Dog looks thin.

Dr. Marie replied:

Thanks for an interesting question. I have a few thoughts on Pixie's situation.

First of all, do you have the numbers from her blood tests? A high protein diet can cause increases in UREA, but shouldn't cause an increase in creatinine (the other kidney enzyme.) High protein food really shouldn't cause an increase in liver enzymes.

Has she had any urine tests done? The urine specific gravity will tell us if the increase in kidney enzymes is due to kidney disease or not. Also, it would be interesting to see if there is any protein loss in the urine.

When her thyroid test was done do you know if it was a free T4 test that was done? This is usually what we test. However, sometimes there are other things that can lower a T4 level. If a dog is struggling with some other condition then the free T4 can look artificially low. In this case, if we upped the thyroid medicine this could cause problems. In a situation like this I may run a special type of T4 test such as one by equilibrium dialysis or a 2-step T4.

It's a bit of a puzzle as to why she looks thin but her weight is not changing. I'm wondering if she has fluid collecting somewhere. Let's say, for example, that she had fluid in her abdomen. If this was the case, the weight of that fluid could make the scale look like she hasn't lost weight when really she has. One possible reason for fluid in the abdomen is liver disease.

It would be great if you could get a copy of her labwork and let me know what her numbers are. If you can, just reply to this message.

I have some other ideas, but seeing the blood tests would be the best place to start to see if I can help you out.


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Dr. Marie replied:

OK. This helps me a lot. "High-normal" in my books is basically the same as normal.

If this were my case I'd be zoning in on the protein in her urine. A normal dog's kidneys should be able to handle a high protein diet. A high protein diet could cause a slight increase in urinary protein but it should not cause a huge increase.

I'm concerned that there is another health issue here somewhere. If her specific gravity is low (it would be a number around 1.008 to 1.012 as opposed to a healthy dog around 1.030) then this is indicative of a kidney problem. It's possible she has a problem called protein losing nephropathy which is quite serious.

Another possibility is cushing's disease. Cushing's can cause protein in the urine. Most dogs with Cushing's will be really thirsty and urinate lots. Usually they have a high appetite, but as the disease progresses they can eventually go off of their food. If you think she has a large thirst and lots of urine then you should ask your vet to test for cushing's.

There are other possible reasons for protein in the urine including infection, cancer and more.

I'm hesitating here on what to type as where my recommendations go from here depend on what her specific gravity is. Do you think you could find out this number and get back to me?

Dr. Marie replied:

Cushing's sounds unlikely then. For now, let's start with getting the urine specific gravity. They'll give you a number like "ten-oh-eight" which would mean 1.008 or "ten-thirty" which would mean "1.030". Let me know that and I'll give you some ideas.

Dr. Marie.