medication (sorry I can't remember what) and she could walk (although she was very weak).

Trying to encourage her to eat even her favourite things like bacon or cheese was just impossible, she knew she was dying. I think when they go off their food or water then it's time to call it a day. We would have had her pts before this but we hoped that the bloods would show that she was suffering from something with some sort of medicinal cure. But it wasn't to be.

We got the blood test results in the morning and by 4.30pm she was gone, we had her pts.

 

[druid]

Umbongo and Redders have covered everything I would have suggested (I'm a vet also). I'm seeing good results with Librela so it is a pain relief modality worth looking into but your dog's comfort and quality of life should be at the forefront of any decisions.

I find ZooPlus good for clients being able to buy smaller sizes and brands of Renal food from various suppliers to see what their animal finds palatable.

 

[Birker2020]

Umbongo is also a vet and has given some great advice too.
I won’t comment on blood tests because they should always be interpreted alongside the animal with the urine results and with full knowledge and involvement in the case.
regarding the renal diet, I would always try it. There are several brands to try now and they will all vary in palatability so one may not be liked, but another may be. Royal Canin, Purina and Dechra are three from the top of my head, there are others but I don’t know them without looking them up. The vet nurses are excellent with nutrition and the vets can refer you to them for an appointment to discuss switching over food slowly and also discuss phosphate binders if you decide to go down that route.
if you try them and he doesn’t like them, well, at least you know you tried, if he likes them, then great!
It’s all about balancing managing the disease progression alongside allowing your pet to live a normal and happy life.

Our 14 year old beagle that hadn't eaten or drunk for a number of days (we were syringing water in her mouth until we got the blood test results back) was booked an appointment to be pts the day she was diagnosed with chronic kidney failure (reply 13) When we took her to her appointment we were shown a side room where we waited with our dog for the vet. The vet came in and started reviewing her history and said she could offer her kidney dialysis (two days a week hooked up to a needle for hours). I was appalled and very angry. I thought it was in very bad taste and we obviously declined and the vet went ahead and pts. I thought it was very unfair as we'd already made our decision and there were some people that might have jumped at the chance of a few more days/weeks with their beloved pet in exchange for a huge chunk of money.

Just out of interest as a vet I wonder what your view is on giving kidney dialysis to a clearly very weak, dehydrated and sick aged dog? Is this something you would offer owners of chronic kidney disease patients? Also open to Druid who is also a vet.

 

[Redders]

As vets we have to give all the options to a client. Another owner may be appalled that we suggest PTS when they would like to try dialysis. It’s not up to me what I offer. I have to offer all the options. Of course I will also offer pros and cons of those options, but if I didn’t offer all of the options, and PTS, and the owner found out that dialysis or some other invasive intervention may have been available, then I may find myself on the rough end of a complaint for not doing Or offering everything possible
When I have a pet who I have diagnosed with a chronic condition, I tend to have a long chat with the owners about expectations, costs and management so we have a good base of understanding. Some owners are adamant and happy with knowing what treatment they do and don’t want, others aren’t, and it’s hard to balance that
I also wouldn’t comment specifically on a case I wasn’t involved in. I imagine your vet was just trying to cover all bases and ensure you were full informed of all possible options.
You mentioned money. Money isn’t the driver for offering treatments. If we compromised welfare just to shave more money off of an owner , we would be in very deep water with our governing body. Vets didn’t become vets to be rolling in money at the expense of animal welfare. In fact, I have just spent time over the last few days discussing vet treatments on a forum to help an owner understand their animals condition, because I know that it’s hard to take everything in when you are actually at the vets and it can be really overwhelming to take in all that new information. For no money. Because I care.

 

[SusieT]

Do you trust your vets to operate on your dog? Or would you let someone who came off a forum and said they know better wield the knife but would wield a 'raw' knife?
I would go with vets suggestion with regular reviews to see if its working. If I didn't trust the vets I would get a second opinion from a specialist.

 

[beth235]

Hello I’m just wondering if any one can offer any advice please. My little boy Charlie who will be 13 in October has been diagnosed in the early stages of chronic kidney failure. He’s had a blood and urine test. He’s my world Iv has him since 8 weeks so I’m heartbroken. The vets have recommended to put him on the specific renal diet along with the pronefra supplement. Iv heard such conflicting advice. Some say this. Others raw. Ideally I’d prefer to keep him on his ljwb/ Lilly’s . He loves his food. Atm he’s not showing signs other than tiredness ( but he is nearly 13) and I feel like he’s drinking a little more. He’s been on loxicom since February for starting with arthritis. Does any one know if there is a link with this and kidney failure- again Iv read mixed stuff :s just really don’t know what’s the best route any help please would be appreciated! I just want to wrap him up .

. Thanks

Hello everyone. Thanks very much for all the responses!! Last night I went to the vets to purchase the specific branded renal diet and supplement. So will begin tonight. Iv also managed to find some treats suitable named soopa. I appreciate all the responses I hope I haven’t seemed ungreatfull I think it’s just hit me hard. Alot to take in I feel angry / upset. He currently seems ok well to me certainly getting tierd quicker / drinking more at times So in some ways it’s hard to believe as at times he’s the same all cheeky chops Charlie I know other times o can see it. I think one of the hardest things is just not knowing the speed of how quickly it will go it’s like borrowed time. ?. He’s like my left leg. But I know at least know om doing what I can. Hopegully he wlll be ok with the diet. Thanks again for all the advice I do appreciate it’s just been a really tough week. As I’m sure you all understand ? my boy

 

[TwyfordM]

So sorry to hear about your dog, just follow vets advice and keep him as happy and comfortable as possible.
Having watched my Nan suffer through kidney failure and dialysis, her quality of life was awful and she eventually made the decision to stop as feeling incredibly sick day after day, the tiredness, restrictions on foods/fluids etc there was no quality of life for her. For that reason I’d probably offer the supportive care and call it before they start to suffer.

Her dog who I still have ironically suffers with bladder stones so is on struvite food which he doesn’t love, but will eat day to day. We persevered as he’s younger and when he moved in with me and realised if he didn’t eat it my dog would ... he started eating it well!

 

[maya2008]

The renal diets are really good, I would do what your vet says.

 

[Redders]

You haven’t sounded ungrateful, just an owner who has had a shock and wants to do the best for their pet. Hopefully he enjoys the renal food, and enjoys the new treats!

 

[beth235]

Thank you

 

[Birker2020]

Thank you

Good luck Beth235, thinking of you

 

[beth235]

Hello I’m just wondering if any one can offer any advice please. My little boy Charlie who will be 13 in October has been diagnosed in the early stages of chronic kidney failure. He’s had a blood and urine test. He’s my world Iv has him since 8 weeks so I’m heartbroken. The vets have recommended to put him on the specific renal diet along with the pronefra supplement. Iv heard such conflicting advice. Some say this. Others raw. Ideally I’d prefer to keep him on his ljwb/ Lilly’s . He loves his food. Atm he’s not showing signs other than tiredness ( but he is nearly 13) and I feel like he’s drinking a little more. He’s been on loxicom since February for starting with arthritis. Does any one know if there is a link with this and kidney failure- again Iv read mixed stuff :s just really don’t know what’s the best route any help please would be appreciated! I just want to wrap him up .

. Thanks

Hi guys so I’m just wondering if I can ask a question please, sorry I’m just finding this so stressful I feel so responsible for everything how he feels … how long h lives ?. He’s my world. So I know some are for some not. But I’m gradually changing him to the renal diet. He is eating. But despite only tiny amounts his stomach isn’t happy. Bloated and gurgly? Also at this stage do people recommend using the phosphate binder too with the renal diet? Sorry about this in just so stressed ? thank you so much. .

 

[Redders]

I would have a chat with your vet and nurse team about it, as they have the most information on your boy and are best placed to advise and discuss such as any diarrhoea/vomiting/signs of being uncomfortable etc all of which will influence decisions. It could also be completely coincidental. Don’t forget that your vet team will be happy to discuss any and all queries you might have - they know the diagnosis throws up questions and it can take a while to get pets and owners on the straight and narrow when dealing with a new condition, so they really won’t mind you getting in touch any time you are worried and not sure about something

 

[beth235]

I would have a chat with your vet and nurse team about it, as they have the most information on your boy and are best placed to advise and discuss such as any diarrhoea/vomiting/signs of being uncomfortable etc all of which will influence decisions. It could also be completely coincidental. Don’t forget that your vet team will be happy to discuss any and all queries you might have - they know the diagnosis throws up questions and it can take a while to get pets and owners on the straight and narrow when dealing with a new condition, so they really won’t mind you getting in touch any time you are worried and not sure about something

Thanks for your reply. Yes your right. I’ll give them a call. Iv already nave him a appointment with the nurse but unfortunately they can’t see him till next week. But hopefully can chat on the phone. It’s hard I just want him to be happy. Thankyou

 

[TheOldTrout]

A couple of mine have had kidney failure at the end of their lives. I think people have mentioned low protein diets further up the thread - that's what the dog needs. Our vet recommended the Royal Canin renal diet.