If he was able to pick up food, chew, and swallow, then I agree that dropping the food may have been due to pain.
I'm a little confused as to the finding of ulcers on the kidney. Was he referring to infarcts or disruptions of blood flow?
The ulcers in the intestinal tract and difficulty swallowing certainly support ingestion of something toxic. Kidney disease can cause ulcerations as a result of decreased clearance of gastric acids and digestive enzymes. But you did not mention any other blood work abnormalities to support this (high amylase levels). The kidney issue may be a direct result of a toxin ingestion or secondary to his dehydration. From my perspective, if the creatinine (the more important kidney value) is not elevated and the BUN has made an impressive drop after just 24 hours of IV fluids, I think his chances for a full recovery of kidney function are very good. You did not mention if a urinalysis was done- this would also help assess kidney function and may help determine the cause (certain crystals or other cell types may be identified) of his disease.
He should be on a gastroprotectant like Pepcid or cimetidine and Pepto for the ulcerations in the intestinal tract. The Pepto (liquid) will also coat the esophagus on the way down and so help with any ulcerations here that may be causing him discomfort.
A broad spectrum antibiotic is indicated to guard against bacteria from the gut moving across the damaged wall of the intestines.
Your dog, when he is eating better, should also be on a more kidney friendly diet during the recovery period. Many prescription brands are available through your vet. The diet helps decrease the work load of the kidney during the healing phase.
I hope he makes a full recovery. Good luck to you.

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That's fantastic! I think that, at this point, his chances for a full recovery are excellent.
The only reported cases of death related to Easter lilies that I'm familiar with were in cats, however, consumption does lead to kidney failure.
You may never know what precipitated your dog's illness, but it's worthwhile to keep investigating to try to make sure it never happens again.
I'm really pleased for you and your dog, I hope he has many happy years ahead of him.

Illness can certainly make an animal a picky eater, at least temporarily. Hospitalization can do that too, after a bit they may get a little homesick. If you haven't already, you can suggest going in to visit him to see if you can entice him to eat. Finally, not all dogs find the prescription kidney diets or bland diets (not sure which one your dog is on) very palatable. So they may eat initially, but then decide that the food isn't to their liking. If his decreased appetite continues, then first I'd re-check the kidney values and a urinalysis to make sure those things are still improving. If the kidney issue worsens, then doing titers for Leptospirosis and/or Lyme disease would be indicated. Addison's wouldn't be the first thing I looked for, given the information you've provided me regarding his bloodwork and clinical signs. Generally with this disease, the signs you see include drinking and urinating a lot, lethargy, vomiting, diarrhea (sometimes black signifying digested blood), weight loss, decreased appetite, collapse, hair loss. The signs can come and go initially or affected animals can crash hard and exhibit nearly all of them in an Addisonian crisis. There are several specific blood work changes that are often seen; the only one you mentioned your dog possessing was an increased BUN. The BUN can be high with a kidney issue as you've been told, it can also be high as a result of bleeding within the intestinal tract. I believe your dog had a combination of factors that led to his high BUN- the intestinal ulcers causing the bleeding, and the dehydration causing kidney dysfunction.
The Tagamet will help with the ulcerations, and I'm assuming he's also on an antibiotic to guard against secondary bacterial infection of the bloodstream.
Keep me posted.

I'm sorry to see that the BUN has risen, but hopefully all is not as bad as it seems. After all, the creatinine actually did decrease, and that is the more important marker of kidney function. I don't know when the steroid was administered in relation to when the repeat blood work was done, but steroids can temporarily increase BUN levels.
I disagree that it is time to put him down just based on an elevation of the BUN. If he is otherwise doing ok, there is time to investigate further and hopefully come to a firm diagnosis.
It is concerning that the rise, if it is a true reflection of the BUN value, came after he was off IV fluids. Therefore, if he is at home with you this weekend, make sure he gets plenty of oral fluids. It's a good idea to syringe feed or "turkey baster" some in just to make sure he gets an adequate amount.
I believe it would be worthwhile to continue with the ACTH stimulation test that was previously planned; it might also be prudent to do the Leptospirosis and Lyme disease titers I mentioned earlier while awaiting the ACTH stim. results, if kidney disease is a real concern. If your vet is not comfortable with further diagnostics, then he may be able to refer you to a specialist that may be able to shed some insight onto the problem. I recognize that to this point you have probably spent a great deal of money on your dog, and so do not want to push you to do anything beyond your means. But if you are lucky enough to have money not be a major concern, then a specialist is definitely a worthwhile endeavor. If money is an issue, you can look into applying for Care Credit (www.carecredit.com). This is credit card that enables you to pay medical and veterinary expenses. The approval process is rapid and you can have an answer in just an hour or so.
This has been a terrible roller coaster ride for you and admittedly, not being privy to a lot of the information of the case, I can only make suppositions as to what's been going on. But if I look at all that you have told me, including how he seems to feel much better, then I believe there's still plenty of hope. Even if this is an issue of kidney failure, in many cases the progress of the disease can at least be slowed and the dog can have a good quality of life for quite a while (survival times are difficult to predict without having an idea of cause and how the kidneys are presently functioning- a specialist might be able to help you here).
Good luck and please let me know what happens.

Edited by Vet help on April 29 2006 at 10:20 PM