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Pet Doc
Pet Doc, Veterinarian
Category: Vet
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Experience:  Veterinarian - BVSc (DVM equivalent).
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my dog of 18 years has been diagnosed with kidney failure.

Resolved Question:

Hi my dog of 18 years has been diagnosed with kidney failure. The vet stated that his blood test results indicated extremely high enzine levels and that we should have him put to sleep within the next couple of days. However, some articles that I have read indicted that this may be treatable; please let me know your opinion.
Submitted: 2 years ago.
Category: Vet
Expert:  Pet Doc replied 2 years ago.
Hi there,

Thank you for your question regarding your 18 year old boy who has been diagnosed with renal failure. He has done extraorinarily well to get to 18. I have had a few clients with cats that get to that age, but never a dog - so I am very impressed. I can imagine this must be a very difficult time for yourself and your family.

Kidney failure in many cases, can be managed for quite some time depending on the stage of the disease. Most cats develop CKD - Chronic Kidney Disease. Dogs can develop acute disease as often as chronic disease. Given the age of your boy, it is much more likely that he has chronic kidney disease, rather than acute, but only your veterinarian would know this for sure, depending on the exact blood results that came through (there are subtle differences). Either way, the prognosis really depends on the level of those kidney enzymes. If the levels are indeed extremely high, then we call this severe kidney failure. There is a special grading system termed the IRIS staing system (international renal interest society). There are several stages of kidney disease from 1 through to 4. Stages 1 and 2 can be managed with certain drugs, a special diet and fluidsi as needed. Even still, kidney tissue can never be repaired, and the disease will always eventually go on to the next two stages. When the levels of kidney enzymes get so high that a stage 4 is reached (probably where your boy is now), there isn't anything that can be done to aid the situation, other than very short term solutions such as intravenous fluids and supportive care.

It would definitely be worth confirming with your veterinarian that your boy is indeed at a stage 4. If he is at a lower stage, then it could definitely be worth trying some intravenous fluids and potentially putting on some appropriate medication. If he is a stage 4, then his care would purely be limited to the very short term, and in many ways putting him to sleep in the next few days would be the fairest option if this was indeed the case.

For more information on kidney disease and the IRIS stages, please visit this reliable pet information site made by veterinarians specifically for pet owners: http://www.veterinarypartner.com/Content.plx?A=572

The next few days will be quite tricky for you and your family, however I would encourage you to discuss the blood results and IRIS stage further with your veterinarian today or tomorrow. Please let me know if you have any other questions. My goal is to provide you with excellent service – if you feel you have gotten anything less, please reply back.

Kind Regards,

Dr E

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If you have any further questions in the future, I would be more than happy to help you again! Just bookmark my profile and ask a question via the question box.
Customer: replied 2 years ago.

Thank you very much for his helpful advice and I believe that he may be at stage 4 only because the vet stated the the enzyime levels were the highest seen. However, his appetite was okay until today bu unfortunately he has not eaten or attempted to drink tonight but he did want a walk. He hasn't vomited and is not moaning in pain. Although, I do not want him in pain and if I thought he were, my decision would be easy, do you, in your opinion, think that he may be in pain or not??

Expert:  Pet Doc replied 2 years ago.
Hi there,

Yes - it sounds as though your boy is likely a stage 4 on the IRIS grading. It is possible at this stage that he has some oral and stomach pain potentially. The high kidney enzymes can cause oral and gastric ulcers which could potentially be painful and put him off his food. Severe kidney disease like this is more likely to just make your boy feel really tired and lethargic (likely why he didn't want to go for a walk). As the disease worsens, he will become more lethargic, won't want to eat or drink, and would become very badly dehydrated very quickly.

Do try and get him to drink overnight, that is probably the main concern here. If he really won't touch any water, the you could try some chicken flavoured water, or low sodium chicken broth for him.

Definitely follow up with your vet in the morning if you can.

Thoughts,

Dr E
Pet Doc, Veterinarian
Category: Vet
Satisfied Customers: 7157
Experience: Veterinarian - BVSc (DVM equivalent).
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