Species: Dog Breed: Yorkishire Terrier Age: 11-15 years
Hi,
We have talked before. Trixie is 13 years old and has had kidney issues. I want to mention her other problems. She has collapsing trachea, slightly enlarged heart with no murmur, luxating patella in both back knees, left knee is turning inward, she has good mobility because of monthly adequan shots and daily walks and Condroflex 2 tablets daily.
Recently I think due to me giving her 2 half tablets of lasix in one day more than I have ever given, she got dehydrated was urinating on herself and received fluids for 3 days. On 4 28 her bun was 54 (6-31 reference) creatinine was 1.0 (0.5-1.6 reference). Urine specific gravity was 1.030, there was protein in the urine 3+ high. We also did a protein/creatinine ratio and it was 2.7 high <=0.5 reference range. On May 13th her bun was 48 and creatinine was 1.1 and her hematocrit was 56 ( 31- 60 normal range) My Vet thought this was high even though in normal range, urine specific gravity was 1.026 and protein in urine was 3+.
She has been on benazypril since 4 28 2011 and the prescription food Royal Canine LP. My Vet had put her on Theophylline for collapsing trachea, but I stopped giving it to her because of the effects it can have on the kidneys and it did not help her cough. I only give lasix when her cough is really bad and I only give her ¼ of a tablet, and she still urinates on herself. She really needs her teeth cleaned but because of her hematocrit level and enlarged heart and kidney issues we are reluctant to do so. My Vet gave me an antibiotic Clindacure for her gums, to be given ¾ mls 2x per day for 5 to 7 days, a month apart. I read that this antibiotic is not good for the kidneys. I went on line and found some Moxclav which is like Clavamox? It is 156.25 mg powder for oral suspension. When constituted as directed each 5 ml ( Clavamox says 1 ml on their box) of the constituted suspension contains Amoxycillin Trihydrate IP equivalent to Amoxycillin 125 mg Potassium Clavulanate diluted IP equivalent to Clavulanic Acid 31.25 mg. I read that Clavamox is not hard on the kidneys, so I would prefer to give her the Moxclav if it is the same as Clavamox. Do you know if it is? She is doing really good. We walk almost .8 of a mile every day. We go back in about 2 weeks for more blood work and Urinalysis to see where we are.
One other question I have is what causes her cough? Is it the collapsing trachea or her heart and why is it so much worse when it is humid out? I got some damp rid for the house, but it does not seem to help. The cough is a dry hack like she has something stuck in her throat. Its not productive and sometimes there is a wheez. When the humidity is low she does not cough as much. I might also mention in March she had Bronchitus, and was put on Clavamox. The cough stopped completely after 5 days of treatment. She did not even have the hacking cough or anything. I have xrays of her trachea if you would like to see it. Not sure if it is an accurate protrayal because of her breathing in and out, could be after she expressed air(my vet pointed this out, he was able to get one just after she took a breath and the trachea collapse did not look as bad)
Thanks so much for your help. I just want to do what is best for her. And my research just has me hesitant with drugs that are not good for the kidneys. I do not give her anything even th
Dr. Marie replied:
Sorry to hear that Trixie may be having problems.
I'll start off by addressing your concerns with clindamycin. I will commonly prescribe this antibiotic for animals with dental problems. I have no concerns with giving this to an animal with possibly kidney concerns. I just checked the drug label for clindamycin and it says to use with caution in animals with severe renal failure.
The reason for this is that an animal with severe kidney disease cannot eliminate the drug properly because the kidneys are not working. But, a dog with severe kidney disease would have a creatinine level >4 and be basically dying of kidney disease. This is not what Trixie has. The clindamycin won't hurt the kidneys.
I do use Clavamox in the same way, however. Both drugs are good for dental disease. If you would prefer to use Clavamox, the best thing is to ask your vet for a prescription. I can't advise you on the dosages as this is not legal for me to do without being your veterinarian.
It's hard to say what the exact cause of the cough is. I would venture a guess that it is related to her teeth. I will commonly see a cough in dogs with dental disease. I think it has to do with the bacteria levels in the mouth. If this is true, then there should be less coughing after the 5 days of antibiotics.
The cough you are describing doesn't sound like a heart cough - usually this is a deep chested cough that really sounds like the dog has a chest full of fluid that it is trying to cough out.
Another possibility is asthma. However if this was the case then the theophylline would have made a dramatic difference. Plus, we will usually see signs of asthma on xrays.
If it is because of collapsing trachea then there is not a lot else that can be done at this point to help the cough.
I hope that helps!
You're welcome to respond if you have more questions. Just so you know, I will be offline until later this evening.
Dr. Marie.
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Customer reply:
Thanks so much for that.\ I will start the Clindamycin today and see if that helps her cough. It may be her teeth. I notice even when I give lasix the cough is not that much better. Should I be giving her lasix if it is not a deep chested cough? I think it may be her trachea especially with the wheezing. Thanks again for your help.
Dr. Marie replied:
Sounds like a good plan to give the Clindamycin. The lasix is something you'll need to discuss with your vet. I don't generally use it as a "here-and-there" treatment, but rather a regular treatment when a dog has a condition that causes fluid on the lungs.
Customer reply:
Thanks again for your help. It is just so strange that she coughs when it is humid yet the coughing is less when it is less humid. I will see how the clindamycin works. Thanks again.
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