Early stage 2 Kidney Disease

[DeAnnaMa]

Hello, I'd like to introduce myself and my Dalmatian, Jessica. She is 14 and has just been diagnosed with early stage 2 kidney disease. She's on librela shot for arthritis and it made her feel so good she jumped out of our truck, hitting the concrete resulting in 4 days in the ICU. They didn't think she'd come home but she amazed everyone and was fine to come home 4 days later. While in the hospital, her kidney values were concerning. She had slight elevated levels last year but nothing they were concerned about as they thought it could just be due to dehydration. In the hospital she had a host of issues from the fall and we didn't know if her kidney values were from the trauma or something chronic. Now a month later, all else has healed except that. I put her on Dr. Harvey's Canine Health and spoke with a "nutritionist" there who put her on 1.3 oz of protein with the Canine Health 3x a day. We are feeding her 3 times a day because she's lost about 6 lbs. She's 38lbs and normal for her is 44. I'm now working with a holistic vet who focuses on Chinese medicine and nutrition so we're creating recipes with Balance.it. She's just not gaining any weight, despite adding a whole other meal, adding carbs back in to her diet and choosing higher fat meats. She has no protein in her urine. I've attached her latest test results from last week. The protein amounts for Dr. Harvey's and Balance.it seem incredibly low to me. In addition, being from Hawaii, they grew up eating avocados. They are everywhere, all over the ground and we really couldn't stop them and they went crazy for them. Coconut too. I'm not concerned about avocados being toxic to dogs (every dog in the tropics would be dead if that was the case - they all gorge on them) but I read they were hard on the kidneys so I stopped giving them to her. Maybe that would put some more weight on her. Any suggestions to put weight on her (as well as opinions about Dr. Harvey's or Balance.it) would be great. Normally she gets raw meat but the vet said to steam it to leach the phosphorus out. She also gets Dr. Harvey's kidney support supplement (mushroom blend), a multivitamin (joint support, pre-pro biotics)

She has no problem eating - she's ravenous, eats anything and everything I put down. She's happy, alert and her Beam score is B - 10 (if we hadn't had the accident we wouldn't know anything was wrong with her other than the weight loss), E - 8 (she is 14) but she paces for 2 straight hours before any meal waiting to be fed (some of that may be doggy dementia - getting lions mane mushroom extract for that) A - 10+, M - 10 (very happy).

Jessica is on the right in the photo (black ear)

 

[NancyK]

I am sorry you are having these issues. I have heard that Librela is a drug with very bad side effects. Please do your own research. I wonder if you have tried other options.

Dr. Harvey’s Canine Health is loaded with inflammatory ingredients and synthetic vitamins and minerals. Have you considered Dr. Harvey’s Raw Vibrance? The formula looks much less inflammatory to me. It is based upon whole foods vs synthetic vitamins and minerals and is not loaded with carbohydrates like the Canine Health formula. I am not familiar with Balance It. You could also make your own food for complete control.

Nancy

 

[NancyK]

Great YouTube by Judy Morgan on Librela.

Nancy

 

[Dr. Jeff]

Hi DeAnna!

Thanks so much for starting this thread about Jessica.

You mentioned that they were following her bloods in the ICU. Are there any other blood tests values from when she was in the ICU?

Or perhaps there are some from prior to starting the Librela (your vet may have run these before giving her the first injection of it).

she jumped out of our truck, hitting the concrete resulting in 4 days in the ICU. They didn't think she'd come home

Wow! When we spoke about her the other day, I'm not sure that we discussed this. It might be worth giving her a few doses of Arnica 10M to deal with any unseen effect from the trauma:

https://www.amazon.com/Boiron-Arnica-Montana-Purple-Count/dp/B000Y284KW/ref=asc_df_B000Y284KW/?tag=hyprod-20&linkCode=df0&hvadid=693600913332&hvpos=&hvnetw=g&hvrand=8980075831284168768&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9003448&hvtargid=pla-2186708483683&psc=1&mcid=21c2465f4f0433869f902ae70248dd54

Thanks Nancy for sharing about Librela.

 

[DeAnnaMa]

Thanks Nancy. Balance.It is a homemade diet formulated with my holistic veterinarian. You can only get the recipe and supplement with vet approval to make sure it is balanced. So we are going to be replacing Dr. Harvey's with that homemade diet for the most part. We were using Raw Vibrance but the Canine Health, once protein, water and oils are added is only .2% phosphorus which we really need to be aware of those levels. And she's never going to gain wait with the Raw Vibrance which is my main concern at the moment because her levels are better than they were a month ago, even on the Canine Health, but I have to get some weight on her.

In regards to the librela, I appreciate the info. I was aware but we had to make a decision. This normally, loving, sweet energetic dog became so fearful of being touched due to arthritis pain that she was snapping and biting before you even touched her out of fear that you would touch her. We couldn't cuddle with her anymore, she had to be muzzled at one point and we've never had to do that. So unfortunately the librela has made a huge difference. She's my lovey, cuddly dog again. No shaking, snapping or biting, just love and snuggles and free movement. So while I'd rather not have to give it to her, she was also in pain and I couldn't let that continue. We tried all sorts of natural and homeopathic remedies for over a year and the aggression and pain got worse, nothing helped her. Unfortunately, sometimes there are trade offs.

 

[DeAnnaMa]

Hi DeAnna!

Thanks so much for starting this thread about Jessica.

You mentioned that they were following her bloods in the ICU. Are there any other blood tests values from when she was in the ICU?

Or perhaps there are some from prior to starting the Librela (your vet may have run these before giving her the first injection of it).


Wow! When we spoke about her the other day, I'm not sure that we discussed this. It might be worth giving her a few doses of Arnica 10M to deal with any unseen effect from the trauma:

https://www.amazon.com/Boiron-Arnica-Montana-Purple-Count/dp/B000Y284KW/ref=asc_df_B000Y284KW/?tag=hyprod-20&linkCode=df0&hvadid=693600913332&hvpos=&hvnetw=g&hvrand=8980075831284168768&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9003448&hvtargid=pla-2186708483683&psc=1&mcid=21c2465f4f0433869f902ae70248dd54

Thanks Nancy for sharing about Librela.

Thanks, tried Arnica for a year, didn't help.

 

[DeAnnaMa]

I've attached her blood work from the ICU, the bloodwork from her regular vet 5 days after being released, bloodwork from a year ago at her annual and an ultrasound from the hospital. there was a lot going on with her there. Like I said, they were amazed she could come home.

 

[Dr. Jean Hofve]

Hi, DeAnna, and welcome!

A few thoughts for you...

First, phosphorus cannot be "leached out" of food by any means. That's not a thing, and it makes me question whatever else that vet says. Maybe everything else is perfectly correct, but that is such a basic misunderstanding of nutrition and physiology I'm having a hard time getting past it.

The combination of carbs and fat is the way to add weight. But all three macronutrients need to be well balanced.

Protein is an essential dietary component, dogs need about 1 gm per pound of ideal body weight per day. But of course, in Dalmatians it gets tricky. Hopefully they have the amino acid balance calculated precisely. BalanceIt does tend to be on the low end for protein, and if the parameters by which the diet was formulated included kidney disease, the protein will be absolutely minimal.

I disagree that protein restriction is justified in early kidney disease. They are even re-thinking this in human CKD. The evidence was never that good. I believe that it will cause problems with keeping weight on. If phosphorus is a concern (and it isn't, in early stages) then a phosphorus binder can be used.

Maybe consider a consultation with a board-certified nutritionist. I personally recommend Dr. Donna Raditic, who does remote consultations.

Whatever you're feeding, though, maybe just feed *more* of it. If it's the right balance, then just increasing the volume may do the trick. Since she's that hungry, it she just may not be getting enough calories.

 

[GinnyW]

As far as homeopathy goes, I see a lot in the case that SHOULD be addressable - with a positive and permanent result. What is needed is very circumspect case-taking resulting in the most appropriate choice, and the most apt remedy, administered in a careful and individual way, following the individual's response very carefully. This is to say that Arnica, or any other remedy "tried" may or may not be the best choice, but that the "trying" may be fruitless if the dosing is not done according to best homeopathic practice. I would have imagined a result here from capable and incisive dosing, and would not write off the poor result as futile. Were you working with an experienced and/or recommended practitioner?...My first dog was pretty impaired by abuse of conventional drugs, but excellent homeopathy brought him comfort and happiness time and again in his last years, so I speak from experience.

 

[DeAnnaMa]

Hi, DeAnna, and welcome!

A few thoughts for you...

First, phosphorus cannot be "leached out" of food by any means. That's not a thing, and it makes me question whatever else that vet says. Maybe everything else is perfectly correct, but that is such a basic misunderstanding of nutrition and physiology I'm having a hard time getting past it.

The combination of carbs and fat is the way to add weight. But all three macronutrients need to be well balanced.

Protein is an essential dietary component, dogs need about 1 gm per pound of ideal body weight per day. But of course, in Dalmatians it gets tricky. Hopefully they have the amino acid balance calculated precisely. BalanceIt does tend to be on the low end for protein, and if the parameters by which the diet was formulated included kidney disease, the protein will be absolutely minimal.

I disagree that protein restriction is justified in early kidney disease. They are even re-thinking this in human CKD. The evidence was never that good. I believe that it will cause problems with keeping weight on. If phosphorus is a concern (and it isn't, in early stages) then a phosphorus binder can be used.

Maybe consider a consultation with a board-certified nutritionist. I personally recommend Dr. Donna Raditic, who does remote consultations.

Whatever you're feeding, though, maybe just feed *more* of it. If it's the right balance, then just increasing the volume may do the trick. Since she's that hungry, it she just may not be getting enough calories.

Thanks Dr. Jean. That "leaching" advice was not given by the vet but rather by the "nutritionist" at Dr. Harvey's and maybe "reduce" is the better word referring to the following sources.

Cooking Methods May Help Dialysis Patients Control Phosphorus - Renal and Urology News

Boiling in water and stewing in an oil-water mixture were found to reduce phosphorus levels significantly in various foods.

www.renalandurologynews.com

Study Probes Boiling Methods for Cutting Phosphorus in Meat - Renal and Urology News

Boiling sliced meat in a pressure cooker filled with soft water may be a promising way for dialysis patients to reduce phosphorus intake.

www.renalandurologynews.com

Balance.it does not allow you to put in any raw meat. Not sure where cooking the meat falls on reducing phosphorus according to the links above but this link to phosphorus food values shows raw meat being less because cooking reduces moisture. Maybe if you steam it, that doesn't apply. DogAware.com Health: Nutritional Information on Selected Foods

I know the whole thing is making me kind of crazy. Balance.it recipes call for things like 1/16 of a teaspoon or 1 13/15 cup. Like does it really have to be that precise? If I use 1/2 teaspoon or 1 1/2 cup is it going to be dire?

I looked in to the board certified nutritionist thing. They give you one recipe for $1000, any additional recipes are $400 or more. Takes months to get an appointment (they recommend using Balance.It in the meantime) and I had someone who went to one, paid the money and she shared with me what she got. It was exactly the same as the recipe from Balance.it. I've done so much research at this point and gotten so much differing advice, my husband thinks we're researched out. That we're not going to find out anything new (or a magic bullet) that we don't already know. I'm just so afraid of doing the wrong thing and making her worse.

We were also instructed to only use distilled or filtered water. We're on a well and she doesn't like it (she was never a big water drinker) we float her food in a lot of water but I have to add some homemade chicken broth to water to get her to drink it. Dr. Jeff suggested structured water. May try that. Again, this is literally taking up a large portion of every day for me trying to get this right.

thanks so much for the advice

 

[NancyK]

What about the Hunde meal mixer below used in conjunction with low phosphorus meats like chicken thighs? It uses seaweed calcium vs bone meal which is lower in phosphorus.

HUNDE - Essential Blend for Dogs

Essential Blend for dogs is a balancing base that makes preparing your dog's food at home a breeze. This nutritionist formulated blend fills common gaps in homemade diets and takes the stress out of ensuring your best mate's food is balanced. Just add raw or lightly cooked meat to create a...

www.rawfeedingmiami.com

This looks like a great product and is not loaded with synthetic vitamins and minerals which it appears are in the BalanceIt products.

Nancy

 

[DeAnnaMa]

What about the Hunde meal mixer below used in conjunction with low phosphorus meats like chicken thighs? It uses seaweed calcium vs bone meal which is lower in phosphorus.

HUNDE - Essential Blend for Dogs

Essential Blend for dogs is a balancing base that makes preparing your dog's food at home a breeze. This nutritionist formulated blend fills common gaps in homemade diets and takes the stress out of ensuring your best mate's food is balanced. Just add raw or lightly cooked meat to create a...

www.rawfeedingmiami.com

This looks like a great product and is not loaded with synthetic vitamins and minerals which it appears are in the BalanceIt products.

Nancy

Hi Nancy, this looks awesome. But like Dr. Jean said, Dalmatians are tricky. Because they can't process purines they can't have high purine foods, specifically organ meats so liver and tripe are out and sardines are high as well.

Was considering this product but it has phosphorus in it and doesn't say it's recognized as meeting AFCO standards. If anyone has used this or knows if it's ok for dogs with kidney disease, they could let me know.

Dog Greens- Organic and Wild Harvested Vitamin and Mineral Supplement

Organic and Wild Harvested plant-based vitamin and mineral blend powder. Dog Greens provides your dog all the vitamins and minerals they need to live a long healthy life and meet their nutritional requirements from a whole food source! Fine powder is easily mixed in with your pet's meals.

drjudymorgan.com

 

[NancyK]

Hi Nancy, this looks awesome. But like Dr. Jean said, Dalmatians are tricky. Because they can't process purines they can't have high purine foods, specifically organ meats so liver and tripe are out and sardines are high as well.

Was considering this product but it has phosphorus in it and doesn't say it's recognized as meeting AFCO standards. If anyone has used this or knows if it's ok for dogs with kidney disease, they could let me know.

Dog Greens- Organic and Wild Harvested Vitamin and Mineral Supplement

Organic and Wild Harvested plant-based vitamin and mineral blend powder. Dog Greens provides your dog all the vitamins and minerals they need to live a long healthy life and meet their nutritional requirements from a whole food source! Fine powder is easily mixed in with your pet's meals.

drjudymorgan.com

I see.

Peter Dobias sells two products...GreenMin and SoulFood. My understanding is that these two supplements can be utilized to make balanced homemade dog food. However, please make sure this is true if you decide to use it. The vitamins are at least fermented which is better than the ordinary synthetic ones.

Nancy

 

[Dr. Jeff]

, this is literally taking up a large portion of every day for me trying to get this right

Hi DeAnna!

I think Jessica would want you to just love her up and have as much fun with her as possible.

Optimizing her quality of life will help you all.

For sure!

 

[Dr. Jean Hofve]

BalanceIt doesn't account for raw meat, but cooked meat has the exact same nutrition, less a little moisture. So you don't have to do much in the way of calculating to make that substitution. Just "pretend" the meat is cooked when working with the recipe.

There aren't really any "low phosphorus" meats, but cooked egg white is a low phosphorus protein that is okay for Dals, if you want to boost the protein a bit. Bone meal is out because it's 50% phosphorus but any other elemental calcium is probably okay.