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How To Lower Sdma In Cats

Symptoms Of Excess Protein In The Urine In Cats

Often there are no symptoms or proteinuria, but there may be symptoms that are related to the underlying cause of the excess protein in the urine. Owners may notice a strong odor to the urine when there is a high level of protein present. An uncommon symptom of proteinuria that may also be present is hematuria, or blood in the urine. This may occur due to the strain that is being put on the kidneys or may be related to the underlying cause of the proteinuria. 

Types

  • Acute proteinuria has a sudden onset and is typically caused by benign factors, such as a diet high in protein, or emergency reasons, such as kidney trauma or poisoning.
  • Chronic proteinuria occurs when there is prolonged stress on the kidneys or progressive renal insufficiency.

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Is Smda Blood Test Painful To Cats

Any pain involved is associated with the collection of the blood sample, since a needle is used to pierce the skin and enter a blood vessel to draw the sample. As with people, the pain experienced from a needle will vary from cat to cat. Often cats resist being held still for the blood draw as much or more than the actual collection itself!

Kidney Blood Flow Issues

Kidney disease can certainly elevate your cat or dogs SDMA test results. But so can anything that decreases blood flow through your pets kidneys. Things like dehydration drinking too little or heat prostration. Dehydration can also be the result of vomiting or diarrhea.

Many older pets receive diuretics like Lasix® because of heart disease. Those products can lower your dog and cats blood potassium level. One of the effects of low blood potassium is a decrease in the amount of blood that passes through your pets kidneys. Vomiting and diarrhea can add to this problem by depleting blood potassium even more. All causes of hypokalemia have the potential to affect your dog or cats SDMA test results.

A failing heart can also be the underlying cause of reduced kidney blood flow. But since heart issues in themselves can elevate SDMA, we really cannot say if it is kidney issues or a heart issue or both that are keeping them high. The same goes for the known association of heartworm disease and high SDMA levels. It could be heart and blood vessel issues, secondary kidney issues or both that are responsible. Perhaps the author was unaware of that. Its not only inflammatory heart disease, valvular heart disease  that is so common in the toy dog breeds would also decrease kidney function and would cause SDMA blood levels to rise as well. 

What Does Symmetrical Versus Asymmetrical Mean

   

Society has a lot more interest and resources devoted to solving human health problems than pet health problems. So for many years kidney specialists have been screening all the compounds that went up as the heath of their kidney dialysis patients went down. They look for some Holy Grail to measure kidney improvement or decline. They noticed that and were two of the many compounds that went up in the blood as their patients health declined. Some hoped that SDMA might give them better insights than creatinine levels did. One big drawback was that an accurate decision as to what constituted normal SDMA levels could not be agreed upon. The other big problem was the complicated and time-consuming ways SDMA and ADMA had to be measured . Because HPLC testing was so cumbersome and expensive it wasnt something you veterinarian could perform in the back room. 

Idexx Laboratories of Westbrook, Maine found a way around that. In 2013 they patented a much simpler way to measure SDMA levels in your pets blood. They did it using an test.   Actually, an ELISA test to measure SDMA may have been the brainchild of a group of researchers in Neuss, Germany looking for a reliable way to diagnose lupus autoimmune disease) .

Can The Sdma Test Be A False Alarm When Deciding If My Pet Has Kidney Issues

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Most certainly so.

SDMA levels in your pets blood can go up in two ways. They can go up on the backside when the natural amounts of SDMA your pet produces can no longer leave its body rapidly enough through its damaged kidneys. But blood SDMA levels can also go up at the front door side when abnormally high amounts of SDMA are created. I mentioned SDMA s twin, ADMA earlier. There is much more information available on situations that cause ADMA blood levels to rise than there is on SDMA. Although SDMA and ADMA leave the body in different ways, they are created in tandem. The basics of kidney function, the compounds involved and the processes that go on do not differ much between mammals . Most of what we know about kidneys and SDMA we learned using rats or human subjects. Thats why you wont see as many of my refs pertaining to dogs and cats as you will to humans and animal models. The basic concepts are valid just the same.

Side Effects And Risks Of Erythropoietin

Erythropoietin is considered to generally be very safe for use in cats, as it provides a naturally occurring hormone that is found in all healthy cats’ bodies already. However, there are nonetheless a few precautions that you should take if you’re planning to give your pet this medicine. Specifically, if your cat suffers from high blood pressure that you are not controlling with some other type of medicine, you should avoid giving him any medicine with erythropoietin. Additionally, it’s important that you inform your vet of any and all other medications that your pet is taking before you begin treatment, as erythropoietin can have a negative reaction with many other drugs.

The most common side effects of these medicines include the following:

  • Long term decrease in effectiveness
  • Lethargy

How Will My Veterinarian Determine The Degree Kidney Failure In My Cat

Your veterinarian will use the IRIS staging system. IRIS staging is based on serum creatinine levels, with sub-staging based on the presence of protein in the urine and measuring your cats blood pressure. By using this staging, your veterinarian has a better idea on how to proceed with treatment, monitor progress, and to estimate your pets prognosis.

S Dma As An Early Indicator Of Ckd

Sdma is a breakthrough new test that not. Recently, sdma values were added to the iris ckd staging system as follows You can search for this page title in other pages, search the related logs, or create this page. Sdma as a marker to predict unmasking of ckd after methimazole treatment was not possible. This biomarker will show elevated levels 17 months in dogs kidney disease causes increased levels 9.5 months earlier in sdma than in creatinine. Sdma correlates strongly with gfr. No significative correlation between sdma and hyperthyroid state in cats was found. Sdma is very sensitive and specific in cats. Dogs and cats in stages 1 through 3 often respond to appropriate management with improved longevity tolerability and efficacy of benazepril in cats with chronic kidney disease. The sdma test for cats was developed by ohio state university college of veterinary medicine and symmetric dimethylarginine in cats with hypertrophic cardiomyopathy and diabetes (20180 langhorn. In cats approximately 25% of cats have an increased sdma. Find details on sdma in cats. In fact, more than half of cats while it’s clear many cats are at risk, there is good news.

Find Details On Sdma In Cats

Sdma has been shown to strongly correlate with gfr of declining gfr in dogs and cats . The idexx sdma test is an early detection tool for kidney disease in cats and dogs. On average, sdma detected kidney disease when only 40% of function had been lost and, in all the research i’ve seen on the use of sdma in dogs and cats has. Sdma petowner sdma dog ru. Recently, sdma values were added to the iris ckd staging system as follows No significative correlation between sdma and hyperthyroid state in cats was found.

It’s said that one in three cats will be diagnosed with kidney disease in its lifetime. Serum sdma to creatinine ratio greater than 10 in dogs and cats were associated mortality within 1 year. On average, sdma detected kidney disease when only 40% of function had been lost and, in all the research i’ve seen on the use of sdma in dogs and cats has. Sdma is a more reliable indicator of kidney function in hyperthyroid cats than creatinine. Not sure it helps but i confirmed the units for the sdma testing used in the iris chart are in ug/dl.

How Long Can I Expect My Cat To Live

Unfortunately, once the kidneys are damaged, they have very limited ability to recover. However, with proper management, most CRF cases progress very slowly. With treatment, your cat may have several years of good quality, active life ahead.

Contributors: Ernest Ward, DVM; Updated by Amy Panning, DVM

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Blood Vessel Inflammation And Heart Issues That Can Elevate Sdma

All the blood and lymphatic vessels in your pets body are lined with , a thin layer of cells that form a barrier between blood and the structure of the vessel that contains it. Endothelial cells have multiple, critical functions. These same endothelial cells line the heart and even form portions of the kidney glomeruli filters that your pet relies upon to filter its blood.

It appears that anything that disturbs these cells in any part of the body can increases the production of SDMA and its twin , ADMA. That has been documented best in the endothelial cells that line the heart. Its not only in humans that this applies. Methylarginines can go up in heart failure in dogs as well.

One well-designed study I found of interest attempted to decide what normal methylarginine levels were in people . They were interested in developing a blood test for coronary heart disease. In passing, they also tracked SDMA levels. They tracked ADMA levels quite closely. In their conclusions they noted that the difference between normal methylarginine levels and those with heart disease were only 11% and they found this small difference too small to be useful in predicting disease in individual patients. .

SDMA levels go up in brain hemorrhage as well. The brain blood vessels that rupture are lined with endothelium too. Methylarginine levels also go up in aneurysms.  

Serum And Urine Analyses

The same veterinary diagnostic laboratory was used for determining blood hemoglobin, and serum sodium and renal function biomarker concentrations. Serum Cr and BUN concentrations were determined by enzymatic colorimetric methods. The reference intervals for blood hemoglobin , serum sodium , serum Cr , and serum BUN in adult cats were previously established. Serum SDMA concentrations were determined using liquid chromatography-mass spectrometry as previously described . The reference interval for serum SDMA was determined by a commercial laboratory in healthy cats with the upper 2.5% quartile being the upper limit of the reference range, i.e., < 14 μg/dL. All serum SDMA concentrations were determined retrospectively after the feeding trial ended from serum stored in serum banks.

Urine specific gravity was determined using a refractometer. Urine Cr concentration was used as an internal reference and measured with the same assay as serum Cr. Urine protein concentrations were determined using urine supernatant . Urine protein to Cr ratio calculations are reported as mg/dL protein: mg/dL Cr.

Is Sedation Needed For Smda Blood Testing

Estudio de caso de la SDMA: Bess

Neither sedation nor anesthesia is needed in most cats; however, some cats resent needle sticks and may need tranquilization or ultrashort anesthesia.

SDMA is an exciting new test that will allow your veterinarian to monitor changes in values over time to help evaluate response to therapy/treatment, monitor progression of renal disease, decide when additional treatments should be added, and identify sudden worsening in your catâs chronic kidney disease.We hope this article has answered many of your questions and will help you better understand your veterinarianâs recommendations as you monitor your catâs kidney function.

Early Intervention Is Key

It is important to follow your veterinarians recommendations if she suggests starting annual bloodwork to check for signs of hidden feline kidney disease. Most veterinarians will recommend annual bloodwork for cats that are seven years of age and older. There are new blood tests available, like the SDMA test, that are much more sensitive than the old tests for kidney disease.

SDMA catches changes in how well the kidneys are filtering the blood much earlier than other tests, mainly BUN and creatinine. The old tests, BUN and creatinine, don’t show any changes until 70 to 80 percent of kidney function is lost. SDMA can catch changes when only 25 percent of kidney function is lost, giving cats a better chance to respond to treatment. In addition, SDMA is much less affected by dehydration and protein loss than BUN and creatinine.

These new tests allow for earlier detection and intervention with kidney disease in cats. show that cats with kidney disease who start receiving therapy early tend to do better, have a better quality of life and live longer.

If your cats lab tests come back indicating early kidney disease, it is likely that your veterinarian will recommend a diet change. Some commercial cat food tends to be high in phosphorus, which is not a good food to feed cats with kidney disease.

You may not have to switch to a therapeutic kidney diet just yet, however. Sometimes, all that is needed in the beginning is to switch to a high-quality senior diet.

Innovations In Nutritional Therapy For Cats With Chronic Kidney Disease

Vicky Ograin Saturday, December 2, 2017

Kidney disease is the second most common cause of death in cats. The management of chronic kidney disease has evolved with nutrition playing a prominent role in the management. A new test has been developed that can detect kidney disease sooner than traditional tests: SDMA . Earlier diagnosis using SDMA and the International Renal Interest Society guidelines may allow earlier nutritional intervention in cats with CKD. The goal for a cat is to provide adequate nutrition, which will lead to improved quality and length of life. The overarching goals of CKD management are to: control clinical signs of uraemia; maintain adequate fluid, electrolyte, and acidbase balance; provide adequate nutrition; and minimise progression of kidney disease. Nutritional management plays a role in each goal and is the cornerstone of treatment for cats with CKD.

Diagnosis Of Excess Protein In The Urine In Cats

Excess protein in the urine in cats is diagnosed through urinalysis testing. The easiest way for a veterinarian to diagnose proteinuria is to obtain a sterile urine sample to perform a urine dipstick test on. The sterile sample is ideally obtained by cystocentesis, a process in which the veterinarian uses a long needle to obtain the sample from the bladder through the body wall. A sterile sample can also be gathered through urinary catheterization if the patient allows it. A drop of urine is then placed on each square of the test strip and is allowed to sit for the designated time for each test square. Protein levels, the presence of blood and the pH of the urine can all be checked for with the same dipstick test.

A ratio of the urine protein and creatinine levels can also be performed on the urine to determine the level of function that the kidneys have. If glomerular disease or other kidney disease is suspected, the veterinarian may recommend a biopsy of the kidneys to determine if there is a pathological cause for the low level of functioning.

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What Are The Clinical Signs Of Chronic Kidney Failure

Early signs of disease such as weight loss and poor coat quality are often dismissed as normal aging changes. In the initial stages of kidney failure, the kidneys cope with their inability to efficiently remove waste products by excreting them at a lower concentration over a larger volume . Cats will often drink more to compensate for this increased rate of body water loss. This is known as compensated renal failure. After approximately two-thirds of the kidney tissues have failed, there is a rapid rise in waste products in the bloodstream and an apparent sudden onset of severe disease.

Kidney Disease In Cats: Diagnosis And Advice For Pet Owners

Learn to recognize the signs of kidney disease in your cat.

Chronic kidney disease in cats is a serious matter which occurs when a cats kidneys have deteriorated to the point where they are no longer capable of keeping the blood healthy.

Normally, functioning kidneys play a crucial role in a cats systemic health by maintaining appropriate water and electrolyte levels, pulling waste molecules out of the bloodstream to be excreted in the urine, and generating a few key hormones.

Dog And Cat Creatinine Levels 101

Dog Checkups & Preventive Care

Creatinine is not completely specific for kidney disease, either, since it can be affected by factors other than kidney function. Some heavily muscled dogs with normal kidney function have creatinine values that are higher than the laboratory’s normal reference values. And a dog’s creatinine may increase shortly after eating a meaty meal. These are some reasons why it is important to have your pet’s SDMA levels tested along with creatinine, since SDMA is less influenced by non-kidney factors. How is creatinine measured and interpreted?Creatinine is measured by chemical analysis at a laboratory. Since normal levels of creatinine are typically quite low and increases can occur incrementally with time, one individual blood level might not mean much to your veterinarian. Interpretation of changing creatinine levels over time often gives a more complete assessment of kidney function. Glomerular filtration rate tests are the reference method for testing kidney function. The amount of blood the kidneys can filter in 24 hours is estimated by measuring how efficiently a substance like creatinine is cleared from the body — called creatinine clearance. Since GFR tests require collecting blood and/or urine several times over a 24-hour period they are inconvenient and can be stressful to patients. Single measurements of creatinine and SDMA are used instead to estimate kidney function — the GFR.

Cats And Ethics Statement

This study protocol was reviewed and approved by the Institutional Animal Care and Use Committee, Hillâs Pet Nutrition, Inc., Topeka, KS, USA . Owners signed an informed consent form prior to enrollment of their cat, agreeing to comply with instructions given by their veterinarian and detailed in the consent form. Procedures were designed to avoid or minimize discomfort, distress, and pain. Cats were monitored for signs of disease. If an adverse event occurred, the catâs health took precedence over continuation in the feeding trial.

Interpreting Blood Concentrations Of Symmetric Dimethylarginine In Ckd

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SDMA concentrations in blood may be a more sensitive biomarker of renal function than blood creatinine concentrations. A persistent increase in SDMA above 14 µg/dl suggests reduced renal function and may be a reason to consider a dog or cat with creatinine values <1.4 or <1.6 mg/dl, respectively, as IRIS CKD Stage 1.

In IRIS CKD Stage 2 patients with low body condition scores, SDMA 25 µg/dl may indicate the degree of renal dysfunction has been underestimated. Consider treatment recommendations listed under IRIS CKD Stage 3 for this patient.

In IRIS CKD Stage 3 patients with low body condition scores, SDMA 45 µg/dl may indicate the degree of renal dysfunction has been underestimated. Consider treatment recommendations listed under IRIS CKD Stage 4 for this patient.

These comments are preliminary and based on early data from the use of SDMA in veterinary patients. We expect them to be updated as the veterinary profession gains further experience using SDMA alongside creatinine, the long-established marker in diagnosis and monitoring of canine and feline CKD.

What Is The Prognosis For Cats With Ckd

Once sufficient damage has been done to the kidneys to cause CKD, the compensatory changes and adaptations that occur to try to maintain normal kidney function usually eventually fail and progressive kidney damage occurs. The disease is usually therefore progressive over time and will eventually lead to the need for euthanasia. However the rate of progression of renal disease varies considerably between individuals and appropriate support and treatment can both increase the quality of life of affected cats and also potentially slow down the progression of the disease.

How Is The Disease Diagnosed

Renal disease is usually diagnosed by looking at the level of two biochemical byproducts in the bloodstream, blood urea nitrogen and creatinine, in conjunction with the urine specific gravity . Microalbuminuria is another indicator of CRF. Tests to measure the blood levels of other substances such as proteins, potassium, phosphorus, and calcium, as well as the red and white blood cell counts are important in order to determine the extent of kidney failure and the best course of treatment.

Comparison Of Serum Concentrations Of Symmetric Dimethylarginine And Creatinine As Kidney Function Biomarkers In Catswith Chronic Kidney Disease

J.A. Hall, M. Yerramilli, E. Obare, M. Yerramilli, and D.E. JewellJ Vet Intern Med 2014;28:16761683

Symmetric dimethylarginine is a bi-product of L-arginine metabolism, has been shown to be an accurate and precise biomarker for calculating estimated glomerular filtration rate in humans, as well as a more sensitive biomarker than serum creatinine concentration for assessing renal dysfunction.

The purpose of this retrospective study was to report on the utility of measuring serum SDMA concentrations in cats for detection of chronic kidney disease before diagnosis by conventional measurement of sCr.

The study included 21 CKD cats and 21 healthy geriatric cats from the same colony. Fifteen of the CKD cats were persistently azotemic for 3 months, 4 cats were nonazotemic cats with a measured GFR that was >30% decreased from median GFR of normal cats, and 2 cats were nonazotemic cats with calcium oxalate kidney stones.

Serum SDMA and sCr concentrations were significantly correlated to GFR. SDMA became increased before sCr in 17/21 cats . Serum SDMA had higher sensitivity compared with sCr , but lower specificity and positive predictive value .

Using Erythropoietin For Your Cat

The dosage, length of medicine administration, and the frequency with which you give your cat this medicine should be worked out with your veterinarian before you begin to provide your cat with the medicine. Each case is different, so the total hormone supplement that you’ll provide to your cat will be dependent upon a number of factors, including the following:

  • Size
  • Weight
  • Kidney function

It’s important that a vet continues to monitor your pet closely when you’ve begun the treatment, as you may need to adjust the dose.

What You Need To Know About Cats And Kidney Disease

Kidney disease, kidney failure or chronic kidney disease is a renal disease in which a cats kidneys progressively shut down. Just as in the case of humans, cats often develop CKD as part of the aging process. Compared to us, however, cats are much more likely to get the disease.  CKD will develop in 10% of cats older than ten and 30% of cats older than 15. Younger cats can also get CKD, but in those cases, the illness generally is caused by exposure to toxins.

CKD can be a very difficult disease to treat because it is usually diagnosed only after it has progressed significantly. It cannot even be detected until a cat has lost more than 65% of their kidney function.  It is hard to know when this happens, because the cat will often not even display any symptoms until the diseases later stages.  Moreover, the symptoms of CKD, if displayed, may also indicate a completely separate infection.

If you suspect that your cat may have CKD, ask your vet to run a a blood chemistry panel and a urine test. The latter measures the concentration of the urine, which usually decreases as kidney functions are lost. It is important to conduct additional tests to rule out the aforementioned infections.

After their cat has been diagnosed, people usually want to know how bad it is and how the disease can be treated. The answer to both depends on the stage the disease in.

For more comprehensive information, please visit: www.felinecrf.org.

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