Sofie was one and a half years old when we began taking her to Banfield Pet Hospital in Bel Air Maryland.
We purchased a preventative healthcare plan for Sofie that included two complete blood work panels and one urinalysis per year among other things such as fecal exams and vaccinations. Banfield provides these plans in order to catch any illnesses the dog may come down with in the early stages of development.
Sofies first comprehensive appointment was on 4/20/2009 and she was seen by Dr. Jill McLaughlin. At
this appointment Sofie was given a blood test as part of the plan. Upon picking Sofie up from her appointment, Sofie was brought out to me by Dr. McLaughlin and I was told that she everything was fine with her. I expected this news because Sofie seemed to be a relatively healthy dog and was only
going there for a check up, not because she was sick. [continued below]....
..... Sofie was taken back to the vet for a dental
cleaning 7/7/2009 and was seen again by Dr. McLaughlin. At this appointment Sofie had another blood work panel run as well as a urinalysis. When I picked Sofie up from her appointment, I was told again that everything was ok with her. In May, Sofie was taken to the vets to get the Lyme vaccine and no
blood work was performed at that time.
In October, Sofie was taken to the vets for a routine comprehensive exam and did not have any blood work or urinalysis performed during that visit because all of the tests from the plan had been used between April and July.
Sofies next round of blood work and urinalysis occurred on 4/28/10 and she was seen by Dr. McLaughlin.
When I picked Sofie up from her appointment I was told as always that she looked great and everything was fine. Sofie had her second round of blood work that year 11/1/10 and she was seen by Dr. Jessica McGallidner. When Sofie was given back to me I was told everything was ok, however, when I got home and looked at the summary report that is typically given to me when I leave the appointments, there was a
comment about Sofies kidney enyzems and that Sofie was slightly dehydrated that day. I assumed this could be possible since she never was a big drinker and since no one ever commented about her blood work before, I figured I didnt have anything to worry about.
Sofies next round of blood work was on 4/30/11 when she was taken in for a dental cleaning. This
time Sofie was seen by Dr. Sheri Sprague. I received a phone call from Dr. Sprague stating that Sofies BUNs (blood urea nitrogen, kidney enzyme) was quite high which alarmed her. Thinking that Sofie may be dehydrated and that could be causing the elevated results, Dr. Sprague administered fluids to
Sofie and repeated the blood test. Her BUNs had come down a bit after the fluids but they were still out of range high. Since by this time Sofie was only 3 years old, this caused Dr. Sprague to investigate further. When I went in to pick Sofie up, Dr. Sprague sat me down and stated that after looking through Sofies blood work history, she has had elevated BUNs for 2 years, while her CREAs (creatinine, another
kidney enzyme) had steadily been increasing and though they were in range, they were at the upper end. Dr. Sprague wanted to put Sofie on a low protein diet immediately and have her blood tested again to see if that brought down the values.
Sofie was restricted to this prescription Hills K/D low protein diet immediately. In the meantime I requested that I receive copies of all of Sofies medical history from Banfield because whenever you pick up a pet from this hospital, they send you home with a summary of things performed that day but they do not give you the specific lab work results. When I got home and analyzed the blood work and urinalysis I was horrified at what I saw. Sofies BUNs had been out of range high since 4/20/2009, never falling within the normal range limits and her CREA were steadily increasing with each test. Her urinalysis had also shown abnormalities and should have raised red flags that something may be wrong but again, nothing was ever said to me when I picked her up from these appointments nor was anything written on the summary
papers that I went home with. I called Dr. McLaughlin because she was the one who saw Sofie the most whenever she had her blood tests and urinalysis performed and asked her why this was ignored. I was very upset because I know what elevated BUNs and CREAs mean; it means an issue with the kidneys, and
kidney damage can not be reversed. Dr. McLaughlins response to me was that I shouldnt look at a dogs blood work the same way as I would look at a humans blood work and she did not seem at all concerned, meanwhile I had Dr. Sprague telling me that I should be very concerned for Sofie!
After Sofie had been on the special low protein diet, we had her blood retested by Dr. Sprauge on 7/28/2011. Her BUN and CREA were now both out of range high and I followed Dr. Spragues advice and took Sofie to see an internal medicine vet. I took Sofie to see Dr. Meredith Miller at the VCA in Newark Delaware. Dr. Miller had gone through all of Sofies medical history form Banfield and diagnosed her as having chronic kidney disease. Dr. Miller also ran her own blood work, urinalysis, urine protein/creatinine ratio test and a urine culture. Sofies blood work still showed elevated BUN and CREA values, her urinalysis was negative for bacteria, and her urine protein/creatinine ratio value was an 8 (normal is 0.5, cause for concern is 1). Because of the enormous amount of protein going through Sofies kidneys, Sofie was prescribed medications and was on them for 10 weeks. Sofies blood work after the medication was worse than ever and Dr. Miller suggested that we put her on subcutaneous fluid treatments. Before I could make my appointment with Sofie to learn how to do the fluid treatments at home, Sofie started to act sick on Thursday December 22. I was very alarmed and took her right in to see Dr. Miller. We started
the fluid treatment everyday but Sofie did not improve, she only got worse. Sofie was sleeping most of the
day beginning Thursday December 22, she stopped eating, and she could not drink. My husband and I tried feeding Sofie and giving her water through an oral syringe to buy us time to allow the fluids to start working and flush out Sofies system of the toxins that were building up from her failing kidneys.
Sofie vomited everything that we tried to give her. On Monday December 26, Sofie woke up from a
nap and started acting very strange. She was flicking her tongue in and out of her mouth violently and rubbing her face in her paws while doing so. When I looked at her tongue, it was turning black and was ulcerated which is why she couldnt drink the water she so desperately wanted. By this day, Sofie could barely keep her eyes open and when she did wake up, she would slowly walk with a hunched back over
to the water bowl and try to drink but because of her tongue she couldnt drink the water she so desperately wanted. We discovered that a blackening tongue is a sign of uremia which is the build up
of waste in the blood caused by the kidneys shutting down very quickly. Sofie had also been losing weight and large amounts of fur due to her not eating. We decided that Sofie did not deserve to suffer another day in pain, misery, and thirst. We had to put our beloved Sofie to sleep that evening. She was only 4 years and one month old.
Below (and attached) is a summary of the neglected blood tests and urinalysis results that were obtained by Dr. McLaughlin over the past 2 years and never mentioned to me when I picked Sofie up from her appointments:
Blood work done on Sofie at the VCA in Newark DE 2/13/2009:
BUN 23mg/dL (normal reference range set at 6-25mg/dL)
CREA 0.8mg/dL (normal reference range set at 0.5-1.6mg/dL)
Blood work history from Banfield:
BUN normal reference range set at 7.0-27.0mg/dL
CREA normal reference range set at 0.5-1.8mg/dL
4/20/09 BUN 43mg/dL, CREA 0.9mg/dL (nothing was said about high BUN)
7/7/09 BUN 56mg/dL, CREA 0.9mg/dL,urinalysis showed protein in the urine with a value of 300 (range
0.0-30.0), urine appearance was abnormal, comments were that the urine was cloudy, urine was positive for white blood cells, urine was positive for epithelial cells with the comments of debris in urine, urine bacteria was positive with the comments of few cocci. (nothing was said about high BUN or abnormal urinalysis results)
4/28/10 BUN 79mg/dL, CREA 1.3mg/dL,urinalysis showed protein in the urine with a value of 100 9range 0.0-30.0), pH was 8 9range 5.0-7.5), urine positive for white blood cells, urine positive for crystals. (nothing was said about high BUN or abnormal urinalysis results, or the increase in CREA from 0.9 to 1.3)
11/1/10 BUN 73mg/dL, CREA 1.3mg/dL (a note was written on summary sheet about Sofie being slightly dehydrated by McGallidner but no cause for concern noted).
4/30/11 BUN 67mg/dL, CREA 1.8mg/dL (finally, Dr. Sprague noticed the trend and history and brought it to my attention).
It wasnt until 2 years later that we were told that Sofies blood work was indicating that she had a possible issue with her kidneys. With Sofies BUNs constantly being out of range high for 2 years, I just can not understand why someone didnt take notice for 2 years. Whenever a kidney issue is suspected, the
first course of action is typically to start the dog on a low protein diet because a diet high in protein can aggravate an already present genetic issue with an animals kidneys. I can not help but wonder that I might have had a chance at slowing the progression of Sofies kidney disease had someone been paying attention to the fact that her BUNs were high, and that her CREA, although still within normal limits, were steadily climbing. I might still have Sofie here with me today had I been given the opportunity to change her diet 2
years ago when her blood work was clearly indicating that something was going on with her kidneys even though she herself was not symptomatic until the end stages