Bloodwork And Urine Show Kidney Problems

[Guest greykat]

Here is our situation. Max will be 10 in August. We've been focused on him for nine weeks now since he fractured a metatarsal(?) on his hind right leg. He is still healing while wearing his splint, and he has another three weeks in it until his next x-ray. So we've assumed his limping and panting have been related to this discomfort of his situation and his boredom since he's not allowed any exercise or stairs.

 

Last visit to the vet included a senior profile. His bloodwork came back almost normal, but his Creatinine was listed as high at 1.8. I looked at his same test last year, and it was .9. So it's doubled in a year.

 

They called today w/ the uninalysis results. He has high protein levels in his urine (3+). I didn't get to talk to the vet (he'll call tomorrow), but they said that's really high and it indicates more than 75% of his kidneys aren't functioning. The vet tech mentioned a special KD diet he'll need to go on.

 

I have been reading again about the greyhound levels and see some mixed messages (one site has greyhound creatinine up to 1.6, but others say up to 2.1 or 2.4 can be normal). I'm not sure how worried I should be about that.

 

I also read that the BUN is important to compare. His BUN/Creatinine ratio is 12, which registered in the normal range.

 

I HAVE noticed what I think is an increased intake of water over the past few months, but unfortunately I am having trouble gauging it. We switched to a filtered fountain (Drinkwell Big Dog), and for a little while we were just excited to watch him drink from it because he was cautious at first. We thought some increase may be attributed to the fact that the water tastes better now...but since we changed our process completely, we really didn't think "Hey, he drinks a lot more these days. Wonder if there's a problem." We went from refilling a bowl to going several days while he drains a gallon bottle.

 

Anyway, all this to say that I'm confused, I can't talk to the vet until tomorrow, and I'm worried. Max has been different, for sure, over the past couple of months, but it seemed so obvious- the poor guy has a broken bone and has the wear this annoying thing on his foot. He can't go for walks or come upstairs at night. We have to walk him on a leash to let him do his business. Life has changed radically, so we assumed this all was taking its toll on him. We've been praying for him to heal so we could go back to normal and he could return to running in the yard and going up and down the stairs and for walks in the park. But have we been missing any symptoms of a different problem? He was showing no signs of health problems whatsoever before this bone break.

 

Help! OH, and I have the printout of complete blood analysis if anyone has questions about other important numbers. It's funny, we have had three greys for 9 years now, and I still feel clueless w/ lots of medical stuff.

 

Any help or advice or anything that might put my mind at ease would be much appreciated.

 

Thanks so much!

Kat

[greyhoundgang]

The bloodwork numbers do not point to kidney disease in a greyhound. CREAT and BUN need to be high. 1.8 is not high for a greyhound, and the BUN is normal.

 

This booklet - Dr. Stack the Deck for Greyt Health - is a compliation of Dr. Stack's articles. It's good to have one, and give one to your vet. It's only $4, (on sale this month at 20% off) with all proceeds helping hounds.

 

Or go to Greyt Health - a web site with Dr. Stack's articles, and print it out.

 

or go to Greyhound Gang. Click on LEARN. Click on MEDICAL. Click on Kidney and Blood Work. Read and print.

 

Now, The broken stuff.

Joint supplements will absolutely help. Acupuncture too.

Get Up and Go products are inexpensive, they work, and proceeds help hounds.

Testimonials - unsolicited

Q&A

 

Some quick info about kidney disease:

Totally manageable with a good diet. K/D Diet - not the best you can do. Dogs need low phosphorus and good quality, high protein. Many internet articles, and kidney info on Gang's site.

 

salmon oil, an Omega 3 Fatty Acid helps with inflammation and is good for all dogs.

 

I would keep an eye on the drinking. Really see if it's more than normal. Stress can cause more drinking, and he could just be stressed about not getting exercise, and not being able to sleep with you etc. Watch that and follow up on the urinalysis.

 

Hope this helps.

They are just my opinions, based on what you wrote, and my experiences with the hundreds of hounds that have been through Greyhound Gang's doors. But you are doing well to do your research, and search the internet and ask questions.

 

best -

[Guest ss556]

When Alan was diagnosed with kidney disease, the specialist ordered a Urine Protein Creatinine ratio - a special urine test. Also, he had an ultrasound by two different vets and that confirmed that he had about 30% of his kidney function left. Then we knew he had a type of kidney disease along with his labs. So after you and/or your vet read the information above, you may want to ask about this and then put the entire picture together.

[Guest greykat]

Thank you both so much! I will definitely read these and give a copy to my vet. He is a great guy and has some experience w/ greys, but not much. We've only been seeing him for a couple of years now, but he's kind, careful, listens, and doesn't rip us off. Still, there are instances when we want a grey expert if anything serious seems to crop up. I'll request a special urine protein creatinine ratio. Thanks for the tip!

 

FYI: While Max can't join us upstairs, we can't let him sleep alone. My husband slept on the couch a few times, but he is very tall and, well, didn't sleep much at all. I am quite short and fit nicely on the couch, so I've been sleeping on it for...almost nine weeks now. Ugh! He's so worth it, though. But I can't wait until we can all sleep upstairs again (we have a sleep number bed, and I miss it terribly..and I guess my husband, too).

 

Thanks, again!

[greyhndz]

Yup, agree totally with above. Can't diagnose renal disease just based upon a urine dipstick showing +++ protein. Dipsticks are notoriously unreliable. I would not consider the creatinine of 1.8 alarming at all, just at upper limits of normal. If the BUN is normal (which I assume since the BUN/creatinine ratio is normal) then it's unlikely there's been any signif. decrease in renal function.

 

The urine protein/creatinine ratio (UPC) will confirm whether or not Max is spilling protein into his urine. This is obtained by getting just one urine sample. If it's normal, I would not take this any further, and I'd tell the vet to chill. If it's elevated, he'll need a renal ultrasound and possibly additional workup (I'd ask for a referral to an internal medicine specialist).

 

I would absolutely NOT start on any kidney diets or medications without a diagnosis being confirmed, meaning via UPC and possibly ultrasound. And even if he did prove to have some type of renal disease, it can often be controlled very well by diet and medication.

 

So, don't freak out.

[Guest Energy11]

The bloodwork numbers do not point to kidney disease in a greyhound. CREAT and BUN need to be high. 1.8 is not high for a greyhound, and the BUN is normal.

 

This booklet - Dr. Stack the Deck for Greyt Health - is a compliation of Dr. Stack's articles. It's good to have one, and give one to your vet. It's only $4, (on sale this month at 20% off) with all proceeds helping hounds.

 

Or go to Greyt Health - a web site with Dr. Stack's articles, and print it out.

 

or go to Greyhound Gang. Click on LEARN. Click on MEDICAL. Click on Kidney and Blood Work. Read and print.

 

Now, The broken stuff.

Joint supplements will absolutely help. Acupuncture too.

Get Up and Go products are inexpensive, they work, and proceeds help hounds.

Testimonials - unsolicited

Q&A

 

Some quick info about kidney disease:

Totally manageable with a good diet. K/D Diet - not the best you can do. Dogs need low phosphorus and good quality, high protein. Many internet articles, and kidney info on Gang's site.

 

salmon oil, an Omega 3 Fatty Acid helps with inflammation and is good for all dogs.

 

I would keep an eye on the drinking. Really see if it's more than normal. Stress can cause more drinking, and he could just be stressed about not getting exercise, and not being able to sleep with you etc. Watch that and follow up on the urinalysis.

 

EXCELLENT ADVICE! And, yes, GH "numbers" are a lot different than "other" dogs!

 

Hope this helps.

They are just my opinions, based on what you wrote, and my experiences with the hundreds of hounds that have been through Greyhound Gang's doors. But you are doing well to do your research, and search the internet and ask questions.

 

best -

 

[Guest greykat]

Thanks to all!

 

To Claudia: How cool! I noticed you are from Kanab. I have been obsessed with Dogtown and Best Friends since January, and all I can talk about is wanting to visit Kanab and volunteer at the sanctuary. I imagine you've been to Best Friends. Is it as magical as it seems?

[MaryJane]

A few things seem a little confusing and one is that usually vet techs are not supposed to give out test results. I'm also very surprised that a vet tech they would say that 75% of the kidney function might be gone. When you do get to talk to the vet, you might want to ask whether it is normal practice for the vet tech to be diagnosing your dog......

 

I think that if your dog has both an elevated blood creat and protein leaking into the urine then the vet may suggest a diet change. One of my greyhounds had a similar profile and he went onto a special kidney diet and months later his blood values were normal and there was no more protein in the urine.

 

 

[Guest greykat]

Yes, I did find it odd to get a message with details from the vet tech. When I called back, though, I did push alittle for info. He sounded like he was probably repeating what the vet had said to him, and he also said he'd prefer that I wait to speak to the vet.

 

Still waiting for the call. I'll call them at lunchtime if I haven't received word.

 

Thanks!

 

[Guest Greensleeves]

Although the numbers *are* in the "normal" range for greyhounds, the DOUBLING of the creatinine in a year would worry me, as well.

 

Your story sounds so familiar; Nelly went through a traumatic surgery a year before her kidney failure diagnosis, and we'd attributed so many "off" things to that. I wish we'd known months earlier that the "slightly elevated" numbers meant she had a terminal illness; I think we may have been able to prolong her comfortable months. As it was, we only started fighting her kidney disease 54 days before her death... way too late.

 

Talk to your vet about a diet change. I would re-check those numbers again in a month, and if they're still elevated or going up, start thinking about what else you might do (renal ultrasound, sub-q fluids, etc).

Good luck!

 

ETA: Is he taking any NSAIDS (Rimadyl, Deramaxx) for the broken leg? They're hard on the kidneys, so that may be part of what you're seeing in the numbers... but, if there *is* an underlying kidney problem, you'll want to think about switching to a narcotic painkiller instead.

Edited June 16, 2009 by Greensleeves

[Guest spider9174]

So the values that are available are AVERAGES. That means there were pups with blood values above and below them. There are some available papers through OSU that talk about this.

 

My male has bun creatinin values that are above he norm. We checked it every 6 months for a year and a half and the values didn't change. We check it yearly now, still no change. His numbers are normal for him.

 

Have you ever done a full blood panel for him previously? If so, what were the numbers then?

[Burpdog]

I wouldn't be worried at all. I have a feeling the test from last year at .9 was incorrect. Do you have one from before last year?

 

Email me at Burpdog@msn.com and I can email you all the kidney papers

[Guest greykat]

I have to run, but I wanted to reply quickly and say that Max did have bloodwork in 2006 (I can't find 2007 right now) that says CREA is 2.2. and the BUN was 15.

 

Any ideas why he jumped from 2.2 in 2006 to .9 last year to 1.8 this year? Maybe the .9 was a misreading? I'll investigate to get more of the blood history. If they are all high except for last year, maybe last year was really a bad test.

 

Vet still hasn't called back. I called this afternoon, and the receptionist said he was not there but would call at 3:30.

 

Gotta run! I'll post more later. Thanks to all!!

[Burpdog]

imo .9 was a lab error. He sounds fine.

[GeorgeofNE]

Thank you both so much! I will definitely read these and give a copy to my vet. He is a great guy and has some experience w/ greys, but not much. We've only been seeing him for a couple of years now, but he's kind, careful, listens, and doesn't rip us off. Still, there are instances when we want a grey expert if anything serious seems to crop up. I'll request a special urine protein creatinine ratio. Thanks for the tip!

 

FYI: While Max can't join us upstairs, we can't let him sleep alone. My husband slept on the couch a few times, but he is very tall and, well, didn't sleep much at all. I am quite short and fit nicely on the couch, so I've been sleeping on it for...almost nine weeks now. Ugh! He's so worth it, though. But I can't wait until we can all sleep upstairs again (we have a sleep number bed, and I miss it terribly..and I guess my husband, too).

 

Thanks, again!

 

Point your vet to the Greyhound Wellness Program--at Ohio State. He can CALL THEM and discuss your dogs labs as a free service!!! They're fabulous!

[Batmom]

imo .9 was a lab error. He sounds fine.

 

Ditto that.

[Guest greykat]

Thanks for putting my mind at ease! My vet called back, but only after I left for my saxophone lesson. He said he'd try back tomorrow.

 

It's weird. Max hasn't been himself for obvious reasons, but yesterday and today he is whining A LOT. I wonder how much his injury bothers him. Boy, wouldn't it be nice if dogs could talk?

 

Oh- to answer the question about meds. He did 3 weeks of antibiotics that ended 6 weeks ago. He also gets metacam when it seems like he needs it (I try to use it sparingly, but there were days when he seemed to limp a lot and I had to use it). The injury was freaky. I was watching him run in from the yard (like he does many times each day), but suddenly I saw (I think) a small branch kick up from the ground and his back paw come up. He cried and lifted it the rest of his trot into the house. That's when I saw a lot of blood. We went to the vet as soon as I saw that I couldn't work w/ it (he wouldn't even let me try to bandage it). Vet sent me to E/R because there was a laceration in a "bad spot" between his toes. E/R called me post surgery to let me know they saw some swelling and took x-rays, and that's how they found the fracture. Just thought I'd let you know why he needed antibiotics.

 

Poor guy. He is SUCH a puppy, so this has been extremely hard on him. Every time I take him out, he tries to at least trot, and he also tries to jump and play. Nothing worse than telling him "no" for something that comes to him so naturally. I can't WAIT for this splint to come off!!!

 

Okay, so this post is all over the place. Sorry! I need to eat some dinner...I'm not making sense.

 

I'll post more after I finally speak w/ the vet tomorrow. Have a great evening, everyone!

 

Point your vet to the Greyhound Wellness Program--at Ohio State. He can CALL THEM and discuss your dogs labs as a free service!!! They're fabulous!

 

How cool! I didn't realize that. I will most certainly tell him to call them. Wow- Ohio State ROCKS!!

Thanks so much for letting me know!!

[Guest suzye]

A few things seem a little confusing and one is that usually vet techs are not supposed to give out test results. I'm also very surprised that a vet tech they would say that 75% of the kidney function might be gone. When you do get to talk to the vet, you might want to ask whether it is normal practice for the vet tech to be diagnosing your dog......

If creatinine is truly elevated, then this is true. Creatinine does not elevate in bloodwork until more than 75% of kidney function is gone. The question here is "IS his creatinine actually elevated?"

 

Have you checked the urine specific gravity on first catch of the day (concentrated sample) using a refractometer (not diptick)? Dilute urine is an earlier indicator -- should be dilute once more than 60% of kidney function is gone. I'd want that checked, too. I actually bought one ($45 and easy to use) so kidney disease hopefully will not sneak up on me.

 

Was the previous creatinine test of 0.9 at the same lab? Jazz's creatinine was all over the place at different labs throughout her life. It ranged from 0.9 to 2.3. Maybe 0.9 was just a bad run, even if it was the same lab.

[greyhndz]

[i'm not a veterinarian but do practice human medicine. I also have an iggy with glomerulonephritis.]

 

An elevated creatinine, which 1.8 technically isn't, doesn't only reflect renal function. There are many other things which cause variability in creatinine. Two things really stand out from what greytkat has told us: he's been on an NSAID (meloxicam) which is notorious for affecting kidney function (but is usually reversible when the NSAID is stopped), and he has a recent injury resulting in muscle breakdown. I don't know what antibiotic he was on, but several can also have an effect on renal function. His diet, hydration status, time of day of urine collection -- all of the above can cause mild elevation or variability of creatinine without there being any underlying renal disease.

 

Explanation of factors affecting creatinine

 

I don't recall if greytkat has mentioned whether Max has PU/PD (urinary frequency and increased volume; increased water intake).

 

I honestly don't see a clinical significance in a large variability of creatinine (0.9 - 1.8) as long as both are within the normal values for a greyhound. This broad spread is easily explained by the factors listed above. Another lab to check would be Glomerular Filtration Rate (GFR) - in human medicine, this is routinely performed anytime serum chemistries are run (which include BUN/creatinine).

 

A couple of OSU articles if they haven't already been referenced:

 

OSU article on creatinine in GHs

 

OSU - lab values

 

Hope this wasn't too medical-esey!

[Guest greykat]

Thanks, houndznigz!

 

Max was on Clavamox for the first week, then they extended for another week, then the stitches were removed and there was still some grossness and oozing, and I asked if he should stay on antibiotics. They said it couldn't hurt and did one more week.

 

Max was given some type of pill pain meds at the E/R, but I don't recall what it was. Maybe Deramaxx? Not certain. My vet switched us to Metacam when the pills ran out. Max had one dose a day and we went through the small bottle quickly (w/in a week?). I asked for more, and I bought the bigger bottle. I was trying not to give too much pain medication, but he would have good days and then a day when he seemed restless and was limping or not even putting any weight on his foot, so I'd give it to him on those days. I often go many days w/out giving it to him. I can't say for sure how much he's had over these 9 weeks, but I can say that it seems like there's still a lot of liquid left in the big bottle I bought.

 

Max eats Eagle Pack Anchovy, Salmon...whatever that dry food mix is. I call it stinky fish. He has become a pickier eater, so we often buy wet food to mix in (a tablespoon or so) to entice him. While the dry food stays consistent, we've purchased lots of brands of wet (a lot of Merrick, and some other high quality brands I can't quite think of at the moment). Most recently, I picked up a can of Trader Joe's chicken wet food, and he LOVES it. We also find he's a milk lover, so when we have run out of wet food, we sometimes just add milk, and he adores that.

 

He has been healthy (w/ the exception of "greyhound neck" stiffness that crops up for a day or two once or twice a year). We had him on gluc supplements for awhile, but my husband often forgot to give them, and even when I was diligent, we didn't really notice a difference. He'd still get his stiff neck from time to time. We stopped the glucosamine altogether, and I have considered buying Get Up and Go. I've also considered acupuncture.

 

Blah. Not sure if they helps give any clues about anything.

 

I'll go back and look at the blood test results to see about GFR. I'll let you know.

 

Thanks so much for all the great help and resources and general support. I really love this site and you wonderfully kind people!!

 

[Burpdog]

NSAIDs can damage the kidneys. Withdrawn, the kidneys usually respond well.

[Guest greykat]

Update: I was able to talk to the vet, and he said he was reading up on greys and creatinine and knows that his level is w/in a normal range. So that isn't a concern to him. He is worried about the urine sample. He said they did do a specific gravity on the urine and that was normal. What wasn't normal was the high level of protein and the presence of a lot of red blood cells. He wants to do another test and asked that I make sure not to start collecting until after Max has peed for a second or two. That should be a better sample. I also asked about length of time waiting, and he said the fresher the better. So I plan to do all that and see what happens. He said he wants to see if the protein is leaking in from the kidneys or the bladder.

 

FYI: The sample I took was last Saturday morning (pre-breakfast), but I didn't get it to the vet for another two hours. I wonder if that would be part of the problem? So this time I will take it as soon as he's done and I'll let my husband feed him.

 

Also: I told my vet about the free service w/ OSU, and he said he'd call- he's actually friends w/ Dr. Couto (Yay!).

 

As for all the blood stuff, I sat and mapped out the blood records I have. The first two have some holes (different vet/different lab). But it does paint a picture of his overall history. I'll try to past it below. I was confused about some since they are written differently depending on the lab. Oh well. Hopefully it makes some sense. I also found scribbles in an old vet record about urine for Max from 2004: specific gravity >1.050, PH 7, Protein T++500, Glucose normal, Bili ++, Bld. @250, Urobil normal, cells rare??? (can't read), bacterial rare ??? (can't read, no ketones, nitrites, or lemo? They also wrote "mild creatinine deviation, BUN and SG >1.050 (pre-renal), UAS-proteinura bilirubinura (??), hematura on dipstick but no RBC's in sediment(??)"

 

Ugh- I want to go to vet school!! I'm so confused.

 

2004 2006 2008 2009

Total Protein 6.64 7.2 6.6 6.9

Albumin 3.9 3.6 3.7

Globulin 3.3 3 3.2

Albumin/Globulin Ratio 1.2 1.2

AST (SGOT) 33 33

ALT (SGPT) 27 49 33 46

Alkaline Phosphatase 56 87 93 84

GGTP <5 <5

Total Bilirubin 0.9 0.1 0.1

Urea Nitrogen 18 22

Creatinine 2.34 2.2 0.9 1.8

BUN/Creatinine Ratio 17.2 15 20 12

Phosphorus 1.8 3.3 3.2

Glucose 120.4 101 81 123

Calcium 10.7 9.6 10.4

Magnesium 1.8 2.2

Sodium 160 141 147

Potassium 4 4.2 4.5

Na/K Ratio 33

Chloride 118 93 105

Cholesterol 228 282 299

Triglycerides 78 77

Amylase 644 870 860

Lipase 480 397

CPK 192 74

Hemoglobin 21.4 24 21.5 22.3

Hematocrit 61.1 63.6 64.9 67

WBC 9.3 5.04 4.9 5.2

RBC 8.48 8.8 9.16

MCV 75 74 73

MCH 28.29 24.4 24.3

MCHC 35 37.7 33.1 33.3

Platelet Count 241 188 117 140

Platelet Estimate adequate adequate

Differential absolute absolute

Neutrophils 5.5 3.52 3626 3796

%neu 69.8 74 73

Bands 0 0

Lymphocytes 0.7 686 780

%lym 13.9 14 15

Monocytes 0.53 245 260

%mono 10.4 5 5

Eosinophils 0.6 0.26 343 364

%eos 5.2 7 7

Basophils 0.03 0 0

%baso 0.5 0 0

T4 0.7

Urinalysis

 

*2004 listed high for hematocrit, hemoglobin, and creatinine

*2006 listed high for creatinine, low phosphorus, low WBC, high hematocrit and hemoglobin, and high MCHC

*2008 listed low for chloride, high for hemoglobin and hematocrit, low platelet, low lymphocytes (no t4 test in results)

*2009 listed high for creatinine, hemoglobin and hematocrit, low for platelet, low t4

Thanks, again, everyone!

 

One more thing- while I do feel like Max is panting a lot lately and drinking a decent amount of water, he still can go up to 9 hours alone while we are at work, and he hasn't had any accidents in the house since...forever? Can't remember him having one. His siblings did, but he's a trooper! So would that indicate that he must not be drinking *that* much? He also doesn't seem to pee for hours like his brother used to.

 

Anyway, just a nervous mom trying to make sense of a lot of info.

[Burpdog]

Looks like he has stayed pretty even over the last 5 years. I don't like the drop in platelets but I am a platelet fairy. HCT looks good.

 

Has he had a TBD panel done?

 

I don't know about the protein. All of my seniors run protein in their urine and as long as the BUN/creatine ratio is ok we ignore it. The red blood cells in the urine indicate an infection, no? Did they do a urine culture?

[Guest greykat]

Looks like he has stayed pretty even over the last 5 years. I don't like the drop in platelets but I am a platelet fairy. HCT looks good.

 

Has he had a TBD panel done?

 

I don't know about the protein. All of my seniors run protein in their urine and as long as the BUN/creatine ratio is ok we ignore it. The red blood cells in the urine indicate an infection, no? Did they do a urine culture?

 

As far as the platelets are concerned, there's a note on both 2008 and 2009 tests that says clumping was found and can prevent a precise determination of platelet count. Is it normal for grey platelets to clump?

 

As for TBD panel- I think he had one in the past. I see something in his old file next that show the following. I assume it means he was tested and had negative results. I can't recall- we used to just do whatever the vet recommended.

 

HW(-)

Lyme (-)

Ehr (-)

Ana (-)

 

I don't know if they did a urine culture. Unfortunately, the vey seemed a little rushed on the phone. I hope to stop by and get a printout of the results for my file. I'll post the details when I get them, but it sounds like we'll be rechecking the urine anyway.

 

Fingers crossed that all is well (or at least treatable/curable)!!

[MaryJane]

As far as I know, people and dogs don't normally don't pass protein in the urine.

 

Most of the literature say that the high creatinine is OK in greyhounds just as long as everything else is normal -- in this case it isn't - there's protein in the urine. At least that is my interpretation.

 

For the urine, try and get the first catch of the day and make sure that it is a midstream (catch the middle part) and when you bring it into the vet, make sure that they note that it is a first catch. Don't let him urinate after about 9 pm and no water either. That way he's got about 8 hours of concentrated urine in him by morning. This should give a better reading on the protein too.

 

Good Luck ...