Kidney Failure

[MelissaC]

Good afternoon-

A friend of mine has a 8 year old female sheltie who started to have kidney issues about a year ago. Now the vet is saying the kidneys have failed. I know sometimes diet can work miracles and I did suggest that, but since the diagnosis she has been feeding Hills Kidney diet, with a homemade blend of turkey, oatmeal, spinach, carrots and rosemary mixed in. 6/29 she is seen by the vet, where kidney numbers are very bad, but Fiona is active and happy, but refusing to eat. Was given appetite stimulant and ate steadily until the 4th. Since then she has refused all food even with the stimulant. Yesterday July 6th, she was given fluids and the vet gave Cerenia because she had some dry heaves and threw up about a tsp of yellow bile.

Fiona still does lots of barking, but exhibits no fear symptoms.

Enalapril is the only medication she is on regularly. She does get Heartguard once a month and Frontline once a month for years.

Any help would be very appreciated.

Melissa

 

[Dr. Christina]

Thanks so much, Melissa, for helping your friend.

First, have her not give any more flea/tick/heartworm meds when they come due.

Second, help her find a holistic vet (free article at holisticactions.com/select) and many can help long distance.

Third, suggest she just feed the fresh food and no K/d or other processed foods.

Fourth, do not let the internet or her conventional vet make her feel that it is hopeless. many dogs live years with "failing" kidneys. Explain about BEAM - if the quality of life is good - enjoy and do not worry while working on different health strategies.

She can learn a lot more about our approach for free by taking the Holistic Pet Health 101 class.

 

[Dr. Jeff]

Hey Missy! How are you?

Any help would be very appreciated.

Yes, the pup needs help!

Do you know if your friend's vet at Town and Country (Dr. Christenson?) is open-minded. If so, I wonder if the vet would like to set up some time to speak about pragmatic strategies to help the young pup's quality of life?

Making The Case For Pragmatic Veterinary Medicine

This expert article by Dr. Heather Kvitko-White makes the case for why pragmatic veterinary medicine should be adopted as an industry best practice.

thepragmaticprofessor.com

 

[MelissaC]

Thanks so much, Melissa, for helping your friend.

First, have her not give any more flea/tick/heartworm meds when they come due.

Second, help her find a holistic vet (free article at holisticactions.com/select) and many can help long distance.

Third, suggest she just feed the fresh food and no K/d or other processed foods.

Fourth, do not let the internet or her conventional vet make her feel that it is hopeless. many dogs live years with "failing" kidneys. Explain about BEAM - if the quality of life is good - enjoy and do not worry while working on different health strategies.

She can learn a lot more about our approach for free by taking the Holistic Pet Health 101 class.

Thank you for replying. I have already done 1, 3, and 4. It was her BEAM that saved her from being euthanized based on the numbers. I’ll have her check out the online holistic vet finder—that is very helpful!

Fiona’s Mom is going to start giving fluids at home. Does that help the body clear the waste products that build up or just hydrate her?

And is it necessary to use phosphorus binders if she is not eating regularly?

Melissa

 

[MelissaC]

Hey Missy! How are you?



Yes, the pup needs help!

Do you know if your friend's vet at Town and Country (Dr. Christenson?) is open-minded. If so, I wonder if the vet would like to set up some time to speak about pragmatic strategies to help the young pup's quality of life?

Making The Case For Pragmatic Veterinary Medicine

This expert article by Dr. Heather Kvitko-White makes the case for why pragmatic veterinary medicine should be adopted as an industry best practice.

thepragmaticprofessor.com

Hi Dr. Jeff,

The vet who did the panel recommended euthanasia. Dr. Hall who owns the clinic suggested trying a few other things based on Fiona’s energetic presentation. Unfortunately, it was just more meds. I do think he is open to working with a holistic vet. I’ll check out the vet finder and see what we can do for Fiona.

Based on the bloodwork, what stage would you put her in?

And why do you think would her glucose be so high when she hadn't eaten for a few days?

Thank you,


Missy

 

[Dr. Jeff]

Does that help the body clear the waste products that build up

That's exactly what the fluids do!

And is it necessary to use phosphorus binders if she is not eating regularly?

Great question!! They're definitely less helpful but since her phosphorus level is so high, they may help.

Based on the bloodwork, what stage would you put her in?

I'm not sure, probably 3+ proteinuria. I don't use the current IRIS stages (or other numbers as a guide to balancing treatment (lab values help guide drug treatments).

http://www.iris-kidney.com/pdf/IRIS_Staging_of_CKD_modified_2019.pdf

And why do you think would her glucose be so high when she hadn't eaten for a few days?

Her body doing its' job of creating fuel from fat, muscle, etc.

 

[MelissaC]

That's exactly what the fluids do!


Great question!! They're definitely less helpful but since her phosphorus level is so high, they may help.

I'm not sure, probably 3+ proteinuria. I don't use the current IRIS stages (or other numbers as a guide to balancing treatment (lab values help guide drug treatments).

http://www.iris-kidney.com/pdf/IRIS_Staging_of_CKD_modified_2019.pdf

Her body doing its' job of creating fuel from fat, muscle, etc.

 

[MelissaC]

Great information!

thanks again,

missy

 

[Dr. Jean Hofve]

Just a little FYI for those who don't know... the point of k/d and similar diets is to restrict phosphorus. Adding meat completely negates that "benefit." You really have to pick one or the other, and do not add add any extra protein, not even meat-based treats, to k/d.

That said, I really hate kidney diets (as do most pets!), and heartily agree that a good homemade diet is best. Freeze-dried and dehydrated diets can be helpful (add a little *extra* water when rehydrating them to increase benefit and dilute phosphorus), or she might like raw frozen. You might even try canned food to help reboot her appetite; they tend to be pretty smelly and may perk up her appetite. The cheaper ones have less protein and more odor! Right now, whatever she WILL eat is fair game. Phosphate binders are helpful to mitigate the higher protein levels in these foods.

Honest Kitchen's foods are very high in carbs, but in this situation may work well because there is less protein but excellent quality ingredients.

Giving fluids is really important for these guys; they are typically pretty dehydrated. Fluids do indeed wash out the toxins, which in turn reduces the headache and nausea they cause. Fluids will help her feel better and be more likely to eat.

Smearing a little meat baby food as a food topper is a good trick to get sick dogs (and cats!) to eat. Though it's high protein, not eating is her worst enemy right now.

Thanks for helping your friend! Please keep us posted!