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Low specific gravity.

Species: Dog
Breed: Pitbull
Age: 8-11 years
This is regarding a 9 year old male pitbull, neutered with no past medical history. For the past 2 weeks he has started to have polyuria, and polydipsia, and loss of appetite. I got blood work done and urinalysis. Urinalysis showed calcium oxalate crystals. X ray was done, and kidneys and bladder were clean, no stones were seen. Urinalysis also showed low specific gravity of 1.011 and blood work only showed a high AST of 73, high ALT of 171, a high alk Phos of 167 and a slightly high calcium of 12.5. Platelet count was low at 118 ( but it was stated that platelet count reflects the minimum number due to platelet clumping). He has also been vomiting. Yesterday he vomited food substances out, and today he vomited out water and whitish mucous.
There are no other symptoms, just increase in urination, thirst and a slight loss of appetite and vomiting. All other lab measures are normal. I just dont know whats going on. Could this possibly be a viral liver thing due to elevated LFTs?

The dog is on no medications. I have recently ordered Marin supplements, when I saw his elevated LFTs in blood work. Marin consists of Vit e, zinc, and syblrin ( from milk thistle).

The vet is more concerned about the low urine specific gravity, and has requested a second urinalysis once the dog is down to drinking 40 ounces of water for three days and then a 12 hour water fast on the 4th day to rule out Diabetes Insipidus. I would much appreciate your suggestion as to how you would proceed and what you think.

Thanking you
VK


Online vet, Dr. Marie

Dr. Marie replied:

This sounds like an unusual case. Any time a dog has an increase in thirst and urination combined with a low specific gravity I get fairly worried. A specific gravity of 1.011 is in the range where we worry about how well the kidneys are functioning. If there were no significant elevations in the kidney enzymes (BUN and CREA) then this is a good thing. However, you can still have kidney problems and not see the blood elevations until things get much worse.

One possible cause for calcium oxalate crystals is ingestion of something that is toxic to kidneys such as antifreeze or certain plants.

It's possible that the calcium oxalate crystals are there because there is something causing high calcium. High calcium is not common in dogs. I would be wondering about things like hyperparathyroidism, possibly hypoadrenocorticism, diabetes insipidus and even some types of cancers. It's also possible that he was exposed to something mildly toxic to the kidneys and that he will recover on his own shortly. The problem here is that getting a diagnosis may be difficult.

I'm not too worried about the slight increases in liver enzymes. I really wouldn't call these liver function tests (LFTs). Now, if there was a really elevated bile acid test then that would have me more concerned. You could ask your vet about running one if you want to be sure but it's not the route that I would take.

I think that if this were my case, my decision on what test to do next would be based on how he is feeling over the next couple of days. If his appetite gets worse then I'd be repeating his BUN and CREA to see if his kidneys are getting worse. If they are then I might consider doing tests for leptospirosis if this is something that is seen in your area.

I'd definitely want to be repeating the urinalysis to see what the specific gravity is doing. If the number is getting even lower, then diabetes insipidus sounds more likely. But, this doesn't usually cause an appetite loss.

I'd probably want to be testing the calcium to see if it is increasing as well. If so, then I'd be doing some specialized tests to look for hyperparathyroidism.

I would not recommend continuing with the supplements unless your vet specifically recommended them. I wouldn't want to be adding anything new to the mix until I felt more comfortable about what the problem was.

I wish I had more answers for you. What I can tell you is that this is a condition that is probably going to require a number of additional tests before any answers are received. I've also had some cases like this where no answer is found but then the dog gets better. I hope things improve soon!

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:

Dr Marie,

Thank you for your quick reponse. Another concern I had was since DI is suspected. Keeping the fact in mind the initial blood work showed normal BUN /Creatinine .... What if this is Central DI as opposed to Nephrogenic. My concern is if it is central DI- Central DI being caused by something more serious like a tumor looking at the symptomology.

Would you recommend he gets a CT ?? Perhaps even be given diagnostic ADH pill to confirm whether it is of Central origin or not?

Thanking You

Sincerely,
Vk


Online vet, Dr. Marie

Dr. Marie replied:

I think that we're a little bit premature for a CT at this point. The ADH test is a possibility but I'd be reluctant to do that while he is not feeling well. If his appetite returns and all that is going on is the increased thirst and urination and decreased specific gravity then this could be a logical next step.

The best advice that I can give you is to trust your veterinarian's advice when it comes to which tests will be the most helpful.

Dr. Marie.



Customer reply:

Sounds Good Dr Marie.

I will wait to see how he does over the next few days and then see how that second urinalysis goes that his vet requested.

Thank you.




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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.