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Letting go of your pet....

This post ''Letting go of your pet....'' is part of a series of posts designed to share with you tips, tricks and experiences encountered by us with our 15 year old female cross breed Marley who was diagnosed with Chronic Renal failure (CRF).
Canine Kidney Disease can be quite frustrating to deal with and if your family dog suffers from it make no mistake, you're in for a rough ride but know this; there are so many things you can do to improve your dog's quality of life and maybe perhaps slow down the progression of the aliment.
The key is to take a broad approach, the more things you do to help your dog's well being the better your dog will feel and with some work and time invested on your end, you will enjoy your animal friend for some time to come.

As you will notice as time goes by with a dog that suffers from kidney disease is that inevitably your dogs symptoms will worsen, what you can hope to accomplish by treating your animal is perhaps not so much to prolong it's life albeit good care will do that but much more importantly to improve the quality of their lives for whatever time they have with you.

We unfortunately had to make a choice with our Marley eventually and the choice was not easy in fact it was the hardest decision we had ever had to make. But in many ways the decision was already made for us.

These are the things to look out for that will perhaps tell you that it might be time and although I do not pretend to know when it will be the right time for you or if you even if should make that choice, look out for these things that might clarify things for you.

• Is it getting harder and harder to feed your dog to the point where your pet may not be eating almost anything at all?
• Does you pet vomit the few things that he or she does manage to eat?
• What about your dogs energy? is it still there? does he or she shake a lot or get cold even on days where it's not cold?
• Does you pet still like to spend time with the family? do you often find your dog separate from the rest of the family sleeping alone?
• Does your dog's breath have a strong ammonia smell? this is a sign that is very indicative of end stage kidney disease.
• Does your dog look to come back home sooner and sooner when out for a walk and perhaps is lacking the energy for stairs and such.
• Do you find yourself asking yourself more and more often if it's time to let go?
• Does your dear dog friend still enjoy being a DOG?

All of these things only you can answer and only you and your family can make a decision either way.

My personal decision when the time came to euthanize and this coming from having gone through it once before with a cat some years back was to be there and do have the procedure performed at home in familiar surroundings.
I also decided to have my dog sedated before hand, we requested a very common tranquilizer used for pets that have to travel on airplanes to try and reduce anxiety levels for everyone involved especially your dear pet.

It all happens very quickly as the vet injects a barbiturate overdose that instantly stops the heart, we stayed with Marley an extra 10 minutes since total brain death can take about 5 minutes.

Although nobody can truly know, I do not think they suffer at least I try to hope and believe they do not.

We took her for cremation at a great pet funeral center called Amicus where she was treated with the utmost respect. http://www.amicus-pet-cremation.com/dog-memorial.html

Amicus pet cremation
9691, Metropolitain Blvd. East
Montreal, Quebec H1J 3C1
Canada
Tel: (514) 353-9999
Fax: (514) 353-0009

Make no mistake, this will all be very difficult for you and your family and you will soon enter a time of grief that will vary from person to person.

One thing that is almost inevitable is a sense of guilt after euthanasia, perhaps not right away but in the weeks following you might find yourself apologizing to your departed friend for having made that choice. I can tell you that feeling is normal and natural but can also be very poisonous and has the potential of lingering for a long time and even replacing grief or the fond memories if you do not deal with it quickly.

Remember why the decision was made and go back on all those questions mentioned above, focus on the good times and those way outnumber the final bad times, know that you did the right thing, for the right reasons and above all thank yourself for being such a loving dog owner and taking such good care for your loved pet especially in the final months or years. Don't be afraid to mourn and grieve for your dog but stay away from feelings of guilt since those are not warranted and unfair to yourself.

You will find that keeping a positive mind set will help in slowly and surely replace those negative feelings with fond memories that you will cherish.

And above all, forgive yourself! this is the best way to honor your friend's memory.


This was the final post in the blog, it is somewhat ironic that it will show up at the very top but please do read on and feel free to share your own thoughts....

Supplements, medications and calorie replacements

This post ''Supplements, medications and calorie replacements'' is part of a series of posts designed to share with you tips, tricks and experiences encountered by us with our 15 year old female cross breed Marley who was diagnosed with Chronic Renal failure (CRF).
Canine Kidney Disease can be quite frustrating to deal with and if your family dog suffers from it make no mistake, you're in for a rough ride but know this; there are so many things you can do to improve your dog's quality of life and maybe perhaps slow down the progression of the aliment.
The key is to take a broad approach, the more things you do to help your dog's well being the better your dog will feel and with some work and time invested on your end, you will enjoy your animal friend for some time to come.

Every dog being different, they will respond differently to medications your vet prescribes, we have found that a trio of meds seem to work well for our dog Marley.

• Lotensin or Fortekor: Benazepril hydrochloride is used for humans as well as animals to treat and slow down Chronic renal disease, this medication can be used in humans under the name Lotensin to treat high blood pressure (hypertension), congestive heart failure, and chronic renal failure. In animals under the brand name Fortekor, benazepril hydrochloride is used to treat congestive heart failure in dogs and chronic renal failure in cats and you see it mostly used with cats and they seem to respond better than dogs to treatment for kidney disease, nevertheless we have found that our dog Marley begun showing signs of improvement after a few days on the drug, she stopped drinking so often, needed to urinate less often and stopped having as many accidents in the house. Dosage will vary according to your dog's weight, consult your vet for the proper dosage.

• Azodyl: Azodyl is a probiotic that claims to work by having the beneficial bacteria feed on the toxins that accumulate in the bloodstream due to renal disease, the claim is that this process will reduce BUN and creatinine levels. This is referred to as enteric dialysis and is often used with another product called Epakitin (see below).

My experience with this product remains inconclusive since we started our dog on this at the same time as Fortekor and sub-Q fluids, therefore I cannot say with any certainty that it made a difference either way but we did not want to mess with things so we continued it's usage and there seems to be a lot of info online that is favorable to warrant it's usage. My advice is to perhaps introduce this last in your treatment to determine if it does make a difference. And also to get it at your local vets since ordering this online may be tricky since it needs refrigeration at all times.

• Epakitin (Calcium Carbonate) acts as a phosphorus binder used to reduce the absorption of phosphate and taken with meals and snacks, this avoids accumulation of excess phosphorus in the bloodstream by diverting it's metabolism to the intestines from the kidneys. This is a tried and tested approach for humans as well and there are other types of Phosphate binders. We decided to simply use s Tums, Tums are also Calcium Carbonate and much cheaper in price, this will become a concern as you continue treatment for your pet believe me. It is also suggested that you add the Epakitin or Tums to your dogs food, But we found that counter productive since it turned OUR dog off the food and since you will also be battling loss of appetite we suggest crushing the Tums and putting it in a eye dropper with some water and feeding it through the corner of their mouth in much the same way you would feed a small puppy. Ideally right after of before the meal.
  

Vitamins

• Vetri-Science Renal essentials for dogs is a multivitamin geared for dogs with kidney disease and is formulated to help maintain optimal kidney function. Again this is something be started to do at the same time as everything else so I cannot say if this is for sure beneficial, but it stands to reason that dogs with bad appetite that are perhaps not eating always properly with kidney disease will have use for supplements, you may also want to look into human multivitamins for seniors since they are low in Phosphorus. the best place I found for purchase of this product was an online store called Cattyvet http://www.cattyvet.com/Renal_essentials.html

Dietary supplements

• Nutri-Cal or Nutri-Stat: Nutri-Cal is a high-calorie palatable dietary supplement used for stressed or debilitated pets, pets suffering from illness, surgery or whelping, aging pets or picky eaters, who need increased caloric and nutritional intake. This product was a life-saver! one of the or perhaps the biggest challenge you will encounter is the lack of appetite most likely due do a metallic taste in their mouths or nausea due to the increased levels of toxicity in their systems.
  

You most likely wont always be able to feed your dog adequately or as balanced as you may have wished and even though there are several kidney diet canned dog foods available at your vet's, there is no guarantee your dogs will like or eat it on a consistent basis. We found that things were cyclical when it came to feeding, our dog would like something for a few days and then out of the blue would not touch it again, so my suggestion is to change the menu often and bring back things that you dog has liked in the past a few weeks or months later.

That being said a high calorie paste like Nutri-cal (there are others and all are very much the same so shop around!) will be essential to keep your dog well nourished especially during those days that eating was low.
There are many places to find products like these and your vet will sell these for a lot more than what you can find them online for if you shop around a bit. The best place I found that delivered to Canada is http://www.petcarerx.com the website is a bit annoying with many pop ups but they do give you coupons and rebates and deliver quickly. if you are in the United States, look for Nutri-stat, it is less expensive and has the same ingredients, many online stores will sell it.
Reference links:
http://www.drugs.com/vet/
http://www.wikipedia.com
http://www.cattyvet.com
http://www.petcarerx.com

Giving subcutateous fluids injections

This post ''Giving subcutateous fluid injections'' is part of a series of posts designed to share with you tips, tricks and experiences encountered by us with our 15 year old female cross breed Marley who was diagnosed with Chronic Renal failure (CRF).
Canine Kidney Disease can be quite frustrating to deal with and if your family dog suffers from it make no mistake, you're in for a rough ride but know this; there are so many things you can do to improve your dog's quality of life and maybe perhaps slow down the progression of the aliment.
The key is to take a broad approach, the more things you do to help your dog's well being the better your dog will feel and with some work and time invested on your end, you will enjoy your animal friend for some time to come.

Read on..

One of the first and best things you can do after diagnosis of renal disease to help your dog is subcutaneous sodium chloride fluid injections SubQ for short.

The main reason to do this is to keep your dog properly hydrated, since your dog is most likely urinating more than normal and dehydration is very bad for the kidneys, this will help both your dog's overall well being and replenish electrolytes due to dehydration.

The dosage is 5 to 15 ml per pound of body weight at one time but to get the exact dosage I suggest you consult your vet, certain other health conditions may require adjustments to the dosage or keep you from exploring this option so please consult.

There are many ways to do this and your vet may show you a different method, other websites or resources as well but the goal is the same and the equipment needed will be similar.

This is how we do it:

First of all you will need the sodium chloride solution (saline), this need to be the injectable kind and can be bought at your vet's or certain drugs stores carry it and should be no more than 10$ for a 1000 ml bag.

Next, you will need one 21 gauge winged infusion set, three 60 ml luer-lok tip syringes, two 18 gauge needles and about six cotton alcohol swabs:


The gauge may vary but we found that a 21 gauge is small enough to be easily inserted without hurting the dog and big enough to allow the fluids to flow freely and easily.

These are the items that should be available and ready before you summon the dog for the injection.



Before you begin start to heat up some distilled water (easily found at any drug store) in a regular non-Teflon saucepan for the purpose of disinfecting all the equipment when you are done. Try to time it so that the water comes to a boil as your are finishing the injections.



*Please note that this will NOT sterilize any of the equipment, the goal here is at best case disinfect or worse case thoroughly clean the equipment.

You are now ready to begin.

Have everything readily available. As the distilled water slowly heats up and the dog is nearby; begin by twisting on the needle to the syringe and cleaning the saline bag's nozzle with a alcohol swab.









The next step is to fill the syringe:

1. Insert syringe into the saline bag's nozzle
2. Begin extracting the saline slowly to avoid air bubbles from building up
3. Extract a bit more than needed to allow for pushing out of any air bubbles
4. Pull out and hold upright to bring any air bubbles to the top and tap a few times to consolidate them and press on syringe until saline squirts out and no bubbles are left.

Remove the needle and put it into the distilled water saucepan. You will be adding things into the pan as you use them.

The next step is to twist onto syringe a winged infusion set, alcohol swab it and like with the needle, push out some saline until you see liquid come out at the end.
Time to get your dog to come over, keep in mind that with time this will become very routine and your dog should not come to see this as a negative thing and should not be painful, if it hurts your dog, you're doing it wrong.

Ideally two people should be involved to help hold the dog and hand over accessories but the pictures will show one person only since some people will have no choice but to do this on their own.

1. With the dog standing either on the floor on better yet on some kind of table if possible, alcohol swab thoroughly a small area on the dog's back along the spine against the grain of the dog's fur to easily reach the skin. Note: if you have multiple injections to give depending on your dog's weight leave your self room for the next ones by starting near the shoulder blades.
2. Next squeeze up the dog's skin next to where you swabbed as if you were picking up a briefcase, a dog's skin on their back is generally very loose so it should not hurt.
3. With your index finger dig a dimple right where you swabbed originally, this is where you will inject, doing this pretty much ensures that the saline will go in under the skin and not between the layers of the skin.
4. Parallel to the dog's back, insert the infusion needle quickly and all the way in, DO NOT HESITATE on the way in this will slow the insertion and will hurt the dog, the quicker you go in the better and painless it will be.
5. Make sure that the pointed tip of the infusion needle is at the bottom for easier entry into the skin.

Injecting the saline solution involves the followings steps:

1. Place your index finger over the wings of the infusion set and with your middle finger form a V shape, this is to guide the saline off to the side and avoid it from staying near the needle puncture so it won't leak out when done.
   
2. Continue injecting the saline in a slow steady pace and be sure to STOP just before reaching the end since there is almost always one air bubble left over.
3. Place index and thumb near the injection entry and quickly pull out the winged set.
4. Pinch the entry area for 15 seconds.
5. Swab thoroughly.

The final step is the clean up and disinfection of the accessories with the by now boiling distilled water in the saucepan for about 10 minutes, remember this in no way will sterilize.
I suggest using things no more than 3 times before discarding particularly the winged infusion set since they loose some sharpness each time they are inserted.

The way to disinfect a winged infusion set is while the other accessories are in the boiling distilled water:

1. Use a spare syringe and fill it about half way with the now boiling water.
2. Hold it upright some water should leak out this is normal
3. Connect the winged infusion set and empty out the syringe back into the pan, while periodically dipping the infusion set into the boiling water.
4. When empty, be sure to pull out any remaining liquid from the infusion set's tube.

Continue to boil the accessories for a total of 10 minutes at medium heat and allow to air dry on a paper towel, after an hour or so, put away in a cool dry place until next usage.

Reference links :

Scooter's Mail Order Supplies for Chronic Renal Failure (CRF)
Dogaware.com/kidney