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Hello, hoping there might be some support here for puppies with kidney issues? I am so depressed, but I need to rally so I can help my puppy.

My 14-year-old female dog Spirit had to have several teeth removed in July and when they did the pre-op bloodwork, she had some values that were out-of-whack, and a bit confusing to read.

Her SDMA was in the normal range (this is the most sensitive test for kidney issues - shows abnormal results when as little as 20% of the kidneys are damaged).

But her creatinine and BUN were both elevated (far less sensitive tests that only show up as abnormal when 75-80% of the kidney is damaged).

The vet thought these results were weird, but thought that the massive infection she had in her mouth might have contributed to the results, so he took out her teeth, gave me antibiotics and recommended to come back in 2 months to recheck.

I just got the results of her recheck, and though the SMDA is still normal, her Creatinine and BUN are also still elevated (but stable).

For people with kidney-dog experience, I've included her test results below, with the current readings on the LEFT in bold and her July readings on the RIGHT (I've only included abnormal stats or kidney-function-related stats):

BUN 69 July: 73 (normal is up to 30)
Creatinine 3.0 July: 3.1 (normal is about 1.5)
IDEXX SDMA 13 July: 13 (Normal is up to 14)
BUN:Creatinine Ratio 23.0 July 23.5 (from what I understand, this is normal)
Phosphorus 5.3 July: 5.5 (both tests within normal range)
Calcium 10.4 July: 10.1 (both within normal range)
Sodium 151 July: 148 (both within normal range)
Potassium 5.4 July: 5.1 (both within normal range)

Here were a few other stats that were off during both panels:

RBC 5.26 July: 5.15 (a little lower than normal)
ALP 198 July: 169 (Higher than normal)
Amylase 1,531 July; 1,528 (higher than normal)
Chloride 121 July: 122 (higher than normal)

Not listed above are all the things that tested in the normal range. She had her T4 checked both times and it went from 1.1 in July to 1.0 in October.

Her urinalysis had a gravity of 1.018 both months. A trace amount of protein was found, but no number indicated. Trace amount of blood was found in October (not July), but no number to indicate how much.

In July, she was sucking down water like there was no tomorrow and she had a few accidents in the house. Over the course of her surgery recovery and and administering of antibiotics, she hasn't had anymore accidents and has been drinking normal amounts of water. Beyond that, she has been completely asymptomatic - she doesn't act or seem sick (though she does have some arthritis).

I plan on getting referred to a specialist and doing everything I can to keep her healthy, happy, fit and comfortable. I am hoping that there might be some people who have kidney-dog experiences they can share? Obviously, I'm hoping for good news, but if your dog went downhill fast, I'd still be interested in hearing your story. She seems so healthy at the moment, but from what I've been reading, she could be fine for 2 years, or I could lose her 2 weeks or 2 days from now.

I'd love to hear your stories.
 

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I am not a Vet or an MD, but from what I see, her creatinine, though elevated is not astronomical. Her BUN values are related to creatinine levels, so high creatinine would lead to a not surprising high BUN level. With kidney failure its rarely reversible, canine or human. Though our dog is healthy, I have kidney failure, so my familiarity is more from my experiences rather than my dogs. You probably need to take her to a dog nephrologist, I'm sure there are some, who will try to identify what may have caused the kidney damage, so further damage can be mitigated. Often, more often than not, the exact cause can not be identified, and the goal becomes kidney stability. There will be many medications that will be off the table for her, though her urine protein levels are ok, so diet will probably not be an issue. If her blood pressure is elevated, the Vet will likely want to get that under control, as high BP is known to damage kidneys. Your right about the timeline, its unknown, and all you can do is all you can do. As long as she is comfortable and her quality of life is acceptable, eating and drinking, and not in obvious pain doing whatever you can to keep her around for as long as possible, would be the track I would take. Keep us posted on her progress.
 

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SDMA, BUN and Creatinine all measure different things. The SDMA test is a sensitive one, but measures protein products and Glomerular filtration, both which can potentially be fairly normal even in some cases of early kidney disease. SDMA is only one more tool to use to detect renal insufficiency but is not a perfect test (as few tests are). Having it be within normal range (high normal, notably) in some dogs and cats with renal failure is not that unusual, and I suspect it will eventually be elevated as the disease progresses. I have a dog with chronic renal failure that I am treating that has an SDMA that ranges from 13 to 22... and then back to 14... yet I know the pet is not going in and out of CKD (chronic kidney disease), just because one of the values varies. If BUN and Creatinine are both elevated, along with a urine Specific gravity in that range, I would say without hesitation that pet is in early chronic renal failure. It may be stable, and with luck, it will be for a long time. But it should be fed accordingly (a diet that is phosphorus restricted and with a LOT of water in it).
 

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Thanks for the responses. She is going in tomorrow to have xrays of her kidneys and an ACTH test to see if she has atypical Addison's disease.

I've been researching Addison's ever since it was suggested (by two different vets, neither of whom consulted with each other to come to this conclusion, and it wasn't suggested by me) that we should test for it. I'm trying really hard to keep an even keel and try not to get my hopes up, because odds are (and with my luck) she has kidney disease. BUT..... after reading the symptoms, to me it seems like there is a very real possibility she could have Addison's instead (which, unlike kidney disease, is TREATABLE with a couple daily pills).

Addison's is called "the great pretender" because it can be mistaken for many things, but its especially mistaken for kidney failure (and pancreatitis - another thing the vet suggested she might have/had recently experienced). BOTH kidney disease and Addison's have excessive thirst, increased urination, lack of appetite, increased BUN and creatinine levels. They can both present with normal OR abnormal salt/calcium/potassium.

But Spirit has Addison-like "symptoms" that I witnessed but passed off completely as old age/arthritis: Hind-end pain, joint pain, muscle pain and weakness, tremors, shivering, excessive shedding (which I thought might be seasonal but it's been going on for 3-4 months), and having the drinking/appetite issues wax and wane. Within the last few weeks, she has started dropping food out of her mouth, which I thought was just because of her not having teeth, but she was eating fine before that - less ability to swallow is also a symptom of Addison's. There are also several other stats in her current bloodwork and previous bloodwork that were off in ways that could indicate Addison's.

Finally, she had an episode about 1-1.5 years back in which she got sick so fast that I thought she got into something and we brought her to the emergency vet. They ran a full panel and toxicity screening and couldn't figure out what she got into (we also searched the house for any sign of anything she could have eaten and found nothing). Gave her IV fluids and the next day she was back on her feet, happy and energetic. That kind of "crash" of unknown cause that seems miraculously fixed with simple rest and IV fluids often happens in dogs that are later diagnosed with Addison's.

Of course, I'm keeping in mind that I'm not the most objective person because she is my baby, and I could be grasping at straws.... But I had previously been thinking of all these things as seperate issues, and suddenly I found this health issue that could possibly explain all of them.

It's hard not to have a glimmer of hope.

And it's also hard not to expect that glimmer to be dashed tomorrow after receiving her xray/ACTH results.

Thanks for listening. If anyone else has experience with these sorts of things, I'd love to hear about it.
 
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