Seven Tips for Managing Heart and Kidney Failure in Your Pet

Medical articles
Multi-system failure in pets

When our 13-year-old Chihuahua-Shiba Inu mix, Kali, was diagnosed with Mitral Valve Disease in April of 2012, it was kind of a non-event, even though it is a fatal diagnosis. Our primary vet caught it so early that when we went to a cardiologist, we didn’t need to do anything at all - not even change her diet or exercise.

She made it to mid-July 2013, and then, one day, she was acting weird. I rushed her in to our cardiologist, where they immediately put her on oxygen. She was in congestive heart failure. We were totally distraught, but steeled ourselves - we knew this would eventually happen, given her disease, and that it would lead to her passing.

Turns out, she had other plans.

They hospitalized her overnight and got her stabilized with oxygen and additional medication. They were pleased with her recovery and sent her home. However, 18 days later, she stopped eating altogether and vomited twice. Something wasn’t right. I brought her in, and sure enough - her kidney levels were through the roof. Her heart medications were causing kidney failure. They hospitalized her and gave her the right amount and kind of hydration to stabilize her kidneys without sending her back into heart failure, which required a very delicate balance.

They also tweaked her meds, including “putting her on a vacation” from some of them. And so far, so good. It’s been 13 days and she has made a nearly full recovery. It’s been pretty miraculous, but it’s also come as a result of a lot of teamwork between her doctors and her family. Managing simultaneous heart and kidney failure in a pet is very challenging, but it’s not as rare as you might think, so I wanted to share some things I’ve learned. It can be very scary and confusing, so maybe our experience can help others navigate these tricky waters.

Here are 7 things I’ve learned on this journey so far.

1. Be Observant, Take Notes, and Over-Communicate with Your Vet

Admittedly, I have a luxury many do not: I work from home. This means I can stare at Kali all day long. If you can’t be with your pet all day, don’t worry; the important thing is to shift your mindset from casual pet owner to “diagnostic observer.” Take mental and physical notes on everything you can. Along with a respiratory rate chart that our cardiologist gave us, I started my own coughing chart for Kali so I could keep a daily count. Those two tools are what told me that I absolutely needed to take her in on that day in July, but what tipped me off in the first place was her unusual behavior.

As Kali goes through this journey, I no longer shrug anything off. If there’s stiffness where there wasn’t before or she refuses a food she at one time loved, I note it and discuss it with my vet. Of course, it could vary based on vet, but you should never hesitate to call your primary vet or specialist with questions or concerns. They are there to help your pet, and they can only do that if you tell them what’s going on. The more they know about the day-to-day happenings and condition of your pet, the better they can treat her.

2. Stock Up on Various Foods, Treats, and Supplements

This is the main thing I wasn’t prepared for. We have gone through so many different dog and human food combinations, as well as supplements. Kali totally lost her appetite, and her tastes changed. It was especially troublesome after her kidney failure, and it perpetuated her weakness and lethargy. We got to the point where we didn’t care what she ate - we were just trying to get her to eat something so she could have a shot at recovery.

Talk to your vet or local pet food expert about safe and nutritionally-sound options that might work for your pet’s (lack of) appetite and keep a stocked pantry and freezer. I have more details on Kali’s ever-changing menu on my blog.

3. Procure Special Supplies for Body Changes and Spirit Preservation

With congestive heart failure, the meds are diuretics, designed to move fluid away from the organs and out of the body. They can do this at such an effective pace that your pet may have accidents. We’ve been a lot more proactive with walks and trips outside, but Kali has had a few accidents, which is completely unusual for her. We put 2 vinyl mattress covers on our bed and they have come in handy.

We also briefly borrowed a doggie sling because Kali went through most of a month not being able to complete her walks under her own power, but wanted so much to be along for the journey. Some of her meds cause muscle-wasting, and that made it physically hard for her to complete the task. Some other items to consider might be a ramp for any stairs or furniture, and some area rugs, if you have slippery floors.

4. Increase Water Bowls and Rate of Refills

This one is simple, but significant. A pet on diuretics needs constant access to clean, fresh water. We doubled the amount of water bowls in the house and I’m still refilling them both about 2-3 times per day (we have multiple dogs in the house, but it’s still a marked difference).

5. Be Ready for the Ups and Downs

Everyone’s journey is different, but the thing they all have in common is that they are emotional. One day, you might think your pet is surely going to die. The next, she could have her best day yet. It’s been a roller coaster with Kali. She’s currently on a 10-day good streak, but during our darkest times, it was literally hour-to-hour.

We take advantage of the ups when they’re here (see “Spending Quality Time with Your Pet”), and hunker down during the hard times. We remind ourselves that Kali’s had a wonderful life, that we are doing our best for her, and that we are prepared to let her go when the time comes.

6. Spend Quality Time with Your Pet

When Kali was first diagnosed, we embarked on this little project of taking her on special outings. We wanted to spend time with her doing all of the things she loved before she couldn’t do them anymore. I’m so glad we did that. We’re still doing it, but her level of activity has changed from when we first began. When we have free time, we assess what Kali’s current state is and choose something appropriate.

Remember that spending quality time with your pet doesn’t always mean an outing. It means closing the laptop at night so you can hang out with her, talking/singing to her, and kissing/petting her every chance you get. It’s just about not taking for granted the little things, because they are fleeting. I know we’re on borrowed time, and I’m grateful for it.

7. Don’t Forget About Other Pets in Home

With all of the attention, special foods and treats, vet visits and trips for your critically-ill pet, your other pets will surely feel the difference. Try to do what you can to maintain the usual routine that your pets count on and carve out even just a few minutes each day for each pet that is just theirs.

One of the things I have to watch myself with is how I transfer my stress, fear, and anxiety about Kali onto my other pets, especially when I bring her back from the hospital or a vet appointment. They always want to sniff her, and say hello to me with typical crazy happiness. I really have to check myself so I don’t scream at them: “Be careful with her! Don’t do that! Watch out for Kali!” It’s not their fault; they’re only doing what they’ve always done. Although a couple of them can sense something is amiss, they don’t understand the intricacies of why they need to be careful around her. It’s challenging when we’ve had a particularly bad Kali day, but I really try my hardest.

Going through this with Kali has been one of the most emotional experiences I’ve had, but I feel so fortunate that we are able to give this level of care and attention. I feel infinitely lucky that we have such an amazing primary care vet and access to advanced critical care. And I feel lucky that I have a platform to share our experience, because it might help someone else out there.