This post is a part of the Caring for Critters Health Issues Round Robin hosted by Heart Like a Dog. As the adorable graphic suggests, pet bloggers will be sharing their personal experiences, health problems their pets have faced, and how we dealt with them. While we consulted veterinarians and specialists in determining our own course of treatment, we are not vets and nothing shared should be considered medical advice. Got it?

I’ll admit – I had trouble deciding what to write about today. My beautiful Bella had numerous health issues over the years, so choosing one was difficult. I also wasn’t necessarily motivated to revisit some of those issues in light of our recent loss. However, inspiration finally hit, and this post is the result.

So, what topic will I be tackling in today’s post?  Chronic kidney disease. (Forgive me if this post isn’t one of my best – it’s a little tough to get on paper(?), honestly.  Fair warning: it’s also kind of a long one.)

Oh no not my baby

Bella was one of those pups who always seemed to be dealing with a bladder or urinary tract infection.  A few years ago, she had a UTI that just wouldn’t go away.  None of the usual treatments were clearing it up, so our vet decided to check Bella’s kidney levels. (I’m not the science-y type, so I’m just going to use “levels” to describe the markers that the vet was looking for in the blood test results. I was much more conversant in this area a few months ago, but I’ve gotten rusty. In any event, being vague will ensure that this post doesn’t end up riddled with inaccuracies.)

Of course, the dreaded “levels” revealed that Bella had chronic kidney disease.  In its early stages, at least for us, it did look a bit like a UTI.  Bella had several accidents in the house, she seemed lethargic, and she drank more water than usual.  Unfortunately, this time those symptoms turned out to be something more serious.

Learning that our girl had a progressive disease was hard to hear.  Bella was diagnosed in the fall of 2011, when she was about ten years old. Ultimately, we said farewell to her in May of this year when her kidney disease was too advanced.

What’ll I do (or, treatment, plans, and things)

(I was going – unsuccessfully – for  a play on “Gypsies, Tramps, and Thieves” in the hope that a little Cher would help keep this post from being a total downer.)

We followed a pretty traditional treatment path, as suggested by our veterinarian.  We switched Bella to a prescription diet and focused on making sure that she stayed hydrated.  (There appears to be some disagreement in the veterinary community about the specific type of diet that is best for kidney disease management – however, as I’m not a vet, I will simply recommend that you talk to your own vet and educate yourself on the various options.)

At the outset, this simple change was fairly effective.  Her levels stayed relatively stable for a while, and she seemed like her old self.  Unfortunately, with kidney disease it can sometimes feel like you’re fighting a battle against the inevitable.  As her levels slowly got higher, her energy levels went down and she lost her appetite.  Getting her to eat became my primary focus.  We tried several different prescription food options, but none of them really seemed to interest her, although we did have occasional success feeding her by hand. Once that stopped working, I started cooking meals for her after talking with my vet about appropriate options. (Canine mealtimes around here lasted at least thirty minutes, if not more, and involved a significant amount of pleading and cajoling on the part of the human involved.)

We were at the vet fairly often, especially once she started to feel worse.  She had, alternately, diarrhea and constipation. A second focus – getting her digestive system working properly again – was added.  We tried probiotics, medication (both prescription and a small dose of Pepcid, as recommended by our vet), and changing her diet.  It was a bit of a roller coaster – many of these items worked alone or in combination for a while, but it often felt like someone kept moving the goal posts.

Another concern was weight loss.  Bella’s decreased appetite resulted in significant weight loss, as well as a loss of muscle mass in her back legs.  I was fairly concerned about her going up and down the stairs, and we took steps to make sure that she did not fall (as her back legs had gotten weaker).

The music’s no good without you

Treating chronic kidney disease can be draining… no matter what you do, you’re really only postponing the inevitable.  There’s no chance that it’s just cured or gone one day.

So, our outcome was ultimately that we had to say goodbye to Bella.  In spite of the fact that we’d been living with this situation for two and a half years (or more), it was shocking in its suddenness.  I took Bella in for a status check on a Friday.  The vet was not encouraged by the significant increase in her kidney levels and told me that we would probably have to consider giving her IV fluids relatively soon.

We went home, and I assumed that we’d probably add fluids to the routine at our next visit.  However, Bella got sick that night.  I called the vet the next morning, and we both thought that perhaps some of her digestive issues were resurfacing.  We decided on a course of treatment to address it and discussed what I should be on the lookout for.  I kept an eye on her, and by Monday morning, it was clear that Bella was far from fine. She was miserable. At one point, she went into the yard and just laid down with her face buried in some clover.  At times, she almost seemed to be having trouble breathing. I’d never seen her like that.

So, I called into work and made a last-minute appointment with the vet. (One benefit of being a frequent flyer is that they know me and are willing to fit me in at a moment’s notice.)  I was definitely in panic mode.

When I got to the vet, he tested Bella’s levels and the news was not good.  They had skyrocketed over the weekend and her kidneys were failing. Our only treatment option at that point would be fluids at the vet’s office – and it wasn’t clear if she would ever be able to leave. We couldn’t do that to her, so we chose to let her go.

If I could turn back time

On one hand, I think it’s fair to say that we had a reasonable amount of success with the path our vet recommended. We did keep Bella with us for over two years.

However, if I could do it all again, I think that I would spend a little more time educating myself and asking questions. To be honest, denial is a powerful motivator – I desperately wanted to believe that everything would be fine.

As a more specific example, I wish that I had decided to talk to my vet about cooking for Bella earlier. I don’t know if it would have made a difference in the long run, but I do think that I should have taken that step sooner in an effort to address her loss of appetite and weight loss.

I got you babe

Have you had any experience with canine or feline kidney disease?  If you’d like to learn more, this site provides a useful starting point for your research and to educate yourself about this issue. (I also just stumbled across this Facebook page, which seems to be a community of people dealing with canine renal failure. It never hurts to see what other resources are out there and what options others are exploring. My vet directed me to some useful websites as well, but I can’t seem to find my list right now.)

Where do you go

Well, that was a long post… if you made it all the way down here, then you deserve some kind of medal. (I don’t have a medal to give you, but I assume that it’s the thought that counts.)

Each day, a different blogger will join the Caring for Critters round robin and talk about a health issue that he or she has experienced. It’s kind of like a blog relay. Yesterday, the fine folks at SlimDoggy shared their experience with spondylosis deformans (fused spine).

Now, it’s time to play a game of tag with the next blogger on the list. Tomorrow, visit My Brown Newfies to learn about Sherman’s torn ACL and the conservative treatment that followed.

Want more? You can find links to all of the Caring for Critters posts here.

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