@debradownsouth Thanks for the info. I did find some renal diet wet food that he loves!! Whoosh. He seems to have more pep in his "dance" and frolicks as he takes his first strides outside. He has become more velcro with me which is fine. No accidents inside and he sleeps through the night. I want to keep him as comfortable as possible. He may have some dental issues but the vet did not recommend cleaning nor extraction under his current condition. Tremors have subsided but occasional large involuntary twitching has not.

@rocky1 Thx for the info!! i agree a raw diet is good. I did feed him one for several years and then slipped away from it. I will look into it further, however, I do not want to compromise his renal status.

@debradownsouth Thanks for all the information. Joey only had one dose. I returned the remaining to the clinic and the vet agreed to keep him off it. The incident was reported to Zoetis and my vet spoke to a vet from the manufacturer as well. I will report to FDA. Flea and tick meds going forward will be topical. Now I have to find an appropriate method to make his renal diet more palatable. Joey looked at me cross-eyed when I tried the coconut oil a 4th time. Low sodium chix broth or the water packed with tuna is next although trying to stay low on sodium.

Saw the vet today and ran some bloodwork again. His BUN/CREA has improved significantly and his CREA improved 0.10 which the vet said was not significant. The change is from one week ago. Joey has become more active and gained 1 lb which lead us to believe he was dehydrated on his recent visit of 3/3. He received his first (and now only) does of the fairly new Simparica med for flea and tick treatment 2/18 and this is also when he started having neurological issues. The letter that comes with the rebate includes a safety warning..."Simparica may cause abnormal neurological signs such as tremors, unsteadiness and/or seizures". There are variables but my gut tells me the new medication impacted his health. I plan to test him again in 1-2 months.
What do you give for flea and tick prevention?

@laskiblue How much do your Bs weigh and what is the dosage you give them?

Has anyone used CBD for pain management in end of life care?

Going to the vet on Friday to see if there is a more comprehensive plan for his comfort. Am arming myself with many questions thanks to all your help!

Oh and his PCT is one point above normal 0.47 (.14-.46) .

Vet sent his labs...everything is normal except renal function and specific gravity which I believe shows protein in his urine. His BUN/CREA is 64 (7-27) and CREA is 2.4 (0.5-1.8). Somehow I feel like there is something additional going on as he has the twitching, they don't look like seizures. He seems pretty well hydrated and his water consumption might have even slowed up a bit. I know y'all are not vets, but maybe someone has a ray of light to shed?

@little-monkey Thank you! I'm sorry for your loss. Joey is eating fine at the moment...once I added coconut oil to his food.

@anna Thank you, Anna! I am familiar with the blood work and urinalysis info.

@tanza Great Info. I'm a bit frustrated with my vet. She did not suggest subq fluids nor any treatment/care for the twitching. Any dog can have renal failure. Hmmm.

Does anyone know why he is having twitching/tremors? Is this from electrolyte imbalance? Is there anything that can be done to relieve or minimize them?

@anna Thank you for the information. Wow! I had no idea SQ fluids would be needed once a day. He had a "pack" on his back once before many years ago for another issue. Does the vet show you how to administer and how does one determine the pet's hydration status? And yes, how would I know if Fanconi caused the renal failure or it is just old age?

@debradownsouth I know this is difficult to say, but how often on average did you do subq liquid?

Joey doesn't like paparazzi

@rocky1 He had food left in his bowl tonight which is not normal so I added a finger tip of organic cold pressed unrefined coconut oil to it. He devoured it and jumped around for joy wagging his tail!! He has not had any weight loss to date. I'd like to balance slowing his decline with keeping some quality of life.

@rocky1 Thank you for your input!

@debradownsouth Thank you very much!!