The Role of Kidney Diagnostics in Overall Pet Health

Monitoring kidney health in veterinary patients is about more than chronic kidney disease (CKD). Kidney diagnostics open a window into a patient’s overall health – and this is important at all life stages, in both well and sick pets. The kidneys provide veterinary surgeons with the information they need to proceed with confidence when delivering results to clients and creating a treatment plan.

As a foundation for systemic health, the kidneys support nearly every organ and process within the body. A few of their key roles include blood pressure management, red blood cell production, hormonal balance and clearance of metabolic byproducts and toxins.25 While kidney diagnostics are used extensively for the monitoring and management of CKD, they can do so much more by informing the veterinary surgeon on overall multi-system function and the possibility of injury or illness affecting the kidneys and other vital organs.

  Diagnostics, technology, and support for deeper insights into every patient’s kidney health.

Abnormal Results Facilitate Appropriate Investigation

When renal screening results are found to be outside the normal reference interval, they can indicate kidney health issues such as a reduction in kidney function, injury to the kidneys or another organ, metabolic disruption or various other processes that threaten homeostasis, long-term health or a patient’s ability to tolerate anaesthesia. A change to a renal value or values such as blood urea nitrogen (BUN), creatinine, and SDMA may not offer a definitive clinical diagnosis, but it does wave the red flag needed to decide if further investigation is warranted.

For example, vector-borne diseases may cause obvious clinical signs, or they may go entirely undetected for extended periods of time. Because they are central to systemic health, the kidneys are often concurrently affected by infectious disease, and SDMA can provide an early indication of kidney health issues and kidney function decline. An elevation in SDMA, with or without clinical symptoms, could alert veterinary surgeons to the need to investigate vector-borne disease as an underlying or hidden issue, especially in endemic regions or in cases where the origin of the pet is unknown.19,20

Renal Assessment Impacts Anaesthetic Choices and Safety

Veterinary surgeons know all too well that patients tend to mask underlying disease for as long as possible. In a clinical study, diagnostic testing (consisting of a chemistry panel, complete blood count, SDMA testing, urinalysis and TT4 {in mature cats aged 7+ years}) in more than 200,000 outwardly healthy pets uncovered clinically relevant abnormalities in 1 in 5 mature adult dogs (aged 4 – 8 years) and 1 in 3 mature adult cats (aged 7 – 9 years). Because of this, SDMA is particularly useful as it indicates a decline in kidney function earlier than other biomarkers.1,2,5

This can be especially important when creating the safest possible anaesthetic plan for a patient. If there is an indication that the kidneys may not be working properly, adjustments can be made to anaesthetic choices to help lessen the negative impact on blood pressure.25

Kidney Assessment as a Monitoring and Management Tool for Disease

The results from kidney diagnostics can be used to monitor the improvement and management of infectious and chronic diseases. In the example of vector-borne diseases, SDMA can be useful in long-term monitoring plans as it tends to elevate earlier than other renal biomarkers.1,2,5 An elevation could indicate a relapse or failure to cure the disease, inciting the veterinary surgeon to take action and, in some cases, save the pet’s life.

Monitoring Canine Kidney Health and Kidney Function

In dogs in endemic areas, studies show a correlation between dogs with positive Lyme or Ehrlichia exposure and an increased risk for CKD, a significant canine kidney health issue.19,20 By including SDMA in the chemistry profile for dogs with a history of tick exposure, veterinary professionals have additional information to determine how significant the tick exposure may have been and whether to continue monitoring that pet for development or progression of tick-borne disease in the future.

Monitoring Cat Kidney Health and Kidney Function

For cats, SDMA and renal biomarkers are routinely used to monitor progression and make treatment choices in cases of CKD. Two other conditions that warrant SDMA monitoring in felines are hyperthyroidism and retroviral infections – feline leukaemia virus (FeLV) and feline immunodeficiency virus (FIV). Hyperthyroidism and retroviruses impact systemic health, including the kidneys.

Many cats with hyperthyroidism have a loss of muscle mass, which can lead to decreased creatinine production and an inaccurate picture of kidney health.14,15 However, SDMA is less affected by the decrease in lean muscle mass and is, therefore, a better monitoring tool in these patients.3,15

Earlier diagnosis of cat kidney health issues such as concurrent renal disease with hyperthyroidism may have a positive impact on quality of life and survival time. Retroviruses, such as FeLV and FIV, are poorly understood, but veterinary surgeons know they can impact kidney health and that symptoms related to these viruses can be compounded by a decline in kidney function. By detecting renal dysfunction earlier, veterinary professionals can obtain a clearer picture of disease progression and take steps to support the kidneys.3,15

The Importance of Kidney Health

When it comes to screening for overall health status, early disease detection and chronic condition management, the kidneys may very well be the most important organ for veterinary surgeons to keep their eyes on. Not only do kidney diagnostics provide information on the health of the kidneys themselves, but they can provide insight into the overall health of an animal, ultimately leading to better care and treatment.

References: https://www.thevetiverse.com/en/latest/sdma-references/
 

Nell Ostermeier
DVM, CVA, FAAVA

Dr Ostermeier is an entrepreneur at heart and operates peopleandpet.com, a virtual practice providing telehealth and education for pet parents as well as consultations for veterinarians who wish to safely integrate holistic options into conventional medicine. She earned her DVM (Doctor of Veterinary Medicine) from the University of Illinois in 2004 and, since that time, has worked with multiple species and performed varied roles, including associate veterinarian, relief veterinarian and practice owner. Dr Ostermeier is an expert in integrative medicine and veterinary acupuncture, and she has spoken at conferences around the world. As an IDEXX regional thought leader, she supports veterinarians in promoting diagnostics as the basis for best preventive care and individual treatment plans. The views and opinions in this piece are the author's own and do not necessarily reflect the views of either The Vetiverse or IDEXX.