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Dr. Deb
Dr. Deb, Dog Veterinarian
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Experience:  I have bred dogs and shown dogs for 20 years.
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Hi- my 1 year old Shichons BUN has been rising for a year

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Hi- my 1 year old Shichon's BUN has been rising for a year now- it started out around 28 at 3 months old, then 30's, 40's, 49, now 60. She had Pancreatitis in December and has a very sensitive stomach so she was started on Science Diet ID Low Fat- after this her BUN jumped from 49 to 60. What is my next step? Should I be worried about significant organ damage? We can't figure this out because her Creatinine is normal (1.3-1.7 I believe) and her Specific Gravity is 10.037. She has no symptoms of CKD such as polydipsia/polyuria. She has actually gain a whole pound since December (went from 10.2 pounds to 11.2 pounds.) She has no symptoms of a GI bleed (no dark tarry stools) and her UA was completely normal (no protein, RBC, casts, etc.) Her only problem is a sensitive stomach so she is on a very strict diet. I have thought about Cushing's Disease? I am a nurse practitioner but I am limited in knowledge of canine disorders.
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. Deb replied 1 year ago.
Hi, I'm Dr. Deb. I will do my best to assist you today.
I'm sorry for this concern for Lulu but it sounds as if one of the most common cause (kidney issues) of an elevated BUN has been ruled out.
Gastrointestinal bleeding can be responsible (as you suggest) even though melena might not be seen. Sometimes it can take a while for black tarry stools to develop.
Having the lab check for occult blood may be useful as well as an endoscopy (to check for ulcers) or abdominal ultrasound although in all honesty, an exploratory is usually going to provide the most results in most cases. I'm not necessarily suggesting that an invasive surgery be done on what appears to be an otherwise healthy dog, but just providing the information.


An elevated BUN can be seen in Addison's disease, rather than Cushing's disease, but usually there's going to be either other signs or changes in the bloodwork (increased potassium and low sodium, for example).

Increased dietary protein can cause this value to be elevated, too...often up to 60. I'd have to double check the protein amount in I/D but diet is suggestive since the value increased quite dramatically after you started it.

Pancreatitis can cause a transient elevation but I wouldn't expect the BUN to remain elevated for long periods of time after the event has resolved.

Personally, I probably wouldn't be too concerned with a BUN of 60 if the rest of the blood work and urinalysis is normal and the patient is thriving. I've seen much higher numbers in other dogs which worried me more...not so much because of this one elevation but because there were other signs of illness or disease.

I hope this helps. Deb

Customer: replied 1 year ago.

Thanks. I agree that Kidney disease seems to be ruled out. But now on to what on earth is it?


 


As I stated earlier, she has an extremely sensitive stomach... she vomits with any PO intake other than her dry dog food, rice and chicken. Could this sensitive stomach be a symptom of a certain GI problem that could be causing this rise in BUN? Anything other than PUD, GI bleed?


 


Also- I am concerned that the BUN is steadily rising... it's not just high, but getting higher... I do agree about the food- we are changing her to Science Diet KD and rechecking in 1 month to see if this helps since ID Low Fat does have a higher protein and phosphorous content then the food she was on previously that she could't tolerate (Blue Buffalo.)


 


I am also wondering about the BUN itself- is this high number causing any organ damage right now? I want to be sure that while we are figuring this out, the sustained elevation in BUN in itself is not damaging her organs.


 


Thanks- Carissa

Expert:  Dr. Deb replied 1 year ago.
Carissa:
You're welcome:)

It sounds like one explanation for her sensitive stomach could be Inflammatory Bowel Disease. This is a fairly common problem in a lot of dogs...even very young ones which is often controlled by diet and occasional use of medication. I wouldn't associate this condition with causing an increased BUN, though, because we don't typically see GI bleeding with it.
But there could be other possible GI issues which could cause a GI bleed and thus cause an elevated BUN....lymphoma, I am sad to say, could be one possibility. And, I don't say this to alarm you but just to provide the information.

No, the elevated BUN is not causing organ damage.

Trying to find an explanation for an increased BUN can sometimes be very, very frustrating once the most common causes have been eliminated. And to be honest, in some cases an explanation is never found despite every test that we can run has been done.
I agree that the number is XXXXX but we have to look at the total picture...in other words, look at the patient and not only at the test result. (and I hope you don't take offense at my saying so).

But, having said that, if the diet is not responsible for the elevation, then I would be focusing on a GI bleed as the underlying cause. Whether or not this can be confirmed may not be easy. Deb
Customer: replied 1 year ago.

Thanks so much. This does help.


As far as Lymphoma is considered- she has gained weight, rarely vomits anymore since we changed her to the low fat diet, and has no other symptoms. She does seem like she gets choked easily when she "speaks" to us- like her throat is small?? Our vet just did her yearly check up a few weeks ago. Her lab work was perfect other than the BUN. I have attempted to palpate lymph nodes but she is small and "fluffy"... plus I really don't know what I'm doing. Haha. What are some other things I should be looking for in terms of Lymphoma? And would it be an intestinal cancer?


As far as her stools- she gets ahold of anything and literally eats it- like paper. I will see it in her well formed, light brown stools and occasional a tiny bit of bright red blood on the end but I figure that is normal.

Expert:  Dr. Deb replied 1 year ago.
Carissa:
You're welcome; I'm glad that this is helpful:)

Lymphoma or any other intestinal cancer is usually seen in much older dogs, obviously, but it can develop in young ones as well which is why I mentioned it. But these dogs are usually losing weight, they frequently have diarrhea or regular vomiting, they might have a decreased interest in food....obviously signs that Lulu doesn't currently have.
And their external lymph nodes are not usually enlarged although they can be in some cases.

Not sure if her "choked" sounds are relevant since her combination of breeds often have issues of this sort but I suspect it's not connected.

A small amount of blood in an occasional stool doesn't worry me either especially if there's a history of dietary indiscretion...it usually is reflective of an irritated colon and nothing more.

I absolutely do understand your concern for the elevated BUN and your vet has done an excellent job of pursuing tests to try and find the cause.
If this were my case (or my own personal dog), I might take the wait and see approach before pursuing any more testing. She just sounds too healthy to be too sick, if that makes sense!
But if additional testing is to be done, then I would be looking at the GI tract. Deb
Dr. Deb, Dog Veterinarian
Category: Dog
Satisfied Customers: 6643
Experience: I have bred dogs and shown dogs for 20 years.
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Expert:  Dr. Deb replied 1 year ago.
Carissa:
Thanks so much for the rating; it's greatly appreciated:)
I do hope you'll keep me posted, especially if you pursue any additional testing...even after the diet change and repeat blood work is done. You can still send me emails as you have been even after you've rated.
I can also send you a follow up email in a month, if this is when a recheck is going to be scheduled.

By the way, please just ignore the request for additional information.
Best regards, Deb
Customer: replied 1 year ago.

Thanks so much- a follow up email in a month would be great!


We love our vet, but with the limited knowledge I have in this area, it was great to get a second opinion to reinforce our plan of care for Lulu (and also for my peace of mind.)


You are knowledgeable and professional and I couldn't be more pleased with your services.


I will keep you updated on Lulu's progress.


Have a wonderful day and again, thank you for helping us care for our sweet girl.


Carissa and Lulu


(I attempted to attach a picture of her but this must not be allowed as the message did not go through)


 

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Expert:  Dr. Deb replied 1 year ago.
Carissa:
I absolutely LOVE the picture!! What a cutie:) Thanks so much for sending it to me; I really like when I can put a face/body with the patient information.

Thanks so much for your kind words; they mean a lot. I'm also happy that you were pleased with the site and the service.

I'll schedule a follow up email in a month but if there's new developments in the meantime, please don't hesitate to let me know. Take care. Deb
Expert:  Dr. Deb replied 1 year ago.
Carissa:
I'm just following up on our conversation about Lulu. How's she doing and what is her BUN value? Deb
Customer: replied 1 year ago.
Hey Deb! Thank you so much for asking- we just went to the vet and after 1month of her new food, her BUN is 32 which is the best it has EVER been!! Praise The Lord! We are thrilled!!! Thank you again for everything!
Expert:  Dr. Deb replied 1 year ago.
Carissa:
Wow, that's great! High normal for the lab I use is 27 so that's really fantastic.

You must be incredibly happy:)

Thanks so much for letting me know; I needed some good news today:) Deb
Customer: replied 1 year ago.
Wonderful!!
Expert:  Dr. Deb replied 1 year ago.

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Dr. Deb
Dr. Deb
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I have bred dogs and shown dogs for 20 years.