Brand New Boy - Elevated Sdma

[Guest sacdukeman]

I got Neal over the 4th holiday weekend to replace my male Hoss who died of osteo last winter. Neal is a 3 year old black male retired from the Tijuana track. He had to have a foxtail removed from his ear so the vet ran bloodwork and creatinine came back at 2.0, so they had me bring him in yesterday for a kidney panel. Results were 1.9 creatinine, 22 BUN and 23 SDMA. The vet said he definitely has kidney disease but doesn't propose to change diet yet other than to increase amount to get weight up some and will weigh him again in a month. He'll run another panel in 6 mos - 12 mos to see if degradation is increasing or slow/gradual. My female Stacy is 10 and now recovered from a partial arthodesis from torn ligaments last winter. This has not been a good last 12 mos. They currently rotate between Fromms Beef Fritatta, Pinnacle Salmon and Zignature (Lamb, Trout, etc) with some canned mixed in and fish oil - I could easily put him on a kibble more normal for protein (<25%), I suppose it could only help.

 

Any thoughts, advice, or views would be welcome, esp. comforting ones.

 

 

[RedHead]

My guy also just had bloodwork done for a dental and I received a call today from the vet saying he has early kidney disease (creatinine around 1.6, BUN 33 and SDMA 15). I am not panicking yet however, until he has his urine checked.

 

I am no expert, but your creatinine levels and (pretty sure) your BUN levels are pretty normal for a greyhound (creatinine would be high for other breeds if your vet is not aware). I am in Canada, so not sure if SDMA uses the same units but the high range here is 14. SDMA is not supposed to be influenced by breed, body type, muscle etc like the creatinine, however greyhounds are the one breed who can run a bit high (15 or 16 can be normal).

 

I would say the most important thing right now is to test the urine (first pee in the morning) for specific gravity (if your vet didn't already recommend this I would look for a second opinion as that is pretty standard before diagnosing kidney disease). That will tell you if the kidneys aren't functioning properly vs. your dog just has normal "higher" greyhound numbers.

 

Good luck, I know how you feel as I am in the same anxious situation waiting for urine results.

Edited August 6, 2017 by RedHead

[greysmom]

He's awfully young to be experiencing kidney disease, minus any intervening poisoning or exposure to kidney-damaging injury.

 

His levels also don't appear to be that high to me. Maybe a bit elevated for a greyhound, but he *is* really just off a track from a foreign country where it's hot most of the time. It could be his kidneys had to work harder, or he wasn't given adequate water at some point. But your vet also may not be familiar with normal greyhound blood levels.

Normal Reference Values for Greyhounds:
RBC - Red Blood Cells: 7.4 - 9.0
Hgb - Hemaglobin: 19.0 - 21.5
PCV - Packed Cell Volume: 55 - 65
WBC - White Blood Cells: 3.5 - 6.5
Platelets: 80,000 - 200,000
T.P. - Total Protein: 4.5 - 6.2
Globulin Fraction: 2.1 - 3.2
Creatinine: 0.8 - 1.7
T4 (younger Greyhounds): 0.7 - 3.6
T4 (older/retired Greyhounds): 0.5 - 3.6
fT4 and TSH reference ranges are the same as for other breeds.

 

Normal Reference Values for Other Breeds:
RBC - Red Blood Cells: 5.5 - 8.5
Hgb - Hemaglobin: 12.0 - 18.0
PCV - Packed Cell Volume: 37 - 55
WBC - White Blood Cells: 6.0 - 17.0
Platelets: 150,000 - 400,000
T.P. - Total Protein: 5.4 - 7.8
Globulin Fraction: 2.8 - 4.2
Creatinine: 0.0 - 1.0
T4: 1.8 - 3.6
fT4: 0.7 - 2.5
TSH - Thyroid Stimulating Hormone: .05 - .42

 

The SDMA may or may not be useful in determining kidney disease. Here's a link to illustrate:

http://www.petmd.com/blogs/thedailyvet/dr-coates/2015/may/how-helpful-new-kidney-test-dogs-and-cats-32725

 

I would really be doing some "watchful waiting" at this point, and not making any more large changes to his routine or diet (though a lower protein % might ultimately be what he will need). Make sure he has plenty of fresh water available at all times. Don't exercise him heavily in the hot weather. And just let him relax and get used to his new home environment and schedule. If his next test is the same or lower, I think it would be just a temporary thing.

 

Also, if he's from Juarez, you may find that he doesn't know English very well. Try using Spanish commands of you feel he's not paying atention!

[3greytjoys]

It's my understanding that Greyhound studies are underway to determine if there are breed specific differences in SDMA results. (Our Greyhounds' SDMA results have leaned towards the high side for "all breeds".)

 

Neal's prior track diet might not be a factor by now, but it appears raw food can increase BUN and creatinine concentrations in dogs without kidney disease.

 

A urinalysis is also important to measure specific gravity, etc.

 

Please see page 2, #2 in this Greyhound Health Packet:

http://www.medinavets.com/wp-content/uploads/2016/03/Greyhound-Health-Packet-2016.pdf

 

My condolences regarding your loss of Hoss to osteo last winter.

 

Congratulations on your adoption of Neal! Hopefully, his test results will improve after he settles into retirement.

[tbhounds]

IMO it seemed to be rather quick of your vet to determine your hound "definitely" has kidney disease. A reading of 2.0 creatinine can be perfectly normal in a gh in fact it was my boys norm for years. It's pretty well documented by Idexx lab that ghs can and often run on the high side of their smda test. You mentioned the bun was within normal range.

Typically, you would determine renal disease when both the bun and creatinine are above reference ranges.

Your vet should have asked you to submit a first morning urine sample to check the urine specific gravity. It requires just a few drops of urine and can be checked in the clinic while you wait. It will measure the kidneys ability to concentrate the urine. Ideally, you would love to see a result of 1.030 or above.

[Guest sacdukeman]

Thank you all so much for your replies and reassurance. It helps!! I too knew from research greyhound values are higher but, even from your postings above, the creatinine is high for a greyhound, though not by much. However, as SDMA of 23 is high, even for a greyhound (based on the initial surveys I've read), so I think the concern is legit. The vet did draw urine directly from the bladder in the morning - ultrasound cystocentesis (though he had just eaten - no way was it digested - he threw up everything on the way home!) They didn't tell me the specific gravity but his urine is very concentrated per the vet (and my observations).

 

Note the vet isn't suggesting even a diet change, except to feed him more (he lost 2 lbs), so we are up to three cups a day of kibble + several tablespoons of canned + two biscuits for a snack. He just wants to monitor over the next year. I rotate kibble anyhow (currently Fromm's Beef Fritatta, Pinnacle Salmon, and Zignature Trout or whitefish), so offering a lower phosphorous (but still decent protein) like the Pinnacle Trout & Sweet Potato couldn't hurt - I used to feed that to my whippets - right?

Thank you for the sympathy re Hoss - his osteo progressed very quickly. He went from controlled, functional, pain to crying all night (even on meds) in a week. The tumor was on his shoulder = he had no chance, so I put him to sleep. Heartbreaking.

[EllenEveBaz]

Our sympathy on your loss of Hoss.

 

And yes, lower phosphorus is good. One of my dogs had progressive kidney disease, but another had elevated BUN and creatinine in a couple of tests a few months apart, and then the levels went back down.

[cleptogrey]

have you checked for tick borne diseases? felix was diagnosed with anaplasmosis and his kidney values were really off. after a regime of antibiotics they returned to just about normal. it might be worth the couple of bucks to do a tick panel.

[Guest sacdukeman]

They did a full tick panel at adoption - negative except for babesia (like every dog from the southwest) but the titre was below the treatment level. The vet is aware of the titre.

[GeorgeofNE]

How is it possible I had a dog with high creatinine for seven years and never heard the term "SDMA"? Well, I just looked it up and it's a new test--that's why! OK, good to know!

 

I think your vet is jumping the gun too, and I would not wait six months to have the tests rerun--and in point of fact, if he is so SURE it's kidney disease and his plan is to do nothing at all, I'd be concerned.

[Guest sacdukeman]

His creatinine and BUN have been tested twice in the past month - BUN was normal both times and creat was 2.0, then 1.9. Only the SDMA was new. I agree that the diagnosis isn't definitive but I don't have a problem with the wait and see attitude because the kidney panels are pricey and he's obviously processing waste well enough to concentrate urine. I read that clinical intervention when creatinine is at 2.0 or below (for non-greyhounds) is of questionable value. I'd like to be proactive by switching to a slightly lower phosphorous food but the vet doesn't tell me what kibble to buy so that isn't really a clinical issue.

 

I see Grandma Lucy's Valor Fish is really low phos - .46, with just over 2:1 calcium ratio - anyone try that? I've always wanted to try freeze-dried (less processed) and this looks really easy and the price is no higher than decent kibble.

[cgs]

Just got pre-dental bloodwork results for Percy. The vet said creat is slightly high, but fine for a greyhound and SDMA is high. She was going to call the lab to find out if there are grey-specific levels.

 

Creat is 1.6. She said that's ok

SDMA is 15. Range on the paperwork is 0-14

 

This doesn't sound alarming to me after what I've read here and on some of the referenced links. And if SDMA is supposed to catch kidney disease earlier than other tests, would a urine test really tell me anything? She suggested a urine test.

 

His HGB was a little high and that wasn't mentioned. It's 22 and the range greysmom posted above is 19-21.5.

Just found this--so it looks like it can be elevated in greyhounds:

 

https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.14720

 

SDMA concentration was higher (P < .001) in Greyhounds compared to non‐Greyhounds (Table 2). Thirteen greyhounds (68%) had SDMA concentrations greater than the upper limit of the commercial laboratory's canine SDMA reference interval (0–14 μg/dL), while 6/19 (31%) had SDMA concentrations ≤14 μg/dL. In contrast, all but one of the non‐Greyhound dogs (95%) had SDMA ≤14 μg/dL.

[cgs]

The vet called back and said the lab people said that as long as BUN is normal (it is) and urine is normal, it's fine. It could be elevated because of his greytness. I'm honestly not sure I'm going to bother with urine sample. The SDMA is one point high which seems totally fine according to the study I linked.

[cgs]

I did get the urinalysis because I might get pet insurance and want to make sure everything is clear going in. The urinalysis was fine. It really does seem like SMDA levels are slightly higher for greys. I just wish they'd write that on the lab work.

[tbhounds]

I did get the urinalysis because I might get pet insurance and want to make sure everything is clear going in. The urinalysis was fine. It really does seem like SMDA levels are slightly higher for greys. I just wish they'd write that on the lab work.

Idexx does provide that info to the vets.

[cgs]

It just says it's being researched. The lab analysis didn't even say the creat level was in range for a greyhound. The written comments said kidney disease was probable. I knew it wasn't probable (and so did the vet), but got the urinalysis so he'd have a clean bill if health before getting insurance for him.

[tbhounds]

It just says it's being researched. The lab analysis didn't even say the creat level was in range for a greyhound. The written comments said kidney disease was probable. I knew it wasn't probable (and so did the vet), but got the urinalysis so he'd have a clean bill if health before getting insurance for him.

Scroll down to section 3...

https://www.idexx.com/en/veterinary/reference-laboratories/sdma/sdma-faqs/

[cgs]

Thanks. I swear I had looked at that, but only remember seeing something elsewhere about greyhounds being studied, and then a study saying that 68% of those they tested had higher levels--which doesn't match their assertion in the link that "most" will still fall in range.

 

In any case, the lab work has comments from the lab tech I guess, saying that kidney disease is probable based on sdma and creat, and then has a note that greys are being studied for sdma levels, but has nothing about the creat actually being normal. I asked the vet if I could call the lab to get them to correct the comments, but she didn't seem to think they'd do it. I may ask again or try another vet--I go to a practice with several--but it might not matter. I'm going to ask the various pet insurance companies if they know this stuff and if it'll be a problem to have those comments on the results.

[NewGrey2017]

Thanks for posting this thread. Our grey has a Creatinine level of 1.8. Vet wanted us to bring in "morning pee". I think I'll pass based on reading above.

 

Leaves more money for monkeys that he can rip to shreds.