Chronic kidney disease (CKD) often goes undiagnosed and untreated because pets don’t exhibit signs until their condition is advanced. Symmetric dimethylarginine (SDMA) is an important CKD screening test, and our Family Veterinary Care of Oakdale team explains five reasons why this diagnostic tool is so important when evaluating your pet’s health status.
#1: Chronic kidney disease causes significant health problems for your pet
Kidney health is critical to proper body functioning. If your pet has CKD, their damaged kidneys cannot adequately perform these vital processes:
- Removing toxins from the body — Tiny filters (i.e., nephrons) make up the kidneys, which are responsible for removing toxins from the body. CKD interferes with this function, allowing waste material to accumulate in the bloodstream.
- Conserving water — Based on your pet’s hydration status, the kidneys produce concentrated urine to conserve water, or diluted urine to remove excess fluid. If your pet has CKD, their kidneys are unable to produce concentrated urine.
- Conserving protein — Nephrons normally filter toxins while preserving important substances such as proteins. When the kidneys are damaged, protein is lost in the urine.
- Regulating red blood cell (RBC) production — The kidneys make the hormone erythropoietin, which is responsible for signaling the bone marrow to produce RBCs. Without this hormone, nonregenerative anemia occurs.
- Regulating blood pressure — The kidneys contain sensors that help regulate blood pressure, preventing abnormalities. CKD can lead to hypertension, which can further damage kidney tissue.
- Balancing electrolytes and minerals — The kidneys are responsible for balancing electrolytes, such as sodium and potassium, and minerals, such as calcium and phosphorus. CKD can lead to imbalances that can cause significant health complications.
- Balancing body pH — The kidneys regulate body pH. Imbalances prevent important metabolic processes throughout the body.
#2: Pets are excellent at hiding illness
In the wild, animals suffering from illness or injury are vulnerable to predators. While your furry pal doesn’t have to evade lions or tigers while lounging on your couch, they retain their ancestors’ instincts to hide weaknesses. Most pets don’t exhibit CKD signs until their condition is advanced, making management more difficult and jeopardizing their prognosis. During your pet’s annual wellness exam, our Family Veterinary Care of Oakdale team will perform regular screenings to detect CKD before your furry pal exhibits signs, helping increase your pet’s quality and quantity of life.
#3: Symmetric dimethylarginine is more sensitive than traditional screening tests
Your veterinarian performs many diagnostic screenings to check your pet’s kidney health. Traditional CKD screening tests include:
- Complete blood count (CBC) — A CBC measures RBCs, which may be abnormally low if your pet has CKD. However, many other conditions can cause anemia.
- Creatinine — During normal functioning, the muscles produce creatinine, a waste product. Elevated creatinine levels typically indicate kidney injury. However, creatinine elevations do not occur until about 75% of kidney function is lost.
- Blood urea nitrogen (BUN) — The liver produces the waste product BUN. An elevated BUN level can indicate kidney injury but may also indicate other conditions, so the test isn’t CKD-specific. In addition, a large percentage of kidney function is lost before a BUN test indicates an abnormality.
- Urinalysis — Pets affected by CKD usually have dilute urine and proteinuria (i.e., protein in their urine). However, such a result can also indicate other conditions.
SDMA is a much more sensitive test for kidney function than traditional screening tests. SDMA elevations can occur when as little as 25% of kidney function has been lost. In addition, SDMA elevations are specific for kidney dysfunction. The International Renal Interest Society (IRIS) recommends SDMA testing in conjunction with traditional tests to screen pets for CKD.
#4: Symmetric dimethylarginine is needed to stage your pet’s condition
To help determine an appropriate treatment protocol, your veterinarian will stage your pet’s CKD. The IRIS staging system is based on creatinine and SDMA levels. Stages include:
- Stage 1 — Pets in stage 1 CKD have minimal SDMA elevations, normal creatinine levels, and no signs.
- Stage 2 — Pets in stage 2 CKD have minimal to moderate SDMA elevations, and normal to minimal creatinine elevations. If a pet in Stage 2 exhibits any signs, they are subtle.
- Stage 3 — Pets in stage 3 CKD have moderate SDMA elevations, minimal to moderate creatinine elevations, and mild signs.
- Stage 4 — Pets in stage 4 CKD have significant SDMA and creatinine elevations. These pets have a high CKD crisis risk.
#5: Chronic kidney disease is easier to manage in the early stages
When your veterinarian detects CKD in an early stage, they can usually manage your pet’s condition, helping them live many years with a good quality of life. Maintaining your furry pal’s hydration level and dietary changes may be all that you need to do if the condition is caught early. However, treatment becomes more complicated as CKD progresses. In addition to fluid therapy and a prescription diet, potential CKD treatments include:
- Phosphate binder — CKD prescription diets are low in phosphorus. When lower dietary intake is no longer sufficient to keep phosphorus at a safe level, phosphate binders ensure excess phosphates remain in the intestine. This medication prevents excess phosphates from being absorbed into the bloodstream.
- Blood pressure medications — CKD pets often have hypertension, and your veterinarian may prescribe blood pressure medications to keep your pet’s blood pressure normal. These medications also help prevent protein loss in the urine.
- Calcium regulation — The body’s calcium and phosphorus must remain at a specific ratio. CKD can lead to an increased phosphorus level, stimulating the parathyroid gland to mobilize calcium from bones to maintain the correct ratio, which may cause their bones to become brittle and fragile. Your veterinarian may prescribe medications to inhibit the parathyroid gland and increase calcium absorption in the intestine.
- Erythropoietin — If CKD causes your pet to become anemic, your veterinarian may recommend erythropoietin to stimulate RBC production.
To help ensure your pet’s CKD is diagnosed before the disease becomes advanced, SDMA testing must be included in the screening process. Schedule your pet’s CKD testing with our Family Veterinary Care of Oakdale team.
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