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Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 18334
Experience:  Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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My cockalier, Rudy, is only 4 years old and experiencing

Customer Question

My cockalier, Rudy, is only 4 years old and experiencing kidney failure. He has had blood work done and so far no conclusive explanation. By all accounts Rudy is a healthy, active dog and loves keeping up with his 3 human brothers. Rudy has not "gotten into" or ingested anything that would be considered dangerous to him. We are waiting for the blood results for leptospirosis and lyme disease but the vet doesn't think it is either of those things. A sonogram was performed and ruled out any genetic abnormality. In the meantime Rudy hasn't eaten solid foods in over a week (very uncharacteristic) Do you have any ideas on what this mystery could be?
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. B. replied 1 year ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.

I am very sorry to hear about Rudy's situation.

In this case, you are the right track in narrowing down causes for his acute onset kidney failure. From your history, it does sound like your vet is ruling out the most common causes for this. This means we will need to think about the less common and more tricky to diagnose issues like fungal infections, amyloidosis (abnormal protein build up in the kidney), autoimmune diseases targeting the kidney.

As well, while its positive that you were able to rule out anatomical, cancerous (which we can see in young dogs on rare occasion), or birth based malformations of the kidneys, that does not rule out all of our congenital or birth based concerns. This is because it is important to know that those genetic based issues that cause damage at the cellular level won't be appreciated with regular testing.

As well, even if we don't think he has been exposed to any kidney harming agents, we have to be aware that this isn't something we will always be aware of. There are often reports of poisonings by careless people (I have even had a young patient present with antifreeze poisoning due to a neighbour leaving raw chicken soaked in the toxin to kill foxes). As well, we do have to consider if there have been and recalls on any food/treats he may have since there have been some Chinese treats linked to kidney damage in dogs.

Therefore, further to the testing you are currently doing, we'd want to also check that his food is safe and that there are no local reports of poisoning. Otherwise, if those other tests come back negative, you may need to take diagnostics a step further for Rudy. To do so, you'd want to speak to his vet about a kidney biopsy (or at least an aspirate). This would be ideal if we wanted a definitive diagnosis since the tissue can be analysed to see what changes are occurring at the cellular level and this could shed light on whether this is genetic, fungal, autoimmune, secondary to toxicity, or if we have anything else lurking. And that may be the key to getting an answer to why this has happened to Rudy.

Finally, since you noted that he is off food (something we see with secondary uremic gastritis), I would strongly advise speaking to his vet about anti-nausea treatment (ie Metoclopramide, Zofran, Cerenia) to reduce the nausea likely affecting his appetite. Or you could consider putting him onto an antacid like Pepcid (More Info/Dose @http://www.petplace.com/article/drug-library/library/over-the-counter/famotidine-pepcid), Zantac (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/ranitidine-hcl-zantac), or Tagamet (More Info/Dose Here @ http://www.petplace.com/article/drug-library/library/over-the-counter/cimetidine-hcl-tagamet). Finally, if he is suffering with clinical signs of kidney disease, we'd want to also treat for that as they work to confirm diagnosis. Therefore, you may want to discuss administration of subcutaneous fluids at home (More Info) and kidney supportive drugs (e Azodyl, Fortekor, phosphate binders, etc). These will help reduce his actual signs from this and cope as you work to determine which of the above is to blame.

Please take care,

Dr. B.

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Customer: replied 1 year ago.
Rudy has been on antacid for 2 days and the vet is already administering medications to get a head start on treating possible diagnosis.
Expert:  Dr. B. replied 1 year ago.

Perfect.

Since you hadn't noted any, I did want to make sure you were. Though if he is not eating, then do speak to them about those stronger anti-nausea treatments (they come as oral and injectable) and potentially trying an appetite stimulant (ie Mertazipine) to help him keep eating for us.

Please take care,

Dr. B.

Expert:  Dr. B. replied 1 year ago.
Hi Tara,
I'm just following up on our conversation about Rudy. How is everything going?
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