“Biscuit” the Golden Retriever Mix

June/ July 2011

(Kidney failure, Glomerulonephritis and Nephrotic Syndrome)

Biscuit is one of our employee’s dogs. Her owner brought her in because she all of a sudden didn’t want to climb up onto the couch one day after playing soccer with the kids.  Her owners noticed she had been drinking a lot of water and was letting go of her bladder while she was sleeping for about two months. Dr. Catherine Stuart noticed that Biscuit had a bit of “edema” on the bottom of her chest. Edema is a collection of fluid beneath the skin. 

            We took a sample of Biscuit’s urine and discovered it was very dilute (weak) and also high in protein. These results made the doctors want to run a blood test. The results of the blood test showed us Biscuit’s main problem; stage 3 kidney failure and a more pressing diagnosis; glomerulonephritis. This is very unusual because she is only 4 ½ years old!

            Glomerulonephritis is when the kidneys filter out protein that’s supposed to stay in the blood. The disease got its name from the “glomerulus” (the thousands of tiny filters that allow the kidney to take out toxins in the blood) and “itis” is the suffix that means inflammation. In this case the glomerulus is not doing its job properly because of inflammatory cells that have stuck themselves to it. These cells cause damage to the tubules in the glomerulus and make holes where protein molecules can escape the blood through. The protein is then filtered into the urine which is one of the ways Biscuit’s disease was diagnosed. 

            The other ways Dr. Stuart diagnosed Glomerulonephritis was to rule out a bladder or kidney infection that might falsely be elevating the protein levels in the urine and by looking at Biscuit’s protein:creatinine ratio. This ratio tells us how much protein is actually being lost from the blood (it is a very good thing to keep an eye on especially because it is not affected by how much water the patient is drinking). Biscuit was bladder/kidney infection free so we ran a protein:creatinine ratio.

            The normal ratio is 0-0.2 in dogs. Biscuit’s level was 6.8! This elevated ratio tells us that Biscuit has developed a complication of glomerulonephritis, an extreme urine protein loss called “nephrotic syndrome”. High blood pressure, forming abnormal blood clots and edema are symptoms of nephrotic syndrome, all of which Biscuit has.

            Biscuit’s treatments include the Fortekor to help control her blood pressure (it went from 210 mmHG to 120 mmHG, normal being 90-170 mmHG), and a renal (kidney) diet that is low in sodium and protein (high protein diets can actually make protein levels in the blood drop faster). A very low dose of Aspirin has been added to the plan to combat forming abnormal blood clots.

Biscuit could have also had a biopsy surgery to take a sample of the kidney to confirm glomerulonephritis. The complication of this procedure is bleeding. With Biscuit’s illness, her owners elected not to proceed with a biopsy as they were told Biscuit may require a blood transfusion if she started hemorrhaging. Biscuit is doing very well – she is back on the couch, playing soccer and swimming with her family. She has only had one episode of urinary incontinence (leaking urine) and she is not drinking as much water. Biscuit will be on medication for the rest of her life. She is lucky to have such great, caring and dedicated owners!