Diagnosing, Staging, and Treating Chronic Kidney Disease in Dog and Cats
Diagnosing, Staging, and Treating Chronic Kidney Disease in Dog and Cats
Diagnosing, Staging, and Treating Chronic Kidney Disease in Dog and Cats
Creatinine
Creatinine
increasing within the SDMA
reference interval
plus
Jun ’11 Jun ’12 Jun ’13
Results of both tests should be interpreted
in light of patient’s hydration status.
Creatinine in µmol/L
≥25
Consider understaged
based on creatinine
≥45
UPC ratio
Canine Nonproteinuric <0.2 Borderline proteinuric 0.2 - 0.5 Proteinuric >0.5
Substage
based on
proteinuria
Feline Nonproteinuric <0.2 Borderline proteinuric 0.2 - 0.4 Proteinuric >0.4
Systolic blood
pressure in mm Hg Normotensive <150 Borderline hypertensive 150 - 159
Treatment Investigate for and treat Same as Stage 1 Same as Stage 2 Same as Stage 3
recommendation underlying disease
Kidney therapeutic diet Keep phosphorus Keep phosphorus
Treat hypertension if <1.60 mmol/L <1.90 mmol/L
Treat hypokalemia in cats
systolic blood pressure
Treat anemia (PCV <25% Consider feeding tube for
persistently >160 mmHg Treat metabolic acidosis
in dogs; PCV <20% in cats) nutritional and hydration
or evidence of end-organ
If SDMA ≥ 25, support and for ease of
damage
consider medicating
Treat persistent proteinuria treatment for Stage 3
with therapeutic diet and
Treat vomiting /
medication
inappetence / nausea
Consider treatment of UPC >0.5 in dogs;
next stage. Creatinine may UPC >0.4 in cats Consider subcutaneous
underestimate degree of
and/or enteral fluids to
kidney dysfunction in Keep phosphorus
patients with poor muscle maintain hydration
<1.50 mmol/L
mass
If required, use kidney Consider calcitriol therapy
therapeutic diet in dogs
+/– phosphate binder
If SDMA ≥ 45, consider
Use with caution treatment for Stage 4
potentially nephrotoxic
drugs