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svanderkolff June 28th, 2018 09:26 AM

Elevated SDMA not sure what to do
We picked up our new dog a week ago from a rescue, she is a lab/husky mix, 5 yrs old. She was a pet for 3 years and then was sold to a breeder who got two litters from her over the course of 2 years. She seems to be well cared for and well adjusted. She was spayed immediately prior to our picking her up.
We took her to our vet just to have them check her out. They determined that she needed dental work and ordered a standard pre surgery bloodwork.
It came back with some abnormalities and now we are trying to figure out how bad this situation is.

Here is what the vet said:
1. Elevated SDMA and BUN, high normal Creatinine. These parameters relate to kidney function, and based on Ginger's levels she is in Stage 2 Kidney Disease. We can further assess the health and function of her kidney's by performing a complete urinalysis, which is $30 + tax if done at our clinic.

2. Elevated Potassium and low Na/K (Sodium/Potassium) ratio. These are the parameters that might possibly indicate adrenal dysfunction, or hypoadrenocorticism (Addison's Disease). We can further test for Addison's disease by testing Ginger's cortisol levels, which costs $64.92. If we contact the lab soon we may be able to run this on the blood sample they already have, or we may need to take another sample to send off. Alternatively, we can re-test Ginger's electrolyte values in 1-2 weeks to see if they are still abnormal.

3. Low free T4 (thyroid hormone). This result may indicate that Ginger is hypothyroid, or could be a result of the other changes we are seeing on bloodwork. Additional testing of other thyroid parameters would help us better assess Ginger's thyroid function. We are looking at roughly $100-200 for this depending on if we can add this on to the current lab sample or if we need to submit a new sample.

Glucose 6.0 3.5 - 6.3 mmol/L
IDEXX SDMA a 15 0 - 14 µg/dL H
Creatinine 130 44 - 133 µmol/L
Urea (BUN) 14.1 3.2 - 11.0 mmol/L H
Phosphorus 1.8 0.8 - 2.0 mmol/L
Calcium 2.80 2.20 - 2.80 mmol/L
Sodium 143 142 - 152 mmol/L
Potassium 5.8 4.0 - 5.4 mmol/L H
Na: K Ratio 25 28 - 37 L
Chloride 108 108 - 119 mmol/L
Total Protein 68 55 - 75 g/L
Albumin 28 27 - 39 g/L
Globulin 40 24 - 40 g/L
Albumin:Globulin Ratio 0.7 0.7 - 1.5
ALT 16 18 - 121 U/L L
AST 13 16 - 55 U/L L
ALP 26 5 - 160 U/L
Bilirubin - Total 2.2 0 - 5.13 µmol/L
Bilirubin -Conjugated 0.8 0 - 3.42 µmol/L
Cholesterol 14.3 3.4 - 8.9 mmol/L H
Amylase 394 337 - 1,469 U/L
Lipase 766 138 - 755 U/L H
Creatine Kinase 117 10 - 200 U/L

Sorry for the information overload but we are at a bit of a crossroads. We have had her for 2 weeks and she fits wonderfully with our family. On the other hand we really don't want to start this relationship knowing she will be gone in a year or two. Unfortunately there is also the financial aspect, her dental work is going to run around $1500, then the kidney tests and treatments on top of that, plus the original adoption fee. I have no problem paying all of this if we are going to have a family companion for the next 5 plus years but if its a short term relationship with heartbreak at the end, thats not a good thing. The breeder is more than willing to take her back and give her a comfortable home without treatments.

Your advice and insight would be very much appreciated.

Thanks for the help.

hazelrunpack June 29th, 2018 12:13 PM

This is a tough one, Steve. Every individual (both human and canine) is different and it's almost impossible to predict with any certainty how long it might take for a condition to progress. Your vet might be able to give you a little more idea of the prognosis and the possible costs, but it's going to have to be a personal decision. So sorry you're faced with such tough decisions right at the start.

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