My Little Dog with Kidney Disease

This is our dog Sadie, she is a Cavalier King Charles Spaniel (ridiculous name - but what a gentle breed). She is an awesome little dog.

She started out very little. 

The vet said to wait until she grew bigger to spay her. She grew very slowly and we waited a long time- at 10 months- and she was still way under weight for her age and breed. So the vet did some lab work and called back, saying "I have terrible news." Her creatinine was 211 micromoles/L (2.4 mg/dl) which is like 5% function remaining. She said that my little dog would not live long. I cried for 4 days.

However, that dog won the dog lottery when she came home me. I put her on a renal diet, and read a ton, downloaded free vet references (like the Merck Veterinary manual) and tried to earn an honorary veterinarian degree meditating over what to do to try to help her. The real vet diagnosed a kidney infection, so we gave her antibiotics for 6 weeks. 

This is what she looked like at the time- she walked around with her back hunched, she was probably in some pain with the infection. So skinny.  I feel badly that we didn't know for so long.
Donkey photobombed this shot.

She then had an ulcer bleed, (black tarry stool) so I put her on anti ulcer medication (Dexilant, given to me in samples by my gastroenterologist friend) and the same antihypertensive that humans take to preserve kidney function (a ACE inhibitor, coversyl- also samples) phosphate binder with her meals (epakitin = CaC03 for little animals), and a little baking soda for bicarb. All in dog doses for a 7 lb dog. And now she's 2 1/2 and doing quite well, almost 2 years after she was maybe going to die. She was on potassium for a while, but doesn't need it now. She barfs sometimes, eats grass, goes off her food for a meal. But then she picks up, and she is generally bouncy and sweet. We never did spay her.

I wrote to the breeder but she just said tough luck, her dogs are only guaranteed for heart and eyes. She checked on the other puppies, but apparently everyone else was OK. She was sympathetic, but not enough to mail me back some cash.

I tried to join a renal dog group on yahoo, K9 Kidney Diet but had to fill in an application form and they rejected me when I said that I was a nephrologist. Which I thought was really weird. I mean, I was beside myself with grief that my little dog was sick and I'm not a vet, I needed advice. So I made up a new name, email and vocation for myself, and they took me in. The site was informative to me, and helped at the time. 

Last summer Sadie got sick, with diarrhea and vomiting. She was a deflated little bag of a dog, and looked like she was going to die. I  told the nurses in my dialysis unit about the problem and they gave me the equipment to give her some IV fluids. I gave her the IV (subcu actually) at home - there are lots of helpful sites on youtube on how to do this. Sadie cried and hated the needle, she squirmed and yelped and had to be held down, when we were done she jumped up and actually howled "ow ow ow ow." But then she got up, drank, peed, and the next morning all was OK. To quote Anne Lamott: Help, Thanks, Wow.

Lots of people give their dogs regular home IV therapy, but I'm not going to- she drinks a lot, and I can't torture her with IVs every second day. Will not be giving her dialysis either-  if there were such a thing. I brought her to the vet for her rabies and other vaccines, and her Cr was 180, about the same as over a year ago. Her phosphate was up, so have to use a bit more binder. 

Sadie's diet, for anyone that cares:
Cooked cream of wheat in the morning, with a good dose of whipping cream (low in phosphate, high in fat and calories) and some strawberry jam (again, was trying to fatten her up) with a good sprinkling of epakitin and a small sprinkle of baking soda.
We mix apple juice with her water for vitamin C, the calories, and the bicarb in it (citric acid turns to bicarb in the body) and for dinner we boil a chicken leg or boil some lamb and cut it up for her, again with a good sprinkle of epakitin. These meats are lowest in phosphate, compared to beef, fish or white meat chicken. She is lucky we have a farm. We give her a  bit of cheese or liver snacks for treats and tricks. I calculated her calorie requirements based on a web site that does that kind of thing for dogs. She needs about 350 calories per day.
We give her pills in cream cheese. 

Here she is recently, with her BFF