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Protein in urine.

Species: Dog
Breed: Yorkshire Terrier
Age: 11-15 years
Hi,
My Yorkie is 12 and had smelly pee starting in September 2010. I took a sample to the vet and he indicated some crystals were forming. He prescribed an antibiotic and Hills C/D. I have since taken her pee 3 more times and the last 2 have had no crystals but protein in the urine(#3 was protein level). He had me come in today to check her blood pressure. It was elevated and he prescribed her 1/4 of a 2.5 Amlodipine pill each day. From what I am reading protein is an indication of renal failure. He did mention they(kidneys) could be adjusting to the loss and they could work fine for awhile. Anyway, I have read alot of negative things about C/D and also am not sure about the blood pressure medicine. She is @ 12 lbs. Anyway, what do you suggest with the medicicine, diet and monitoring of the kidneys? Any advice would be great! Thank you very much...


Online vet, Dr. Marie

Dr. Marie replied:

Thanks for an excellent question. I have a similar case in my practice right now and I can tell you that cases like this can be difficult to figure out!

So, let's see if I can help to make things a little less complicated and hopefully together we can figure Angel's situation out.

Protein in the urine can mean several things. Yes, if a dog is in kidney failure we can see protein in the urine. However, finding protein in the urine (proteinuria) does not necessarily mean that the kidneys are not working properly. Another possible reason for proteinuria is high blood pressure. When the blood pressure is high, this pushes more protein through the kidneys and this protein ends up in the urine. And another reason is something called cushing's disease. I'll talk more about this later.

So, how do we know if the kidneys are failing? The main factor is how well they are concentrating urine. Did your vet mention to you what her specific gravity is? This number tells us how worried we need to be about the kidneys. If this number is between 1.008 and 1.015 then I would be focusing my efforts on protecting the kidneys. However, if it is higher, then the kidneys are not the primary problem.

You can ask your vet if cushing's disease is a possibility. This condition can cause protein in the urine. It usually causes a great increase in thirst and urination and makes dogs hungry all of the time.

I think Hill's CD is a great food. It really shouldn't cause protein in the urine. It will help greatly to keep her from producing crystals in her urine.

It does sound like your vet is doing all of the same things that I would do.

This type of case can be confusing, so feel free to respond if you have more questions! I'll be online for about another 30-60 minutes tonight.

Dr. Marie.



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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Thanks Dr. Marie...

Do you feel the blood pressure medicine and dosage is ok? And is there any food I should be giving her for the protein loss and what steps should I/vet be taking from here? Thanks so much for your help.


Online vet, Dr. Marie

Dr. Marie replied:

You're very welcome!

Amlodipine is a very safe medicine and the dose that was prescribed to Angel is what I would prescribe.

The next step now is to see what happens after she has been on the medicine for a while. Unfortunately this will require more visits though, but these are necessary. Your vet will want to recheck her blood pressure in the next 2 weeks or so to see if the medicine is getting the blood pressure down. If so, then this really should cause the protein levels in the urine to go down. Your vet will likely also check her protein levels at this time as well.

Regarding food for the kidneys, I think the question we need to ask is whether or not there really is a kidney problem. At this point we know there is a problem with crystals and so c/d is a good food. But, we don't know that there is a kidney problem.

It would be great if you could find out what the specific gravity of her urine was. You can post back a response to this question once you have that number and I can tell you more about how worried we need to be about her kidneys.

While there is a special food that can be fed to help protect the kidneys it sounds like right now, the crystals are more important.





Customer reply:

Thanks again...

The only number he told me was "3" and it was next to protein. He said it was not extremely high but elevated and was "3" the last couple times. Does that help?


Online vet, Dr. Marie

Dr. Marie replied:

This is not the number that I'm looking for. It would be great if you could call your vet's office tomorrow and ask if they could tell you what the specific gravity of the urine was. They'll say a number that starts with the word "ten".

So, if they say, "Ten fiften", this translates as 1.015.

If they say, "Ten thirty", this translates as 1.030.

If you can find this out tomorrow, then post back and I'll give you more of my thoughts. Again, it is this number that tells us how worried we need to be about the kidneys.



Customer reply:

Hi Marie,
I wanted to follow-up after I spoke with her Dr. with the gravity reading. I asked and he said 1.044 or 144. Not exactly sure how it is written, but he did say it has stayed consistant and was ok. What are your thoughts? I asked if it could be thyroid also and he said he would wait to see what the next blood results showed.

Thanks again...


Online vet, Dr. Marie

Dr. Marie replied:

OK, this number tells us a lot! The number is likely 1.044, which would be called, "ten, forty four". This number tells me that the kidneys are concentrating urine really well. We get worried when the number gets between 1.008 and 1.012. So, a number of 1.044 tells us that the kidneys are not the primary problem.

It looks like your vet has zoned in on high blood pressure being the problem and from what you have written this is probably what is going on. Hopefully the medication helps to keep the blood pressure down!

A thyroid problem is not likely to cause protein in the urine in a dog. In a cat, we can see hyperthyroidism which can cause high blood pressure. But, dogs always get hypothyroidism and we don't see blood pressure issues along with hypothryoidism.

So, to answer your question about food, I would stick with the c/d that was prescribed.



Customer reply:

Hi Dr. Marie,

I wanted to update you on my dog and ask for more advice. I will leave a bonus for you as a thank you, but didn't want to start a new question so you would see the same thread of info. Anyway, my Yorkie's kidney's have started to fail. Her BUN is 33, Urea Nitrogen 150 and Creatine 4.5. She started to not eat the same and making black stool. I took her to the vet 3 days ago. 2 days ago they added fluid to her and took the blood work. I know she is not a puppy. She is not as active but relaxing and still sweet as anything. I will be following up at the vet for more fluids in a few days but wanted to see if you could give me advice on what she should eat and if you think natural supplements like Tripsy's for kidney disease may be helpful? Any other advice for this issue would greatly be appreciated! Thank you !


Online vet, Dr. Marie

Dr. Marie replied:

Oh, I'm sorry to hear that your girl's kidneys are not doing well. I am really concerned by the Creatinine level of 4.5.

Fluids are by far the best thing that can be done for ailing kidneys.

As far as foods go, I am a big fan of prescription foods for kidney disease such as Hill's k/d, Medical or VMD Reduced protein or other similar foods. These foods have protein molecules that are easier for the kidneys to handle. Plus they are a little bit higher in fat than most diets. This encourages animals to eat and also helps them to get some extra calories.

I do not feel that Tripsy is worthwhile. I classify this in the group of products that people put out there to take advantage of people's desperation.

I do occasionally prescribe a supplement called Azodyl for kidney disease which sometimes helps to get the Creatinine levels down. I am also a fan of Epakitin which is a phosphorus binder. You can ask your vet if your dog's phosphorus level is high as often happens with kidney disease. If so a product such as Epakitin may help.

Another drug that I use often for kidney disease is famotidine (pepcid). This is something that helps with the nausea that often goes along with kidney disease. (Also, if your dog has black stools this could be a sign of bleeding in the stomach and famotidine will help with this.) Famotidine is the same thing as Pepcid. You can buy it in the drug stores over the counter, but you will need to get your vet's permission first.

I hope things improve soon!
Dr. Marie.

p.s. Thank you for the bonus!



Customer reply:

Hi Dr. Marie,

Thank you sooo much for the quick response. I guess if you could just help me by telling what you suggest I feed her over the next 2 days until I see the vet again, and anything else I could be doing? Plus they are closed until then and I wasn't told what to feed her. I can get to a store tomorrow and buy whatever is best for her but getting prescription food might be hard until Tuesday. Plus, do you recommend bottled water?

Thanks again soo much...


Online vet, Dr. Marie

Dr. Marie replied:

You're very welcome.

If her appetite is not good, then I would actually give her whatever she wants to eat.

But, if she is willing to eat, then I would recommend any good quality regular adult food. If you can get it, a food for senior dogs would be even better as this tends to be a little bit lower in protein.

Don't try to read food labels and pick based on protein levels because it's almost impossible to read a dog food label properly!

I don't think bottled water will make a difference. I think tap water is perfectly fine.

Hope that helps!

I'll be heading offline now (bedtime here) but I'll check in on your question in the morning in case you have more questions.



Customer reply:

Thanks Dr.,

How did you know I would have more questions! HA! Anyway, is a small walk ok, exercise? She is less active but wanted to walk when I got her leash. Also, you said the creatine level was most concerning. What will help that the best? Anything I can do, also to help it? Thanks and have a good night!


Online vet, Dr. Marie

Dr. Marie replied:

As far as exercise goes, let your dog be the judge. If she wants to go out and seems to handle the walk well, then this is good. But if she seems to be tired or is really pooped out afterwards then keep exercise to a minimum.

There is nothing specific to help the creatinine, just all of the things that we mentioned above.

Just so you know, I'll be offline till this evening.

Hope your girl has a good day!



Customer reply:

Hi Dr. Marie,

I wanted to see your thoughts on my dog's bathroom habits. She last went # 2 Friday morning. It was dark, runny stool. I gave her a very small amount of food yesterday, including a little of her C/D with rice and a few crackers. Today she is wanting to eat and I gave her a few small meals(1/2 a tablespoon) of C/D(canned) with water. And another 1/2 of cracker. I did give her the Pepcid. A half of pill in the morning and at night yesterday and 1/2 of pill today. My vet said that was ok. I know she hasn't eatin a lot or close to normal, and she seems to want more but I do not give it to her...but let me know your thoughts on this. Thanks again...


Online vet, Dr. Marie

Dr. Marie replied:

I don't get too worried when a dog goes a couple of days without a bowel movement. It's likely because she hasn't been eating as much as usual.

The fact that the previous stool was dark and runny is probably because she's not feeling well because of her kidney disease. Hopefully the treatments will help her to feel better.



Customer reply:

Thank you !

Do you think I should give her the Pepcid 2 times a day? It seems to have helped but not sure if it will hurt her bowels/bowel movement or anything in any other way?

Thanks again...


Online vet, Dr. Marie

Dr. Marie replied:

Unfortunately I can't legally advise you on dosing medications...you'll need to get your vet's advice on that one. It won't be causing any negative effects though!



Customer reply:

Hi Dr.,

I wanted to get your opinion about my dogs condition. She has received 4 fluid injections since last Friday. We are scheduled to get the 5th ine tomorrow and another Monday. And new blood work is scheduled for Monday to see if its working. She has been very off and on. I left for a bit this morning. She ate before I left(K/D) and drank then urinated before I left. When I came back there was a regular, solid colored stool on the carpet. Silly, but I was excited because the stools had been black, solid or not. Then I fed her lunch. I called the Hills office and asked how much to give her of the K/D. The said 3/4 of a can per day. I was not giving her much because I didn't want to upset her stomach so much. So I was giving her about 1/3 of a can in small amounts each time. For this lunch I gave her a good amount more. She inhaled it, then regirgitated it within 5 minutes. It didn't even get beyond her throat I think. Then she went out and has some so-so colored soft stool. I let her rest and gave her a small amount of food with water, went out for an hour and when I came back there was stool looking solid on the carpet with maybe timy bits of food. Not sure...it was hard to tell and smell was like stool but not as strong. Plus I have 2 cats and its possible they coughed it up since 1 did this morning cough up mucus. Anyway, I am not sure. Sorry to be so graphic. Just looking for some help and advice. Thanks again...


Online vet, Dr. Marie

Dr. Marie replied:

Hmm...not sure how much I can help here John. My main concern would be that this is not because of the food but rather than the kidney condition is getting worse.

She certainly may have thrown up because she had a lot of food at once. It's likely a good idea to keep doing small frequent meals.

If she continues to have soft stools you can talk to your vet about possibly giving her some probiotics. These may help. But, if she is having these problems because her kidneys are getting worse then this is definitely not good.





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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.