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Dr. Bruce
Dr. Bruce, Veterinarian
Category: Dog
Satisfied Customers: 18918
Experience:  15 years of experience as a small animal veterinarian
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My dog has been diagnosed with kidney failure and has had several

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My dog has been diagnosed with kidney failure and has had several treatments and she is okay afterward for a couple of months. The last time her creatine was over 8. She was in ICU for a week flushing her kidneys with fluids. She is on florinef and predisone now. She has started throwing up again with diareah again. I am sure they are up again. She is on a low protein diet but not eating. When she does she throws up. She has lost weight again over the last two weeks. Is the high creatine levels painful. I don't want to keep putting her through this. "Tinker" is a 16 year old Cairn terrier

Welcome. I'm Dr. Bruce and I've been a small animal veterinarian for over 12 years. Thank you for your question. I'm sorry to hear about Tinker's situation. Based on the treatments that she's on, did your vet diagnose her with Addison's disease? Did they do a specific blood test to evaluate for it?
Customer: replied 3 years ago.

Yes, they did and yes she has addisons as well. It all started about 1 year ago. She started with a severe skin infection. then was diagnosed with addison and kidney failure. then had to remove both eyes to glaucoma.

Oh my. Tinker has been through some major issues. Glaucoma is a frustrating situation to have occur. A lot of times it ends up with the affected eyes being removed to keep the pet comfortable. The positive thing that I try to instill in owners when they are faced with this situation is that a dog can do very, very, very well with being totally blind. I'm hoping that you're seeing her doing well with not being visual. In cases that are diagnosed with Addison's disease, it is very, very hard to know if they have underlying renal disease too. The reason for that is that the kidney values will be very high due to the Addison's and the actual function of the kidneys isn't a renal failure situation, but more of a renal dysfunction due to the lack of the hormones needed for them to function well. If the hormones are supplemented appropriately, the kidneys function absolutely normally and there is no damage to them. So, in her situation, I wouldn't say she was in kidney failure, but compromised function that should have returned to normal when her Addison's was treated well. Here is a great link on the disease.

So, in saying that, if she's not doing well with the vomiting, then I would question if she's being treated successfully for her Addison's. Honestly, I like the once a month injectable called Percorten for the treatment of Addison's. I feel that combined with daily oral prednisone is much more effective than the oral Florinef. Having creatinine levels being up isn't painful, but it indicates that the body is being stressed and not feeling well and it gets them run down.

In her situation, I would get her seen by your vet to have her blood checked again. More than likely she's dehyrdrated and has her electrolytes off. Getting some IV fluids into her and starting her on the Percoren (DOCPP) would be something I'd have high, high hopes for making her feel much better. With any Addison's patient, they can have down times when their body needs more steroids during times of stress on it. She may need more oral prednisone during the times she's "worked up" as her body can't do it on its own.

I would have high hopes again with her that she can be managed in a little different way to give her a good quality of life.
Customer: replied 3 years ago.

By the way Tinker is 16. I accidently put 10. The last time she was in the ICU for a week the gave her carafate, cerenia injections, flagyl 5 day of fluid therapy, 2 blood chemistry test and urinalysis. After trying everything else we started her on the steriods and now she is back to the same problem. All of this was with September 15 - 20. They have said that addison and kidney failure are very similar. After the kidney flush she did so well. Almost like a young girl again. I am concerned with her quality of life. I want her to have the best life possible. I wonder if it is time to let her go.

At some time, with every pet, the consideration goes towards quality of life issues. It is the unfortunate conversation that every good pet owner has at some time. I know you want her to be happy, healthy and active. If all she has is the Addison's disease, then it is very much a goal / expectation of mine to get any Addison's patient back to that level. I feel that Addison's is the one disease out there that can be managed extremely well. In her situation, she may need more steroids on a daily basis and the trial of the Percorten to see how she does.
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Customer: replied 3 years ago.

You were so sure that Tinker's Addison was her problem. You did not address my concern about her kidney failure. On Wednesday the 16th, she went into complete failure and passed. Address the concerns of people who have gone to the extremes of taking care of her vet.