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Dr. Barbara
Dr. Barbara, Board Certified Veterinarian
Category: Vet
Satisfied Customers: 1614
Experience:  Thirty years experience in small animal medicine and surgery.
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My dog has renal failure. She has just this week been

Customer Question

My dog has chronic renal failure. She has just this week been lethargic and is obviously in pain. I took her to her usual vets today who thought she had a bad back and gave her tramadol. Since then she has been even more lethargic, has not eaten and has not drunk anything. Prior to this she had a good appetite and has been weeing pooing and drinking normally for her. What else should I do. I am really concerned she is in acute renal failure and the vet misread her symptoms.
Submitted: 3 years ago.
Category: Vet
Expert:  Dr. Barbara replied 3 years ago.
Dr. Barbara :

Hi, Welcome to JustAnswer. I am a licensed veterinarian and I'd be happy to try help you and your dog. Lots of things including decreasing kidney function and a painful back could cause her loss of appetite and severe lethargy. How old is your little girl and what breed (and her name!). Has she been on any medications, special diet, and/or fluid supplementation for her chronic kidney failure? Do you know what caused her kidney condition? Thanks in advance for your answers. They will help me to better assist you.

Customer:

Lupin was 7 on the 5th August she is a beautiful black and tan ckcs who has been full of life upto now. I believe her Renal Failure is due to a drug error my vet made in May 2013. However he has always disagreed and has concluded there could have been many causes for the renal failure but has failed to be able to confirm any conclusive cause for her condition. She was on Epiphen 45mg bd for epilepsy and had been for just over a year when he dispensed 60mg tablets in error and I gave her 90mg bd for 5 months as a result instead of the usual dose of 45mg bd. Before the drug error all her blood results were normal. In October last year her liver and kidney function tests were abnormal and the drug error was discovered.

Customer:

She was briefly put on a liver protecting medication and her liver recovered but her kidneys did not and they have declined steadily ever since. Up to know in herself she has been good still able to go to Dog Agility which she is amazing at and only suffering very occasional nocturnal enuresis. She was seen recently by the animal health trust at Newmarket who started her on fortekor 2.5mg she has 1 and a half tablets od. She started amlodipine 1.25mg od 2 weeks ago to further bring down her BP which was 170 and her epiphen is now down to 12.5mg bd. A week ago she was fun and fine. On sunday she showed signs of pain and slowed down a bit. This has worsened over the course of the week until I decided to take her back to my vet yesterday who diagnosed the "back problem" and gave her the tramadol 10mg. This has nocked her out totally and I don't trust the vets so not sure what to do. If her Renal failure is the cause I do not want her to suffer but the animal health trust said the CKD was grade 2-3 and typically dogs at that level could have upto 1-3 years this was in June. Now I am at a loss at what to do for the best. I do not want her to suffer and at the moment she is but equally if she has another condition that is causing this problem I am prepared to give this a chance to heal and get over it. With the recent addition of the amlodipine could it be that has caused more complications or side effects? I am at a loss as to know what to do. Your advise would be useful as I cannot afford to keep going back wards and forwards to the vets. I would if I thought she would have a good prognosis but I cannot bear to see her like she is. It breaks my heart.

Dr. Barbara :

Thanks for your thorough response. I hear your heartbreak over her long term condition, but also over this acute situation. Because she feels so terrible right now, I very strongly recommend that you get her to her vet tomorrow (today for you) and have a blood profile run to see where she stands with her kidney function. She also needs fluid support, and if nausea is the cause of her loss of appetite than that should also be addressed. What does Lupin weigh? Tramadol is dosed at 5mg/kg every 6-12 hours, should be used with caution with other CNS depressive drugs (phenobarbital) and dosage adjustments should be made in dogs that have renal or liver impairment.

Dr. Barbara :

I would not give the Tramadol dose on Saturday morning, but see your vet (or a vet) for further testing and supportive treatment asap. Back pain can definitely slow a dog down, but so can worsening kidney function as well as a myriad of other pathological conditions. I very much agree that you need to get a solid diagnosis of what is going on right now to make her feel so miserable, and then treat and support her if her prognosis indicates that.

Dr. Barbara :

It sounds like Lupin's life has been marvelous, and I do hope that she has a problem that is very treatable and that she can get back to the active and very enjoyable life she has.

Customer:

Lupin weighs 6.2 kg. I have not given her the tramadol. I am sure that was really just knocking her out and maybe what is responsible for her loss of appetite yesterday as she has eaten and drunk something this morning. In fact she seems a lot brighter today and no obvious signs of pain despite not having the pain relief. Thank you for the advice. I will get back to the vets and go from there. I may leave it until Monday if you think that is ok? The vet can then get in touch with the animal health trust team who can advise on what we should do. Obviously if she goes off her food or wont drink over the weekend I wont leave it as I know that wont help her kidney function. She has passed urine today and had a normal poo so far so good!

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Expert:  Dr. Barbara replied 3 years ago.
What good news about Lupin. . .thanks for letting me know.
If she is eating and drinking over the weekend and has no nausea or vomiting, then I'd say it is fine to wait until Monday.

Thank you so much for your very kind rating. . .greatly appreciated!

This thread should stay open for a couple of days, so if questions or concerns arise, just let me know. I will put you and Lupin in for a little follow up in about 5 days, just so I can know how things are going. There is no more charge for this.

Best of luck to you two!
Dr. Barbara
Expert:  Dr. Barbara replied 3 years ago.
Hi,
Just checking up on Lupin and you. . .how are you two doing?
Thanks for letting me know!
Dr. Barbara
Customer: replied 3 years ago.

Hi Thank s for your concern and the advice last weekend. Lupin is absolutely fine. She has made a full recovery and seems back to her normal self. No idea what was wrong but back to normal for her now thankfully. Fingers crossed she will remain so for the future.

Expert:  Dr. Barbara replied 3 years ago.
That is wonderful news!!!!
Thanks so much for letting me know!
Dr. Barbara