Hello Again Tracy,
I'm back inquiring about some new specific information about Abbey. She is now 11 yrs. old and has been diagnosed with serious kidney disease and severe anemia. It started out with what appeared to be a urinary tract infection, back in April of this year... which she was treated for with Amoxicillin, and PPA for incontinence. Also Farnam Canine Red Cell (6 tsp/day) was recommended for her anemia. Her gums and lips have been becoming very pale during walks, and she was lagging behind rather than pulling me as she had even a few months prior.
She finished the Rx's, but shorty afterwards she resumed having the incontinence & developed another UTI, and was given the same antibiotic and more PPA until she could be seen for blood tests, which was last Tues. ...the day when we also got the results.
The blood tests revealed a BUN of 64 and Creatin is 4.1
plus her anemia levels are:
PBC - 2.73
HCT - 20/5%
HGB - 8.1 g/dl.
My vet recommended that she begin eating Purina Veterinary Diet NF Kidney Function. I bought the 18 lb. bag plus 6 cans to get started, to reduce her phosphorous intake which I understand converts to nitrogen in the body...I'm told this is one of the biggest culprits in causing and perpetuating kidney disease, (I guess the "NF" stands for nitrogen free). He also recommended doubling the Red Cell, and to continue having her take the PPA...to keep bacteria from re-entering her urinary tract. He said to limit her walks, and to stop when she appears to be getting tired, so her system isn't 'overtaxed'. In the meantime, I decided that I should get her onto an a different diet right away that would take the load off her kidneys and hopefully also improve the anemia, (which the vet says is directly related)...until I can explore all the options for the best possible treatment and food, as well as finding other things that I can do to improve her chances to keep the kidney disease from progressing. I realize that there is no way undo the damage that has occurred..and no real 'cure' for this, only maintenance.
He recommended that she return in 30 days to repeat the blood tests, to determine if this diet has improved (lowered) her numbers related to her kidney function, and improved her anemia. He also told me that he cannot tell me the stage of kidney disease she is in, without an ultrasound & biopsy, neither of which they do in their office...and that she would need to see a specialist. I understand that there could be an underlying cause, such as a tumor or other medical issue...if the changes I've mentioned don't show much in terms of improvement when they repeat the blood tests, I'll seriously consider taking her to the specialist.
Another thing I'm curious about...is that I read online that feeding dry food can rob the body of moisture, and that can put stress on the kidneys. Lastly, there is also conflicting info. online, regarding how much protein if any dogs with kidney disease should be getting. The NF food has 12%.
Tracy, any thoughts, info. and help you can offer, would be greatly appreciated!
Thanks!
Karin
Abbey...Serious Kidney Disease and Anemia Diagnosis!
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ArtistKarin
- Posts: 8
- Joined: Mon Sep 23, 2013 7:51 am
Re: Abbey...Serious Kidney Disease and Anemia Diagnosis!
Was a urine culture ever done to determine if there were bacteria that may not respond to amoxicillin? (UTI's can be tough and when they reoccur, a sample should be cultured to ensure you're not dealing with something else) - was there any unusual casts or sediment in the urine samples?
You didn't mention if Abbey had common signs of kidney disease (i.e., increased water consumption, increased urine output, unable to concentrate urine, nausea or vomiting, weight loss, dehydration). Other than the UTI and tiredness, was there anything else that alerted you?
What did her chemical profile look like? (i.e., calcium, albumin, phosphorus, potassium, etc) - anything abnormally high or low?
Was she hospitalized on IV fluids, or, are you giving them at home? Did vet say she was severely dehydrated? Is she having any intestinal issues?
As for food, any of the veterinary brands are appropriate - they are reduced protein, but high quality protein. You don't want to reduce too much protein, and you don't want a diet with too high protein, because it has a necessary function for kidneys/urinary health and gastrointestinal health etc - right now, she is losing protein in her urine, and combined with a UTI, fluids and appropriate diet might be your best bet at this point. I ask about her chemical profile in the event she may also require other supplementation, although I'm assuming the iron supplement you're giving has a ton of vitamins and minerals in it. (it just might not be the appropriate "dose" of a particular mineral supplement in the event your vet thinks she may need a separate supplement)
I don't think feeding dry food stresses the kidneys, although in older pets, you certainly want to provide more moisture (water to make gravy in the kibble dish) or canned when a pet has diabetes, kidney disease, urinary tract disease, GI disease etc - however, it also depends on the pet and the pet's preferences, willingness to eat, and of course, ensuring the pet is eating sufficiently.
As for xrays/ultrasound - both can provide a good idea of size and shape and density of the kidneys (and check for masses), but I would think your vet would already have a pretty good idea just having palpated her kidneys during her exams. On the other hand, imaging can be useful to rule out secondary problems sometimes associated with the primary disease.
I don't know if I'd go as far as a biopsy. I think at this point, the lab numbers are telling you what you need to know in the here and now - address dehydration, address anemia with sufficient supplementation, culture the urine to determine if anything amiss or requires stronger antibiotics, make sure she's drinking and eating sufficiently, ask vet if he checked for hypertension. I'm guessing he didn't think this was an acute form of renal disease (acquired suddenly, usually from a toxin, injury etc) but the anemia is definitely concerning (please ask vet if he thinks Abbey's hematocrit should be checked sooner than a month) - lastly, I'm assuming he wasn't worried about viruses, worms, bugs and didn't feel the need to test for those?
Watch her carefully -check her hydration status daily, her gums and skin coloring often, and again, ask vet if he checked her for hypertension.
You didn't mention if Abbey had common signs of kidney disease (i.e., increased water consumption, increased urine output, unable to concentrate urine, nausea or vomiting, weight loss, dehydration). Other than the UTI and tiredness, was there anything else that alerted you?
What did her chemical profile look like? (i.e., calcium, albumin, phosphorus, potassium, etc) - anything abnormally high or low?
Was she hospitalized on IV fluids, or, are you giving them at home? Did vet say she was severely dehydrated? Is she having any intestinal issues?
As for food, any of the veterinary brands are appropriate - they are reduced protein, but high quality protein. You don't want to reduce too much protein, and you don't want a diet with too high protein, because it has a necessary function for kidneys/urinary health and gastrointestinal health etc - right now, she is losing protein in her urine, and combined with a UTI, fluids and appropriate diet might be your best bet at this point. I ask about her chemical profile in the event she may also require other supplementation, although I'm assuming the iron supplement you're giving has a ton of vitamins and minerals in it. (it just might not be the appropriate "dose" of a particular mineral supplement in the event your vet thinks she may need a separate supplement)
I don't think feeding dry food stresses the kidneys, although in older pets, you certainly want to provide more moisture (water to make gravy in the kibble dish) or canned when a pet has diabetes, kidney disease, urinary tract disease, GI disease etc - however, it also depends on the pet and the pet's preferences, willingness to eat, and of course, ensuring the pet is eating sufficiently.
As for xrays/ultrasound - both can provide a good idea of size and shape and density of the kidneys (and check for masses), but I would think your vet would already have a pretty good idea just having palpated her kidneys during her exams. On the other hand, imaging can be useful to rule out secondary problems sometimes associated with the primary disease.
I don't know if I'd go as far as a biopsy. I think at this point, the lab numbers are telling you what you need to know in the here and now - address dehydration, address anemia with sufficient supplementation, culture the urine to determine if anything amiss or requires stronger antibiotics, make sure she's drinking and eating sufficiently, ask vet if he checked for hypertension. I'm guessing he didn't think this was an acute form of renal disease (acquired suddenly, usually from a toxin, injury etc) but the anemia is definitely concerning (please ask vet if he thinks Abbey's hematocrit should be checked sooner than a month) - lastly, I'm assuming he wasn't worried about viruses, worms, bugs and didn't feel the need to test for those?
Watch her carefully -check her hydration status daily, her gums and skin coloring often, and again, ask vet if he checked her for hypertension.
..........Traci
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ArtistKarin
- Posts: 8
- Joined: Mon Sep 23, 2013 7:51 am
Re: Abbey...Serious Kidney Disease and Anemia Diagnosis!
Hi Traci, thank you for getting back to me so quickly about Abbey! I'm thinking that there are a lot of questions I need to ask her vet, and I may actually email them to him and then forward his responses to you here. We had strong T-storms last night which knocked out our internet until a little while ago, otherwise I would have done that today. Hopefully I will hear back from him tomorrow, and I will be providing you those answers.
Thanks again!
Thanks again!