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Welcome! I am Dr. Altman, a licensed veterinarian and happy to answer your questions today.
Do you know whether a urine protein: creatinine ratio has been done for Cody Bear to better assess the stage of kidney disease?
Is he on a renal/ kidney diet at this point?
I am going to change formats in a moment if I note you are still having difficulties with live chat
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I am referring to a urine protein:creatinine ratio which is different than the bun/ creatinine ratio
Let me explain:
Still something different
The kidneys should be recycling protein into the bloodstream and removing creatinine. So a normal ratio should be less than one
In a dog with early kidney disease the ratio is elevated
It means that the increased creatinine in the bloodstream and the protein is being lost through the kidneys
It is one of the best ways of regulating progression of disease
Since it takes 75% damage to kidneys to see changes in the bloodwork it can be the earliest ways to monitor progression
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
Research has shown that the earlier that a diagnosis is made and diet changes are performed the better the longterm prognosis
What diet do you currently feed?
Do you feed just dry?
That brand has a tendency to be fairly high in protein...
Yes I would definitely advise the testing
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
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
If you have done a recent urinalysis they should be able to run it off a current sample
Otherwise collecting a fresh sample (first morning ones are always best) for the evaluation
It is a fairly specific test
It also goes by the name UPC
Was the urine specific gravity of 1.011 a first morning sample?
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
If it is redone on a first morning sample and is more concentrated then the worry level goes down significantly
Perhaps when you check the UPC on a first morning sample it would be worthwhile to recheck that number as well
It is something your vet should have to test in house
Does this information make sense? I hope I am answering some of your questions...
And did you see the link to azodyl for kidney support function that I attached?
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
I can get a better terminology if you can give me one moment
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.
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.
Does this make sense?
It is a very helpful number to monitor as well
No it is low
It is very confusing and difficult to explain
The higher the number at the end the more concentrated
The lower the number after 1.0 is the more dilute sample
Closer to 1.000 is water, the most dilute
Higher numbers such as 1.040 means there are more products in the urine indicating concentration
I hope I am not confusing you further!
Sorry, it can be quite confusing
Are his gums dry/ tacky when he is not getting them?
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
Especially with his kidney values not being a big concern at this point
If you have been doing them for a year and he is stable I probably would not change things
It will vary with every pet
Sometimes pancake syrup, or a flavor he enjoys
But it has to be changed more regularly
Something to encourage/ entice increased water intake
A few drops in the water
Just water in the food right before you put it down to increase water intake
I fill water to the top of the food
My dogs will often drink the water then eat the food
You are very welcome
Can I assist with any additional questions or clarify anything else for you this evening?
Kudos for keeping him stable for as long as you have. It sounds like a lot of work and love!
You are welcome, good luck to you and Cody Bear!
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