Dog Veterinary
Second opinion] Dear Vet, my 10-years Maltese Sissi passed a minor surgery. Vet did all the necessary tests before the
my 10-years Maltese Sissi passed a minor surgery. Vet did all the necessary tests before the operation (ultrasound, X-ray, cardiological, blood test). Everything was normal. She only had a diagnosis of a narrowed trachea and a slightly enlarged heart (no heart failure, she didn't need medication). She had a perfect blood test before the preventively operation of a 1-cm skin lump and dental cleaning. She experienced respiratory distress just before the operation, 15 minutes after premedication with Insistor. She received Torphadin and Dexamethasone. From that moment on, we were no longer present during the operation. The operation lasted about 30 minutes. Immediately after the operation, when Sissi woke up, I received a call from the vet that everything was fine with Sissi and that she could go to home care in an hour. About an hour after the operation, she was given to us for home care. Research lately showed the skin growth wasn't cancer (it was benign lipoma of the mammary gland).
After the operation she wasn't feeling good. She got worse day by day. She started vomiting and refusing food. We took her to the vet. Blood test showed acute kidney failure. Vet healed her with iv fluids. She got an ulcer on her tongue. She couldn't even use her tongue to eat. We fed her with a syringe. Vet healed her with antibiotic Convenia and Cylanic and NSAID Ficoxil. After one month of treatment...the blood test showed Urea 90+, Crea 400+. Why does a dog with no prior kidney disease develop sudden kidney failure after minor surgery? What could be the cause?
Reduced blood flow through the kidneys during the operation? If this happened vet will see decreased blood pressure during the surgery, am I right?
Is it possible that the respiratory distress experienced just before the operation affected the kidney failure? Can surgery be performed immediately after respiratory distress?
Is the use of painkillers (Ficoxil) and antibiotics (Convenia, Cylanic) at acute kidney failure appropriate medicine?
Blood test before (date: 2 February) and after operation (13 February and 3 March) in the attachment.
20,890 satisfied customers
Specialities include: Dog Veterinary, Dog Medicine, Dog Diseases, Small Animal Veterinary
Hello, my name is***** and I'm an emergency veterinarian. I'm here to provide you with excellent service.
I’m very sorry to hear you are experiencing these issues, but I appreciate you reaching out to us for assistance. Hopefully I can help. I’m so sorry Sissi went into kidney failure. You must be so worried. I have some questions I will ask below that will help me to understand what could be going on with her.
Please be aware I am a licensed veterinarian, but I am not your pet’s veterinarian and cannot examine your pet, so I cannot legally provide you with any specific veterinary medical advice such as diagnosis or prescribing medication. However, I can generally speak to help you understand resources that may help you and advise you to seek medical attention.
How long after the surgery was the kidney failure diagnosed? How long was she given IV fluids in the hospital?
Hi, I was just checking in to see if you received my request for more information. If not, here it is again:
Did her numbers intitially improve after the fluids?
Without the information I requested, I can only give you general advice so I hope this helps.
I am so sorry your dog went into kidney failure. Certainly like you said the blood flow could be less anytime the animal is under anesthesia and we are always fighting to maintain normal blood pressure, but still there is always the possibility anytime and animal is put under that that can happen. I'm not sure how long she was treated on fluids and if they got blood work after the fact that set her kidney values were normal and then made that determination that she could leave the hospital based on that. I am not familiar with the drug Ficoxil But it looks like it is an NSAID. Possibly a
non-steroidal anti-inflammatory can make things worse if there is already kidney disease but it would be completely reasonable to give it if the prenesthetic blood work was normal
I'm not sure what treatment she is on at the moment, if they sent her a home on a special prescription low protein diet and with you giving her fluids everyday under the skin or what the plan is at this point.
I'm happy to discuss this further if you wish. I thank you for reaching out to us here at Just Answer and I sure hope Sissi is doing better soon.
Dr. Nicki
Just checking in as I did not hear back. I sure wish you all the best with Sissi and please let me know if you wish to discuss them further. Thank you again for reaching out to us here at Just Answer.Dr. Nicki
About an hour after the operation, the vet sent her to home care. Three days after the operation, her appetite decreased, she vomited several times. We took her to the vet. She received Cerenia. The vet did not check the blood. She stopped vomiting. But one week after the operation, she completely lost her appetite. I contacted the vet. According to his instructions, I fed her with the help of a syringe. Since she didn't have a fever, the vet thought it was nothing serious. After a few days she became very sick, she started shaking. I took her again for a check-up. At that time, the vet checked the blood and found kidney failure (10 days after surgery). She was on fluid therapy for three days. She had her appetite again, and was placed in home care. Three days later, she developed an ulcer on her tongue and lost her appetite. She was again on IV fluids for three days. The blood count has improved. Then the vet sent her home. At that time, she received an injection of the antibiotic Convenia, as well as the antibiotic Cylanic and the NSAID Ficoxil for home therapy. She was sent home without fluid therapy. We fed her with the help of a syringe. After a week, the situation worsened again. Blood values were Crea 400+, Urea 90+.
How common are such postoperative complications? What is the most common cause of such a complication? Based on the example described, what would you say caused such a complication?
Had her kidney values I proved before they sent her home from IV therapy? Then got bad again?
I don't know which anesthesia they used and how much fluids she got. Was it a quick procedure?
I apologize I am in and out of appointments today.
propoven, dexamethason, torphadine, cerenia
When I asked for explanations as to why the kidney failure occurred, they said that they assumed that there was a reduced blood flow through the kidneys. A narrowed trachea and an enlarged heart were said to have contributed to the complication. Do you think this is possible? However, if there was indeed reduced blood flow, the machines would detect the reduced blood pressure during surgery. Am I right? What do you think about it?
Do you know why they used a steroid? For 30 minute operation it's reasonable to send a dog home an hour later in my experience.
What do you mean by respiratory distress?
Did she get IV fluids during the procedure?
Not all clinics monitor blood pressure, you could ask them that but even doing our very best it's inevitable that it happens, by definition in order to put an animal under anesthesia It has to happen and we do our best to counter it.
She experienced respiratory distress just before the operation, 15 minutes after premedication with Insistor. She began to choke. She received Torphadin and Dexamethasone to manage respiratory distress.
They monitored blood pressure. If there was indeed reduced blood flow, the machine would detect the reduced blood pressure during surgery. Am I right? She was on IV fluids during surgery.
Why would the vet not give her something to sedate her prior to the exam in the future?
When you say respiratory distress what do you mean by that? Was she stable and a candidate for anesthesia? That would be my question. I don't know if they checked blood pressure, that would be a question for them.
I think no matter how much we intervene to keep the blood pressure up it's not going to be normal during anesthesia by the very definition of what b
an ananesthetic drug does.
You could ask them about that, I'm not sure what they meant by respiratory distress.
I don't see that a little morphine would cause that unless they think her breathing was depressed which morphine can cause. But it wouldn't cause distress, as much as the animal being too sedate.
It's considered very safe and it sounds like they gave the steroid in case there was any inflammation which is something that we often do.
If they gave morphine I'm not sure why they then gave butorphanol or what the time frame is on that. But I don't see that that would cause a problem.
Are Convenia and Cylanic antibiotics appropriate drugs for healing ulcer at kidney failure?
I would not think the antibiotics are involved, although I don't normally use antibiotics for kidney failure. Unless there was a bacterial component.
Ask for help, 24/7
Expert will respond in minutes
Save time & money
20,890 satisfied customers
Ellen
Licensed veterinarians
31,131 satisfied customers