Renal Biopsy To Confirm Glomerulonephritis

[Guest HersheysMom]

Susan - her bp is normal

 

Diane - a lot - her protein/creat ratio is 9.3

 

Melissa - Do I again hear you offering to cook for her for ten days?

[duncan41]

Here's some basic information found during a random search:

Glomerulonephritis is a lot more common than amyloidosis. Glomerulonephritis is inflammation of the glomeruli (the filtering structures of the kidney). It can occur secondary to many other illnesses, including many disease organisms (leptospirosis, Lyme disease, heartworms, brucellosis, hepatitis), cancer, pancreatitis, immune-mediated hemolytic anemia, hyperadrenocorticism and systemic lupus erythematosus and other immune mediated diseases. It can also occur as a primary, or idiopathic, illness. Sometimes finding and controlling the underlying problem can arrest the degenerative process and stop the progression of kidney failure. More often, once this problem starts it is slowly progressive over time.

 

There are treatments that can help with glomerulonephritis. As mentioned above, an effort should be made to find and treat any contributing condition. To help prevent protein loss and control high blood pressure associated with kidney failure, enalapril or other acetylcholinesterase (ACE) inhibitors may be helpful. The usual dosage of enalapril for this condition is 0.25 go 0.5mg/kg once or twice a day. Aspirin may help to prevent blood clotting that sometimes occurs due to glomerulonephritis. The dosage for aspirin therapy for this purpose is usually lower than for other conditions. A dosage for aspirin of 0.5 to 5mg/kg is enough to inhibit blood clotting. A low sodium, low total protein but very high quality protein diet, such as Purina NF or Hills k/d is helpful. Encouraging fluid intake is helpful. If the serum albumin level drops low enough to cause fluid accumulation in the abdomen it may be necessary to give diuretics. Calcitriol is more likely to provide a benefit in a patient with glomerulonephritis since this tends to be a more slowly progressing disease.

 

 

I would HIGHLY recommend contacting Dr. Rebecca Remillard at Angell Animal Medical Center, Boston, MA. She is absolutely top notch in canine nutrition and does telephone consultations. You must send her a complete history and test results in order for her to map out a diet specific to your needs.

As an aside to this whole discussion, I would cast my vote as a NO to a kidney biopsy. Having had one with ARF, even the internist treating my girl said that a he would only recommend a biopsy every other possible treatment had failed. Not something you want to do without a great deal of thought.

 

[Guest Fasave]

Yes Carolyn, I will cook for Sonie. And I second the Dr. Remillard at Angell. She did Safari's diet for me. With all of Safari's issues, it was a relief to know that he was finally getting a meal he could tolerate AND that was nutritionally balanced.

[Guest gretzky]

Carolyn, have you considered changing her diet? She is on a prepared raw if I remember correctly. Do you know what the phosphorus level is? Dr. Feeman had an article on it, I'll see if I can find it.

 

I'm glad you decided to try the Baytril path first. Food and supplements were 2 of the other things my Vet wanted to know about when Wonder was having issues. Just as in humans, not all dogs can handle all the different herbs etc., especially in some combinations. We took Wonder off everything except her food for a while and slowly added only essential things back in, all the while monitoring her levels. 9.3 is really high for no other symptoms to be present other than occasional incontinence. Does the new Vet use Idexx? Diet is something I would look closely at before I considered an ultasound even. I would not biopsy.

 

Wonder has been successfully managed for 2 years now with a low protein, low phosphorus commercial kibble diet and enalapril. She's doing great for a 12 year old!

 

Hugs to you and Sonie.

 

 

[Guest HersheysMom]

Hi Kelly! Yes she's on mainly a prepared raw diet, and also prepared Delifresh refrigerated food, and a bit of kibble and canned. The protein sources (mainly beef, turkey and bison) are all selected by Dr. Caviness at Integrative Animal Health as a cooling, anti-anxiety diet. My regular vet called a dietician to see if a high protein diet may cause the high protein/creat ratio, and she said not to the extent we are seeing. So the current diet is not causing this.

 

My plan is if the protein/creat ratio is the same after the course of Baytril I'm going to bring her to a great IM specialist I was just referred to - one of her specialties is renal disorders. There's still so much we haven't ruled out, Addison's, Cushings, I hate to say it but Cancer could cause this high protein in the urine. An IM specialist can help me decide where to go next, and I think an abdominal ultrasound could tell us a lot about the kidneys as well as what kind of shape her other organs are in, if there's any masses, etc.

 

If we find out after all this she does in fact have a kidney problem, I am more than willing to change her diet. Right now there's too many other things it could be though, and I don't want to change her diet to a kidney one until I know she has a kidney issue for sure. I remember Hershey also had protein in his urine, our last vet diagnosed him with a vague "early kidney disease" I put him on a kidney diet and about a year and a half later he was diagnosed with cancer. The cancer diet completely contradicted the kidney diet, and I'd wished he was put on a cancer diet sooner - that may have even been the cause of the protein to begin with, if I had only done an ultrasound sooner. Ah, hindsight....

 

Great idea about taking her off the herbs before the next protein/creat ratio test. She's on a ton of herbs for anxiety. I'll take her off a week before the next test (and try to keep her calm!)

[Guest MZH]

We went through this with Tucker. Our vet recommended not doing the biopsy b/c all the other evidence was clear he had GN. She said she didn't want him to lose any glomerular filters which the biopsy might cause (I think that's how she phrased it). The BP will likely be high. If the vet prescribes Enalapril, do give it. That's very important!

[Guest MZH]

We went through this with Tucker. Our vet recommended not doing the biopsy b/c all the other evidence was clear he had GN. She said she didn't want him to lose any glomerular filters which the biopsy might cause (I think that's how she phrased it). The BP will likely be high. If the vet prescribes Enalapril, do give it. That's very important!

 

She didn't recommend a low protein diet b/c he was very thin but that might have worked better. It's a tough disease that can be managed but not cured.

 

We went through this with Tucker. Our vet recommended not doing the biopsy b/c all the other evidence was clear he had GN. She said she didn't want him to lose any glomerular filters which the biopsy might cause (I think that's how she phrased it). The BP will likely be high. If the vet prescribes Enalapril, do give it. That's very important!

 

She didn't recommend a low protein diet b/c he was very thin but that might have worked better. It's a tough disease that can be managed but not cured.