Kidney Values - Are These To Worry About?

[Guest DiforDan]

OK, here's the thing: we suspected discoid lupus on Pixie's nose so she was scheduled for a punch biopsy (which terrifies me, the idea of taking a lump of tissue out of a houndie's nose). The pre-op bloods have given our vets cause for concern about her kidneys, so the nose biopsy has not gone ahead.

 

This was 5 weeks ago and meanwhile I have put her on a low-phosphorous diet, made up from nutritional tables on dogaware.com.

 

Sadly her kidney values have not really changed much in that 5 weeks, but I am wondering if these numbers are really anything I should be worrying about in a greyhound:

My apologies if these results are expressed differently than you would normally do because I am in UK and I am aware different measurements are sometimes used.

 

Creatinine is 165 (1.86) and has not really changed since we put her on the diet. Vet says this is too high.

Globulins have improved slightly in 5 weeks from 21 to 24.I am told this is low and indicative of protein loss.

Do you think these Creatinine and Globulin results mean that renal treatment is required in the form of drugs or diet?
Or should we wait and see and have her tested again in some weeks/months time?

 

Her urine test for kidney function was 0.13 and I was told that anything under .5 is fine, so all is good with that.

 

I am waiting for vet to phone me to tell me her BUN.

My vets are strongly recommending the packaged "renal diet" that they state all their patients have gone on in these situations, however special diets are not covered by our
insurance and would be prohibitively expensive for us. Previously Pixie was on a raw diet and I am very reluctant to put her back on any processed dog food, although I have
removed much of the phosphorous-rich bone from her diet now, giving her the odd wing or carcass as a treat.

 

Cooking this home-made diet for her is hard work, she doesn't especially like it, (she hates carbs and spits out rice and sweet potato) and if it's not improving her numbers I wonder whether I should get her back on her raw diet which she liked? I have also read that raw feeding can skew kidney markers on blood tests, in the absence of actual kidney disease.

 

She shows no signs of being unwell, her nose is improving with Isoderm ointment (until last night when a tiny pin-hole of a wound has started bleeding ) and I am still very reluctant to put her through a punch biopsy on that nose unless it really worsens.

 

Any help and advice would be gratefully received.

[JohnF]

Greyhound kidney test values are naturally higher due to their greater muscle mass and can be higher still shortly after they have exercized.

Pass this useful health packet to your vet.

http://www.greyhoundadoptionofoh.org/Library/2010-greyhound-medical-packet.pdf

 

It's good that you already visited Dogaware.com.

 

Also, for a high-volume Canine Kidney forum site take a look at:

https://groups.yahoo.com/neo/groups/K9KIDNEYS/info

 

To join they want you to post a copy of the latest lab results. Over many years I've lost 3 dogs to kidney disease, all of them different progress, and I found that site incredibly helpful.

 

Whether to go ahead with the Lupus invesigation? Is it Discoid or the more serious Systemic....

http://www.petwave.com/Dogs/Health/Lupus/Diagnosis.aspx

 

Discuss any anaesthesia protocols with your vet so that it can be as light and rapidly reversible as possible. If the dog doesn't have serious heart problems then having Amicar on hand for a potential bleed is helpful

[tbhounds]

Greyhounds renal values run on higher side of normal or often even elevated. One thing to check is the first morning urine specific gravity-typically if that's normal (=or>1.030) there's less concern of renal disease. It appears that your vet already checked the UPC and that result isn't of concern.

Regarding the biopsy--obtaining a dermal biopsy is rather straight forward-it's required the tiniest sample-each area only needing a single suture. That said IMO there's two ways to approach this-treat symptomatically as you have been or biopsy seeking a definitive diagnosis. I am certain that most clinicans would prefer the latter. If after speaking with your veterinarian you are still not comfortable with either treatment plan I would seek out another opinion. Do you have access to a veterinarian dermatologist?

You may want to consider consulting with Dr Couto (he's our "gh guy" and he's well versed in Euopean test values).

http://www.coutovetconsultants.com

http://vet.osu.edu/sites/default/files/greyhound_pdfs/faq/KidneyFailure.pdf

Pictures of Pixie please ;-)

[Guest DiforDan]

 

Oooo ... haven't posted photos on here before so hope this works, it's Pixie on the left and Pingu on the right, and me top/middle!

[macoduck]

What good looking furkids! Especially the gray hairs on Pingu.

[tbhounds]

Yea-it worked-lovely :-)

[RedHead]

I recently got a bloodwork panel done in the same units as you would use in the UK.

 

From my lab report a creatinine of 165 isn't necessarily too high if the BUN results are normal. My grey actually has a creatinine level of 179, my vet also told me he may have kidney problems. Luckily, after getting his urine tested, we found out his kidneys were just fine. I did a lot of searching, and read that a good percentage of greyhounds can have creatinine levels that are slightly elevated even from the "breed standard." This is normal for many greys as long as everything else is functioning properly.

 

I don't know a lot about the Globulin, but FYI my grey's Globulin was 24.6 and this was listed as "normal" on my sheet for a greyhound. The normal range was from 18-38.

 

If your BUN checks out okay, I wouldn't think you would need to worry about a kidney diet.

Edited February 26, 2015 by RedHead

[Guest DiforDan]

To recap: Globulin 24, Creatinine 165 (1.86)

 

So her BUN is fine and I have consulted another vet who has more experience with greyhounds and these are his conclusions:

 

"These results show only a very mild elevation in creatinine, which can be accounted for by natural variation, dehydration, and so on - certainly no indication to go on renal treatment (including diet) if everything else is normal. If the nasal problem is resolving then I would treat her a a normal dog and keep her on a regular diet.

 

Globulins are affected by many variants, and can fluctuate depending on other things going on, for example viral infections. Albumin levels (another type of protein) are more closely linked to protein levels and loss.

Also, so called "normal ranges" are really just an average based on results from a small group of tested dogs. If Pixie is fine in herself, but the results are just outside the "normal" range, then I wouldn't necessarily base any concerns on this."

This response confirms my suspicions that rather than bankrupting ourselves giving Pixie a diet that she would hate, and would be of dubious efficacy and nutritional value, the best thing is to do nothing for now but have her tested again in a few months.

If her results deteriorate into anything beyond the outskirts of normal for a greyhound then I would consult Dr Couto as suggested. It's a bit expensive for us right now though, as Pixie is so just borderline.

So disappointed though in vets who just try to push these manufactured, rip-off diets on to us, even when they know they would be financially prohibitive and they have no knowledge of what is in them, just relying on what a sharp-suited rep told them!!!!

We mentioned that the prescribed diets are low-phosphorous, which we could achieve ourselves in a home cooked diet, and a vet said the canned stuff has "other things" in it. Really? "other things" eh? Very scientific. I doubt they have even read the back of the tin.

Sorry, rant over!

[tbhounds]

I'm glad you sought another opinion and more delighted that she's officially a gh with gh norms ;-). Don't be bitter torwards the original vet-he/she was acting in your dogs best interest. Prescription foods have their place and have extended lives of thousands of pets. They do have their place in veterinary medicine--just not in Pixie's :-)

Thanks for the update-glad it's a positive one!!!