Dear Dr. John,
My old dog, 14, is nearing the end of his life. Less than a week ago, I sensed something was wrong and took him to a veterinary hospital where blood tests showed that his kidney values were getting very bad. My dog had values of BUN 92, Creat 5.6, and Phosphorous of 7.7. They admitted my dog and gave him fluids and anti-nausea medication. The next day the bloodwork was repeated, and the same values were 111, 7.3, and 9.5 respectively. I was told my dog had a poor prognosis and that I could take him home for hospice and to give him fluids and more medication for nausea. I brought my dog home to be comfortable.
Yesterday, my own vet repeated the bloodwork, and the same values were 158, 7.2, and 9.6. In July, the values were 29, 1.4, and 3.6. What should I do? My dog is eating a low protein diet and doesn’t seem to act that weak or abnormal. Is kidney failure reversible? S.B.
Dear S.B.,
The typical treatment regimen for all forms of renal failure is infusing the patient with fluids to flush the kidneys, low protein diets to help lower the workload of the kidneys, and various supplements to improve kidney function if applicable. What you should do is exactly what you are doing in giving fluids presumably subcutaneously, anti-nausea medication, and a low protein diet. Keep him happy and comfortable. Normal BUN is 6-30, Creat 0.5-1.5, and Phosphorous 2.5-5.6.
Renal failure can be reversible depending on the cause, age of the dog, how long it has persisted, and many other factors. In his case, it appears quite clear that the key indicator values are going in the wrong direction day by day and that things are only getting worse.
No veterinarian, myself included, can give you a timeline but I suspect that, given the values, your dog’s lifetime is very limited. Clearly you have done all that you can for him so enjoy this time together. You will know when his time is up as he will likely become weak and lethargic, seem uncoordinated or disoriented, lose his appetite, have pale gums, and fail to thrive. Good luck at this difficult time.
Dr. John de Jong owns and operates the Boston Mobile Veterinary Clinic. He can be reached at 781-899-9994.
