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Old Dogs and Kidney Disease
Old 07-02-2019, 08:19 PM   #1
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Old Dogs and Kidney Disease

Anyone have any experience with this? Our Maltese is 15 and despite being on pain medications and Xanax at night she canít sleep more than 5 hours at night. Then restless making noises and not letting us sleep. I think she has pain but my husband doesnít. Of course itís me sleeping in shifts. I made a vet appointment tomorrow to see if any other medications will help. I think we should put her to sleep and my husband doesnít. Since we have had old rescues we have had to make the decision 7 times in 15 years. Itís his favorite dog but not willing to get up with her because I wanted the dogs. Helpful suggestions please.
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Old 07-02-2019, 08:25 PM   #2
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Our little yorkie was in chronic kidney failure for a year or so, then had an acute episode from which she did not recover. She was on various meds, in the hospital on IV for several days and appeared to be getting better and came home. Started having seizures, more meds, but did not survive one of the seizures. My heart is still broken. It will be 3 years next month.
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Old 07-02-2019, 08:25 PM   #3
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I didn't see why you believe it is a kidney issue--does the pup have a history of renal problems? It is certainly true that many dogs have kidney trouble.
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Old 07-02-2019, 08:28 PM   #4
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Sam, it was diagnosed a year ago.
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Old 07-02-2019, 08:38 PM   #5
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Sam, it was diagnosed a year ago.
Thanks. I'd probably ask the vet straight out if there's a way to know if this dog is suffering. I'm not an expert, but my impression is that, as pack animals, they instinctively go to some lengths to avoid showing that they are in distress. (It hurts their group staus, access to resources, etc) Now, a Maltese is a long way from a wolf, but I've had dogs that, in retrospect, were probably in more discomfort than they, or I, were willing to admit. It might be good if your hubby joins you for this vet visit.
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Old 07-02-2019, 08:46 PM   #6
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That’s a good idea Sam. I had a old 5 lb Maltese and we got stuck in a airport overnight. There wasn’t enough time to get a hotel room. She stayed awake and when I fell asleep sitting up and someone came near me she woke me up growling. Once we got on the plane she slept and did so for 24 hours. She died a week later. They can be fearlessly loyal.
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Old 07-03-2019, 07:19 AM   #7
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Thatís a good idea Sam. I had a old 5 lb Maltese and we got stuck in a airport overnight. There wasnít enough time to get a hotel room. She stayed awake and when I fell asleep sitting up and someone came near me she woke me up growling. Once we got on the plane she slept and did so for 24 hours. She died a week later. They can be fearlessly loyal.
Fearlessly loyal. In 2000 my cspine went out and my then PCP was an idiot. As a result I spent 3+ months in severe pain with very little pain medication. The only thing that helped me was laying flat on my back on the floor. The dog wouldn't leave my side, for over 3 months that dog laid with me and wouldn't leave my side.

Samclem's post is the best advice you can get.
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Old 07-03-2019, 09:42 AM   #8
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Retired vet here. Kidney disease probably isn't the source of any pain. Urinary tract infections are common in older female dogs, and those are certainly uncomfortable. Ask your vet to do a urinalysis and a urine culture as well (they can be hard to detect in the presence of kidney disease). Many pain meds (nsaids) can make kidney disease worse,so have some blood tests done to be sure that's not happening. If not, maybe try adding another pain med (narcotic) on top of the current one to rule our pain. Good luck and keep us updated.
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Old 07-03-2019, 09:54 AM   #9
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Would it not just be cheaper to treat for UTI than to actually run tests to confirm such a diagnosis?
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Old 07-03-2019, 10:06 AM   #10
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Would it not just be cheaper to treat for UTI than to actually run tests to confirm such a diagnosis?
Yes, but you wouldn't know for sure which antibiotic to use (or if one is needed at all). The goal is to see why her dog can't sleep through the night. If its not a uti, you need to look for other causes. Also, overuse of antibiotics is a human health concern. Her vet may not be willing to treat without running diagnostics.
Your right though - it's going to run up a bill of several hundred dollars.
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Old 07-03-2019, 10:31 AM   #11
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Just a general question, Asmo (or anyone else who'd like to chime in): Are there good ways to get objective indicators that a dog is in discomfort/distress? E.g. maybe blood cortisol levels, or some other test? This is a scenario most pet owners eventually face. Sometimes it is clear that "it is time," but in my experience it is often very murky.
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Old 07-03-2019, 11:15 AM   #12
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Just a general question, Asmo (or anyone else who'd like to chime in): Are there good ways to get objective indicators that a dog is in discomfort/distress? E.g. maybe blood cortisol levels, or some other test? This is a scenario most pet owners eventually face. Sometimes it is clear that "it is time," but in my experience it is often very murky.
I never really found a reliable way. No biochemical markers; just behavior changes - and those varied among individuals and species.
When I was treating animals that I didn't know if they were painful or not, I just gave pain meds for a week and asked the owner if they felt the pet was improved. Not very scientific, but the best I could do for my nonverbal friends.
I agree that murky situations are common at the end of life.
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Old 07-03-2019, 11:21 AM   #13
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Asmo, thanks for the advice but we ran those tests a month ago. The gabapentin has helped Mandy because she is less restless during the day. The vet thinks she has dementia so we are trying traxadone for night sleep. I tried Xanax because that worked for my old dog with dementia previously but it didn’t help Mandy.
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Old 07-03-2019, 12:10 PM   #14
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I never really found a reliable way. No biochemical markers; just behavior changes - and those varied among individuals and species.
When I was treating animals that I didn't know if they were painful or not, I just gave pain meds for a week and asked the owner if they felt the pet was improved. Not very scientific, but the best I could do for my nonverbal friends.
I agree that murky situations are common at the end of life.
You're obviously a veterinarian. We've had dogs (sometimes 2) for 35 years. One, dear sweet black lab, passed naturally next to my bed (she was 16). I struggle with euthanasia, they've all gotten very old and seem in pain, then recoup with energy. Actually, my love in my avatar, let us know the day he wanted to go. It was so obvious. This must be a big struggle with your patients.
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Old 07-03-2019, 12:27 PM   #15
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I really struggled the first time I had to make the decision. It has gotten easier because I have more confidence in my ability to know. I always suffer greatly afterwards but it’s the price we pay for loving our pets so much. Some decisions are more clear cut like when one of my dogs with congestive heart failure had strokes. It was obvious she was suffering and there was no choice but to end it. I couldn’t be a vet.
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Old 07-03-2019, 01:03 PM   #16
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I couldnít be a vet.
Nor could I. Their suicide rate is double (male vets) to triple (female vets) the national average. There are lots of identified reasons for this, including traits they had that helped them get accepted into veterinary school on the first place (perfectionism, etc), plus occupational stress, burnout, etc. In my experience they are tremendously qualified, committed to animal welfare, and empathetic.
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Old 07-03-2019, 01:07 PM   #17
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I am guessing that the stress comes in when people can’t or won’t pay for treatment and just want the animals killed. Many people see pets as disposable and that would get old fast.
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Old 07-03-2019, 01:13 PM   #18
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My compassion/empathy are with all animals. This is weird, but bugs are considered animals and I pick them up with a cup and put them outside.
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Old 07-03-2019, 02:09 PM   #19
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I am guessing that the stress comes in when people canít or wonít pay for treatment and just want the animals killed. Many people see pets as disposable and that would get old fast.
I don't think euthanasia requests have a part in the suicide rates quoted.
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Old 07-03-2019, 02:12 PM   #20
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I am guessing that the stress comes in when people can’t or won’t pay for treatment and just want the animals killed. Many people see pets as disposable and that would get old fast.
+1000

have had many pets who need extensive and sometimes expensive care, and you can see how much the vets appreciate owners like me who will not only pay but will keep up with care requirements at home
so many treat their pets as disposable assets for their own gratification and not as dependent creatures with feelings and needs

You may want to consider Neutricks, a supplement.
we used both gabapentene and tramadol as well
it helped noticeably with my dog who had dementia, at least it did for about six months before it was clear she was too confused and anxious to live a relatively happy life. it is not easy in any case, but especially with dementia, to know when it is time to help them pass on.
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