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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog
Satisfied Customers: 14882
Experience:  Over 20 years of experience as a veterinarian.
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Our 12 year old Greyhound, Eddie, has become unwell very suddenly.

Customer Question

Our 12 year old Greyhound, Eddie, has become unwell very suddenly. The vet says there is no sign of renal damage but his unine is dilute and there is protien / blood in it. Eddie was eating well and his toilet habits were normal: he was still asking to go out. However, he has become increasingly lathargic and unwilling to do much, but pants a great deal and seem to find it hard getting comfortable at times. Just 2 weeks ago he was bouncing around as normal! The vet gave antibiotics but these seem to cause laboured breathing so after 48 hours we stopped them. I must add that his back teeth are awful though they have never seemed to cause pain and we have been reluctant to put a old Greyhound under aneasthetic. Now he seems less willing to eat which is a new worry. What could be wrong and what do we do to make him comfortable?
Submitted: 2 years ago.
Category: Dog
Expert:  Dr. Kara replied 2 years ago.
Hello, my name is Dr. Kara and I have over 20 years of experience as a veterinarian. I am sorry to hear that Eddie has elevated protein levels in his urine, poorly concentrated urine, a poor appetite, increased panting and is lethargic.

Though bad teeth can predispose to all sorts of problems as the infection spreads in the body they rarely interfere with appetite. Most greyhounds have rotten teeth and continue to eat very well.

Panting in a dog can be due to poor oxygen exchange, either due to heart or lung disease or anemia, but it can also be caused by abnormal blood gases due to metabolic disease (like kidney disease), nausea, pain or anxiety.
If his gums are nice and pink and he isn't anemic and his heart rate and rhythm are normal then I believe his panting could be due to pain, anxiety, nausea or abnormal blood gases.

I understand that his kidney blood enzyme levels were normal, but 2/3 to 3/4 of the total kidney function must be gone before we see those rise. Early kidney disease may show up as poor concentrating ability and increased levels of blood protein in the urine.

The level of concern for protein in the urine depends upon whether he also shows signs of a urinary tract infection as urinary tract infections artificially elevate protein levels due to red and white blood cells in the urine. If there is protein in the urine and blood cells I recommend culturing it look for an infection.
I understand that he was started on antibiotics, which seemed to make him feel worse, but antibiotics can lead to worse nausea, and thus more panting. So it may have been that he became more nauseous, not necessarily that the antibiotics were truly worsening his condition.

If he doesn't have an infection then we need to compare the amount of protein in his urine with his urine concentration. If his urine is highly concentrated (specific gravity of 1.045 or higher) with small amounts of protein I am less concerned. But if his urine is poorly concentrated (1.020 or less) with even small to moderate amounts of protein I start to get concerned. This may point toward poorly functioning kidneys and is a sign of early kidney failure.

A good test to run in a dog without a urinary tract infection and poorly concentrated urine is called a urine protein/creatinine ratio. This compares the amount of protein in his urine to the waste product creatinine. If he is spilling a high amount of protein compared to waste products then yes we do need to be concerned about kidney failure.

If he has kidney disease causing protein loss then checking him for high blood pressure is recommended and placing him on medication to help decrease protein spilling in his urine, such as Benazepril or Enalapril is recommended.
It may also be advised to start him on a diet formulated for kidney failure, such as Hills k/d or Royal Canin Renal LP.
I will often recommend adding an omega 3 fatty acid supplement as well as a natural anti-inflammatory to help with kidney health.

To decrease nausea and hopefully get him eating better I recommend either:

1) Pepcid-ac (famotidine) at one 10mg tablet per 9 to 18 kilograms of body weight
 every 12 hours.

OR 

2) Prilosec (omeprazole) at one 10mg tablet per 9 to 18 kilograms of body weight
 every 24 hours.

These will reduce stomach acid and should help him if this is related to nausea, whether it be related to kidney disease or other reasons.

It may also help to offer a bland diet of 1/3 boiled, lean hamburger (or boiled, white, skinless chicken), all fats and juices drained off mixed with 2/3 boiled, plain white rice. Feed several small meals a day. Once he is eating better you can start mixing in his regular dog food or a kidney support diet very slowly. Less bland more regular with each day. It should take a week or so to convert him back.

The other possibility given his age is that we are dealing with cancer. An abdominal ultrasound may give you the information that you need. It will allow your veterinarian to evaluate his kidneys, and all of his other abdominal organs.
Please let me know if you have any further questions.

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