[Bev A]

My 14 year old Teacup poodle has been having high BUN levels. The other day when they rechecked it was up to 77. I saw a post by Shawna that there was nitrogen trapping which sounds great. Bitty is 4 pounds and the pickiest eater you will ever come across. It has been a challenge her whole life to find food that she likes and then she will only eat it for so long and that is it. Now I have heard they won’t starve to death but I totally disagree. She was lonely after the loss of another poodle and refused to eat. She lost a whole pound and they were trying to prepare me for her death. It was only by accident that I found if there was another animal about she would eat. I am on a very limited budget but Bitty has been with me so long and I want her healthy. She doesn’t seem to be in pain and is still very active. So my question is if I do the nitrogen trapping how much of it do I give her. I have switched her diet to science diet KD and malt-o-meal with cream and turkey gravy. She is eating that fairly well but it has been 4 days so who knows how much longer that will last. She also has seizures which she has had for years but is very well controlled on Phenobarb twice a day.

[Bev A]

Any advice for this is welcome. Bitty has gone 24 hours without eating. I give her goats milk in a syringe when she does this.

[anonymously]

She is old, I don’t want to upset you, but it may just be her time. You could take her to an emergency veterinary clinic (no appointment needed).
Let them run some tests and see what they advise regarding aggressive treatment vs keeping her comfortable. Or call her regular vet, if you think that would be helpful.

If she is nauseas, forcing her to consume things might make her even more uncomfortable and prolong her agony.

PS: I hope I am not coming across as harsh, I understand your distress and I wish you and your dog well.

[Coonhound Mama]

I would agree with Anonymous. This sounds like a job for your local vet and it very well could be age related at this point regardless of her previous dietary history. I’m so sorry for your little pup though and I hope things get better for her soon. <3

[Bev A]

She has done this all her life. I know she is old and no I don’t consider you harsh but it is the way she is. But I am always on the lookout for something she will eat for more than a few days. Am hoping to hear from Shawna at some point on amounts of probiotics and fiber to bring the BUN down. She is as active as ever. The vet doesn’t know what else to do for her either. She has been her vet for her whole life and she is always amazed that she has made it for so long. I think she just has a strong will to live. No nausea either thank goodness. We have gone through that as well. But right now is just pure stubbornness. Thanks for your replies.

[anonymously]

Not wanting to eat is a symptom of nausea. I would not advise taking advice from a stranger on the internet as good idea right now (myself included).
If you want to identify any further treatment options….see my previous post. Best of luck

PS: I have a 15+ year old senior I have to assist so that he can have a bm. Can’t leave him alone for more than 2 hours. I get it. I focus on keeping him comfortable, he has a good appetite…in fact, he is hungry all the time. I took him in for a geriatric workup not long ago, his lab work is better than mine.

[Bev A]

Yes, it certainly is/ I would agree with you if was my other dog. Bitty does have nausea at times but you can always tell when she does. She will demand treats after a while and I will give her the food I have offered before. She still won’t eat that but will continue to demand treats. It is a merry go round with her

[Bev A]

I learned a long time ago not to fall for wanting treats. She would eat them around the clock if I would let her but I know they aren’t good very often.

[anonymously]

I give my senior 4 or 5 small meals a day, that seems to help. Another thing to consider is that dogs get dementia just like humans, they are confused about mealtimes.

[Bev A]

I wish that worked. Bitty is 4 pounds. She is lucky to eat a tablespoon of food a day. I would be thrilled if she would eat that often.

[anonymously]

I figure if he is at the end of his life and it makes him happy, so be it.

[Bev A]

I think that when that time comes she won’t want the treats either. But I agree. Make them happy and comfortable.

[DogFoodie]

Hi Bev, I let Shawna know that you were hoping she might chime in regarding your pup.

I hope you have many more happy years with your pup!

[Shawna]

Hi Bev A,

I don’t come on DFA, and especially the forums, that much any more so didn’t see your post. Betsy alerted me that you had asked me a question. Thanks Betsy!!

Probiotics and certain prebiotics do help lower BUN – even the Merck Vet Manual agrees “feeding moderately fermentable fiber can facilitate enteric dialysis and provide a nonrenal route of urea excretion.” Unfortunately it seems most vets don’t know this yet. 🙁 http://www.merckvetmanual.com/mvm/management_and_nutrition/nutrition_small_animals/nutrition_in_disease_management_in_small_animals.html

How high is your baby girl’s creatinine? Creatinine is more indicative of how the kidneys are doing. BUN can be elevated for additional reasons besides the kidneys. Example — feeding kibble (even KD prescription kibble), while simultaneously not getting enough water, can increase BUN. Does she have unlimited access to water and does she drink often? If you are feeding KD kibble, I would HIGHLY recommend switching to Science Diet’s KD canned foods — they have three of them (one is egg based, one is chicken based and one is beef based). Mixing up the canned food could keep her eating better based on her history. IF her creatinin is on the low side of high AND you can get the BUN down by feeding canned food and giving probiotics/prebiotics, you can also consider adding some higher protein, lower phosphorus toppers to her food and see how she does. The Merck Vet Manual has some info on this too. “In addition, research in dogs is also showing that higher protein levels than what are typically used in most therapeutic renal diets is beneficial as long as the diets are phosphorus restricted. Energy should be supplied primarily via feeding relatively more digestible fat and carbohydrates.” As stated, most of the “energy” in the diet should be fats and appropriate carbs but adding the right kinds of protein can help as well as being more appealing. For now, while the BUN is high, don’t mess with adding anything with protein, including treats, to the diet. If she likes organic, extra virgin coconut oil you can add small amounts of that to each meal and blend it in well so she doesn’t pick it out. It won’t add to the BUN. Oh, and I do like raw goats milk.

Changing from a kibbled diet to a canned KD diet should help reduce BUN. Adding a GOOD quality probiotic (I like Primal Defense by Garden Of Life or the product at Mercola Healthy Pets website) and the right prebiotic can help further reduce BUN. Adding the wrong prebiotic (fermentable fiber is another term) can make things worse as they ferment in the wrong part of the digestive tract apparently. The product I found the most beneficial for my KD girl is called acacia fiber. NOW brand makes one. http://www.nowfoods.com/Acacia-Fiber-Organic-Powder-12oz.htm

If she’s never been on probiotics and prebiotics before then I would introduce them slowly over several weeks period. My Audrey was 9 pounds and I gave her 1/2 of a Primal Defense and 1/8 tsp of acacia fiber in her food as needed (when I noticed she seemed off). To start out I would give maybe 1/8 of the probiotic for a few days. Then continue that dose but add a pinch of the fiber for a few more days. Then increase the probiotic to 1/4 but leave fiber at 1/8 for a few more days. If you don’t see any symptoms you might be able to go a little quicker. If you do see symptoms you might want to decrease the amounts being given a bit. Given to quickly to dogs not used to them, probiotics can often have diarrhea as a symptom as an example.

Let me know if you have any more questions for me and let us know how things are going.

Good luck to you and your baby!!!

• This reply was modified 8 years, 5 months ago by Shawna.
• This reply was modified 8 years, 5 months ago by Shawna.

[Shawna]

PS — the malt o meal with turkey gravy won’t increase the BUN much as it’s lower protein but it is decreasing the protein of the overall diet and KD diets are already very low in protein. The kidneys need adequate protein to be able to filter properly (referred to as GFR).

Here’s a little blurb about it if interested
“In 1923, Addis and Drury [45] were among the first to observe a relationship between level of dietary protein and rates of urea excretion. Soon after, it was established that increased protein intake elevated rates of creatinine and urea excretion in the dog model [46]. The common mechanism underlying increased excretion rates was eventually attributed to changes in GFR [47,48] and Van Slyke et al. [49] demonstrated that renal blood flow was the basis for GFR mediated changes in clearance rates in response to increased protein intake” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1262767/

Protein INCREASES excretion of urea (also referred to as BUN) and creatinine by helping move them through the kidneys more efficiently.

• This reply was modified 8 years, 5 months ago by Shawna.

[Bev A]

Thank you Betsy!
Thanks Shawna for answering me. Bitty drinks plenty of water, I always keep water in the bedroom as well and she gets off the bed a couple times to get a drink. Through all of this she has had a good water intake. Even when she was trying to starve herself because she was lonesome she would drink. She lost a pound that time and it was by accident that I discovered she was lonesome. I had taken her to my girlfriend, she hadn’t eaten in days except for the goats milk. My friend had cooked a pork roast and she offered her some. She turned it down but then her cat walked in. Bitty jumped right down and ate the whole dish.
I am not sure what the creatinine is. It was ok three months ago. And I am sure they checked it but it was the BUN she was concerned with. I am sure I can get a copy and will do so this week.
Bitty eats canned food all the time. She has very few teeth left so canned is about all she eats. It is the Science Diet KD that I feed when she will eat it. But this has got to be the pickiest dog I have ever had in my life! She will eat it for a few days and that is it. I tried the Weruva which they said no dog would turn it down, haha! I keep goats milk on hand for when she refuses to eat. After a couple syringes of that she will usually eat so I won’t give her more. I picked up a can of the Holistic grain free today when I went to see my doctor and did some shopping after. She was hungry I guess because she ate 2 tablespoons. But tomorrow she may not. She was eating the malt-o-meal which is why I was giving it to her. It is mixed with heavy cream and turkey gravy, but today she decided she didn’t like it.
I really am not sure how to add more protein when she is so picky. Once in a while she will eat a scrambled egg, but she turned that down this morning as well. When I make her food at home I always crush calcium carbonate into the whole batch so she is getting that as well. I have found the acacia powder and the garden of life. Should I also add the Renal Support? I think I will have to crush and add to a bit of water or goats milk or she won’t take it. If she thinks it is in the food, she will stop eating again. she is so ornery! Thank you so much for responding. You are awesome! I didn’t know how else to find you and just hoped it would work by coming here.

[Bev A]

PS, thanks for the websites. I really appreciate that. I have done research and wasn’t finding a bunch. My vet didn’t know anything about the nitrogen trapping and wasn’t too keen on giving her more since she is so tiny but I am willing to try if it brings the level down.

[Bev A]

Well I picked up Bitty’s test results and the Creatinine level is a little high. It is 1.6. I wonder if that makes a difference in what I give her in the supplements.

[Shawna]

Hmmmmm? Creatinine is only a little high… Something doesn’t jive here. I’m sure there are exceptions to the rules but creatinine is a better indication of how well the kidneys are actually functioning (from everything I’ve ever read). Maybe newer data is suggesting different but data on this site, veterinary medicine dvm360, published in 2011 still agrees “A serum creatinine concentration is the most commonly used measure of severity of renal dysfunction and is the basis for staging chronic kidney disease (CKD) (Table 1). To optimize accurate staging of CKD, serum creatinine concentrations should be evaluated on two or more occasions when the patient is well-hydrated.” http://veterinarymedicine.dvm360.com/laboratory-evaluation-kidney-disease?rel=canonical

Based on a BUN of 77 and a creatinine of 1.6, I personally wouldn’t do low protein but rather moderate amounts of “high quality” protein.

Does your girl have large amounts of very dilute urine? Was there any protein in the urine? Was any other tests done? Is there any other medical conditions? Did you get a second opinion? She doesn’t want to eat often but you said this is just her normal. Does she have any other symptoms such as vomiting, depression etc?

This may help… My Audrey was diagnosed when she was just 13 months old but had symptoms when she was just 6 weeks old. Within the first year of diagnosis I made dietary changes and then had her blood work done every three months. On December 18, 2007 (the second blood work done after the dietary changes) her BUN was 77 (6 to 25 normal) and her creatinine was 1.9 (0.5 to 1.6 are normal ranges for this lab). Audrey didn’t eat a lower protein diet for another almost 7 years.

They also now know that senior dogs actually require MORE protein than adult dogs because they are less efficient at digesting it. Even toy breed dogs – I had a 4 pound Chihuahua live to age 19 eating a HIGH protein diet.

Please take some time to read the articles on this website. http://www.dogaware.com/health/kidneyprotein.html

Okay……..YES – I would highly recommend starting her on Standard Process Canine Renal Support. It’s pricey up front but will last a long time for a four pound little girl. I’ve never used Five Leaf but others I’ve directly talked to felt it helped. The Primal Defense and Acacia Fiber will help lower BUN. I personally would look at feeding foods with higher quality and amounts of protein and getting rid of the cream of wheat and gravy. See if you can find canned tripe — a brand that is just tripe. There is one out with quinoa but I’m not sure how much phosphorus is in quinoa so not sure it is suitable? It may be, I just don’t know. Tripe itself is higher in protein with moderate amounts of phosphorus. Most dogs really really like it too. You can continue the goat milk (best if it’s raw in my opinion). Eggs are a good option but the yolk is higher in phosphorus so, recommendations vary depending on stage of the disease, you might want to feed more cooked whites then whole eggs (maybe a one to one ratio – one whole egg with one white only). I would also suggest against feeding homemade as it is really important to get the phosphorus to calcium ratios correct and to limit phosphorus to appropriate amounts for the stage of the disease (which is early stage based on the numbers you mentioned—unless your lab normals are way different than mine?). There are recipes online if you want to home prepare. Dr. Meg Smart has a recipe – you would want the one for “early to moderate stage” http://petnutritionbysmart.blogspot.com/2013/02/home-made-diets-and-renal-disese-in.html

There’s lots more you can do but you mentioned you have a budget so start with these and then if there’s more for other things you can add on as able–such as herbs that can be helpful.

• This reply was modified 8 years, 5 months ago by Shawna.
• This reply was modified 8 years, 5 months ago by Shawna.

[Bev A]

Ok, I will start with that. However the diet you gave me from Meg I have already used. She loved it for about 3 days and then decided yuck and turned her nose up to it. I haven’t gotten a second opinion for a couple reasons, one I simply can’t afford another vet bill, hers stays high and has all her life. And 2, if they decided to keep her over night she would stress so much she would go into a seizure. She has never in all her almost 14 years never been away from me for more than a few hours. They had to pull some teeth and she did very well but the vet said she hadn’t woke up so she would call me when she did. A couple hours went by and she called me and said, Bev you know I never do this but Bitty has not woke up yet. Would you come by, I think she just knows you aren’t here/ so I went in. They brought her out wrapped in her blanket and she was sound asleep. So they handed her to me and I said, Bitty you have to wake up now so we can go home. That little tail started wagging and the vet said, I knew it. She would have laid there and died because I was not there. She is very attached to me. No she never has large amounts of urine, maybe the size of a quarter if that. But she does leak urine now if she sleeps very hard, or if she isn’t eating. Seems that is better when she is willing to eat right. And there hasn’t been a lot of testing done. The vet feels there could be an ulcer and she gets meds for that from time to time. She really stresses when I leave her at home. She does get lonely which is why I have another dog, a Pomeranian. Seems as long as there is another animal for her to compete with she is better. I wish she was more willing to eat some other foods. I have gone through hundreds of dollars of different foods over the years and she has just refused them. I did buy liver and lightly cooked it. She will eat it if I hand feed her and if Katie is there to take a bite every time she does. I get my goats milk from a dog food treat store. She refuses to drink it but I freeze it in ice trays and take out a couple cubes from time to time and put it in a syringe. She gets no choice in the matter. She is just so stubborn! I don’t know if this site allows us to share email addresses so won’t put mine here but if they do or if admin will give it to you and you don’t mind me having your I would be willing. I so appreciate your help.

[Bev A]

I have to tell you it struck a cord with me when you asked about other problems. This may sound strange but I have a program on my computer that deals with healing tones. I have used it with Bitty before with parasites. I test for myself and you would have to see what I do but after I used that on her she vomited after a couple hours and felt really good for a long time. So I used it again on her a few minutes ago. We will see how that goes.

[Bev A]

Well the tones really didn’t do much or maybe they did depending on the point of view. I sent a message to Caru, whom I am told makes a wonderful dog food that no dog ever turns down. But it is very expensive. So I sent an email to them and they willingly sent me a couple samples. Well, there is a first for everything because Bitty refused to touch it. I mixed the Science Diet KD with goats milk and gave that to her in a syringe every couple hours. She is just ornery. I went to give her some medication, her phenobarb, and she got down in front of me, that little butt up in the air and her tail wagging. Every time I got close she took off, barking, and ran to another area. I finally cornered her to give her meds. But she was having a grand time so that is why I knew she was just being stubborn. I did pick up a can of Tripe, thinking I was wasting money again but by golly she ate it this morning!!So maybe the tones worked or maybe she was just hungry enough to eat finally. We will see how it goes. Still waiting on the supplements to come in.

[Bev A]

Hi, Bitty has been on the Canine Renal Protection for 3 months now and I also started her on the Acacia Fiber and Probiotics at the same time. Her Creatinin is now normal and the BUN has come down but still nowhere near normal but it did drop. So I continue giving the supplements. The latest blood work however has me concerned and any suggestions for meds, foods, supplements, whatever would be greatly appreciated. Her Albumin is low. 2.1 and her globulin is high at 5.7. She is 14 but her eating habits have improved greatly over the past 3 months. I switched her to Science diet KD and to Solid Gold Tripe. A third one is Merricks Grandmas Pot Pie. Bitty is a picky eater so I give her whichever one she will eat at the time. She does have bad teeth, so I am concerned for that but we have pulled the majority of them. She doesn’t do well with anesthesia so we have decided not to pursue the surgery as we don’t think she would survive. Shawna, your advice was right on. I didn’t tell the vet what I had done till the test results were back. She was iffy on it when I first mentioned it but said that it was because she had not used that before. But she could see that Bitty is more perky and aware of what is going on around her and suggested I continue doing what I am doing. . She has always been very anxious and has to have tummy meds all the time and I suppose that probably has a lot to do with the blood work. She has maintained her weight of 4 pounds and even gained 1/4 pound in the past 3 months. Thanks for any advice you can give at this time.

[Ania V]

Hello,
At first, thank you for this conversation which I read and has helped me a lot. Please, excuse my english as I am from Greece. My dog Maya is 16 years old and has kidney disease for 1,5 year (May 2018) with her BUN at 70 and Creatinine at 3.2 in her latest tests. Creatinine has been stabilised all this time around 3 but BUN has unfortunately increased. It was 56, around 4 months ago. I cook and feed her home food with beef all this 1,5 year with white bio rice, bio vegetables like butternut pumpkin, carrots, cale, green beans, sweet potato, bio apples and bio eggs (no yolks at all). I also give her carbonate calcium in her food and omega-3. Also, my vet subscribed PRONEFRA for the kidneys which Maya takes from the beginning and HEMOVET the last 4 months because her haematocrit (HCT) was a bit low (39). Now it is 42.4 again but the vet suggested to keep giving them. Her PHOS is normal at 4.6, never high or low.
My question is what can I do to reduce BUN. I read that you suggest Probiotics and Acacia Fibers. Would that help Maya’s case? I would appreciate any suggestion and help as I am doing all this time a massive effort to keep her as healthy as I can. My vet has unfortunately confused me sometimes. For example, she told me when we had the latest tests that I should reduce the beef in her food in order to reduce protein. Is it a good idea to reduce protein now? She also told me to give Maya brown rice and not white, but I ‘ve read that this is not a good idea. I am confused and in need of advice regarding BUN’s latest increase.

Thank you in advance.

Ania

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