German shepherd kidney disease or what could it be? please help!

My dog is a 7 year old German shepherd, recently diagnosed with chronic renal failure. I don’t know what to believe honestly. The blood test results are really bad, but the vet says that the X-ray looks good and the kidneys are in perfect condition. Creatinine levels are 6, BUN >140, AMY 2500, phosphorus 11, ALT 123. I’m kinda confused by the diagnosis that’s why I’m asking for an opinion. So, 2 weeks ago my dog suddenly started acting weird: he started pacing and scratching his back. He was in pain when touching his back or the tail and he didn’t move his tail at all. The symptoms were on point for limber tail syndrome. I don’t know what to do honestly we aren’t ready to lose him! The vet prescribed us Marbofloxacin and Pronefra supplement (calcium carbonate, magnesium carbonate, chitosan, polysaccharides of Astragalus and marine oligopeptides). He is very sad right now, but eats, drinks and everything but it’s getting worse day by day. Coughing, vomiting from time to time. Unfortunately, the reason why I’m asking for help here it’s because the vet clinics in my area aren’t so advanced. (eh, even the healthcare system is bad). The vet we chose is a family friend and is the best here, but I think it’s weird that my dog had that tail problem and then this.. Before his condition got worse, I observed that my dog was urinating in spurts, asked multiple vets and I was told<span style="-webkit-tap-highlight-color: rgba(0, 0, 0, 0);"> </span>that’s normal for dogs.. I had a feeling that it wasn’t right. :( My questions are: Do you think he’ll be able to recover, or should we go for a more aggressive treatment? Do you think the diagnosis is correct or could it be another cause/ another illness? (ex leptospirosis) I’m also looking for food suggestions or anything that could make him better!

Hello - there are many avenues to explore with this case and it would be difficult and inappropriate for me to look at another vets' bloods out of context, and tell you what the vet ought to be doing.  In the UK we wouldn't declare kidneys to be normal on the basis of an x-ray, because kidney damage usually takes place at a microscopic level (of the nephron), which simply cannot be seen on a  radiograph.  It is true that sometimes kidney cancers, cysts, infection and even 'chronic failure' can result in radiographic changes to the kidney, but most kidney disease is detected much earlier than that, using blood and urine samples.  A high blood Urea and Creatinine do not always confirm kidney disease, because that pattern can also be seen in severe dehydration or, indeed, in cases where an animal is unable to empty their bladder.  This may be worth exploring, in particular, given the tail problem.   Diagnosis of kidney disease is usually made using an IRIS score (there is a website about this for clinicians), along with a measurement from the urine known as the specific gravity of urine.  Good questions for your vet therefore include:  a) can kidney disease definitely be ruled out using the IRIS system?  What would the IRIS score be?  b) May there be something blocking the flow of urine between the kidneys and the outside world (hence the spurts) - eg does the prostate feel ok?  Could there be a blockage?  What does your vet think about that high potassium?  Would fluids be a good idea?  We cannot give you a second opinion here, because this should be done with all the history and consent of the animals' vet, not to mention an examination of the patient.  Healthcare has limits at every faculty and in every context.  I do not know where you are, but a good question is:  What is the biggest threat to their quality of life at the moment?  In this place, with this pet, at this moment, could we be doing anything better? - I hope that something there helps.