Why SDMA Testing Should Be Included in Wellness Cases

Wellness screening is an essential part of veterinary medicine for one obvious yet significant reason: our pets can't tell us when they're sick. Screening diagnostics help identify unknown health issues, confirm an animal's well status, and establish a patient's baseline.

The kidneys play a critical role in blood pressure management, red blood cell production, hormonal balance, fluid and acid-base balance, and toxin elimination. In addition to BUN and creatinine, SDMA (symmetric dimethylarginine) should be included in screening protocols to identify trends and changes in kidney function.

Including SDMA testing in every patient's wellness blood work can raise the level of care and confidence for all patients—not to mention detect a range of illnesses—in patients of all ages and health statuses. Here's how.

  Diagnostic, technology, and support that give you deeper insights into your patients' health.

Why Is SDMA Important in Wellness Cases?

Put simply, wellness testing can reveal increased health risks in cats and dogs. During a routine wellness exam, diagnostics are extremely valuable for confirming health and establishing a patient baseline that allows for more individualized assessment should the patient become ill. They also provide early indications of patient-specific change. When you have information about your patients' baseline levels, you can recognize slight changes that may indicate the start of a problem. This allows you to address and monitor the situation to ensure the condition is managed appropriately.

SDMA is a sensitive, reliable glomerular filtration rate (GFR) impairment indicator that enhances wellness screenings by improving detection of early changes in kidney function.1-5 A mild SDMA increase can be the first indication of kidney dysfunction and should be investigated to begin appropriate treatment, if necessary. SDMA provides an earlier flag of kidney function decline than other screening methods. As GFR declines, SDMA increases with an average of 40% loss of kidney function, and as little as 25% loss, versus creatinine, which does not increase until 75% of kidney function is lost.1,2 Recognizing these changes can also lead to the detection of other concurrent diseases.19,20 Early diagnosis and intervention may improve patient prognosis and outcomes.

Why Is SDMA Important for Every Wellness Patient?

Pets are notorious for hiding illness, and many don't exhibit signs until their condition is advanced, which can make management difficult and negatively impact their prognosis. One study of more than 200,000 apparently healthy cats and dogs (consisting of a chemistry panel, complete blood count, SDMA test, urinalysis and TT4 {in cats 7+ years of age}) found clinically relevant abnormalities at each life stage:

  • Young adult: 1 in 7 dogs and 1 in 5 cats (aged 1-3 and 1-6 years respectively)
  • Mature adult: 1 in 5 dogs and 1 in 3 cats (aged 4-8 and 7-9 years respectively)
  • Senior: 2 in 5 dogs and 3 in 5 cats (aged 9 and 10 years or older respectively)

A lack of clinical signs doesn't necessarily indicate good health, and SDMA testing is an easy, non-invasive way to assess your patients' kidney function. This minimally invasive screening tool is appropriate for all age groups and should be included in every patient's wellness protocol.

Which Patients Benefit Most From SDMA Testing?

All patients can benefit from a robust assessment of kidney function because it is integral to systemic health. Abnormalities are most frequent in the following populations:

  • Senior pets: Senior and geriatric cats and dogs are generally at higher risk for diseases, such as chronic kidney disease (CKD). Including SDMA in wellness diagnostic profiles can help discover kidney dysfunction earlier in this population.1,2

  • Cats: Up to 20% of all cats and 30% of cats older than age 10 have CKD, even though they don't typically show outward clinical signs in the initial stages. Because CKD is highly prevalent in cats, specifically as they age, including SDMA in their wellness diagnostic profiles can help identify disease earlier. Early CKD detection is the first step toward appropriate intervention and successful management.3

  • Preanesthetic patients: Preanesthetic diagnostics are important to detect conditions that could cause anesthetic complications or compromise post-surgical healing and are sometimes included in wellness exams in preparation for a scheduled follow-up procedure (e.g., a dental cleaning). Kidney dysfunction can lead to significant health complications in patients undergoing anesthesia, and including SDMA in a preanesthetic profile can improve kidney function assessment at a low cost.1-5 SDMA testing can improve the recognition of at-risk patients, allowing for knowledgeable decisions regarding anesthetic choices and timing. A mild SDMA increase may not require canceling anesthesia. If the patient's complete blood count and urinalysis are unremarkable, the procedure can go forward, with the kidney profile, including SDMA, rechecked in five to seven days.

Including SDMA in your wellness screening blood work is essential to detect kidney dysfunction as early as possible, so you can begin prompt treatment in affected patients and provide the best care for every pet you see.

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

Angela Beal
DVM

Angela Beal is a veterinarian in Columbus, Ohio who loves using her writing to help veterinarians live more fulfilling lives by helping make practice life more efficient and less stressful. Angela has a background in private practice and academia, and since 2020, she has worked full-time with Rumpus Writing and Editing, a veterinary-specific writing and editing company. Rumpus’ clients include veterinary practices and industry partners, including marketing companies, national corporations, consultants, and several international businesses. Learn more at rumpuswriting.com. The views and opinions in this piece are the authors own, and do not necessarily reflect the views of either The Vetiverse or IDEXX.

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