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Rebecca
Rebecca, Dog Veterinarian
Category: Dog
Satisfied Customers: 8170
Experience:  29 years of companion animal practice.
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My 4 mo old Shiba Inu puppy had a swollen abdomen. At first

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My 4 mo old Shiba Inu puppy had a swollen abdomen. At first I thought he had eaten a large meal, but it got bigger so I took him to the ER. He's always been a playful, happy puppy, but drinks a lot of water and eats little. All questions to my vet said that his behavior is normal puppy behavior, and honestly, they had no reason to suspect anything different. To save him pain, we had an x ray done at the vet instead of cyntesis. The xray was obscured by fluid. So we did the cyntesis and a CBC. I have all the results here, so if you need further information, let me know. I don't understand the readout, so bear with me. The thing being tested is listed first, then in the second column is a number. The third column has the units used, I believe? And the fourth is a sliding chart with a high and low number and a marker in between. The BUN has "120+" in the second column and the marker is all the way at the end (25). I assume this just means it was off the chart's scale. The calcium says 10.5 and the marker looks like that's about where it's at. Phosphorous says 9.9+ in the second column, but the marker on the fourth column looks like it's around 5 (the chart there goes from 2.9 to 5.5. Creatinine says 5.4+ and the marker is at the end of the chart (ends at 1.4), again, this just means it's off the scale of the chart I think. GLU says 130+, but the scale is from 60 to 110 and it looks like the marker's at about 100, not the end. Everything else is normal, including protein levels. Could this be caused by his excessive thirst diluting the levels? I know protein will dilute, but creatinine and phosphorous will not. He's still playful as ever. We saw the regular vet today and had an ultrasound (the ER didn't have one), and he didn't see anything that stuck out, though he's not a specialist, admittedly. The playfulness and normalcy of his behavior made both the ER and regular vets say it was probably congenital CRF. The regular vet prescribed Royal Canin LP and an appetite stimulant, as well as aluminum hydroxide to bind to the phosphorous when he eats. He's been eating with less urging than normal, but we've only been back from the vet less than 12 hours and the ER was the night before that. Is this congenital CRF? Is there anything I could have done to cause this? I've had him since he was 8 weeks old and he's been vaccinated and saw the vet regularly (yeast infection in his ears a few weeks ago). He's well cared-for. I feel so guilty about this but the most important thing is that he isn't suffering. When he starts to decline (no longer interested in playing all the time, appears to be in pain), I'll put him down. I have no qualms about that, only with how it got so bad without me noticing. I am literally with him 24 hours a day. He runs, jumps, attacks his toys, digs holes, enjoys his puppy play class and has been working one on one with a reputable trainer since he was 9 weeks old. He's well-behaved, comes when called, can do a couple tricks, etc. My vet is trying to get me into an overbooked specialist here as soon as possible. He spoke to the specialist on the phone and he concurred with the CRF diagnosis. He won't give me a straight answer about the prognosis (understandably, he knows what the dog means to me). I've been in tears, worrying that I did something, let him get into something, should have noticed sooner (he potty-trained like a dream come true, by the way), or there's a solution I'm not seeing. What is your opinion on the situation? Do you think he's in pain? His abdomen is still full of fluid, should it be drained? Would medications that increase kidney function be helpful and extend his life, keeping his quality of life intact? Or is he too far along for them to help and the side effects wouldn't be worth it? 

Submitted: 8 months ago.
Category: Dog
Expert:  Rebecca replied 8 months ago.
Hello,
I am so sorry to hear about your puppy. What a sad thing to find out when he is so young.

The high BUN, Creatinine, and phosphorus do indicate that his kidneys are failing. At this age, it has to be something he was born with; you could not have caused this if you tried. The toxins that cause kidney failure, like antifreeze, kill quickly.

Has a urinalysis been done? If a urinalysis showed there is excess protein in his urine, the medication enalapril or benazapril might help.

There is a supplement, a probiotic called Azodyl that may help him feel better and eat more.

His excessive thirst is because his kidney are wasting water; everything he drinks goes back out in the urine, so he has to drink a lot to keep up with the loss of water from the kidneys.

The only way to find out exactly what is wrong with his kidneys would be a kidney biopsy, which might not be a safe procedure to do.

Draining the fluid might make him feel better, and take pressure off his abdomen and internal organs, but it will fill back up. Sometimes it does not fill for a week or so, but sometimes it is a matter of days.

As long as he is eating, I don't think he is suffering too much. When he stops eating, he will be feeling pretty bad. I do not consider him to be suffering too much if he is still playing, and eating. SInce he was most likely born with this problem, he never knew what a normal puppy should feel like. As his kidney failure progresses, he will feel worse, and stop eating.

I did a search on a vets only website and could not find any reports of this being a problem in this breed. I did find a report that chicken jerky treats from China may be linked to kidney failure in dogs, so if he got any chicken jerky, see where it was made.

I am so sorry about your puppy. Please let me know what else I can answer, help with, or research for you.

Rebecca

Customer: replied 8 months ago.

Thanks for such a complete answer. He did have a urinalysis done.

Sp. Gr. 1.006

pH 5.5

WBC rare

RBC rare

Epi rare

There are just dashes next to all the other things: protein, glucose, ketone, bilirubin, blood, sperm, urobilinogen, casts, crystals, bacteria. I'm unsure what that means.

The only treats I've ever fed him were from the Dogswell line from Petco: the duck breast jerky and the veg chicken biscuit things. I just looked it up and these have been linked to kidney and liver failure in dogs and Fanconi syndrome. Could this be the cause and, if it is, how do I report it? He was born on June 6th and the offending treats were recalled June 26th. He wouldn't have had access to them. Could they still be causing problems?

Expert:  Rebecca replied 8 months ago.
Thank you for the additional information. The dashes probably mean normal, or negative. If the protein is negative, then he does not have protein loss in the urine.

Most of the dogs with the reaction to the jerky treats got better after stopping treats. With Fanconi syndrome, you usually see glucose in the urine, and he was negative. Still, it is possible the jerky treats affected his kidneys, and that the damage was worse because he is so young and still growing.

You should get your veterinarian involved with reporting this reaction to the treats, even if there is only a chance of that being the cause. The more reports the FDA gets, the more likely there will be an official investigation. Just recently Australia has officially reported these treats as causing kidney disease in dogs.

The low SG, or specific gravity, is a measure of how concentrated the urine is. 1.006 is low, indicate non concentrated or dilute urine; his kidneys are not concentrating the urine. That is why he has to drink more water than a normal puppy.

Please let me know what else I can answer, or help with.

Rebecca



Rebecca, Dog Veterinarian
Category: Dog
Satisfied Customers: 8170
Experience: 29 years of companion animal practice.
Rebecca and 10 other Dog Specialists are ready to help you
Expert:  Rebecca replied 8 months ago.
Thank you for the great rating, and the bonus. I appreciate it.

Good luck with your puppy; I will be checking in to see how he and you are doing.

Rebecca
Customer: replied 8 months ago.

I'm starting to be able to see his spine and the fluid in his stomach is getting worse. I don't think it's fair to put him through more exams and needles and scary, unknown people touching him and the drive to the specialist, so I've decided to put him down. I spoke to the vet and she will come out when we are ready to do it. I'm going to wait until he doesn't want to eat with the appetite stimulants and then do it. He's curled up with me in bed right now, he's sleeping a lot, but still playing as much and as hard as ever. I got his DNA test results today confirming, as I suspected, that he's half Klee Kai. I love him anyway. It breaks my heart to "give up" but I have to do what's best for him. And suffering through tests that won't make a difference isn't what's best.

Expert:  Rebecca replied 8 months ago.
I am sorry about what you have to do, but I agree it is best. No sense putting him through more tests and visits to the vet.

I just had to put down a kitten, about 8 months old, born with bad kidneys that our kennel worker had adopted. So sad; she was just a wasting away little 3 pounds but was so loved.

My best wishes, sympathies and support for you and him.

Rebecca
Customer: replied 8 months ago.

Roku

(Roku a few weeks before his death.)

 

Last Wednesday was beautiful and we played outside all day before laying in front of the fire. I called the vet and she came and put him down. He didn't suffer that I could tell and he went peacefully. I'm heartbroken, but I can take solace in knowing that I did the right thing.

Thank you for helping me make the right decision.

Expert:  Rebecca replied 8 months ago.
What an adorable picture! This has to be one of the cutest breeds.

I know you did the right thing. His short life was happy, and meaningful, and left a lot of love behind. My sincere condolences.

Rebecca

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