I may have another ultrasound in a year to evaluate progression, because two good friends of mine who are nephrologists (for humans) have told me that the ultrasound findings are not necessarily progressive and they could be indicative of an old injury - especially since her creatinine has been high-normal for years. We will check her blood work and urinalysis every three months to keep track of things. I am also giving her only purified water, fish oil supplements, and k/d treats. Right now, I have changed her diet to ground lamb (lowest phosphorous meat I can feed other than chicken, which she is allergic to), and Grandma Lucy's Artisinal Base Mix, which is also very low in phosphorous, so she's eating low phos/lower sodium/moderate-to-low protein. Her blood pressure is also normal and she tested negative for Addison's. Her urinalysis was completely normal - no protein in her urine, and she is still concentrating her urine very well with a specific gravity of 1.050. We had an ultrasound and it should signs consistent with early CKD ("slightly irregular renal cortices which are consistent with renal cortical infarcts and fibrosis"). I'll do whatever I need to to keep this dog as healthy and happy as possible (and right now she has no idea anything is even wrong), but it's just a lot to process. Sorry for the super long post - I am just going through a lot right now and trying to get all of my thoughts straight. Obviously more tests are needed to figure this out. Unfortunately, I don't know her medical history at all before I got her at ~3 years old because she was abandoned. My vet's current hypothesis is that she had some sort of acute kidney injury in the past, rather than chronic kidney disease. They always told me her blood work was great, so this was troubling news to me. When I lived in Boston from 2012-mid 2013, Honey had quite a bit of blood work done, and after reviewing her values from those times with my current vet, it looks like her creatinine has been on the high end of normal (around 1.2-1.4 mg/dl with ref ranges of 0.5-1.6 or 0.5-1.8) the entire time I've had her. They did do a dipstick in the office, which detected only traces of protein (and I was told traces are okay, especially with a higher specific gravity, which she had), but I know that dipsticks are not that accurate. They did a cystocentesis to take urine for a urinalysis and culture yesterday so we should get results in a few days. I'm sure there is something out there that will suit her needs, but it's just very daunting at the moment. Of all the rx diets out there, I like Royal Canin the best, and my vet carries it, but their renal diets contain chicken. I am concerned about putting her on a veterinary renal diet because all of the ones I've looked at contain chicken or turkey and she is very allergic to both of those proteins. Her current diet is low phosphorous/low sodium/moderate protein (not on purpose - but I looked and the phosphorous and sodium contents are equal to or lower than all the rx renal diets I've looked at). Yes, we are seeing a board certified internist at Animal Medical Center on Thursday, and will be getting an ultrasound done.
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