How much medication is too much?

Hello

My Westie of 14 years and three months has very rapidly developed a condition of the kidneys.

I'm trying to help my Westie with benazepril 5 mg, but he was also prescribed Dried Aluminuim Hydroxide. Because he simply won't eat anything at all I can't get this into his system. I also have a Antepsin Suspension to help line his stomach and alleviate his sickness.

I know he is an old dog, but I just feel that this is too much medication. I have also noticed that since I am squirting the Antepsin suspension directly into his mouth, his saliva is very sticky, more like treacle and extremely smelly. I thought this may be due to an abscess in his mouth but on close inspection his gums and teeth look okay for a dog of 14.

I know I can save him and am not ready to let him go yet, I know this is quite selfish, but he is has been so strong all his life I am desperate to get some nutrition into him and I am sure he can get help.

Should I use Dried Aluminuim Hydroxide as well as Antepsin as they both appear to be doing a similar function of reducing acid in his stomach? He does not appear to have constipation but it is his appetite I am worried about and from what I can gather benazepril should improve his appetite.

Can anyone help?

Thanks
Mark Almond, Manchester

Richard Allport, vet, advises…

Interestingly, Benazepril is licensed to treat congestive heart disease in dogs, but not kidney disease. Even more interestingly, some lists of side effects for Benazepril in dogs include loss of appetite and nausea (although for cats usually an increase in appetite is noted). However, if your vet has prescribed any medication, don’t stop giving it without discussing it with your vet first.

Without knowing the extent of the kidney problem it’s difficult to suggest what medication could be stopped and what else used, but a good natural anti gastric irritant is Slippery Elm powder, and a good natural way of stimulating the appetite is to ask your vet to give weekly injections of Vitamin B12 for a few weeks, and to dispense Nutriplus gel. This is a tasty gel, full of vitamins and minerals, that usually gets dogs eating pretty quickly.

Offer him warm food, consisting of attractive morsels of minced beef, or chicken livers, or anything you know he would really enjoy. In addition there are homoeopathic and herbal kidney support medicines available (but you would need to ask your vet to refer you to a holistic vet to get these formulated and prescribed).

Don’t give up on your Westie – I’m sure there’s life in the old dog yet!

Living with GCKD

I have a dog (a one-year-old Italian Spinone called Mylo) who was born with one kidney and it's also been discovered that he has GCKD (glomerulocystic kidney disease). Mylo is on lots of medicine and a special renal diet so he can never put on weight like my other six-month-old Spinone can.
Mylo was born with GCKD but has always been very active and full of life. When we heard of the condition we knew nothing about it, always thinking only older dogs had kidney problems. The vets gave him no longer than six months; we found out when he was three months old. It was very upsetting and no one knew much about GCKD, so we took him to a specialist who did tests, scans and a biopsy, and we now believe that Mylo is the only living case of a dog with GCKD. The other animals were discovered at post mortem.
When we found out we had no clues about GCKD or what to do. Does anyone have any information about the condition? Has anyone heard of another case of a living dog with GCKD?
It would be excellent if this could help someone else, I know I read all I could but felt very lonely.
Anne, by email

Taking on a puppy should be such a happy time, so it must seem very unfair that you have had these health worries with your Mylo for most of the time that he has lived with you. I do hope you are still able to enjoy the good times – I am glad that you describe him as ‘very active and full of life’. You certainly have your hands full with two young Spinones!

I am thrilled that Mylo has lived beyond the life expectancy he was predicted. I must admit I do tend to fight shy of giving an idea of how long a pet with a serious health condition will live, because it can be a double-edged sword, but I do know that it can help owners to understand just how grave the outlook might be.

Being able to survive with one kidney is, I think, common knowledge but it is essential for that remaining kidney to be healthy and functioning properly. For poor Mylo, this is sadly not the case. We do have far more resources to hand for the management of renal failure than was previously the case. Early diagnosis enabling early instigation of appropriate diet and drugs will undoubtedly have stood Mylo in good stead.

I do hope Mylo continues to lead a full and active life for as long as possible. Do keep in touch – you needn’t feel lonely when there is the Dogs Today Think Tank.

Alison Logan, vet

Holistic kidney advice needed

Hello.
I don't know if you can help. I just need some advice. I have about four years back issues of Dogs today magazines and I'm sure you have covered this before, so if you could point me at the right issue that would be good. If not I will go through them all! It won't be a hardship!
My beautiful boy Bosley dog has had a problem with incontinence that has got worse lately. For a while he has been treated with propanol syrup which worked at first.
He became that way when he was 14 and had to have an MRI scan.
We think they may have pumped too much fluid through him while he was under and it broke him a little bit (The vet sort of confirmed this).
For the last few months he's got worse. It's like a leaking tap and happens when he is asleep mostly. He sleeps a lot these days as he is nearly 16.
He has been in the vets today for an ultrasound and more blood tests.
The blood tests have shown up possible kidney disease but not definite as the results were not strong enough as it is not advanced enough.
But all the symptoms now point to that too.
Urine samples show it's very diluted indicating that the kidneys are not doing their job.
The ultrasound showed that his kidneys were shrinking too.
His back legs have started dragging a bit and we think it is connected.
He is also very stiff and his front legs give him trouble sometimes.
He has been on loxicom for that but after today the vet says that he can't have that as it's not good for kidney problems. He now has 2 tramadol to take a day (I will be googling those tomorrow).
So basically what I am asking is if anyone knows of any holistic remedies that we can give him to help his kidneys?
Our vet has put him on another Hills prescription food, and while I do trust our vets I would like to know if there is anything else I could do to help him.
He's so happy most of the time, still has lots of puppy moments and our life revolves around him.
I know he's old and I have to face the inevitable but we just want to help him as much as we can.

Thanks.
Sue Bridle
Further to this, have you heard of a product called Tripsy that is available in the US? It is herbal and it treats kidney failure. I just wondered if you knew anyone who has had experience of it? There are lots of good reviews but you never know if to trust them!

Making the diagnosis

My vet has tried without success to find out what is wrong with one of my dogs, so I am hoping that someone reading this blog has come across a similar case.
My dog is an 11-year-old mongrel (a collie-terrier cross type) weighing about 10kg. She was first blood-sampled about a year ago and this has since been repeated twice. Each time the results have suggested either a liver problem or Cushing's Disease (i.e high cortisol and alk./phos. levels). She has had an ultrasound scan of her liver and been tested for Cushing's three times (2 x ACTH and a dexamethasone test). The scan did not identify an obvious problem and she tested negative for Cushings each time. However, I am very worried about the long-term effects of her having a high cortisol level. She was initially blood-sampled because I noticed a significant change in her coat, and because she started drinking more than normal. Her coat is now shorter, finer and softer than previously, and she moults more - although she does not have any bald patches. She was drinking a large quantity in the evening and then was incontinent through the night - usually not emptying her bladder completely. The blood results showed normal kidney function, and therefore I now remove her water bowl at 8pm to prevent 'accidents' overnight. She doesn't appear to feel off-colour and can comfortably complete a 45 minute walk, provided it is not hot. Please, please can anyone help?
Claire Murison, by email

It can be notoriously hard to make a definitive diagnosis of hyperadrenocorticism or Cushing’s syndrome. Veterinary medicine is not an exact science! One reason is that we vets are much more aware of the possibility of Cushing’s syndrome than was the situation twenty years ago, so we are trying to diagnose it at an earlier stage.
It is not often that one encounters a dog showing all the classical signs of Cushing’s syndrome which include the three p’s (polyphagia or ravenous appetite, polyuria/polydipsia or increased urination and thirst), pot-belly, blackheads, bilaterally symmetrical hair loss on the flanks, and panting. There may be only a few of the signs present. One of my patients was investigated for a voracious appetite – that was the only sign of a problem that he showed. I am a little concerned, though, when you say that blood tests have shown a high cortisol level, as well as raised liver enzyme levels. I wonder whether you mean high cholesterol levels, which are a common finding on a basic blood screen for a patient with suspected Cushing’s syndrome, and would have led on to your vet advising the more specific stimulation and depression tests for Cushing’s syndrome.
If your dog does have raised cortisol levels, then it would be worth repeating the specific tests, and I think it would be worth doing that anyhow. I can think of at least two of my patients who have looked cushingoid to me but yielded negative or non-conclusive results on at least two occasions, but have eventually given positive results. It does happen!
If your dog has raised cholesterol levels, rather than cortisol levels, then a different endocrinological or hormonal problem might be present. Changes in hair coat occur with an underactive thyroid, for example.
Do go back to your vet because, as you rightly say, your dog does have a health problem which needs diagnosing.
Alison Logan, vet