WHWT with urine specific gravity of 1.011 without pu/pd

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Moira Hamilton — Thu, 27 Mar 2014 13:51:31 GMT

When we had him in he didn't drink at all, so had to give up on that! Owner did a water in and urine out and in 12 hours he drank half a pint and urinated the same? His urine culture came up with being a sterile sediment with no inflam cells seen. I requested UCC ratio and was 35.7 so just above the 34 that would suggest it def wasn't Cushings. Since I strongly suspect he has glomerular nephritis I understood that can mess up ACTH stim tests from what I've heard in the numerous webinars out there on Cushings! Latest bloods came up with raised(just) reticulocyte count 116.7 (

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Moira Hamilton — Thu, 27 Mar 2014 13:51:26 GMT

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Kate Richardson — Mon, 24 Mar 2014 10:39:01 GMT

[quote user="Stephen Courtney"]

If he is losing protein in the urine and is not azotaemic, then renal diet is inappropriate - he needs to replace the lost protein. I've had a few of these cases, a couple were hypertensive. Have you done a BP?

[/quote]

I thought I had read that the current thinking with protein losing diseases was to use lower protein diets rather than higher protein diets these days?

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Rob Loxley — Sun, 23 Mar 2014 22:04:25 GMT

and worth considering anti-thrombotic prophylaxis

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Stephen Courtney — Sun, 23 Mar 2014 17:59:39 GMT

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Anthony Todd — Sat, 22 Mar 2014 15:50:00 GMT

[quote user="Moira Hamilton"]am having him in for the day[/quote]

Don't think you told us how much water he drank and how much he peed and all the details??

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Moira Hamilton — Sat, 22 Mar 2014 13:33:47 GMT

Suspect that he does have nephtotic syndrome, will post up the newest results later today, he's been on renal food for a couple of months since I first saw his UPC results. Just wondering if he's also got Cushings on top, see what u think later when I'll enter his newest urine and blood results.

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Hanna Bennett — Mon, 17 Mar 2014 20:36:38 GMT

[quote user="Anthony Todd"]

[quote user="Hanna Bennett"]has he got a raised chol or glob? nephrotic syndrome? I see quite a lot in westies, may be coincidence.[/quote]

Would he be"the best he's been for ages" if he had this??

[/quote]

nephrotic dogs can be quite bright in my experience?

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Moira Hamilton — Sun, 16 Mar 2014 23:07:37 GMT

He has got raised cholestrol but not globulin, is on Renal food as I was initially thinking glomerular nephritis or amyloidosis. I agree that he can't be drinking more water or urinating more, am having him in for the day to see what he does with us, and repeat bloods and urine culture. Owner happy to do more bloods but suspect they soon will be having problems with the steeply rising costs! Hopefully they will reveal some answers and will take blood pressure measurements when he's in. Also think I might test thyroid levels at the same time, so hopefully I can at least cross some things off the long list! Will update you all on the results! After definitely no water for 4 hours USG had dropped to 1.010, so want to get to the bottom of things sooner rather than later! Thanks everyone for helping me with this one.

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Anthony Todd — Thu, 13 Mar 2014 20:07:36 GMT

[quote user="Hanna Bennett"]has he got a raised chol or glob? nephrotic syndrome? I see quite a lot in westies, may be coincidence.[/quote]

Would he be"the best he's been for ages" if he had this??

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Hannah Wynne Richards — Thu, 13 Mar 2014 13:19:20 GMT

I'm another suspecting an unauthorised source of water.

Wynne

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Hanna Bennett — Wed, 12 Mar 2014 17:51:24 GMT

has he got a raised chol or glob? nephrotic syndrome? I see quite a lot in westies, may be coincidence.

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Anthony Todd — Wed, 12 Mar 2014 16:03:13 GMT

He wouldn't be drinking elsewhere? Old bucket in the garden or on walks? Sorry but as Robin has said.....

This is a dog apparently well in itself and as the dog seems "the best he has been in ages" why not just monitor?

Do many dogs well in themselves and so well have much wrong with them?

The bill, already, must be enormous.

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Robin Grimmer — Wed, 12 Mar 2014 15:54:14 GMT

You can't have a dog drinking only 30ml per kg per 24 hours (which is less than maintenance) and consistently passing urine of SG 1.011. It just doesn't add up! He would have died from dehydration as he's peeing far more than he's consuming.

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Stephen Courtney — Wed, 12 Mar 2014 15:18:37 GMT

Urine SG below 1.008 is hyposthenuria ie active dilution of the filtrate - so no, you don't have this.

I'd start with blood screens and a blood pressure. If you can get a sterile urine sample by cysto - need a friendly ultrasonographer - that is far better than free catch - and culture is important. This will also give a look at the kidneys and possibly adrenals, and the liver.

I'm still not convinced 30ml/kg/24hr is excessive - is the dog wetting in the home?

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Thomas Johnson — Wed, 12 Mar 2014 08:33:28 GMT

Have you checked your refractometer with distilled water to make sure it's calibrated properly?

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Anthony Todd — Tue, 11 Mar 2014 23:18:32 GMT

Dare I suggest that some dogs just love drinking nice cold water, the more the better, used to see it on a regular basis, or often enough to do the test as below.

Also he may be compensating for the lack of food by filling his stomach with lovely cold water [it is a recommended trick for human dieters]

In the absence of signs of illness, I used to suggest boiled water at room temperature only, which they disliked intensely, until they really needed it, and usually water consumption returned to reasonable levels.

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Moira Hamilton — Tue, 11 Mar 2014 23:05:23 GMT

The urine sample came back with protein creat ratio of 5.8 so is increasing, bloods show falling Alk Phos and Alt, all else now normal. Sediment was looked at in house and by lab, only scanty epithelials. Haven't cultured as no sign of bacteria but may have to. Haven't done measurement myself, but owner fills bottles of 500mls and keeps them in the fridge and measure any water left when they refill the water. Haven't yet done testing for hypothyroid, and again no obvious clinical signs, no bradycardia, no hair thinning or altered pigmentation but will definitely give it a go! Really tearing my hair out with this, especially as the dog seems the best he has been in ages as he's been on a strict diet. Know the unseen water in the food and salt content could be pushing the amount in up but urine this dilute must be caused from something, and correct me if I'm wrong, but I thought to be this dilute there has to be active dilution taking place, aargh!!!! Thankfully the clients are wanting to find out what is going on, and are very compliant. Thanks for the thoughts from everyone, if anyone has anymore thoughts please let me knew otherwise will be bald from so much hair pulling!

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Stephen Courtney — Mon, 10 Mar 2014 10:02:47 GMT

You also need to collect the FIRST urine sample of the day - ie urine that has collected in the bladder overnight under the influence of ADH.

Once an animal is awake , urine production accelerates so subsequent urine samples are often a lot more dilute and are affected by things like breakfast and preferences of the individual animal about water consumption.

30ml/kg/day is not sufficient to produce a sustained isosthenuria, but might well account for a sporadic low urine SG. and there is water in food, and sometimes manufacturing issues like a sudden increase in salt levels can affect urine output. Something to consider anyway...

Did you do a urine sediment exam? a raised UPC is not relevant if there is an inflammatory sediment, and in the face of cystitis is probably not an issue. more concern is why did the dog get cystitis? And is it on a 'urinary ' diet - these tend to lower the urine SG . In addition to be signifcant, the UPC needs to be raised on a sustained basis over a period of time - not just on one sample.

It can be very frustrating checking water in vs water out problems, but if you are satisfied that there really is an issue, basic biochem and haematology, then ACTH stim, poss LDDST, poss abdo scan...and some of these animals will provide normal results at least at first. Warn the client that some tests may need repeating, and it might take many months to get to the bottom of things, if at all...

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Kate Richardson — Mon, 10 Mar 2014 09:23:22 GMT

I think you should wait and see what a current urine sample is doing. It could have been a one off however with the history of cystitis and a raised UPC a bacterial infection would be most likely. Did a sediment gèt examined or a culture done? What did he get treated with? Get a fresh sample- if usg is low do a full analysis on including culture and also see if it is persistent or related to time if day.

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Robin Grimmer — Mon, 10 Mar 2014 09:13:19 GMT

Have you measured water consumption yourself? The urine sg which is isosthenuric doesn't fit with the amount drunk.

Re: WHWT with urine specific gravity of 1.011 without pu/pd

Tiago Henriques — Mon, 10 Mar 2014 08:56:04 GMT

Hi.

Maybe is a good ideia testing T4 and TSH to see if it has hypothyroidism.