March 11 – Progress with the new routines

Original by Mary posted as a recap to Hawksbill Cabin, May 2009 -

Gracie’s about the same, eating a bit more but it’s still a struggle. I’m getting used to sticking in the needle between her shoulder blades after pulling up some skin to form a “pocket” but I’ve got needle pricks in my fingers from my learning curve. Occasionally, she will bleed if I hit some capillaries. It’s a huge bore needle and Gracie flinches when I stick it in her flesh. Jim has become adept at holding the fluid bag and pushing the fluids to regulate the flow. But, Gracie’s a very calm dog and takes the pain stoically.

Jim sits on a chair to hold the bag up and I sit on the floor in front of him with my knees up around Gracie, sort of forming a corral. She sits between us and only gets restless towards the end of the treatment. She gets her G3Chews and Pet Tabs as a treat as we begin the treatment and after is rewarded with a few tosses of her fluffy soccer ball. The fluid collects under her skin and forms a big mound which eventually seems to move down around to the front of her neck. To make her more comfortable, we warm the fluids bag in a pot of warm tap water to bring it closer to her body temperature, and we warm a bath towel in the dryer and lay it across her back and sides as we administer the fluids. This acts to keep her calm and also helps keep her warm.

The carafate and blood pressure medicine are costing a small fortune for a one or two week supply, which is disheartening. I’m also buying five bags of fluid with set ups and needles from the vet every 10 days. The fluids cost about $10/bag. The medication regimen is fairly rigid, administering the carafate an hour or so after the others since it will prevent the other medications from being absorbed in the stomach. We have a follow-up with the vet next Tuesday. Hopefully, Gracie’s numbers will have stabilized—that’s about the best we can hope for at this point.

She’s still a trooper—enjoying our walks and the small fluffy soccer ball tossed up to her as she waits at the top of the stairs to catch it. She the rolls it down the stairs, starting the game again.

March 9 Follow-up

Mary’s recap of March 9 (recap originally posted on Hawksbill Cabin in May 2009)
Thankfully, Gracie’s rallied and is now home. We must now give her 500 ml of subcutaneous fluids every morning, plus carafate for her stomach, amlodipine besylate 2.5 mg every 12 hours for high blood pressure, Pepcid, plus her tramadol (1 to 1 ½ tablets twice a day for arthritis), G3 Chews for glucosamine and Omega 3 fatty acids, and a Pet Tab vitamin once a day. The pills are given in a Greenie Pill pocket, which she loves. She’s also still interested in Iams dog treats (weight control variety which is lower in protein than other varieties.)

Note from Jim, the emergency vet visit and overnights during the treatment and diagnosis were costly, with a vet bill in excess of $1,000.  As I’ve mentioned in some of the blog posts, this is part of our commitment to see things through with Gracie.  We are fortunate that we are in a position where we can make this kind of decision, and recognize that this may be a real hardship for others.

March 9 updates – post vet visit

Originally posted by Jim on Hawksbill Cabin, March 2009

It’s been a while since I’ve given status on Gracie’s chronic renal failure. She was diagnosed as being in final stage about six months ago, but the symptoms have only been noticeable the last two or three months, since January. Mainly, there is noticeable weight loss and she is losing strength – she can’t jump into the car herself anymore, and it takes a long time to climb stairs, for example. 

Food boycotting has been particularly troubling. She just won’t eat anything, it seems, having gone off her regular diet a few months back. Mary has even tried preparing meals for her using diets found on-line. Gracie would generally try these, but wouldn’t come back to a second meal.

Last week, Gracie lost about four pounds overall. She stopped drinking water, and wasn’t getting any fluids from her food since she wasn’t eating. Mary asked about it during a check up for our other dog Sofie, and the vet told her to bring Gracie in.

We did, and after diagnostics, they decided she was in a close to dangerous situation. We checked her in for the weekend, where they rehydrated her, and conducted additional diagnostics for possible kidney damage, calcium deposits, or tumors. Nothing there, the kidney failure is a chronic condition, simply because of old age – Gracie is 14 years old (Sofie is older).

Despite the gravity of her condition, you could still wave any toy in front of her and she’d be interested – rising to play, pouncing on the ball. She’s a trooper and there is strong Border Collie instinct here.  From this, Mary and I conclude that her time hasn’t come yet, and we decide that it is worthwhile – financially and from a quality of life perspective – to continue with the treatments recommended by the vet.

We checked her out of the hospital last night, and on the positive side, she is in high spirits.  They got her to eat baby food, with chicken, so we’re trying that.  However, there are new prescriptions and we’re going to have to do subcutaneous injections of fluids starting today (see photo).

Along with all of this news, it’s clear we are in the final stages. We are not sure how long we’ll have her with us at this point. So we’ll enjoy the time we have, as it comes.

March 6 – 8 Recap

originally posted to Hawksbill Cabin in digest format – May 2009

Gracie is in crisis—lethargic and weak – and has had to be hospitalized for three days with IV fluids, antibiotics, and a host of other medications. Her BUN and creatinine levels are through the roof. She’s down to 39 pounds, a loss of more than 12 pounds over the past year. The crisis has forced Jim and me to face the fact that Gracie may not be with us much longer. We are discussing how much intervention we think is appropriate for our dear girl. Our other old dog, Sofie, is anxious and nervous, looking for her missing friend.

February 27 Vet Visit – Mary’s Journal

(first posted to Hawksbill Cabin blog on 5/22/2009)

 Another follow-up visit to the vet for blood and urine testing today.

 Gracie’s been shivering and she’s still not eating enough. I’m trying hard to find prescription food that she will eat. She doesn’t like the Hill’s k/d or the Royal Canin Renal, canned or dry. I’ve tried to incentivize with small amounts of regular dog food, boiled chicken, fresh chicken broth, but she’s not interested. I’m trying her now on a homemade diet based on Hill’s canine restricted protein diet (from our vet, via the internet):

¼ lb ground beef, not lean
2 cups cooked white rice without salt
1 hard boiled egg, finely chopped
3 slices white bread crumbled
1 teaspoon (5grams) calcium carbonate (ended up grinding up eggs shells for this)

Cook beef in skillet until lightly brown, add rest of ingredients and a little water if too dry. Keep in refrigerator. Yields 1.25 lbs.  (Analysis: 6.9% protein, 5.5% fat, 21.1% carbohydrates, 65.5% moisture)

A 40 lb dog such as Gracie should eat 1.5 lbs of this mixture per day – one batch is slightly less than one day’s worth of food. (Daily amounts according to Hill’s: 5 lb. dog, ¼ lb of food; 10 lb dog, ½ lb of food; 20 lb dog, 1 lb food; 60 lb dog, 2 lbs food; 80 lb dog, 2 ½ lbs food; 100 lb dog, 3 lbs food).

Poutin’ Grace

(first posted 2/6/2009)

 On Sunday afternoon it was pleasant enough to sit out on the Hawksbill Cabin’s brick terrace and read. At first, I had Gracie and Sofie outside with me, but they kept wandering off in opposite directions and I had to track them down in the side or backyards, so I put them back inside.

About 20 minutes later, I looked over at the windows and caught site of Gracie in pout mode. She actually had fallen asleep with this disgruntled look on her face.

Gracie seems to be coming around these days. Mary has found the secret for getting her to eat the special diet, and Gracie has gained back the pounds she lost. We haven’t been to the vet in a few weeks, but things seem to be going well just now.

Status after the First Month

Canine Renal Failure – update 1 (first posted to the Hawksbill Cabin blog 1/26/2009)

Since I posted on Gracie’s diagnosis of canine renal failure on January 15, we have some updates. We did some web research on the situation.  The first thing we learned from other owners is that the disease upsets the stomach so the dog won’t eat.  This is what results in food boycotting, which we had been attributing to her not liking the food.

The advice we got on this was that it is most important to get her to eat – even if it’s not necessarily the (expensive) prescription diet.  So Mary has begun looking into alternatives, starting with the idea that we might be able to incentivize the food, and she’d checking protein levels on candidate incentives. 

 Also, we read on another blog that additives such as B- vitamins and safflower oil may be a help (readers finding this blog from a search on Chronic or Canine Renal Failure – please be sure to do your own due diligence, and check with your vet!). Our vet confirmed that these things can be helpful, but she wants to check the dosages the next time we are in. We look forward to that welcome advice.

We got her some Pepcid, and that seems to have quieted the stomach issues.  Mary is taking some extra care to make the food more attractive – it’s quite a project.  Now mealtimes attract quite a bit of canine attention as both dogs (Gracie and her sister Sofie, the Chow mix) stand patiently in the door of the kitchen, patiently as they can, that is. Mary says, “I’m just glad they’re domesticated!” when they finally charge in to the food bowls.

Gracie’s appetite has returned, and she is gaining some of the lost weight back…her energy is back – even during the stomach issues and weight loss period she still wanted to play.  She’s almost her pesky border collie self again.

Vet Diagnosis – January 9, 2009

January 9 Vet Visit (originally posted by Mary on the Hawksbill Cabin blog May 2009)

Gracie, our 14 year-old Border Collie, has been diagnosed with canine renal failure. Her kidneys have been weakening for about a year. In retrospect, one of the first signs was weakness in her legs; she wouldn’t stand for any length of time, preferring to lie down even if we stopped for a short time on our walks.

She’s also lost a lot of weight. She’s not eating, and really hates the renal prescription dry and wet foods. (And, it’s very difficult to get this special food, too. It either has to be ordered through a vet or bought on line – a big waste of money if the dog won’t eat it.  Petsmart sells canned Hill’s k/d and Royal Canin, but a prescription card is needed.)

Loss of appetite is another symptom of the disease. Apparently, the toxins built up in the blood by failing kidneys makes the dog nauseous and can even lead to stomach ulcers.

Thoughts on … Canine Renal Failure

(first posted on Hawksbill Cabin 1/15/09)

Gracie playing in the snow, March 2009.

I hesitate to write this post – while the blog is meant to journalize experiences, and is certainly personal, once I make this entry I’ll have started down a path revisiting this topic until a final post sometime.

This week our vet diagnosed Gracie as having entered the final stage of chronic renal failure, which means her kidneys aren’t clearing all the toxins from her body. She has progressed from a mild stage of the disease which was diagnosed last year.  About three weeks ago, she started boycotting her food, and we thought, okay – she really doesn’t like the food (a special diet, recommended by the vet, which we were using to treat the early stage with), and the battle to try and get her to eat it isn’t worth it.

So last week we went to the vet for alternatives.  In the meantime they tested her progress with the disease again, and found that she had lost five pounds over the last month, since our last visit.  It was an abrupt weight loss and concerned us.

We found another version of the special food, wet this time, and a second vet visit yesterday confirmed that her condition had improved.  Gracie is still a nut, driven like the Border collie she is, constantly trying to tempt us with her toys, as always. She even tried to convince a Page County Deputy to play football with her over the weekend!

But the simple matter is she is 14, and her body is starting to wear out. The vet told us that some dogs only live a few weeks with final stage renal failure – given the spirits Gracie is in, we don’t think this is the case for her – but it could be months until the end.  In any case, the news was that it is likely that we’ll lose her this year.