Elevated BUN in senior dog

[LynneE]

@Dr. Jeff, @Dr. Christina

Thank you so much in advance for reading through this as I know there is a lot here. I wanted to give you as complete a picture as I could without going off on too many irrelevant tangents. I look forward to any advice you can offer and am truly grateful for your time.

I'm looking for some help with our 15 yr old, 14# Spayed Chihuahua mix with elevated BUN. The BUN has gradually increased over the last couple of years, most recent value of 53. Up until recently, we haven't really noticed much in the way of symptoms - if we didn't know about the number, we wouldn't have known anything was "off" She has been on VetriScience Renal Essentials per the recommendation of our holistic vet for the last couple of years.

Just a quick background on our vet care. We have 2 dogs (sisters) and they had the same allopathic vet from when we got them around 8 weeks until about 3 years ago. When we moved up to NH from MA we decided to seek out a holistic vet and have been primarily working with her for their care. Sometimes they go to our other vet still (if they need a dental surgery for example) and this past year they went there for annuals and lab work.

So a few weeks ago, Wynnie was getting more excited/anxious in the morning to go outside, sometimes even waking up an hour or so before usual to go out (around 4-5, instead of 6 or so - we usually get our dogs up, not the other way around, lol). She also had an accident on the bed (isolated event) and was having to go out more regularly. That seemed to mostly subside when we introduced Kidney Works by Sustenance Herbs (product/ingredient pictures attached), hard to know if it's a coincidence or the reason. She still is a little more excited to go out than she used to be even at her usual time in the morning, but then again, so am I as I get older, lol

She had a urinalysis last week and it looked pretty normal, other than very slightly elevated WBC and a trace of bacteria. Our allopathic vet who ran the lab work suggested that it could be a UTI and wanted to either have her come in and get a sterile sample via syringe to be sure or just put her on antibiotics. We steer clear of any potentially unnecessary interventions, so I told her I would think about it and maybe just want to retest in a couple of weeks and then reevaluate.

Our holistic vet said she wouldn't suggest putting her on anything based on the test results (which I've attached). We're thinking re-test her urine in the next week to see if anything seems off at all. I also have been giving her the juice from fresh cranberries by adding it to each of her meals. There is a product by NOW called Mannose Cranberry which I'm not opposed to using - I just always prefer to use the food option first (when possible) to see if it helps. This morning she seemed less "anxious" to go outside, but we'll have to see how tomorrow goes.

At her annual exam in July, our allopathic vet gave her a rectal exam, without our consent or knowledge - it was inadvertent as she did the exam out back after they drew her blood and did it on auto-pilot by mistake (they know we want to be involved in anything and everything and don't usually do that). When the vet brought Wynnie back in from what we thought was her blood draw, she was definitely off and not herself which is when we found out about the rectal exam.

In any event, we spent the next hour and a half in that room, wondering if she was having a stroke or back spasms or who knows what. The vet brought the ultrasound machine in and checked her a couple different times to make sure there was nothing internal going on, which there wasn't, and had another vet come in and look at her. She couldn't stand on her own and just seemed listless. By the time we left, she was walking on her own, wagging her tail a bit and starting to seem like herself and by the time we got home (1 1/2 away, it was like nothing had ever happened).

My gut is that it was a freak thing and she went into some kind of back spasm/problem from getting her tail lifted for the rectal exam, but not positive. The vet followed up of course, but Wynnie seemed totally fine after that. This was in early July and I don't know if there is any relevance other than the traumatic experience in and of itself (at least for me and my husband anyway).

Wynnie's diet is Primal Raw and has been since she was around 3. She was having a rough time a couple of years back with bloody stools temporarily and mucus as well. Our holistic vet recommended Sustenance Herbs Pet Probiotic and Digestive Enzyme Blend which seemed to help since those issues stopped - we still give this to her at every meal. She's had 3 dental cleanings (surgeries) over the last 10 years. We haven't vaccinated her since 2013 when her titers showed she needed Distemper, but no other vaccines since (other than required Rabies). She's been on antibiotics/pain meds for each of the 3 dentals over the years as well.

In addition to the 3 Supplements I already mentioned, she also gets Sustenance Herbs Bor-L-Immune for tick prevention. She also receives BICOM bioresonance therapy treatments from our holistic vet periodically. I'm wondering if she needs a change from the VetriScience Renal - we're definitely grateful for any suggestions. Hawaii Pharm has 3 different Kidney specific formulas and this one caught my attention, Kidney Bladder Support, but we welcome any recommendations.

Other symptoms/concerns:

• A little more tired than usual, tends to sleep a lot, but energy and mood is good when she's awake.
• She's drinking more water than she normally would.
• Around meal times, she gets vocal - more than she used to - and more anxious and restless for us to put her food down (she won't sit still like she used to). Ironically, she seems to eat a little slower than usual.
• She has had an irritated area of her mouth for a while though so I'm not sure if it's some gum inflammation causing the eating change. We have had both our vets look at her mouth multiple times and she gets hand scalings done a couple times a year as well - they don't seem concerned. I brush her teeth every night - she really has gotten less interested in me brushing that area, which I do very gently of course. I was looking at Hawaii Pharm Dental Support to possibly give her and welcome any thoughts or other recommendations for the inflammation/dental health in general.
• Not really a symptom, but for a variety of reasons, we haven't been sitting with the girls as much as we have in the past. We have worked from home for several years and always been able to sit with them for periods of time during the day while still being able to get our work done. Recently that wasn't really able to happen much at all. They weren't alone or anything, but being in the same room with them is very different of course than sitting with them. Recognizing this, we have started making adjustments to make sure that we're sitting with them more often and they are always most relaxed in this case. Ironically, we spend a lot of time at home so they are rarely alone, but sitting with them makes a big difference, so we're prioritizing it whenever we can!
• One other thing to mention is that we used to rotate proteins, but were having issues for different reasons and she now exclusively eats duck. We're wondering if there are any proteins you recommend she should/shouldn't eat factoring in the BUN levels? We might try to rotate another protein or 2 back into her diet if necessary. We also recently bought Primal Market Mix Sardine Topper and are thinking about incorporating that into her meals - any thoughts on this or other food recommendations?

Thank you again for all of your help, we are truly grateful ?

 

[Dr. Christina]

Lynne,
You have been doing a wonderful job over the years of caring for your dogs. You have followed their energy levels, and used symptoms as clues to effectiveness of the different holistic treatments, as well as lifestyle issues.

I will specifically answer some of your questions. Maybe @Dr. Sara could add some more.

So a few weeks ago, Wynnie was getting more excited/anxious in the morning to go outside, sometimes even waking up an hour or so before usual to go out (around 4-5, instead of 6 or so - we usually get our dogs up, not the other way around, lol). She also had an accident on the bed (isolated event) and was having to go out more regularly.
good clues that something in the urinary system was off.

That seemed to mostly subside when we introduced Kidney Works by Sustenance Herbs (product/ingredient pictures attached), hard to know if it's a coincidence or the reason.
Not a coincidence unless proven otherwise

She still is a little more excited to go out than she used to be even at her usual time in the morning, but then again, so am I as I get older, lol
For both of you, rather than assigning symptoms to aging, assume they are clues of internal imbalance.

She had a urinalysis last week and it looked pretty normal, other than very slightly elevated WBC and a trace of bacteria. Our allopathic vet who ran the lab work suggested that it could be a UTI and wanted to either have her come in and get a sterile sample via syringe to be sure or just put her on antibiotics. We steer clear of any potentially unnecessary interventions, so I told her I would think about it and maybe just want to retest in a couple of weeks and then reevaluate.
Perfect to not take antibiotics as they should only be given if a culture and sensitivity is done. Given the context of an energetic renal imbalance and since other values ok, no need for a sterile sample.

Our holistic vet said she wouldn't suggest putting her on anything based on the test results (which I've attached). We're thinking re-test her urine in the next week to see if anything seems off at all. I also have been giving her the juice from fresh cranberries by adding it to each of her meals. There is a product by NOW called Mannose Cranberry which I'm not opposed to using - I just always prefer to use the food option first (when possible) to see if it helps. This morning she seemed less "anxious" to go outside, but we'll have to see how tomorrow goes.


In any event, we spent the next hour and a half in that room, wondering if she was having a stroke or back spasms or who knows what. She couldn't stand on her own and just seemed listless. By the time we left, she was walking on her own, wagging her tail a bit and starting to seem like herself and by the time we got home (1 1/2 away, it was like nothing had ever happened).My gut is that it was a freak thing and she went into some kind of back spasm/problem from getting her tail lifted for the rectal exam, but not positive. The vet followed up of course, but Wynnie seemed totally fine after that. This was in early July and I don't know if there is any relevance other than the traumatic experience in and of itself (at least for me and my husband anyway).
Probably not a cause of current issues. I think your gut is correct.

Wynnie's diet is Primal Raw and has been since she was around 3. She was having a rough time a couple of years back with bloody stools temporarily and mucus as well. Our holistic vet recommended Sustenance Herbs Pet Probiotic and Digestive Enzyme Blend which seemed to help since those issues stopped - we still give this to her at every meal.
While fine to continue, I like to stop supplements that were given for specific problems once the problems resolve. If they return fairly quickly it is an indication that deeper energetic treatment is needed and they are merely palliating.

She's had 3 dental cleanings (surgeries) over the last 10 years. We haven't vaccinated her since 2013 when her titers showed she needed Distemper, but no other vaccines since (other than required Rabies). She's been on antibiotics/pain meds for each of the 3 dentals over the years as well.
Great for no vaccines. Even when titers decrease, there is cell mediated immunity, so no need to revaccinate. That is why I recommend only one set of titers, and if there is adequate antibodies, never repeat unless needed for shows/etc.

In addition to the 3 Supplements I already mentioned, she also gets Sustenance Herbs Bor-L-Immune for tick prevention.
Again, I tend to avoid lots of supplements, so I would only use that if you are doing a ton of hiking and the suggestions made by Dr. Judy in her tick prevention Empower Hour are not sufficient. Often there can be some overlap in different supplements, so only use when really needed.

She also receives BICOM bioresonance therapy treatments from our holistic vet periodically. I'm wondering if she needs a change from the VetriScience Renal - we're definitely grateful for any suggestions. Hawaii Pharm has 3 different Kidney specific formulas and this one caught my attention, Kidney Bladder Support, but we welcome any recommendations.
I do like to change supplement companies periodically, since there are now many good ones. Learning to do muscle testing/pendulum/dowsing can help decide when it is time to change. The Hawaii pharm looks good.

Other symptoms/concerns:

• A little more tired than usual, tends to sleep a lot, but energy and mood is good when she's awake. Goal is no extra sleep needed
• She's drinking more water than she normally would. Goal is to restore balance so she does not need to do that
• Around meal times, she gets vocal - more than she used to - and more anxious and restless for us to put her food down (she won't sit still like she used to). Ironically, she seems to eat a little slower than usual. Again - goal would be for that to resolve by healing the mouth, or asking an animal communicator what is going on. Appetite and Behavior are part of the BEAM, so goal is to have a perfect BEAM.
• She has had an irritated area of her mouth for a while though so I'm not sure if it's some gum inflammation causing the eating change. We have had both our vets look at her mouth multiple times and she gets hand scalings done a couple times a year as well - they don't seem concerned. I brush her teeth every night - she really has gotten less interested in me brushing that area, which I do very gently of course. I was looking at Hawaii Pharm Dental Support to possibly give her and welcome any thoughts or other recommendations for the inflammation/dental health in general. Again, I tend to minimize supplements. It may be needed but I think, again, the gum issue indicates the need for Homeopathy or TCVM and some other energy treatments (Reiki, Eden, Quantum, etc).
• Not really a symptom, but for a variety of reasons, we haven't been sitting with the girls as much as we have in the past. We have worked from home for several years and always been able to sit with them for periods of time during the day while still being able to get our work done. Recently that wasn't really able to happen much at all. They weren't alone or anything, but being in the same room with them is very different of course than sitting with them. Recognizing this, we have started making adjustments to make sure that we're sitting with them more often and they are always most relaxed in this case. Ironically, we spend a lot of time at home so they are rarely alone, but sitting with them makes a big difference, so we're prioritizing it whenever we can! Your love for them shines through.
• One other thing to mention is that we used to rotate proteins, but were having issues for different reasons and she now exclusively eats duck. We're wondering if there are any proteins you recommend she should/shouldn't eat factoring in the BUN levels? We might try to rotate another protein or 2 back into her diet if necessary. We also recently bought Primal Market Mix Sardine Topper and are thinking about incorporating that into her meals - any thoughts on this or other food recommendations? I do like to rotate proteins, including dairy, egg, fish. I also like to have you purchase the fresh ingredients from local, sustainable farmers when possible.

@Dr. Sue Howell may have some more input on giving multiple supplements as she was staff veterinarian at Standard Process for a long time.
Dr. Christina

 

[LynneE]

Thank you Dr. Christina for all this wonderful feedback! It gives us a lot to think about and help us start moving forward ?

I'll be curious to see what Dr. Sue has to say about the supplement question for sure!