Full Diary Part 5

[Continued from Full Diary part 4]

For a dog with kidney or canine renal disease, I repeat, preserving the kidneys is SO important!

Kidney or canine renal disease is so serious but I didn’t let it overwhelm me although still with all all that I’ve accomplished I really can’t know how long Pnut will improve.   But it’s been 6 months since diagnosed, and I’d like to think she will die of old age or an unrelated affliction, because I am preserving what she has left of her kidneys and she is doing really well.  In fact, she is really doing fabulously well – without any subQ fluids or anything drastic like that.  (Just the prescription potassium gel:  RenaPlus.)

[Note: Please also do again remember that in the following links, the articles contain some statements that I don’t agree with at all, especially if they are about favoring commercial kidney canned foods, but the articles do contain other bits of information that I find noteworthy and helpful so I have included them.]

Help from canine renal disease forums

UPDATE: June 3, 2012 When asking questions on kidney or canine renal disease forums, it made me aware that Pnut’s blood work still showed a very high BUN reading even though her creatinine had been brought way down and a high BUN should indicate an existing problem such as uremia which was puzzling to me as she showed none of the clinical signs, such as lethargy, lack of co-ordination, loss of appetite, vomiting, mouth and limb swelling, sores or abscesses in the mouth, extreme bad breath, dehydration and anorexia – all associated with canine renal disease.  She didn’t have ANY of those symptoms.  In fact she has gained even more weight and is now up to 2.75 lbs, almost back to her normal 3 lbs. So I am tackling that and asking questions of my vet and other professionals but in the meantime I am reducing the amount of protein (green tripe) she gets daily which I want to do anyway as it has Omega-6 fatty acids [60] which has been thought to be inflammatory then increasing the sweet potato and pumpkin treats. (As mentioned earlier I do give Wild Sockeye Salmon oil which is good for the kidney in that it is a really strong anti-inflammatory and something else I just learned recently is that it only is good for 90 days as long as it is recapped immediately after use and refrigerated. [61]) And I am alternating the treats feeding Brie and pumpkin in the am; cream cheese and sweet potato in the pm. Furthermore, I am reducing the amount of Brie (a lot) and Cream cheese (some) that I mix in so as to reduce saturated fats, and the greater reduction in the Brie is because it has a high sodium content – 166% higher than cream cheese (and again, that is why I didn’t go to reduced fat/low fat cream cheese because it’s sodium was considerably higher) although I had read that in general, there’s no need to reduce sodium for dogs with kidney disease. They used to recommend that, but I read studies showed it really didn’t make any difference. The body keeps electrolytes (sodium, potassium, chloride) in balance regardless of how much you feed for the most part, so having sodium at the high end of the normal range is not indicative that you are giving too much (high end of normal is still normal). Drinking more water because of a higher sodium intake is not a bad thing and I would not consider it a bad sign unless the drinking/urination becomes excessive.  I have used a sodium calculator and converted her weight to kilograms so I can monitor the amount of sodium she is getting per guidelines. [63]

I also added sodium bicarbonate (baking soda) to neutralize her PH and gastrointestinal bleeding but I have found it could make her also drink more, but again that may not be bad per what I wrote previously. I just have to understand why she may be going to the drinking fountain a little more and peeing a little more.

Also, as I have come to understand that probably every site you visit for medical advice, regardless of whether they are self-taught and highly respected or physicians or veterinarians they will have a disclaimer.  You must do what you feel is best for your pet.

I can know she is hydrated again when she performs her toilette, licking her paws, etc. And she has her sense of smell back which of course is tied to appetite. When we walk, she takes forever discovering and lingering over so many new outdoor smells .

There was a period of concern I had because she had excessive licking of the lips so I searched online and found that it is often tied to stress, but I didn’t feel she was stressed at all and continued to think what else it could be when I came across a comment that it can be just something as simple as cleaning the mouth area – which she was doing excessively. So I realized since I had started finger-feeding sloppy sweet potato and pumpkin with Brie or cream cheese treats, I was aware it was kind of messy and it would get smeared around her mouth area, so I started taking a soft cloth with a small portion of the end saturated with cool clear water and after every treat feeding, I would keep her sitting on my lap, and take the cloth in both hands and proceed to wipe her mouth area, which she has come to enjoy a lot so much so that I can be very thorough and press her gums up and even gently wipe the surface of her teeth.  And sure enough, within a few days, no more licking. It would seem before, the cheese and vegetables were sticking in her fur around her mouth and it was bothersome for her.  But, problem solved.

Something I learned about exercising her, was that when she started improving so much, I started taking her on walks again. She is so little, I just carry her to the far end of our upstairs balcony, put her down and we mosey back. It is about a 75’ walk. Once, I got really busy and forget to take her out for these walks, and she didn’t do as well as when I walk her so I’ve written little notes to myself, to be sure to get her out for her walk at least twice a day. I think when I forgot the walks, her circulation suffered, she didn’t drink as much water and as a result her poops became very small like pellets which means she wasn’t as well hydrated and she even became a little “sore”, whining a bit when picked up and wanting to be put back down. But I started the routine walks again, and that all went away – no soreness and big poops again.

I also discovered she didn’t like the blood of the green tripe, so after defrosting it I absorb as much as I can with a paper towel, then replace the fluid with purified water so it is still a high moisture content. She even doesn’t like that portion from the very bottom of the package, so I save that to give to her 4.2 # brother, who is advised to have tripe once a week.

I also reduced the amount of green tripe I was giving her at her two meals because her bun at her last reading was still 83, which I have read online from someone that anything over 80 is their marker to reduce protein. And it wasn’t going to hurt her, because she likes it so much that I was giving her way more than the recommended amount.  So I cut it back and a big benefit of that is that she really looks forward to getting it, and eats it completely, licking every morsel from her bowl. When I was giving her more, she would sometimes leave a teaspoon or so and when it is cut back, she doesn’t leave a morsel. Also cut back on her Brie and cream cheese too, especially the cream cheese because I mix it with the cooked sweet potato pulp which is so tasty by itself. I cut back the Brie that I mix with the pumpkin treats too, but not quite as severely as the cream cheese.

Basically now she is a vegetarian, eating 85% sweet potato or pumpkin and twice a day a half-dollar single layer of raw green tripe on a smidgen of reconstituted and pureed vegetables from Veg-to Bowl. And regarding the veggie treats, since she is feeling so well, she wants to accommodate me and eat everything I present to her, and she is eating 3 times more veggie treats than before. Whatever I make, she will stay with me through the end and I am making an amount, that she used to want to bolt half way through, and now she eats it all!   Regarding the pureed veggies I’ll give with her tripe, when I start steaming my own veggies, green beans, baby carrots and squash I’ll try to increase the veggies mixed in to provide additional vitamins and minerals.

Every time I give her a finger full of sweet potato or pumpkin, I think: “Go in there, and attach yourself to toxins and put it in her poop to relieve her kidneys.”   And so far it is working but one time I did over do it and gave her too much too fast and she vomited it all.   I had realized I had just been giving her more and more each day, and I have to say I was surprised she kept eating it all, but it goes down so smoothly and she loves sitting on my lap and getting the attention. But I have to keep reminding myself, more is not always better. But then when I cut it back, she got a little sore again so I had to find a happy medium by watching her reactions and gave her a little more but not near as much as I had before when it made her lose it all. And I have to say, she is back to her normal, active, happy self and not sore when I pick her her. I’ve ended up with less protein, a very nice amount of pumpkin and sweet potato and she is doing so well. I feel I’ve got the right ratio now, as today for the first time in a long time, she wanted to play.   How great it is to see that!

8-29-12 Added Butter and Molasses – felt I needed more calories – Butter seemed great but then she got really sore and I realized it had irritated her pancreas horribly. The Omega 6 fatty acids in the butter were absolutely NOT good for her and I hadn’t paid attention to that because a few websites indicated adding butter for additional calories.   By 9/3/12 she was so sore, pain in the abdomen/ hunched up, vomited yellow bile upon waking. As soon as I stopped the butter she got better and I stopped any cream cheese and Brie as well so she would recover faster. Read that I should give her small meals so as not to overwork the sore pancreas and also read that increased high quality protein was necessary – “Low-protein diets have also been shown to predispose dogs to pancreatitis, especially when combined with high fat intake” . The article referenced in the sentence before is GREAT with lots of helpful information for my little one with this apparently flare up of chronic pancreatitis (not acute.) Don’t know why some of the sites recommended butter although I have read all dogs with kidney disease do not have an irritated pancreas and I guess I knew she went that direction because the amylase reading on her blood panel was often quite high and the lipase not high at all which would appear to confirm hers is chronic and not acute (in fact on her last blood panel amylase was very high and lipase on the low end.) [65]

But that caused me to look more closely at the nutrition pages I had printed out for her food and realized they give an inflammatory index, so important to consider when dealing with canine renal disease, pointing out which products are inflammatory and which are anti-inflammatory. [66]  Zero was neither inflammatory or anti-inflammatory and a negative number indicated inflammatory and positive (not negative) number was anti-inflammatory. What an eye opener. Butter had an inflammatory index of -727 the greatest of anything I had ever given her (Brie was only -147 and cream cheese was -397 and salmon oil had an anti-inflammatory index of 30284! WOW. So I decided to try giving her more salmon oil and it looked like that would be a VERY good move so started her on 12 drops a day 9/15/12 since a moderate amount was supposed to be 1000mg per 10 lbs of body weight (I factored her weight in at 3 lbs). [67]

Decided to look into adding honey and it looks like it might be a good addition to her foods [68] and that article linked to another that was more scientific [69] so I am trying that as well for increased energy but mainly because it mentioned it may have a calming effect on the pancreas. I did read that it should be raw honey, preferably a raw local honey.  But it is puzzling to me that NutritionData.com has its inflammatory index at -1247 but then another article says honey is a protective food from inflammation? [70] Seems to be conflicting information but I do give a drop of salmon oil which is 30284 to the good so feel it is easily offset. One article said it also lowered kidney stress (in the diabetes paragraph. [71] so I’ll just watch her and see how she does. I’m not concerned at this time about the sugar content as her Glucose reading on the blood panel is in the middle of the normal range.   [Continued Full Diary Part 6]