Full Diary – Part 4

[Continued from Full Diary Part 3]

I was so worried how I would get my little dog with canine kidney disease well, but no more!

Now I have to admit she is doing so well (knock on wood) that I no longer stress at all about whether she will eat or not, and I can almost forget she is ailing from canine kidney disease – she behaves so vibrantly and full or energy for her age and is able to stretch out and totally relax free of discomfort and pain. And again, for those who realize they can’t do all of this from the get go, it is really probably better to introduce things just one a time and wait a few days or so to add something else so you can notice any change in behavior and realize how well what you have added is tolerated and be sure you see an improvement, or a least not a set back.

I’m sure I’m forgetting something, but this is becoming an epic as I wanted to be thorough and supply everything anyone would need to help them come to their own conclusions about what they want to consider for their pet. You are the caregiver and one size does not fit all, but all of this sure changed my dog and gave her a rewarding life back.

I must repeat what I said at the start of this, I am absolutely delirious with joy at her success. She has been doing so well, that she is getting aggressive, barking at her much younger irascible playmate 2 yr old 4.2 lb Prancer and she actually tried to jump up on the couch the other day rather than using her two stair-steps and she almost made it! Didn’t hurt herself because there is a firm cushion on the floor in front of the couch and there are days she’ll just jump off the couch onto that cushion which I hadn’t seen in over two years!

Now here is the important soluble/fermentable fiber lesson I learned and mentioned earlier.  A not so good part of her feeling so much better and being aggressive was that she began now letting me know when she doesn’t like what I’m feeding her.  She started to eat maybe only two–four pumpkin treats, and alternating Brie or cream cheese didn’t change that, and she started refusing her tripe and vegetable puree at mealtime when she is obviously very hungry.  But when I put a little fresh, unmixed tripe on top, she’d pick that off and quickly eat it and leave the rest with the veggies mixed in.   I had been reducing the amount of veggies every day, but even 75/25 tripe to veggies, she still refused to eat it.  So last night when thinking she really just needs to eat something very good for her, I thought why not give her just tripe with her vitamins, minerals and herbs and hope she eats that, because I want her to get all of the benefit from the vitamins, minerals and herbs too and maybe with just tripe, she’ll eat.  So this morning I eliminated the pureed vegetables entirely and fed only tripe with the vitamins, minerals and herbs mixed in and she INHALED it! Gone in 5 seconds. Even had seconds!  So I would just feed her green tripe, and plenty of it, so I could mix in all her necessary vitamins, minerals and herbs and I was not all that concerned about that decision and these vegetables WERE from the dehydrated mix so I have always thought they really didn’t offer that much in nutritional value. Plus I was thinking that when she gets a really good appetite back I could always try to sneak in a few vegetables because I have to remember fermentable/soluble fiber is good to assist her kidneys by absorbing toxins directly into the intestine so they can be passed with the stool and she had not been eating as many sweet potato or pumpkin treats as before. But still, I was thinking that with her consuming a good amount of premium protein again, that just might stimulate her appetite to eat more of the good sweet potato & pumpkin treats.  And with tripe being balanced 1:1 calcium to phosphorus I really thought I didn’t have to be that concerned with getting the fermentable fiber in her because there shouldn’t be that much in her to stress her kidneys plus she had taken to eating Stauffer’s Animal Cracker Original treats now after refusing them for a few months which I bought a long time ago after reading about another kidney-diseased dog that loved them [46] and they contain NO phosphorus. I had called the manufacturer with that query, and they returned my call stating they contained NO phosphorus. [47]

[Note:  This is an important section to be sure to read thoroughly.] Well, as I am trying to finish this “epic”, I had again come across the unexpected side effect that is a good news/bad news scenario. In that the good news was Pnut seemed to be feeling better than ever, the bad news was that it had made her aggressive and picky so that she was refusing her sweet potato treats (or pumpkin) and didn’t want her tripe mixed with so many veggies.  So as I just wrote, I let her have her way (mistake: I am the caregiver with the brain needed to make the proper decisions) and indeed she ate only green tripe for her two meals for two days then she went right down hill. Again, I had hoped it would still be OK since green tripe is to be 1:1 calcium to phosphorus and as I was still putting all of her vitamins, minerals and herbs on it I hoped she would suffer no ill-effects,  but in the back of my mind I was thinking that is way too much protein and no soluble fiber to help pull toxins out in her poo and not add to the strain on the kidneys.  And sure enough, it became obvious right away that the 100% protein started making her feel bad, she became sore in the abdomen, stopped eating altogether, didn’t eat anything for two days even though she appeared hungry and would just stand over her bowl, then got diarrhea and threw up a little white frothy bile and the following morning threw up a tiny amount of yellow bile, and she was gurgling inside terribly. And upon awakening, she got four drinks of water in an hour, when she only usually drinks maybe three times in a whole day.  So I certainly knew she was hurting inside because of her kidney.  Got on the internet and read about the yellow bile which… surprise… I found is often the result of being hungry and is accompanied with a gurgling noisy tummy.  I read further, on what to do and realized I had to break her fast and put food right in her mouth and get her to swallow and it had to be food that was good for her – she didn’t need any more protein, she needed fermentable, soluble fiber to soak up the acid from only eating protein and take the strain off her kidneys.  So, first thing I did, was spread out some cream cheese and snipped three sweet potato treats (made of sweet potato, organic rice flour and egg white) into tiny pieces on top, then mashed it all together with a heavy fork until it was a smooth creamy consistency (almost like peanut butter) and pried open her mouth and spread a finger full on the roof of her mouth, then holding it closed and rubbing the side of her neck  got her to swallow.  Fed her the whole mixture and she wasn’t horribly opposed to it – not a lot of resistance – maybe just the slight discomfort of having her jaw forced open to put something inside.  But then she quickly started swallowing rather than using her tongue to try to expel it.  She still had retained a decent energy level but she was a bit “humped” from the soreness inside which I hadn’t seen in months.  So I knew I had to be diligent and keep up the soluble fiber to help her recover from this setback caused by my poor judgment of letting her eat just protein.  After she finished that creamy mixture of the cream cheese and mashed baked sweet potato treats, I thought just plain cooked sweet potato would be even better, so I nuked a sweet potato and at lunch put down a very small portion of green tripe mixed with a little more veggies and she showed some interest but not enough to eat which was fine with me since too much protein got her into this.  The fat and calories in the cream cheese I thought would be enough for energy and the soluble fiber from the sweet potato EXACTLY what she needed so for this mixture, I spread out some cream cheese and forked out some fresh cooked mushy sweet potato and mashed it all together until thick and creamy and finger fed her again, and this time she was a lot more willing to open her mouth for it and swallow it.  NO MORE 100% protein.  If she refuses a meal mixed with veggies, so be it.  And if she refuses sweet potato treats, I’ll just mash them up and finger them into her mouth.  I must be disciplined and see that she gets this fermentable/soluble fiber because I THINK I KNOW WHAT IS BEST FOR HER!  And this has proven how badly she needs it in ADDITION to the quality protein from raw tripe, however well-balanced it is with calcium and phosphorus.  I think I have proven to myself with my dog how important the fermentable/soluble fiber is to her well being.  On the second day where her first three meals was just the sweet potato mixed with cream cheese, at her fourth meal she had tripe with a small amount of veggie puree and she lapped it up.  The following morning she had sweet potato and cream cheese for a mid-morning snack which after I hold her and put a little in her mouth to “prime” her she ate the rest which I had separated into little globs and she snarfed them right off my finger.  Then she ate a little tripe & veggie puree at lunch and got back to normal, stretching out flat, jumping into her bed and being very active.  Stopped drinking excessive water and is back to maybe three visits to the drinking fountain over the whole day.  After a  few days she was back to 100% .  Black and white for me what I did wrong with my little one.  And a nice perk now is that I don’t have to do the time-consuming little baked treats for her – I can just nuke a sweet potato and go from there.  Way less labor for me and she isn’t really a chewer.  Seems to prefer the soft globs rather than a chewy pieces too because now that I started putting her on my lap to finger it right into her mouth, she much prefers that to standing on the floor and slurping it off my finger.  While sitting on my lap, after swallowing a glob she’ll starting looking for my finger for the next offering and opens her mouth wide for me to put it in.  Maybe it is just nicer to sit on my lap and now that she is feeling really good, like I said, she can be demanding in what she wants.  Let’s me know she’s doing fine.  And I am using all of the sweet potato eraser-sized treats I froze, because I just put them on a small plate and add some bottled water and warm in the microwave, then smoosh it all up, add a good bit of cream cheese, and mix it then separate it into little marble-sized globs and she is eating that just as well and since there is rice flour in the treats which is also soluble plus there is a little egg white in them for low phosphorus protein, it’s all good.  And the added water is of course good her – purified only.  I’ve decided since the rice flour is such a good source of B vitamins which she needs since I can’t mix any B-complex in her meals, I’ll not feed a plain nuked sweet potato mixed with cream cheese but instead mix some rice flour and egg white in after nuking and removing the skin then shape them into balls to bake, so I can just get one ball out at a time to warm and smoosh with some water and cream cheese Having said that, just a few days ago she ate her morning mashed sweet potato/cream cheese globs but then didn’t touch her tripe breakfast.  I didn’t worry because I saw that it is good to fast a raw fed dog once a week.[48]  So I didn’t offer any afternoon treats, so maybe she’d be hungry for dinner, but she didn’t want to eat anything for her dinner either so I just took it up and refrigerated it.  She was still very comfortable, active, and normal in every other way so I put it out of my mind and thought, let her fast.  Sure enough, next morning she woke up very alert and perky so I gave her morning treats, then when I put down her tripe/veggie breakfast she cleaned her bowl.  Had her afternoon treats and cleaned her bowl likewise at dinnertime.  Ate routinely the next day and every day since so I wouldn’t  panic if your dog misses one meal or even two.  If it goes on for 36  hours I’d start force-feeding, right into the mouth again, to build up energy and appetite and a return to normal, but I haven’t had to do that since I stopped the all protein-no soluble fiber treats fiasco.  There are articles on the internet about force-feeding which if you have a larger dog you’ll want to read as if they are really ill you don’t want them to aspirate on the food and choke.

One other lesson I have learned I want to pass on, is that you will have a tendency if your dog gets to feeling better to start to add a little more and more of the vitamins, minerals and herbs and you can’t do that.  I have found if I added a little more of something she started refusing all of the meal.   I’d see her picking out pieces, and discarding them and realized there was too much of something on them for her to want to eat them.  Don’t over do it.  Now I did also order Heather’s Tummy Fiber [50] which is 100% Acacia Senegal which is a tasteless fiber which I planned to use if she refused the Tripe with some fresh veggie mix as it is advised for IBS -Irritable Bowel Syndrome in that it works as a soluble fermentable fiber, BUT there are NO studies on how it affects those with chronic kidney disease except for a few that state it does increase creatinine clearance [51] which is favorable in kidney insufficiency [52]  and it is also used in the traditional treatment of patients with chronic kidney disease in Middle Eastern countries but again states the effects of GA  (Acacia Senegal) on renal function remain ill-defined. [53] But when I see how poorly she felt when she regressed after eating just protein and no soluble fiber, I ordered it just to have an alternative backup in a worst-case scenario.   So far since I successfully got her back to eating sweet potato treats by offering it in globs I haven’t tried it.  But again, if she ever refuses the sweet potato or pumpkin treats even as globs or the tripe mixed with a small amount of pureed veggies, I will certainly consider trying it as possibly a “last resort” introducing it very slowing then watching her closely and then I would monitor her very closely to see if a trip to the vet was called for. On a another note, I do not administer topical Revolution for heartworms as it is an anti-parasitic medication and even though my vet says it is OK, I have read somewhat viewpoints otherwise on the internet as follows:

Drugs. Blood pressure medication, aspirin and anti-inflammatory medications, anesthetics, anti-parasite drugs, antibiotics, and NSAIDs. Nephrotoxic antibiotics may be the most common cause of acute kidney failure. [55]

And even though it is a TOPICAL medication, it still enters the bloodstream, so I won’t use it as: when the kidneys fail, they are no longer able to remove waste products, and toxins build up in the blood producing clinical signs of kidney disease.  I guess I look at it as a tradeoff, and because of her age am choosing to try to preserve her kidneys.

I also don’t use Glucosamine as I have read that it is hard on the kidneys  [58]  MSM too. She’s doing OK, so I won’t take the chance.   [Continued Full Diary Part 5]