My cat lived a year with sub-Q fluids given about 1-2 times a week. I didn't get his blood tested often enough, and toward the end I should have increased the frequency. I used Lactated Ringers and we supplemented it with Potassium.

I learned a lot.

You should be getting his blood tested often. I would say once a month, and write down his numbers in a journal. BUN, creatinine, urea.

Oh - WARM the fluid bag in a sink of hot tap water (not boiling) until when you squirt some on your wrist you can't feel it. (Body temp). Otherwise have fun trying to hold the dog down injecting cold water into his skin, hahah!!! (Or do what I did and try it with a clawed cat).

He needs hydration so try and avoid dry kibble at all costs.

 Quote: nicole kelly

I disagree about the food, I work in a Specialty and Critical Care facility where we see some of the worst cases, the ones the regular vets refer to us because we are the last chance these animals have. I have seen several animals thrive on the prescription diets. SD also has a kidney diet for patients with kidney disease called K/D. The I/D is more of an intestinal, low protein diet...very similar to a 'bland diet.' I am not one of those in the veterinary community that will just subscribe to whatever claim a 'big food' company wants to give.

Really? Now I'm confused. I was under the impression that you wouldn't want to lower the protein in the diet, as is usually recommended for CRF and is done in prescription diets. I also thought you would want the most "bio-available" protein for a dog whose kidneys were not working at their fullest potential.

I'm no expert, but it really looks like these diets just hide symptoms.

The funtion of the kidney is to:
1. regulate blood ionic composition (Na, K, Ca, Cl, & phosphate ions)
2. regulate blood pH, osmolarity and glucose
3. regulation of blood volume (reabsorption or excretion of water)
4. regulation of blood pressure (secreting renin and adjusting renal resistance)
5. release of erythropoietin (regulates red blood cell production) & calcitrol (increases blood calcium levels)
6. excretion of wastes and forein substances (ie drugs)

So as can be seen...the kidneys have a couple of important jobs to do. Compromised kidneys, ie chronic renal failure, do not have full function of course and can have lost 75% of function. Luckily, humans have the advantage of being able to undergo dialysis and/or kidney transplants (transplants are avail for dogs). When the kidneys do not function, toxins are basically building up in the body and the body slowly looses its fight trying to keep up and remove them. This can be very miserable especially if left untreated.

You don't necessarily have to do LOW protein and HIGH protein does not CAUSE kidney failure (at least it hasn't been proven) in healthy animals. It is especially not suggested to start feeding higher protein than the dog is already on after it's been diagnosed with renal failure. In considering the physiologic process of the disease, the less extra 'work' the kidneys have to do, the better.

Nicole, if I can distract the discussion a bit, I'm wondering if you'll know something I've long wondered....

Why is it that kidney failure/CRF doesn't show up until the kidneys have lost 70%+ of their function? How come tests don't show it sooner? I guess I don't understand why there isn't a more effective test.

 Quote: nicole kelly

So as can be seen...the kidneys have a couple of important jobs to do.

Obviously.

It still seems like while symptoms are dealt with in the K/D, it is at the expense of overall food quality.

Not necessarily "hide" symptoms, as I said in my last post. More like treat each individual kidney function instead of the kidneys and the body as a whole.

I still feel there is a better way. Maybe a little more work involved, but by putting together a homemade diet you would be able to use higher quality ingredients and tailor it to YOUR dog. Not a one size fits all diet.

I'm absolutely horrible at wording stuff. Sorry if I'm hard to follow.

Michael... I DEFINITELY agree that there may very well be a better way to feed than the K/D. But therein lies a couple problems:
1. OWNER COMPLIANCE, OWNER COMPLIANCE, OWNER COMPLIANCE
It is practically impossible to even get an owner to quit free feeding, give meds on time if they even remember to keep giving them at all. Yes, there is the rest of us that are more aware of a hair out of place on our dogs than our own body but the general public doesn't work that way.
2. Research ability: Unfortunately, I do not have the thousands or millions of dollars to make sure the food I am cooking/feeding is going to have the right: protein, fat, vit, mineral, moisture contents etc. Granted I do not believe all big company research but if you really look into it you can come out with good info and some of the foods out there are not SO bad.
If an animal is in chronic/end-stage kidney failure...fluid therapy is highly recommended. The dog is often times becoming more ill with decreased appetite, seemingly unquenchable thirst, and sometimes vomiting or being completely lethargic. The fluid therapy helps the body to directly dilute and help flush some of the toxins out. If the kidneys are not working properly...you need to treat the 'whole body' b/c it is essentially being poisoned.

Jennifer...
I think the reason that most are not discovered until the kidney function is nearly gone is a couple of reasons... depending on the cause of the failure, it can be a rather quick onset. ALSO, ppl don't usually take their dog to the vet until it has signs of being ill (ie long period of increased water consumption, lethargic, vomiting, inappetance, etc). Most are not taking their dog to the vet intermittently for creatinine and blood urea nitrogen checks just for grins. By the time the signs are present and the tests run, you may already be in chronic or end-stage renal failure. No offense to anyone on the board but look how many ppl get on here and ask why their dog might have been vomiting for the last 3 days and ppl tell them all these crazy at home remedies instead of saying 'GEEE maybe you should get that dog to the vet!!' That being said...I don't freak out and rush my dog to the vet for every little thing.

So that was a much longer explanation than may have been necessary... but to directly answer your question: Yes, renal values could be monitored if one really wanted to do frequent blood testing on their dog that appears otherwise healthy. The dogs usually begin to 'act' sick once the toxins have started building up in the body.

 Quote: nicole kelly

1. OWNER COMPLIANCE, OWNER COMPLIANCE, OWNER COMPLIANCE
It is practically impossible to even get an owner to quit free feeding, give meds on time if they even remember to keep giving them at all. Yes, there is the rest of us that are more aware of a hair out of place on our dogs than our own body but the general public doesn't work that way.

I forget that folks here are a different breed of dog owner. Good point.

 Quote: michael wise

Not necessarily "hide" symptoms, as I said in my last post. More like treat each individual kidney function instead of the kidneys and the body as a whole.

 Quote: nicole kelly

If the kidneys are not working properly...you need to treat the 'whole body' b/c it is essentially being poisoned.

Just clarifying. This is what I meant, too. I read back over my post and it sounded like *I* was saying that you SHOULD treat each individual function instead of the kidneys and body as a whole. Its the K/D that I feel isn't treating the kidneys and the body as a whole. It definately addresses all the kidney's functions, but some of its solutions are at the detriment of other functions. And a dog in the beginning stages of CRF doesn't have the same requirements as one in the end stages. The K/D looks more suited for the worse stages of the disease as far as the way it handles symptoms.

Thank you for your discussion. You are obviously WAY more educated than I. Its humbling to have all these smart folks at my disposal to learn from and bounce things off.

 Quote: Nicole Kelly

Jennifer...
I think the reason that most are not discovered until the kidney function is nearly gone is a couple of reasons... depending on the cause of the failure, it can be a rather quick onset. ALSO, ppl don't usually take their dog to the vet until it has signs of being ill (ie long period of increased water consumption, lethargic, vomiting, inappetance, etc). Most are not taking their dog to the vet intermittently for creatinine and blood urea nitrogen checks just for grins. By the time the signs are present and the tests run, you may already be in chronic or end-stage renal failure. No offense to anyone on the board but look how many ppl get on here and ask why their dog might have been vomiting for the last 3 days and ppl tell them all these crazy at home remedies instead of saying 'GEEE maybe you should get that dog to the vet!!' That being said...I don't freak out and rush my dog to the vet for every little thing.

So that was a much longer explanation than may have been necessary... but to directly answer your question: Yes, renal values could be monitored if one really wanted to do frequent blood testing on their dog that appears otherwise healthy. The dogs usually begin to 'act' sick once the toxins have started building up in the body.

thanks my cat's CRF was caught during either the annual checkup or 6 month bloodwork, i don't remember which, and has always been hovering around the 70% - it has never gotten worse, actually has shown some improvement - i just never understood why the vet didn't flag it at around 60%, for instance. he's never been particularly symptomatic, especially now - his hydration is great - but it bugged me that it wasn't caught in any earlier blood tests.