Interpreting test results, UTI, kidney, hot spots

[altuspups]

Hello,

This is my first post.

I have a 10 yr. 7 mo. old spayed, female lab.

She was kibble fed up until Jan 2016 ( the first 8 years of her life) and fully vaccinated - it wasn't me!

Jan 2016, we started her on Grain Free Honest Kitchen (Beef or Chicken) Jan 2016.  At this time she had an ear infection, inflamed red skin with brown smelly discharge.  RX Quadritop but did not help. We are still fighting this ear infection 2 yr 7 mo  later but I believe it is finally clearing.

A Biochemical Panel at that time revealed slightly elevated (out of range) for CRE, GLU, HGB, HCT, MCV, MCH. And slightly below range for WBC, LYM, MON.

These are all within range today, except her CRE is still at 1.5 (range 0.3 - 1.4). BUN is normal at 18 (range 7-25). In the 2 yr 7 mo the BUN has come down from 23 to 18.

Are there concerns to watch for since her CRE has been at this level over the last 2 yrs 7 months,  who know what it was at before we started tracking blood panels. It concerns me that she now has a UTI, with blood in the urine, confirmed today. She has been urinating more often over the last 3-4 weeks.  I follow Anthony William and according to AW the UTI means bacteria (strep) but I wonder why this might be coming up now?

I realize it could take some time to "reverse" damage to the body from only feeding kibble for so long but is there anything I can do for kidney function outside of focusing on kidney friendly foods like what Anthony recommends for people:  higher electrolytes/mineral salts (celery, cucumber, fennel, spinach, mango) in their diet and less protein.  Would it be ok to lower protein for a period of time, like a month, for a canine or do I need to lower protein at all?

Since kidneys are responsible for eliminating toxins - her kidneys might be in overdrive trying to "detox" since I changed the diet. Thinking out loud here.

In May, 2017 we switched to exclusively raw meals  (no grains) and then in Jan 2017 added the GF Honest Kitchen back in, in addition to some raw meals. When we do raw, we do various  frozen then thawed proteins of hamburger, turkey necks, canned sardines or mackerel with other fruits/veggies/bone marrow. Is it possible to get bacteria (causing UTI) from frozen then thawed raw meats?

She's also got a hot spot coming up on her back right hip/back area. In Anthony's Pet Health show he says hot spots could be due to a reaction from food and I did recently add quinoa ( a grain according to MM) in over the last 10 days so I will take this out but I wanted to mention this in case it ties in with anything else.

Thank you for the help!

Aimee Altus

 

 

[Dr. Jeff]

Hi Aimee and welcome!

First thing to do is confirm that the slightly elevated creatinine level is indeed indicating any kidney dysfunction.

You can do this most easily by testing a urine sample for any protein and its concentration (specific gravity).

Drop off a first am (before she drinks) mid-stream urine sample to your vet. Ask them to send it out to the lab for full analysis (lab analyses are 30% more accurate than in-house vet tests).

Even more information would be gleaned by running a full Idexx renal profile. This will include the urinalysis as well as a blood test called SDMA. This test is a very sensitive internal test for kidney function.

In lieu of the SDMA, take a look at the creatinine trends over the years. Is cr level rising or is this level just her "normal"?

BUN is more of a reflection of her dietary protein so not as specific to kidney function.

Yes, there are indeed kidney supportive foods and herbs including those which Anthony recommends. Dandelion, parsley, celery, wild blueberries, etc.

Lots more kidney details and suggestions are in the cystitis and kidney webinar course which you can find by <a href="https://www.holisticactions.com/holistic-actions-for-cystitis-and-kidney-dis-eases-webinar/">clicking/tapping here</a>.

Regarding her ear discharge and inflammation (and possible secondary infection), this is an important way her body is trying to rebalance internally. How are you currently addressing it?

Yes, as Anthony says, quinoa is a pseudo-grain as you can read in <a href="https://ucdintegrativemedicine.com/2016/08/busting-whole-grain-myth/#gs.CoyJZ6I">this</a> UC Davis integrative medicine article.

Protein does not need to be restricted in her diet at this time.

Let us know what the urinalysis shows.

Dr. Jeff

 

[altuspups]

Thank you Dr. Jeff.

I did not see your reply until just a few days ago but wanted to post an update here.

Since her vet visit on July 10th with an injection of Amoxicillin, she seemed to be improving as she was not urinating as frequently or with urgency .

Since May her mood/activity seems to have changed somewhat in that,  in the past she usually wanted to be outside or she liked to play fetch with the 2 year old lab. She still plays today but since May it's more of a trot to the ball (rather than a full speed run) then walking back to me or she'd go potty then go to the door to be let in. I couldn't tell if her lack of play was from the heat or from an injury. Injury from playing fetch too much, some favoring of her back left leg, trying to keep up with the 2 year old. And it does seem like she has been napping a lot more than she had prior to May.

On Mon &amp; Tues she had 3 ounces of celery juice first thing in the morning, something new we did but they occasionally eat the pulp of my celery juice.

Friday, Aug 10th. I was out for 3 hours or so and as I let her out she seemed to urinate for minutes, then she walked around and tried to urinate two more times, not normal behavior for her.

Friday after this abnormal potty break I gave her 2 tablespoons of the LipoNaturals Liposomal C, a teaspoon of Silver and Goldenseal tincture + honey.

Saturday morning thinking her UTI returned, I gave her goldenseal + honey again and then juiced two cucumbers for her . 20 min later I made her a mash of chia, hemp hearts, green beans, apple, celery, wild blueberries, 1/2 tsp spirulina and  1/2 tsp of Barley Grass Juice Powder. Then out for a potty break.

As she was urinating, the stream was more like a dribble and then a gush of urine and I saw the stone drop.

She was panting so I gave her 3 doses of Arnica 30c every 30 min.

Brunch/lunch was her normal The Honest Kitchen Grain Free Beef.+ Base Mix. I also made a smoothie of an apple slice with 1/2 cup of cranberries and 1/2 cup mango.

She seemed to feel much better as she grabbed a toy to play with and ran around the house a bit.

The remainder of the day the stream was moderate, not a normal stream and some blood.

Sunday morning she seemed to feel better . Her urine wasn't clear the first couple of potty breaks but then she had 3 potty breaks in a row where the urine "looked" normal (without the tint of blood) and the stream was not a dribble. But before bedtime she had another break with blood in the urine.

Today, Monday, I took her to the vet. An x-ray shows several stones in the stomach (will attached in the files). The vet will send the stone off to the Minnesota Urolith Center and I caught her first urine of the day mid-stream and asked him to send this out for the Idexx renal profile as well as the SDMA blood test.

He didn't seem to concerned with the CRE levels. Should I be concerned here?

Her CRE over the past 2.5 years:

1.5  Jan 2016 (on kibble previous 8 years, stopped all kibble this month - switch to Honest Kitchen)

1.2  June 2016 (off dry dog food for 6 months)

1.1  June 2017 (her coat was like silk here but today it is very dry and thinning on her backside toward the tail - very thin). In July 2017 , we switched from Honest Kitchen to homemade and raw meals.

January 2018 - added The Honest Kitchen back in for some meals and Orijen Regional Red for a lunch snack - 1 cup per day.

1.4  July 2018  (is this a significant rise in one year or is this "normal"?) - stopped the dry kibble lunch.

I have attached a picture of the stone and the x-ray with the stones in her stomach. I will attached her lab work in the next post.

The options were to see if they would dissolve with Royal Canine Urinary or c/d Urinary Care kibble but I did not get these. OR depending on the test results, surgery to remove the stones.

How do we dissolve these stones?

The vet also sent me home with 14 capsules of 500mg Amoxicillin. Should I use these? What is the alternative?

I've ordered Tinkle Tonic, the cranberry extract and d-mannose.

How long does it take for stones to form?

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[altuspups]

X-ray attached

 

[altuspups]

Prior diagnostic labs attached: Jan 2016 to July 2018.

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[Dr. Jeff]

Hey Aimee-

Thanks so much for posting an update about your pup.

Sorry to hear about the bladder stones, but she will overcome this health challenge.

Regarding your questions:

1) The increase in creatinine could indeed be significant. However, it also may not indicate a primary kidney problem.

Was a urinalysis done at the time of any of the blood tests?

I ask because it is the concentration of the urine (a test called urine "specific gravity") and presence of albumin in the urine that is typically more sensitive than creatinine alone).

The clues in the blood work do not otherwise indicate a problem.

Also, it looks like these tests might have been run in the clinic. If so, that also can explain the abnormal values.

I'm so glad that the Idexx renal profile (which includes an SDMA) and urinalysis was run today. Please update when you get those results.

BTW-don't be surprised or worried if the urinalysis shows blood (even if the urine looked clear) as this is expected from the stone irritation of the bladder.

1b) Yes, the rise in cr could be significant. The recent Idexx tests will be much more sensitive though.

2) How to dissolve the stones will depend on the minerals in them. The MN urolith lab results will tell us.

Regardless of those results though, the Tinkle Tonic, vitamin C, cranberry and D-mannose will help.

In addition, increasing her fluid consumption is also extremely important. If she's not a big drinker, organic chicken broth added to her food works well.

3) Regarding your anti-biotic question. I'm personally not a fan. Especially if her urine was cultured. They may find any bacteria in it to be resistant to amoxi you were given.

That being said, research has shown the effectiveness of using these drugs along with diet in management of bladder stones.

In my practice we use homeopathic individualization and immune boosting rather than the anti-biotics.

4) Speed of stone formation is determined by individuality, susceptibility, diet, etc.

Typically it can take months and months (or even years). And in fact small non-detectable (by x-ray) stones and crystals could have been there for most of her life with you!

Has she had other urinary problems?

You are already doing everything you can to support her while she heals.

I would also consider working with an experienced vet homeopath to help curatively stimulate her body.

If I, Dr. Christina or any of our resources have other suggestions, we'll post them here.

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[altuspups]

Thank you Dr. Jeff,

No, no urine samples were taken when the blood draws were done Jan 2018-July 2018.

We rec'd the results from the Idexx renal profile. The vet says the kidneys look good, the chem panel is great, the CBC was normal and the urinalysis presented with cells, bacteria, blood and struvite crystals. And then we will confirm struvite stones w the stone analysis.  I have attached the Idexx results.

We are on a 3-4 month waiting list with a homopathic vet, local to us. Is it necessary to consult with someone local? Are there any recommendations for the North Dallas area?

We noticed change in her potty habits (increased frequency and urgency) issues in June. Other than that she has not had any known urinary issues.

What is a normal pH to look for? Are there any recommended test strips I could get to occasionally test her?

Is the low AST  an area of concern? What does a low AST mean? I'm only finding a high AST would cause concern with the liver.

Thanks for all the help!

Aimee

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[altuspups]

Idexx test results attached for June.

 

[Dr. Jeff]

Hi Aimee-

Sorry for the slow response.

Great news about the Idexx results.

No, it's not necessary to use a local vet homeopath as long as your local vet is willing to work along with you for any needed exams, diagnostic tests, etc.

Urine pH changes throughout the day, but in general, acidic urine of around 6.5 (or less) is preferable for helping to dissolve struvite stones.

The vitamin C will help lower her urine pH.

Yes, home urine testing is great. Most of the urinalysis strips include an accurate pH test.

There are a few readily available on Amazon, and you'll find some recommended in the urinary webinar toolkit.

No worry about the low AST. It doesn't indicate any problem or even mild dysfunction. As with other test results, the number is changeable throughout the day.