We have a shetland Sheepdog "Karla" who is twelve years old.  She recently started to lose weight and to vomit intermittently at night time.  Last week, she became very unwell and our vet advised us that she had kidney failure.  He put her on a drip for 3 days to see how she would respond.  We brought her home for the weekend to see how she would react.  Our vet told us that her prognosis is gaurded and also informed us that she has stomach ulcers.  She is currenlty on "antepsine" 1/2 tab three times a day and zantac syrup.  She was unable to digest the dog food that the vet prescribed for her i.e. Mr. Hills R/D tinned food. 

We are desperate for any advice that anyone could give us as regards how to help her to retain her food.  She is actually quiet perky which makes it all the more difficult for us.  We do not want to give up on her yet, as she is our life!

I have been given her some yogurt and a very small amout of fisht this morning.

We would be grateful for any advice at all.

Kind regards,

Siobhan and Paschal Mullery

What is the vomit like?  Only asking because we had a Rough Collie who we had to put to sleep with oesophageal cancer.  We were taking him to the vets for about 3 weeks and he ended up just skin and bone with the vet not knowing what was wrong with him.  We asked for a second opinion and was sent to PDSA who before we arrived home had phoned with the diagnosis.

When he was being ill it was like a clear bag with the food inside.

Thank you for replying so swiftly.  Her vomit last night was actually just undigested food.  What is this organisation you are talking about "PDSA", as we are live in Galway, Ireland.

Hi Siobhan,

I'm very sorry to read about Karla - you must be extremely worried :(   Re.the stomach ulcers, while Antepsin is a good med for lining the tummy it takes an exceptionally long time to break down - as with the Zantac syrup, there is a liquid form of Antepsin and I'd ask your vet if Karla can be changed onto that instead.  If she is able to tolerate the yoghurt and fish without bringing any back up I'd stick with that for a few days at least and not try to add anything else.  Each time she is sick she is producing excess acid (is there yellow bile in the sickness?) and this will exacerbate the ulcers which is what you want to avoid.  Try and feed her little and often to prevent her tummy being empty - so a light meal just as you go to bed and something asap on waking.

Only give her very easy to digest food - gradually increase the quantity if you can and providing she has a few days of non sickness on fish and yoghurt you could try adding some very thoroughly mashed potato - don't use rice which is an irritant to flared ulcers.  An additional light but good quality source of easily digested protein when ulcers are present is cottage cheese.

Please keep us posted, sending healing thoughts to your precious girl, Teri :)  

Thank you Teri for that fantastic advice.  We will try her on the fish and yogurt for a couple of days.  Our vet did advise that we give her rice!!!  You obviously know alot of information.  I will keep you updated, we are keeping our fingers crossed that she keeps the fish down for today.  We think that if we can get her to keep the food down, that this will help to keep her going for a while longer.

We are very, very grateful for your advice.

Thank you so much.

Siobhan and Paschal

Will keep everything crossed for her :)

Teri x

The advice re the antacids is useful Teri, but this poor dog also has failing kidneys so protein needs to be kept to a minimum. 
It is a very specialist diet she needs, Mullery, you say she is not digesting the food, do you mean she is just throwing it up?  I think you really need to discuss with your vet alternative foods.

There is nothing in my advice to cause concern Isabel   Perhaps you're simply unaware of the fact that the use of fish and/or cottage cheese is common with nutritional experts of GI disorders, both being easily digestible sources of protein which don't take the levels through the roof in comparison to most other sources?  The question from Siobhan is whether anyone could recommend something as

>any advice that anyone could give us as regards how to help her to retain her food<

Since this poor little dog is not able to digest the renal diet prescribed by her vet, what could possibly be wrong with suggesting an alternative?  At the very least it may stop her being sick and therefore will not only provide a source of bland but nutritional ingredients but potentially prevent further vomitting which at least will give interim relief from the chronic discomfort of internal ulceration.  Of course I'm confident that Siobhan will enlist the support of her vet for providing an altenative diet should it prove necessary but at least until such times as she is able to do so, this little dog doesn't need to starve or be encouraged to eat something which is making her feel worse.  regards, Teri :)   

I am just speaking from the experience of a very close friend, our best man, whilst waiting for his transplant, even though on dialysis, could not have eaten fish or cottage cheese, even the protein levels in normal bread were a no no, he had to buy special stuff from Boots.  I think in the case of renal failure the diet is very much a prescription job, that is not to say it cannot be home made but it needs veterinary knowledge to help devise it.

The information provided is based on that given to me by a specialist in the field at Glasgow University Veterinary Hospital Isabel.

The recommendation is white fish or low-fat cottage cheese - the high grain level in "normal white bread" would certainly be a no-no as although a degree of grain can be useful in absorbing the over production of bile acid often associated with liver disease it depends on how else the GI system is coping.   NB. this advice is based specifically on canine management - I'm not suggesting or even aware of whether it is suitable for humans. 

In the case of this little dog, she already has been diagnosed as having stomach ulcers and is presenting with vomiting - one therefore exacerbating the other - hence why I suggested, also as recommended by experts in the field, that potato would be of easier digestion than rice.  If a grain were to be substituted for potato, oatmeal is often recommended - certainly rice could potentially further complicate the irritation of the ulcers.  

It is excellent advise for GI management but unfortunately this poor dog has not got properly functioning kidneys, unless protein is kept to the minimum she will become overloaded with urea which is going to make her feel pretty grotty and vomit anyway.  Don't take it personally, we tend to know about the problems, and treatments that we have experience off most people would not realise protein is going to be a problem ever.  This poor dog is very unfortunate to suffer two serious problems and management is obviously going to be quite a challenge for the vet no doubt helping settle the GI with medication is going to be useful but diet has to be sorted in conjuction with her other difficulties.

At this rate Isabel the unfortunate OP is just going to sit and watch her much loved dog starve   frankly whether you choose to turn this into the usual "food fight" with me is neither here nor there - I don't take it personally, merely as par for the course.

I have had in-depth discussions on specific diets for several extremely serious medical disorders with specialists and have attempted to share that information with someone who's primary concern is the wellbeing of her dog.  Whether you choose to disbelieve me again is of little relevance.

As to management being a challenge for her vet - sadly, I'm sure it will be and hopefully specialist advice will be sought sooner rather than later.

I don't recall having a food fight with you but this is not just about the general feeding of dogs it is about a very sick dog, it is about veterinary treatment which in this instance would include diet.  Your discussions do not seem to have been about kidney failure but about gastric problems and anyway I don't think anyone should prescribe what amounts to treatments over the net even if qualified to do so.   Inappropriate food could hasten the demise of this dog quite frankly.  I have looked in my human medical book which tells me humans with acute kidney failure require a diet restricted to a maximum of 60g of protein a day so clearly it is very much an issue.   I forgot to say my friends prescription bread was nothing to do with digestability, he didn't have any digestion problems, it was purely because ordinarily bread of any hue has too much protein.
I really think it is very important for the poster to discuss their dogs diet with their vet that is all.
The poster may choose to see a specialist but failing kidney function is quite common in the elderly dog so I'm sure their vet will have a deal of experience in that area even when complicated by digestive problems.

Isabel I have NOT "prescribed what amounts to treament" merely proffered a short-term solution on food which is what the OP asked for and one which is NOT specific ONLY to GI disorders.  As you are so well versed in matters to do with kidney failure you will be aware that it's the high potassium levels in specific proteins which are the greatest cause for concern.

No-one should diagnose anything over the net - qualified or not - and I've already stated, Siobhan should discuss diet further with her vet but today, having failed to be able to cope with the diet prescribed by her vet, her dog eats what?

Of course its not specific to only GI problems my dog would enjoy fish and cottage cheese and it would not do her any harm.  The breakdown of protein produces urea that is the problem as I understand it, it is the kidney we use to excrete this.  It therefore does not seem appropriate to a condition that requires very low protein management to offer protein based foods.  I don't know what she should eat, that is why I am recommending they speak to the vet, I'm sure the emergency vet could suggest an appropriate food over the 'phone in anticipation of an appointment tomorrow.

Hi again Siobhan,

Apologies for the way things have veered away from addressing you directly.  Here are two links to web groups which may be able to help you - they are no substitute for veterinary advice but these Groups are generally a wonderful source of support and have somebody on-line around the clock as they often have a membership which is world wide.

http://groups.yahoo.com/group/K9KIDNEYS/    or    http://groups.yahoo.com/group/K9KidneyDiet/

My very best wishes that Karla's condition improves,
God bless, Teri :)

  

Dear Teri,

We wanted to let you know, that Karla unfortunately did not make it and has gone to Doggy Heaven this evening.  Her kidney function was obviously very badly damaged as her urea and creatinine levels were very high.  We are very sad needless to mention, but we wanted to say thank you to you for the wonderful word of encouragement that you gave us over the weekend.  We hope that you will continue to encourage other amatuers like ourselves.  We wish you all the best for the future and that every grace and happiness will come to you.

With best personal and warm regards.

Siobhan and Paschal.

I am so sorry Karla did not make it.  I sincerely hope my questioning the recommendations did not upset you more that you were obviously going to be already.  I doubt anything that was given would have made any difference if things had reached that stage with her.  I hope your memories of her are a comfort.

Sorry for your loss Siobhan.  Run free Karla - no pain where you are and lots of friends to play with.

Dear Siobhan and Paschal,

I've thought much about you both and Karla over the last couple of days and I am so very, very sorry. 

I have sent you a little private message which I hope in time will bring you some solace.  If you click on the word "Messages" at the top right of this page you will be able to read it.   Teri