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Dr. Altman
Dr. Altman, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 6248
Experience:  Practicing small animal veterinarian for 15 years.
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I have a 15 year old golden retriever in which we recently

Resolved Question:

I have a 15 year old golden retriever in which we recently had full blood and urine studies performed. we have had blood studies done at least once a year for a number of years now and understand there is kidney disease and he does have glaucoma and being treated with sub-q fluids lactated ringers(1000ml) per day, amlodipine 3.75/day, and eye drops , 3 different types per day.

My concern is the recent blood studies results, most all values in the normal range,except microalbuminuria greater than 30, specific gravity,1.011, ph 7.5. the urea nitrogen is 26, creatinine 1.1, bun/creat ratio 24. these last few values are high but in the range.

our dog eats well, does not vomit gets around ok with some help. any recommendations..Paul Havey. XXX-XXX-XXXX
Submitted: 8 months ago.
Category: Dog Veterinary
Expert:  Dr. Altman replied 8 months ago.

Dr. Altman :

Welcome! I am Dr. Altman, a licensed veterinarian and happy to answer your questions today.

Dr. Altman :

Do you know whether a urine protein: creatinine ratio has been done for Cody Bear to better assess the stage of kidney disease?

Dr. Altman :

Is he on a renal/ kidney diet at this point?

Dr. Altman :

I am going to change formats in a moment if I note you are still having difficulties with live chat

Dr. Altman :

CLICK HERE for a supplement that has good success in pets stabilizing the renal disease

Customer: Bun/creatinine ratio is 24
Customer: he is not on a special diet, our vet did not recommend
Dr. Altman :

I am referring to a urine protein:creatinine ratio which is different than the bun/ creatinine ratio

Dr. Altman :

Let me explain:

Customer: urine protein is 2plus
Dr. Altman :

Still something different

Customer: ratio was not done
Dr. Altman :

The kidneys should be recycling protein into the bloodstream and removing creatinine. So a normal ratio should be less than one

Dr. Altman :

In a dog with early kidney disease the ratio is elevated

Dr. Altman :

It means that the increased creatinine in the bloodstream and the protein is being lost through the kidneys

Dr. Altman :

It is one of the best ways of regulating progression of disease

Dr. Altman :

Since it takes 75% damage to kidneys to see changes in the bloodwork it can be the earliest ways to monitor progression

Dr. Altman :

I definitely agree with his kidney values not being elevated to not be aggressive with diet but perhaps consider monitoring the protein in the diet and using a low protein over the counter food

Dr. Altman :

Research has shown that the earlier that a diagnosis is made and diet changes are performed the better the longterm prognosis

Dr. Altman :

What diet do you currently feed?

Dr. Altman :

Do you feed just dry?

Customer: taste of the wild
Dr. Altman :

Which formula?

Dr. Altman :

That brand has a tendency to be fairly high in protein...

Customer: adult form, alternate favors.. our home vet said food did not matter that much. do you recommend doing the urine ratio test
Dr. Altman :

Yes I would definitely advise the testing

Dr. Altman :

I can attest the research does not agree with the assessment that diet does not play a role. Protein is metabolized to a certain degree through the filtration system of the kidneys. The kidneys purpose is to remove protein and put it back in the bloodstream. A higher protein food in a dog predisposed to renal disease can put additional pressure on the filtration system and cause breakdown earlier. I completely understand your hesitation with your vet's information but perhaps it might be worth a little research for you to make a decision for Cody Bear

Customer: is that urine test specific test that has to be redone by the lab
Dr. Altman :

When purchasing the variety, just try to aim for the ones that are less than 26% because they do have a few formulas that this is the case

Dr. Altman :

If you have done a recent urinalysis they should be able to run it off a current sample

Dr. Altman :

Otherwise collecting a fresh sample (first morning ones are always best) for the evaluation

Dr. Altman :

It is a fairly specific test

Dr. Altman :

It also goes by the name UPC

Dr. Altman :

Was the urine specific gravity of 1.011 a first morning sample?

Dr. Altman :

If I get a level this low on a dog I typically will want to confirm that it is really that low when concentrating overnight

Dr. Altman :

If it is redone on a first morning sample and is more concentrated then the worry level goes down significantly

Customer: no it was afternoon
Dr. Altman :

Perhaps when you check the UPC on a first morning sample it would be worthwhile to recheck that number as well

Dr. Altman :

It is something your vet should have to test in house

Dr. Altman :

Price $10-15

Dr. Altman :

Does this information make sense? I hope I am answering some of your questions...

Dr. Altman :

And did you see the link to azodyl for kidney support function that I attached?

Customer: yes, what generally does the specific gravity tell me
Dr. Altman :

It is a little difficult to explain but the ability of the kidneys to concentrate. So 1.000 is water, a normal concentration is 1.040. We worry about kidney function when we have a level between 1.012-1.016

Dr. Altman :

I can get a better terminology if you can give me one moment

Dr. Altman :

This is one definition: the Urine Specific Gravity measurement (uSpG) that indicates how concentrated the urine is compared to distilled water (SpG = 1.00) will display a dilute reading ... actually, very close to distilled water.

Dr. Altman :

Since the action of conserving water while allowing undesirable metabolites and toxins to remain in the urine is the job of the tubules in the kidneys, whenever the tubules are damaged water conservation is less efficient; therefore more water flows through the tubules unresorbed and washes away in the now dilute urine.


 


Most cases of kidney failure display a SpG of about 1.008 to 1.012. Generally, a normal dog's urine SpG will be 1.020 to 1.040.

Dr. Altman :

Does this make sense?

Dr. Altman :

It is a very helpful number to monitor as well

Customer: yes, so Cody's is high then at 1.011
Dr. Altman :

No it is low

Dr. Altman :

It is very confusing and difficult to explain

Dr. Altman :

The higher the number at the end the more concentrated

Dr. Altman :

The lower the number after 1.0 is the more dilute sample

Dr. Altman :

Closer to 1.000 is water, the most dilute

Dr. Altman :

Higher numbers such as 1.040 means there are more products in the urine indicating concentration

Dr. Altman :

I hope I am not confusing you further!

Customer: ok. , I generally understand
Dr. Altman :

Sorry, it can be quite confusing

Customer: do you think it is a good idea to continue the sub q fluids
Dr. Altman :

Are his gums dry/ tacky when he is not getting them?

Dr. Altman :

I also prefer to start with flavoring the water and adding water to dry food right before giving it first to encourage further water intake and perhaps lower the fluid amount you have to give daily

Dr. Altman :

Especially with his kidney values not being a big concern at this point

Customer: I don't know, about gums, we have been doing the fluid therapy for over a year.
Customer: what flavor for the water
Dr. Altman :

If you have been doing them for a year and he is stable I probably would not change things

Dr. Altman :

It will vary with every pet

Dr. Altman :

Sometimes pancake syrup, or a flavor he enjoys

Dr. Altman :

But it has to be changed more regularly

Dr. Altman :

Something to encourage/ entice increased water intake

Customer: pancake syrup in the water or food
Dr. Altman :

A few drops in the water

Dr. Altman :

Just water in the food right before you put it down to increase water intake

Dr. Altman :

I fill water to the top of the food

Dr. Altman :

My dogs will often drink the water then eat the food

Customer: ok, great, Thankyou so much for the great information.. we will have the additional urine tests done
Dr. Altman :

You are very welcome

Dr. Altman :

Can I assist with any additional questions or clarify anything else for you this evening?

Dr. Altman :

Kudos for keeping him stable for as long as you have. It sounds like a lot of work and love!

Customer: that is all. Thankyou...
Dr. Altman :

You are welcome, good luck to you and Cody Bear!

Dr. Altman :

If you have more questions or if I can help in any other way, please do not hesitate to ask! If you would like to accept my answer, please press RATE OUR CONVERSATION. Bonuses are always welcome. (I am not compensated in any other way). Thanks!


 


If you have additional questions after you rate the question, you are welcome to request me for additional conversations if I am on-line or by beginning your question "Dr. Altman..." or "Dogdoc4u..." and others will leave the questions for me. Good luck to you both!!!

Dr. Altman, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 6248
Experience: Practicing small animal veterinarian for 15 years.
Dr. Altman and 3 other Dog Veterinary Specialists are ready to help you
Expert:  Dr. Altman replied 8 months ago.
How is Cody Bear? Did you get additional information on the UPC?

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