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Chronic Kidney Failure in Dogs Community
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9644933 tn?1407772490

Urine Gravity

I have a double merle Aussie which I rescued at the age of 4 months. She is now 4. She is deaf and has impaired vision. Since 6 months she has also had seizures. They are sporadic, occurring on average once every 3 months. She has also been dealing with a vulva issue (discharge, red ulcered skin since October of 2013 that after SEVERAL vet visits never seemed to clear (development on this below)

I apologize for this long post but want to include some history, feel free to jump to a recap on the bottom of this post

Up until May she has been a healthy happy dog despite her challenges. Mid-May I requested some blood work and a urine analysis as something just wasn't quite right with her, but I could not put my finger on it as signs would come and go (inapetance, loose stools, laziness). At that time all of her work was normal aside from an elevated ALT of 235. Her specific gravity at this time was 1.050 (first morning urine, free catch). Two weeks later (May 31st) I was back in the office as she was vomiting, refused to eat, lose weight, stools were still loose and she would tremble. At this point blood work showed ALP of 202, TBIL of 11 and ALT of 1392. At this time her specific urine gravity was 1.005 (mid-day, free catch). I rushed her from my regular vet to a DMV medical center with 24 hour care where she was on IV for 72 hours and an ultrasound was performed. Despite the time on IV her blood levels never dropped. The ultrasound showed no signs of a shunt or tumor but they did advise her liver was very small and abnormal in shape. The finding on her kidneys were that they appeared normal. The specialist said that he felt we were dealing with a chronic liver disease which would result in failure. I made the decision to bring my dog home as I did not see the point of her spending any more time there. He advised me with her levels and no improvement, I probably had 2 days and he sent me home with a small supply of a nausea meds and a probiotic. That was on June 2nd and today she is still with me :) It took a lot of research and work on ways to help her, but we made it.

I brought her back to the DMV after initially brining her home for further exams on her vulva to see if they could determine the issue. They took a culture and prescribed Baytril to treat a susceptible infection. Blood work at this time showed minimal changes in value and no urine sample was tested. I was advised at this time that the Baytril may help her liver in the event the trouble was due to an infection.

July 2nd I brought her back to the DMV for a follow up on her vulva and for blood work. The vulva discharge cleared but the skin condition remained the same, additional crusted lesions also began to form, as well as one non crusted on her anus and 3 or 4 non crusted on her lips. Her coat was also noticeably dry. Blood work came back fantastic aside from the ALT being 234 all else was normal. Her specific gravity came back at 1.011 (first morning urine, free catch). We made an appointment for a dermatologist appointment and a biopsy of the skin on her vulva and lesions. We were encouraged to continue the Baytril to ensure that if there was a liver infection, that it clears.

July 17th we went to the DMV for a Bile Acid test for liver function. They came back normal.

July 24th, was the biopsy date. No urine work was done but her blood work came back normal! We were encouraged to stay on the Baytril until end of August to ensure the infection would be completely cleared. The result of the biopsy stated that Discoid Lupus was suspected as the issue affecting the vulva. This could also be the cause of the other lesions but they were also not ruling out the fact it could be a reaction to the Baytril as they began around the same time.

August 5th I went for a meeting with my regular vet who will now retake Bella's case. I requested a urine gravity test. Result was 1.016 (first morning, free catch).

Kidney Questions:

I know that most of my dogs history appears with Liver and Dermo issues. I felt the need to include it in case it gives off other indications. The specific urine gravity results however do worry me that I could be looking at Kidney troubles as well and wanted advice or thoughts on the matter. All her blood work that related to the kidneys as well as the other urine values are normal. The ultrasound also did not show any abnormalities. It is the specific gravity that remains low.

Mid- May: 1.050 (morning, free catch)
May 31st: 1.005 (mid-day, free catch)
July 2nd: 1.011 (morning, free catch)
August 5t: 1.016(morning, free catch)

I have read that Liver enzymes being elevated can cause low gravity but those have been cleared up now (fingers crossed that stays). Her appetite is back and she is on a homemade diet of hard boiled eggs, ground turkey, fresh cod, sweet potatoes, barley, carrots, spinach, broccoli, zucchini and pumpkin. She eats 3 cups of this mix per day. I include with each one cup, 1/4 digestive enzyme, 1 teaspoon of a nutrient supplement for homemade diets, 1 teaspoon of Metamucil (she was having constipation troubles) and I add about 3/4 cup of water to each cup of food to breakdown the Metamucil. She then daily also is on 2 tabs of denolsy, 2 teaspoons of liver tone (milk thistle, dandelion roots etc.) and 2.5 teaspoons of an omega blend for her skin and coat. Her energy level is normal and her stools are consistent. I put Otomax (ointment) on her vulva which has really improved. She still has the lesions including the ones on her lips.

She urinates 3 times a day. Once in the morning, evening and then before bed. She urinates for about 12 seconds each time (I know I am crazy to count it, but it gives me a gauge if I am asked). Her water intake is essentially all given through her food as she rarely drinks from the water bowl (which is always clean, fresh and available). She also eats watermelon, cantaloupe and blueberries for treats which I know are high in water content. She has no accidents in the house, no incontinence and does not ask for the door aside from our routine

My vet at this time says that she is not too concerned about the gravity measurement since the rest of all results are normal and her condition otherwise is great. She states that a high water consumption can cause the urine to be more dilute. She also states though we will look at this monthly alongside blood work.

I am still worried though. I was told by another vet at the same office to not worry about the initial ALT elevation either and within two weeks was in survival mode with my dog receiving 24 hour care. I also don't feel her water intake would be high enough to cause a first morning urine to have such a low gravity. She would generally last receive the water in her food around 6:30 PM and would urinate between then and the first morning urine catch around 7:00 AM.

She is still on Baytril and an Otomax ointment on her vulva

We have another appointment for blood work and urine test the week of August 25th.

Would anyone have any insight as to why this reading is now consistently low? Is she really in taking too much water in her food? Could the antibiotic cause this low reading? If it was something serious would other values not also be out of a regular range? Can the low gravity tell anything on its own? Is this usually the first sign of worse to come?

I really am sorry for the long post. My dog and I have just been through so much and she seems so much better that I don't want to miss anything and be as prepared as possible. I will accept any advice, insight, suggestions and even sharing your own story to see if there are any connections. THANK YOU!
8 Responses
1916673 tn?1420236870
Hi. Well, we can't say you skimped on detail - which is great, because all too often people don't give that level of detail when asking about things. Firstly, I am a little concerned about the volume of vegetables being given. While all the veg you have listed are fine for dogs, they should only be given in relatively small amounts. Dogs really don't need vegetables, other than for some of the vitamins they provide. A dog needs meat - and other than the ground turkey (not really meat but poultry) - there may be a lacking of essential fats, which are so important to dogs. I also think you are probably giving too many eggs - as this seems to be a part of the daily mainly vegetable diet, which is not particularly good for a canine digestive system.

But on to your main question ... the low gravity urine result. The normal result should be between 1.015 and 1.060. This puts your dog within acceptable normal values. A dog with liver and kidney issues may struggle to maintain this kind of reading, so providing it remains within the level above, you have nothing to get concerned about. The specific gravity of urine also goes up and down depending on very many ailments and daily routines, such going up due to dehydration but then falling again once a dog drinks water to combat the dehydration. The reason vets tend to ask for an early morning urine sample is because this is the time when the highest specific gravity result is likely to be disclosed.

If the low-end of normal result continues over let's say the next two monthly reading, then there may be a liver or kidney concern, and more so if the level falls further below the normal end. In addition to the infection you have already mentioned (which will almost certainly have caused a low urine sp gravity readiong), there is also the possibility of excessively high calcium readings, which can also send the urine sp gravity low. However, as your vet has performed a blood sample, and as that sample came back with normal values, I am assuming they checked the calcium levels within that test. It is extremely unlikely the urine sp gravity would be abnormally low (suggesting liver and/or kidney issues) while the remaining blood levels (albumin, bile acids,cholesterol and liver enzyme tests, ALT, AST, AP, bilirubin), remain normal. Overactive Adrenal glands (Cushing’s disease, hyperadrenocorticism) or corticosteroid medications often cause low specific gravity urine in dogs, but I realise your vet has already probably checked for this and has discounted it. Diabetes insipidus, a rare form of diabetes, will also cause pets to produce a urine with low specific gravity. This disease is usually due to a failure of your pet’s pituitary gland to produce the hormone ADH. I suspect you would already have seen other suspicious symptoms before now though, so I doubt this is a cause of the lower-end sp gravity.

In short, other than a diet that is largely inappropriate (unless there are associated allergies you haven't mentioned), I can't imagine you have a serious problem - yet. It is certainly worth continuing with the monthly urine tests to see if the specific gravity level works its way upwards or further downwards. If the results continue downwards, then there would be reasons for concern.

Tony
9644933 tn?1407772490
Thank you greatly for the reply. I appreaciate the details.

Thank you for the concerns on her diet. Despite my detailed post I missed that element and for that I do apologize. I will confirm those additional details here.

This is a diet that was supplied by the DMV as (hopefully) a temporary measure. Once the Baytril regime has ceased and we can confirm that blood work remains consistent, she will be switched back to a much more protein enriched and canine nutritionally balanced diet. Right now she is on a diet that was created by the specialist using Balance IT (https://secure.balanceit.com/), taking into consideration a possible Hepatic disease. It was produced on a daily calorie requirement of approximately 1100 calories 22% of which come from protein, 25% fat calories, 53% carbohydrates. Another item I failed to mention is that dependednt on which of the two recipies I was given, either canola oil or corn oil is added.

This is to be reavaluated as soon as possible.

That being said, I will ask for some more of your expertise/experience. Is there a specific direction of a diet you would suggest? She is approx 26kg and the only confirmed conditions we do know of is the small liver as well as the highly suspected autoimmune disease of Discoid Lupus. Commercially prepared food can be so "iffy". Is there a brand or company you would trust more than others? I am also willing to cook for her myself.

My intention is to not keep her on her current diet long term unless the end result is that it is what is best to support her liver.

Thank you for hosting this forum and being so kind to share what you know with myself an others.  

1916673 tn?1420236870
Hi. Thanks for replying in detail again. That makes much more sense now. I'm not entirely convinced that diet creates a 25% fat source though - maybe your person at Balance IT has given more details about it. Also, although there is some truth in dogs needing a good balance of omega 3 and omega 6 acids (the first is provided by canola oil and the omega 6 by corn oil), omega-6 is something to be very wary of - it has been linked to some bad effects in dogs, so I would limit this, unless the mix of omega 3 and omega 6 is done very carefully . It is worth noting the same process happens with eggs, which contain both omega 3 and omega 6 - but the natural mix in commercially produced eggs is a bad one, making it unbalanced. If you can, buy organic eggs or so-called omega-3 eggs, which are much more like eggs used to be many years ago - more natural and more fatty acid balanced. Although omega-6 is meant to help manage Discoid Lupus dogs, there is no point solving one ailment and (in doing so) starting another in its place.

One very worthwhile form of treatment is to try coconut oil. A worsd of caution, the coconut oil needs to be PURE 100% COCONUT OIL with nothing added to it. Half a teaspoon a day added to food is advantageous (any more and you risk causing diarrhoea) - it can also safely be applied externally as well as a form of topical cream (just melt the coconut oil in some warm water and rub it on).

Grains are said to be one real problem with Discoid Lupus, so make sure all foods are grain free - including any treats you might feed. Most dogs are allergic to corn, to a greater or lesser degree, so corn in dog foods or treats is a definite no-no.

Wild game meats are said to be very healthy for Diuscoid Lupus, but getting it might be a problem. You might look around the internet and see what you might find or check locally. Alternatively, I would suggest any all natural meats for ongoing control (once things have settled down under your current regime). I favour blocks of all-natural meats (including chicken, rabbit, lamb, white fish and green tripe), which you may be able to find in a good pet store. These need cooking and then mixing with a grain free mixer of your choice.

Hope this helps.

Tony
9644933 tn?1407772490

Hello Tony,

Thank you again for your reply. I will be bringing all this information forward at her next visit when hopefully we can re-structure her diet, hopefully following good blood work once again.

I will be monitoring her closely and keeping an eye on the urine gravity results as well as the blood values that relate to the kidneys. If there is anything I want to catch it as soon as possible, possibly even before other symptoms arise so I can try and support her best I can.

As wonderful as this interaction with you has been, I hope not to need to be back too soon.

All the best to you and all of the fur babes you are helping.

Cynthia
1916673 tn?1420236870
Hi ... and I too hope you won't need to be back, but you are very welcome to join in discussions, because the experience and knowledge gained during this period may just be helpful to someone else. We are really just one huge self-help group here.

Anyway, just wanted to add that the earliest sign of kidney disease or kidney failure is actually seen through changes in the urine, and that can appear sometimes many months and even a year or two before other symptoms begin to become more obvious. This is an extract from my article on diet and kidney failure ...

"High levels of urea, protein products, and amino acids in the blood are the primary symptoms of uremia. Consequently, the outflow of urine becomes obstructed and fluid regulation becomes imbalanced, causing an increase in body toxins. Interestingly, it is possible to detect some of these changes during the early development of chronic kidney failure by undertaking a simple urine test. Conscientious owners can routinely test their dog's urine for protein and other relevant changes using widely available test strips."

The rest of the article can be found here:

http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease

Hope that helps and good luck with your next vet appointment.

Tony
9214378 tn?1408885184
I read thru Bella's story. What a beautiful girl!

Her issue is complicated, but I believe, whenever possible "less is more". I say this as finding  answers to my Darbie's woes spun into chaos. I had to step back and allow Darbie to tell me. Leap of Faith, Oh Yes...

I wish you great hope in finding your answer. As I have said to friends on these forums, it is trial by fire. I'm sure Bella will respond with your TLC and careful diet.

Fondly,
Lynne and Darbie
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