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I feel quite sad... my old girl is, well, getting old.

She had her ACTH stim test this week for her Cushings, which is a little high, but she is not going back on meds at this stage. Reason for this is that she is showing signs of chronic kidney disease / kidney failure (her kidney enzymes were elevated a little, but all other levels were fine), and a symptom of Cushings is increased drinking, which actually helps flush out the kidneys of toxins.

So, I just want to know as much as I can about chronic kidney disease / kidney failure. How long does it take to become fatal, what we need to look out for, how we can help? What kind of foods are good to assist with the slowing of this disease?

I know we are on borrowed time with Chloe, and at 13yo I appreciate every day. I still feel sad she may not be with us for a long time now though... :laugh:

Thanks for any advice/info given.

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I'm sorry, Kelly Louise. :laugh: It really sucks when they get old.

This article might be some help as regards your diet questions:

http://calve.massey.ac.nz/comp/urology/Ren...0with%20CRF.pdf

ETA - if you can't access it, the gist is that yes, commercial renal diets (in this case Hills specifically) do appear to slow the rate of kidney damage quite substantially compared to regular maintenance diets, in dogs with CKD. The CKD diet tested had reduced protein, sodium & phosphorus, and increased omega 3:6 ratio, compared to the maintenance diet.

Edited by Staranais
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Thanks Staranais... I feel so teary. We've put so much effort into her health and it's been an ongoing battle since she was 8years old... and I knew this day would come, but you never really feel ready for it do you?

I spoke to the vet about a commercial diet for CKD, however with her tendency for tummy upsets he thinks she is better off to stay on a senior formulation for the time being. But I think we should give it a try. She's such a fussy eater though. But anything we can do to help slow it, the better.

Does anyone know about which meats/raw food might be best for this kind of thing? She eats alot of chicken and beef (cooked, not raw) with vegies - but not sure if this is okay or if there is any kind of meat/vegies that may be better than others?

Good news is her phosphorous and sodium levels were good. Her elevated kidney enzymes hadn't changed since late November/early December so that is also a good sign I guess.

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If you wanted to do the raw/home cooked CKD diet route, I wonder if it would be worth getting a consult with a canine nutritionist to help you design a suitable diet? I wouldn't know where to start, personally - I don't know which raw ingredients are high/low in potassium or sodium and omega ratio, plus it might be quite hard to get a low protein diet using typical raw foods? And it's not the kind of thing you'd want to play around with. Sorry I can't be more help.

ETA, I've had a hunt around & apparently there are a few books out there with supposedly nutritionally balanced homemade recipes for CKD patients, such as:

"Home Prepared Dog & Cat Diets" by Dr Donald Strombeck.

"Waltham Book of Clinical Nutrition of the Dog and Cat".

I've never read either of these so can't vouch for how good or how well balanced or how easy to formulate the recipes are - but they might be helpful if you can get hold of them.

Edited by Staranais
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Thanks so much guys... I've purchased some Hills K/D wet and dry food to give a try. Hopefully she will take to it. She goes on and off foods all the time though, doesn't help that Mum panders to it.

Maybe if we mix in a little fresh meat she will be more inclined to eat it.

I read some reviews on the Hill KD and they seem to be promising, and fairly palatable to dogs.

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ETA, I've had a hunt around & apparently there are a few books out there with supposedly nutritionally balanced homemade recipes for CKD patients, such as:

"Home Prepared Dog & Cat Diets" by Dr Donald Strombeck.

"Waltham Book of Clinical Nutrition of the Dog and Cat".

I've never read either of these so can't vouch for how good or how well balanced or how easy to formulate the recipes are - but they might be helpful if you can get hold of them.

Thanks so much Staranais - that's an awesome help :laugh:

Will start the hunt for them!!

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No help from me, I'm afraid :laugh: . But ;) to you KL - you're a trouper with all that you have done and are doing for Chloe.

Oh Erny, you have no idea how much it means for you to say that, it actually brought some tears. We've been through the wars, Chloe and I, but we've always come out the other side. It's been a full on emotional roller coaster ride for the last 5 years... but as long as she continues to love life, be happy and is comfortable - I will continue to give her every chance. She certainly deserves it. One of the bravest dogs I've ever known.

I'm trying to tell myself to just do what we can to help her along - and until her time comes (hopefully not for a couple of years yet??) enjoy every single day we are blessed with her. And she is a blessing. :thumbsup:

Have found a copy of the diet book Staranais just in the process of ordering it - so hopefully will find lots more info to help ChloBo. Thanks for the tip :rofl:

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Oh Erny, you have no idea how much it means for you to say that, it actually brought some tears. We've been through the wars, Chloe and I, but we've always come out the other side. It's been a full on emotional roller coaster ride for the last 5 years... but as long as she continues to love life, be happy and is comfortable - I will continue to give her every chance. She certainly deserves it. One of the bravest dogs I've ever known.

Who is blessed with a wonderful owner. Draw strength from the fact that you've put in yards that many others would not have.

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Sorry but in my experience, kidney failure in old dogs or cats is usually a sign that the body has simply worn out. It is a common ending for animals that have had to have a lot of medication. Eventually the kidneys can no longer cope and they are usually just the first organ to fail as the body can no longer function. For me personally it spells the end of the line and I have pts my animals that have gone into kidney failure after battling long illnesses.

My attitude is keep them going with medication as long as they are fit and happy but be prepared for when the kidneys fail from that medication and let them go before they really start to suffer. I kept a cat with kidney failure going far too long once and will never do that to another animal.

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dancinbcs - thanks for your honest input... I guess that's exactly why I feel so sad. Everything we've had to battle with Chloe has always had a management side, and altho CKD can be slowed - it does mean the clock is now ticking. :eek:

This is the reason that although her Cushings levels are a little on the high side (but still relatively normal), she is not being put back on meds. She isn't showing symptoms or discomfort, so at the moment, we are keeping her off meds for as long as possible (the remission came at a good time). The only meds she is on at the moment is Previcox, which I know is bad for kidneys - but she is given a very small dosage only when absolutely necessary (on days her legs are really playing up) and a course of 10 tablets can last quite a few months. I'm also thinking of re-trying her on cartrophen injections - not sure if it will be as effective now that her arthritis has worsened, but I guess it's worth a shot if it means even less Previcox. Not sure if Cartrophen would have any negative effects on the kidneys either - would anyone be able to confirm that please?

I will never allow Chloe to suffer, it is one thing I have promised her, myself and my Mum. She has been through so much, it would be utterly selfish of us to keep her going - even though I will never be ready to let Chloe go. I'm sure she is tired from fighting these battles... but she is still happy, she still bounces around and LOVES to go for walks. While this is the case, we will do what we can to make things as easy as possible for her.

Erny - you have touched my heart, and in doing so, have made the reality of the situation that much easier to bear. It's lovely to have our efforts acknowledge from someone so knowledgeable, and who I know also goes above and beyond to give their dogs the quality of life they deserve - even if they aren't well. I remember when her health issues all started, I used to pray to God to keep her well - and to give us more time with her. I think about how unfair it is that this has happened, but have to remember that God did answer our prayers and has given her many more good years with the ones she loves than anyone expected. We have been more than fortunate, even if hasn't always appeared that way. I feel selfish to ask for more than that, but still, you always have to have a little hope don't you?

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Not sure if Cartrophen would have any negative effects on the kidneys either - would anyone be able to confirm that please?

The only contraindication of relevance that I'm aware of is that pentosan polysulfate can affect coagulation times in some animals, so it is not recommended that they are used at the time of surgery. Aside from this they are considered to be very safe.

Prudent use (lower than recommended doses, lowest frequency of administration) of NSAIDs like Previcox is acceptable if the benefit they give outweighs the potential negative effects. With progression of renal failure, other drugs like gabapentin and tramadol can be useful for managing pain without having significant effects on the kidneys.

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Not sure if Cartrophen would have any negative effects on the kidneys either - would anyone be able to confirm that please?

The only contraindication of relevance that I'm aware of is that pentosan polysulfate can affect coagulation times in some animals, so it is not recommended that they are used at the time of surgery. Aside from this they are considered to be very safe.

Prudent use (lower than recommended doses, lowest frequency of administration) of NSAIDs like Previcox is acceptable if the benefit they give outweighs the potential negative effects. With progression of renal failure, other drugs like gabapentin and tramadol can be useful for managing pain without having significant effects on the kidneys.

Thanks so much for that info Rappie - very handy to know. We shall give Cartrophen a try, see if it will assist in anyway (can't harm).

Thank you also for the pain relief med info, I will definitely speak to her specialist about perhaps changing over should it be required. As it is, she is only taking it sparingly... but still, if there is something better we can be using it's good to be able to investigate it.

I love DOL, always a place for useful, reassuring info. What would I do without it? :heart:

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Have found a copy of the diet book Staranais just in the process of ordering it - so hopefully will find lots more info to help ChloBo. Thanks for the tip :rofl:

You're more than welcome - please let me know if it's any help or not (so I know whether to recommend it again!)

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Hi KL, I don't have any answers for you but I wanted to wish you lots of luck with Chloe and I hope she can stick around as long as possible. I too have a dog who holds my heart but who's body is starting to let him down. I know both my dogs are the same age but Bella is healthy as an ox!

big hugs to you and Chloe :crossfingers:

Thanks so much WSM... it's very sad when the will and mind are still happy and healthy, but the body just can't keep up - and there's just no much you can do about it, you feel so helpless. God love her, she still keeps going though - loves a game of ball, loves her walks, loves to visit her doggy friends.

My last wishes for her now, is that when her time does come - and hoping that will be in another couple of years - that she passes quickly, quietly and unexpectedly in her sleep one day. To me, that would be the perfect ending to her life - and certainly what she deserves... however, regardless how the time comes, we will be with her letting her know how much she is always loved, and will always be a part of us.

Okay, enough of the morbidity.... she is still with us, and we are lucky to get to enjoy her being a part of our family. That is enough for now. She had a good day yesterday, didn't drink TOO much and was full of energy and ate all her dinner... so hopefully her Cushings is still holding back for a while.

Still waiting for her new prescription diet to arrive... fingers crossed the stubborn old bugger eats it. :crossfingers: Keeping fingers crossed!!

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Kelly - our dog came up with one of her levels rated as 'a little high' in a routine blood test last June. Started on the k/d food and the tablets (Fortekor) which has been combined with her previous dry food during the day but her night meal is the k/d dry food and some 'healthy weight' low everything wet food. Vet explained for our dog at this stage it just has to be managed (and its not cheap the food and tablets) - we also have to watch how much meat such as chicken she gets as meat is protein. However he said it was an overall thing so as long as the dry food makes up a majority of her diet.

SHe is also on the joint powder Joint Guard (vet said tht doesnt have an effect at all) and gets cartrophen course twice a year (again no mention of any issue there). Thats the chronic kidney disease to be managed to keep her going - she is currently nearly 12.

The vet also mentioned its not all that common in dogs as compared to cats (though my family when I was young had a female Afghan who ended up with kidney problems but back then there was no treatment no special food)

Edited by rubiton
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