Trace Protein In Urine - Update Post #12

[NeylasMom]

Any thoughts on this? I'm waiting for results to be faxed over, but all of Violet's blood work is normal, including kidney values. Urinalysis is good as well except there is trace protein in it. Part of the reason I took her in was because last week I thought she may have had a minor rhabdo incident and when I checked her urine a few times with the dipstick it showed protein (which is common after rhabdo). Her urine is always really concentrated, which I know can turn up false positives on the dipstick, but urinalysis via lab confirmed the protein is there.

 

If I'm right about the rhabdo, there's really nothing to do and if there isn't permanent kidney damage the protein should clear out. Otherwise, vet suggested the possibility of Enalapril if we suspect early kidney issues, or she said we could go the full ultrasound route if I wanted to be really thorough.

 

My plan right now is just to retest her urine in the lab in a few weeks and if there is protein again, especially if there is more, I may take her back to the internal medicine specialist.

 

Any info on whether I should be concerned and what, if any treatment or testing to pursue? Violet is raw fed so I wondered about that, but while she has had protein her urine after previous rhabdo incidents or when infection was present, the other urinalyses we've run just to do follow-up after she recovered had no protein (those were in 2014).

 

ETA: Here are the renal values from her blood work:

BUN 20 (9 - 31 mg/dL)
Creatinine 1.5 (0.5 - 1.5 mg/dL)
IDEXX SDMA 13 (0 - 14 µg/dL)

That creatinine is normal for her. I don't have SDMA from previous blood work for comparison, at least not on the 2 sets from 2014 I have from our vet. It is on the high end of normal.

 

 

I'll also just add that the other thing I've noticed recently - that could be nothing or could be something - is that she seems to be panting harder after exercise than normal. She is 7 btw, and the vet didn't hear anything unusual when listening to her heart and lungs. The panting was first noticeable the night I thought she had the rhabdo incident, but has continued at times since then.

Edited October 18, 2016 by NeylasMom

[MaryJane]

Was this on a first morning specimen? Do you by chance have the Specific gravity results?

[NeylasMom]

Was this on a first morning specimen? Do you by chance have the Specific gravity results?

It was, and her urine was very concentrated, as it always is unless she's just had a ton of water (1.052).

Edited October 5, 2016 by NeylasMom

[MaryJane]

Others may differ on their opinion but, my opinion is that there should never be protein in the urine. In her case, the specific gravity is high enough that it might be contributing to the "trace protein" and if she was better hydrated, it could be that maybe no protein would be showing because the sample would be more dilute. Having said that, if I was in your position I would check her urine every other day for about 10 days and see if the protein is still showing up. How much water does she drink? Is there a chance that she could drink more water and see if that changes the results?

 

If the trace protein is still there after 10 days, then I would reduce her protein intake and increase the carbs & veggies. Keep on testing every other day and see if the trace protein disappears and if so, then maybe her diet needs to be adjusted for at least the short term for a different ratio.

[Rickiesmom]

There is a follow-on test you can have done, can't recall the name but your vet should know, which will give you a better sense of whether this is a concern or not.

 

My whippet in his later years often showed a bit of protein in his urine, but that second test, whatever it was, ruled out any real problem. That said, rhabdo was not in his history.

[Batmom]

You usually don't worry about a trace in highly concentrated urine.

[tbhounds]

You usually don't worry about a trace in highly concentrated urine.

This. I would recheck with the lab in a few weeks. If you get persistant positive protein results run a UPC (only on an inactive sample).

[dmswartzfager]

The SDMA is a marker of early kidney disease, and IDEXX started offering it only within the past hmmm... 18 months at most, which is why you don't see it on the 2014 blood work. While IDEXX is still validating the SDMA value for greyhounds, most patients I've seen recently have values between 12 and 14, so 13 doesn't excite me in any way. Neither does the trace protein excite me. Since your vet is using IDEXX, you can request a urinalysis with a reflex UPC. It costs a few more bucks up front, but if there is protein in the urine, they will check for an active sediment, and if the sediment is inactive, then they will proceed with running the urine protein creatinine ratio automatically. Requesting the UPC separately usually costs more.

[tbhounds]

Also don't take the smda test to seriously when testing a greyhound. Idexx has now stated that greyhounds can and often do normally run on high and above the reference range.

Edited to add-regarding the above post--we used to run the UPC reflex all the time--it's a great test and can really be a money saver :-)

Edited October 6, 2016 by tbhounds

[NeylasMom]

Also don't take the smda test to seriously when testing a greyhound. Idexx has now stated that greyhounds can and often do normally run on high and above the reference range.

Edited to add-regarding the above post--we used to run the UPC reflex all the time--it's a great test and can really be a money saver :-)

That makes sense and at the same time, it's all relative. You wouldn't necessarily be alarmed by a creatinine of 1.8 in a greyhound, but when Zuri's reached that level it was because his kidneys were failing. He had consistently had a creatinine of 1.5ish so with that as baseline and the start of some symptoms we reached a different conclusion. In all likelihood this is a normal value for her. I'm just hesitant to make that assumption *just* because she's a greyhound, if that makes sense.

 

Thanks for all of the info so far. The test you guys are mentioning, do we need to request that in advance or could we wait to see if there is protein and if there is, ask them to run it?

[tbhounds]

The UPC needs to be run on a free catch voided inactive sample. It can be submitted any time--but the sample must be inactive or the test may return with inaccurate results. For example if there's blood present in the sample provided it will increase the protein results.

That's why the UPC reflex is such a great test. They with first run a urinalysis and if the urine is void infection Idexx will automatically run the UPC.

Keep in mind that it used to be any result of 0.5 or over was a concern-in speaking with Dr Couto he feels that number needs to be doubled or tripled before he decides to make food changes or recommend medication.

Also rule of thumb is you really need to run 3 upc's before determining consistent proteinuria.

[NeylasMom]

Quick update - dentist wanted us to follow up on the protein issue, recheck for protein on the dipstick and if present, run a urine protein:creatinine ratio. So I took a sample in and there was no protein.

 

So not sure if that protein was just other "stuff" because her urine was so concentrated or whether my theory that she had a mild rhabdo incident was correct, but either way things look good now so that's one thing off my mind. Not to get her lameness addressed and get through her dental next week.