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Shih Tzu puppy elevated kidney level

My almost 9-month old Shih Tzu had a second blood panel done yesterday, and one kidney level was still elevated.  It was down from 51 (results from when he was fixed in March that they never mentioned) to 47.  She explained that normal levels were around 28?  I have done some reading and am very nervous he may have Juvenile Renal Disease.  He tends to be very lethargic in the mornings, and very hyper in the late evenings.  A couple of people have also noticed that he drinks alot, especially compared with how much our other dog drank as a puppy.  He is a very happy puppy, and does not seem to be affected by it at all.  My vet has not been very helpful in explaining the situation and has left me very confused.  What would your recommendation be for how to progress?
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234713 tn?1283530259
The definitive diagnosis of kidney disease is determined by many factors, and not by just one elevation in a patients blood work, or by increased water drinking.

These factors include blood work and urinalysis abnormalities as follows:

1.  For blood: Increased Creatinine and increased  BUN (blood urea nitrogen) levels (early in the disease);  and increased phosphorus, potassium, and anemia, later in the course of the disease.

2.  For Urine: Dilute urine, usually with a low specific gravity, high protein in the urine, and, high urine microalbumin.

I think that you are taking about an elevated BUN in your puppies blood work.  Has a urinalysis been performed on your puppies urine?  

Other questions that your must answer about your puppy include: Was your puppy very difficult to house train, and have frequent accidents in the house?  Does your puppy dribble urine?  Does your puppy have not only increased water drinking but also urination?  Is your puppy often inappetant?

As I mentioned above BUN is only one parameter, and it would be worse if the Creatinine was also elevated, which it is not at this point.  

If you are worried that your puppy may be at risk for juvenile renal disease it would be best to frequently monitor your puppies blood work and urinalysis, have an abdominal ultrasound on your puppies kidney's performed, and begin feeding your puppy a very high quality protein food, (note that this is different than a high protein food), and give your puppy Omega 3 Fatty acids, Azodyl, Rehmannia 8, Vitamin C and Co-enzyme Q-10, B-12 and B Complex vitamin supplements.

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