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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 23
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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 can¿t be rushing to the vet often. Even though I don¿t 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 won¿t 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!

Date: May 5, 2017
Category: Kidney Disease
Pet Type: Dog
Topic: Kidney failure

Question:I was told my 14.25-year-old Yorkshire Terrier has chronic kidney failure. This was first diagnosed by chance 1 ½ years go (although they thought at that time it may just be dehydration). In January his BUN was still a bit high, but the vet said early kidney disease (BUN 38.3, creatinine 1.1). His eyesight is not very good ¿ and sometimes seems to be better than other time (is this normal?). He has had cateracts for many years now so I am not sure if it is that or the kidney failure. He also has severe arthritis. He has slowed down a lot with is age, but was still acting comfortable and even excited about things. He had been on the k/d diet (half dry/half wet). However, about 3 days ago he became extremely picky about eating and acted pretty lethargic and like he was in pain (he does take rimadyl & tramadol daily for his arthritis). So much so I was thinking we may have to put him down soon. He will no longer eat any of his k/d food. In fact, he looks like he may be nauseated because of the way he sometimes tries to eat and then moves his head away. The vet did give me some Certnia which I gave him yesterday but I could not tell if that really changed anything. I feel like what has helped the most is offering variety of foods in small amounts throughout the day. He looks to be more comfortable and pretty much the same behavior as he was before the pickiness started. He will eat the cesears steak dog food and I made him boiled carrots/chicken/rice and he will eat that. But anytime he eats, he eats about ¼ of what he use to eat at a sitting. He will also eat some carrots/apples during the day. I have been able to get him to eat enough by giving him many opportunities to eat. And since he is not eating the k/d food, I added some calcium carbonate with his meals to hopefully cut down on his phosphorus. I just started giving him bottled water (not sure of quantity because we have another dog/cat that are also drinking). Also, his urine is a normal color (not too light or dark). And I am starting to add a fish oil capsule to his diet. Maybe this is more information that you need, but I have a question that I thought that the background may help you understand. I understand that kidney disease is irreversible and will only get worse over time. But my question is ¿ if some of these changes do help and not as many toxins are released into the body - what happens to the toxins already in the body? Do they work their way out naturally? I know we cannot pay for dialysis for him, but I am just wondering if there is a little hope for him to feel better with changes I have made. Thank you.

Answer:At his age, I would expect his eyesight to not be what it was when he was younger and just like older humans, they seem to have good days and bad days - that is probably more a result of the cataracts than the kidney disease especially if his blood pressure isn't elevated. Consider giving him subcutaneous fluids as a cheap form of dialysis - it really shouldn't be that expensive and some owners can do it at home. Other things that may help him are Azodyl and/or Epakitin - you can read more about them with these links: http://www.1800petmeds.com/Azodyl-prod10986.html and http://www.1800petmeds.com/Epakitin+Powder-prod11134.html

Date: Apr 10, 2017
Category: Kidney Disease
Pet Type: Cat
Topic: Early stage of kidney disease in cats

Question:My cat is about 15 years old and he's just been diagnosed with an early stage of kidney disease. Could you please recommend what's the right levels of phosphorus and sodium (on a dry matter basis) are good for him in both canned and dry food? Also what should be the right amount of protein in his dry food? Thank you in advance for your help.

Answer:Rather than going strictly by a % of protein, phosphorus and/or sodium, I prefer to see how cats with renal failure do on specific diets in proven trials and over time - like, do my patients do well on them. Everyone wants to make their cat's own food or grab a food off the grocery store shelf with a certain % protein but a lot of research goes into the prescription diets that are formulated and approved for cats with renal failure - they are more expensive for this reason, but they are proven and I trust them because I have seen them work over many years and many patients.

Date: Mar 19, 2017
Category: Kidney Disease
Pet Type: Dog
Topic: Diet

Question:Do I just give my dog K/D Canned and Dry Dog food and NOTHING ELSE. Can treats i.e. , milk bones, greenies and other treats bought at the pet store be given? Also what about people food. I had been giving him white tuna in water, salmon, Frosty Paws etc. Also Beef Marrow Bones (frozen and I cook them in boiling water for 5 mins. There isn't any meat on them, but the marrow inside he loves and chewing on the bone should be good for his teeth. Thank you.

Answer:If you just had her diagnosed, I would just do the K/D pretty strictly for a while until you have her rechecked and see how her kidney values are doing. You can take the canned food and bake her some crunchy cookies until your recheck. (It will kind of stink up the kitchen, lol)

Date: Feb 13, 2017
Category: Kidney Disease
Pet Type: Dog
Topic: Understanding Kidney Disease in Dogs

Question:My dog was recently diagnosed with Kidney, her BUN is 30 and creatinine level 1.6, we will retest in June. She doesn't particularly care for the Royal Canine wet food D, and the dry A, do you have any suggestions of what I can add to make it easier for her to eat. She eventually does, but my vet wants her to eat 2 times a day, any suggestions?

Answer:You can try adding some sort of doggy spice flavorings which may help such as Halo's dinner party which you can find on ilne. You can also ask vet about other prescription diets like HIlls K/D wet food or even consider proper home made diet, the latter, which is ideal and best. See the kidney diet recipe in the book Dr Pitcairn;s guide to natural health for dogs and cats by Richard PItcairn, DVM, phd which has great kidney diet recipe. You can also likely access this recipe on line. MAny dogs prefer the fresh, nonprocessed home versions of kidney diets

Date: Feb 9, 2017
Category: Kidney Disease
Pet Type: Cat
Topic: subq fluids

Question:If I incorrectly insert the needle to administer subq fluids to a cat, will it kill him?

Answer:Should not be a problem. NO risk to the cat


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