Is my dog's kidney disease really Stage 4 given his SDMA 34?

SDMA (symmetric dimethylarginine) is a renal biomarker specific to kidney function. It has proven to be a more reliable indicator of kidney function than creatinine which enables veterinarians to detect kidney disease earlier. Once elevated, it usually will not go back down. A complete blood chemistry would check for any underlying diseases that might be causing kidney damage. Diseases like diabetes, hyperthyroidism or Cushing’s disease. If Tobi is on any chronic medications (like an NSAID (Rimadyl etc.) those may cause a decrease in kidney function. A urine bacterial culture might be indicated and an x-ray for possible urinary tract stones. You should have his blood pressure checked as hypertension is often associated with kidney disease. Tobi will need to continue to have the SDMA monitored as well as the other kidney values ( BUN, CREA, Phosphorus). If you want more information as to how the kidneys are functioning you could request a urine protein:CREA ratio test. The urine protein:creatinine ratio is a simple test that measures how much protein is being lost through the kidneys. It is used to determine whether a pet may have serious kidney disease. The test involves measuring the amount of protein and creatinine in the same urine sample, and expressing the difference between the two values as a ratio. Also, an abdominal ultrasound can be done to look at the architecture of the kidneys. This should be done by a specialist. They will also measure the kidneys to see if their size is appropriate. Kidney disease cannot be "fixed" but it can be managed especially if caught early with the SDMA test. Tobi should be placed on a prescription diet to help support the kidneys. Talk with your vet about this. I hope this helps. If you have any more specific questions please post again. Best wishes to you and Tobi.

It doesn't look like Pitambar received a urinalysis. This test needs to be run to help stage the renal disease or if dehydration is present and causing the increase in the renal values. Talk with your veterinarian about having this test run asap: https://www.petcoach.co/article/urinalysis-testing-a-urine-sample/ There is another test called an SDMA which will help stage renal disease: https://www.idexx.com/en/veterinary/reference-laboratories/sdma/ Pitambar should also have a urine protein:creatine ratio run to check for protein loss and the need to medication to control that if it is present. This website discusses how renal disease is staged: https://www.idexx.com/en/veterinary/reference-laboratories/sdma/sdma-iris/ Kidney disease is serious and if caught early, many pets will respond to easy treatment and this will not only slow down disease process but will also increase the life expectancy. Often the first step is changing the diet to a prescription diet meant for pets who have kidney disease. These diets have lower protein, phosphorus and high amounts of omega 3 fatty acids, higher amounts of antioxidants and have a higher calorie amount. Supplementing with an additional omega 3 fatty acid can also help. Pitambar will need followup bloodwork and a urinalysis 4-6 weeks after starting treatment. As things progress, other treatments will be needed. https://www.petcoach.co/article/kidney-disease-causes-signs-diagnosis-and-treatment/ I hope this helps and please feel free to post any additional questions.

Hello. I am sorry about the diagnosis of kidney disease in Layla. We do generally stage kidney failure based on certain markers in the blood. This includes blood urea nitrogen ( BUN ) & creatinine. Another test, called SDMA is a very sensitive marker for very early kidney disease. Specific gravity refers to the amount of solids found in urine. If urine is very dilute ( has a low specific gravity ), this is a poorer sign, especially if there is also protein in the urine. We really need to look at everything, blood & urine, to determine how serious or dangerous the kidney disease might be, but that is why we sometimes need to look a little further to understand exactly what might be going on. I hope you can work with your veterinarian to manage Layla's kidney problems. Good luck & thanks for using Petco Pet Education Center, formerly Petcoach.

The SDMA test can be frustrating when values are borderline high, but all other kidney values are spot on. Elevated SDMA values can indicate that kidney disease may develop within the next few years... but this is not true 100% of the time. As with any test, false positives are certainly possible. At this point, with well concentrated urine (great urine specific gravity!) and a low UPC, it sounds as though Maddy's kidney function is great. I agree with your vet - lowering the protein content in her diet is out of an abundance of caution. It does not sound as though any changes in dietary phosphorus are necessary at this point. Instead, plan to recheck Maddy's blood and urine tests twice a year to track these changes, or more often if she shows signs of kidney disease, including increased drinking and urination, weight loss, loss of appetite, or vomiting. Try not to stress - this result sounds like a bit of a red herring. I hope this helps and that all goes well for Maddy!

Creatinine level of 2.4mg/dL means mild to moderate elevation. Creatinine level goes up with kidney diseases but it also can go up after a large, meaty meal or excessive excercise. Some dogs with a lot of muscle mass have naturally elevated creatinine, not related to kidney problems. SDMA test will confirm (or rule out) kidney disease in Charlie's case. Please, note that SDMA is not a better or more specific test that creatinine, it is just another blood test to check kidneys funcion. In the best case scenario, Charlie had elevation in creatinine because of aforementioned physiological conditions and his kidneys are ok. In the worse case scenerio, he has early stage of kidney disease and will be put on a special diet.

Thank you for submitting your question regarding Tony. I agree that he is in the early stages of kidney failure based on the lab results you have provided. Kidney disease can cause low levels of potassium so it is good that you are supplementing him. Kidney values can fluctuate up and down a bit, but you want to assess trends over time to see how he is doing. SDMA and creatinine are more sensitive indicators than BUN. I would ask if his phosphorus level is in the target range for his degree of kidney disease (based on the IRIS staging) and make sure he has had his blood pressure measured recently. I hope this information helps!

Hi, thanks for using Petco Pet Education Center, formerly Petcoach! I am sorry that Tony is experiencing early kidney disease. Yes a prescription diet has been shown to help with chronic kidney disease and there is a chance it could lower the SDMA and other kidney values. It will help with progression. I would be sure your Vet has checked a urine sample for protein and infection as well as a blood pressure. There are medications that can and should be started if those things are abnormal. I wish you and Tony the best!