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Dr. Laura Devlin, DVM, DABVP
Dr. Laura Devlin, DVM, DABVP, Small Animal Veterinarian
Category: Dog
Satisfied Customers: 1801
Experience:  DABVP, Specialist in Canine and Feline Medicine, Veterinarian since 2000
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kidney problems in my Weimaraner

Customer Question

My 10 year old Weimaraner has had elvated alk phos >2000, alt up at 141, bun up at 48, creatnine up at 3.5. Repeat labs 1 week later showed alk phos down to 1348, alt down to 117, bun up to 68, and creatnine stable at 3.5. He is scheduled for an abdominal ultrasound. I am a nurse, and just checked his urine with a dipstick we use for our human patients. His specific gravity was 1.030. The strip showed small to moderate blood, and +3 (300mg/dl) protein. I know this indicates kidney disease and his kidneys are failing. What causes are likely? I am trying to prepare myself for what I know is probably not a good prognosis.
Submitted: 6 years ago.
Category: Dog
Expert:  Dr. Laura Devlin, DVM, DABVP replied 6 years ago.
I am Dr. Devlin, and I am a Board-Certified Specialist in Canine and Feline Medicine.

I'm very sorry to hear about Cooper's lab values. I know you must be very worried about him.

Can you tell me how he is feeling currently? Is he acting sick?

At this point, I am definitely concerned with what you have described.

Here are some thoughts on his case:

Do you have a baseline for his ALP from a few months ago or even last year? Any elevation at that time?

Some dogs are VERY sensitive to steroid preparations, even those applied topically, such as in an otic prep. Did his ear medication contain any sort of steroid? The ALP can go to well over 1000 in some dogs from topical administration only, and depending on the activity of the steroid, can take up to 6-8 weeks to return to baseline....

Rimadyl, unfortunately, can affect the kidneys - although I would not expect to see renal abnormalities after only 3 days of rimadyl unless there was already significant kidney disease present.

In dogs, depending on the reference, when the BUN and Creatinine are elevated, you need to see the urine concentrated to 1.030 or 1.035 to rule out renal insufficiency. I would like to see the urine more concentrated then this if from dehydration alone, but it's important to remember that other factors can influence concentrating ability - presence of steroids in the system, for example, endocrine diseases, infections, liver disease... at this point it would be impossible to diagnose kidney failure without a GFR study. Again, at 1.030 - he's on the borderline anyway.

Also, I don't know the timing of his sq fluids and this urinalysis, but it's possible that the fluids may have diluted his urine more - so that it looks less concentrated then it is.

At this point, I would recommend having a urine culture and complete urinalysis performed - the samples will need to be obtained by needle directly from his bladder- male dogs can have increased protein from their urethra/prepuce contamination.

In addition, I would recommend a leptospirosis test.

Have you discussed hospitalization with your vet? I would encourage you to have him hospitalized for fluid therapy until this can be sorted out in case there is renal insufficiency. A dog his size is going to need more fluids then you will be able to administer comfortably and safely SQ - probably a liter or so a day.

To better evaluate the concentrating ability, consider an early-morning urine sample. Also, we routinely do not use the dipstick for our specific gravity readings in dogs - its often inaccurate. We use a refractometer. Also, nitrates and leukocytes are not accurate on dipsticks in dogs - just wanted to make sure you were aware of the differences - I have no clue about human medicine here!

I hope this information helps and gives you a little peace of mind. Please let me know how else I can help.
Dr. Laura Devlin, DVM, DABVP and 5 other Dog Specialists are ready to help you
Expert:  Dr. Laura Devlin, DVM, DABVP replied 6 years ago.
I'll be heading off line in a few minutes but will be back in a few hours. I know you are worried, and just wanted to make sure you didn't need anything else right now.
Dr. Laura Devlin, DVM, DABVP and 5 other Dog Specialists are ready to help you
Customer: replied 6 years ago.
I got your message that you were getting offline. It took me a bit to find your answers and compose my reply. I will look for an email later. Thank you so much!
Expert:  Dr. Laura Devlin, DVM, DABVP replied 6 years ago.
Thank you for the accept - I appreciate it.

Can I help with anything else? It sounds like you might have another reply to post - I'll keep a watch for it.