Dog with renal failure

Question
We a six year old female dalmatian.  She hasn't been eating for the last couple of days, which is very unusual for her.  My husband took her to the vet today.  Externally, she seemed fine, but they did some routine lab work which showed that her kidney function is very poor.  Aside from this, she has been a pretty healthy dog.  She was spayed when she was younger.  She has had some problems with incontinence in the last year or so, for which she has been on phenylpropanolamine.  Also, several months ago, we thought she had blood in her urine - we would see blood on the fur.  She was treated for a kidney infection, but hasn't had any problems since.

Our veterinarian kept her to give her fluids all day today, and wants us to bring her back for more fluids tomorrow.

We will of course be talking more with our vet, but I was wondering if you have any ideas about what questions we should ask or what type of
treatments, if any, are available?  It sounds to me like she might have had a glomerulonephritis several months ago, which is finally now ecoming evident. My other thought is an obstructive stone, since dalmatians are prone to kidney stones.  Her BUN/Creatinine doesn't really look like dehydration or a stone, though.  I have a bad feeling that hydration is not going to help much.  We are devastated.   We lost another
dalmatian a few years ago to heart failure, also at a relatively young age, so this is all too familiar.  I would really appreciate any ideas you might have.

I am including her labs below.

Thanks,
Sarah

These are her labs from today:
Abnormal:
BUN - 44 mg/dL (7-27)
Creatinine - 3.4 mg/dL (0.5-1.8)
Total protein - 4.5 g/dL (5.2-8.2)

Everything else was in the normal range:
Alkaline phosphatase - 51 U/L (normal 23-212)
ALT - 10 U/L (10-100)
Glucose - 103 mg/dL (70-143)
Hematocrit - 34.6% (33.1-35.7)
Hemoglobin - 10.4 g/dL (9.2-11.4)
MCHC - 30.1 g/dL (28.7-30.8)
WBC - 17.9 (15.6-19.5)
Granulocytes - 8.9 (8.3-10.1)
%grans - 50%
L/M - 9 (7.3-9.4)
%L/M - 50%
Platelets  - 129 (116-162)  

Answer
Hello.

I would recommend having a urine sample sent out for culture and sensitivity to make sure she is not brewing any underlying infection.  Also, starting her on Amoxicillin to be safe would be a good idea.  Having her x-rayed for stones is also a good idea since she is a Dalmatian....most likely not obstructive, but could be a source of chronic infection that led to the kidney damage in the first place.   

If she is dehydrated, that means her total protein is LOW and she is ANEMIC.  I would also check a urine protein:creatinine ratio on the urine as this can be a predictor of how well they do...when they have kidney damage, they will lose albumin (ALB) in the urine.  Sometimes low dose of Enalapril can help reduce protein loss.

If she will eat the K/D food that would be of benefit. (Do not feed U/D...it is too restrictive in protein and I have seen several Dalmatians develop heart murmurs while on it).  If she won't eat this just give her chicken or burger and rice with plain yogurt.  I would also recommend starting her on B complex vitamins to help combat the anemia...you can give a B50 once a day.  For the nausea, you can try Pepcid AC 10 mg twice a day.  

If she is eating and acting normal, then it doesn't matter what her lab values are--you just have to keep her comfortable.

And I would encourage you to check out Transfer Factor.  I had a friend who prolonged her cat's life by a few years by giving this immune supplement.  I take it myself and haven't been sick in a long time, and my cats get it daily to help with their chronic illnesses.   There is a product specifically for dogs (TF Canine Complete) or you could give the Animal Stress Packs to boost up her immune system and help her body fight.
www.transferfactor.com
www.4tf-pets.com/testimonials.htm
www.my4life.com/drfry

GOOD Luck!
Dr. Fry