Proteinuria - when does it matter?

Proteinuria is a common diagnostic dilemma in small animal practice. Data suggests that 1.5% of dogs presented in general veterinary practice have chronic kidney disease, and glomerular diseases may account for over half of these. CKD is very common in cats, and although tubulointerstitial lesions are the most common lesions in cats, around 20% of cats are overtly proteinuric using IRIS criteria. In this talk we will look at what to do next when proteinuria is discovered in a dog or cat. This will include how to recognise a glomerular problem, and what further tests to do to investigate further. When do we need to do diagnostic imaging, or even a renal biopsy? We will also talk about when we should be reaching for those ACE inhibitors, Angiotensin receptor blockers, renal diets, or other treatments.

• List the causes of proteinuria in dogs and cats including those that are not a consequence of glomerular disease
• List the features of a case that suggest the presence of a glomerular problem
• Describe when further investigation is needed and list the recommended tests
• Describe the management of proteinuria in various situations