- Species: Dog
- Age: 3 years
- Sex/Neuter status: Male, neutered
- Breed: Mixed breed
- Body weight: ~21–23kg
- History: Congenital CKD diagnosed at a young age with recurrent urinary/kidney infections and kidney stones. History of PU/PD since puppyhood. Previously hospitalized during a major kidney crisis about 2 years ago and later stabilized on renal diet/supportive care.
Two weeks ago developed decreased appetite and lethargy. Bloodwork showed severe azotemia and anemia, leading to hospitalization for one week. During hospitalization diagnosed with severe AKI on CKD, Proteus mirabilis urinary/kidney infection, severe hypertension, suspected pancreatitis, and significant multivalvular heart disease.
Received supportive inpatient treatment including IV fluids, blood transfusion, antibiotics, antiemetics, appetite stimulants, antihypertensives, diuretics, and cardiac medications. Discharged after stabilization attempts.
- Clinical signs: Severe lethargy, hyporexia/anorexia, nausea despite medication, weakness, sleeping most of the day, weight loss. Still ambulatory, drinking water, urinating/defecating normally, responsive and interactive.
- Duration: Current decline approximately 2 weeks. Chronic urinary/kidney issues since puppyhood.
- Your general location: Israel
- Links to any test results, X-rays, vet reports etc. that you have: Recent findings include:
- Creatinine approximately 11–13 mg/dL
- BUN >130 mg/dL
- Severe anemia
- Severe chronic structural kidney changes bilaterally
- Large nephrolith
- Recurrent urinary/kidney infections
- Severe hypertension
- Suspected pancreatitis
- Significant heart valve disease affecting all 4 valves
My main question is regarding prognosis and quality-of-life assessment in advanced renal disease cases complicated by significant cardiac disease.
From a veterinary perspective:
- In cases this severe, is temporary stabilization still sometimes seen despite values this high?
- What clinical indicators are generally considered most significant when evaluating quality of life in advanced renal/cardiac patients?
- How commonly can severe nausea alone account for profound appetite suppression and lethargy in advanced CKD patients?
Thank you to anyone willing to read and respond.