Jasper (12 yr old Mini Schnauzer) is now at peace

[Trish]

Hi Tina
We are googling the same thing at the same time! Flynn still has proteinuria 3+ on dipstick, so I have to take in another sample to check the protein:creatinine ratio. His has been high for a year, but normal blood creatinine and BUN and that was done a month back. So we will be waiting for that urine result next week. Get some sleep Tina, I have been reading up on kidney stuff after reading about Jasper, time to take it a bit more seriously I think!
Trish xxxxx

[Tina]

Hi Trish, just posted on Flynn's thread. Yes, it looks like we were googling things at the same time. I have done quite a bit of internet research in the past couple of days about kidney disease, it is quite overwhelming.

Ok everyone, I got the results of Jasper's chem panel, and the BUN and creatinine were in the normal range, which is great news! This is so scary to me, but my vet told me that the kidney has to have lost 2/3 of it's function before those values will show abnormalities. 2/3??!! Has anyone else ever heard that? I guess I don't understand why there aren't tests that would detect problems sooner. I need to add that to my list of questions for her on our next call.

Here are the chem panel results, drawn on 1/24/13:

Glucose 90 (70-12) mg/dL
Urea Nitrogen Serum 12 (10-28) mg/dL
Creatinine Serum 0.69 (0.50-1.50) mg/dL
BUN/Creat Ratio 17 (no reference range given)
Bilirubin Total 0.1 (<0.6) mg/dL
Bilirubin Direct 0.0 (<0.3) mg/dL
Bilirubin Indirect 0.1 (no reference range given) mg/dL
ALT 133 *H (<100) IU/L
Alk Phos 2782 *H (<95) IU/L
AST 17 (<65) IU/L
Cholesterol 283 *H (125-260) mg/dL
Triglycerides 154 *H (41-115) mg/dL
Calcium 10.9 (8.3-12.0) mg/dL
Phosphorus 4.5 (2.8-5.7) mg/dL
Sodium 149 (138-154) nmol/L
Potassium 4.8 (3.7-5.8) nmol/L
Chloride 106 (104-118) nmol/L
Protein Serum 6.8 (5.4-7.5) g/dL
Albumin 3.4 (2.5-3.9) g/dL
Globulin 3.4 (no reference range given) g/dL
Osmolality Calculated 295 (280-310) mOsm/Kg


I was happy to see that the electrolytes were all in the normal range from the cushings/addison's perspective! The Alk Phos has increased significantly since the last time I could find a result, it was 1869 on 10/22/12. The ALT is now elevated and it has always been in the normal range before. When my vet phoned the results, she mentioned that the liver enzymes were up due to the steroids. I will ask further about it now that I have the specific results. His triglycerides have been elevated in the past, it is a bit lower than the last time, maybe due to the low fat i/d diet, however the cholesterol is now elevated. Overall, I think these are good results considering everything. Any feedback on the lab results would be appreciated!

My vet was pleased that the BUN and creatinine were within the normal range, but said that he has protein losing kidney disease. I think she called it Protein Losing Nephropathy. I need to clarify that this is the diagnosis for sure. I was on information overload so forgot to ask a few things. She said it was caused from the Cushings.

The plan for treatment is to change him over to a kidney diet, Hills prescription k/d, I started the slow transition last evening. In a few days after we see that he is tolerating the food, she will start him on either enapranil or benzapril. These are both cardiac/BP meds but are used for kidney disease also. I did some reading, but need to research further. My vet said his kidney values have to be rechecked 5-7 days after starting the med because sometimes the med itself can cause the kidneys to be unhappy. But she said it is necessary to slow the progression of the disease in the long run. So I am a bit worried about that, as I did read that the meds can cause kidney problems/damage themselves. Yikes!

I am guessing from the lack of previous responses from the wonderful experts around here, that nobody has much experience with any kidney issues. PLEASE HELP if you do!!!

I searched for a Kidney Disease forum like this one, all I found was a yahoo group called K9Kidneys. I did register for it, but within minutes I had about 20 automated emails with instructions etc. I checked it out a little but it is not set up like this forum. I have not posted anything there yet, I am not real sure how to do it. It seems a bit confusing how it is set up. Has anyone here ever belonged to a yahoo group? How do you enter posts, is it by emailing?? Well, that might have to wait, I am feeling quite overwhelmed and not sure I have the energy to tackle figuring that out at the moment. And I am scared. Of course some of the things I read on the internet paint a pretty dismal picture, but I am trying to not think about that right now.

Thanks for reading all of this and for any help/advice anyone can provide.

Hugs,
Tina and Jasper

[Harley PoMMom]

Hi Tina,

My boy, Harley, had kidney disease. It is true that it is not noticeable on the blood panel until at least 50%-75% of kidney function has been lost.

Has Jasper had an UPC done?

The Yahoo K9kidney forum is a great site, which I did belong to, the members there have a wealth of knowledge about canine kidney disease so I do urge you to join there. You do post to that site through your own e-mail account.

Two of the supplements that I gave to Harley for his kidney issue were CoQ10 and wild salmon oil. Harley was on enalapril and benazepril and these may elevate the creatinine and BUN but these values should level out.

It is also a good idea to give something to help coat the stomach lining such as Pepcid AC or slippery elm bark. Both of these aid to eliminate ulcers which are prone in dogs with kidney disease. These products can make the absorption of some meds/vits/supplements more difficult which is why it is recommended not giving any of these for at least 1 hour before or 2 hours after giving the Pepcid AC or SEB.

Along with the creatinine and BUN, the phosphorus and potassium levels need to be watched for elevations. If phosphorus levels begin to climb then a binder is needed.

Feeding a moderate-protein diet is now what is recommended, here is a site with info about diet: http://dogaware.com/health/kidneyprotein.html

If I can be of help in any way, please do let me know.

Love and hugs,
Lori

[addy]

Hi Tina,

I am sure someone will be along to read through your labs

I know Lori will be more than happy to answer any of your questions, as she offered, so take her up on it, okay?

I belong to a Yahoo group for Zoe's IBD. I am not on it much anymore, no time, but if I remember right you have the choice of getting posts from your group (updates) via email or just logging in to the group so I could ask a question either just being logged in to the group via email or via from the updates I received via my email. It depends on how much you want to read via emails. I eventually changed my setting to not getting updates via email, I could not keep up.

We adjust and learn with each new challenge we face. I know you are on info overload so I'm sending you a ((((((((((((((((hug))))))))))). Sorry I cant be of more help today, have had a horrible headache since last night. I have not yet heard of Protein Losing Nephropathy so I'll learn about it with you

[Squirt's Mom]

Hi Tina,

Yahoo! groups are a bit of a hassle in my book. You can, like Addy said, reply either from the digest in your email or by signing into the group. If you are signed in and reading a post, you will see a blue "reply" button in the upper RH corner of the text box. From there it's much like any other forum to send/submit. Your post may be immediately visible or it may take a bit to hit the board, it depends on how the group is set up.

The thing I really, really dislike about Yahoo! groups is that you can't keep info in one place like the threads in this type format. Each post on Yahoo! just sorta hangs there and to read the "conversation" you have to click each reply that is under the original post. I get lost as to which ones I've read and haven't! The email digests come across looking more like this format but the board is not at all.

There are some good groups on Yahoo!, tho, so don't give up. The kidney group is supposed to be a great one.
Hugs,
Leslie and the gang

PS. Wish I could help with the labs but alas, no....

[molly muffin]

Tina! Hugs.

I know this is extra scary on top of everything else that you have gone through with Jasper and continue to deal with. I do think you have a good vet who is very caring and patient. It's great to have a vet that will work with you.

I wish I could tell you all about Kidney Disease and alleviate your worries. Alas I don't know and have no experience with anything other than crystals.

I will google for you though till the cows come home as they say.

This is one paper I found on Protein Losing Nephropathy.
http://www.vimpva.com/articles/Prote...0in%20Dogs.pdf

hugs,
Sharlene and Molly Muffin

[Tina]

Thanks so much for the replies everyone.

Lori - thank you for all of your information, and the offer to help. I can't tell you how appreciative I am. I'm sure I will have some questions, I just can't get it together right now. My head is spinning with all the reading I have done today, and I can't seem to really focus very well. But I wanted to answer your question about whether Jasper had a UPC done. Is this a urine protein:creatinine ratio? If so, yes, he has had this test done twice. I had posted them a while back. The results are as follows:

10/22/12:

Protein, Random Urine 138.9 mg/dL (no reference range given)
Creatinine, Random Urine 110 mg/dL (no reference range given)
Protein/Creat Ratio 1.27 (no reference range given)

1/14/13:

Protein, Random Urine 73.3 mg/dL (no reference range given)
Creatinine, Random Urine 21 mg/dL (no reference range given)
Protein/Creat Ratio 3.57 (no reference range given)

The increase in the ratio from 1/14 is what made my vet say that we needed to start treatment now, she said it was a pretty significant elevation in that value and indicated that he is losing a lot more protein from his kidneys.

I went to the site you gave and read all the diet information. I am a bit anxious about that now, because the Hills k/d is the food my vet has me switching Jasper over to. She also mentioned Purina and Royal Canin kidney diets as possibilities also. She said she didn't have a preference. I brought a sample of the k/d home to see if he liked it. It seemed ok so figured we would go with that. Should I ask my vet about it? I don't know what else she would prescribe. The k/d does have a bit higher protein content than the Purina. I couldn't access the nutritional info on the Royal Canin website.

As far as the yahoo group, I did join and complete my registration. I am going to need to tackle that another time, they have a lot of questions and lab results that they request for the first post. And I need to figure out how their site works when I am not so over loaded. I am glad to know it is a good site to join.

Thank you again for the help.

Hugs,
Tina and Jasper

[Tina]

You guys, thanks for the hugs. I sure need them. Sharlene, I am so scared I can't think straight. I calm down for a while and for a short time feel that it will be alright, but then the fear creeps back in. I haven't gotten anything done the whole weekend except research all of this stuff. I can't stop, I just feel so anxious.

Now it is almost time to face another work week and I don't even have laundry done. And the next 2 weeks are going to be tough at my job, someone is on vacation. I have to figure out how to function somehow. I am starting to second guess my vet after reading all the kidney diet info at that link that Lori provided. My friend keeps telling me to take things one day at a time. I know she is right, but I am not able to do that very well right now. I know you all understand, and I am so thankful that I can vent here. I have a headache from crying so much and I want this sick feeling in my stomach to go away. I feel like kind of a wreck.

[molly muffin]

It's okay, of course you can't concentrate on anything else other than this at the moment. Remember when cushings came up the first time? And then Lysodren, then the crisis, etc, etc, etc. You handled all of that so well, really proud of you.

However, YOU have to learn as much as you can before you start to take it in and feel calm, so finding out what you need to know is your way of coping. Once you have a better handle on it, things will seem more manageable. Your friend is right too, one day at a time and right now, this time, is that you need to step back away from the reading for a bit. You are starting to overwhelm yourself it sounds like and that doesn't let you fully just digest the information. So, calm, step back, do the laundry, do anything else, but try to just not look up new info till you can really wrap your mind around what you have already read.

Just deep breathes. Think calmly, make your notes to talk to vet and go from there.
Big Hugs,
Sharlene and Molly muffin

[Tina]

You are starting to overwhelm yourself it sounds like and that doesn't let you fully just digest the information.

You are so right Sharlene, as usual!! I have actually stopped researching and reading as of a couple of hours ago. I am wiped out. Now I need to stop ruminating over everything!!

How was your weekend? I hope you had some fun for the both of us!

Love and hugs from me and Jasper