I'm not sure I am about to give you the answer that you need but I can answer your questions.
They did an ultrasound and the doctor told me that everything he's seeing points to chronic kidney disease, but she also has a bladder infection 'that leading to the kidneys' (does that sound right, i'm pretty sure that's what he said).
An undiagnosed UTI can lead to kidney damage. If bacteria finds its way up the urinary tract and settle in the kidneys it will do damage. That damage is irreparable.
They'd like to keep her for 3-5 days on fluids, but the part I'm not understanding is if they keep her on fluids for that long and antibiotics will she be better or will it just get her through till something like dialysis. If dialysis is the end option, we really would not want to put her through that for the rest of her life. Nevermind the amount it would cost...we just can't do it.
They kept her for 3 days to do what they call an IV flush. This is usually done over the course of 3 days and is different than subQ because the fluid is pumped directly into the blood stream. It skips the hydration phase of regular fluid therapy and goes straight to thinning the blood so that the body can filter it more easily. If successful it will bring her BUN and CREA down significantly. It won't cure her, but it will give her more time. It will give YOU more time to come up with a plan.
There is no dialysis dogs in the way you are thinking. What they do is pump fluids into the body. That subcutaneous fluid (or subQ) is absorbed into the kidneys and other organs and eventually into the blood. This serves several purposes. First it keeps the body hydrated and secondly, it helps the body flush out the waste products so the kidneys don't have to work so hard to do their job. In human dialysis blood is filtered out of the body. cleaned and pumped back in. The fluids your doctor (and eventually you) is giving her are lactated ringers, it does nothing to "clean" the blood. But it will add significant time to not only the length of her life but the quality of it. The fluids themselves are cheap. You can buy a bag from the doctor, he will charge you around 25 bucks for one. Or you can get a script to take to Walgreens or Costco. There you can get an entire case for 28.00. You can buy the tubing (called admin kits) and needles online. Our internist wanted to charge me 50 cents per needle and 10 bucks per kit. You can buy the same things online for 2 bucks a tube and 8 bucks for a box of 500 needles. If you have a good relationship with your vet they might even match those prices. Abbys doctors did. I got a case of ringers, 12 kits and a box of 19 gauge needles for under 30 bucks. At 30 pounds, Abby went through 2 cases a month.
The doctor is kind of irritating me b/c I think he's trying to be nice and break things to me gently, but I really need the blunt facts in order to make a decision.
Are you sure that's what you want?
Does a dog really ever come back from having kidney problems?
That answer depends on what caused the problem in the first place. If some sort of toxin like antifreeze was ingested then yes, a full recovery is possible. Sudden onset CKD is curable if caught in time. But if it was caused by a genetic disorder or over time the kidneys just grew weak or were otherwise damaged then no, there is no recovery. Kidney cells (called nephrons) are one of the few cells that they body cannot make more of. Once they are dead or damaged they stay that way. The fact that your doctor used the term "chronic kidney disease" leads me to believe this wasn't sudden onset. If that is the case all you can do is love her, keep her comfortable and know the signs to look for that signal the end. Some dogs lose their fight with CKD sooner than others but it's not all that rare for the dog to live 2 or 3 years with the disease. I was told that Abby wouldn't last the month but as you know, Abby was with us for 13 beautiful months.
SubQ fluids are the single best thing that you can do for her next to diet. They will tell you at first to do it every couple of days but trust me, demand every day. The less the kidneys have to work the longer they will last. The key to successfully stalling the progression is daily subQ fluids. You can't stop kidney disease. But you can slow it down if you act quickly.
They're going to check her levels tomorrow and see where she's at and then we're going to go in and talk with internal medicine to see what our options are. I just don't want her suffering.
The internal medicine doctor can't give you much more information than what you already have. Maybe they can give you a cause but probably not. Mostly they guess. You will get conflicting information. Some doctors will tell you low protein. Others will tell you high protein. They will try to sell you expensive prescription foods. If you decide to buy it, ask for something other than Science Diet k/d. It looks like styrofoam and smells like soap. Royal Canine makes a renal LP that actually looks and smells like dog food. It also has a higher moisture content and that is something that you definitely need to pay attention to.
I'm going to tell you that it isn't the amount of protein in the diet that matters. You need her on a LOW PHOSPHOROUS DIET. Phosphorous is that causes further damage, not protein. We can get to all that later.
For tonight sleep. Being upset is not going to change the diagnosis at all. Sleep tonight then tomorrow when you are there get copies of all her test results. Get in that habit because you will need those records on hand to adjust her diet to help her live longer.
