Caring for a Three Legged Dog or Cat
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As if synovial cell sarcoma resulting in a front leg amputation in late March, newly diagnosed lymphoma in the GI tract and mets to the liver were not enough, my 13 year old now has elevated BUN-96 and creatinine of 2.3 He was initially treated with doxorubicine. When the lymphoma was diagnosed he had metastatic disease in his liver and he was treated with CCNU and L/spar for 2 treatment and has had one CCNU alone. The liver mets are gone for now on the ultrasound as is an enlarged node in his stomach. The other spot of lymphoma is smaller so all this is good. However, his one week post CCNU#3 showed high BUN and creatinine levels. The oncologist said not to start fluids becasue it was too early and very unpleasant for the dog but my regular vet feels fluids would help. She wants me to give 100 ML twice a day for 5 days. I can do this at home subq and i have done it before with a cat. Both vets think my dog could be in early renal failure. My dog is lethargic in the morning but feels better and eats great toward mid morning. I think he is dehydrated as he has trouble drinking becasue of his facial paralysis, another affliction. He can lap for 5 minutes and the water level hardly goes down. I put a lot of water in his food-rice and boilded sirloin and pumpkin.
My questions:
Could dehydration cause the elevated BUN and creatinine?
Should he get any more chemo? Can the chemo be damging his kidney's?
Can fluids cause harm?
Can they help him?
Thnak you for all the time and help you give to all the dogs here. Usually I am very well informed by my wonder vets but this time i am at a complete loss becasue I am getting contradictory information and of course it is saturday and no one is available!
Susan
Susan,
I'm so sorry to hear about the elavated liver enzymes... It could be caused by so many things... age, diet, chemo, or cancer itself... From the #'s you quoted, seems like the kidneys are comprimised... but that could be just temporary... The creatine is still on the low end... so that's a good sign... I would listen to your oncologist for now... and redo the bloodwork in a week. If the levels get worse... it'll probably be time to start fluids. Is your babie's appetite still good? Have you switched your babie's diet to something low in protein yet? Has your vet recommended that or anything else yet?
Please keep us posted on what's going on...
Angel Jake's Mom
Jake, 10yr old golden retriever (fractured his front right leg on 9/1, bone biopsy revealed osteosarcoma on 9/10, amputation on 9/17) and his family Marguerite, Jacques and Wolfie, 5yr old german shepherd and the newest addition to the family, Nala, a 7mth old Bengal mix kittie. Jake lost his battle on 11/9/2009, almost 8 weeks after his surgery. We will never forget our sweet golden angel… http://jakesjou.....ipawds.com ….. CANCER SUCKS!
Susan - I'm not a Vet and this is ONLY my experience....please take it for what it's worth. Zeus was lazy during the last few weeks of August and I attributed it to the usual time of the year when the heat and humidity of the Northern Virginia area get to him. He always hated August so I didn't think much of it. When he started throwing up, I got concerned and after 2 days I took him in. We did a full work up and by this time his BUN and creatinine numbers were really high (much higher than yours) and his kidneys were smaller than normal. Not good. He stayed in the hospital for 4 evenings pumping fluids and he did fabulously. His counts were coming down and we were facing some kidney damage management, but I never expected the turn for the worst the day I was bringing him home. We lost him 6 hours after I brought him home. Everything just shut down on him and we had to make that heart wrenching decision....
Susan - I'm not an expert because I only dealt with this for a week, but from what little I learned, the lower the counts and sooner you get on fluids the better chance you have. You want to flush out the kidneys and level out the counts to see what you're dealing with. If there is minimal damage, my understanding is that it can be managed with diet (low protein like Jake's mom said) and meds. We had too much damage and the kidneys were over 75% gone by the tiime we knew what the problem was. I wouldn't wait to push the fluids...but I may also be over-reacting based on my experience.
Please keep us posted on your baby...hang in there. We're here for you.
Love Heather and Spirit Zeus
Heather and Spirit Zeus - Our life changing journey…from the earth to the heavens…one day at a time…always together
Thank you for your reply. I am so sorry you lost your Jake and so soon after his amputation. that must have been so hard, thinking that maybe the surgery woud help and then loosing him anyway. What rollercoaster we ride!
Actually my dog's liver profile is great. his mets are no longer visible on the lltrasound. that was a bonus as the target of the new chemo is his lymphoma. it is his kidneys that are the newest issue. i don't know if i should do fluids as reccomended by my regular vet. the oncologist says not to so i need another opinion. I don't see that they would hurt and it is hard to do nothing.
Thanks again and I my thoughts are with yiu and Jake.
Susan
Hi heather,
My post above should have gone under Angel Jake's Mom's reply. This reply is to what you wrote. I am sadden by your loss too and after a dramatic recovery, what a shck it must have been. I have read that the kidneys can been very damged before clinicakl signs appear and then it is too late. I guess we are lucky to have discovered the problem before he showed signs. I agree with you but I too am not a vet. it seems to me, the earlier I start treating the kidney failure, the better. Thnak you for sharing and I am going to give him some fluids nowm, at home, under the guidance of my reglar vet. i don't think i can do any damage. there is a danger of infection because his WBC is very low from the chemo 11 days ago. maybe thta is why the oncologist was against fluids. i will probably have to wait until monday to talk to her.
Thank you for your support.
Susan
Hi Susan and "13 year old dog" ("dog", what is your name?)
Pam is the only one who is qualified to give you the info you need, but I will also pipe in for the meantime. My dog Tazzie (don't get confused because Pam's dog was also named Tazzie), entered the cancer world with Creatinine values that were on the high side of normal, presumably due to acute kidney failure from getting into Advil when he was 18 mos old (he will soon turn 9 yrs old).
We started with Doxy for chemo and alternated with Carboplatin. Kidney values remained stable on Doxy and I do not think that doxy is supposed to affect kidney values. The Creatinine increased after one Carboplatin treatment and remained high for about 8 weeks. Carboplatin is supposed to be quite safe on kidneys, and is used instead of Cisplatin for that reason, but my dog's prior condition probably put him at risk. I know nothing about the other drugs you mention (CCNU).
I would think that fluids would only help not hurt. The main reason I am writing is something I did the last 6 weeks, which might have helped my dog's kidneys. He is currently on Metacam (not good for kidneys) and Cytoxan (not as bad as metacam but not good on kidneys either). When starting the Cytoxan, I started giving him what I call a "vegie flush" throughout the day. The reason was to keep the Cytoxan from causing problems - crystals - in his bladder, which can happen if it sits in the bladder. We just did bloodwork and the Creatinine is well down into the normal range - it is not even sitting at the high side of normal as it has been for years until this recent jump into the high zone. I can't say for sure it is due to the vegie flush, but it seems the most reasonable explanation, plus my vet thought it might be good for the kidneys when I first began.
What I do is get a big pot on the stove nearly full of water. Add lots of chopped broccoli, a couple of carrots, cabbage (doesn't really matter what you use as long as it is not toxic (no onions!) but this is what I have used). I boil and then simmer for about 40 mins. I give him a cup of vegie water a few to several times throughout the day (you might need to be careful at night depending on your dog's bladder ability). He laps it up like a treat. Unfortunately I discard the vegies (which are pretty much pale pulp). Some vegies are healthy, but this would be too much! He has been drinking 1-2 liters of vegie water per day for the last 6 weeks. (I did not want to use prepared broths because of all the salt in those.)
Previously, I had put water in his food, but this way he doesn't have to take in more protein or food with the liquid. But with your dog's facial paralysis, it might not be a good option (and maybe IV is your best option for that reason).
My dog has never peed much, but now he has no choice given all the water he takes in. Of course, this is not the same as a saline IV and might not be sufficient if your dog's values are really high, but I just wanted to throw it out there.
Susan & Tazzie 2
I'm so sorry to hear about your pup. I too am not a vet but my dog's tumor triggered kidney problems so he was on Enalapril and special diet. If you haven't already I would try to cut down on protein and feed a very pure diet as possible that he will eat. It sounds like you might already be doing that by feeding rice and pumpkin. If I were you I would probably stop the chemo because it can be making things worse and unfortunately if he is at the point of no return in is kidneys and actually in failure then that is the number one priority over any cancers. Fluids are good unless the albumin level is low in which case it can lower it even more, but since you didn't mention albumin level I'm assuming it's ok. My dog Mac had problems drinking as well and I had to fill a syringe with water repeatedly and squirt it into his mouth in order to get enough fluids. Since you know how to administer IV fluids and it's been recommended by your regular vet I would go ahead with that as it is probably actually less stressful than trying to force it in orally.
Thank you Susan and Jackie for your suggestions,
My dog's name is Beacon. We even had an Avatar on this site but it has disappeared!
His oncologist called me last night and I feel much better after talking to her. What a great vet she is.We agreed to do the fluids. I do not know how to do IV so I am doing subq. the problem with that is it is not possible to give enough fluids subq to a large dog-55 pounds-to make a difference. i am trying however, and we will redo his UA in 3 days.
The chemo we are using does not damge the kidneys so if his attitude is good, we will do the next dose in about 10 days.
Thnak you Susan for the vegie flush receipe but I know he won't drink it. The oncologist suggested freezing his food in small bite size pieces and feeding like treats. I put it in ice cube tray compartments. He thinks it is just great and is eating them up!. He makes me laugh!
Because he is eating reluctantly, until i froze his food, weird, i don't want to change his food just yet. i will have to if his condition worsens, when it worsens.
Thanks again, you guys roc!!!!
Susan
I love the idea of freezing the food. Emily did not have problems eating or any physical problems with drinking that we knew of (we found out she had a large tumor pushing on her esphagus) but towards the end she did not drink as much as I thought she should. She was prednisone so she should have been thirsty all the time. If I made small ice cubes and fed them to her she would eat them. I didn't fill the tray to the top though as those seemed harder for her to eat. I am guessing because Beacon has partial paralysis that the big cubes might be to hard to handle. You may already be doing this but just in case you aren't I thought I would throw the idea your way.
Please keep us informed. Beacon will be in my prayers.
Debra & Angel Emily
Debra & Emily, a five year old doberman mix, who was diagnosed with an osteosaecoma. She had a right rear leg amputation on May 19, 2009. On November 10, 2009 she earned her wings and regained her fourth leg.
suespin said: We even had an Avatar on this site but it has disappeared!
Welcome back Sue! We are sorry to hear about Beacon's latest issues, but glad you checked in here.
Things have changed quite a bit around here since you last visited. Here are the new instructions for uploading your user avatar, and information about the new and improved Tripawds Blogs community.
Too bad you missed last night's ask a vet chat! Hopefully you'll get some answers to your questions here.
Tripawds Founders Jim and Rene
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Hi Susan and Beacon
Tazzie also liked the ice cubes, which I made out of meat broth last summer, and I recall Cherry eating frozen food when she was particularly picky. So it does not seem unusual. They also seem to like the idea of eating from our hands, don't they.
Glad your vet was helpful. Best of luck.
Susan & Tazzie 2
Sorry for the delay but I was out of town last night and not near a computer. As your oncologist has already told you CCNU does not usually affect the kidneys (mainly liver or bone marrow). I agree that it his hard to give enough fluids SQ to a dog that large so IV is definitely preferred but may not be needed yet. I would not feed this dog a high protein food unless your oncologist says it is okay. Was there any protein in the urine? If so then benazepril or enalapril can slow protein loss through the kidney.
Most likely this is just kidney insufficiency due to age but sometimes lymphoma can also affect kidneys and that would be seen on ultrasound. I would recheck blood values frequently to stay on top of things.
It sounds like your dog is quite a fighter! Good luck with the lymphoma treatment.
Pam
I never really left but things were stable for a long time and that was so nice. I am sorry I missed the chat but I was just too beat to join. I would have loved to hear it. When is the next one?
I will work on the Avatar soon. I did notice that many others were missing. It's great that you are always updating and improvng the site. I feel so much better knowing all these wonderful people are here together, helping eachother.
Thank you for having this site for us,
Susan
Hi Pam,
Thnak you for your reply. I can't do IV without some further instructions so that will have to wait. With his bone marrow supression from the CCNU I don't want to take him anywhere, plus the stress etc. The oncologist also said the kidney insufficiency may be unrelated to his lymphoma and that he would have gotten it even without the cancers etc. I think that even though I have accepted that Beacon has 2 cancers and that I was shocked to learn of his kidney disease, it will be the cancers that finally get him. He is a fighter and I have learned to fight with him. I won't stop until he does.
I have to laugh at him, however, eating frozen food like it was something really special! How silly is that. Beacon has made me laugh for 13 years and is still doing so. Next time I boil up his chopped sirloin, I will make ice cubes from the broth as Susan and tazzie suggest-great idea.
Thanks again, i think we are all set for the moment, but tomorrow is another day-which is wonderful really.
Susan and Beacon
suespin said:
I would have loved to hear it. When is the next one?
We posted a transcript here. Subscribe to the Live Chats Forum for announcements, or schedule your own, anytime!
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
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