Kidney disease dog. Looking for thoughts

My 13 yr old Shina Inu was diagnosed with Chronic Kidney Disease in February this year. Blood levels were a high stage 2. We have had her since she was 6 (adoption). She’s a good dog, but has never really bonded with either of us and has had the classic aloof personality of the breed.

She’s ALWAYS been a picky, difficult eater, so I’ve been cooking her low phosphorous, low protein, low sodium meals from scratch and rotating proteins, veg, fat, and filler to keep her eating. Once she gets tired of a protein or fat source, I’d switch the another. I used a recipe calculator to make sure the calories and other values were in the recommended thresholds. She did great on this diet for months and was happy and spunky.

Now she won’t eat pork (raw or cooked), salmon (raw or cooked), chicken (raw or cooked), turkey (raw or cooked), eggs in any form, cod (raw or cooked), or smelts (too high is phos but it was a last ditch effort). She’s never been able to tolerate beef and doesn’t enjoy duck. The only additional protein I can think of would be lamb…I forgot about it.

The biggest issue is that she won’t eat any type of filler at this point. She absolutely won’t eat rice, oatmeal, white potato, or our homemade white bread. Not with butter, oil, or chicken fat added.

We tried 2 of the canned kidney diets, but she would barely eat a single meal and they are wicked expensive to waste.

If she doesn’t eat, she gets upset belly and vomits stomach bile, then it’s even harder to get her to eat. Previously, I could make her little rice and fat balls and poke them into her mouth (gap where tooth was extracted) and she’d eat it and feel better enough shortly to be spoon fed, and then later eat on her own, but now she spits it out.

Out of desperation, my husband went back to offering her regular senior dog wet food. She eats it enthusiastically, but after just a couple days of this, she’s hunched and getting that “far off” unhappy look in her eyes like when she was originally diagnosed. After talking to our vet, we tried anti-nausea pills, but they haven’t made a difference in her willingness to eat her kidney diet.

The vet’s other recommendation was an appetite simulant, but I’m torn on whether to try. She seems like she wants to eat and she WILL eat, she just doesn’t want to eat her kidney diet. She will eat regular dog food and tries to get at the cats’ food, but if I mix the wet food she likes with rice to dilute the protein,etc, she won’t touch it.

My husband wants to put her down. I feel like if we can get her eating properly, she can still be ok for a while. I’m open to thoughts and suggestions and appreciate the consideration if you read all this.

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In the year of hell, 2020, I lost one of my dogs to kidney failure, so I know and feel your pain and I am so sorry you are going through this.

My dog absolutely abhorred the kidney diets. I think, from talking with his vets, that is a pretty common problem with those foods, that maybe someday will be improved.

I will say, an appetite stimulant along with anti-nausea meds did help quite a bit. The vets also had us giving omeprazole because with everything else, he developed some not fun acid reflux, which made him even less willing to eat.

One thing I don’t see that you’ve tried, and maybe you have, is a phosphorus binder. Our vet had a compound pharmacy make one in a flavor that he actually likes, and being able to use that opened up the proteins we could try a little.

Every day was kind of an adventure in things he would eat. But there were a few constants. Pasta - that boy would eat pasta all day long. Scrambled eggs. Bonus if it was scrambled eggs and pasta together. And the vet was perfectly happy with him eating eggs (although the resulting gas was less fun for me).

Gerber Ham flavored Baby food. Now, he was approximately 60 lbs and opening those little jars got old, but sometimes, I could mix one jar in with something else and get him to eat more that way.

That boy also had a weird love for pancakes and syrup.

Chicken thighs are lower in phosphorus than the rest of the chicken and I could get him interested in a chicken thigh here and there.

For treats - he loved a lot of the Gerber’s baby food snacks. Plain animal crackers meet the kidney diet requirements. And Honey Nut Cheerios, omg. I kept those as a super special treat though, and only brought them out when everything else failed, because he loved them that much, and sometimes a handful of those would remind him that food is not bad and maybe he really could eat some more.

Cottage cheese - he loved it. This is one of those things that is higher in phosphorus than the vets wanted, but that’s where the phosphorus binder came in. And it was usually one of my last ditch attempts to get something in his stomach, because, as you’ve seen, getting something down there is better than nothing.

It is such a devastating disease, and it’s so exhausting. Every day I woke up thinking, what food battle will we have today? So, some days I just made up a buffet of the things I knew he liked, and let him pick and choose throughout the day.

If your vets aren’t already, make sure they’re watching blood pressure, too. Ultimately that was the one thing we never could get under control and was his demise.

People questioned my sanity in doing this and honestly, euthanasia wouldn’t have necessarily been wrong, because I lost him anyway, but man, up until the last day, he was still living life, playing fetch, playing with the other dogs and just being a trooper.

Sorry for the long essay, and again, I’m very sorry you are dealing with this.

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This is soooooooo helpful!! I didn’t see that in my independent research and the vet never offered it. I will ask. Was it wildly expensive? My vet did not warn me that the nausea pills were $12/daily tablet…

The Gerber baby food and snacks are also an incredibly helpful new suggestion. Thank you!

I don’t think euth would be wrong in this case either…but it seems premature to me in the immediate future if we can get her eating properly again. That said, this dog is not enjoying life right now.

Thank you for making me feel less alone in this battle. I really appreciate the suggestions and will try pasta and baby food today along with asking the vet about a binder (she does love cottage cheese and that’s what I’ve been using to get the anti-nausea pill into her).

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I’m glad I could help!

You know, I don’t remember it as being one of the more expensive things we bought? You CAN buy it over the counter, and Chewy sells some, but I went with the compounded, prescribed one because I really wanted one thing that was easy to get him to eat on his own. The one we bought was like a paste.

Cerenia? Yep, that stuff is insanely expensive, and the bigger the dog, the more they need. Sigh.

I’m glad I could help, and no, you’re not alone. It’s such a challenging journey.

One thing I learned on the journey was, if I found something he loved, I didn’t over due it. It just became part of a rotation, so he wouldn’t end up deciding after three days that scrambled eggs were evil and he would never eat them again. And if he showed ANY interest in what I was eating, as long as it was generally dog safe, like no onions, I’d let him try it. If he liked it, I’d add it to the rotation.

I swear I have notebooks full of notes, so if I think of anything else, I’ll share.

Edit to add: ask them about Vitamin B12. We did injections at home and that helped his appetite a lot.

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Why not just give her the regular dog food if that’s what she’ll eat? It seems you’ve tried everything else and it’s come to the point that it’s either that or euthanize her. Yes, the regular dog food may accelerate the loss of kidney function, but she probably doesn’t have much time left no matter what you do. Feeding her regular dog food may give her a little more time with a reasonable quality of life.

You’re in the zone where it’s not unreasonable to consider euthanasia. With my animals, when they refuse to eat I know it’s time to say good-bye.

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I did a quick search, and so far nobody has mentioned pumpkin? It’s a good stomach settler for dogs

You had mentioned potatoes as a filler. Have you tried instant mashed potatoes? Those blend right in to whatever else you are cooking and just wind up coating everything. Peas.

I lost my big dog to kidney failure. Very sorry to hear you are struggling with this.

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Have you ever treated her nausea? Kidney disease comes with nausea. Nausea causes this food aversion.

I would absolutely treat with pepcid, or perhaps omeprazole given how long this has been persisting. I’d be tempted to add zofran. Once you have the nausea in hand, add an appetite stimulant if necessary, but definitely not before.

Nausea is, in my experience, the life limiting factor in kidney disease. Once control has slipped, quality of life isn’t maintained. Aggressively manage nausea, monitor your control by how willing they are to eat, and once control slips, schedule euthanasia.

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We can feed her regular dog food, but she’s gone so far downhill the last few days on it, that I would probably euth her by the end of the week so she doesn’t suffer too much.

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We relied on pumpkin (homemade from our home grown pumpkins) frequently. Unfortunately, she won’t ieat it now. Nor cabbage.

ETA: I missed the instant potato suggestion. I’ll look into that if we can get her past the weekend

She’s currently on daily Cerenia for nausea. It’s only been a few days, but I haven’t noticed a difference.

I ran out and bought baby food and she ate about 2 oz of the chicken and noodle flavor! Then walked away from the rest. I’ll try the chicken and gravy for dinner with pasta. We don’t keep pasta in the house so that hadn’t occurred to me!

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Cerenia doesn’t treat the excess acid production that kidney disease causes–you need a PPI or a H2 blocker for that. Given her size, it may be easier to use pepcid. You can get it OTC.

I’ve never found Cerenia alone to be all that hot for nausea. Zofran has always worked much better. Zofran and Cerenia together make a nice combo, and Cerenia has nice action on visceral pain. My last round with kidney disease was very well maintained for far longer than the vet expected on a pepcid/zofran/cerenia/mirtazipine regime.

You can aggressively work to control the nausea now, and improve QoL for more quality time. It’s hopeful she’s willing to eat–she still has an appetite. But playing food roulette isn’t solving the nausea. Uncontrolled nausea is a massive QoL issue. If you cannot control it, euthanasia is the kindest option.

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Oh, yay! Some success! That’s good!

I should have said it earlier but, check the ingredients on the baby foods. Some of them sneak a bit of onion in them. But generally, they are pretty palatable, and they are also generally low enough in sodium and phosphorus to pass the Vet test, I learned.

I don’t know why but pasta was always a happy thing. I hope it works.

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I wanted to highlight this because I too also found that things worked better once we had the omperazole on board. For whatever reason (freak dog, maybe) it worked better than Pepcid, which we did try first. But one or the other helps a lot because of the acid buildup.

I did see onion powder as the last ingredient of the chicken and noodle food, but since it’s cooked and the last ingredient and I’m desperate…I tried it. Our local grocery had ample fruit and veg baby food options, but only a handful of meaty ones and only one that had no onion powder in it at all :upside_down_face:

I also got her plain corn in hopes that she still loves corn (we give her sweet corn cobs to chew on in summer) and I can coast some scrambled eggs in corn so that she doesn’t know she’s eating eggs. In reality, she will lick the corn off the eggs or refuse to touch it at all, but I have 15 laying hens and a girl can dream.

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Ok I’ll put a call into the vet (who has not suggested this at all), but anyone know off hand the dosage for a 20 lb dog of an over the counter omperazole?

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Not surprising, since these two drugs treat different reasons for inappetence. PPIs like omeprazole are more effective overall than the H2 blockers, but take a few days to come into effect vs the immediate action of H2 blockers, and dosing can be more challenging with smaller pets since you can’t split the tablet/capsule.

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I’m so sorry to hear this @RJC. I’ve had a lab that we lost to kidney failure and it was hard to feed him near the end and we did end up putting him down.

I’m not sure where you are located but my crazy picky pup loves dehydrated raw food and I feed her a brand called Smack (Canadian but is now newly available in the US). Perhaps you can try and see if she likes it? My girl still wont eat anything in the mornings and will have bile vomits if her stomach is empty. She loves Smack and will eat it with gusto every morning.

I also just read you feed corn cobs. Not sure if you know but I was always told its a huge no no as dogs don’t digest them and it can easily cause a blockage or perforation. They are dangerous to feed. Corn off of the cob is totally fine to feed of course.

The dose for a 20# dog is less than a pill. You cannot split them. So treating a small dog with the OTC med is not really feasible.

Which is why I suggested pepcid.

5 mg to 10 mg twice daily. You can split these pills.

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What’s her reaction to peanut butter?