If you suspect RENAL DISEASE in your canine,
seek professional help IMMEDIATELY!
Thank you to
K9Kidney Forum for
permission to post this article.
MY DOG WAS JUST DIAGNOSED WITH RENAL
FAILURE - WHAT DO I DO?
First off, don't panic. Renal failure in
dogs isn't necessarily the "deathly knell" it used to be. With dietary
modifications, supplements, medications and fluid therapy (or none of the
above!); many dogs can live a few years longer with some quality of life.
Be prepared to post the complete results of your dog's last lab tests, and what
lead you to the vet for the diagnosis. This will give the experienced list
members a better perspective on how to help you. The complete list of
items from the lab reports to post is listed below.
Be prepared to post what you're currently feeding (commercial diet, home cooked,
other), currently supplementing with (vitamins, anti-oxidants, etc) and
currently medicating with (anything!).
Don't be discouraged if at first your veterinarian is less than enthusiastic
about the long-term prognosis. Unfortunately, for the dogs, the end
result of chronic renal failure is the same. It is important that
you have confidence in your vet, and be adamant at the levels of treatment you
are willing to go to. There is a great emotional and financial
investment that is to be made in the care of a chronically sick dog, and no one
will look upon you as being a "bad person" if you choose to let your dog go at
an early phase.
There will be *MANY* theories of treatments that are presented on the list.
It is up to you to decide the most appropriate one based on your dogs'
condition. DO NOT EVER FEEL PRESSURED BY THE LIST to make a change to what
your veterinarian has prescribed without talking to them first. DO NOT
EVER FEEL PRESSURED TO CHANGE VETS BY THE LIST unless you find you absolutely
cannot work with your vet. Many vets are not used to owners who are
willing to "go the extra mile" for their dogs.
If you find you absolutely *have* to change vets, ask for a recommendation on
the list for someone in your area. If there isn't one, check out the
"American College Of Veterinary Internal Medicine" for a local, board certified,
practioner. Make some phone calls and ask if they are familiar with
treating dogs with renal failure.
THINGS TO DO RIGHT AWAY SO THE LIST MEMBERS CAN HELP YOU OUT:
Get a copy of your dog's blood work from the vet. BE SURE TO GET THE
NORMAL VALUES FOR THE LAB THAT WAS USED.
Critical "renal" numbers are:
* Urinalysis - including specific gravity, protein, bacteria, blood, glucose
* Any other lab work that was done
Chances are your dog's levels are all elevated. Speak to your vet about
subcutaneous fluid administration immediately, based upon your dog's condition.
In the case where dogs have underlying cardiac, respiratory or circulatory
problems, this may not be appropriate. Subcutaneous fluids (called "Sub-Q
Fluids") can be done at home after a little instruction and will help your dog
immensely. The fluid used depends on the lab values; your vet should
decide which subcutaneous fluid to use. You will likely require a
prescription for: the fluids, the needles, and the tubing. Please
ask your vet for it right away. *NOTE: You can purchase from your
vet, but there are online suppliers who are much more economical, and we have
that information in our files. You WILL need to fax or mail your
prescription (script) to these pharmacy/suppliers, but using these resources
will save you a LOT of $$$$$.
Some dietary changes to make. Start with supplements. Go to a health
food store (get human vitamins - they have much better quality and variety and
are much more economical):
* Fish Oil (with the highest amount of DHA/EPA you can find) (do NOT get cod
liver oil - you do not want anything with extra Vitamins A & D).
* Vitamin E
* Pet-Tinic (an iron supplement, available online from pet suppliers, can be
used as the dog starts to become anemic)
Phosphorus Binder: If your dog's phosphorus levels are elevated you will
need to get a phosphate binder. This is given either WITH your dog's food
OR immediately afterwards. The premise of giving a phosphorus binder is
that it adheres to the extra phosphorus in the food, binding it so it does not
go into your dog's body, exacerbating an already elevated phosphorus level.
It is very important to keep the phosphorus level within normal range, as
elevated phosphorus level will cause your dog to get very ill, very fast.
(See "files" section for more information about phosphorus and binder dosages).
Some commonly used phosphate binders are:
* Alternagel (aluminum hydroxide) (non-script)
* Alum-Caps (aluminum hydroxide) (non-script)
* Phoslo (by script, a calcium acetate binder)
* Renagel (by script, a non-aluminum/non-calcium binder - expensive and
relatively new on the market; not much is yet known about side-effects)
Ulcers/Nausea: Many renal dogs develop ulcers. Pepcid A/C or Tagamet
are given about a 1/2 hour before eating (or some just dose their dogs once or
twice a day as needed). Some are using Prilosec-OTC. If your dog is
not getting any relief using the Pepcid or Tagamet, ask your vet for a script
for Carafate (liquid). Carafate coats the stomach, cuts down the acid and
helps heal ulcers. Reglan or another type of anti-nausea medication may
Dietary Modification. Chances are your vet has given you a bag of Hills KD or
some other type of renal diet. There are various renal foods on the market
(Eukanuba, Waltham, Triumph, IVD Modified) - you are not limited to just the one
brand. You may also want to do a home cooked or other diet with your renal dog
instead. Renal dogs become very picky in what they will eat (especially if
they are nauseous). This will be on going. But while it's important
to get your renal dog on a lower protein/lower phosphorus diet, it's more
important that he EATS. If your dog is not eating, then anything goes...
give him ANYTHING that he will eat at this point (of course try to keep it
healthy for him, but sometimes they just want what they want and that is it).
High Blood Pressure: If your vet did not do it, insist on a blood pressure
check. Many renal dogs have high blood pressure and meds may be needed to
get this under control.
Anemia: Renal dogs become anemic. Sometimes adding the B vitamins
and an iron supplement will help. Epogen/Procrit are a human
treatment that sometimes works on dogs, but only for a limited time before the
dog's body rejects it. Once the dog's body has generated antibodies to Epogen,
however, it can cause anemia to return and become worse, a type of "rebound"
effect as the dog's immune system fights the epogen and any intrinsic
erythropoeitin of his own.
Panic: Don't. Your dog will definitely pick-up on this. Try to
keep as positive an attitude as possible, and things will go much smoother for
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