Which things affect SDMA?

RE: Which things affect SDMA?

Iain Richards — Sat, 24 Apr 2021 09:56:44 GMT

I'll be honest, I don't really get SDMA but it does seem it is just a proxy for GFR, but valid to monitor change. ANyone care to properly enlighten me please?

RE: Which things affect SDMA?

Francisco Gomez — Thu, 22 Apr 2021 19:42:42 GMT

Just so you all know, I sent new bloods and urine to idexx and everything is now back to normal. SDMA 11

RE: Which things affect SDMA?

Iain Richards — Wed, 21 Apr 2021 15:36:35 GMT

IT isn't just a dehydration impact is it?

RE: Which things affect SDMA?

Francisco Gomez — Tue, 20 Apr 2021 09:58:20 GMT

[quote userid="9239" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29782/which-things-affect-sdma/229976#229976"]

Francisco Gomez said:
I had a blood sample at the time of grape ingestion and another one yesterday hence progression.

I don't know Francisco, can you call it progression if the dog is asymptomatic?

[/quote]

Touché.

Just to let you all know, I have repeated blood and urine sending all to idexx laboratories. The dog continues to be asymptomatic and the urine has high SG.

RE: Which things affect SDMA?

Dinu Catilina — Tue, 20 Apr 2021 09:34:16 GMT

[quote userid="11493" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29782/which-things-affect-sdma/229973#229973"] I had a blood sample at the time of grape ingestion and another one yesterday hence progression.[/quote]

I don't know Francisco, can you call it progression if the dog is asymptomatic?

RE: Which things affect SDMA?

Francisco Gomez — Tue, 20 Apr 2021 08:42:33 GMT

[quote userid="4367" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29782/which-things-affect-sdma/229972#229972"]it is fair for progression of disease, but not as an early indicator[/quote]

That's actually my point - I had a blood sample at the time of grape ingestion and another one yesterday hence progression.

RE: Which things affect SDMA?

Iain Richards — Tue, 20 Apr 2021 07:21:50 GMT

Call me Mr Cynic, but when one searches for SDMA, it's mostly vet references, many of which track back to IDEXX testing. The brief searh makes me feel that it is fair for progression of disease, but not as an early indicator. There is a very recent review that include this "Based on total biological variability (analytical, intra-, and interindividual) in healthy dogs, the use of SDMA as a single measurement is not recommended to screen for early renal functional loss, rather serial monitoring and use of the critical difference (CD)isrecommended for monitoring kidney function instead of com-parison with population-based reference values."

So take it out of the (already pointelss) pre-anaesthetic bloods

RE: Which things affect SDMA?

Lucy Fleming — Mon, 19 Apr 2021 21:52:13 GMT

Idexx do have an algorithm for SDMA results (for what it's worth) which would suggest investigating/ treating impaired GFR at that level.

https://www.idexx.com/en/veterinary/reference-laboratories/sdma/interpreting-your-sdma-results/

I'm another one who's found it fairly non useful. Goes the other way, too - my own dog has just been diagnosed with stage 3 CKD and her SDMA is only 20 despite a creatinine of 344 at diagnosis.

RE: Which things affect SDMA?

niamhjl — Mon, 19 Apr 2021 21:41:08 GMT

My approach would probably be to check USG of a first morning urine sample. If it is concentrated then I would ignore the SDMA (or maybe monitor periodically, but not panic) but if it was dilute then I would take the SDMA more seriously.

in fact, when looking for evidence of renal compromise after grape toxicities, I am more likely to check urine first and then only do bloods if the urine is dilute.

RE: Which things affect SDMA?

Neil Wheadon — Mon, 19 Apr 2021 20:30:30 GMT

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29782/which-things-affect-sdma/229965#229965"]I've had cases where SDMA has been raised, and Crea , Urea, Phos have all been well within normal ranges[/quote]

It gets vets in a real knot when used as part of a pre-anaesthtic profile, especially if every animal gets one

'So Mrs Smith everything is normal, apart from the pesky SDMA'

'What do you think veterinary?'

'Well Mrs Smith it shows very early renal failure, but the rest are OK'

'Any increase of risk to Tibbles?'

'Well we can't ignore it'

20 minutes later, you move onto the next cat castrate having abandonned that one

Neil

RE: Which things affect SDMA?

Clive Ansell — Mon, 19 Apr 2021 19:59:48 GMT

I've stopped using it, as I've found it unreliable and misleading at times

I've had cases where SDMA has been raised, and Crea , Urea, Phos have all been well within normal ranges, and where the lab has suggested early renal failure. Some of these cases 18 months later have no clinical signs of renal disease, and Urea, Crea and Phos are all still within range.