16-year-old Yorkshire Terrier with recurrent severe pulmonary…

Question

16-year-old Yorkshire Terrier with recurrent severe pulmonary edema, mitral valve disease and kidney dysfunction – looking for veterinary opinions

Hello,

I'm reaching out to ask for veterinary advice regarding my 16-year-old Yorkshire Terrier, who has been struggling with recurrent pulmonary edema and kidney dysfunction.

Unfortunately, my previous description was cut off due to the character limit, so I've included **the complete medical history, treatment details, medications, laboratory results, recent episodes, and all my questions in the attachments**.

Everything is explained in detail in the three attached images, including the challenges we've faced in balancing his heart and kidney treatment.

I would be extremely grateful if you could take a look at the attachments and share your professional opinion or any suggestions that might help us manage his condition and maintain his quality of life.

Thank you very much for your time and help.

Best regards

Dylan Wilson · Accepted Answer

I see you provided the rest of the information. Rule of thumb for emergency azotemia is that halfing the highest creatinine value is considered a successful management for the aoztemia. Kidney damage is not reversible due to having a set number of nephrons that take damage with kidney injury events. I suspect at a physiological level that the diuretic efficiency has decreased as there are less nephrons for the medication to work on. You have to increase dosages to achieve a therapeutic level (level where the drug actually works). The only other medical management help I can think is to add a thiazide diuretic or sodium sparing diuretic to work at another level of the nephron. Those additions would require frequent bloodwork to make sure electrolyte abnoramilities won't develop. Unfortunately, his kidneys may be unable to keep up with a balanced fluid state due to his progression and he will keep having fluid backup into his lungs.