The Cutting Edge Veterinary Podcast

STUDENTS: Steffany Schluessel and Mackenzie Campsall

FACULTY MENTOR: Dr. Serge Chalhoub

Kidney disease in companion animals is chronically misunderstood. While cats often suffer from chronic kidney disease (CKD), dogs are usually affected by protein-losing nephropathies (PLN). PLN encompasses glomerular disorders defined by protein loss, including glomerulonephritis, glomerulopathy, and amyloidosis. The main causes of PLN include immune-mediated disease, inflammation, neoplasia, and idiopathic disease. Confusion regarding CKD and PLN, paired with the higher prevalence of CKD in small animal medicine, leads to misdiagnosis of many dogs with CKD. Diagnosis of PLN requires demonstration of persistent renal proteinuria and elimination of other causes of proteinuria; further characterization of its underlying cause is less straightforward. When tackling PLN, clinicians should reduce the proteinuria. Concurrently, the underlying etiology should be identified through testing, such as complete blood count, serum chemistry, urinalysis and culture, pathogen testing, and abdominal and/or thoracic imaging to screen for neoplasia where appropriate. Management of PLN must change according to etiology, because recovery will depend on whether the cause of the proteinuria is addressed. Use of a clinician’s guide to diagnose and treat PLN will improve the prognosis of patients in general practice.