Something that you may consider is to speak with your dvm about the use of calcitriol for the kidney disease.
Chronic Renal (kidney) Disease:
BENEFITS OF CALCITRIOL IN PATIENTS WITH CHRONIC RENAL (KIDNEY) DISEASE
In patients with chronic renal disease (CRD), there are several abnormalities that occur. One of them is that the failing kidneys communicate with the parathyroid gland, a small gland that lies within the thyroid gland in the neck. CRD causes the parathyroid gland to secrete parathyroid hormone (PTH). PTH has the following effects:
1) in people, and we assume this can occur in dogs and cats, PTH causes depression
2) PTH causes slowing of nerve conduction which can result in weakness
3) PTH can cause anemia (CRD can lead to anemia, in the final stages, not only because of increased PTH, but also because of loss of erythropoitin, which is needed for the manufacture of red blood cells)
4) PTH causes white blood cells, which are necessary to fight off infections, to be less effective, resulting in a tendency for infections to occur more easily in CRD patients
There are several other negative results caused by PTH elevations. The aim of using calcitriol is to slow down the progression of CRD.
Benefits reported by owners, especially for those cats and dogs who have more than just mild or early CRD, is improved appetite, more interaction with the family, and more normal behavior. In those pets who have not become ill from their CRD, there will be no observable improvement, but, we are trying to prevent deterioration.
a) When used as a “preventative”: Assess serum calcium concentration on days 7 and 14 after initiation of calcitriol therapy and every 3-6 months thereafter. If hypercalcemia is detected, a week of discontinued calcitriol will allow determination of whether or not the medication is the cause. Hypercalcemia may be due to inadequate calcitriol rather than too much. Serum creatinine should be monitored on a regular basis (q 1-3 mos. depending on the stability of the patient). The Phos x Ca should not exceed 60.
b) In patients with initial elevation of PTH: Along with those measures recommended above, PTH levels should be reassessed 4-6 weeks following initiation of calcitriol. If still elevated, then increase the dose by 1-2 ng/kg depending on prior response (do not exceed 6.6 ng/kg/day unless ionized calcium is measured). When higher doses seem needed (5-7 ng/kg/day), a “pulse dosing” strategy (ie. giving the calculated dowe every 3.5 days, as an alternative can be considered. According to Dr. NaGode (the kidney disease guru). Determine clinical benefit by improved appetite, attitude and mobility, as well as slowed progression of the CRD.
If the specific gravity is over 1.035, the creatinine is under 1.4, and there’s no proteinuria (need a UPC – Urine Protein Creatinine Ratio), then, maybe the kidneys are really okay. W/ early kidney disease, calcitriol can be quite protective.
Support groups for kidney disease in dogs: