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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 15789
Experience:  Over 20 years of experience as a veterinarian.
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My dog recently has been drinking a lot of water however not

Customer Question

My dog recently has been drinking a lot of water however not more than her daily requirements that I calculated it out. I took her to the vet who did some bloodwork. Cbc and Chem panel as well as a UA. The vet called me today and said there is some protein in her urine. Should I be worried? Does she have kidney failure? The vet said I could either being her back for a redo in a few weeks or run a creative ratio test on the specimen they already had. I should also mention she is on premium edge diet dog food that has 44 percent protein in it. Could that be the cause of this? I'm so worried. The vet also through around cushings the other day when I brought her in. She acts perfectly normal, pees about 3 long ones a day and has a huge appetite. She does get stressed out at the vet. Could that be another cause? Any feedback would help. I keep reading horrible things online
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Kara replied 1 year ago.

Hello, my name is***** and I have over 20 years of experience as a veterinarian. I am sorry to hear about Nova's increased water consumption compared to normal and positive test for protein in her urine.

A normal dog's kidneys can handle them eating high levels of protein, because they can effectively filter protein even at higher amounts, so although a 44% protein food is higher than usual, I don't believe that is the issue.

Even though her water consumption may be within normal limits for her size, if it is consistently more than usual for her without very hot weather or lots of exercise, or a change in diet from canned to dry then that tells us we may be at the beginning stages of a health issue.

The level of concern about urine protein depends upon whether she also shows signs of a urinary tract infection, as urinary tract infections artificially elevate protein levels due to red and white blood cells in the urine. If there is protein in the urine I recommend culturing it look for an infection.

If she doesn't have an infection then we need to compare the amount of protein in her urine in context of how concentrated her urine is. If her urine is highly concentrated (specific gravity of 1.045 or higher) with small amounts of protein I am less concerned. But if her urine is poorly concentrated (1.020 or less) with even small to moderate amounts of protein I start to get concerned. This may point toward poorly functioning kidneys and can be a sign of early kidney failure. That would explain her elevated urine protein levels.

A good test to run in a dog without a urinary tract infection and poorly concentrated urine is called a urine protein/creatinine ratio. I suspect that is the test your veterinarian is recommending. This compares the amount of protein in her urine to the waste product creatinine. If she is spilling a high amount of protein compared to waste products then yes we do need to be concerned and we need to control her protein spillage with drugs, such as Enalapril or Benazepril.

SDMA is a new test to help evaluate kidney function. SDMA usually increases when there is about a 40% decrease in kidney function, compared to elevations in creatinine, which doesn’t increase until there is up to 75% loss of kidney function. If this test wasn't part of the bloodwork checked on Nova it is worth discussing checking that with her veterinarian.

If she has high blood pressure that can certainly cause protein to spill into her urine so they should check her for high blood pressure as well.

It may also be advised to start her on a diet formulated for kidney failure, such as Hills k/d or Royal Canin Renal LP if kidney failure is suspected.

I will often recommend adding an omega 3 fatty acid supplement as well as a natural anti-inflammatory to help with kidney health. I recommend an omega 3 fatty acid dose based upon the EPA portion (eicosapentanoic acid) of the supplement as if we do that the rest of the supplement will be properly balanced. Give him 20mg of EPA per pound of body weight per day. For example a 50 pound dog 1000mg of EPA per day.

So to answer your primary question, without knowing what her urine specific gravity is, and whether she has high blood pressure or signs of an infection on a urine culture, I can't say how concerned you should get and what sort of follow-up should be done. Her protein levels need to be taken in context.

Please let me know if you have any further questions.

Customer: replied 1 year ago.
I just spoke to the vet and her sg was 1030 and her ratio was normal. She said nothing to worry about. I thought maybe high bp from being stressed out. Her eyes get beat red when she goes to the bet
Expert:  Dr. Kara replied 1 year ago.

She would need consistent high blood pressure to spill protein in her urine.

And the urine in her bladder was produced several hours before her visit, so would not be influenced by her blood pressure during her visit.

I am glad to hear that her specific gravity was 1.030. Although I'd like it higher I would just recommend rechecking her urine periodically to monitor specific gravity and protein levels.

Customer: replied 1 year ago.
Can I dip it at home?
Expert:  Dr. Kara replied 1 year ago.

I'm not sure what you mean by "dip it at home"?

You could collect a fresh urine sample in a very clean glass or aluminum container and get it right to her veterinarian for testing. That way you know that she wasn't at all stressed at the time of collection. A very clean, caught sample is fine for measuring trends in specific gravity and protein levels, although for cultures a sterile sample collected by her veterinarian is best.

But if you mean try to test her urine specific gravity and protein at home with dipsticks then no, I don't recommend that.

Specific gravity estimates on dipsticks are wildly unreliable. There are so many things that interfere with their accuracy I don't even bother looking at the dipstick estimate.

For an accurate measurement of specific gravity a quality refractometer needs to be used. An accurate refractometer can be $200 - $300. With these instruments you get what you pay for and the cheap ones simply aren't worth buying.

Protein can be measured on a dipstick, but there are many dipsticks on the market and some are horribly unreliable and some are very good. They must be kept in a sealed, dark container and used before their expiration date. Your veterinarian may agree to sell you some to test her at home.

Expert:  Dr. Kara replied 1 year ago.
Hi Erica,
I'm just following up on our conversation about Nova. How is everything going?
Dr. Kara