Saturday, December 15, 2007

Late post

Snow post is up: White white thing things!!

Monday, December 3, 2007

Jaffa/Sunshade Kidney Regime

I know the words, "THANK YOU" from me now might seem like such a cliche, and you're probably all tired of hearing them from me......hehe.. BUT, that's exactly how I feel day after day. I continue to get words of encouragement from people all over the world who have grown to love Sunshade & Jaffa. We have also just started to receive our Christmas cards from the exchange, and they are all filled with words of comfort. So THANK YOU! I am so grateful to have all of you with me on this journey to make OUR Jaffaman the best he could possibly be health wise.

Jaffa is still feeling great with LOTS and LOTS and LOOOOOOTS of energy. Clinically, he shows no signs of being in renal failure. We won't be doing blood work for another few weeks (I'm thinking to wait until after X-mas....) so we have no idea how his kidneys are currently functioning. I will definitely keep you updated tho, so no worries!

A few people have asked me about the renal supportive supplements I've been giving Sunshade and Jaffa, and also about Jaffa's diet. So I will be posting what I've been giving Sunshade for the last five years that's kept her kidneys healthy, and what I'm doing with Jaffa now.

(Sunshade: I think she meant to say, the post gets boring from here on. Not that it was interesting to begin with, it wasn't about the perfect ME.... Nothing is ever about the perfect ME anymore....)


Diet restriction only needs to be done when serum Creatinine & BUN are elevated. If done too early, you risk doing more harm than good. This is why even tho Sunshade has compromised kidneys (normal blood work), she has not been on a kidney diet.

(Sunshade: I swear I'm on a restricted starvation diet. I'm literally STARRRRRVED!) That's a weight restriction diet Sunshade, not a kidney diet..........

There is a common misconception that "protein" is bad for compromised kidneys. The truth however, is not actually the protein that is damaging, but the nutrient "Phosphorous". Usually, foods high in protein contains higher amounts of phosphorous. Meat for example is a lot higher in phosphorous content than say vegetables. So you do, inadvertently end up limiting the amount of protein in take per day when trying to limit phosphorous content.

Keep in mind when formulating a kidney diet, you want to feed foods that are most bioavailable (little waste, easiest on kidneys), higher fat content (for extra calories), while keeping the Phosphorous content within the daily allowance. Cooked egg white is the PERFECT type of food for kidney dogs as it contains moderate amount of VERY high bioavailable protein, and is very low in phosphorous.

The daily allowance for dogs in mid-stage to late-stage renal failure is:

11-15 mg of phosphorous/per pound/per day.

According to Jaffa's last blood work, he is in very early stage of renal failure. However because his condition might be acute or reversible, we are treating him more aggressively than we normally would for a dog at his stage.

Jaffa should weigh around 60 lbs, so his diet is based on his daily allowance of 660-900 mg of phos per day.

I use a very useful site called NATS (Nutrition Analysis Tools and System) to formulate his diet.

Sample Kidney Diet for Jaffa (growing, high energy, large breed dog):

  • 50 g Whole Milk Yogurt
  • 1 Cup Cooked Glutinous Rice
  • 1 Cup Cooked Butternut Squash
  • 600 g Regular Ground Beef
  • 4 Large Egg Whites

Once I punched all that in, I get the analysis for each individual food item: (click to enlarge)

I click again, and I get the combined analysis. This is what I'm more interested in because it tells me the total amount of Calories, Protein, Calcium, Phosphorous, etc the diet provides.

From the analysis, I can see that he gets 897.67 mg of Phos/day, which is within the allowance range. He is getting enough calories (Sunshade: waaaaaay tooooo muuuuuuch energy for land sharrrrrrrrrking!), and the protein he gets are in high bioavailable forms (raw meat, cooked egg whites). I divide the diet into three portions and feed him three times a day to make things easier on his kidneys.

I have dropped all raw bones from Jaffa's diet. As nutritious as raw bones are, they are also very high in phosphorous. The Calcium to Phosphorous ratio in the diet needs to be balanced or the body will pull calcium from bones/teeth to try to balance the serum Calcium. Because he is no longer getting calcium from bones, I am having to add a calcium supplement with every feeding.

Ca : Phos ratio in diet should be ~ 1.25 : 1

From the recipe, he is getting 897.67 mg of Phos, and 166.92 mg of Cal.

I multiply his Phos number by 1.25 to get how much Cal he should get to get the ratio:

897.67 mg X 1.25 = 1122.1 mg of Cal

Then I take the should get Cal amount (1122.1 mg) and minus the Cal already in the diet (166.92 mg) and I get how much Cal supplement I need to add.

1122.1 mg Cal - 166.92 mg Cal = 955.2 mg Cal to add

Since I'm dividing the recipe into three feedings, I divide 955.2 by three to get how much Cal supplement I need to add per feeding:

955.2 mg / 3 = 318 mg Cal per feeding

I use pure Calcium Carbonate or a veterinary kidney formula Epakitin (Calcium Carbonate + Chitosan) to balance phosphorous.

This is what I give Sunshade too instead of bones on days she gets red meat only. All the white meats Sunshade gets have bones ground in them.

I believe in feeding different varieties. So I alternate meat sources and also buy ground chicken/turkey without bones for him. Yes.... that means a different analysis with each item I changed since they all have different phosphorous contents.

I don't like all the carb he is getting, especially the glutinous rice, but they provide extra calories and are low in phosphorous. Basically used as fillers.... SIGH... gotta do whatever that's best for those kidneys tho..... at least for now.... (can you tell how much I dislike giving them grains?? LOL)

KIDNEY SUPPLEMENTS for Sunshade & Jaffa:

Here are the supplements Sunshade has been getting since I found out about her kidney insufficiency in 2003:

  • Vit-B complex, Vit-C

Both are water soluble vitamins. Kidney dogs pee a lot more, so those get leached out.

  • Fish body oil (highest EPA/DHA)

protect kidneys, and other body organs. The higher the content of long chain fatty acids EPA/DHA are the better. It is also great for Sunshade's arthritis.

  • Vit-E

Fat soluble vitamin. Given to slow down the oxidation process of the high dose fish oil given.

Glandular supplement made from raw bovine kidney tissue. Provides kidneys the nutrients they need. Also cleanses blood.

  • Hawthorne/Milk Thistle/Ginkgo tinctures

Hawthorne and Ginkgo are both to increase blood flow throughout the body. Increased circulation, better for the kidneys. Milk Thistle is detoxing liver. Sunshade usually goes on the tinctures for about two months, then she's off them for three months, and back on two and so on. The tinctures come in an alcohol base, so I pour boiling water over to evaporate the alcohol before giving.

  • CoQ-10 (Coenzyme Q10)

An antioxidant aiding heart health. However, studies have shown that it seems to reduce serum Creatinine reading in human kidney failure patients. It needs to be given in or with an oil base for it to be properly assimilated. Some products come in an oil based Q-Gel capsule,

some come in dry capsules like this,

Dry capsules should be given with fish oil.

Here is a medical journal on the effect CoQ10 has on humans with end stage renal failure - "Randomized, Double-blind, Placebo-controlled Trial of Coenzyme Q10 in Patients with End-stage Renal Failure"

More reads,

  • Probiotic Formula with a Metamucil capsule

I give a probiotic formula that contains a few specific strains of bacteria (Streptococcus thermophilis, Lactobacillus acidophilus, and Bifidobacterium longum) together with a capsule of psyllium husk (Metamucil).

The reason I give the above is based on Kibow Biotech's Enteric Dialysis - "the process by which colon-friendly, non-pathogenic microbes consume uremic toxins or metabolites."

Basically those probiotics work together with a prebiotic (psyllium husk) to form a nitrogen trap, and trap the excess uremic waste the compromised kidneys cannot process. Instead of going through the kidneys and being eliminate via urine, the uremic wastes are eliminated through the bowel. Hence reducing uremic toxins in blood.

You can read more here about Kibow Biotech's Breakthrough Veterinary Product - Using the bowel's capacity to substitute for failing kidney function

If you have a small dog, you might consider buying the Kibow product. It is also being sold under a different name now - Azodyl.

Unfortunately, I can't afford $200 per month on one supplement for the two of them. So I found a probiotic formula which contains the strains I want and just give it together with a Metamucil capsule. I have no idea if I'm giving them at the right ratio for it to work the way the company's product works.... but Sunshade has been doing well so far.... knock wood.

Recommended for dogs in kidney failure to use as a phosphorous binder. It contains calcium carbonate and Chitosan. Company claims studies have shown Chitosan to be effective at lowering serum calcium.

1 scoop = 1 g = 100 mg calcium carbonate + 80 mg Chitosan

With Sunshade, she ever only got this when on days she got red meat only, no bones to balance out the phosphorous.

From what I've read on the K9KidneyDiet list, Epakitin should NOT be used if the serum Calcium is elevated. Also, it is NOT an effective phosphorous binder *if* the serum Phosphorous is elevated. An aluminum based phosphorous binder (ie, Amphogel) is required then. Some suggested buying Chitosan alone and give it on its own if it does indeed lower serum Creatinine reading.

Right now with Jaffa, I alternate Epakitin with pure calcium carbonate. Because his serum phosphorous level is normal, he does not need an aluminum based phosphate binder.

SUPPLEMENTS for Jaffa only:

Here are some supplements only Jaffa is taking because he needs all the help he can get right now. His liver was also effected, so he is on some liver supplements as well.

Kidney glandular supplement with some herbal ..... stuff... LOL. Prescribed by Janice

Liver glandular supplement with some other herbal... stuff. Prescribed by Janice

Sam-E or S-Adenosylmethionine. Protects liver cells from cell death, useful in cell repair and healing.

Ummmm..... eight different kinds of chinese herbs combined. Aids dogs with kidney failure. Prescribed by Janice.


Jaffa gets 500 ml of Sub-Q fluids a day. I know some feel since he is in an acute stage, I should be treating him more aggressively with anywhere between 700 - 1300 ml of Sub-Q per day. However, the truth is, I can only get about 500 ml in him in one spot, and I really DON'T want to have to poke him twice a day with those HUGE needles. I'm not sure if you can tell how big that needle is beside a ball point pen..... but it scares me..

He has been so good, so co-operative with me poking and giving him fluids. The first time I poked him, he turned and gave me that "Why did you hurt me mummy?" look, and followed by a few kisses.... almost made me cry (but I didn't!). Then I told him to lie down and stay, and he fell asleep with his head on my lap. My Jaffaman!!

Here are a few pictures of Jaffa getting Sub-Q,

And some loving!! It takes about 15-20 mins to give him 500 ml.

Oh, and he looks like he's got a big growth on the side with all that fluid inside him.....

I do get at least another 500 ml of water/broth in him be it through mixing with food or syringe.
(Sunshade: mum, are you gonna talk about ME?? How perfect I am??)

Ok ok, here is a little brag about the perfect Sunshade.. hehe. Since I found out about her kidneys back in 2003, I knew keeping her hydrated was very important. She never drank enough water (I felt), possibly due to the moisture from her raw diet. So I, of course, was worried.........

(Sunshade: so you know what SHE did to the perfect ME???

Teeeeeeelllllllll them mum, about how you've tortured your perfect Airedale TERRRRRRRRRIERRRRRRRRRRRR!!)

Hmmmm...... I trained the perfect Sunshade..... to um.... drink on command LOL. Yea... so everyday, I tell her to "GET WATER" and "FINISH IT UP" anywhere between 1 Litre to 1.5 Liters of water throughout the day.... for the last almost 5 years....

(Sunshade: you keep saying I'm over weight, I eat too much, you cut my food portion down. I bet you anything, I'm made up of ALLLLLLLLL water!


Sunshade really is a good girl. I by no mean "forced" her to drink, not even by syringe. I started out by making her broth, and gave her full strength broth while adding in a command like "GET WATER" while she was drinking. She associated the drinking action with the command. Then I started to mix half broth half water, slowly cutting down the broth while upping the water. Used the same command, and she learned from drinking that "GET WATER" meant to finish the bowl of broth/water put in front of her. So now she knows the command even when I give her plain water.

I do get that "I'm really NOT thirsty!" look from her a lot of the times, but if I tell her to, she will finish up the bowl for me. This is the dogter that would walk through fire for me. My fully hydrated, Perfect Sunshade!

Anyway, so this is what I've been doing for Sunshade and Jaffa. Jaffa has not shown signs of any acid reflux problems, and he is not anemic, so I haven't had to give him those meds yet. Hopefully, he really is only in acute renal failure, and his blood work will return to normal by the next testing....

Saturday, December 1, 2007

Jaffa Update 4 - Dec. 1, 2007 (by mum)

Hi everyone, thank you for continuing to check back to the blogs and offering support for me, and my Aire-kids. Those who have e-mailed me privately, thank you, I will respond to all of you soon.

The good news is, I'm done sulking and feeling sorry for myself, Sunshade and most importantly, Jaffa. Jaffa is not feeling sorry for himself, so I shouldn't be either. It must be all the positive energy, Aire-Zens, prayers sent by caring folks from all over the world that have kept Jaffa feeling SOOOOO great despite his blood work! He really appears completely NORMAL. Sunshade is very in tuned with my emotions, and she has been counting on me to cheer up so she can cheer up herself too. That's exactly what I'll be doing for my special girl!

The shock, and denial stage is over. I'm not going to dwell on the unfortunate event that has happened, instead, I'm focusing my energy on how to make the best of things given the situation I'm in. I want to do everything in my power to give Jaffa the best quality of life for as long as possible. Same goes for Sunshade.

In the last couple of days, I've been talking to some folks on the Yahoo K9KIDNEY and K9KidneyDiet groups. I don't think Miss Sunshade has ever mentioned this before, but she too has kidney insufficiency. Back in 2003 when Sunshade was 3.5 years old, an abdominal ultrasound intended for her pancreas showed she had scarring of both kidneys. The exact cause of the scarring is unknown, but we suspect it's due to NSAID (Non-Steroidal Anti-Inflammatory Drugs) toxicity. Sunshade was prescribed very high doses of NSAID's for her joint problems over a long period of time when she was young; before I knew anything about dog health/natural therapies. In Sunshade's case, her blood work was *never* out of the normal range. Meaning, she didn't have 100% kidney function, but she had more than 25% function which was all you need to lead a normal life. If we hadn't done the ultrasound, I still would not have known about her kidney condition even 'til today.

I joined the two kidney groups mentioned above when I first found out about Sunshade's kidneys back in 2003. I lurked the group and learned about managing kidney disease through diet modification, medication, supplementation, and daily Sub-Q fluid administration. The reason I did all that was to prepare myself so that if heaven forbid one day, Sunshade went into Chronic Kidney Failure, I would know how to manage it. Luckily, FIVE years later, Sunshade's bi-annual blood works have been nothing but perfect. Other than having her on some renal supportive supplements, I haven't had to do much.

Jaffa always calls Sunshade, "his" Sunshade, because in a way, she is always watching out for him.

Because of his Sunshade, I am able to quickly formulate a raw diet that is easier on his kidneys. He has also been put on all of Sunshade's renal support supplements since day one. Because of his Sunshade, I am not overwhelmed (after the initial shock stage that is) with what is needed to be done to keep him feeling well for as long as possible.

After talking to the very knowledgeable groups of people on K9KIDNEYS/K9KidneyDiets, I have decided to start giving him Sub-Q fluids at home everyday. Sub-Q fluids go under the skin instead of into the vein like IV's do. It keeps the dog hydrated while flushing and helping to take the load off those kidneys. He is also being fed a diet that is low in phosphorous (most harmful nutrient for failing kidneys) at around 11-15 mg of phos per pound of body weight per day. Those are very strict protocols usually used for dogs in "late stage" kidney failure.

However, some felt Jaffa's ibuprofen ingestion is still considered an acute assult. Which means, he is in "acute renal failure" and there is a chance that his serum kidney numbers can go down to the normal range. They suggested I treat him as aggressively as possible for NOW, baby those kidneys, and give them all the support I can possibly provide with diet and hydration.

Sunshade's kidneys suffered an assault, but whatever damage was done, was done and the kidneys have not worsened. Sure she doesn't have 100% kidney function, but she only needs 25% kidney function to live a healthy, normal life span (that's why kidney donors can live on 50% kidney function). This, is what I'm hoping for Jaffa as well. Whatever permanent damage he has suffered or will have suffered from the ibuprofen toxicity will leave him with > 25% kidney function (blood work in normal range).

I am hoping against all odds that I'll end up with two very expensive dogs to upkeep, but neither in Chronic Renal Failure......

Janice suggested we not do another blood test until Dec. 20th, which marks the one month anniversary of ibuprofen ingestion. I think she sensed the increase in my stress level with each blood work LOL. Meanwhile, we will continue with all the kidney supportive care and treat Jaffa as if he were a "late stage" renal failure patient.

White white thing things!!

My Sunshade said said look look white white thing things fall from the sky.

I said said ok ok me go check check with you ok ok Sunshade??

Mummy said said Jaffaman wear Goofy shirt shirt so no no cold ok ok?

I said said ok ok, my Sunshade wear shirt shirt too, so me wear shirt shirt too ok ok?

Jaffaman no no mind Goofy shirt shirt, see see, me smile smile!

Me jump JUUUUUUUMP high high too in Goofy shirt shirt, see see Kaylie Kaylie??

I got got my ball ball!!

Then me took my Sunshade's ball ball, and Sunshade said said I'm pull pull and drag drag you so you give me my ball ball!! Jaffaman said said ok ok, me no no care.

(mum: that's my kidney failure pup....... can you tell??)

(Sunshade: he is so NOOOOOT sick, he toooooook MY ball!)

Jaffaman happy happy in white white thing things!! Mummy said said me make a good good Goofy doggie!

Wednesday, November 28, 2007

Jaffa Update 3 - Nov. 28.07

I just got a call from Janice regarding the blood result from yesterday.

It is not good. Both his BUN and Creatinine (kidney numbers) are elevated now. His liver number (alt) is still elevated, but better than before. So his liver is on the mend. Urine Specific Gravity 1.020, so low concentration.

Here are the newest results:

I didn't really understand his last blood work so I came home and looked up in the Small Animal Clinical Diagnosis by Laboratory Methods (I know... I'm a freak). I seemed to recall liver malfunction falsely lowers the reading of BUN and not Creat. His BUN was normal the entire time, while his liver was bad.

This is what I read on pg. 132 of Small Animal Clinical Diagnosis by Laboratory Methods,

"Causes of Decreased BUN - BUN is decreased by decreased production (hepatic insufficiency or dietary protein restriction) or increased excretion (polyuric conditions, overhydration, or late pregnancy. Decreased BUN may be an indication for hepatic function tests (see Chapter 9)."

Hepatic insuficiency - Jaffa's liver wasn't functioning well

Polyuric (Pu) - Jaffa was having to urinate a lot due to IV

Overhydration - Jaffa was on IV while all the blood works with normal BUN were taken

That is probably why his BUN was normal before. Now that his liver is recovering, and he's off the IV, the true BUN number is starting to show.

I asked Janice, "Is Jaffa considered to be in Renal Failure now?". I had a lump in my throat when I asked, but I did.

Janice took a moment, and reluctantly said, "Yes, at the moment with both BUN & Creatinine being elevated, combined with low Specific Gravity of Urine."

Janice knows how worried I get, so she hates to give me bad news. However, this didn't come to me as a shock, I think I had prepared myself for it since the very beginning. Remember, I always imagine the worst case scenario so that when it happens, I can deal it (I hope).

Janice said she also put in a referral for us to go for ultrasound. There's always a line up for ultrasound so that probably won't happen for another couple of weeks.

Mean while, there isn't much we can do other than supplementing him, modifying his diet, and keeping him hydrated (via drinking).

Janice is e-mailing me the blood result, I will post them when I get them.

You know how sometimes, you wake up from a bad dream and realize it was just a dream? How relieved you feel?? Every day I wake up hoping this was just a dream, but reality hits... NOT a good feeling!


Tuesday, November 27, 2007

Jaffa Update 2 - Nov. 27.2007 (by mum)

Jaffa was taken off IV around 2 am Monday morning. I stopped the IV, took his catheter out. Janice wanted to run another blood work today, which is a week after he ingested 200+ Advil pills, to see how everything is. She wanted the IV to be stopped for at least 24 hours before the blood work.

So today, I gave him breakfast, his meds, and brought him to Janice late afternoon to have yet another blood work done. He wasn't fasted, so that might effect the results (BUN, etc) somewhat. Will know the result tomorrow.

As you saw in Sunshade's birthday videos. He is acting completely normal, he IS being Jaffaman!! Jen the vet tech said he gets an "A for enthusiasm"; while Janice announced it to the people in the waiting room that "this is our miracle dog! He was poisoned"! I guess Janice thought it was amazing he still looked and acted fine despite what his blood works say. He was being a clown in front of everyone, and tried to play with every dog there (a little too much for some..hehe).

He weighed 55.8 lbs today, up from 54 lbs from Sat. I am giving him more food now that his stool is normal. He has been weaned off the Gastro canned food and is now on the cooked chicken/egg, cottage cheese, and chicken broth diet.

The traffic from North Vancouver back to Vancouver was very slow. So I decided to take them to Stanley Park on the way back for a walk. It was great to have both of them out again, but A LOT more work for me!! Jaffa was wearing his blue, fleece padded harness (same as the red one Sunshade wears), and not the no pull harness. Yea... so I was dragged all over the place. Sunshade was ready to walk the perimeter of the 1000 acre park, in the dark, along the sea wall, but I wasn't LOL. It was freezing!

Sunshade has a great nose, she's a great tracker. Mid way through our walk, she picked up a scent. I could tell from her body language it was an animal she picked up on. She had her nose up air scenting, going left and right, nose to the ground etc. I watched Jaffa as he watched his Sunshade with undivided attention. He was trying to figure out what she was doing. Then he started to imitate her, going left and right but not really using his nose yet. Finally, Miss Sunshade's hunting nose found the source. It was a raccoon, and they chased it up a little tree. Both of them were on leashes, wearing the harnesses made easy for pulling LOL, so I went with them..... Sunshade barked, grabbed a branch from the tree and started shaking it violently. I think she was trying to shake the raccoon off the tree of something. Jaffa watched, and decided to grab a branch too. He hadn't mastered the death shake yet, so he started chewing on it. But I guess it just didn't feel like it was the right thing to do, so he started barking. He started barking with his "big boy" bark. I don't hear that bark very often. It is quite a bit deeper, a little louder, a little more piercing than Sunshade's. I love it! The first time he barked, he startled himself. Turned back to look at me as if he was saying "that came from me me??". I told him "good boy", and he was all proud. Turned back to look at the raccoon up on the tree and did his big boy bark again!

Anyway, I literally had to work my way up their leashes while making sure I gave NO slack (or they pull forward more), and eventually grabbed a hold of the handles on the back of the harnesses and DRAGGED them both away from the tree. The poor raccoon is probably going to have a heart attack.

It's amazing how gentle and loving Sunshade is with little critters at home. That's one thing I'll never understand since she was not raised with little critters. The first time she met one was when she was 3, and that was her "Mousie". It's almost as tho she can turn her terrier instinct on and off. Off when the critter belongs to home, and is part of the pack. FULL ON when she meets them outside. Or maybe she has a very strong pack mentality?? She definitely gives her all protecting pack members.

That's the update for now, we'll keep you updated! Again, thank you all for your continual support, maybe that's why my Jaffaman is feeling so good.

Jaffa will do Sunshade's B-Day post under this post later on. So make sure you scroll down to see the little man!!


Saturday, November 24, 2007

Nov. 25th, 2007 - Jaffa Update (by mum)

I received an e-mail from Janice this morning in regards to Jaffa's blood work taken yesterday, after he's been off fluids to see how his kidneys were functioning. In the e-mail, Janice said she was "VERY HAPPY" with the results, and that she would call me later to discuss.

I assumed, because she was happy about it, his numbers were actually better. My heart sank after I opened the attachment with his blood result. His kidney number Creatinine had increased yet again, from his last blood work taken a day and a half ago. His Urine Specific Gravity was low, which meant his kidneys aren't really concentrating urine. However, there were no proteins in the urine analysis (which is good). One of his liver values that was previously elevated is now normal, the other one is still elevated and higher than before.

I wasn't really sure how I should be happy about these results.

Here are the results:

Then I spoke to Janice, and she thinks that there is a possibility his liver malfunction might be effecting the reading of his Creatinine. Which I guess would mean the Creat reading you see right now, might not be a true indicator to the exact state his kidneys are in right now. Her reason being, yes his kidney indicator - Creat is up, but his other kidney number (BUN) is normal and has always been normal. Also, usually compromised kidneys would cause the Phosphorous level in blood to be elevated, and Calcium to be low. His Phos is normal, Calcium is elevated. Janice also mentioned something about not seeing any casts in urine, which meant kidneys aren't damaged. I'm not quite sure what casts are, forgot to ask.

So I guess Janice feels that the rest of the results are inconsistent with malfunctioning kidneys (I don't want to use the term "Kidney Failure", but technically, once the reading is out of the normal range, the dog is considered to be in Chronic Renal Failure. There are different stages of CRF of course, and Jaffa would be in the very early stage..).

Jaffa is still acting quite normal. His poop firmed up as soon as I added cottage cheese and cooked chicken with eggs to his meals. Janice thinks his stomach might not like the grains in the Gastro canned food because he has been raised on a no grain, raw diet since he was 8 weeks old. I can slowly wean him off the Gastro and have him on cooked chicken and cottage cheese. Janice still doesn't want him back on raw until his blood work looks better, or at least stabilizes.

I started him on a few kidney and liver support supplements since Thursday. I don't know what else I can DO...


You can poke him a thousand times, and he would still greet you with the same happy face and enthusiasm on that 1000th time. He is just so happy go lucky, loves and trusts people.

It's Sunshade's birthday, and for the first time, I didn't feel like doing anything. I feel guilty I felt this way, and she is my special girl. But everything that's happened in the past week has been nothing but draining. I've been quite emotional and I know Sunshade feels the effects of it. This really has been an unfamiliar territory for Sunshade - not being my # 1. However, she has been so patient (even tho she might not want to admit LOL), just hanging around at home. I can tell she's disappointed she's not getting her walks as everytime I walk towards her harness, she gets all perky. Then I tell her noooo, and the tail levels off, and she goes back to her bed.

Both of them did have a little something to eat with a little celebration and opening presents. Will post when I'm able.

Thank you for all the support you've given me, I'm very touched and grateful.


Wednesday, November 21, 2007

Oh NO NO........ Bad Bad Candies.....

***(mum: This incident happened on Tuesday, the 20th. I have only just had time to sit in front of the computer and put everything together. As you read on, you will see what transpired in the last few days... Positive thoughts are greatly appreciated.)

Today, mummy said said here is a kong kong with treat treats, Jaffaman be good good and wait for mummy ok ok??? I said said ok, me like treat treats!!

Jaffaman eat all the treats treats from the kong kong, so me said said me go find find other thing things ok ok?

Me find find a bottle, see see,

It got got sweet sweet candies like this,

So Jaffaman take take it to my bed bed and chew chew bottle, and eat eat sweet sweet candies,

(Sunshade: I TOOOOOOOLD you not to eat it, told you it's disgusting once the sweet coating is gone....... but you wouldn't listen.... so I got frustrated and went UPSTAIRS...sigh...)

Mummy came came home and said OH NO NO NO..... Mummy called called Sunshade's Aunty Janice, and Aunty Janice said to take Jaffaman to this place FAST FAST,

NOV. 20th, 2007 - 7pm

(mum: Jaffa is in the emergency hospital right now. I was out for about an hour and a half,and I gave Jaffa a kong with treats inside before leaving. Cleared everything off the coffee table. Somehow, he managed to find a 250 tab bottle of Advil one of my friends had left over. He ate the entire, almost full bottle except 3 tabs. I'm not sure where the bottle was, it might have fallen under the coffee table or the sofa bed from before and I missed it.

We live about 30-40 mins away from our regular vet, and Jaffa didn't have that much time. Thankfully the Animal Emergency Clinic is located only 10 mins away from our house, and I rushed him there.

Jaffa had ingested way over the toxic dose for humans, and they fear he might end up with gastric ulcers and permanent kidney damage or even die. He threw up in the car on the way to the emerg, and it was all pink (coating), no tablets which meant he absorbed most of the tablets. He appeared normal when I came home, but it was too soon to tell.

Sunshade was stuck upstairs when I came home and I know she wouldn't have put her mouth near Advil or any type of pills.

Jaffa LOVES candies. He must of liked the sweet coating on the Advil pills and decided they were candies. I usually have to put his vitamin pills in the back of his throat for him to take them or he spits them out.)

See see, all the thing things doctors do do to Jaffaman..... me me no no like hurt hurt... Mummy said said be brave brave Jaffaman, I said said OK OK mummy, me try try!

NOV. 21st, 2007 - UPDATE 1

(mum: Jaffa is doing ok. His preliminary blood work taken shortly after he was admitted to the emerg showed his kidneys were effected.

They got those results back just this morning and I could only hope the damage was acute and the fluids he's been given throughout the night have somewhat helped. The doctors at the emerg told me there is no point taking anymore blood works until he's been on fluids for at least 48 hours as that is when the real effect would appear on blood work. The I-STAT (in house) panel they ran this morning after he's been on the fluids showed normal BUN (one of the kidney values) which is good. They didn't have Creatinine (most important kidney value) in the I-STAT, so we still don't really know what condition his kidneys are in.

People at the emerg loved him. Said he was so cute, sitting in his kennel looking around, wagging his tail. Left his IV line alone, ate, drank, peed for them no problem. That's my Jaffa boy!

Sunshade's Aunty Janice called me this morning after receiving updates from the emerg and told me I was welcome to transfer Jaffa over to her clinic to continue IV/treaments. The emergency clinic charges a lot more than regular vets do. Janice taught me how to do IV at home with Sunshade before when she had her knee surgery, so I will be doing that with Jaffa tonight and possibly tomorrow night. I'm grateful as I know Janice is trying to keep my cost as low as possible while at the same time giving Jaffa all the treatment and care he needs. She knows how much Sunshade and Jaffa mean to me...

I went straight to emerg this morning as soon as I was allowed to visit Jaffa. Got his updates, signed him out of the emerg and brought him straight to Janice to continue IV. He was bright, stalking the clinic cat with his eyes, acting totally Jaffa like. Janice sent me home to sleep just now because I will be up all night with Jaffa's IV. I don't know if I can sleep, but I do feel a lot better knowing he is going to live. I'll really be able to sleep once I know he doesn't suffer any permanent damages to his kidneys.)

Me me no no see mummy last night, and I said said
where did mummy and my Sunshade go?? Jaffaman was so happy happy when mummy came to see me me!!

Mummy said said lets take Jaffaman to see Sunshade's Aunty Janice ok ok?? I said said OKIE OKIE, mummy come come too?? See see, Jaffaman getting water in my arm arm at Aunty Janice's clinic,

Jaffaman no no know why me need water in arm arm... Mummy said said we use water to wash out bad bad candies, and make Jaffa feel good good ok ok?? I said said ok ok, but Jaffaman no no feel bad bad...

UPDATE 2 - 11pm

(mum: Jaffa has been home since about 6pm this evening. I brought home all the supplies (fluids, needles/syringes, food, medication, etc) to keep him comfortable throughout the night,

We have IV set up in the living room and he is continuing his IV therapy in an x-pen.

He wasn't too pleased about this arrangement LOL.....

He is on a few different meds for his stomach, but he's looking pretty fine to me. In fact, he's looking so fine that Janice consulted with one of her vet friends to ask about Jaffa's situation. He's not showing *any* signs of gastric problem (no vomiting, no diarrhea, no tender abdomen to the touch). Janice said she would have expected him to show some sign of discomfort.

Maybe he's being a stoic Airedale.... mind you he's usually a big baby LOL. Janice thought even tho no tablets showed up when they induced vomit, maybe the dissolved parts did come up, and he is not as toxic as we had first thought. Anyway, Janice didn't want to wait 'til 48 hours after fluids to take another blood work, so she took some blood today just before I took him home. We'll know the results tomorrow, and get a better idea at his kidney function.

Jaffa acts very hungry, but poor guy can only eat 1/4 can of gastro food every 3 hours LOL.... oh boy!

Oh and he's having to pee every 2 hours due to the fluids...hehe... Ah well...

Jaffa was so happy to see his Sunshade when he came home.

Sunshade took one look at him, and went to check out all stuff in bags I brought home with me. I bought lots of chewies for Jaffa before I was told he really shouldn't eat anything other than the gastro canned food. So while I was busy settling Jaffa in and setting up the IV....

Miss Sunshade was doing what she does best - " Seize the moment, no opportunities wasted. "

She definitely makes me smile and shake my head at the same time LOLOL!

Jaffa goes back to the vet during the day tomorrow, so I can get some rest. Clinic does the day shift, I do the ...... graveyard shift! Have a look at my schedule... hehe!

This calls for LOTS of coffeeeeeee!)

NOV. 22nd, 2007

(mum: Jaffa is back at the vet for more IV. I managed to get about 2 L of fluids in him last night and this morning and he is looking as healthy as could be - dragged me everywhere to see EVERYTHING lol, jumped on people and bear hugged Janice and Jen, you know, just the usual stuff..... LOL.

We go his blood work result back from 24 hrs post IV fluids.

All his kidney numbers are currently normal. However, it could just be the fluids diuresing his system. We really won't know for sure until he's been off fluids for 24-48 hours, and see how his numbers are at then. Even then, he could still have suffered permanent kidney damaged but its just not showing up on the blood work.

Kidney numbers only become abnormal when there is less than 25% total kidney function. If you only have 30% kidney function, your blood work would still appear 'normal'. Soooooo, if Jaffa's blood work is normal after he's been off fluids, then I will have him ultrasound-ed to make sure there is indeed no permanent damage. If there is damage, at least I'd know and I can be more proactive with diet modification/supplementation, etc.

I know, I know..... I really should be happy (and I AM) and more optimistic especially he is doing well. But I just can't help it but worry when it comes down to Sunshade and Jaffa.... I tend to look at the worst case scenerios.....

Now, one of his liver enzymes (ast) did come back elevated which Janice said it's probably his system detoxing. She said usually with ibuprofen poisoning, you see gastric/intestinal distress first, then kidney failure, and lastly the brain goes. However, Janice said we're not even seeing gastric distress from Jaffa so she thinks his kidneys/brain will be safe. I'm not too concerned about his liver enzyme being elevated at the moment. I would much rather deal with liver problems than kidneys since liver does regenerate, kidneys don't.

We will have another blood work done before I take him home tonight to keep monitoring him. It will have been 48 hrs after IV therapy. Janice still wants him on fluids after I bring him home tonight just to be safe, so that's what we'll do. NO sleep for me again......)

NOV. 23rd, 2007 - UPDATE

(mum: Well I guess I spoke too early. Jaffa's blood work taken at 48 hours IV therapy shows his kidney number - Creatinine is back up, higher than it's ever been, and both of his liver enzymes are up too, a lot higher than the day before.

The 48 hours after ingestion was our chance to do everything we could, give his system all the support it needed to see if we can reverse any damage. For his kidney values to be normal at 24 hours after IV, and abnormal 48 hours after IV tells me that he did indeed suffer permanent damage to his kidneys, which really SUCKS. I did IV with him last night (thursday), and brought him back to the vet again this morning (friday) to get more IV flush. Janice has decided to not do any IV tonight, and do another blood work tomorrow morning to see how much his kidneys are functioning without the help of IV. More IV from this point on won't really help with the damage he's suffered from ibuprofen poisoning. He is also starting to show some protein in his urine, which means kidneys aren't functioning as they should.

I don't know what to say about his liver, only that I hope it regenerates once the crisis is over.

Today for the first time, he had bloody diarrhea. So he is showing some gastric problems as well. I think it just took 48 hours for the full impact to hit.

I asked about his prognosis, both Janice and the vet she consults with said it was too early to tell. Whatever his long term prognosis is, we know his kidneys are damaged, and are currently working at less than 25 %.

SIGH..... He's so young..... He was so healthy.....

Now the bright side, Jaffa is still acting completely normal. Land sharking Sunshade, and everybody else. Lots of energy, wants to play with every dog, and is always busy looking around. Since I knew I wasn't going to be doing IV tonight, I stayed at the vet with Jaffa. Sunshade had her acupuncture as well. Jaffa was fine in the kennel until he heard Sunshade's barking (she announces her presence to everyone in the clinic everytime she goes in LOL, she thinks she owns it) and the jingle of her tags. He was frantic that he could hear her but couldn't see her. He wasn't calming down, so I had to go to the back with Sunshade, made her lie down beside his kennel, opened his kennel door so he could sniff and see his Sunshade and not feel like he's being separated from her. Right away, you hear this non-stop thumping of his tail against the kennel walls. He was so happy, so relieved his Sunshade was there. He soon fell asleep with his head hanging out of the kennel next to Sunshade. I didn't bring my camera, but it was the sweetest thing. Janice, Jen and everybody there could tell how much Jaffa really loves and looks up to "his" Sunshade. Sunshade had to stay there all day too because everytime she left (for pee breaks) Jaffa would start crying, whining and howling. It really sounded like a dog was being slaughtered LOL.

Of course, Miss Sunshade put on her pouty pouty face all day because the world wasn't all about her LOL. She made it very obvious to everyone (lying with her butt facing me, ignoring me when i called her, looked away when I tried to pet her, put her head down to the floor looked extremely sad, and etc).

Anyway, I'm pretty disappointed, sad, and hurt for Jaffa as I was hoping the effects would be acute and not chronic. I take comfort in the fact that he is acting fine, eating fine, and feeling pretty fine in general. I guess this is why people say "treat the dog not the numbers"..... easier said than done, but I'm gonna try my best to stay positive for him.)

NOV. 24th, 2007 - UPDATE

(mum: Jaffa was off fluids last night, so we could draw blood to see how his kidneys do without fluids. I took him to Janice this morning to have his blood drawn. The results probably won't be in until tomorrow, and Janice will e-mail me or call me as soon as she gets the results.

I brought more fluids home with me and had Janice put another catheter put in his other leg. It was time for his first catheter to come out, and it did last night. I'm not even sure why I brought more fluids home since I already knew the damage to his kidneys are irreversible doesn't matter how much more flushing I do. Maybe, the fluids will take the load off his damaged kidneys until they adjust to compensate for the loss in function? Or maybe I just need to feel like I'm doing SOMETHING....

Yes... he is once again, in the x-pen getting IV.

Jaffa is still having runny poop with little or no blood (which is good). Janice thinks maybe his system doesn't like some of the ingredients in the Medical Gastro Formula, so she suggested I start to add a little bit of cottage cheese and cooked chicken to each meal and slowly wean him off the Gastro.

He weighed 54 lbs today. He was 60 lbs on Wednesday. Maybe it's the IV flush, maybe it's the Gastro food, or maybe he is that sick??)