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Canine Kidney Trouble – Not Good, Not Dire

Now that it seems Lilly has been free from bladder bacteria for a few weeks, after nearly 6 straight months of back-to-back bladder infections, we turned our attention to the levels of protein in her urine. Infections can produce high urine protein levels, so we checked again, 2 weeks after Lilly’s last clear urine culture — where her protein level as a 2 (zero is normal). And … it wasn’t good news.

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Rather that merely looking at protein levels, which with Lilly have been as high as a 4 in recent months, we ran a fancier test for the protein-creatinine ratio in Lilly’s urine. The ratio came back high. Silly, silly, silly high — 4.5.

I found a page on the Cornell vet school site that said dogs on long-term steroids can have a ratio of 1.3 or so. So, I burst out laughing with worried surprise when our vet called to share the 4.5 number.

Yikes!

Lilly officially has proteinuria. Essentially, her body is throwing off protein through her kidneys.

While this isn’t yet full-blown kidney disease, it could easily go there. So, Lilly needs intervention soon to protect her kidneys from further damage.

My knee-jerk reaction is to blame the MANY meds Lilly takes to keep her rabies vaccine-induced brain and spinal cord inflammation at bay, but a friend who is a veterinary professor says it’s just another outcome from her primary inflammatory reality.

Either way, we need to take action. The most likely treatment includes a medicine (drug decision pending our veterinary neurologist’s return from the ACVIM conference in Seattle this week) AND to change Lilly’s diet to one MUCH lower in protein.

Usually, you add the med and change the diet and recheck everything in a month. It’d be really interested to try just meds or just food and retest, but we don’t really have time to risk fiddling around. The usual protocol is to do both.

While I wait for a meds decision, I’m exploring my food change options — both on my own and through my contacts at a couple big pet food companies, with science-based therapeutic food lines. We don’t think we need to go whole hog into a true kidney diet, but we do need to get Lilly’s dietary protein down to around 20%.

I’m waiting to hear from her current dog food company on the true levels of protein in her current food. You cannot go by the guaranteed analysis on the label (which in this case says 32% protein). You need to look at the dry matter % chart for the real number. I suspect it’ll still be higher than 20%, but I want to know before I go making a change so that I’m clear on where we were and where we are going.

We lost our dalmatian at 14 1/2 to kidney disease. The special kidney diet gave us 3 more years, so I know diet helps a lot.

Initially, I took the news hard, then I convinced myself it wasn’t that bad, then I came full circle … all the way back to discouraged … after reading this from a 2012 review article:

“Increase in urinary protein excretion correlates with decrease in survival and this is independent of any other factor. Proteinuric renal disease progresses more rapidly than nonproteinuric renal disease and reduction in urinary protein excretion slows progression of renal disease and renal interstitial inflammation in humans and dogs. Thus it is speculated that proteinuria itself contributes to ongoing renal damage. If proteinuria is present and persistent then efforts should be made to diagnose the cause and reduce the level. UP/C values > 0.5 in the dog and > 0.4 in the cat are significant.”

Now, I’m mostly tired.

Lilly has another round of cytarabine injections (yesterday and today), so we’ve been busy with that. I also have some heavy deadlines this week, but there is a delay with some info I need to write, so I had a couple minutes to draft a quick blog post.

IN OTHER NEWS, I took Lilly to the Golden Farmer’s Market Saturday morning before her veterinary appointment. She has only been there twice since getting so sick. It was actually pretty funny.

I suppose because everyone gives her love and food at the veterinary hospitals we visit and because those are the only places Lilly has gone for a long, long time … she assumed everyone she saw LOVED her.

She truly tried to mooch attention and food from almost everyone we passed. If they ignored her, she would SIT and scoot closer and closer until they noticed her.

I had to laugh. It was super sweet.

I’m sorry I don’t have any pix. It took everything I had to take care of her in the crowd and such.

In fact, we bought some dog treats from the new vendor since our old one shut down, and somehow we got home without them. I don’t know if I never put them in my bag after paying or if I set them down while buying something else or dropped them. We were SO bummed when we got home with no treats.

Clearly, I was distracted.

Ah, well. It was a nice little outing for our silly-silly girl.

 

 

 

 

 

Roxanne Hawn

Trained as a traditional journalist and based in the Rocky Mountains of Colorado, USA, I'm a full-time freelance writer for magazines, websites, and private clients. My areas of specialty include everything in the lifestyles arena, including health and home, personal finance and other consumer interests, relationships and trends, people and business profiles ... and, of course, all things pet related. I don't just love dogs. I need them in my life. Seriously.

Kelly - July 14, 2013

Tucker has had proteinuria for a couple of years now. He has been on Enalapril, but we have not modified the protein in his diet.
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ruth pennebaker - June 20, 2013

I second Vera’s idea. You’re halfway there.
ruth pennebaker recently posted..Taken Down But Not Out By the TSAMy Profile

HeatherL - June 20, 2013

Poor Lilly. You both deserve a break.
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Pup Fan - June 19, 2013

I hope the diet helps! I can totally relate to this post – we’ve been dealing with Bella’s kidney issues too, for about a year now.
Pup Fan recently posted..How to tell the sex of a kitten or puppy, as explained by a childMy Profile

Jane Boursaw - June 17, 2013

So glad you guys had a nice outing. So sweet about Lilly’s scooting tactic for attention at the farmer’s market.
Jane Boursaw recently posted..‘China Beach’ Finally Released on DVD After 25 Years!My Profile

merr - June 14, 2013

As always, I’m rooting 110% for Miss Lilly. She (and you) are both incredible. I am hoping (as always!) for the best.

Jeanine Barone - June 14, 2013

Oh no. I’m so sorry for you and Lilly. I’m hoping that the meds and low protein diet work. Wishing you both the very best.

Carol Bryant - June 13, 2013

I have been following this saga since the beginning, Roxanne. The things we learn when our babies are ill. I wish there was something I could do.
Carol Bryant recently posted..The Truth About Pet Health InsuranceMy Profile

Sam - June 13, 2013

Oh poor Lilly, if it’s not one thing it’s something else; though it sounds like she enjoyed her trip to the market.
Sam recently posted..Are You Bribing Your Dog?My Profile

Kris @ Attainable Sustainable - June 13, 2013

Hugs, Rox. I’m happy to hear Lilly was able to get out to the market, though.
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Jackie Bouchard - June 12, 2013

So sorry you are having to deal with this now. At least there are options. Hope the diet helps super quickly!

Glad she had a nice outing. What a sweetie. I’d love to give her some lovin’! Anyone who passed on the chance is just plain silly!
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Alexandra - June 12, 2013

I saw some photos of Lilly recently on Facebook and she seemed so much better and looked happy. I’m sorry to hear this news. She is so fortunate to have you.

Sheryl - June 12, 2013

It’s so difficult when a dog is sick. We went through it for years with ours. Counts were up, counts were down. Heart was bad, heart was worse. As always I’m rooting for Lilly. She sounds so endearing.
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Brette - June 12, 2013

I’m sorry to hear you have yet another battle wage. Hoping you can get this under control too. It’s so sweet that this has taught her to assume people love her!
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Vera Marie Badertscher - June 12, 2013

Have you thought about becoming a vet? Honestly, you’ve had so much education, you could ace out of half the courses. Or at least a pharmacologist or nutritionist!
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