Fanconi vs Renal Failure?

[Anna]

What a handsome boy! I hope everything works out for both of you. I had a cat that had renal failure and we were giving subcutaneous fluids and oral potassium gel. The subcutaneous fluids were difficult because the volume was large and the needle was very big. It didn’t hurt Stuart at all but I felt horrible doing it. My husband would hold him and I would just pinch his skin and insert the needle underneath, then squeeze the IV bag so it would empty faster. We were giving anywhere from 500 to 1000 mls once a day. This was about 4 years ago so I am not sure of the exact amount. I

[Anna]

Sorry, I had to reply again because I can’t get the cursor to stay on the line. It keeps going between the lines. Anyway, Stuart tolerated the SQ fluids very well. We also put him on a special renal diet made by Hills. If you have any other questions that I might be able to answer, please feel free to ask. I also noticed that you titled your post Fanconi vs Renal Failure. I have a Basenji that has Fanconi Syndrome. If you have any questions about specific tests to determine if the Fanconi Syndrome is what caused the renal failure I will answer whatever I can. Good luck and hang in there!

[JoeyQ]

@anna Thank you for the information. Wow! I had no idea SQ fluids would be needed once a day. He had a "pack" on his back once before many years ago for another issue. Does the vet show you how to administer and how does one determine the pet's hydration status? And yes, how would I know if Fanconi caused the renal failure or it is just old age?

[tanza]

@joeyq - I have had more than one with late age renal failure, not Fanconi. SubQ fluids were used once a day or every other day. Vet Techs will be able to show you how to give fluids at home. I used my grooming table with a grooming arm/noose. My Basenjis were used to this so I could give the fluids myself. I would hang the fluids on the on the arm. If you don't have a groom table with grooming arm, you can search to find one.

[JoeyQ]

Does anyone know why he is having twitching/tremors? Is this from electrolyte imbalance? Is there anything that can be done to relieve or minimize them?

[JoeyQ]

@tanza Great Info. I'm a bit frustrated with my vet. She did not suggest subq fluids nor any treatment/care for the twitching. Any dog can have renal failure. Hmmm.

[Anna]

Yes, the veterinarian showed us how to give the SQ fluids and it was very easy. @tanza had a great idea using a grooming table. I just put Stuart on a table so it would be easier for me to give the fluids. I know with Lily that she had glucose in her urine but her blood glucose was normal. She also had certain venous blood gases that were not in normal range. All of this combined led my veterinarian to diagnose her with Fanconi Syndrome. Her HCO3 was below normal, her TCO2 was very low, and her pH was low. From what I understand, with kidney failure there is a low urine specific gravity, an increase in protein in the urine, and sometimes the blood urine nitrogen (BUN) and blood creatinine (CREA) are elevated depending on how much kidney function is compromised. So from what I can see there are different things that they look for in the blood work and urine analysis. I hope some of this information helps and doesn’t confuse you more. There is a great article written by Dr. JD Foster, staff veterinarian and director of hemodialysis at UPenn Veterinary Hospital (Ryan Veterinary Hospital). It is in todaysveterinarypractice.navc.com and the title is canine chronic kidney disease. It was written in September/October 2013 but the information might still be relevant. Hope this helps and good luck!

[JoeyQ]

@anna Thank you, Anna! I am familiar with the blood work and urinalysis info.

[DebraDownSouth]

@joeyq said in Fanconi vs Renal Failure?:

@debradownsouth I know this is difficult to say, but how often on average did you do subq liquid?

With her only every 3 days. Like I said, first was early, did subq only as support. I often wish I had done daily and probably given her more time. My vet was shocked at how fast.

However my first basenji, during chemo, had to do it daily. If I ever had to do daily again, if they hated it like my first dog, I would have a port put in.

[DebraDownSouth]

@joeyq said in Fanconi vs Renal Failure?:

Does anyone know why he is having twitching/tremors? Is this from electrolyte imbalance? Is there anything that can be done to relieve or minimize them?

That is the most likely cause. Talk to your vet about supplements. It's important to help him feel better.

[Little Monkey]

Okay, so my little girl, Kenya was diagnosed with kidney failure about 2 years prior to her passing. My vet from Tufts told me that the most important thing was to keep weight on her. I cooked for her and spoon fed her daily. It was a challenge to keep her interested in food but I was determined. I boiled her sweet potatoes, steamed rice with veggies, baked her salmon, whatever she would eat. Sometimes she only wanted baby food and that's what she would get, mostly beef or chicken in gravy. The thing about kidney disease is that they feel nauseated and don't want to eat the same thing every day. On days when she didn't want to eat (more advanced stages), she would lap up goats milk or Ensure. I gave her famotadine 10 mg twice a day for the upset stomach; I hid it in goat cheese. She also got sub q fluids, less frequent early on, but more so as she advanced. I took her to have blood work every 3 months to monitor her levels and she did well for a long time. In the end she began to have seizures and I knew it was time to let her go. She was the love of my life and it was hard, but she fought hard and I was by her side, helping to do what I could for her; she lived to almost 17 yrs old! Good luck to you and yours, I hope you can give yours a long and comfortable life.

[JoeyQ]

@little-monkey Thank you! I'm sorry for your loss. Joey is eating fine at the moment...once I added coconut oil to his food.

[JoeyQ]

Vet sent his labs...everything is normal except renal function and specific gravity which I believe shows protein in his urine. His BUN/CREA is 64 (7-27) and CREA is 2.4 (0.5-1.8). Somehow I feel like there is something additional going on as he has the twitching, they don't look like seizures. He seems pretty well hydrated and his water consumption might have even slowed up a bit. I know y'all are not vets, but maybe someone has a ray of light to shed?

[JoeyQ]

Oh and his PCT is one point above normal 0.47 (.14-.46) .

[JoeyQ]

Going to the vet on Friday to see if there is a more comprehensive plan for his comfort. Am arming myself with many questions thanks to all your help!

[JoeyQ]

Saw the vet today and ran some bloodwork again. His BUN/CREA has improved significantly and his CREA improved 0.10 which the vet said was not significant. The change is from one week ago. Joey has become more active and gained 1 lb which lead us to believe he was dehydrated on his recent visit of 3/3. He received his first (and now only) does of the fairly new Simparica med for flea and tick treatment 2/18 and this is also when he started having neurological issues. The letter that comes with the rebate includes a safety warning..."Simparica may cause abnormal neurological signs such as tremors, unsteadiness and/or seizures". There are variables but my gut tells me the new medication impacted his health. I plan to test him again in 1-2 months.
What do you give for flea and tick prevention?

[DebraDownSouth]

@joeyq said in Fanconi vs Renal Failure?:

Simparica

I'll run the numbers past my vet tech friend.

I had never heard of the drug... but I have learned not to touch any new drug for at least 5 years. I don't want my dogs to be beta testers. I looked and it just came out in 2016. Please report your suspicions to the drug company AND to the FDA. Keeping track of potential issues is how they figure out if it really is the drug. Europe research says 1 in 10,000 get ataxia, goes away on it's own.

I had been given a drug for about 2 mos, older drug, probably 10 plus years. I get a call from CVS telling me the drug has been pulled by FDA, don't take another dose, to bring remainder in for them to destroy or to mix with water and let it dissolve so no one could get them. All those years, now they find it causes liver damage. So it's always best to let them know if you have an issue, even if you can't prove it is the drug.

We used frontline spray for decades, but then, we very rarely had fleas. So when traveling we use K9 Advantix II Flea, Tick and Mosquito prevention.

However, we are not in Israel and our monthly wormer includes flea and tick. I am not sure if we'll continue with a separate product.

[DebraDownSouth]

Okay so my friend called me back.
She said first, get off the Simparica as it is certainly capable of causing the tremors. They do resolve on own.

She said the increased values is a good sign it's early, as the more it progresses they can't produce something (I didn't have a pen to write it down), so that is the positive part. She agreed... changed to low but high quality protein and get started on subq fluids. If your vet is reluctant to teach you, there is a good video and also info on Mar Vista (they are superb, keep extensive library of information on line and the vet there will respond to email.).
http://www.marvistavet.com/subcutaneous-fluid-administration-at-home.pml

[JoeyQ]

@debradownsouth Thanks for all the information. Joey only had one dose. I returned the remaining to the clinic and the vet agreed to keep him off it. The incident was reported to Zoetis and my vet spoke to a vet from the manufacturer as well. I will report to FDA. Flea and tick meds going forward will be topical. Now I have to find an appropriate method to make his renal diet more palatable. Joey looked at me cross-eyed when I tried the coconut oil a 4th time. Low sodium chix broth or the water packed with tuna is next although trying to stay low on sodium.

[Rocky1]

Joey Q,
Why don't you just give raw a try or at the very least cook some chicken or beef with some veg.
Kibble of any kind is not ideal for dogs. A species appropriate diet is a raw one. Dogs didn't evolve to
eat kibble,I'm sure the native basenjis ate whatever what was tossed to them or whatever they could
catch. Our dogs would all be healthier if they stuck to a fresh,raw or gently cooked diet.
I'm sure your B will gobble up this type of diet.