An estimated 1% of dogs and 3% of cats have chronic kidney disease (CKD). This prevalence may seem low, but risk dramatically increases when adjusted for age, especially for cats, with up to 50% of cats older than age 15 having some degree of kidney dysfunction. CKD is usually diagnosed only after most kidney function is irreversibly lost and the condition has progressed to an advanced stage. Our Dove Mountain Veterinary team has adopted a new testing protocol that allows us to identify and treat this frustrating disease sooner than traditional methods.

What causes chronic kidney disease in pets?

CKD can result from many underlying causes, as the kidneys are particularly prone to damage from other diseases or conditions. Most pets with CKD are seniors, and their disease is attributed to aging, with no clear understanding of the cause, which could have occurred months or years before the disease’s onset. Some CKD cases’ cause could include the following:

• Inherited or genetic disorders

• Reduced blood flow during anesthesia or a vascular event

• Kidney stones or urinary tract obstruction

• Systemic or urinary infections

• Toxins or kidney-toxic medications

• Immune disorders

• Cancer

What are the signs of chronic kidney disease in pets?

The kidneys filter waste products from the blood, conserve water and protein, regulate mineral and electrolyte balances, and contribute to red blood cell (RBC) production and blood pressure regulation. When kidney cells first become damaged, other healthy cells step in and work harder to keep the body functioning stably. Unfortunately, a pet doesn’t exhibit CKD signs until they have lost around two-thirds of their total kidney function.

CKD signs stem from waste product buildup, water loss, electrolyte and mineral imbalances, and other alterations in the body’s metabolism. A pet’s CKD signs may include:

• Dehydration

• Increased thirst and urination

• Bad breath

• Nausea or vomiting

• Weight loss and muscle wasting

• Mouth sores

• Lethargy

• High blood pressure

• Vision loss

What are the traditional chronic kidney disease diagnostics for pets?

Veterinarians have traditionally diagnosed pets’ kidney disease by analyzing several diagnostic test results together. After identifying CKD, a veterinary team may order some additional tests to determine the disease stage as defined by the International Renal Interest Society (IRIS) guidelines. CKD staging provides your pet’s veterinary care team with important information that guides their treatment decisions and helps them make the best choices for your pet’s care. Traditional CKD diagnostics include the following:

• Blood work - Blood urea nitrogen (BUN) and creatinine are typically elevated during CKD, and RBCs may be low.

• Urinalysis - A pet with CKD has dilute urine and may lose protein in the urine.

• Imaging - X-rays and ultrasound evaluations may reveal kidney abnormalities that confirm the diagnosis or help rule out other causes.

• Blood pressure evaluation - Blood pressure is often elevated in pets who have CKD.

How is the symmetric dimethylarginine test used to diagnose chronic kidney disease in pets?

IRIS kidney guidelines help veterinarians understand what your pet’s blood and urine test results mean and how this affects their CKD prognosis. In recent years, a new test, the symmetric dimethylarginine (SDMA), was developed and is now included in the IRIS staging guidelines. SDMA detects changes in kidney function up to 18 months sooner than BUN or creatinine tests, facilitating an earlier diagnosis. SDMA also helps overcome the limitations of creatinine and BUN measurement, which can be affected by weight loss or dehydration. In contrast, the SDMA remains stable despite these changes and is a more reliable disease progression indicator.

How does early detection change the treatment course for pets diagnosed with chronic kidney disease?

SDMA is a major game-changer for diagnosing and treating CKD in pets because this test allows our Dove Mountain Veterinary team to detect the disease far sooner than other tests alone. On average, SDMA becomes elevated when about 40% of kidney function is lost, compared with 60% to 70% of lost kidney function necessary for other tests to indicate disease. The SDMA test enables our team to detect a pet’s CKD earlier, and start treatment sooner, which helps protect an affected pet’s remaining kidney function.

If our team diagnoses your pet’s CKD at an early disease stage, we can recommend a special diet that reduces their kidneys’ workload. In addition, we can prescribe medications that reduce your pet’s protein loss, which significantly slows CKD progression. However, a pet who is not diagnosed until a late CKD stage may only live for a few months. By using the SDMA test to determine whether your pet has CKD, we may be able to add years to their life.

Our Dove Mountain Veterinary team recommends routine blood and urine screening tests, including SDMA testing, at least once per year for all pets and more frequently for our senior four-legged friends. Early disease detection is key for effective CKD treatment and for many other common age-related disease processes. Call us to schedule your pet’s next wellness visit and diagnostic screening tests or if you have questions about the SDMA test or CKD treatment.