[Mandie]

Hello everyone,

When I posted here last year, Max (11) was struggling with back and elbow problems. Really glad to say things calmed down on a combo of previcox, gabapentin, glucosamine/chondroitin (Dasuquin - wonderful stuff!). For the last 9 months he has been back to 45-60 min walk am and 20-30 mins pm.

The bad news is his blood test May this year showed stage 3 chronic kidney disease, when blood tests last year had been clear. So we had to stop previcox, and take him off Millie's Wolfheart Obedience Mix kibble and start him on Hills Prescription K/D - Millie's help desk said we must not have any of their food with a k/d diagnosis and in the absence of any better ideas, went with Hills as we panicked about stage 3 ckd. Good news is he has started on Librela for pain relief and is doing fantastically with that.

My question is about food amount. His whole adult like he has been on roughly 240g kibble a day total. Tried a few foods over the years, but settled on Millie's Wolfheart Obedience Mix for a long time now.

I think I panicked when he went onto Hills, and started him too high - 300g a day split over two meals. Their guidance is 350g minimum. Anyway, he was 34.7kg and had been steady for years. He's a big show lines lab, quite leggy, big head. As soon as he went on Hills his weight started creeping up, like over 2 weeks. So we reduced to 280g a day, and then 270g. But he has gone up to 36.4kg.

I don't want to add weight gain to his issues, but Hills and the vet nurse at our practice have warned against under feeding and have told me if we underfeed, he might gain weight through water retention?? My gut is telling me to come down to 240g a day, but I don't want to cause him problems - I think the diagnosis of stage 3 CKD has frightened me.

In comparison, Millie's was 368 kcal/100g, 31% protein, 14% fats, and phosphorous too high at 1.29%. Hills is 390 kcal/100g, 13.8% protein, 19.2% fats and phosphorous much lower at 0.22%. To me Hills looks designed to gain weight with higher fat and presumably carb ratio - I realise dogs with CKD can lose weight, but Max hadn't been doing that.

So would you drop daily feed to 240g? Vet nurse says hold fire, but Max has never gained weight this quick and I just feel it must be the food? He still has a waist, can still feel his ribs but his "blanket" covering ribs is getting thicker. I do think he has gained a bit of muscle tone last couple of months as he has been exercising more, which would weigh more. The nurse said they prefer oldies to have a little bit of extra weight in case they get sick and naturally lose some through that, so I'm going round in circles.

Sorry to be long winded but hope it makes sense, grateful for more experienced thoughts,
Mandy x

 

[JohnW]

36.4kg is not overly heavy for an elderly show bred dog, and I can understand the nurse saying a bit of extra weight is an added safety reserve. But with kidney failure fluid retention is always a possibility. Is this becoming a problem do you think? Remember, what goes in has to eventually come out. I would suggest measuring what he is drinking. I measured what I was putting down over a 24 hour period. But then comes the question, why bother? You must not restrict him because it's the fluid intake helping to flush the impurities through his system. At the time when I was measuring Anna's intake it was for diagnostic purposes where in your case, you already know the reason so there seems little point in measuring his fluid intake other than out of interest, and to see if there is any change. But then, I could quite understand if this was something you really did not want to know. There is medication which can be given for fluid retention, but with him already receiving medication it's important that any new medication does not interfere with what he is already getting.

Bottom line, I'd be very reluctant to change the present regime.

 

[Mandie]

Hi John - thank you for your reply.

Re fluid intake, our feeling based on watching him closely, although not measuring, is that fluid intake and output seem about the same. On Monday/Tuesday this week when it was 40 degrees, I did noticed him drink more volume each drink on Tuesday but by that point we were all struggling a bit, and as soon as the temperature reduced yesterday, he has gone back to "normal".

In terms of fluid retention, is it the same as in humans eg literally puffy legs/body? I haven't noticed that, and he doesn't seem any more lethargic or breathless - seemed to cope quite well in the heat with our attempts to keep him as cool and calm as possible, walking at 5am and 10pm etc.

I'm glad you feel he isn't too heavy. Certainly last night at the vet's for his Librela injection, the nurse was erring on watch and see and the vet was very much deferring to her opinion with regard to condition and feel.

I guess what's concerning me is his weight has started to creep up since starting Hills end of May, and if that trend continues it might become a problem and I'd rather not have to cut back drastically. We are weighing him fortnightly as we alternate allergy injections with Librela, so we will keep a close eye.

 

[JohnW]

In terms of fluid retention, is it the same as in humans eg literally puffy legs/body?

You tend to notice it more in the body. The rear of the body behind the rib cage. You may well have seen your vet tap one side while having his hand the other side. You can sort of feel the water sloshing about inside. (Thats not exactly what it is, but it is what it feels like.)

Yes, everything, us included was drinking more in that heat. Nothing to worry about.