Please Tell Me Everything You Know About...

[Kelly_Louise]

Thanks for the info Rubiton! I'm sorry your girl is also going through this.

So, there is medication that can assist with kidney disease? I asked Chloe's specialist about medications or similar that can help treat it, but he didn't mention anything at all??? If so, then I can only assume that it may conflict with her Cushings disease and perhaps that is why they are not treating it with any medication??? Food for thought, I will check it out!!

Yes the Hill prescription diet is very expensive isn't it... but if it can help (and if she'll eat it) then it's well worth it in my mind Will also re-start her on the cartrophen... I'm not sure it will be as effective anymore, but it's worth a shot. In saying that though, she normally only suffers badly with her arthritis in summer - in winter it doesn't seem to affect her as much (which is weird I know - but she's always been a bit backwards with everything!!).

She will also have regular blood tests to check all her levels, so at least we will always know where she's at and how she's coping, and if what we are doing is working. She goes back in mid April - so hoping that again the levels at least remain stable again.

[Sheridan]

I think the medication depends on the type of kidney disease.

[Kelly_Louise]

I think the medication depends on the type of kidney disease.

Ohhh okay - thanks Sheridan. I was beginning to suspect that as much of the info I read on the net says it's for more heart related issues, but I could see some are using it for some kidney complaints.

Guess it won't hurt to discuss it with the specialist.

[Staranais]

Chronic renal failure means that a certain proportion of the kidney cells have died - and once they're dead, you can't bring them back with any sort of drug.

Fortekor is Benazepril, an ACE inhibitor, it's usually used for heart problems in dogs (it reduces blood pressure & therefore reduces stress on the heart). I haven't heard of it used for chronic renal failure in dogs, but that's not to say that it can't be I guess. Or perhaps Rubiton's dog also had hypertension (high blood pressure), and the Fortekor was being used to treat that?

[Kelly_Louise]

Yes I've also been reading that it's mostly used for heart related conditions in dogs - and only a few instances of it being used for kidney related issues (but not sure exactly what issues). Maybe if the kidney issues affects other organs or puts stress on the heart or something?

Staranais, I think you might be right - if Chloe's specialist thought it would help her, he would certainly have recommended it. I'm positive of that. I did ask when we were discussing the results if there was any medication to treat it, and he said no... so I'm assuming that it wouldn't help in Chloe's case. I will discuss it again regardless, but I have trusted him with Chloe's life, and he's never let me down and don't think he would this time either.

Still haven't received my book as yet, could take a couple of weeks - but I'm excited to see the info it contains, have read really good reviews about it and I'm sure there will be something in there that can help or guide us. Also can't wait to receive the prescription diet to see if it will be well received, or she'll turn her nose up at it

She's doing well, seems to drink alot more water at night (and occasionally has an accident in her bed) - but otherwise is eating well, tonnes of energy to walk etc. ;)

[Rappie]

The medications are used in chronic kidney failure to prevent damage to other organs, but do not change the 'failure' status of the kidneys. The main problems are related to what we refer to as 'end organ damage' due mainly to high blood pressure - which can cause problems with eyes, the vascular system and other parts of the body.

The kidney diets are the mainstay treatment - they have a moderate protein restriction (smaller amounts of high quality, bioavailable protein) and are low in sodium and phosphate. Sometimes a phosphate binder will be added if the phosphate levels in the blood are increased.

Regular monitoring is important - both of the creatinine level (we usually measure the serum urea level too but it is not a very sensitive indicator of worsening kidney disease), other blood levels like calcium and phosphate, blood pressure, urine protein levels and urine concentration. It's only once we find that there are changes in either of these that other medications are really indicated. Once a diagnosis has been established, they would generally be checked every 3 months or so. Dog (and cats) with dilute urine are also prone to developing urinary tract infections, so I would generally do a urine culture if there was any question over whether a UTI might be or could be present. It's also important to be aware of the hydration status of animals with kidney failure as they have no way of retaining water when they start to get dehydrated and may need to go on IV fluids even if they have non-kidney related problems like diarrhoea or vomiting.

[rubiton]

OUr dog is being treated for the onset of Chronic Kidney disease - this is the long term one where old age sees it happen in some dogs. The fortekor apparently increases the blood flow or something in the kidneys (vet did explain it a lot better)- she also has a weird cough that is intermittent but I hadnt mentioned that when she was prescribed the tablets (which has decreased while on them apart from when she was really excited or stressed). The tablets are more common to be used on cats but then cats are more likely to develop the problem.

Our dog does not yet have renal/kidney failure which was explained much more acute and serious - the idea of the food and tablets are to manage the condition so she doesnt go downhill as happens if no treatment no change in diet occurs (like the family afghan back in the 80s).

Edited February 24, 2011 by rubiton

[Her Majesty Dogmad]

A few years ago I adopted an old terrier from Sutherland Pound. She wasn't in a good way and blood tests revealed kidney failure. My vet said I would have max of 2 months with her. I went to the All Natural Vet at Russell Lea (nr Drummoyne) and they spoke to my vet and read blood tests. They prescribed Chinese Herbs - if I hadn't seen it for myself I would never have believed it possible. Within a couple of weeks, with the herbs and the special diet from the vet for kidney failure, she was a new dog, running round the oval. I had her for a year in good health until she got a stomach bug and didn't recover, she was gone within 2 weeks. I'd do it again if it happened with another dog with kidney probs.

[Rappie]

I would suspect that Kelly Louise's specialist will let her know when treatment is indicated, there are many approaches. I would suspect that most of the specialists follow the IRIS guidelines for staging and sub-staging renal disease which many vets in general practice may not (although plenty do). Under these guidelines, early stages of chronic kidney disease do not require ACEI unless there is evidence of persistent hypertension, or end organ damage (the guidelines are slightly different for cats).

Edit to add: My comments are not a criticism of vets in general practice (I am one!) but there are several different approaches and many contradictory articles and theories - even just related to the one type of drug. There have been reports of protective effects, positive effects on glomerular filtration, evidence that ACEI should only be used in cases with high levels of protein in the urine, that ACEI are not indicated in dogs etc etc. The more important thing is that good reasoning stands behind the decision to use any drug and regular monitoring is undertaken so that any changes in clinical condition are detected early.

Edited February 24, 2011 by Rappie

[Kelly_Louise]

Thanks so much for the comments and opinions everyone, they are definitely very helpful and allowing me to learn more and more about the disease.

I do understand that different vets approach things differently, and I fully trust Chloe's specialist and his treatment of her. I find it's the same with her Cushings disease - I find that many vets have different approaches to treatment of it, which is why I pulled her out and took her to the specialist clinic. She will go back for further testing every 2 - 3 months (or if ever her condition changes with her kidney issues or her Cushings disease), so I'm sure if the need arose where she may benefit from medication he will pursue that. It's also a very delicate situation with her Cushings, it's a bit of a balancing act to keep the Cushings symptoms at bay, but also not allow it to affect the kidney problems.

She has full testing each time - all the levels that Rappie mentioned are tested each time, and she is also tested to ensure there are no low level UTI's present. So we will be able to keep a close eye on her progress. Her levels have not changed since December (and we really didn't know we needed to do anything different so her diet hadn't changed in this time), so that is a good sign. Now that she will start the prescription diet, I hope that she can continue to have little to no changes.

Thanks again for everyone's input - and Rappie, your information is invaluable. Sometimes her specialist will explain things, but it's not until I come here that I fully understand the real meanings of some things