Tag: supplements

Treatment and Diet

Percy was very young when we discovered that his kidney functions were dramatically abnormal. Though his nutritional needs were still in many ways that of a less-than-four-month old pup, to ease the strain on his kidneys he would need a special diet  low in protein and phosphorus. On the vet’s recommendation I started with Purina KD kibble  and added some canned food from the same line or from Royal Canin. Percy loved it all, so that was no problem. I had concerns about this kind of diet for such a young, growing pup. However, it was simply a question of picking the lesser of evils.

Over the next two months I gradually transitioned him to an all homemade diet. I did this because I felt it would be better for Percy– the special kidney diets from Purina, Royal Canin and the others contain a lot of fillers– but I took that long to do it because I was worried about getting the right balance of nutrients for him– his body was still trying to grow– and about unwittingly doing more harm than good if I got it wrong.

The two central issues were protein and phosphorus: both had to be very low, especially low given Percy’s age.  A pup of his age normally would have a diet where protein constitutes close to 30% of total intake, but I  whittled that down to 10% and less as his numbers– BUN, creatinine, phosphorus– continued to remain high.

For phosphorus, I used the tables on the aforementioned site about kidney disease, Dog Aware (& see Links page), as a guide to know what foods contained phosphorus and in what quantities.

So about once a week I would bake up pans of winter squashes and sweet potatoes, mash them up and add the most highly usable, lower phosphorus protein with some variation. There was always some egg, egg being about the most perfectly usable protein source there is– but the yolk is high in phosphorus, so needed to be used judiciously. I often poached chicken thighs with skin and then removed from bones and shredded. I used the poaching liquid as broth that I would warm to moisten the food at mealtime. Fatty fish would have been a great protein source but many fish are high in phosphorus, so were added sparingly. Beef, pork, lamb were all in the mix at times depending on and in relation to what else was appearing that week. I would add some grain, like barley– not very much rice as it didn’t seem so digestible for Percy after his long bout of loose stools– and vegetables such as sauteed kale or another dark green; applesauce if I’d made some; bits of butter for additional fat and energy were mixed in as well. All of this was weighed individually to get the correct proportions– so say there was 100 oz. total food mix, the protein could only constitute 8-10 oz. of that total. This was then mixed in giant bowls and put in large tupperwares in the frig.

At mealtime I heated chicken or beef broth, homemade or good-quality bought, to pour over the food for warming, and mixed in his medicines and supplements, and usually once a day added a little dairy for deliciousness, because Percy was crazy for it– a small spoon of yogurt or quark. He was known to lunge into the open frig if there happened to be a pitcher of milk resting there, and in a split second would begin lapping it up. Rather than weaning him to two meals/day as I normally would have when he reached five or six months, he remained on three meals a day to to not overwhelm his body processes. He got a heaping cup of the homemade mix per meal, plus the following:

breakfast

  • probiotic from Nature’s Farmacy
  • ground flaxseed
  • colostrum powder
  • Alternagel
  • milk thistle
  • slippery elm
  • multivitamin
  • Gastrodia 9
  • Azodyl cap
  • Epakitin powder

lunch

  • Alternagel
  • colostrum
  • slippery elm

supper

  • cod liver oil
  • colostrum
  • slippery elm
  • milk thistle
  • multivitamin
  • Gastrodia 9
  • Antler 8
  • Alternagel
  • Azodyl cap
  • Epakitin powder
  • Cholodin chewable

The slippery elm and colostrum varied depending on how Percy was doing: when his stools were fine, I reduced the amounts.

The Alternagel served as an additional phosphorus binder.

Our regular vet prescribed the Epakitin and Azodyl, while the other supplements were on the recommendation of our holistic vet.

I also used two flower essences for Percy, from Green Hope Farm’s Animal Collection: Kidney Vetch and Flow Free. http://www.greenhopeessences.com/

As you can see, this bordered on a full-time job at times, but with some organization it was manageable. Oftentimes I would simply cook larger amounts of whatever vegetable or grain I was otherwise preparing, for example. Percy was so sweet and deserving; preparing his food allowed me a sense of helping him, though I had no proof that a homemade diet made a difference.  It just seemed and felt better.

If I had to be away for a long day I had a wonderful person to come in. I was loathe to leave Percy alone for any length of time because of the seizures.

Though his diet had to be carefully controlled in many regards I also let him have normal treats, like the occasional marrow bone that he and Nocci could go off and chew outside. I wanted him to enjoy his life as a dog as much as possible.

Clip of Percy and Nocci having a biscuit

November – December 2009

While October had just seemed an unreal series of events, especially after mid-month November began to be more real. Though Percy still seemed healthy and active, I began to see slight differences: he did sleep a little more, perhaps, than what I remembered our other puppies doing. There were moments or days where something seemed a little off. But I hoped I was just looking too hard.

Then, after a respite of almost exactly two months, he had his third seizure, late in the evening of November 18. Then his fourth, around 3 a.m. November 22. Those in the middle of the night were surely the worst– perhaps for Percy, robbing him of rest, but certainly for me, coming up from whatever stage of sleep to the sound of Percy’s howl as he began the seizure was pretty horrific. I began to feel the exhaustion of the months I was a new mother with middle-of-the-night feedings, 20 years earlier, but now rather than nurturing my son into life I was watching my puppy die. All I could do when Percy seized was to witness it: I held him as I could without wanting to get in the way of his body movements, and I always spoke to him, wanting to believe my voice somehow made a difference. The seizures lasted perhaps two minutes, and then Percy would come back, and try to get up, but stumbling crazily he would crash into things and fall over. He did not want to be contained or restrained, though, and I did not want to increase his agitation and possibly provoke another seizure. In those first months he consistently urinated during the seizures so I would change his bedding and try to clean his fur– he didn’t like this– and hold him until he would settle again into sleep. And I would eventually drift off myself, wondering when the next one was going to strike.

A few times Nocci’s behavior told me a seizure was coming: once I woke in the middle of the night to see him pacing anxiously, and within a few minutes Percy seized. This was not consistent, and as time passed I wondered if Nocci sort of turned this off; he too wanted some state of grace, to be in denial and if he didn’t predict what he felt was about to happen, maybe it wouldn’t happen. But that of course is my human analysis, and I can’t know.

From those two November seizures there was a lull of just over three weeks. The lulls allowed me to think that maybe things were getting better, or at least that they wouldn’t get much worse. Our vet had advised thinking of starting Percy on phenobarbital, before the seizures became so frequent and/or severe as to become a determining factor beyond the JRD. But knowing the possible marked side effects, unpleasant especially for such a young dog– lethargy, dullness– I resisted making that step.

In the meantime, Percy was also having digestive issues– he ate well but his stools were consistently extremely loose– like liquid– and voluminous to a point that I wondered if he was absorbing any nutrients. In November, I consulted a holistic vet who practices alternative as well as traditional medicine, and among other supplements we started Percy on powdered colostrum, which healed his digestion almost immediately. Following more bloodwork she also thought Percy could benefit from adrenal cortex injections. I was under no illusion that anything we could do would make his disease go away but I wanted to make his life, what he would have of it, better– more comfortable, more normal, if possible. So I began the injections.  Around mid-December the holistic vet also recommended giving Percy fluids through an IV over several days to help his system beyond what his kidneys were unable to do; we began the series. But after the second day Percy had what was now the fifth seizure of his life, December 16; the following night he had another, the first time he had seized on subsequent days, so I ceased the IV flushes. Though there was no way to know if there was a correlation, and logic said giving him the fluids could only help his system by giving his very weak kidneys a rest rather than overload him in any way, I’d become suspicious of everything. I also stopped the adrenal cortex injections.

Percy had the last of this series of seizures December 18. I remember going to get our Christmas tree the following day with one eye on him continually, as there were multiple moments he seemed about to seize. But he didn’t. He was very weak that weekend, not himself– he mostly slept and had none of the puppy energy left, at all. He would go off to the other side of the house to sleep, whether to be alone or because he was hypersensitive to noise and light. But I would continually go to check him, as his going off by himself to sleep could presage a seizure. I feared he would not make it to Christmas. But after a few days he rallied. I continued  to resist beginning the phenobarbital– illogically, it may seem in retrospect, but I simply didn’t want to subject him to anything worse than what he had been born with and had to contend with daily. But he seized twice more before the month’s end, and I realized couldn’t ignore that the seizures had to be treated.

 

November 12 BUN 152, creatinine 4.5, phosphorus 9.8

December 15 BUN 125, creatinine 5.0, phosphorus 13.2