This article is sponsored content brought to you by IDEXX Laboratories.
A summary of the latest innovations supporting the diagnosis and management of kidney disease in cats and dogs
Kidney disease is encountered with some frequency in companion-animal practice. The diagnosis typically relies on the findings of a clinical history and physical examination, along with the results of blood (CBC and biochemical profile) and urine (complete urinalysis) testing to establish a diagnosis. One of the challenges here is that on average there has to have been the loss of approximately two-thirds of kidney function before urine concentrating ability is lost, and approximately 75 per cent loss of kidney function before the development of azotaemia. This means that kidney disease can be relatively advanced before diagnosis occurs.
Enter IDEXX Laboratories, who developed an assay for SDMA (Symmetric Dimethylarginine) in cats and dogs, and a brand new urine sediment analyser.
Firstly, SDMA is evidenced as more reliable than creatinine for the diagnosis of kidney disease. There are a number of reasons for this:
1. SDMA is a very accurate marker of kidney function.
2. SDMA increases earlier than creatinine (reliably by the time 40 per cent of kidney function has been lost).
3. SDMA is specific for kidney function (unlike creatinine, it is not affected by muscle mass).
This is a critical advancement in veterinary medicine with earlier diagnosis allowing earlier management with the potential to slow progression of the kidney disease. Armed with the knowledge of the presence of early kidney disease, care can be taken to minimise further damage to the kidneys, such as careful utility or dosing of potentially nephrotoxic drugs and careful monitoring during anesthesia.
Secondly, urinalysis is an important part of a complete minimum database when evaluating any patient, but becomes essential for any patient with kidney disease (either confirmed or potential), or signs of urinary tract disease. A urinalysis should comprise three parts—the physical properties (colour, clarity and concentrating ability), the chemical analysis (the urine dipstick), and the urine sediment analysis. The urine analysis should
be conducted as soon as possible after collection, as stored urine may have changes in the pH or sediment examination over time.
A challenge here is that the sediment examination is time-consuming in both preparation and examination, and can be somewhat subjective. The IDEXX SediVue DxTM urine sediment analyser provides a consistent and objective result in approximately three minutes, delivering high-quality images and semi-quantitative results as a permanent part of the patient record. The IDEXX SediVue DxTM can identify red and white blood cells, epithelial cells, crystals (struvite and calcium oxalate dehydrate), bacteria (cocci or rods), and casts (hyaline and non-hyaline), and offers advanced functionality for magnifying or cropping images, and labelling the cellular elements and crystals within the sample.
Add these advancements to the existing modalities for investigating, diagnosing and managing kidney disease and it could be argued that we are in a golden era of diagnostics.
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