# Kidney Issues....



## Lennap (Jul 9, 2010)

The values you described certainly indicate protein losing nephropathy (PLN) - quite possibly Glomerulonephritis - but you certainly don't know that yet.

With a 10.5 year old dog, I can totally understand not going for aggressive diagnostic testing especially because kidney biopsies are quite dangerous, but I would certainly request a urine analysis with UPC. While there is no cure for PLN - you can certainly try to slow down it's progression.

Treatment would start with trying an ace inhibitor which can reduce the protein loss by reducing the blood flow to the kidneys. It needs to be done carefully, and monitored until you get the right dose - but why wouldn't you try?

I was given the same diagnosis for Remy in June 2013 - he was also acting like a puppy - in fact he was not even 5 years old yet. I was told that he would likely last another 3 months, although up to a year was certainly possible.

I did not stop there - I pursued holistic treatments where he was given lots of other supplements, but to be honest not omega threes - but I have read that they provide benefit. In the end I did get a kidney biopsy (remember he was very young) and while he does have a PLN - the prognosis was not as bad as I was originally told.

He is on 40 mg's of enalapril a day and his kidney values have been stable since November 2013. I worry my head off every 3 months when we go for testing - but overall I am thrilled with how things are going. Remy is a happy bouncy almost 7 year old puppy.

Good luck to you - if you have any questions, please do not hesitate to reach out to me - PM me - whatever I can do to help I will!


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## Lennap (Jul 9, 2010)

I forgot to mention Remy was on Orijen until we discovered his kidney issues too. Since October 2013 he has been on prescription Kidney formula. I'm not a big fan of the Science Diet prescription foods, but I am not about to mess with what appears to be working.

The kidney specialist who put him on the science diet felt that it would put less strain on his kidneys. Just something to think about.


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## GoldensGirl (Aug 2, 2010)

Welcome to the Forum!

I'm so sorry that you and your Cassie have to face these problems. Having had multiple dogs with renal issues, I know this is a tough path to follow.

There are veterinary dietitians at vet med schools that will formulate special diets specific to the needs of individual dogs. It might be worth consulting with one of them, at least if you are willing to invest the effort to prepare foods for Cassie. That is a non-trivial commitment, both in time and money, and each of us has to make that call based on our own circumstances. In the end, I think the financial cost is lower than that of prescription dog foods, but the price is higher in terms of time and effort. Thus far, we have always found alternatives. 

My very best way to battle renal issues involves diluted chicken broth at breakfast and dinner to keep my dogs well hydrated and their kidneys flushed. That kept my Sabrina healthy for years longer than anyone expected when she was diagnosed with chronic/congenital renal disease at age 3.

Good luck and please keep us posted.


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## BuddyRich (Jun 23, 2015)

The urine analysis showed the UPC ratio as 3.2.

Urine protein was 308 mg/dl

Creatinine was 8641 umol/L

Given that her 2014 blood test showed lower protein she has quite possibly already lived with this for a year.

The plan is to try the food and fish oil and flush the kidneys and retest urine in 3 months to see if there is lower protein in the urine. If there is not we will then try some drugs.


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## Lennap (Jul 9, 2010)

I am not familiar with the majority of the numbers you gave me, the UPC is high, but I've seen worse. When Remy was first diagnosed his UPC was 5.4, using enalapril we've gotten it down to 1.6 and it has held steady around there since January 2014.

The thing with glomerulonephritis is that it is typically not found until the dog is failing and the kidneys are around 75% gone, so you have been given a gift that you have found it early, so I can understand you taking a slower approach. 

Having said that - it wouldn't hurt to at least find out if there are any renal specialists close enough for you to consult with. I am entirely convinced that the renal specialist saved Remy's life when my original vet had given up on him.

Whatever you do, there is no doubt it will be the best for your girl. I am only trying to share the benefit of my experience of having received an incorrect glomerulonephritis diagnosis.

Best of luck to you!


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## BuddyRich (Jun 23, 2015)

thanks lenna. if not glo.. what ailment does remy have that caused his upc to spike?

pic of cassie resting after a busy week at vet and groomers!


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## Karen519 (Aug 21, 2006)

*Cassie*

Cassie is so beautiful!!


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## Lennap (Jul 9, 2010)

BuddyRich said:


> thanks lenna. if not glo.. what ailment does remy have that caused his upc to spike?
> 
> pic of cassie resting after a busy week at vet and groomers!
> 
> View attachment 540113


 Remy has Focal Segmental Glomerulosclerosis ("FSGS") - basically glomeruli are the tiny vessels in the kidneys that filter the blood, sclerosis means scarring, focal means some not all have been damaged and segmental means it's limited to a smaller area/amount. 

The ONLY way to get a definitive diagnosis is a kidney biopsy. That is not something to take lightly - they are scary and not something I agreed to do eagerly. I had taken Remy from my original Vet to a fancy pants holistic (really homeopathic) vet for several months and saw no improvements. Even fancy pants vet then said we needed greater expertise - and I ended up with an exceptionally renown specialist with enormous experience in biopsies. But please do not think I am telling you that you have to do one - that is very personal decision, and there are many variables in the decision process. I am only pointing it out - because without the biopsy Glomerulonephritis cannot be confirmed, only suspected - and I would at least be talking to a specialist - or connecting my vet with a specialist.

My decision to go for the biopsy was helped by the fact that Remy was otherwise doing great - he was happy, his blood pressure was low, etc. After so many months with bad kidney values (both blood and urine) that was odd. I cried my eyes out when I handed him over for the biopsy - basically begged them to make sure to give him back to me alive, I was scared.

The results took three agonizing weeks to get, and I was told that was record time because Remy's case was interesting (lucky me). When we first started seeing the expert we were told he had a Protein Losing Nephropathy and the prognosis was poor. When the biopsy came back as FSGS his prognosis became cautiously optimistic, that was November 2013 . It took us a little while to get his values stable, with the right meds, but he's been stable since January 2014.

Remy is on 20 mg of enalapril 2X a day and prescription KD food, and he gets acupuncture 1X a month for a whole bunch of things, including his kidneys. We do blood, urine and blood pressure checks every three months.

One other point to note - when we were trying to get his meds right - and of course I was a neurotic mess - the kidney specialist told me there were loads of other drugs to try if enalapril did not work, so not to worry. That made me feel better then and now - because I know we will still have options.

Again good luck to you! I am here if you need an experienced supportive shoulder. PM me and I'll give you my #.


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