Our pet Yorkie has been unable to keep anything down recently, the Vet has taken blood samples and says that there is a high level of protein in his urine. If he cannot keep anything down by this afternoon they will need put a drip into him and keep him overnight.

Could this just be a virus or something more sinister? He has previously had galbladder troubles.

Any info would be great

W

Hi, Wendy,

A high level of protein in the urine can mean he has a serious kidney problem, or that he has cystitis (inflammation of the lining of the bladder)
Blood tests will distinguish which.
If he has a high blood urea and serum creatinine as well as a proteinuria, he has kidney problems -if the creatinine is high, it is really serious and may wll be incurable.
If they are both low, it suggests a cystitis which should be treatable.
I would not like to see you having to have repeated IV infusions if his kidneys are severely damaged.

W

Any sign and symtoms if the dog has protein urine?
Becasue my dog always drink large amount of water recently
and I check the urine, he has positive result in protein.

Hi,

A high urine protein level often indicates a kidney problem. You need to have him blood-tested to find out for sure.

W

I have a 10.5 yr old boston terrier that was diagnosed with high levels of protein in his urine. He is eating really well, drinks alittle more than normal, has lost weight. His blood work has come back totally normal and my vet says the next step is xrays and ultrasound. Any idea what could be going on with him? Thank you

Hi,

Your dog is 'leaking' protein into his urine because he has a kidney problem, but the kidneys are still functioning well enough for it not to affect blood urea and creatinine levels. I do not see how x-rays and ultrasound examinations could help with the diagnosis.

W

My dog was diagnosed with Cushings and diabetes early 2008. We moved and have been trying to find a vet that has expereince treating these types of dogs. In November, a vet had a urine analysis done and it came back with a high protein/creatinine ratio of 6.3 which was due to high protein. The BUN/Creatinine ratio, Urea nitrogen, and creatinine in blood samples done repeatedly are normal. First vet stated that the high protein/creatinine ratio was due to his Cushings not being in control. Since the dog is on Anipryl there is no way to test. In the meantime the vet put the dog on enalapril to see if it helped the kidneys I was told. In looking on the internet I came to find out the medicine was for high blood pressure. I had asked the vet before about checking for high blood pressure but told they could not do it. I was concerned as this is a known problem with Cushing dogs. I have since then gone to another vet for a second opinion. The second vet measured the dog's blood pressure and it is high even though on the medicine. Based on all his blood and urine test he stated that the high protien in the urine is most likely due to the high blood pressure and not due to kidney damage from the Cushings. I cannot find anything specific on this and looking for any information. Since both Cushings and diabetes can cause high blood pressure, how does one know which is the primary cause?

D Becker

Hi,

Firstly, I have to say that blood pressure measurements in dogs are very suspect - the difficulty in getting a precise reading, and the wide variation in size of different breeds - eg. a Yorkshire Terrier and a St Bernard make it impossible to establish a 'norm'.
The high urine protein coupled with normal blood urea and creatinine levels suggests a 'protein leak' in the kidney rather than kidney failure per se.
I take it that the vet has ruled out any inflammatory condition in the bladder which may explain the high urine protein?
Positive diagnosis of diabetes melitus is relatively straightforward, and I expect that your vet has eliminated this in his differential diagnosis

W

I'm finding all the information above very interesting. We have been trying to find out "what" is wrong for a few years now! My dog, a Maltese Yorkie new labwork is all over the place this time. BUN/Creatnine is 50, BUN is 55, Potassium 6.0, Platlet count 488, Urine Protein 3+ (prev. was 1+ & 2+ so slowly getting higher). NOW we have lows as well...Albumin 2.2, Total Protein 4.4, NA/K ratio 25. She is on 5.0 Enalapril and now the doc has added 1/4 of a 2.5mg tab of Amlodipine Besylate. After these labs shes taking Sucralfate & Famotidine. She's been on a presciption low-protein diet and we've never had any prob. stomach-wise. Vet wants to do another x-ray & ultrasound. Bloodpressure high last visit & wants to do another in couple weeks as well as followup labs again. Mentioned MAYBE Addison's or a tumor affecting her neurologically because she has tremors once in a while (not seizures...just tremor...hard to explain unless you saw her). My husband & I are at a loss if we should pursue constant tests & more x-rays/ultrasounds to find once again...nothing...even though there's something going on obviously. Vet says it's possible we may find something this time and we can treat it. He said kidney function is fine though?

Hi,

This is very complicated picture. You say it has been going on for a few years now, but you do not say how old your dog is, or what are the signs of illness (apart from the tremors, which are so common in this type of dog as not be be of concern)
If you have been getting veterinary attention for that long your vet must be building up a handsome pension fund by now!
You do not say if there are signs of heart disease, but she is getting Enalapril.
Serum urea and creatinine are not remarkable, but the urine protein loss coupled with a low protein diet ( why?) will account for the low blood albumen/globulin levels.
I cannot see what more x-rays and ultra-sound exams are likely to reveal.

W

Hi
Our 5 yr. old pom. has just been diognost with high tryglicerids, and very high protien the her urine.2 weeks ago have a small sezier, vet does not seem to know what to do HELP

Hi,

i suspect that your dog is going into renal failure - cannot say whether acute or chronic, but a blood urea and a serum creatinene test could help tell which, and give a better prognosis.

W

Hi my keeshound has very dark urin it showed some protein. she seems well in herself, but she has suddenly started eating lots of mud and grass and stones on the beach the stones seem to have charcoal in it. she is in remission from AIHA so have to be careful what meds to give her.

Hi,

The proteinuria may be from the kidney, which is potentially more serious than if it is coming from te bladder, the wall of which may be inlamed - cystitis, and the dark colour may bue due to blood. She really should be checked by your vet - remember to take a urine sample wiith you.

W

My female 11 y/o Jack Russell has been diagnosed with diabetes and we are slowly getting her regulated with Humulin. She now has 2 + protein in her urine. She is going for a Urine creatinine test Mon. Can I give her a good quality of life with meds for a few more years? She is so active chasing birds, bunnies, and such in the yard. In 1 month we have tested her urine 2 x's with 2 + urine as the result. Can diet cause an elevated urine protein test?

Elevation of protein in the urine can be caused by urine infections which are common in diabetics and a urine culture should be performed even if no white blood cells are seen in the urine. It can be commonly caused by kidney disease and also by Cushings disease which is not uncommon in this breed. If the urine protein-creatinine value is not elevated then the 2+ protein is not significant. These problems need to be excluded but overall getting the diabetes under control is the most important thing in improving your dog's quality of life. Many diabetics do well if well controlled but some can be problematic, the usual reason being concurrent infection or other diseases.

Hello, I have a 3 year schnoodle who is not yet neutered. At a recent vet checkup we explained that he will some times urinate a little here, a little there. Like if we take him out he'll pee for a second and then put his leg down but seems like the stream was strong where he should pee more, if I tell him to, he'll move on and pee somewhere else. We told the vet we didn't know if he is just saving the pee to mark here and there outside or if he is having some problem with his urine. The vet noted a slightly swollen prostate on exam and said it could be because he is not neutered and that the prostate may be causing the hesitation with peeing. Since we were going to check his blood to start heartguard we did a cbc and chem which noted slightly elevated BUN 36, creat was normal. Our vet said this is not impressive and he could just be dehydrated. My vet no longer does surgery so we went to another vet to talk about doing the neuter. This vet also noted a slightly swollen prostate. He suggested a urinalysis and culture and repeated blood. This time the BUN was normal: 30 and the creat was also normal. All other blood lab values were normal. The urine culture was negative, and the urinalysis noted 2+ protein. When I spoke to this vet he suggested another urinalysis to check again; however I asked if his high protein diet could cause high protein; he said maybe but it could be some other kidney disease that is causing him to leak protein into his urine, I asked if he would have higher protein levels if it was something like a kidney disease causing the leak but, he didn't really answer that. I suggested if we did do the repeat I would have to take him off the food for a while first in order to know if the food is the culprit, he agreed. I talked to my original vet who agrees that a repeat urinalysis is probably a good idea to check if this is an early sign of disease. My questions are, if his bun/creat are normal but there is 2+ protein, could this likely be food related? if he had a more serious kidney disease would the protein levels be higher in the urine? would 2+ protein in the urine be a hindrence for the neuter procedure, in other words, would this complicate the processing of the anesthesia? because this second vet didn't want to schedule the procedure until his urine was rechecked. Can a swollen prostate somehow cause a protein leak if the urinalysis and urine culture is negative for infection? Finally, how long should I change his food for before doing the repeat urinalysis and ruling out if it is due to the food? and any suggestions on what to switch him to? We are in NJ, United States. He eats 'Merrick before the grain' food and eats their lamb lung treats as well (all high protein). Thanks for your feedback.

First diet and urine protein - this does not alter the urine protein. If there is protein in the urine it has come from the kidneys, ureters, bladder, prostate (in male dogs) or the lower urinary tract - urethra and vagina (females) because it is getting into the urine from the bloodstream or the result of inflammation. Infections can cause elevated protein - this could be anywhere in the urinary system and when the infection is cured the protein is usually normal afterwards. The protein could be leaking from the prostate in your case.

The important thing here is that the protein level needs to be adjusted for the concentration of the urine to see if it is really elevated - we measure what is called the urine protein-creatinine value (UPC) - this adjusts the protein level to see if very small amounts of protein are really significant in very dilute urine and also if high protein levels are significant in very concentrated urine. If the UPC is greater than 1 then there is too much protein in the urine - your vet will need to send a urine sample to a lab for this test. This is the only way to assess whether the 2+ protein is a real problem or not.

If it is significant then further tests need to be done to see where the protein is coming from and why - the list is very long! Some of the causes may influence the anaesthetic, but not all.

Your dog is a bit young to have prostate trouble but it could have, what you describe are typical signs but equally they could be purely marking behaviour.

Finally yes, a negative culture does not exclude infection in the urinary tract.

Hi, my female 12 and a half year old labrador x alsation has been drinking a lot recently and has been losing weight over the last few months. We had her urine checked this morning and her protein was 4 (4 being highest on chart). She had no sign of diabetes. She is also off her food recently and is now having diarrhea. The vet says the next step is to have a blood test, he wouldn't say any more than that. Does it sound like my dog has kidney failure? and what treatment is available if she is? I really don't want her suffer, she is too great a dog for that. Thankyou.

Certainly high levels of protein in the urine are most likely to be associated with kidney failure, particularly if the dog is off her food and losing weight, although there are other causes. If the kidney failure is due to an infection then there may be significant improvement after a long course of antibiotics. Sometimes dogs get a high calcium level and this can cause renal failure but unfortunately although the kidney function may resolve once the calcium is lowered, the most common cause for an elevated calcium is a malignant tumour somewhere. The next step is a blood test to see what the kidney function is like and to check for other causes.

Unlike in cats, dogs often present late in the course of kidney disease (unless the kidney problem is sudden in onset) and many dogs do not do very well. The mainstay of treatment is a change in diet to reduce the amount of work the kidneys have to do getting rid of protein waste products. Drugs which protect the stomach lining from the effects of these waste products can be helpful in improving appetite and phosphate binding drugs may help slow the progression of the disease. Supplements such as potassium and B vitamins may be helpful in some cases. Some cases respond well to IV fluids but this really needs to be for 3-5 days to make a difference and in cases where the blood values are high may be unrewarding. In cats the prognosis and response to treatment is much better.

Hello,
My dog is a 13 year old collie mix. He has a host of issues including pretty bad arthritis in his hips (keep falling down to sitting position on linoleum or wood floors, higher than normal liver enzymes, a cyst on his eye that causes irritation (have to keep putting jelly type meds in his eye). He also can't hear, and his eyesight had diminished. Has become incontenent both ways. Doesn't seem to know he's even going in the house. This was a dog that never had an accident. Doesn't do it everyday but almost. Cognitively is off too - vet concurred on that. This happened mostly over the past year or so except for the arthritis which he had for years. Now he has what the vet seems to think is an absessed tooth. Swelling below his eye. They did the pre-surgery bloodwork and all was good- she said his liver enzymes even went down some which before they were always going up, but the urinalysis showed protein. So she just sent a culture out yesterday for that, but he is scheduled to have the tooth removed this Monday 5/22. He is on pain meds and an antibiotic now and has been for about a week. Before they remove the tooth, they are going to x-ray his teeth to make sure it's an absessed tooth and not a mass in the sinus but she told me this morning, she's not sure and will do the x-ray first .. I told her if he does have a mass, don't pull the tooth as we intend then to put him down shortly thereafter. We don't want this dog to suffer anymore. Even at this point, we're not sure we're doing the right thing as his quality of life is really declining. If the culture comes back clean, what does the protein mean to you? Our vet said it could be a random result and not show at all next time or could be something more serious, which again if it's kidney failure or something like that, we would not want to put him through any treatment. What is your opinion going forward?
Elaine

Firstly and probably least importantly the urine protein - if you look a couple of messages above at what I said on May 11th you will see the urine protein explained.

More importantly however what you describe is a dog with lots of problems and possibly a poor quality of life. Quality of life is something which should be looked at independent of any diagnosis - some dogs with serious problems have a good quality of life despite them, others are miserable with less serious diseases. The advice I usually give is 'Is the animal happy most of the time? If it is then keep going, if not don't'. This obviously applies to patients with long standing problems which are not responding well to treatment, not to patients which have something which can be easily fixed but makes them feel miserable until the treatment kicks in. At the end of the day the decision must be yours, however difficult it may be to deal with.

As far as the tooth abscess goes, in a dog with all these other problems I would see how it responds to antibiotics and a long course (a good 2 weeks) may hold the problem at bay; if it recurs quickly when the antibiotics finish then that is the time to consider dentistry under anaesthetic, if it does not come back for a few months then a second course of antibiotics is probably the place to start.

As far as cognitive dysfunction there are several drugs that can help such as propentofylline, selegeline and nicergoline.

I have a 7 year old cocker spaniel who was quite ill 9 weeks ago she has suffered with pancreatitous in the past we thought it was this, she was hospitalised as she wasnt eating and was very lethargic she was put on steroids in the hospital and then antibiotics when she came home within 2 weeks of her return home she was back to normal eating her normal diet of royal canin obesity management food a food we have always gave her as she is prone to putting on weight.. in the mean while it was reported by our vet that she was anaemic non regenerative and also had protein in her urine after several blood tests and several xray and ultra sound scans they couldnt pin point what was going on and referred us to the Royal Dick In Edinburgh. We took her up 2 days ago and have just collected her this evening they have just performed all of the tests our vet performed plus a more involved blood test and come up with the same prognosis along with a slight heart murmur which they say is not significant and Thoracic radiographies with mild lung changes.

They have suggested that we return next week with Ellie my dog for further tests they want to perform a renal biopsy and also a bone marrow biopsy and an endoscopy of the bronchi. We are insured but feel they have repeated all the tests our vet done to arrive at the same result for our insurance to be charged again. Our little cocker is so fit and well you couldnt tell there was a problem please could you advise us what to do we dont want to have any harm come to her and apparently the renal biopsy could cause a bleed. All i want out of this is to find a cure but would hate to think i was putting my dog through all of this for nothing if they couldnt treat the problem.

I really look forward to your response.

Karen

First I expect some of the tests were performed again to see if anything had changed and also possibly because the method used to get the results (basically to do with how the tests are run on the machines in the lab) differed from those the university uses so they needed a 'baseline' to compare future tests results to.

Second the non-regenerative anaemia is probably the most important thing to investigate and a bone marrow biopsy is what is needed and I would strongly recommend this is done as there are various causes and these could be linked to the urine protein levels in some diseases that spring to mind.

Third the bronchoscopy - if the x-ray changes are mild then this might be overkill but again results might help explain the other problems.

Fourthly the kidney biopsy - yes there is a chance of bleeding but the chances of anything serious are not that high. Cocker spaniels have inherited kidney problems and this might be why it was suggested. Also certain kidney conditions that cause proteinuria can only be diagnosed on a biopsy. In my experience, however, kidney biopsy is better reserved for cases where all other avenues of investigation have been exhausted, mostly because they are not always helpful.

What tests are carried out is up to you in the end and you may wish to suggest that you wait for the results of the bone marrow biopsy before doing any other tests. The university pathologist is likely to give you an answer within 48 hours of the test so this does not drag things out too much. You must remember that the university is a teaching hospital and having taught in the same environment myself at Cambridge, it is important that the students learn something from your dog. This sometimes means that investigations are somewhat more thorough so that the students can see exactly what is going on, rather than taking the word of the consultant with no proof. I am sure my colleagues at Edinburgh will look after your dog well.

Please help. I think my first posting never went thru.

I have a 13-1/2 year old sheltie/JRT spayed female (sheltie is dominate in appearance and personality) who was just diagnosed with either glomularonephritis or amyloidosis. We are not proceeding with a biopsy since the treatment is essentially the same and she has been thru many tests already.

In addition, she is being treated for hypertension. Her highest reading was at 234 systolic. After 6 weeks of trying different medications including enalapril and amlopidine, we got her systolic down to the 130s, though her diastolic was still a bit high, I think.

She has had a small level of proteinuria in her kidneys for about 4 years. With 2x/year physicals, it stayed the same until a little over a month ago. Now it seems to be rapidly increasing. This last weekend the vet said the measurement should be less than .5 but hers is at 4.4 now.

I have been convinced for several months now that her time has been coming. It's not only how she has seemed to feel, but her behavior - relinquishing her rank as alpha to my younger sheltie boy, and snuggling up to him for comfort.

Her heart has been slowly but steadily enlargening. Her liver is also slightly enlarged. Two weeks ago we had her at an ER vet while we were on vacation - she was coughing up water with white mucus in it and her breath smelled like ammonia. Test results there were inconclusive but they thought it might have been a virus. 24 hours later, she was feeling better.

My vet is uncertain if she has weeks or months - she said it depends on how quickly her kidneys fail. It seems to me they are not functioning well very quickly.

I want to do what is best for her so we are keeping her comfortable and living each day happily. But I'm wondering how long I may have her and when to make a decision to let her leave this earth peacefully.

I'd appreciate any guidance. I'm not sleeping well at all - and not sure what else I can or should do for her.

Thank you for any help!

Suzy

It sounds like you have done well maintaining things for this long. The main problem with increases in urine protein is that this means that you have to put more protein in the food or the dog loses weight. This has to be carefully balanced as poor quality protein will push up the BUN and make the dog feel worse. Although the UPC is 4.4, the question is whether this is a blip or a trend in an upward direction. As long as you can maintain the blood protein levels and the dogs weight without pushing the BUN up too far this should be a manageable situation. Bear in mind that your dog has already done well and reached a reasonable age so you must be pragmatic here. The most important thing is the quality of life.

This rise might be due to some other disease process superimposed on the hypertension such as a urinary infection and I would consider culturing the urine to see if that is the case. Otherwise you will need to increase the dose of enalapril or change to another ACEI such as ramilopril to see if that works better.

Thank you that was helpful.

I should have mentioned the urine culture as well. It came back clean - no infection. We have increased the enalapril.

I agree about the quality of life issue - I want to do right by that sweet girl. I want to make sure I'm doing everything I can to help her, and if it's time, to let her go peacefully.

We took our 7 year old female Maltese/Poodle to the vet for a complete check up, she hadn't been to this vet or any vet for a few years. She has always licked herself in her female area since she was little. We asked the vet about it. He checked her and said she was a little inflamed and wanted a urine test. The urine test came back high (not sure of level) of protein. At this point they wanted her to come back in for a blood test and a second urine test. The blood came back good, but the urine was +3 protein, and +2 crystals. The vet said there was no blood in the urine. Now they are talking about ultrasounds and asking how she is "doing at home" like she was sick or something when we brought her in. She has no symptoms of anything, she was just getting a checkup. They want to do an expensive ultrasound to find out if we should change her diet?? She eats fine, hasn't lost any weight, urinates normally, everything seems fine to us, no changes other then she went to the vet? Any idea what the +3 protein, and +2 crystals with no blood in the urine could be?
Thanks in advance
Jason

To be fair to your vet the licking around the dog's vulva is a symptom, although as you say your dog appeared well. The crystals are suggestive that the dog may have bladder stones and this is why your vet wants to do an ultrasound; the vet is just being thorough. Some animals have crystals in their urine normally, especially if they have eaten a few hours before the urine sample was taken. What is important is what the crystals are as diets can be effective in dissolving the crystals so the dog does not get stones; not all crystals/stones can be dissolved by altering the diet though. The protein suggests inflammation associated with the crystals in this case. If the dog is licking because of the crystals then this suggests they are irritating the dog and so the dog would benefit from further investigation and treatment.

I have a 6 year old English Mastiff that has become ill within the past week or so. It all started when I noticed she was refusing the bread that I gave her daily meds (fish oil, etc) in. Then I noticed she wasn't running with the other dogs. On Thursday I brought her in the house to try and get her to eat. She refused. She would drink water from a bowl given to her, but usually she is the first one lined up when I fill the water bowls! Friday was the same...no food. I began to worry that something was wrong and planned on a trip to the vet on Saturday morning. That morning I noticed she was "leaking" and her vaginal area was swollen. The dr. tested her blood and said she had an infection. Her white blood cells were up at 19k. He gave me the option to leave her or get meds and treat at home. Since it was an infection, I took the meds and went home. On Sunday, all was the same, but she seemed a little perkier. Again, no food...even denying bacon! That evening she vomited a bit and I knew she needed to go back. I took her Monday morning. Blood work came in today and her BUN is 181. Dr. says that normal is 20 and 100 is a limit for possible survival. Her calcium is in the 8s, but her potassium is double that, which he states is concerning. I have researched some tonight and I can't seem to find anything on levels this high. He feels she got into something, but knowing my dog, it isn't likely and we can't find anything she might have gotten into. He has said that the chances of survival are slim, but we are flushing her system and hoping for a miracle. He says the next 24 to 48 hours will tell. We went to see her tonight and she is still awake, clear eyed, walking around, etc. She even urinated while we were walking around...which I hope is a good sign. My question is if this is something sudden, would flushing her system and proper meds save her? What is your opinion? Advice?Thank you!