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Family Forum / Pregnancy / Breastfeeding / August 2005FAO Hillary Israeli - OT - Dog with kidney failure
Hillary - I have a veterinary question for you. If you are not comfortable answering this type of question online, I fully understand. I don't want to impose on you, but I don't know any veterinarians to ask! We will of course be talking more to our veterinarian, but I am trying to go in with some more information if possible. We have two dogs, an eight year old border collie/lab mutt, and a six year old female dalmatian. Our dalmatian hasn't been eating for the last couple of days, which is very unusual for her. My husband took her to the vet today. Externally, she seemed fine, but they did some routine lab work which showed that her kidney function is very poor. Aside from this, she has been a pretty healthy dog. She was spayed when she was younger. She has had some problems with incontinence in the last year or so, for which she has been on phenylpropanolamine. Also, several months ago, we thought she had blood in her urine - we would see blood on the fur. She was treated for a kidney infection, but hasn't had any problems since. The vet kept her to give her fluids all day today, and wants us to bring her back for more fluids tomorrow. Do you have any ideas about what questions we should ask or what type of treatments, if any, are available? It sounds to me like she might have had a glomerulonephritis several months ago, which is finally now becoming evident. My other thought is an obstructive stone, since dalmatians are prone to kidney stones. Her BUN/Creatinine doesn't really look like dehydration or a stone, though. I have a bad feeling that hydration is not going to help much. We are devastated - this dog was our baby before our human baby was born six months ago. We lost another dalmatian a few years ago to heart failure, also at a relatively young age, so this is all too familiar. I would really appreciate any ideas you might have. I am including her labs below. Thanks, Sarah These are her labs from today: Abnormal: BUN - 44 mg/dL (7-27) Creatinine - 3.4 mg/dL (0.5-1.8) Total protein - 4.5 g/dL (5.2-8.2) Everything else was in the normal range: Alkaline phosphatase - 51 U/L (normal 23-212) ALT - 10 U/L (10-100) Glucose - 103 mg/dL (70-143) Hematocrit - 34.6% (33.1-35.7) Hemoglobin - 10.4 g/dL (9.2-11.4) MCHC - 30.1 g/dL (28.7-30.8) WBC - 17.9 (15.6-19.5) Granulocytes - 8.9 (8.3-10.1) %grans - 50% L/M - 9 (7.3-9.4) %L/M - 50% Platelets - 129 (116-162) Hi, Sarah, I'm no vet and have no advice for you, but I do offer my sympathy and compassion. I'm a dog-lover, too, and I know how very upsetting it is when your "hairy babies" are ill. Hope all goes well, PC "PCBH" <herroyalhighnessprincessconsuela@yahoo.com> wrote in message > Hi, Sarah, > [quoted text clipped - 3 lines] > > Hope all goes well, Thank you for your good wishes (thanks to Hillary too for her email). It is always so hard to see pets get sick, especially when you're not really sure what's going on. Sarah Not a vet, but mine mentioned to me that Lyme Disease presents in otherwise healthy dogs often as kidney failure. Has your woofy had a Lyme titer done lately? *Not a vet, but mine mentioned to me that Lyme Disease presents in *otherwise healthy dogs often as kidney failure. Has your woofy had a *Lyme titer done lately? I'm thinking perhaps there was some misunderstanding here from one side or the other. Lyme disease does NOT present "often" as kidney failure. There is a syndrome called "lyme nephritis," which occurs when an animal infected with the causative organism for Lyme disease develops an immune-mediated glomerulonephritis and protein-losing nephropathy (types of kidney disease). That is one of the reported lyme syndromes in dogs, and it is a particularly frustrating one because the patients almost always die, and quickly. That being said, it's not even been proven yet that this syndrome is due to borrelia burgdorferi - more on that later. The other canine Lyme disease syndromes include febrile arthritis, carditis, and neurological disease - but by FAR the most common presenting syndrome is the febrile arthritis syndrome - basically a dog who limps, and has a fever, is treated pretty effectively with antibiotics, and doesn't have any longterm sequelae. Of course the most common result of lyme infection in dogs is - nothing. Most (>95%) Lyme infections in adult dogs are asymptomatic! Typical Lyme disease signs (including fever, anorexia, and lameness/swelling of one or more joints, often carpi/hocks) may be seen in a small percentage (<5%) of seropositive dogs. I would now like to quote from the Proceedings of the American College of Veterinary Internal Medicine forum in 2004 [Littman MP] A much more serious entity putatively associated with exposure to Borrelia burgdorferi antigens is known as "Lyme nephritis" or "Lyme nephropathy".2,10,11 The incidence is not known but this life threatening renal disease is seen in some dogs with positive Lyme titers. It has not been seen in experimental models of Lyme disease (which used Beagles predominantly) and therefore Koch's postulates have not been satisfied. 2. Littman MP: Veterinary Clinics of North America - Small Animal Practice 2003;33(4): 827-62 (136 refs). 10. Dambach DM et al: Vet Pathol 1997;34:85-96. 11. Sanders NA et al: ACVIM Abstr 1997:674 and Proc 18th ACVIM 2000:627-628. Ok, so bottom line, this is all just a long winded way of saying I don't see how anyone can claim that Lyme "often presents" as renal failure. We don't even know for sure that it EVER does, but if it does, it's not the bulk of the cases! It is "some" of them. But nice of you to make the suggestion in any case :) -- Hillary Israeli, VMD Lafayette Hill/PA/USA/Earth "Outside of a dog, a book is a man's best friend. Inside of a dog, it is too dark to read." --Groucho Marx See this is why I said, not a vet :-) All I remembered was my vet blaming Lyme for 3-5 dog deaths due to renal failure in his practice every year. This was in a conversation with him trying to convince me to have my dog tested for Lyme as part of her well dog checkup and shots, worm test etc.... For the record, I did consent to the titre and it was positive. *See this is why I said, not a vet :-) I know. :) *All I remembered was my vet blaming Lyme for 3-5 dog deaths due to *renal failure in his practice every year. This was in a conversation Ah, see - I can understand someone saying THAT - but given the overall Lyme caseload, I can't see saying that so few dogs would be a large percentage of them, if you see what I mean. *with him trying to convince me to have my dog tested for Lyme as part *of her well dog checkup and shots, worm test etc.... *For the record, I did consent to the titre and it was positive. Yeah, well - the seroprevalence in an endemic area is high - about 85% of all dogs tested in my area will have a positive titer. Only about 5% of that 85% will actually be sick, though. Not to say it's not a good idea to get the titer. A positive titer proves the dog is being exposed to ticks, and can help convince an owner to use better tick control to avoid serious disease in the future. Also, it is good to check for proteinuria if the titer is positive, just to be on the safe side, IMO. Just my opinion here :)  SignatureHillary Israeli, VMD Lafayette Hill/PA/USA/Earth "Outside of a dog, a book is a man's best friend. Inside of a dog, it is too dark to read." --Groucho Marx |
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