Chloe has kidney failure - YorkieTalk.com Forums

Bmulford · 08-22-2015, 09:48 AM

Hi all! I took my 6yr old female to be spayed last Monday. I was pretty sure she had pyometria. She was vomiting on the Friday prior and in heat. They scheduled her right away. The day before the surgery she was back to her old self. I took her in and they wanted to do some tests and completed the spay. I picked her up and she was completely lethargic. I of course followed her post-op instructions. Two days later the vet called me regarding her labs and told me she was in renal failure. Her labs were all over the charts. He ssid her kidneys were functiining at > 30%. I wasn't impressed with his lack of sympathy and picked up her lab results and took her to an animal hospital. The animal hospitals staff were awesome! But her prognosis was not good. They said that she may have been muddling along and the anesthesia exacerbated the kidney failure. I called the clinic where she was spayed and inquired on whether her blood was drawn before or after surgery. It was drawn after.
The hospital allowed me to do her care at home. She's on IV fluids, pepcid and a renal diet. This was Wednesday. I haven't left her side. She seems to be doing better. She's eating, drinking, still not herself but much better. They say not to get my hopes up. Has anyone else experienced anything like this? I'm praying for a miracle!

Yorkiemom1 · 08-22-2015, 10:50 AM

So sorry to hear about your young lady....I have not had any experience with this in any of my dogs, but I did copy some information from a vet site, that may help add to your understanding of what you are dealing with....maybe provide you with questions to ask, etc....

Chronic Kidney Disease in the Dog

Chronic kidney disease is a relatively common disorder in dogs, especially geriatric dogs, although it can occur in young dogs. It occurs when the kidneys are no longer able to perform their normal function of removing waste products from the blood. This is not the same as the inability to make urine. In fact, most dogs with renal disease are producing large volumes of urine. This disparity between the large volume of urine produced and declining kidney function are often a source of confusion for owners.

Typically, chronic kidney disease comes about as the kidneys undergo aging changes and begin to “wear out.” It is a process that develops over months to years. Initially, there may be no apparent signs and the dog’s bloodwork is normal. However, there are irreversible microscopic changes underway in the aging kidney. Eventually, the kidneys will begin to shrink because of scar tissue and will become small and hard. By this time, there are usually signs of progressive kidney disease and the labwork will indicate associated changes.

The kidneys are nothing more than filters which selectively keep certain compounds in the blood, while allowing unnecessary waste products to escape into the urine. When aging causes the filtration process to become progressively less effective, blood flow to the kidneys increases in an attempt to improve filtration. This is the reason that the dog with kidney disease is producing a large volume of urine. Because of the loss of excessive fluid through the urine, the dog is obligated to drink more water to avoid becoming dehydrated. This is called a compensatory change.

Thus, the early clinical signs of kidney disease are increased water consumption (polydipsia) and increased urine production (polyuria). Sometimes weight loss and muscle loss are noted. In the lab, urine changes and blood changes can often be noted much sooner.

Diagnosis

The diagnosis of kidney disease is made by determining the level of two waste products in the blood: blood urea nitrogen (BUN) and creatinine. A urinalysis is also needed to complete the study of kidney function.

Although BUN and creatinine levels reflect kidney disease, they do not predict it. A dog with marginal kidney function may have normal blood tests. If that dog is stressed with major illness or surgery, the kidneys may fail, sending the blood test values up quickly.

Treatment

1. Diuresis – sick patients need this therapy

In the first phase of treatment, large volumes of intravenous fluids are given in an attempt to flush toxins from the body. This flushing process, called diuresis, is designed to maximize the function of all remaining kidney tissue. If enough functional kidney cells remain, they may be able to adequately meet the body’s needs for waste removal, with the help of this additional fluid. Also, the fluid therapy helps to replace various electrolytes, especially potassium. Other important aspects of initial treatment include proper nutrition and drugs to control vomiting and diarrhea.

Unfortunately, there are no reliable tests that will predict the outcome of this first phase of treatment. We hope that intensive fluid therapy will substantially decrease the blood levels of BUN and creatinine. If there is no improvement after 3+ days of fluid therapy, the prognosis is more guarded than for dogs who show significantly decreased values.

2. Ongoing Medical Therapy at Home

The second phase of treatment is designed to maximize the remaining function of the diseased kidneys. This is accomplished with one or more of the following, depending on the situation:

1. A low protein, low phosphorous diet. First, the diet helps to minimize excess protein waste products that require the kidneys to work excessively. Secondly, this helps to keep the blood tests as close to normal as possible. This improvement in the bloodwork often correlates with improvement in the way the dog feels. You will need to purchase the special kidney diet from the veterinarian. Possible diets that may be suggested are g/d (only for early problems), k/d, or Renal LP (most palatable). All foods purchased from your veterinarian have a palatability guarantee and the purchase price is refunded should the food not work for your pet.

2. Potassium supplementation. Potassium is lost in the urine when urine production becomes excessive. A potassium supplement will replace that loss. As mentioned above, depletion of body potassium can worsen kidney function. RenaKare (powder) or Potassichew (flavored tablets to crumble on food) are the two best products.

3. A phosphate binder. As the filtering ability of the kidneys declines, phosphorous begins to accumulate in the blood. High serum phosphorous contributes to depression and anorexia. Phosphate binders will attach to excess dietary phosphorous in the intestine so that it is not absorbed with the food. Blood levels of phosphorous can be monitored to help tailor the drug dosage. These drugs are used when the kidney failure diets are not able to control phosphorus levels. Epakatin is the name of the med we recommended. It also contains a nitrogen trap to help reduce BUN values as well. Blood levels of phosphorous can be monitored to help tailor the drug dosage.

4. Azodyl. This is a beneficial bacteria that is given in a capsule or in food. It works to reduce waste products in the body by metabolizing them in the GI tract. This allows the pet to feel better as there are less waste products in the blood and helps the kidney to have less waste to filter. The main compounds that are broken down by Azodyl are the urea containing compounds, effectively reducing the BUN value and improving the bloodwork and quality of life.

May not be needed at initial presentation or may be needed right away:

5. Fluids given at home. After your dog has completed a course of intravenous fluid therapy in the hospital, fluid can be given at home. The fluid is dripped under the skin, or subcutaneously over 5-10 minutes. This serves to continually “restart” the kidneys as their function continues to decline. This is done once daily to once weekly, depending on the severity of kidney disease. This technique is easily mastered by most owners so don’t be afraid to consider this very helpful option.

6. Drugs to control high blood pressure. About 20 to55% of dogs that have kidney failure also have hypertension. Its control is important in preventing blindness and strokes. We need to test blood pressure to determine the need.

7. Drugs to stimulate appetite. Famotidine is a drug that helps to neutralize excess stomach acid. This is often helpful in improving appetite because excess stomach acid is a cause of nausea that adversely affects the appetite. This is drug is available and has a very broad margin of safety, but may not be needed for your dog.

8. A drug to regulate the parathyroid gland and calcium levels. Calcium and phosphorus must remain at about a 2:1 ratio in the blood. The increase in blood phosphorus level, as mentioned above, stimulates the parathyroid gland to increase the blood calcium level by removing it from bones. This can be helpful for the sake of the normalizing calcium

hosphorus ratio, but it can make the bones brittle and easily broken. Calcitriol can be used to reduce the function of the parathyroid gland and to increase calcium absorption from the intestinal tract.

9. A drug to stimulate the bone marrow to produce new red blood cells. The kidneys produce erythropoietin, a hormone that stimulates the bone marrow to make red blood cells. Therefore, many dogs with kidney disease have a low red blood cell count, anemia. Epogen, a synthetic form of erythropoietin, will correct the anemia in most dogs. Unfortunately for some dogs, the drug cannot be used long term because the immune system recognizes the drug as “foreign” and will make antibodies (immune proteins) against it.

Prognosis

The prognosis is quite variable depending on response to the initial stage of treatment and your ability to perform the follow-up care. However, we encourage treatment in most situations because many dogs will respond and have good quality life for up to 4 years.

I am praying for you and your little lady....hopefully, with aggressive treatment, you can get ahead of this and keep her around for more precious time. I have an excfellent vet for my kiddos...but if I had ANY questions that I was concerned about, or more detailed information/more aggressive treatment or approach to treatment, I high-tail it to our vet school at A&M! (Actually, we have a super first rate emergency vet service, Gulf Coast Vet Hospital here in Houston that has saved many trips to A&M by many people!) If possible, I would take my little dog to a vet school at the University in your State....they have the best equipment, all cutting edge equipment and treatments available in vet medicine.....they are teaching vets, so it is all right there! Best of luck on this tough road you are facing....bless you and your young lady.....

Lizchloe · 08-22-2015, 11:19 AM

My Yorkie is also named Chloe, and we are sending you special prayers for your Chloe, please get better soon.

08-22-2015, 09:48 AM	#1
Bmulford YorkieTalk Newbie! Join Date: Aug 2015 Location: Taylor, az Posts: 1	Chloe has kidney failure Hi all! I took my 6yr old female to be spayed last Monday. I was pretty sure she had pyometria. She was vomiting on the Friday prior and in heat. They scheduled her right away. The day before the surgery she was back to her old self. I took her in and they wanted to do some tests and completed the spay. I picked her up and she was completely lethargic. I of course followed her post-op instructions. Two days later the vet called me regarding her labs and told me she was in renal failure. Her labs were all over the charts. He ssid her kidneys were functiining at > 30%. I wasn't impressed with his lack of sympathy and picked up her lab results and took her to an animal hospital. The animal hospitals staff were awesome! But her prognosis was not good. They said that she may have been muddling along and the anesthesia exacerbated the kidney failure. I called the clinic where she was spayed and inquired on whether her blood was drawn before or after surgery. It was drawn after. The hospital allowed me to do her care at home. She's on IV fluids, pepcid and a renal diet. This was Wednesday. I haven't left her side. She seems to be doing better. She's eating, drinking, still not herself but much better. They say not to get my hopes up. Has anyone else experienced anything like this? I'm praying for a miracle!

08-22-2015, 10:50 AM	#2
Yorkiemom1 Rosehill Yorkies Donating YT Member Join Date: Dec 2007 Location: Houston Texas Posts: 9,462	So sorry to hear about your young lady....I have not had any experience with this in any of my dogs, but I did copy some information from a vet site, that may help add to your understanding of what you are dealing with....maybe provide you with questions to ask, etc.... Chronic Kidney Disease in the Dog Chronic kidney disease is a relatively common disorder in dogs, especially geriatric dogs, although it can occur in young dogs. It occurs when the kidneys are no longer able to perform their normal function of removing waste products from the blood. This is not the same as the inability to make urine. In fact, most dogs with renal disease are producing large volumes of urine. This disparity between the large volume of urine produced and declining kidney function are often a source of confusion for owners. Typically, chronic kidney disease comes about as the kidneys undergo aging changes and begin to “wear out.” It is a process that develops over months to years. Initially, there may be no apparent signs and the dog’s bloodwork is normal. However, there are irreversible microscopic changes underway in the aging kidney. Eventually, the kidneys will begin to shrink because of scar tissue and will become small and hard. By this time, there are usually signs of progressive kidney disease and the labwork will indicate associated changes. The kidneys are nothing more than filters which selectively keep certain compounds in the blood, while allowing unnecessary waste products to escape into the urine. When aging causes the filtration process to become progressively less effective, blood flow to the kidneys increases in an attempt to improve filtration. This is the reason that the dog with kidney disease is producing a large volume of urine. Because of the loss of excessive fluid through the urine, the dog is obligated to drink more water to avoid becoming dehydrated. This is called a compensatory change. Thus, the early clinical signs of kidney disease are increased water consumption (polydipsia) and increased urine production (polyuria). Sometimes weight loss and muscle loss are noted. In the lab, urine changes and blood changes can often be noted much sooner. Diagnosis The diagnosis of kidney disease is made by determining the level of two waste products in the blood: blood urea nitrogen (BUN) and creatinine. A urinalysis is also needed to complete the study of kidney function. Although BUN and creatinine levels reflect kidney disease, they do not predict it. A dog with marginal kidney function may have normal blood tests. If that dog is stressed with major illness or surgery, the kidneys may fail, sending the blood test values up quickly. Treatment 1. Diuresis – sick patients need this therapy In the first phase of treatment, large volumes of intravenous fluids are given in an attempt to flush toxins from the body. This flushing process, called diuresis, is designed to maximize the function of all remaining kidney tissue. If enough functional kidney cells remain, they may be able to adequately meet the body’s needs for waste removal, with the help of this additional fluid. Also, the fluid therapy helps to replace various electrolytes, especially potassium. Other important aspects of initial treatment include proper nutrition and drugs to control vomiting and diarrhea. Unfortunately, there are no reliable tests that will predict the outcome of this first phase of treatment. We hope that intensive fluid therapy will substantially decrease the blood levels of BUN and creatinine. If there is no improvement after 3+ days of fluid therapy, the prognosis is more guarded than for dogs who show significantly decreased values. 2. Ongoing Medical Therapy at Home The second phase of treatment is designed to maximize the remaining function of the diseased kidneys. This is accomplished with one or more of the following, depending on the situation: 1. A low protein, low phosphorous diet. First, the diet helps to minimize excess protein waste products that require the kidneys to work excessively. Secondly, this helps to keep the blood tests as close to normal as possible. This improvement in the bloodwork often correlates with improvement in the way the dog feels. You will need to purchase the special kidney diet from the veterinarian. Possible diets that may be suggested are g/d (only for early problems), k/d, or Renal LP (most palatable). All foods purchased from your veterinarian have a palatability guarantee and the purchase price is refunded should the food not work for your pet. 2. Potassium supplementation. Potassium is lost in the urine when urine production becomes excessive. A potassium supplement will replace that loss. As mentioned above, depletion of body potassium can worsen kidney function. RenaKare (powder) or Potassichew (flavored tablets to crumble on food) are the two best products. 3. A phosphate binder. As the filtering ability of the kidneys declines, phosphorous begins to accumulate in the blood. High serum phosphorous contributes to depression and anorexia. Phosphate binders will attach to excess dietary phosphorous in the intestine so that it is not absorbed with the food. Blood levels of phosphorous can be monitored to help tailor the drug dosage. These drugs are used when the kidney failure diets are not able to control phosphorus levels. Epakatin is the name of the med we recommended. It also contains a nitrogen trap to help reduce BUN values as well. Blood levels of phosphorous can be monitored to help tailor the drug dosage. 4. Azodyl. This is a beneficial bacteria that is given in a capsule or in food. It works to reduce waste products in the body by metabolizing them in the GI tract. This allows the pet to feel better as there are less waste products in the blood and helps the kidney to have less waste to filter. The main compounds that are broken down by Azodyl are the urea containing compounds, effectively reducing the BUN value and improving the bloodwork and quality of life. May not be needed at initial presentation or may be needed right away: 5. Fluids given at home. After your dog has completed a course of intravenous fluid therapy in the hospital, fluid can be given at home. The fluid is dripped under the skin, or subcutaneously over 5-10 minutes. This serves to continually “restart” the kidneys as their function continues to decline. This is done once daily to once weekly, depending on the severity of kidney disease. This technique is easily mastered by most owners so don’t be afraid to consider this very helpful option. 6. Drugs to control high blood pressure. About 20 to55% of dogs that have kidney failure also have hypertension. Its control is important in preventing blindness and strokes. We need to test blood pressure to determine the need. 7. Drugs to stimulate appetite. Famotidine is a drug that helps to neutralize excess stomach acid. This is often helpful in improving appetite because excess stomach acid is a cause of nausea that adversely affects the appetite. This is drug is available and has a very broad margin of safety, but may not be needed for your dog. 8. A drug to regulate the parathyroid gland and calcium levels. Calcium and phosphorus must remain at about a 2:1 ratio in the blood. The increase in blood phosphorus level, as mentioned above, stimulates the parathyroid gland to increase the blood calcium level by removing it from bones. This can be helpful for the sake of the normalizing calciumhosphorus ratio, but it can make the bones brittle and easily broken. Calcitriol can be used to reduce the function of the parathyroid gland and to increase calcium absorption from the intestinal tract. 9. A drug to stimulate the bone marrow to produce new red blood cells. The kidneys produce erythropoietin, a hormone that stimulates the bone marrow to make red blood cells. Therefore, many dogs with kidney disease have a low red blood cell count, anemia. Epogen, a synthetic form of erythropoietin, will correct the anemia in most dogs. Unfortunately for some dogs, the drug cannot be used long term because the immune system recognizes the drug as “foreign” and will make antibodies (immune proteins) against it. Prognosis The prognosis is quite variable depending on response to the initial stage of treatment and your ability to perform the follow-up care. However, we encourage treatment in most situations because many dogs will respond and have good quality life for up to 4 years. I am praying for you and your little lady....hopefully, with aggressive treatment, you can get ahead of this and keep her around for more precious time. I have an excfellent vet for my kiddos...but if I had ANY questions that I was concerned about, or more detailed information/more aggressive treatment or approach to treatment, I high-tail it to our vet school at A&M! (Actually, we have a super first rate emergency vet service, Gulf Coast Vet Hospital here in Houston that has saved many trips to A&M by many people!) If possible, I would take my little dog to a vet school at the University in your State....they have the best equipment, all cutting edge equipment and treatments available in vet medicine.....they are teaching vets, so it is all right there! Best of luck on this tough road you are facing....bless you and your young lady.....

08-22-2015, 11:19 AM	#3
Lizchloe Senior Yorkie Talker Join Date: Aug 2015 Location: Oshawa, Ontario, Canada Posts: 211 Blog Entries: 1	Chloe sending prayers My Yorkie is also named Chloe, and we are sending you special prayers for your Chloe, please get better soon.