Pup Headed for Renal Failure?

[bildio]

I found this forum yesterday, and I have spent hours reading posts. Lot’s of great information, compassionate Yorkie people, and some very sad stories. This is my first post, and I apologize for being long winded, but I’m very concerned about my pup’s health. I have two Yorkies. A 12 year old, and an 11 month old.

I purchased Gus from a breeder in early March of this year. A very happy day, and he’s been a real joy.

Last week the vet told me that, based on the downward change in the specific gravity of his urine, Gus is headed for renal failure, and he needs an ultrasound to check his kidneys. First some history, before I give the SG values or just skip ahead.

During his initial vet check after I purchased him, he tested positive for the isospora parasite, and was given sulfadimethoxine. Subsequently, I became concerned about Gus’ frequent urination, and thirst, although he may have had this problem all along. The breeder said it might be a reaction to the medication, and my vet said that it might be behavioral.

He’s had a couple of more positive stool sample tests for parasites, but different ones, and they were successfully treated. I think Gus gets them from eating things off and from under the ground in my back yard. Unfortunately, the soil is damp and moldy, etc.

Gus had a urinalysis in July and it showed a high bacterial content, and one parasite egg. He finished his Amoxi mid-July, and the Amoxi cleared up the bacterial infection. His frequent urination & drinking remained unchanged while taking Amoxi. However, I think there was a reduction in frequency of urination for 2 to 3 weeks after he finished the Amoxi. Since then he’s been, again, urinating frequently and drinking frequently. Although he urinates frequently during the day, most nights makes it through without urinating.

He is otherwise very healthy, active, alert, curious, constantly chewing, etc. He has a healthy appetite. My wife thinks he’s on the chubby side, and I think he’s just right.

Fast forward to September. I had two urinalyses done to see if the bacterial infection returned, and a stool sample test. He tested positive for hookworm, and there was no bacterial content in his urine. However, based on specific gravity values (reference range 1.015 – 1.050), the vet said that Gus is not concentrating his urine and is headed for renal failure. SG was 1.008, on 7/16, when he tested positive for bacteria. SG was 1.019, when he was retested after taking Amoxi. On 9/15 it was 1.016, and on 9/22 (after being given Panacur for hookworms) it was 1.015. The 9/15 and 9/22 urinalyses were otherwise normal. Gus’ blood test results, on 9/29 were within the reference range except for Total Protein – 7.7 (reference range 5.4 –7.1). His BUN is 11 and Creatinine is 0.5. The vet observed that Gus’ blood serum was cloudy after it was separated out, and it should have been clear. Prior to getting the blood test results, the vet thought that this might be a sign of a liver shunt.

I plan to talk to another vet, this week, about the test results, need for an ultrasound, and if he may still has a bacterial infection that didn’t show up in his urinalysis, but should show up in a urine culture.

I am very concerned about Gus having a serious problem. Any thoughts on what the problem might be, and what I should ask the vet to look at?

[Patti]

I got Dixie in December aand she was 6 months old. I was concerned because her pee was clear (on the pee pads) and had no odor and she peed a lot. I took her in just because I thought it was weird, she was acting normal, but was very tiny and thin. The vet did a urinalysis and said she wasn't concentrating her urine, so her did bloodwork and called me an hour later and said she was in full kidney failure and nothing could be done, I couldn't believe it so I had him refer her to a nephrologist and he felt hs could help her. Well one week and 1900 dollars later she was so sick I had to put her to sleep. Her Bun level didn't even register at my vets ut was so high and at the specialist it was over 200 the first test and when I took her in the day I had to put her down it was over 400. He said they can do a lot with dogs and kidney failure but Dixie's kidneys were only functioning at 13% he said they need at least 25% to live. I would suggest having a specialist see Gus and making sure what is going on and what can be done to help him. I will keep him in my prayers.

[bildio]

Patti, sorry to hear about your little one, and thanks for your prayers.

I went to the vet this afternoon, prepared for x-rays, ultrasound, and bad news.

Just the opposite. The vet immediately said that she did not see any renal failure indicators in the blood test or urinalyses.

She suspects a urinary tract infection that was not evident in the urinalyses. So, a urine sample was taken, by needle, and I await the results of a urine culture test.

So, I'm very, very relieved.

[KellyV]

When are his urine samples being collected?
If he was running around all day, drank some water and then you collected the sample, naturally it's going to be more dilute since he just drank a bunch. If he hadn't been drinking anything (say if he was sleeping all night) and then he woke up and went outside before getting anything to drink and you got that sample, and that one was dilute, then I'd be worried.
I always get the "first morning" urine sample when they've been sleeping all night and go out to go potty first thing before eating or drinking anything. That way they don't have any fresh food or water in their system that may affect the results.


It's good that his bloodwork was normal, but the kidneys usually need a significant amount of damage/loss of function before it shows up (up to 75%). It typically shows up in urine as a low SG before it shows as an elevation in bloodwork.
How was the rest of the panel? Were his liver values normal?
You mentioned he has a "healthy appetite". How "healthy" is it? Is he just a good eater or does he act like he's starving all the time?
You also mentioned he may be a little overweight. Does he have a pot belly?
Does he pant a lot?
How is his coat?
Any vomiting or diarrhea?

[bildio]

Originally Posted by KellyV

When are his urine samples being collected?
How was the rest of the panel? Were his liver values normal?
You mentioned he has a "healthy appetite". How "healthy" is it? Is he just a good eater or does he act like he's starving all the time?
You also mentioned he may be a little overweight. Does he have a pot belly? Does he pant a lot? How is his coat? Any vomiting or diarrhea?

Thanks very much for your questions. One of my concerns was that I read that dogs with renal problems can be quite normal until the serious symptoms appear. Gus is quite normal except for the frequent urination, thirst, and urine SG.

I collect his urine samples first thing in the morning.

Liver values? I don't know which are the liver specific values. The only out-of-range value was total protein at 7.7.

He is a good eater. However, when I take him outside he is continuoulsy picking stuff up off the ground and chewing it, and likely swallowing it. I don't know if this is because he is hungry or something else.

The vet said that he is not over weight, but he is at the high end. No pot belly.

His coat is normal.

No panting.

No vomiting or diarrhea.

[KellyV]

There's other conditions that can cause low urine specific gravity and excessive thirst/urination.... Cushings is one of them, but usually they're super hungry, overweight, pant a lot, have elevated liver values..... Just though I would ask.

Hopefully the culture shows something and it's just a bladder infection.

[bildio]

Kelly, thanks for your comments. I'll post results of the culture when I get them.

[bildio]

Gus' urine culture tested negative.

Over the last couple of days, Gus' symptoms (frequent urination & thirst) appear to be less frequent, but he's not what I'd consider normal.

When the vet gave me the results of the culture, yesterday, she said she'd run a check on Gus' SG. Got the results from this morning's sample - 1.026. This is the highest SG of a samples tested. I new it was going to be okay, before getting the results, because this was the first sample that was yellow, i.e., not clear. Conincides with the symptoms subsiding.

I don't know why the change for the better.

I have been making a serious effort to stop Gus from eating things off the ground in my back yard and on the street. Can't believe that this is the answer. Time will tell.

[bildio]

Today he's back to frequent urination & thirst.

I guess I'll just have to accept it and go with the flow.

[JeanieK]

I'm sorry to hear about your little one. has the breeder offered to help at all? Did they give you a health guarentee?

[bildio]

Yes, I can return him up to a year from date of purchase.

I would never give him up though.

I just wish I knew what was causing this.

[Patti]

If possible I would take him to a nephrologist (kidney specialist) just for peace of mind

[Lorraine]

It is very possible your problems with Gus is from whatever he is picking up from the yard as you described is as mouldy etc and those sorts of things can compromise the kidney and/or liver even to the point of permanent damage.
There may also be a congenital kidney issue, an ultrasound may perhaps show if the kidneys are normal or not and may give some info regarding the liver. However, a BA test for liver shunt would likely not be a good idea at this time as given all the medications he has been on particularly sulpha I would be surprised if it were normal, I would expect BA to be high.
I have also heard of Juvenile diabetes in a pup that eventually outgrew it but i have no idea what all the symtoms were and i would suspect if that's the problem he might need some insulin.

[bildio]

I really appreciate everyone’s input. Thank you very much.

Since the second vet thinks Gus is okay, I’m going to assume that this is correct for the next 30 days.

I’ll continue to focus on what he is eating. I think that something that he eating is triggering excessive thirst. If this is the case, he may still have a problem because I’m not feeding him anything unusual. Perhaps the dry food makes him thirsty, but lot’s of dogs eat dry food, and don’t have Gus’ problem.

From late March until September, I fed him Science Diet – Nature’s Best for puppies, with a small amount of canned Pedigree puppy food to moisten the dry food. The second vet recommended either Pet Promise or Paul Newman’s dog food. I purchased both, but Newman’s is very concentrated, and I’m afraid his hunger will not be satisfied. So, now I’m feeding him Promise.

Gus either sleeps, or chews, or is hunting for something to chew. One year old today, and he’s still chewing non-stop. I need to find something for him to chew, that doesn’t trigger his thirst. The other day I gave him his first Bully Stick, and it triggered thirst. Two nights later I gave him a Pedigree Dental Bone, and this triggered thirst. I only resorted to the latter two chew products, because he lost interest in his other chew toys.

He sleeps in my bedroom at night. I close the door so he can’t get out, and get into trouble chewing things. He has no access to water in my bedroom. Most of the time, recently, he makes it through the night without urinating in my room. I’m surprised that, when we get up to go for a walk, he bypasses the water bowl. This seems to support something the premise that something he is eating triggering the excessive thirst.

[bildio]

Well, it's been a little over 30 days since my last update.

Vet said that Gus' SG is 10.32. This is the highest to date (higher is better). She said that I have a healthy Yorkie, and not to worry anymore.