“Case of the Month” – December 2017

Niya, 15-year-old female Keeshond, was battling urinary tract infections and incontinence, and her medication was decreasing her appetite, so her primary veterinarian in Maryland thought that help from a specialist was warranted. Around that time, Niya’s owners, Debora and Chris Luther, were planning a trip to California to see family. The Luthers were very familiar with the UC Davis veterinary hospital—Debora graduated from UC Davis in 1977, and Chris grew up in Davis with his mother Linda having worked at the university for many years—so they decided to bring Niya with them to California and have her examined by specialists at UC Davis.

“We know how wonderful UC Davis is,” said Debora, having utilized the hospital’s services with a previous dog in the ‘80s. The Luthers loaded up Niya in their new travel trailer and headed to California.

Dr. Sean Hulsebosch of the Internal Medicine Service found Niya to have stones and moderate mineralization in her kidneys as well as thickened walls of her ureters (connection between kidney and bladder). Both of her kidneys showed signs of infection. Due to the severity of her kidney injury, Dr. Hulsebosch determined she would do best with aggressive fluid therapy, antibiotics, and appropriate supportive care. Niya was hospitalized for five days, with her kidney function being reevaluated and improving daily. She responded well to the treatment and was discharged with home care instructions.

Unfortunately, kidney bloodwork at her one-week recheck appointment showed kidney values that were higher than at discharge. Niya’s kidney condition was determined to be persistent—possibly as a result of the infection, or more likely was a sign of chronic kidney disease (CKD)—and thus required long-term treatment.

Dr. Hulsebosch consulted with the Nutrition Service to devise a specialized diet to help manage her CKD. Faculty members Drs. Jennifer Larsen and Andrea Fascetti, along with resident Dr. Rae Sires, evaluated Niya for management of CKD and poor appetite. They determined that a balanced home-cooked diet formulated specifically for Niya’s needs was appropriate for her renal disease. The diet consisted of simple ingredients such as ground beef, eggs, white rice, and flour as well as sources of fatty acids and other essential nutrients. Niya loved the diet, so a second home-cooked diet using chicken, eggs, and white rice was later developed to provide variety.

“It’s really easy to make,” Debora said. “I’ve gotten to the point where I can quickly put it together in about 10 minutes.”

The Luthers returned home to Maryland and continued to consult with the Nutrition Service via phone and email.

“We’re 3,000 miles away, but it feels like it’s next door,” said Debora. “It’s so easy to work with the nutritionists remotely.”

Niya has been on her new diet for three months, and it is working well to control her CKD.

“She’s starting to feel like her old self,” said Debora. “I can’t believe how much life she has in her again. She’s 15 years old, and she plays with her toys again like she’s a puppy.”

The Luthers report that Niya’s veterinarian in Maryland is very pleased with her progress. Her kidney disease is stable, the elevated liver enzymes are back to normal, and all else appears well.

“Having the right diet is the key to keeping Niya happy, healthy, and with us longer than we might otherwise expect,” said Debora. “We just think the world of UC Davis.”

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