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2nd Opinion Kidney Disease In A Dog

by jschell - June 28, 2017 View Case Report

Hello
I am treating a 5.5 year old Rottie mixed breed dog with elevated SDMA and crea above 140
He is improved but SDMA is still 15 and Crea is 149- he is on Ba Wei Di Huang Wan, Prescription Diet k/d food with 10% t/d food (owner cannot home cook for him)
He is also on Aventi KS and weekly vitamin b12 injections.
I was able to get his Crea down from 151 to 149 and SDMA down from 16 to 15, but he is still in Stage 2 IRIS renal disease.
His urine protein:creatinine is normal.
USG is 1.019.

What else can I do to help improve his kidney health?
His blood pressures are normal.

Thank you!
Julie

by naturevet

June 30, 2017

Hi Julie,

I would start by increasing the BWDHW dose. You can also enhance BWDHW by adding in San Ren Tang. If there's an inflammatory component, it will address that a bit better than BWDHW alone.

Middle-aged animals usually have a significant (diet-mediated) component to their renal insufficiency aggravated by virtually any processed diet. I'd suggest raw or at least a freeze-dried diet to end this dog's struggle and get things back to stage I. There's no reason to suspect k/d will help this dog. Only when there is marked glomerular inflammation (accompanied by a high UPC ratio) do I feel there is a reasonable evidence base for restricting protein.

Hope that helps! You can nail this one!

Steve

San Ren Tang

by jschell

June 30, 2017

Thank you Steve.
I forgot to mention I also have him on XCHT that I started in March 2017.
That's why I was surprized he didn't return to Stage 1. (the processed diet is probably the main reason).

Like you suggest, I will increase his BWDHW from 1 tsp BID to 1.5 tsp BID and keep working on getting him on a fresh diet.

Do you prefer San Ren Tang to XCHT for inflammation in kidney disease?

Thank you very much!
Happy Canada Day!
Julie

by naturevet

June 30, 2017

XCHT and BWDHW kind of cancel each other out. SRT is anti-inflammatory but enhances BWDHW, so for this case, it might be a better choice.

Enjoy your holiday, too, Julie!

Steve

by jschell

June 30, 2017

Thank you Steve! So, if a pet is on XCHT because of suspected inflammation/glomerulitis, then take them off the BWDHW?

Thank you!
Julie

by naturevet

June 30, 2017

Yes, that's correct. You'll need it later, when acute inflammation has subsided, to actively resolve any lingering inflammation and to help restore oxygenation and nourishment. I use the drop in UPC ratios as a rough guide to when that has been achieved

Steve

by jschell

June 30, 2017

Sweet! Thank you very much!
Julie

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