# SDMA/Kidneys (14 year old non-GSD)



## jarn (Jul 18, 2007)

Since @Sabis mom asked for more Neb content...well, this probably wasn't what she had in mind!

Neb: 14 year old mutt (parson russell terrier/husky/lab/etc per DNA) who has arthritis. Has tried cartrophen (same idea as adequan I believe) - after doing injections at home for quite awhile, nothing. Tried gabapentin - nothing. For the last...year? longer? he has been on meloxicam/metacam. He is ideally around 40lbs, maybe a bit less. Not too sure it's done much of anything, he goes through periods of being spritely, and periods of doddering around, but - he's 14, so he's earned his retirement IMO.

Currently he weighs 36.4lbs. He's lost about a lb in the last month, and we've been trying to put weight on him. For the last six weeks of so he's had intermittent GI issues that seemed to be resolved before I felt well enough to take him in to the vet - and then this week cropped up (diarrhea around 16 times in 24 hours) so as soon as the diarrhea happened once I called and got him in the next day (which was yesterday). 

He's got metronidazole which has worked well enough that he hasn't pooped in 22 hours (I expect he's rather cleaned out). We hadn't fasted him but had reduced his food/given 'easily digestible' food. Normally he gets Acana. We did bloodwork (was concerned about kidneys) and I brought in (midday) urine. 

His bloodwork is mostly excellent - but - his SDMA is 16 (14 is high end of normal). His urine was very dilute (but not a first thing sample) with a very small amount of blood (but no other indications of an UTI and in any event he shows no symptoms of a UTI). 

Our vet wants to have us bring in some first thing samples to test for USG a few times over the next bit before we discuss next steps. 

Even if his USG is normal, we'd still like to move him to a more kidney-friendly diet. I am of course happy to do stuff like give fluids if necessary (had a cat with CRF for six years, am quite comfortable with sub-q fluids (have given to that cat, a cat of ours who had cancer and needed supportive fluids, to my rabbits if their tummies got funny (that wasn't prescribed, but it did help), and, when I still did rescue, to a feral cat who was sluggish post-neuter - that was chancy - and I taught my mom how to give sub-q to her cat), and one of our cats now has arthritis and cartrophen does help him so I do still do sub-q injections). 

Is there anything else in particular I should be discussing with our vet? Quality vs. quantity protein issues? We'd like to get his weight back up, he hasn't weighed this little since he was a young guy (I've had him since he was six weeks). 

Vet thinks meloxicam likely GI culprit and we are likely not going to continue it (she said to discuss with each other).


----------



## Magwart (Jul 8, 2012)

I'd be suspicious of the NSAID too, as that entire category of drug is known to cause kidney issues in some dogs.

How are the other kidney values (BUN, creatinine, etc.)? 

That SDMA value can be mysterious if everything else is normal. The SDMA test is proprietary to IDEXX. IDEXX claims it detects very early loss of kidney function. It can be weird though -- I've known several dogs who had wonky SDMA numbers once, when everything else was perfect -- and the vets were stumped because they couldn't find a cause, so we retested a few weeks later (and SDMA was then normal), and then a few months later (still normal). In fact, the wonky SDMA never repeated. So...I'm still not sure what to make of it as an indicator. 

If you don't mind a slightly technical read, you can read what IDEXX says to vets about it here -- it links to their decision-tree and other materials that you may find interesting: The IDEXX SDMA Test - IDEXX US

With an old dog who is having trouble holding weight, the worry we always have is cancer (cachexia). You might think about running a C-reactive protein test for inflammation (it's not very specific -- won't tell you where or what is causing it if it finds it, but it can be an early sign of cancer -- or not), or a more specific OncoK9 liquid biopsy (which checks for 30 kinds of cancer with simple bloodwork -- it's brand new, so your vet has probably never run it as it was just released about a month ago, but your vet has likely has been sent a bunch of materials from the mfr and/or heard about it at a CE, as it's a "big deal" in conversations right now-- OncoK9 gets sent out to IDEXX like other bloodwork). 

I don't know much about kidney-friendly diets -- I would probably use an RX diet from the vet, just because I don't know what else to do. I think @onyx'girl may have some expertise with an excellent home-fomulated one that she used to recover her dog after lepto, if I'm remembering correctly.


----------



## jarn (Jul 18, 2007)

Thank you so much @Magwart - I was actually reading that IDEXX site yesterday, heh. 

His SDMA was 15 last year (I didn't realize/remember that, I get copies of his bloodwork, but we changed email providers from google to icloud recently and honestly I didn't transfer all of my emails because I'm lazy - we have them stored on a drive somewhere but I haven't pulled them). So there's a general progression.

Everything else looked great - I haven't gotten a copy of his lab results yet (I think the vet forgot to send them over, I'll bug them) but that was the only result out of parameters. Just the SDMA and the dilute urine (with a bit of blood, which I don't love). I got another urine sample this morning so when the vet opens I'll drop it off (I had to chuckle, I took him out on his own - just after 5am, our usual time - but I'm out there wandering around with a bottle of his urine and there's a guy chasing after his dog that has diarrhea). 

Re: cancer I will ask them about that test. I know I asked about a cancer test years ago and they said they didn't have one yet. I think that was while we were waiting for Esme's (cat) biopsy results. I've been worried about cancer for the same reason. His WBC and all the sub-WBC things were fully normal. So there's that much at least, in terms of inflammation. 

He doesn't look super skinny to me, but he's also lost hind end muscle so he wouldn't as much. If he still had more I think he'd look quite skinny. All our dogs tend to the thin side and I've wanted him thin because of the arthritis but all this latest GI stuff has made me want to have him have a bit more weight on him - more 'normal' than 'thin'. 

We were thinking a rx diet too. But yes, any input @onyx'girl or anyone has would be great!!!!!!


----------



## onyx'girl (May 18, 2007)

sorry, haven't been on this board lately. I found good info on Dogaware.com as far as diet for renal support goes. I didn't do an Rx diet, but did contract with a well known 'nutritionist' that basically robbed me of precious time and $. The diet that was formulated for Karlo was a basic chicken rice with a touch of liver and buy the supplements from the nutritionist.
I ended up doing a cooked dark meat chicken, pearled tapioca, veggie stew and added in baked pulverized eggshell. I also supplemented CoQ10, B, taurine and gave Chinese herbal renal support supplement from my holistic vet. We did subQ, magnetic loop therapy to keep the kidneys flushed and the loop provided help with circulation of the kidneys.


----------



## jarn (Jul 18, 2007)

onyx'girl said:


> sorry, haven't been on this board lately. I found good info on Dogaware.com as far as diet for renal support goes. I didn't do an Rx diet, but did contract with a well known 'nutritionist' that basically robbed me of precious time and $. The diet that was formulated for Karlo was a basic chicken rice with a touch of liver and buy the supplements from the nutritionist.
> I ended up doing a cooked dark meat chicken, pearled tapioca, veggie stew and added in baked pulverized eggshell. I also supplemented CoQ10, B, taurine and gave Chinese herbal renal support supplement from my holistic vet. We did subQ, magnetic loop therapy to keep the kidneys flushed and the loop provided help with circulation of the kidneys.


Thanks! This is very helpful. For now we're mostly just adding in hydration - but that's a great help, we can start to slowly transition him. I'll check out the website. 

I really appreciate it.


----------



## Magwart (Jul 8, 2012)

Did you use an Assisi Loop or a different product?


----------



## onyx'girl (May 18, 2007)

Magwart said:


> Did you use an Assisi Loop or a different product?


so sorry to respond so late to this, yes, I bought the Assisi loop from my holistic vet.


----------



## Magwart (Jul 8, 2012)

That's really interesting that you were able to use the loop that way. I bought one for an ancient dog's ortho stuff. It hadn't occurred to me that it could help inner organs too.


----------

