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Renal failure.

Species: Dog
Breed: Yorkshire
Age: 8-11 years
Dear Dr. Marie,

My 10 year old Yorkie Bobo has been diagnosed with chronic kidney failure today. The vet that we saw was unable to provide more suggestion than taking prescription dog food (Hill's k/d etc). We'd like to know if there's any medication that can be used, pills, injections etc, in addition to the adjustment of diet.

Bobo stopped eating anything since day before yesterday. He refused to eat anything today too. Only drank some water so far. He tried to vomit but only water came out since he hasn't been eating. He looks very weak, unable to walk for long. We had a full examination at the vet's today, saying everything else appears fine, only renal problems.

Over the years his diet has been mainly fresh cooked chicken and rice.

Please let me know if you need further information. Basically we'd like to know a systematic way of slowing the process of kidney failure for him. Thank you very much in advance.

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Online vet, Dr. Marie

Dr. Marie replied:

Oh dear. I'm worried about what you have written about Bobo.

There are different degrees of kidney issues in dogs. When a dog has mildly high kidney enzymes, but is otherwise healthy, then we would call this mild renal insufficiency. Dogs with mild renal insufficiency generally do well on a prescription renal food (such as Hill's k/d or Royal Canin Reduced Protein). These foods have the optimal level of protein and have a number of other ingredients that help to support the kidneys.

However, it sounds like Bobo is much sicker than just mild renal insufficiency. When the kidneys get really sick then animals really don't feel well. The kidneys are supposed to filter out toxins. If they are not working well then toxins can build up in the body and cause an animal to feel really nauseous, lose their appetite, vomit, and generally feel unwell.

When a dog gets to this stage of kidney disease then we can sometimes be in a lot of trouble. Sometimes we can help the dog by putting him on intravenous fluids and keeping him in the hospital for a couple of days. The fluids help to flush the kidneys and also help to flush out toxins in the body. I have had some cases where this gets a dog feeling well again and then we can help support the kidneys by feeding the prescription food.

I will sometimes also add a supplement such as Azodyl or "Renal" supplement which can help support the kidneys as well. But these are not going to be miracle drugs on an animal that is really really sick.

Did Bobo have any blood tests done today? The creatinine level can tell us a lot about how severe the kidney disease is. If the creatinine is very high then this is a poor sign.

You can ask your vet if a medication called famotidine could be helpful for Bobo. This is an antacid. You can buy it at the pharmacy as Pepcid AC. It can help with the nausea that comes along with renal disease.

I wish I could give you more tips on things you can do at home to help with this problem but ultimately, the only thing that is likely to be at all effective is some intensive IV fluid therapy.

One final could also ask your vet if leptospirosis is common in your area. Sometimes serious renal disease can be caused by lepto. If this is a possibility, then antibiotics can possibly help. But, the kidneys would still need to be treated with IV fluids.

I really hope things look up soon for Bobo.

Dr. Marie.

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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.
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Customer reply:

Dear Dr. Marie,

Thanks for your detailed reply.

Yes he did blood tests yesterday. I can't really read all shorthand notations, but I suppose CREA stands for creatinine, and his number is 2.6 mg/dL.

Others are:

GLU 111 mg/dL
BUN 54 mg/dL
PHOS 7.5 mg/dL
CA 10.2 mg/dL
ALT 87 U/L
AST 46 U/L
ALKP 162 U/L
TBIL 0.3 mg/dL
CHOL 146 mg/dL
CK 48 U/L
MG 1.91 mg/dL
TP 7.4 g/dL
ALB 2.8 g/dL
GLOB 4.6g/dL

How severe is his kidney disease based on the numbers? Thank you very much.


Online vet, Dr. Marie

Dr. Marie replied:

According to the IRIS scale for kidney disease, a creatinine level of 2.6 is a stage 3 (out of a maximum of 4). Cases like this are borderline. I have some dogs that do well for quite a while on renal food. And then there are others that can very quickly progress into illness.

You didn't mention the normal (i.e. reference range) values for the enzymes you included. But, one thing that I noticed is that the phosphorus level is a little high. High phosphorus can be an indication that renal disease is more serious.

Ultimately what makes our decision about how serious this disease is, however, is how Bobo is feeling.

I would highly suggest asking your vet their opinion on placing him on IV fluids for a day or two to see if this will help.

Dr. Marie.

Have you tried the Purr Pillow? This is one of Dr. Marie's top recommended pet products for 2016.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.