25/11/2025
This sweet CKD pup has been on my radar since spring — BUN ~60, creatinine 2.6, positive UTI/UMIC, and an ultrasound suspicious for pyelonephritis. We treated for 6 weeks and he improved beautifully: creatinine down to 2.0, BUN 36.
Then a few days ago he came in vomiting, diarrhea, not eating, dehydrated. Current labs? BUN 39, creatinine 2.6, BP normal, UA normal, UMIC negative.
So why did I restart antibiotics?
Because real-life medicine isn’t always clean.
Because his history matters.
Because this exact treatment helped him before.
I don’t have a diagnosis of recurrent pyelo…
But when you’re managing CKD dogs with complicated histories, sometimes you treat based on the pattern, the response to previous therapy, and the goal of preventing a crash.
Sharing because you all always ask how I manage real cases — this is the honest version.