Renal diets & wonky creatinine values

[Magwart]

My 10-y.o. neutered male has had some weird blood work -- his Creatitine jumps up as high as 2.4, then goes back down to 1.4, then back up again -- and all other values remain in the normal range, including B.U.N. His urine culture came back negative, and his blood pressure is normal. It's a bit of a head-scratcher.

He's been off Rimadyl for several months, so it's long cleared his system. We thought his first wonky blood test might have been from that, though the dose he was on was ultra low. Things went down for a while after that....and this week we got a repeat of the wonky creatinine level.

He still takes some Gabapentin, but that's not known to affect kidneys. He eats Fromm 4-Star kibble, rotating the protein sources. He rarely eats bones, but occasionally enjoys a bully stick.

We're going to re-test in a week, to see if it's still elevated, and if it is, likely move to a renal diet. I'm not excited about the Royal Canine or Hills RX food offerings at my vet, so I'm thinking about doing a consultation with a vet nutritionist to come up with home-cooked meal plans made from real food. We may also do a round of antibiotics in case there's a low-grade kidney infection that didn't culture, which I understand happens sometimes.

In the meantime, I think I'll start CoQ10 supplements. He's already getting the other supplements I see recommended for renal support-- fish oil, vit. E mixed topherol, B complex, and Ester C.

Has anyone ever seen this sort of oscillating creatinine in a senior? Did you figure out a cause? Or find a diet that worked well?

[M&J]

I feel your pain. I have an app't with a nutritionist next week. I can't wait to get Rudy off this Hill's K/D and Royal Canin Renal. Thing is, he loves it. Ugh.
Hope you're just dealing with an undetected infection and antibiotics help those numbers. Look into d-mannose, too.
Did they do a tick panel, the kind they send out? Thyroid?

[Jax08]

Here's a thread for you to browse thru. Lots of info in here for seniors.

Chronic Renal Failure in Senior

Banshee's went up to 1.8 and then back down to 1.2. First, was it a fasting bloodwork? Second, my vet said (and it's exactly what happened) that the levels will go up and then often level off as the body adjusts.

I feed Banshee a RAW diet. If you decide to go that route, I can send you the spreadsheet I made to help track levels. There are also many recipes and food suggestions on
https://www.facebook.com/CRFDogs/notes

Have a chem17 done. It will tell you phos and calcium levels which are important.

[JeanKBBMMMAAN]

Originally Posted by Magwart

My 10-y.o. neutered male has had some weird blood work -- his Creatitine jumps up as high as 2.4, then goes back down to 1.4, then back up again -- and all other values remain in the normal range, including B.U.N. His urine culture came back negative, and his blood pressure is normal. It's a bit of a head-scratcher.

He's been off Rimadyl for several months, so it's long cleared his system. We thought his first wonky blood test might have been from that, though the dose he was on was ultra low. Things went down for a while after that....and this week we got a repeat of the wonky creatinine level.

He still takes some Gabapentin, but that's not known to affect kidneys. He eats Fromm 4-Star kibble, rotating the protein sources. He rarely eats bones, but occasionally enjoys a bully stick.

We're going to re-test in a week, to see if it's still elevated, and if it is, likely move to a renal diet. I'm not excited about the Royal Canine or Hills RX food offerings at my vet, so I'm thinking about doing a consultation with a vet nutritionist to come up with home-cooked meal plans made from real food. We may also do a round of antibiotics in case there's a low-grade kidney infection that didn't culture, which I understand happens sometimes.

In the meantime, I think I'll start CoQ10 supplements. He's already getting the other supplements I see recommended for renal support-- fish oil, vit. E mixed topherol, B complex, and Ester C.

Has anyone ever seen this sort of oscillating creatinine in a senior? Did you figure out a cause? Or find a diet that worked well?

Yes, I have 2 dogs who have had up and down creatinine levels. Both were just over the line in elevation and I charted it, but it was always elevated. We would do the blood work, follow it up in 6 months, do the urine, it was all normal/good. Always just the creatinine, BUN, all else normal.

I did two things differently and have no idea if either made a difference. I put a bowl of water in the living room for them. That way they don't have to walk ALLLLLLLL the way into the kitchen to get a drink. They love it. Sillies!

Then I started mixing grain free foods with lower phosphorus types of grain foods. Because as much as everyone tells you it's the quality of the protein, I think that kibble is harder to process - and even on the dogaware site for kidneys, there is a point where you lower the protein. I could not imagine that my 2 senior girls would need that much protein to nap anyway.

How to Reduce Creatinine Levels in Blood

http://bestpractice.bmj.com/best-pra...aetiology.html

The other thing is that both girls are VERY nervous at the vets. In fact, when they did the ultrasound to do the clean urine draw, both pottied during the procedure. My vet was like wow, their urine and creatinine numbers match, as does their poop! I tried to see if that would have any impact - acute stress releasing something to increase that number, but didn't find a lot. Assessing Factors that Decrease or Increase Stress Levels in Cats in Animal Shelters

So after doing those 2 things, I had to take the one in for not feeling well and did her blood work and the number was normal. After a couple of years of elevated levels, back to normal. I don't know if having her blood drawn when she was relaxed (not feeling well enough to amp up) had anything to do with it.

The vet I saw was fascinated by both of their blood work trends and posted it to the VIN forum and got some interesting comments back, but no information that was too helpful.

I just had the other girl in for her blood work and now her creatinine is normal.

They also started Springtime Longevity, which the one has decided she no longer likes.

So definitely a weird thing.

[Magwart]

Thanks for all this great info.

We're still in weirdness -- and it's gotten weirder. While reviewing the file with the vet, we noticed that all the high creatinine readings came from the vet's inhouse labwork machine. The normal ones all came from the reference lab where they send blood out -- owned by the same company.

We thus decided to see if the machines were off, or the blood chemistry was oscillating by doing one blood draw, and sending some of the sample for testing inhouse, and some of the same sample to the outside lab. They should have had identical readings, since it's the exact same sample. They didn't.

The in house one repeated the high (2.4) value, and the outside lab came back well within the normal range. This is the same vial of blood!

They are not getting high creatinine readings in-house on other dogs -- just mine. It's very, very weird. We may have to do yet another sample to a different outside lab.

My vet has us in a holding pattern while he works with the company that owns the equipment to get to the bottom of the discrepancy -- one number would tell us not to do anything, the other would tell us to change the diet, so we need to figure out which is right. There will be no dietary changes until we figure out the lab discrepancy, as it's a big one.

I think there's likely something going on with the kidneys though, as he's had a few little accidents in the house lately, and he's been reliable in the house his whole life. We're just having a very hard time figuring it out.

All the other numbers in the bloodwork (including BUN, calcium and phosphorus) are in the normal range. It's just the wonky creatinine we can't figure out.

I'm going to follow the vet's advice and hold-off on changing diet significantly until we figure out the bloodwork. I did add 100 mg of CoQ10, as it's useful whether there's kidney stuff or not.

If we have to go with diet, my vet's willing to refer me to a nutritionist to oversee homecooked or raw meal recipes -- he's not pushing the Hills and Royal Canine, thankfully. We may not need to go there at all though...if the "normal" number turns out to be the true one.

For now, we still have no idea whether his kidneys have problems or not.

[JeanKBBMMMAAN]

I just sent you a PM from a VIN message my vet got - the lab information may be of help to you! I read this after I sent the PM.

With the accidents, I would ask about doing an x-ray because of crystals and stones in male dogs.

So weird - how do you know which is right!

[Magwart]

The lab (IDEX) is now working on trying to get to the bottom of the inconsistent values. They are paying for another blood draw, which will be checked by their local reference lab and an even bigger, national reference lab in another state. That lab's results have to be right.

My vet drew the blood while Simon got to enjoy a day of playcare at the vet's office today. There was, by chance, a group of big, old dogs attending playcare. The vet staff told me seniors all waddled around and had a great day in the yard together--slowly running after a tennis ball and playing together. She was grinning as she described how cool it was to have a bunch of large-breed senior dogs randomly show up on the same day.

Simon came home happy. I hope he has a lot more days like this. We won't get results until next week, but I'm cautiously optimisitic it will come back normal.

There's a chance we may have nothing more than run-of-the-mill senior loosening of urethra, causing occasional leakage. He's the right age for it. That's a whole lot less worrisome than failing kidneys!

[GatorBytes]

I had read your thread and was like WTH, either dogs are being misdiagnosed with kidney problems or dogs with kidney problems are being missed.

I am hoping for the former for your doggie

[Magwart]

Well... testing the same sample to three IDEXX-owned labs proved that they are getting inconsistent values on my dog, even with the same sample of blood. One set says kidney failure (2.4), the other set says healthy dog (1.3-1.4).

Now IDEXX decided they wanted to have us pull another sample to see if it would happen again. At least they're paying for it. We know it will happen again, as it's apparently been happening for about six months, as we've been testing periodically and seeing numbers oscillate, depending whether they were done inhouse or at the reference lab--except now we know they weren't oscillating at all, but rather the assay is generating inaccurate results.

We decided to send part of this latest sample to a different large reference lab, that my vet thinks uses a more sophisticated process, and is owned by a totally different company. It's more expensive, but it needed to be done. IT CAME BACK NORMAL -- 1.4!

Given that it matches the IDEXX reference lab (the most reliable of the IDEXX numbers), my vet is now very comfortable concluding Simon's kidneys are healthy, and the high values we saw were testing errors. The conclusion is that Simon has just got some loosening of the urethral sphincter due to old age. That's easily treated, and not life threatening -- it's a far better result than kidney failure. There's no indication of kidney stones, infection, or anything else that my vet can find wrong with him.

If we had been the sort of people who got a one bad lab result and couldn't afford to pay for lots and lots of follow-up testing, or had a vet that anything less than diligent about wanting to see repeatable lab values before making a dire conclusion, or hadn't noticed the values varying depending on where the sample was tested -- this poor dog would be on a highly restrictive diet he doesn't need to be on, and I'd be thinking my best friend was dangerously ill, when he's perfectly fine. What a mess.

IDEXX has no explanation so far, but my vet is hounding them to get to the bottom of it, since they own the in-house equipment his clinic uses, and he wants to know why its results were flat-out wrong on my dog.

[JeanKBBMMMAAN]

Very, very glad!

I am also very thankful my vet stays cool when a number is a little out, does follow up, checks things, because the same could have happened to my dogs.

Whew!