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Ask the Vet About Kidney Disease in Dogs and Cats

Kidney Disease in Dogs and Cats
Symptoms & Diagnosis
Treatment
Ask the Vet
Ask the Vet About Kidney Disease in Dogs and Cats
MichaelDym, V.M.D.
Michael Dym, V.M.D.
Doctor of Veterinary Medicine
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As a practicing veterinarian, Dr. Dym has over 19 years of experience and dedication to enhancing the overall health and well-being of pets. His commitment and passion for pet health continuously drives him to learn more about the art and science of homeopathy through ongoing training and education.

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Showing 1 - 15 of 28
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Showing 1 - 15 of 28
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Date: Oct 16, 2017
Category: Kidney Disease
Pet Type: Cat
Topic: emergency care

Question:If a cat is dehydrated with CKD, is it normal to inject Cerenia, Convenia, Dexamethasone, and Famotidine to treat the condition? My cat just showed signs of drinking a lot of water and was moving slow and brought her to the ER for care. 30 hours later she died. Before we brought her to the vet she ate fine and everything seemed somewhat ok ,but she started drinking alot of water and had a little mis step. I don't want to accuse anyone, but it seems that her form of treatment caused her death

Answer:None of those medications (in an appropriate dosage) is very potent or harmful. Cerenia is for nausea, vomiting or inappetance. Convenia is an antibiotic. Dexamethsone is an anti-inflammatory (weak steroid). Famotidine is an antacid like pepcid. If she was dehydrated, did they give her fluids? Even this would depend on a lot of things - did they diagnose the kidney disease or have you been maintaining her at home - did they run blood work on her - what were all of her values (with low potassium, anemia? etc they may have opted not to). I am sorry for your loss.

Date: Oct 8, 2017
Category: Kidney Disease
Pet Type: Dog
Topic: Flea Ned and kidney disease

Question:Can my 2 year old dog getadvantage II drops on back if he has kidney disease

Answer:Good question - it should be fine but it may depend on the severity of his kidney disease. The active ingredient is pretty benign but it is ideal to call the 1-800 number on the box and speak to one of the Bayer veterinarians to know for sure.

Date: Sep 27, 2017
Category: Kidney Disease
Pet Type: Dog
Topic: Acute vs Chronic

Question:It is possible that a 12 year old dachshund whose BUN and Creatinine were within normal values 8 months ago would be in chronic renal failure, or is acute renal failure more likely now with elevated markers? Overnight onset of diarrhea with blood and vomiting. Prior to this, eating, drinking, etc. as normal as ever. Thank you for your response.

Answer:8 month is a long time in a dog's life, so it could be chronic. I would really have to see the rest of his blood work to help - is his potassium high or low? is his albumin low? is he anemic? etc. A few parameters like that can help but, unfortunately, it is kind of "wait and see" with what kind of trajectory his kidney failure will take.

Date: Sep 2, 2017
Category: Kidney Disease
Pet Type: Cat
Topic: Cat health

Question:Hi, I have a 13 year black cat. Lately Ive noticed hes been drinking a lot of water and peeing in the litter box a lot. Sometime hell even just lay next to the water bowl. All my research tells me he has kidney problems. He has lost some weight Recently Ive changed his diet. more expensive food like hills.and dry cat food for urinary tract infections. Again its just a guess from researching. I usually feed him dry and can food. He also vomit white foamy liquid which Im assuming its hair balls. This happens like 3-4 tines a week but its brief. Since changing his food to keep more to improving his kidney. He has show more improvement. Is it a bad idea to give him both dry and can food? I started that to help him gain weight. He does still drink a lot of water and I add additives in the water for his teeth. For his vomit, Ive use some gel laxative for hairballs. He has vomit less since. Max is 13, sleeps a lot and lost 3 sisters last year. Hes never gone outside and also never got his shots. But he seems pretty healthy. Any other recommendations you could recommend me as in food product? I know he needs to se a vet to confirm but he wont leave the apt so its like impossible. Been trying different foods. Mixing dry some cheaper brand with expensive brands.

Answer:It is hard for me to advise you because he may not have kidney disease - a few other things will cause drinking a lot and vomiting like Diabetes and hyperthyroidism, so you really need for your veterinarian to run some quick blood work so you will know exactly how to treat him. Food formulated of "urinary tract health" does not help kidney failure patients - it is formulated for cats that have lower urinary tract problems with crystals and FLUTD so this type of food wouldn't help his problem (and may make it worse). In general, canned food is better just because it gives him more water.

Date: Aug 28, 2017
Category: Kidney Disease
Pet Type: Dog
Topic: Best medicine for kidney

Question:Hi , I have a st.bernard and he is just found with kidney disease with high keratine of .10 and he is prescribed to eat Renel plus tablets. Please suggest if it is the best medicine for him? Also he got tick bite last week on his eyes and today he got 105 fever. Please provide best opinion to avoid his frequent fever. Thanks

Answer:With his high fever, he almost certainly needs some antibiotics but you really need to run some more tests on him to try to determine what antibiotic would be best. If it is a tick born disease, doxycycline (or a similar antibiotic in that family) would be ideal. If it is leptospirosis, intravenous penicillin and then doxycycline is usually what we use in the United States. It could be many other types of infection as well, so running more tests is still ideal.

Date: Aug 15, 2017
Category: Kidney Disease
Pet Type: Cat
Topic: proper use of omeprazole

Question:I have a 16 yr. old cat who was diagnosed with CKD about 6 months ago. I give him Azodyl twice a day. He frequently vomits first thing in the morning, often frothy and white, but sometimes it is tinged with blood. I was advised by his veterinarian to give him 1/4 of an omeprazole tablet each day, until he 'feels better'. His stomach often settles down after 3 or 4 days but in a week or 2 it starts all over again. Can he be given omeprazole on an as needed basis indefinitely? I've read that it should be given daily for 6 or 8 weeks, and that it then cannot be repeated for 4 months. When I mentioned this to the doctor, she said sometimes there are no happy answers. I would like to hear your advice on using omeprazole.

Answer:Your veterinarian is definitely the best one to answer this question, mainly because s/he knows how bad his kidney disease is based on his blood work and history. No good studies have been done on chronic omeprazole dosing in cats so we basically don't know. With my patients in kidney failure, it becomes a quality of life issue - if it makes him feel better, I would give it to my own cat.

Date: Aug 10, 2017
Category: Kidney Disease
Pet Type: Cat
Topic: Drug dispensing error & effects

Question:A 14 year old cat is taking 5mg of Tapazole BID. The pharmacy dispensed Zaroxalyn 5mg in a dispensing error. The cat was given 14 tablets total before error was found. The cat was taken to vet & blood work reveals fatty liver, renal function low, possible uti, & severe dehydration. The vet cannot say whether the medication caused this or if the disease was already there. Last blood work done in 2013 showed some probability of kidney disease & liver problems. Poison control says Zaroxalyn is not harmful to animals, although it does decrease fluids. Is there any information available to confirm it is not harmful to animals? Thank you

Answer:Maybe try asking an animal poison control specialist like: ASPCA Animal Poison Control Center Phone Number: (888) 426-4435 or Pet Poison Hotline: 855-764-7661

Date: Aug 1, 2017
Category: Kidney Disease
Pet Type: Dog
Topic: hates prescription dog food

Question:Help I need some food recipe for my dog with kidney problems right now, I've tried all prescription food and decided to make it myself being she likes real food anyways, any suggestions? She is on subcutaneous fluids and I just need a good recipe

Answer:It is so hard to balance a homemade diet correctly, you ideally need to work with a veterinary nutritionist, so I really lean toward the prescription diets with kidney disease. You have probably tried Hill's Scinece Diet K/D and maybe Purina NF, but Blue Buffalo just came out with one called KS Kidney Support that one of my patients really liked. Royal Canin also has a prescription diet for dogs with kidney problems - it's called "Renal Support". Hopefully you haven't tried one or 2 of those.

Date: Jul 27, 2017
Category: Kidney Disease
Pet Type: Dog
Topic: Diet

Question:Idexx smda 17 Creatinine 1.9 Bun. 45 Hello I have Caitlin terrier 14 years old Still active started drinking lots of water should we change diet? When should we worry about her kidneys?

Answer:I would love to see a urinalysis with that blood work, but if he is normally hydrated, all of those values are slightly elevated, so with the "drinking lots of water", it does seem like a good time to get him on a prescription kidney diet. {This is also assuming that the rest of his bloodwork was normal (normal blood sugar, normal alk phos, etc)}

Date: Jul 11, 2017
Category: Kidney Disease
Pet Type: Cat
Topic: 18 y/o kitty with kidney disease

Question:My cat has kidney disease and stopped eating and started vomiting last week. I took her to the vet, who said that her kidneys had gotten worse, and I now give her daily injections of water and various electrolytes, but I think her back leg weakness may have gotten worse, too. They slide forward and to the sides when she's eating and tend to be flat on the ground rather than on just the toes. She doesn't leave her bed as much, so I figure she's tired and maybe that's making her muscles worse. She only eats the softest of chicken baby food now that she eats again (stopped eating 7 days ago, started eating 4 days ago), so perhaps she's not getting enough nutrients and I need to wait until she eats regular cat food again. She also hasn't had a bowel movement since she stopped eating, so I started mixing in pumpkin puree with her food 2 days ago since pure chicken isn't exactly high in fiber. Was this a good move and is there something more I should do? Also, she spends all her time in her bed, which is in a different room than I'm usually in (I currently live alone). Should I move her to a more active area of the house so we can interact more?

Answer:HI Jack. I would probably put her on a potassium gel supplement from your vet known as Renal K gel or it also comes in powder or tablets. Many cats who are on daily subq fluids like this under the skin will become depleted of potassium in their bodies, even if blood levels in normal range. I also put on kidney failure cats on injectable B complex and B12 shots once to twice weekly which can also help with energy and neurological function. Ask your vet about the prescription medications cerenia(for any nausea and helps with abdominal pain) as well as the drug mirtazipine, which helps stimulate appetite and can be helpful in some of these cats. I would keep her in areas of house that she is comfortable in, whether near you or somewhere else. Sounds like you are doing everything possible in advanced situation with scarred and aged kidneys in 18 year old cat

Date: Jul 9, 2017
Category: Kidney Disease
Pet Type: Cat
Topic: Intravenous fluid treatment

Question:Abby just turned 13 years old. No symptoms of appetite loss/urination has not increased/diarrhea/vomiting/bad breath/lethargy. No change in cat's daily routine. The vet advises changing over to special food for kidney disease which of course I wish to do. She is not dehydrated. I pinched her skin between her shoulder blades and the skin snapped right back. The vet wants to start intravenous fluid once a week. Is this necessary at this early stage? I should add that I am the sole caretaker for my mother who has lymphoma and alzheimer's disease. This would be very difficult for me to do presently. We love our cat and I do not want to seem uncaring which is certainly not true. Please advise. Thank you.

Answer:I would definitely start her on the prescription diet. As far as weekly intravenous fluids, I think you mean subcutaneous fluids. Whether asymptomatic cats need subcutaneous fluid therapy is kind of debatable and depends on many things - her physical exam, how bad her blood work is, etc = things your veterinarian has access to but I don't, so follow their advice over mine, for sure. I can tell you that I tend to not start asymptomatic cats with only mild elevations in their blood work immediately until I see how they are doing on the food. Don't rely on skin turgor as a good test of dehydration - cats have to be VERY dehydrated for their skin to stay tented when you pinch it.

Date: Jun 10, 2017
Category: Kidney Disease
Pet Type: Dog
Topic:  puppy died from kidnepy disease

Question:Hi Sadly my 11week old puppy died from kidney disease. All other pups (so far) are healthy from the litter he came from. He was fine/active on Thursday, Friday alittle tired, Friday not alittle diarrhea. By Sat nite he was at the vet severe diarrhea/not eating. The vet gave him meds. Nothing worked. By Monday my puppy had lost alot of weight and was in hospital but nothing could be done. He was diagnosed with 'congenital renal failure'. He may of picked up a gastro bug/ecoli infection and this caused all this too. Just so heartbroken in space few days my puppy was gone. Is it common for a 11week old puppy to have kidney disease? Or is it our fault as owners our puppy picked up a bug? He had got his first shots/microchipped/well fed and loved and we are just in shock by it all.

Answer:I'm so sorry for your loss. No, to die of congenital kidney disease is not common, thank goodness. No, it's not your fault that the puppy may have picked up a bug. Viruses, like parvo virus, are very aggressive and can live in the environment for many months, sometimes years in the right conditions. If you get another dog, consider getting an older dog that has been vaccinated - maybe one that's been at the shelter and already had all of it's vaccines (initial ones and boosters).

Date: May 30, 2017
Category: Kidney Disease
Pet Type: Cat
Topic: Euthanasia and sedation.

Question:Hello, Dr. Dym, It's Irina from Russia. I have already asked you about cat euthanasia. I asked about propofol overdose. Now, I want to find out about Alprazolam (Xanax). Can I use it as a sedation before euthanasia in my cat? Cause I am still trying to find out THE BEST way to euthanise my cat. I want him to feel no pain or anxiety even. So, do Alprazolam pills work in cats for sedation? And how much should I give before the euthanasia? And in Russia they mostly use Zoletil (tiletamine+ zolazepam) or Propofol for anesthesia. And then different vets do different things. Some may make IV lidocaine or magnesium sulfate. That's how they euthanise. I don't know how painless is that and that's why try to find out on my own. And you say, that barbiturates are the best way. And does it demand only one shot of barbiturate? Is it the anesthetic and euthanasia agent at the same time? Thank you very much. I rely on your help a lot.

Answer:We only use barbituates for euthanasia here in the United States so you should really contact your veterinarian there that is going to euthanize your cat. I would hate to tell you to give the Xanax and then it adversely interact with whatever they choose for euthanasia or affect your cats blood pressure and make it hard for them to find a vein, etc etc.

Date: May 9, 2017
Category: Kidney Disease
Pet Type: Dog
Topic: kidney/blood in stool/high leukocytes

Question:14 1/4 year old yorkie. Recently became extremely picky, even at times not wanting to eat. Has severe arthitis and diagnosed with early kidney failure about 1 1/2 years go. Has been eating k/d diet until about 1 week ago. I started feeding him smaller amounts of homemade food that he would eat most of the time. He is still eating the smaller amounts, but I just started making it half homemade diet/half k/d to hopefully switch him back to his k/d diet fully. He is very slow, but has improved the way he appears to feel since last Tuesday which was at an all time low. I found a new (still warm) urine puddle on the floor. I know it wouldn't be considered a sterile sample, but that would be impossible for me to do. I tried to only touch the top of the puddle with the urinalysis stick. Everything seemed fine except - bilirubin 30s which matched the "small 17" and then the leukocytes 120s which matched the highest level on the chart "large 500". Also, yesterday I noticed what look like blood & mucus on his formed stool. And then again today so I took a sample of that up to the vet. I know I will know in a few hours and I am pretty much fearing the worst because of everything that has preceded the recent to things. I have an appointment with the vet today, but I am just curious of your thoughts. Does this sound like cancer? And any questions that would be good for me to ask the vet? Thank you.

Answer:It doesn't necessarily sound like cancer - he may just have a urinary tract infection and an upset stomach. Since his stomach is kind of upset you may want to ask if they have a long-acting injecteable antibiotic that won't further upset his stomach (Convenia). They may put him on metronidazole for his upset stomach too but that will depend on a lot of things. You may want to ask them if they carry Purina's kidney diet as an option to mix in - but wait until his stomach goes back to normal.

Date: May 5, 2017
Category: Kidney Disease
Pet Type: Dog
Topic: Follow up to: Jill Coleman, DVM

Question:To: Jill Coleman, DVM Thank you for answering my questions. I like to understand how things work, especially with health so I have a few more follow ups. So when you (really whether a dog or human for that instance) increase fluid intake into the body (whether it is subcutaneous fluids or a person drinking more water) that helps rid the body of the toxins floating around even if the kidneys are going downhill? Can I use Azodyl & Epakitin WITH the Calcium Carbonate I am giving him now? How long does it take to start working and possibly see improvement? Are there any other supplements you think he should be on? He has the prescription Cerenia tablets, but are there any other over the counter options available that may prevent nausea? The vet only suggested the k/d diet and lots of fluid back in January. However, the latest changes of not wanting to eat like he used to (2 k/d meals a day) is something that just started on Tuesday. Since he looked so bad on Tuesday that I thought he may need to be put down soon, I wanted to see if there are any other options and it seems there are. Please note my husband was raised in the country where you just got a new dog if yours get sick and not spend a bunch of money on animals so I have to keep that in mind and cant be rushing to the vet often. Even though I dont feel that way I do have to keep that in mind. I have found an article on low phosphorus home cooked dog food since he wont eat the k/d food anymore. So hopefully your information with these supplements will help. You gave me some hope that there are a few other options I can try. Thank you so much for help.

Answer:1 - "So when you (really whether a dog or human for that instance) increase fluid intake into the body (whether it is subcutaneous fluids or a person drinking more water) that helps rid the body of the toxins floating around even if the kidneys are going downhill?" Yes, kind of, or it dilutes them out to the point where they don't build up in the bloodstream and make him nauseous. 2 - Can I use Azodyl & Epakitin WITH the Calcium Carbonate? You can give Azodyl with the calcium carbonate but Epakitin has it in it so you wouldnt want to with Epakitin. 3 - How long to see improvement? That varies with every dog to days or a week or so and it's nothing dramatic - they basically make him feel a little better as the kidney disease progresses. 4 - Over the counter alternatives to Cerenia? Nothing works anywhere near as well as cerenia tablets for nausea that I have found 5 - There are other prescription diets formulated for dogs with kidney disease that may be worth trying to see if he likes them - Purina's is called NF. Blue Buffalo came out with one recently called KS too. It's hard to get a homemade diet balanced but that is an option as well 6 - Good Luck!


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