Acute renal failure

DrKumar Ravi hi docs i have a case of great dane who hao acute renal failour with b/t reports of last week as tlc-4800, n-20 l-80 blood platlets-1.20 lack serum creat-4 bun 120 vomitting off feed. after treatment with iv fluids, conciplex, rantac, lasix, enrocin to combat sec bac infection as its a viral origin of renal failour. now he start taking food little bit no vomitting. today i repeat the blood test s.creat rise to 5.1 tlc 4200 l-75 n-20 blood plat- 80000. what should i do im totally confused . i recheck the samples but results r same

10 January at 16:41 · Comment · · Flag

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    Ajitesh Kumar

    dr i dont know whether its a case of acute renal failure of viral origin or not. acute renal failure is a rare condition. and viral origin is still rare. if it is acute then the onset will be sudden,with olig uria or anuria mostly. reason could be poisoning, nephrotoxic drug, leptospirosis etc.whether there was polydipsia/polyurea, what was the hb level? what was the temperature?urinalysis would have been a good option. u can see the specific gravity of urine, casts,pus cells etc . it can be prerenal azotemia also.
    as per the reports which we have ie platelet count 1.2 lakh and then 80000. leptospirosis can be the cause.
    treatment options will be fortified procaine penicillin, lasix,rantac,emeset/ondansitron(if there is no loose motion)and enrocin along with aggressive fluid therapyi.e normal saline @ 25 ml/kg bw bd. if there is no appetite then 5%
    dextrose, and amino acid solution (astymin)should also be given. blood test after 3 days again to see the parameters i.e creatinine and bun. if it does not come down then prognosis is very poor.then peritoneal dialysis can be tried.
    

    10 January at 19:46 · · Report
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    Ajitesh Kumar and every 3rd day vitamin k injection to take care of bleeding due to low plate count

    10 January at 19:47 · · Report
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    Gagan Gaudi if possible get it checked for tick borne diseases

    11 January at 06:40 · · Report
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    Saurabh Saxena go for ultrasound immed. and check shape ,size and consistency of kidney ,liver in particular and other vital organs.

    11 January at 08:14 · · Report
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    Amardeep Singh i agree Dr gagan

    11 January at 10:10 · · Report
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    Swarupmay Majumdar

    There is drug called AZODYL ( gut acting pre+probiotics which reduce Ammonia production in gut ) on TID orally can reduce Sr Creatn level drastically. stop enrofloxacin as it is excreted through kidney, use omeprazole alt days with sucralfate for saving GI tract. Use phosphate binders tab phostat675mg bid po. use herbal liver tonics for appetite.
    do not stop fluid. use RL 500ml 2 bottles + D25 2 bottles. check for sr protein ,if below 5 go for iv Aminoacid supplements, its not contraindicated. some people uses envas tabs to see that there is bettre perfusion in kidney. can use this too and its very safe.
    Make a chart of all drugs, tell clearly how and when to give which medications. need more details ?
    
    one more thing, this may be a case of just renal failure post meloxicam pain therapy!! low TLC is not always indicative of viral renal failure.am I wrong?

    11 January at 10:21 · · Report
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    Amardeep Singh thanx SM

    11 January at 10:40 · · Report
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    Ajitesh Kumar i have never heard abt viral renal failure. i think renal failure due to tick fever is also unlikely

    11 January at 11:33 · · Report
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    DrKumar Ravi dr ajitesh there is no bleeding n protozoal cause i dont think i9n that case . platelets r also decreased in long term viral cases. his hb also reducing day by day to 8.1 which is common in kidney dysfunction. there is no poly or oligurea. final thing is that he loses weight n s.creat rising thats it

    11 January at 16:47 · · Report
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    Ajitesh Kumar then that is a chronic renal failure case not acute renal failure.hb will not be low in arf

    11 January at 18:22 · · Report
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    DrKumar Ravi dr saab its a acute on day of prasentation of dog to me first time now you can say its a cronic one after two weeks of kidney dysfunction hb is reducing na.

    12 January at 15:20 · · Report
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    Ajitesh Kumar that is 100% possible. good that the patient is recovering.

    12 January at 16:53 · · Report
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    Swarupmay Majumdar whats the outcome, whow is the bun creatinine level, and what did u do? who did u listen? ha ha laughing!!

    13 January at 15:23 · · Report
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    Saurabh Saxena yes that is important which line of treatment helped the dog .wud be better to know for everyone concerned...thanks

    13 January at 16:30 · · Report
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    DrKumar Ravi its you dr saab . creatnin - 3 . dr saab i think in india 80 % vets circling around tick fever only.

    13 January at 16:37 · · Report
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    DrKumar Ravi phostat 675mg biob n omeprazole once a day lasix . ringer lactate twice a day with conciplex n ranitidine i v . cap azodyl thrise a day . we got it from france all thanks to dr swarupmay

    13 January at 16:43 · · Report
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    Saurabh Saxena gr88 work dr kumar and dr majumdar ..see SAVIN has saved a dog and helped a fellow vet.WHAT AN IDEA SIRJEEE..HAHAH

    13 January at 16:46 · · Report
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    Swarupmay Majumdar oh my god! I am on Cloud nine, for SAVIN"s one another real case achievements and little more on my praises!!

    13 January at 17:31 · · Report
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    Swarupmay Majumdar

    Now that the Serum Cr is down, try Royal canin diet "RENAL" as per label instructions, continue with "AZODYL" life long.the prognosis is good now. If you find any side effects with PHOSTAT, stop it. Use Pentab_D 20 mg once in 2 days. ADD ENVAS TABLETS> very important!! Give him a homeopathic medicine called " PYROGENIUM 200, 6 doses- a dose twice a day with homeopathic CANTHARIS 1M wkly twice+ Biochemic Natrum sulph 6x ( in leu of lasix). Stop lasix. Use tab lasilactone alt days.
    
    ENVAS+LASILACTONE +PENTAB _alt days
    AZODYL+PHOSTAT-BID
    Not to food: use Bayer's Tonic or Ventriliv!!get good result.
    DR Ravi, Great job. thanks for posting such a geat topic which has ran a long thread.

    13 January at 17:43 · · Report
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    Neelam Singh Josan would just want to check, why antacid is advised only once in 2 days-since i almost always advice it daily once atleast.GREAT, INTERACTIVE DISCUSSION!!!!

    14 January at 08:41 · · Report
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    Swarupmay Majumdar omeperazole is giving good results if given once in 3 days in dogs, rantac once in 24 hrs. the more frequent dosing in this case will still reduce the appetite as gastric acid secretions will supress toptally. Anyway, most vets uses it dosed frequently, some book reference gives omeprazole is very good in dogs and once in 3 days is ideal!! Pentaperazole isalso good once in 24 hrs. tabletsof 20mg avl. cimetidine is not very effective in dogs.

    14 January at 09:53 · · Report
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    Ajitesh Kumar thanks dr swarup

    14 January at 11:12 · · Report