kidney failure in dogs | Diary of Gracie"s Canine Renal Failure

Hi,

I am sorry about the condition you and your pet are experiencing that led to your search and that brings you here.  This is a running list of some of the search terms that have been used to find this site.

If you are finding this blog from a search, please take a look at the ”about” page for details of what is here.  This is a journal of our experience taking care of Gracie the border collie during the final phase of her fight with canine renal failure. 

• old canine won’t eat drinks alot


• collie kidney failure


• burst of energy during canine labor


• blogs for kidney disease in dogs


• border collie kidney failure


• vet visit preparing


• canine kidney failure last days


• end stage renal failure dogs last day


• canine kidney disease not eating


• getting renal dog to eat


• canine kidney disease protien value 3.6


• peanut butter and kidney failure in dogs


• canine renal failure + final stages


• border collie with kidney failure


• final stages of canine renal disease


• is it right to put a dog to sleep if it has stage 3 renal failure


• hawksbill cabin


• renal canine


• canine renal failure tricks eating


• end stage canine renal failure some bad days some good days


• canine renal failure


• final stages of canine kidney failure


• canine late stages kidney failure


• canine renal failure euthanasia


• alternagel for dogs dosage


• kidney failure dog weak


• my dog’s creatinine has gone to 9


• alternagel for dogs dosage


• do sub q fluids work for kidney dogs


• subcutaneous fluids for kidney dogs


• canine bun numbers


• canine kidney disease euthenasia


• how much pepcid for 5lb dog


• final days of kidney failure in dogs


• chicken broth canine renal failure


• baby food dog renal failure


• pepcid and canine kidney disease


• morning meal for acute renal failure


• dog renal failure medication


• dog kidney failure how to tell the end


• at what point in renal failure is euthanasia considered

Gracie, ready with a ball, as always

(Originally posted to Hawksbill Cabin September 25, 2009, by Jim)  Readers of the blog already know this, but Mary, Sofie and I lost our beloved friend Gracie a few weeks ago. Gracie, the Border Collie we adopted from relatives in 1995, suffered canine renal failure for about two years, entering the final stage in approximately January of this year.

Mary took on the primary care giver role for Gracie as the disease progressed.  She compiled a series of previous entries on the disease (they’ve also been published here on the WordPress blog in a digest format); since Gracie passed away she put together her records from the last three months, July to September, 2009.  On the Hawksbill Cabin blog you can follow the story by clicking on the “canine renal” label in the index in the right hand column.

Even as I am consolidating and editing these posts in October 2009, it is still hard, and perhaps too early, to look back at these events for us (note: re-posting this here, four months later, it’s still hard).  We definitely still feel the emptiness of loss.  But we wanted to publish these notes on the blog and elsewhere for other owners who may be just receiving the diagnosis.  I hope that in some way these posts will help prepare those owners for what’s ahead and the decisions that will need to be made along the way during the course of the disease.

For my part, I thought I might have more to add after reading Mary’s eloquent posts, and preparing them for the blog. It’s still too early for that, like it is for Mary and Sofie, although I find that now, sometimes my thoughts are turning to fond memories:

•  Playing soccer with Gracie on the hillside near the grade school in Adams Morgan, or at several of the other parks there in the District.


• The fun times we had when we first moved to Alexandria, when Sofie and Gracie would play up at the Masonic Memorial.


• A special cove that both dogs liked at Great Falls, their anticipation picking up as soon as they got on the trail to it.  During the summer, they would lie down in the shallow water to cool off.


• Our vacations in the Outer Banks and later at the Hawksbill Cabin, where the girls delighted in exploring the outdoors with us, an alternative to our urban environments – the city wasn’t a bad place for dogs, just necessarily constrained because of the confined populations.

Our vet sent a condolence card after Gracie died. As a near final note, her words:

“Gracie was truly a special patient and I will share your loss. Her tenacity to forge ahead and live life to the fullest was admired by all. Your dedication to her these past nine months has been dearly recognized. Thank you for allowing me to be a part of her life all these years. My thoughts are with you, Fondly, Donna.”

Thanks to everyone for the kinds thoughts and comforting words. We lost a good friend in Gracie.

12/27/1994 – 9/7/2009.   

Monday, September 7 (originally posted by Mary to the Hawksbill Cabin blog)

After our visit to the vet last Thursday, Gracie seemed to perk up a bit, finding a tennis ball under a table in the sun room and bringing it to me for some play. Months ago, we modified the game to one where she lays down and I roll the ball to her, which she then traps between her front legs and bites soundly to stop.

She seems so happy during these moments, recalling perhaps the more rigorous games of fetch we played in her younger days up on the hill at the Masonic Temple here in Alexandria, or, later, the “stairmaster” game when she would stand or lay at the top of the stairs and I would toss the ball up to her, which she would catch, then roll back down the steps to me to start the game all over again. However, this burst of energy and interest is short-lived and she grows weaker.

We are out at the cabin in the Shenandoah for the Labor Day weekend. On Saturday, she had enough strength to walk with Jim around the house, sniffing and enjoying being with him as she explored some of her favorite bushes and trees. During the night from Sunday to Monday, Gracie woke me up and I took her outside to pee. She sniffs in the dark for awhile then returns to me but has a difficult time walking over the black drain pipe leading from the downspout that crosses the back path. I also help her up the step to the side porch and into the house. She wags her tail as I pat her now boney back.

As I clean up the kitchen this morning, Jim has Gracie outside and later tries to give her the semi-weekly dose of calcitriol.  She is suddenly drastically weaker and can no longer lift her head and can’t seem to swallow.  She can no longer stand-up.  We’re not sure if she’s had a stroke or not.  She’s conscious and continent but we realize that the time has come to end Gracie’s fight against the disease that has taken her strength and dignity.

We return to Alexandria and take Gracie to the vet, which we have called ahead of time. Jim carries our girl into a pleasant green-painted room with some comfortable chairs and plants and an examination table covered with towels.

After a brief consultation, the vet agrees that to continue Gracie’s life in this way would be cruel and we begin the process that we have been dreading for so long. We have a chance to hold and kiss her before they administer the sedative and she is unconscious when the last medication is given. She leaves us quickly and peacefully, a gentle, loving companion to the end. She was three months short of her 15th birthday.

Gracie’s status (originally posted by Jim, September 5, 2009)

Not to be too much of a downer today, but since I am going to be off-line for a few days, thought I would give a quick update this morning.  We’ve had another setback, a complete food boycott on Thursday. Plus, she was visibly weak from not eating. These are typical symptoms of end stage Canine Renal Failure.

Off to the vet for a consultation. We’re told that finally, the effects of the disease are piling up, getting quite strong, and the nausea and other symptoms may be just overpowering her.

It’s most important that we continue to get her to eat. Mary has been so diligent about this – trying something new and different almost every day. We are having success with freshly cooked hamburger right now, and the vets gave us some food that is used to help get dogs back on track after major surgery – very much like chopped liver, with a strong smell and overwhelming deliciousness for canines. To our surprise, during this visit’s weigh-in, Gracie had gained back 2 pounds!

The advice from the vet was to keep an eye on things, and recognize that there is not a lot left that can be done. Quality of life is the key now, and with a chronic disease, the one benefit you do get is to spend that much more time with your pet.

It’s day to day now, and we are a little more flexible with the meds understanding where we are with this – sometimes she’ll take them and sometimes not.  Of course, a visit to the vet was enough to give us a rally. When we got home, she ate very well – and she brought a tennis ball to Mary for a toss.

Thursday, September 3, 2009 (originally posted by Mary)

Gracie seems so much weaker today that both Jim and I take her to the vet. I am steeling myself to the possibility that the doctor may advise us to put her to sleep today.

After the exam, the vet advises us that Gracie is in decline and that she probably only has about a week or two left at the most. As the disease progresses, she may suffer a stroke or go into a coma. The vet also gently answers our questions about the process of euthanasia and also tells us that today isn’t Gracie’s time, that we should enjoy her last days but to prepare ourselves.

When the time comes, we have decided that we want her sedated before the administration of the medication that will cause her heart to stop. We don’t want her to know what is happening and we also don’t want her – or us – to experience the involuntary twitches or vocalization that may occur as that medication takes effect.

Thursday, August 27, 2009 – Originally posted by Mary to Hawksbill Cabin

Gracie and Sofie on August 27 before the vet visit

Gracie’s test results came back and her numbers have risen. Her BUN has gone from 82 to 117, creatinine from 3.5 to 4.3, but most troubling, her blood pressure has risen from 160 to over 200. In response, we have increased her amplodipine dosage from 1 tablet to 1.5 tablets every 12 hours for the high blood pressure, and will begin daily administration of 500 ml of fluids. The doctor has advised us that at this point it is probably best to let her eat whatever she wants just to keep her from starving, even if the food isn’t on the strict diet. The vet also advised stopping the AlternaGel dosages with her food since forcing the liquid medicine down her throat with the oral syringe at meal time is probably not helping her at this point.

I have begun to feed Gracie grilled or fried hamburger, about 4 to 6 ozs. per meal. She will sometimes take penne pasta cut up in small pieces. I also try to entice her with some “maximum calorie” dog food provided by the vet that they give to sick dogs recovering in the hospital. Everything must be hand-fed or given to her in small amounts on the floor as she lies in the kitchen. She will no longer stand and eat from a bowl. Chicken, rice, baby food, even bread are no longer palatable to her. She will still accept small bites of Iams weight control dog biscuits, but it is now a struggle to get her to take her meds in the pill pockets or in the G3 Chews. She seems to have the most problem with the tramadol tablets; I have to break them up and put the pieces in separate pill pockets so she doesn’t have to chew them – their taste is something Gracie definitely does not like.

This situation is not good and I am trying to accept the fact that our long journey with Gracie along this difficult path of canine renal disease may be coming to an end. I will work hard to keep her with us but the disease can not be reversed and it is taking its toll on our dear girl. She still seems engaged and happy and not in pain but she is losing strength by the day.

(Originally posted by Jim, August 25, 2009, to Hawksbill Cabin)

Last weekend, Mary went out to the cabin for an errand or two, leaving me and the dogs home in Alexandria. Mary has been mainly working from home the last few years, and the dogs have gotten very used to that routine, so we had some worries about what might happen with “mom away.”

There was howling and anxious panting. And then, there was a food boycot that started the morning after.

With canine renal failure, this is a sign that you keep an eye on…dog’s gotta eat, and if they don’t it could signal that something is going wrong.

I tried all the tricks – smearing turkey baby food on some wonder bread (surprisingly looks like peanut butter). Gracie has taken to eating Greek style organic yogurt with honey in a pinch, but that didn’t work this time either. At least she was still taking her meds.

By Monday, she was even spitting out the treats that we use to hide the pills, and she’d grown a bit listless. I was worried, and when Mary got home we talked about next steps. We already had a vet appointment to get the dog checked out.

Turns out, Gracie’s blood pressure had spiked, and that might have caused a little nausea, keeping her from eating. There are a few new meds to get us through this episode, and we’re going to daily sub-Q fluids for the rest of the week, but everything seems to be working and hopefully we’ll be back on an even keel by Saturday.

As far as a diet update, we’ve had to make some changes…this week, there are grilled hamburger patties and ziti pasta on the menu. It doesn’t have everything in it we’d like to see her eating, but the important thing is that she is getting some food in her.

The number of posts we put up at Hawksbill Cabin (and now here, on the Gracie Dawg Blog) about Gracie’s Chronic Renal Failure (I’ve also used ‘kidney failure’ to refer to the condition, and notice that that is one of the web search terms readers frequently use before arriving at the Hawksbill Cabin blog) is up in the teens.

We certainly appreciate all the interest that was shown in Gracie’s progress – by the time this post was originally written in July 2009, she was pretty stabilized for the moment, getting about a half liter of sub-q fluids every other day, along with all the other meds, and the special diet.  I also hope that readers who find these entries on the web find some useful, or at least, reassuring information here on the Hawksbill Cabin blog.

One thing I wanted to be sure to highlight is a comment that reader “Linda” left on Hawksbill Cabin – it was reassuring and provided additional resources that readers may want to check out. A quote from her comment:

“I have been dealing with my dog’s renal disease for three years. I was wondering if you had found the website http://www.dogaware.com/? It has a lot of good articles…”

I’ve spent some time on that site, and there is plenty of useful information here. To get right to the point on canine kidney failure though – follow this link: http://www.dogaware.com/kidney.html#protein .

(originally posted July 2009 by Mary to Hawksbill Cabin)

Late last month, Gracie had another blood test to see how she’s doing. Her numbers indicate that she’s stabile:

• creatinine at 3.5, down from 5 at the last test;


• BUN at 82, which is a little high but acceptable; and


• her calcium level is at 11.7, 1.2 for the ionized test.

This is all very good news.  The vet said to do a retest in three months unless she seems to be declining.  We have our fingers-crossed that she will meet this milestone.

Gracie remains alert and interested in her toys and walks. She gets a little sleepy from both the arthritis medicine and the blood pressure medication but is still willing to roll the fuzzy soccer ball for a little game of easy fetch. Meal times are still trying – she needs incentives in her food and she has a tendency to spit out the rice as she walks away from her bowl. Grains of rice can be found all over the house.

Mealtimes are time-consuming. She gets her pills first thing, then her food, but she can’t be fed too close to the time she has her pills because the AlternaGel she must receive shortly after eating to coat her stomach must be given at least an hour after she receives her meds. Warming the subQ fluids, then administering them to her takes another 20 minutes or so in the morning every other day. So, her morning meds-meal-and fluids routine can take about 90 minutes to complete. She needs a mid-day dose of AlternaGel with some food, again to coat her stomach and protect against ulcers. Evenings repeat the meds-meals-AlternaGel routine.

(originally posted by Jim to Hawksbill Cabin blog, June 15, 2009)

It was a rare weekend not heading out to the Hawksbill Cabin, with me just getting back from being on business in San Antonio, and Mary headed up to NJ to visit some cousins preparing to relocate to Germany.  Besides getting nine holes of golf in, and catching up on some reading (I’m currently reading Michael Perry’s Coop), I’ve been spending some quality time with Sofie and Gracie.

The girls were recently groomed. Because of the trauma bath time imparts, I haven’t given Gracie a bath in more than five years.  We have a service that comes around twice a year in a converted RV, called “Bubble Buddies,” that actually specializes in older dogs, like our two. Gracie, the Border Collie, is 14 and a half; Sofie, the Chow mix we found as a stray in the DuPont Circle area of DC, is older than that.  In fact, it has been about 13 years since Sofie joined our pack.

They don’t really get dirty and smelly like younger dogs anymore, so the twice a year schedule works out well for us.  They actually seem to like it when the groomer hooks up the leash and leads them into the van – it’s an amazing difference from the “flat Gracie” routine I would experience when I tried to get her into the bathroom.  Who knew a dog could actually expand to cover so much square footage, so that she couldn’t fit through a door?

When the groomer leaves, the dogs have been bathed and trimmed, and their nails are clipped. They get a special bandana, and they seem to like the extra attention we give them afterwards.

With Mary out of town, Sofie and Gracie have been hanging close by, mainly snoozing away as dogs at their age do.  But at times, I still see glimpses of the old personalities.  Sofie is mainly motivated by her tummy (or other bodily functions), so she is up and by my side any time I pass through the kitchen.  Gracie has mainly been content to lie on the floor nearby, as she is now while I write this, but when I speak to her I can see the eyes darting around the room in search of a tennis ball or other toy.

Sofie is living proof that treating dogs the way you want them to behave makes them great pets.  She’s smart, she has a great vocabulary, and with her, we’ve been through a lot.  Almost 10 years ago she blew out a disk in her back, a fatal injury for dogs if they don’t receive medical attention.  We got immediate emergency surgery for her (we had pet health insurance that helped).  To this day, Mary and I both swear that the vet treating Sofie could operate on us; too, he was so well qualified and had such a great manner with his patients.

When our regular vet first met Sofie, she looked at her teeth and the Chow posture and said, “I like this dog.  She has good hybrid vigor.”  That inspired us to have Sofie’s DNA checked out: the Chow is definitely there, not just because of the purple tongue, but it gets hazy after that.  The most significant other breed represented is Poodle. Who would have guessed?

Beyond the parentage, we get a glimpse of her life before she joined us whenever we meet an “intact” male dog on a walk.  Even at the advanced dog age of at least 15 (person) years old, these encounters involve a lot of squealing, spinning around, and boxing the male dog.  She seems to know what she is doing, but the male dogs are left puzzled by all this, standing there perplexed, worriedly checking with their masters about whether this (spayed) old lady is going to hurt them or not.  She probably had a litter of fuzzy little Chow mix puppies somewhere along the way, (and she has probably outlived them.)

Sofie has slowed down some, but she is still in great health and full of good spirits.  Her sister, Gracie, on the other hand, is not in the best of health.  Still, she is doing well, in good spirits, and holding her own for now.  Having been diagnosed in January with final stage canine renal failure, she is on a full regimen of prescriptions, and she gets a half liter of subcutaneously administered IV fluids every other day.  She has lost most of her hearing, although she can hear a loud whistle, or one of her vocabulary words, when spoken directly to her in a loud voice.

Border Collies are widely considered one of the most intelligent dog breeds, and they were very popular around the time of Gracie’s birth, which was when the movie “Babe” came out.  Our relatives had taken Gracie, but seemed to be finding the four-month old pup to be a whole lot of dog, so we offered to adopt her.  Or maybe she adopted us, as I do remember the first weekend we met I spent eight or nine hours learning that border collies (1) love to fetch; (2) have incredible stamina, even at the age of four-months; and (3) upon first meeting a new human, have a wily ability to keep the human busy paying attention to them.  Even now, despite her health and age, whenever we have visitors, there is a big production that we call the “Border Collie Parade of Toys. “

A few years ago, there was a story about a German border collie, named Rico, who knew the names of something like 200 dog toys.  There is a Wikipedia article about Rico here: http://en.wikipedia.org/wiki/Rico_(Border_Collie).  Rico could retrieve articles he’d never seen before, and that he did not know the name of, using a deductive reasoning approach called “canine fast mapping.”  There is a second Wikipedia article about a border collie named Betsy who is said to know 340 words, and I like to think that Gracie has a vocabulary around that size.

Sometime during the first year we had her, we took Gracie out for a ride in the Shenandoah Valley.  While Mary and I had a picnic on the lawn at North Mountain Vineyard, we played fetch with Gracie.  Later, she napped while we drove with the windows down the Old Valley Pike to Shenandoah Vineyard.  There were sheep farms in the area, and the scent of the pastures eventually woke her up, at first just enough to raise her nose to the lowered window to sniff.

Slowly, the Border Collie genes took over, and she stood up in the back seat to have a look. When she finally figured out that there were animals over there in the pastures, she let out a long “Aooo-ooo-ooo” and watched the sheep carefully as we drove by.

We’ve had these girls a long time, but it had been a while since I have had to chance to sit with them at home, without the stress (for them) of the drive out to the cabin, and just enjoy them for what they have become as “senior” dogs.  I know we may not have much time left with each other, especially compared to the time we’ve had together.  But the character of their company is rich with experience and warmth, and there seems to be an innate understanding of all thoughts – verbal and nonverbal – between us as we hang out in the house.  And this weekend, that’s been as good a time as I could have asked for.