Early Signs Of Renal Disease Plus Pancreatitis

[Stitch]

My 12yo girl has just had a blood test which came back with slightly elevated levels of creatinine.

She is now on Amoxyclav for a few weeks and then will have to have the creatinine level tested again.

She also has been diagnosed with pancreatitis.

I have been feeding her kangaroo and veges stew for some time now to control the pancreatitis.

I don't know what to feed her after reading the other recent topic started by Jaybeece which recommends Hills KD.

She had to stop chicken as the protein source which is one of the reasons she is on kangaroo.

She developed an intolerance to RC Hypoallergenic food that she was on for 6-9 months...she got very itchy.

What can I give her now? I am very concerned. Would it help to take her to an internal medicine vet?

Edited August 28, 2014 by Stitch

[JulesP]

I would probably keep feeding her the same as you are. If she reacted to the RC chances are she isn't going to do well on K/D. My other dog that has food sensitivities doesn't do well on Hills.

[Stitch]

Yes she was initially put on Hills ZD after a really bad bout of bloody diarrhoea etc. but after a while we switched to RC Hypo which was a better fit until the allergies surfaced.

I was reading on the other thread for renal disease that it shouldn't be a high protein diet.

I am starting to think that everything I feed is wrong for one of her 3 problems.

[JulesP]

Yes she was initially put on Hills ZD after a really bad bout of bloody diarrhoea etc. but after a while we switched to RC Hypo which was a better fit until the allergies surfaced.

I was reading on the other thread for renal disease that it shouldn't be a high protein diet.

I am starting to think that everything I feed is wrong for one of her 3 problems.

Well a grain free kibble sitting at around 30% protein would probably be bad. Your meat has water etc in it so a slab of roo isn't pure protein :)

You could look up kidney diets so you get your mixture of roo to veggies right.

[Stitch]

Yes I have to get the vege content down as she is getting terrible flatulence.

I have been including sweet potato, celery etc. but apparently that is not good for a dog with my girls problems.

This is really doing my head in.

I am trying to feed pro biotic foods and will be trying very ripe bananas but she can't have too much of the green leafy veges. etc.

You are right I will have to look up kidney diets.

Edited August 29, 2014 by Stitch

[Stitch]

What about ZiwiPeak Lamb,Venison & Tripe wet food?

Anyone had any experience using it?

[brightstar123]

Was the bloody diarrhoea caused by the pancreatitis? I usually recommend RC Gastrointestinal low fat or Hills i/d for chronic pancreatitis. The RC and Hills i/d dry food both have chicken, however the Hills i/d wet food only has turkey, so maybe you could try that. The gastro foods are much higher in protein than a renal diet though and the renal diets are quite high in fat for a dog with pancreatitis. Perhaps stick with a low fat gastro diet until the creatinine levels have been retested (there are many other causes of elevated creatinine - even just dehydration - urinalysis is important to rule these out); you could also ask your vet to recheck TLI (for pancreatitis) at the same time. Were the antibiotics prescribed because there was a suspicion of pyelonephritis (kidney infection)?

Your vet should be able to recommend an appropriate diet if your dog does turn out to have stage one chronic kidney disease and chronic pancreatitis - perhaps something like Hills d/d salmon which doesn't have chicken, is pretty low in protein (d/d 18.9%, k/d 16.1%) and is lower in fat than k/d, which should help with the pancreatitis. If the pancreatitis has resolved then I would probably risk going with the renal diet and keeping a close eye out for any signs of the pancreatitis returning, however that would be up to your vet to recommend. Phosphate binders, omega 3s and anti-hypertensive drugs may also be needed. Let us know how you go :)

[Stitch]

This dog has a long history of gut problems. She gradually got worse and ended up with a BIG episode of bloody diarrhoea several years ago where she stayed in hospital for almost a week getting it all under control. She came out with the recommendation of her having Hills Z/d however it was an imperfect fit...poos were not well formed and she was mildly unwell so after about 4-5months on that I switched her onto RC Hypo and she was much happier and poos were good.

After a long time on the RC Hypo she started to itch badly. Skin specialist said to put her onto a kangaroo & veg diet which I did and the itches completely went away.

So for many months now I have been feeding her the kangaroo but she isn't a well dog and she isn't doing well on her current diet. She looks thin, her coat is dull and recently she has vomited a few times in the morning. There is no food in the vomit but it has flecks of blood in it. I have had her to the vet many times for what I thought was IBD.

Vet gave me Zantac to give her anytime when her stomach started rumbling which was the signal that she was going to be unwell. It would keep things under control but recently it wasn't working and she was refusing to eat. For these times I was given a supply of Metrozine (Flagyl) to give her to stop things progressing to a full blown diarrhoea episode. It was very good at getting her back to eating again.

I have felt for a long time that there must be more that can be done for her so I requested that they do a full spectrum of blood tests and it came back with Pancreatitis and mildly high creatinine. Because she had been unwell on and off for a while the vet decided to give her a broad spectrum antibiotic I suppose to ensure that there wasn't some sort of infection there.

To me blood flecks in the vomit suggests an ulcer, and then there is the pancreatitis and the presumed renal disease. I will be a happy camper if the next blood test shows the creatinine levels back to normal.

I have gone on for so long believing this dog has IBD, because this is what the specialist vet said it was years ago. Perhaps it is just a term to cover multiple problems. I will keep going until this whole thing is sorted but it seems to be very difficult to resolve.

[*Avanti*]

One of my Labradors had pancreatitis and a few years later after recovering from that had kidney failure. She had been on a fresh roo meat diet when the kidney failure developed but I don't know if that contributed to it. I took her off it though and she was given Royal Canin renal formula dry food for at least six months. Her condition improved and I put her on Advance Weight Control that is low in fat and she has been ok for years (she turned 12 yesterday :) ). I realise your dog's issues are different but thought to share my experience though this is probably not much help. I hope you find some answers and her condition improves.

Edited August 29, 2014 by LabTested

[Stitch]

I am concerned to put her back on dry dog food especially RC but maybe a different type of Hills might be OK for her now??

With RC it was interesting to find that a dry food that was supposed to be hydrolysed protein brought on an intolerance manifesting in serious itching.

I am quite confused and there doesn't seem to be any vets that can give good advice on diet...or maybe I just haven't found them yet.

Dry or canned dogfood is not my idea of good food but if it works for her then I will get it.

It is the not knowing what will set her off and make things worse than they are at the moment that is getting to me.

[JulesP]

This is how I would look at it. Your current diet hasn't caused the kidney issue. It is also acceptable for a dog with kidney issues. It is helping with the pancreatic issue. I would say that the pancreatic issue is more diet related, as in one fatty meal might immediately cause a problem. You want to avoid straining the kidneys but you aren't likely to shut them down with one meal.

Your girl is also 12. When my dogs get to that age I move into a quality of life phase. So if she likes her current diet and isn't itchy I would keep her on it. You could look at adding some Omega oil & B vitamins and other things that support kidneys. Make sure she is drinking enough.

A good vet should be able to give you diet guidelines. With liver & kidneys opinion is slightly divided in whether you need low protein or easily digestible protein.

[Charjas]

This dog has a long history of gut problems. She gradually got worse and ended up with a BIG episode of bloody diarrhoea several years ago where she stayed in hospital for almost a week getting it all under control. She came out with the recommendation of her having Hills Z/d however it was an imperfect fit...poos were not well formed and she was mildly unwell so after about 4-5months on that I switched her onto RC Hypo and she was much happier and poos were good.

After a long time on the RC Hypo she started to itch badly. Skin specialist said to put her onto a kangaroo & veg diet which I did and the itches completely went away.

So for many months now I have been feeding her the kangaroo but she isn't a well dog and she isn't doing well on her current diet. She looks thin, her coat is dull and recently she has vomited a few times in the morning. There is no food in the vomit but it has flecks of blood in it. I have had her to the vet many times for what I thought was IBD.

Vet gave me Zantac to give her anytime when her stomach started rumbling which was the signal that she was going to be unwell. It would keep things under control but recently it wasn't working and she was refusing to eat. For these times I was given a supply of Metrozine (Flagyl) to give her to stop things progressing to a full blown diarrhoea episode. It was very good at getting her back to eating again.

I have felt for a long time that there must be more that can be done for her so I requested that they do a full spectrum of blood tests and it came back with Pancreatitis and mildly high creatinine. Because she had been unwell on and off for a while the vet decided to give her a broad spectrum antibiotic I suppose to ensure that there wasn't some sort of infection there.

To me blood flecks in the vomit suggests an ulcer, and then there is the pancreatitis and the presumed renal disease. I will be a happy camper if the next blood test shows the creatinine levels back to normal.

I have gone on for so long believing this dog has IBD, because this is what the specialist vet said it was years ago. Perhaps it is just a term to cover multiple problems. I will keep going until this whole thing is sorted but it seems to be very difficult to resolve.

[Charjas]

This sounds exactly like my Charlie.

I'll be following this too. I'm not sure if he had creatine test but amylase and lipase were 10 x rec level yet he's settled on RC hypoallergenic and he's not sick now.

[Sheridan]

Has the vet discussed Protein Losing Enteropathy with you? It's often caused by gut issues where the glomeruli is damaged and causes protein to leak from the intestines.

[Yonjuro]

This is how I would look at it. Your current diet hasn't caused the kidney issue. It is also acceptable for a dog with kidney issues. It is helping with the pancreatic issue. I would say that the pancreatic issue is more diet related, as in one fatty meal might immediately cause a problem. You want to avoid straining the kidneys but you aren't likely to shut them down with one meal.

Your girl is also 12. When my dogs get to that age I move into a quality of life phase. So if she likes her current diet and isn't itchy I would keep her on it. You could look at adding some Omega oil & B vitamins and other things that support kidneys. Make sure she is drinking enough.

A good vet should be able to give you diet guidelines. With liver & kidneys opinion is slightly divided in whether you need low protein or easily digestible protein.

I think this is a very good post :)

[brightstar123]

Sounds like a challenging situation. I completely agree about quality of life being important but I'm not sure leaving her on the current diet would be the best approach if she is thin, has a dull coat and is vomiting (with or without blood in the vomit). I might be able to help a bit, Stitch, I'll PM you!

[Stitch]

Her life is OK but then I am constantly watching her diet and her health and reacting to how she is.

I have to listen to her stomach noises, if they are loud and easily heard I have to medicate her.

I don't really call this quality of life for her or for me.

Don't get me wrong, she appears quite happy and healthy however her condition can change in a very short period of time.

She can be fine on Friday morning and Friday afternoon I am rushing to get her into the vet so I don't end up in the emergency vet on the weekend having to pay mega$$$ for treatment I can get Monday to Friday for 1/4 of the price.

There has to be a better way to manage this situation.

Edited August 30, 2014 by Stitch

[Stitch]

Sheridan, thanks for your post.

I am happy to say NO it is not PLE. PLE is a genetic disorder most commonly found in SoftCoated Wheaten Terriers. The dogs develop an autoimmune reaction and they lose protein through their gut. Usually PLE is fatal in young dogs (like 4-5 years old).

The serum protein levels I think would be low in PLE

Epigenetics plays a large role in so many disorders, especially of an autoimmune type. Prenatal nutrition, nutrition during growth can turn genes on or off. I think many dogs with iffy stomachs and itchy skin have experienced “triggers” during gestation and growth. According to Dr. Ian Billinghurst (the BARF diet creator) it may taken numerous generations to correct problems that are due to inappropriate diet.