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2nd Opinion Kidney Disease In A Dog

by jschell - November 28, 2017 View Case Report

Hello
Wendigo's littermate is doing really well- her SDMA and crea and urea are all normal now after starting BWDHW and SanRen TAng formulas.

However, Wendigo still has SDMA at 16 (above from 15) and crea is climbing up to 185, even though he is also on BWDHW and SRT.

What do you think I could try to help him further?

Thank you!
Julie

by MatthewJMuir

December 1, 2017

Has muscle mass score changed between renal stagings?

Take care intepreting SDMA levels if there is haemolysis as it can behave erratically based on absence or extent of haemolysis on sample.

Await others feedback re: TCVM energetics and recommendations.

Matt

by MatthewJMuir

December 1, 2017

Julie,

I am still studying TCVM but do work with experience herbalists.

I guess my mentors would ask by saying what are the reasons for the two formulas used (apologies if there was a previous thread with rationale explained)

Also ensure he doesnt have any sequalae including UTI/ crystalluria.

Is there any other differences between the litter mates, heat/cold intolerance, historical gastrointestinal disease issues etc.

Is she on any other herbs, supplementation, diet modifications for other issues that may be further supporting kidneys by default, i.e. probiotics for gut problems re: microbiota difference on renal function.

Do you have a western biomedical dx for the cause of kidney disease? if it is cystic perhaps he has larger cysts?

Depending on signalment, and dog is clinically well, perhaps an SDMA of 16 and Creat < 200 may be ok with ongoing support to support remaining nephrons/ slow fibrosis.

Do you have a UPCR?

Matt

by naturevet

December 2, 2017

Hi Julie,

One thing you could try is just upping your doses of both formulas. Or if things really started to move along once Rehmannia was added, you could give even more of just that one formula.

Failing that, if you can let me know symptoms and signs, pulses and the points they respond to, that might help me suggest something new

Steve

by jschell

December 7, 2017

Thank you very much Matt and Steve! We are going to try increasing the dose of each formula and see how he does.

Those are good questions Matt--the urine protein:creatinine ratio is normal at 0.20. Neither he nor his littermate are suffering from any negative clinical signs.

We have not yet done any radiographs or ultraound of their kidneys. However his urine culture and urine cytology are normal.

Thank you!
I will post updates asap!
Thank you!
Julie

by jschell

December 25, 2017

Hello!
we started this higher dose of his herbs, and will recheck his blood work and urinalysis in February 2018

So far he is accepting the increased doses well.

I will re-post his results as soon as they are done.

Thank you!
Julie

by jschell

February 15, 2018

Hello! I would like to post an update. Wendigo was re-checkd yesterday after being on the higher dose of herbs. He has been getting 2 teaspoon BWDHW twice daily (up from 1.5 teaspoon twice daily) and 1.75 tsp SRT twice daily (up from 1.25 teaspoon twice daily) for 2 months.

His Creatinine is improved- went from 185 down to 160 but his SDMA rose to 17 from his previous value of 16.

His phos is normal at 1.13 (and was also normal 2 months ago). Urine specific gravity stayed the same at 1.024.

I am glad we are improving his Creatinine, but I want to get his SDMA down further.
He is a hot dog, enjoys the outside weather expecially when it is cold. He is an overweight (Body condition score 4/5) Akita mixed breed dog. Tongue color red, pulse normal. His owner does not feel she can home cook for him. He eats Prescription diet k/d food.

He acts alert and clinically normal.

I am thinking of starting weekly vitamin b12 injections and Aventi Kidney Complete and increasing his herb BWDHW to 2.25 teaspoon twice daily. (and highly encouraging owner to start home cooking his food)

How does that sound?
Thank you!
Julie

by naturevet

February 15, 2018

Hi Julie,

If you think he's on the hot side, you could use something like Yi Guan Jian instead. It has potentially more Kidney tonifying power

You could also try lowering the SRT dose, so it's maybe just 1 spoon or less. It does enable Rehmannia to work better if the kidney has inflammation, but once that inflammation is resolved, it can get in the way. So I'd edge it lower, while you boost your Rehmannia formula. Rehmannia 6 is also an option, if you don't have YGJ

If the SDMA continues to climb, the food may be the issue. There's evidence to suggest that processed foods produce an immediate post-prandial inflammatory response within the kidneys that, over many months or years, can produce renal failure. A homemade low protein diet, or even a raw diet, would be superior to the k/d, given the success you're seeing in lowering his creatinine

Hopefully this advice helps you out!

Steve

Yi Guan Jian

by jschell

February 15, 2018

Thank you Steve! Those are great ideas . Thank you very much!

I'll re-post with his results.
Thank you!
Julie

by jschell

May 8, 2018

Hello! San Ren Tang is on back order. Is there any other option to use for Wendigo in combination with Yi Guan Jian?

Thank you!
Julie

by naturevet

May 9, 2018

Hi there,

Kan has San Ren Tang as liquid and tablets, available through the nphc website

If they are also out, probably the main active ingredient in SRT is the Yi Yi Ren. We could just add it to Wendigo's food as a single herb. San Ren Tang in granule form is about a month or less away

Steve

by jschell

May 9, 2018

Thank you Steve! Great idea! I have Yi Yi Ren Tang. I'll add that until the SRT is available again!

Thank you!
Julie

by jschell

June 15, 2018

I want to get his creatinine down more. He is currently on Yi Guan Jian and Yi Yi Ren Tang. What else can be done: Owner is finally interested in home cooking- wil use the Hilary Watson Renal diets

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