Help Needed! Kidney Stones - Stent

[SamiSalo]

Update. His personality is still there. Energy & walks are better than it was between the stones. He gained 1 pound so hopefully that continues. Appetite is definitely there. All good.

He stopped drinking water last night. He drank in the afternoon at my request. More later during a walk in/out of the sun. But last night & this morning, refuses.

I'm adding water to the vet/wet canned food - maybe 4/5 tablespoons - and soaking it up in the food. When we play w/the hose, he drinks some but I think that's play (muscle) memory. I tried offering stock in the water dish, no sale. Have a second water bowl by the balcony door. Obviously this isn't enough water. I can try the ice cube trick later.

Tests - skill pull on his head - fail (never done this before, no baseline). Back - pass (but could be just gravity, loose skin there). Gums are moist but we just ate.

Blood test in 2 hours at the surgical place. No plans to stay but if the results or exam confirm he's dehydrated...

Forgot another observation - 3-4 head tremors yesterday. He’s had them all this life but never that frequent. They’re harder than usual to get rid of too.

Banana or cheese does the trick - anything really to get him to move his neck & jaw.

I’m hoping they go away when his weight comes back up & we resolve the hydration.


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[SamiSalo]

He's fine. He's not dehydrated. No concerns as long as he's eating. My baseline is way off because of the canned food - lots of moisture. Sticky gums are normal with kidney disease. They think his tremors/increased frequency is related to his condition.

FYi - also using Pet Wellbeing Kidney Support. Contains Rehmannia Root. The comments/feedback is amazing:

https://www.amazon.ca/Pet-Wellbeing...rds=kidney+gold+support&qid=1588443038&sr=8-1

 

[2BullyMama]

He's fine. He's not dehydrated. No concerns as long as he's eating. My baseline is way off because of the canned food - lots of moisture. Sticky gums are normal with kidney disease. They think his tremors/increased frequency is related to his condition.

FYi - also using Pet Wellbeing Kidney Support. Contains Rehmannia Root. The comments/feedback is amazing:

https://www.amazon.ca/Pet-Wellbeing...rds=kidney+gold+support&qid=1588443038&sr=8-1

Keep us posted.... continue prayers


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[Dollys Owner]

Glad to hear he's doing better ! I would recommend using frozen raw food over canned food, since canned food has undergone more processing. Thaw it in the fridge before serving and add water to it at time of serving. If his phosphate levels are high you can give the supplement your vet recommends to lower it. You can also try fish oil (100 mg/kg of combined EPA/DHA per day) and coenzyme q10 (1.5 mg per pound per day).

 

[SamiSalo]

Glad to hear he's doing better ! I would recommend using frozen raw food over canned food, since canned food has undergone more processing. Thaw it in the fridge before serving and add water to it at time of serving. If his phosphate levels are high you can give the supplement your vet recommends to lower it. You can also try fish oil (100 mg/kg of combined EPA/DHA per day) and coenzyme q10 (1.5 mg per pound per day).

Thx, noted.

He’s been on raw most his life. He gets hemp oil because he’s allergic to fish mix. I saw Coenzyme supplements online so that’s already on the list to discuss.

We haven’t discussed long term treatment yet. She wants to see him stable first. She hasn’t officially declared the stage. Based on the last couple tests, his numbers put him in stage 4. She knows I’m keen on raw diets. She already admitted that studies show that low protein diets at late stages don’t do much.

Yep, phosphate binders have come up. She doesn’t like the one my family vet picked - Aventi Kidney Complete. Sounds like she’ll recommend another.

I’m really counting on that herbal supplement from Pet Wellbeing. The Amazon feedback is crazy positive.


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[SamiSalo]

Quick update. Yesterday his creatinine was lower - 450 (490 last Thursday). Next checkup Thursday.

SQ fluids - their position, it’s difficult to get hydrated this way because of his size. Adding water/food more effective.

Tremors. Wow. Never been this long (15 min) or frequent (3+/day). 3am I woke up, he walks to the door. Ends up being a 45 min walk, tremors stopped during first poop.

I was on the ledge ready to blend in his raw diet but I changed my mind. He’s not in pain & I want to see if his creatinine goes down again. No long tremors today, yet. Meantime, I’m logging info to see if I can find a trend. Forgot to check this morning, but weight looks better so maybe that’s it.

Walks, he’s pulling me farther than he usually does - today was 2 hours. Guessing still stir crazy from the hospitalization.

Bonus - no shedding on the new food. This dog shed a ton on raw. Trade off - his stool is loose. Think I prefer the shedding.


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[2BullyMama]

Quick update. Yesterday his creatinine was lower - 450 (490 last Thursday). Next checkup Thursday.

SQ fluids - their position, it’s difficult to get hydrated this way because of his size. Adding water/food more effective.

Tremors. Wow. Never been this long (15 min) or frequent (3+/day). 3am I woke up, he walks to the door. Ends up being a 45 min walk, tremors stopped during first poop.

I was on the ledge ready to blend in his raw diet but I changed my mind. He’s not in pain & I want to see if his creatinine goes down again. No long tremors today, yet. Meantime, I’m logging info to see if I can find a trend. Forgot to check this morning, but weight looks better so maybe that’s it.

Walks, he’s pulling me farther than he usually does - today was 2 hours. Guessing still stir crazy from the hospitalization.

Bonus - no shedding on the new food. This dog shed a ton on raw. Trade off - his stool is loose. Think I prefer the shedding.


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Thanks for the updates... hoping he continues to improve


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[RiiSi]

Anesthesia and all the medication he has had can increase the tremors or be the sole cause of them. Vitamin B can help.

 

[SamiSalo]

Update, creatinine dropped again, 450 to 384.

And it was a urate stone. As explained to me - could be genetic or liver trouble. Liver trouble not likely but to be sure, liver specific test tomorrow. There’s another test to 100% confirm it’s genetic - might pass on this one.

If urate, there’s medication + special diet to address the existing/smaller stones they saw in past ultrasounds. Going down this road will be expensive because follow ups will be ultrasounds.

I dunno how I can say no because stones started this mess.


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[Dollys Owner]

Update, creatinine dropped again, 450 to 384.

And it was a urate stone. As explained to me - could be genetic or liver trouble. Liver trouble not likely but to be sure, liver specific test tomorrow. There’s another test to 100% confirm it’s genetic - might pass on this one.

If urate, there’s medication + special diet to address the existing/smaller stones they saw in past ultrasounds. Going down this road will be expensive because follow ups will be ultrasounds.

I dunno how I can say no because stones started this mess.


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I read that bladder X-rays and urinalysis will be performed one month after treatment and then every three to six months for life.
Avoid foods high in purine such as Brewer’s yeast, wheat germ,spinach,mushrooms, asparagus, cauliflower,shellfish, sardines, cod, herring and haddock,soy,Organ meats (liver, kidney). Feed your dog a low purine diet. It seems like the best way if you want to avoid commercial kidney stone diets is to buy a base mix such as Honest Kitchen Preference Base Mix or Balance it canine K and add your own proteins such as eggs and cheese and turkey bones etc. Or perhaps if all that is overwhelming ask your vet about a commercial kidney stone diet and adding taurine powder to it. Most importantly, keep your dog well hydrated and make sure urine pH is around 7 or a little higher (you can test with strips or a pH meter). If it's lower than that you'll have to give KCitrate or Sod bicarbonate. You may also have to give a low dose of allopurinol. You may also have to give a phosphate binder if phosphate gets high.

Some good articles

https://animalwellnessmagazine.com/urate-stones-in-dogs/
DogAware.com Articles: Urate, Cystine and Less Common Urinary Stones

https://web.archive.org/web/20140213053021/http://hattrickdalmatians.com/PreventingUrateStoneFormation.html

DogAware.com: Dog Food Mixes

https://secure.balanceit.com/marketplace2.3/home/18-balance-it-canine-k.html

I'm pasting this info from a vet manual.
CHRONIC TREATMENT

Promote water consumption to avoid concentrated urine (e.g., canned food, wetting dry food, use of cat water fountains).
Feed low-purine calculolytic diet (see Nutrition/Diet, below).
If urine remains acidic after diet change, consider adding sodium bicarbonate (25-50 mg/kg PO q 12 h) or potassium citrate
(50-150 mg/kg PO q 12 h), with dose adjustment to maintain urine pH of 7.0 to 7.5.
Allopurinol 10-15 mg/kg q 12 h PO, with dose reduction for azotemic dogs
NUTRITION/DIET
Reduced protein (therefore reduced purine) diet:
Dogs: for example, Hills u/d, Royal Canin Urinary UC Low Purine, Royal Canin Vegetarian Formula. For English bulldogs, a
renal diet may be preferred, as ultra low-protein diets have been associated with cardiomyopathy.
Cats: for example, Hills l/d or k/d
POSSIBLE COMPLICATIONS
Chronic use of low purine diets may result in cardiomyopathy, perhaps related to carnitine or taurine deficiency (esp. English
bulldogs).
Severely protein-restricted diets are inappropriate for growing, pregnant, or lactating animals.
Xanthine urolith formation with allopurinol administration
RECOMMENDED MONITORING
Serum biochemical profile and urinalysis 2 weeks after diet change. Goal is urine pH 7.0 to 7.5, specific gravity < 1.020, and
absent crystals. Assuming adequate renal function and diet adherence, BUN should be < 10 mg/dL. Monitor urinalysis q 2-4
weeks until uroliths resolved and q 3-6 months thereafter.
Monitor dissolution of uroliths q 2-4 weeks via lower urinary tract contrast studies or ultrasound. Monitor for recurrence in like
manner q 3-6 months for a year, then q 6-12 months.
PROGNOSIS AND OUTCOME
Prognosis for dissolution is good in dogs.
Recurrence is common unless cause resolved (e.g., PSS corrected).

 

[SamiSalo]

Thx for the info. Chatting w/my family vet tomorrow. Want to discuss timing for her to take over & making reasonable assumptions. I'm happy his kidney heath is improving. I'm concerned they're following a veterinarian playbook & not exercising personal opinions & experience along the way. if that makes sense...

 

[Dollys Owner]

Any updates?

 

[SamiSalo]

Oops, missed your message.

Salo is doing well, thx for asking.

He’s eating royal canin low purine kibble & taking allopurinal. Hoping to dissolve remaining stones. It’s been 3 weeks. No eta for next ultrasound. Follow ups are monthly.

Weight back to normal - 47 lbs,reduced his food to keep it there. Stool is consistently loose. Tried increasing his pumpkin & changing his probiotic, small improvement.

Annual titer this week, did a blood panel too. Creatinine down to 230 (was steady at 190 before all this). He’s anemic now, will start Amino B Plex supplements when it arrives.

His coat is dull, blaming the diet.

Skin infection on his chin, blaming diet too, rarely happened on raw. Family vet backed up, neighbourhood vet gave us isaderm gel to apply for 1 week. Not sure it’s working tbh. Forgot I had Surolam at home, will try that next or go see my vet.

Running/exercising every day. He’s less motivated to walk outside of playing time & IMO lost a step in his back legs. He barely clears the couch when he jumps up. Similar observations last few hikes.


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[helsonwheels]

[MENTION=9655]SamiSalo[/MENTION], can I ask why you took him off on raw n putting him on royal canin low purine kibble & taking allopurinol? It’s completely the opposite as he should stay on raw. Your vet is from the old school mentality that was thought in vet school. There’s more n more studies we need to feed a high protein diet like raw to not block the kidneys. Up to you but I sure wouldn’t give RC to any dog as you probably know.

https://www.corrinascorner.com/raw-feeding-perfect-diet-dogs-kidney-problems/

https://www.darwinspet.com/resources/types-of-dog-food/dog-food-kidney-disease/

https://www.dogsnaturallymagazine.com/canine-diets-for-kidney-failure/

 

[SamiSalo]

@SamiSalo, can I ask why you took him off on raw n putting him on royal canin low purine kibble & taking allopurinol? It’s completely the opposite as he should stay on raw. Your vet is from the old school mentality that was thought in vet school. There’s more n more studies we need to feed a high protein diet like raw to not block the kidneys. Up to you but I sure wouldn’t give RC to any dog as you probably know.

https://www.corrinascorner.com/raw-feeding-perfect-diet-dogs-kidney-problems/

https://www.darwinspet.com/resources/types-of-dog-food/dog-food-kidney-disease/

https://www.dogsnaturallymagazine.com/canine-diets-for-kidney-failure/

Kibble diet is temporary to dissolve existing urate stones in his kidneys. Once they're gone, he's going back to raw but w/a few tweaks. He was hospitalized because one stone got stuck in a ureter. Week later, hospitalized again, passed a stone in the other kidney.

I'll be doing something like this:

https://bigcountryraw.ca/wp-content/uploads/2018/03/Urate-Stones.pdf


My family vet agrees the food is crap. She's the one who recommended raw 6 years ago. The internal medicine doctor from the hospital is looking after us for the time being. Family vet will take over soon. But... the plan will continue until the stones are gone. Hospital wants us to stay on the diet for 4 months. I won't wait that long. We'll get an ultrasound in another month and if its all good, switch back...