Hello, my 14-year-old female dog Spirit had to have several teeth removed in July and when they did the pre-op bloodwork, she had some values that were out-of-whack, and a bit confusing to read. Her SDMA was in the normal range, but her creatinine and BUN were both elevated. The vet thought these results were weird, but thought that the massive infection she had in her mouth might have contributed to the results, so he gave me antibiotics and recommended to come back in 2 months to recheck.
I just got the results of her recheck, and though the SMDA is still normal, her Creatinine and BUN are also still elevated (but stable). I've included her test results below, with the current readings on the LEFT and her July readings on the RIGHT:
BUN 69 July: 73
Creatinine 3.0 July: 3.1
IDEXX SDMA 13 July: 13
BUN:Creatinine Ratio 23.0 July 23.5
Phosphorus 5.3 July: 5.5
Calcium 10.4 July: 10.1
Sodium 151 July: 148
Potassium 5.4 July: 5.1
Here were a few other stats that were off during both panels:
RBC 5.26 July: 5.15
ALP 198 July: 169
Amylase 1,531 July; 1,528
Chloride 121 July: 122
Everything else was in normal range. She had her T4 checked both times and it went from 1.1 in July to 1.0 in October.
Her urinalysis had a gravity of 1.018 both months. A trace amount of protein was found, but no number indicated. Trace amount of blood was found in October (not July), but no number to indicate how much.
In July, she was sucking down water like there was no tomorrow and she had a few accidents in the house. Over the course of her surgery recovery and and administering of antibiotics, she hasn't had anymore accidents and has been drinking normal amounts of water. Beyond that, she has been completely asymptomatic - she doesn't act or seem sick at all.
I got the results via email and when I called to talk to the vet, she had left for the day but will be back tomorrow. In the meantime, I've been trying to figure out what stage she would be in, but none of the tables seem to take into account having a normal SDMA.
I also plan on getting referred to a specialist.
My questions in the meantime are:
What stage would this be considered? It seems she is straddling 2 and 3?
Are there any reasons why her SDMA would be normal but creatinine and BUN not? The vet said the SDMA test is supposed to be more sensitive and reveal kidney issues when as little as 25-40% of the kidney has been damaged, but that the elevated Bun/creatinine usually indicates that 70-80% of the kidney has been compromised? The FAQ from the idexx SDMA test even says that these types of incongruous results are unusual.
Could her kidneys have been injured in an acute attack back in July when she was having issues, and now she has permanent damage as opposed to something that is progressive? (Because her results stayed stable, even though no changes or interventions were made to make her situation better - we thought it would clear up when her infection did)
With what looks like her pancreas and possibly other organs also at least slightly affected, could this be something else - like cancer? Or Addison's?
I see conflicting information about whether low-protein diets are really effective, and at what stage/point they are effective vs. potentially accelerating the disease. With these kinds of numbers, what sorts of tests and/or interventions should I consider asking my vet about?
Anyways, I've been reading a few people's stories and saw some of the great support and advice that people were getting here. I hope someone might be able to chime in on my questions. Thank you. ~ Sam