I brought my dog, Trixie (10 year old Shih Tzu) in this morning for her yearly dental cleaning. The vet always does blood tests beforehand to make sure that her organs are functioning properly. The vet called after the blood test results were configured, and he said that Trixie's kidney enzyme levels indicated that the procedure would not be safe. When I picked Trixie up, the vet gave me a print out of her results.
The abnormal levels are as follows:
-LaserCyte heading on the blood results:
--->PLT = low at 111 K/μL (normal range 175-500)
-Catalyst heading on the blood results:
--->BUN = high at 38 mg/dL (normal range 7-27)
--->CREA = high at 2.9 mg/dL (normal range 0.5-1.8)
--->GLOB = high at 4.7 g/dL (normal 2.5-4.5)
--->CI = low at 107 mmol/L (norman range 109-122)
Everything else indicates a normal range. I am very worried about my dog. The vet told me that the results indicate that Trixie's kidneys are functioning at only 25% and that she would eventually succumb to kidney failure. He said that I could schedule an ultrasound to determine if the problem is treatable, but he was not optimistic.
Trixie was not allowed to have anything to eat after 6 p.m. last night, so when I returned home from work at 5:45, I gave her some tuna. Trixie is a very picky eater and always has been, so I knew I wouldn't be able to get her to eat her dog food within the 15 minutes that I had to get her to eat before she had to begin fasting. She also had two chicken jerky dog treats. That is the last thing that she had to eat before she began fasting.
The last time Trixie's blood work was done was one year ago, and all of her results were normal. I'm just shocked that she can have such a grim prognosis when she seems fine. She seems healthy and fine. She isn't having any trouble going to the bathroom, although she did have diarrhea about a month ago. She isn't urinating more or less frequently that I have noticed.
My questions are these: does this test result mean that Trixie is definitely on her way to kidney failure? Could this just be a fluke result? What can I do to keep my baby around longer? I'm just devastated right now. My vet was very helpful and compassionate, but he just seemed to think there was no hope for her. I just don't see how that's possible when she is still so active and she seems to be acting just like she always has.
Afterthought: Trixie has a lump in her upper abdomen (close to her ribcage in the center of her belly) that appears to be a hernia. She developed it about a year and a half ago. It seems to have gotten slightly bigger in the last 3-4 months. The vet didn't seem worried about it at her last checkup in May. I don't have any specific questions about this, I just didn't know if it would help you in evaluating the current situation with her kidneys.
Thank you for your time.
Dr. Marie replied:
I'm sorry to hear that your dog has received these worrisome blood results. We do sometimes see elevations in kidney enzymes for reasons other than significant kidney disease, but these elevations that you are showing me do seem significant.
Do you know if your vet has also run tests on her urine? The way to tell whether these elevations are really showing kidney problems is to look at the urine specific gravity. In cases of kidney disease we almost always see that the specific gravity is between 1.008 and 1.012. Normal dogs would have a specific gravity more around the 1.030 level.
There are a good number of things that can cause kidney problems and many are treatable. The problem is that it is often difficult to determine the cause. If your dog seems relatively healthy then your vet may decide to just monitor her for now and recheck her kidney enzymes in a month or so. If she perhaps got into something that was toxic to her kidneys then you should be seeing some improvement.
If, however, she is getting sick, has a reduced appetite or is urinating excessively then I am more concerned.
Blood tests are not always 100%. However, I think that it is the correct decision to hold off an an anesthetic for now and investigate this problem fully.
Also, the lump that you are seeing is very unlikely to be part of the problem.
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My vet did not do any tests on her urine. Is this something that I should get done soon? My dog is acting fine. Her appetite and bathroom habits have not changed at all that I have noticed.
Dr. Marie replied:
It's not a bad idea to ask your vet if having a urine specific gravity done would help them understand her case better, yes.
Dr. 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.
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