Pet food safety: sodium in pet foods

Healthy dogs and cats appear to be able to adjust to differing amounts of sodium in their diet via the rennin-angiotensin-aldosterone mechanisms. There is no strong evidence that increased dietary sodium increases the risk of hypertension in dogs and cats, and the current recommendation for hypertensive animals is to avoid high dietary salt intake without making a specific effort to restrict it. The prevalence of salt sensitivity and its effect on blood pressure has not been determined for cats or dogs. The ideal amount of sodium in the diet of dogs and cats with cardiac deficiency has not been determined, as increasing may detrimentally increase the extracellular fluid volume, but decreasing it may detrimentally increase the activation of the rennin-angiotensin-aldosterone system. Increased dietary sodium increases urine output and may decrease the risk of forming calcium oxalate uroliths due to the decrease in relative supersaturation of solutes. However, caution should be used in increasing the sodium intake of patients with renal disease as increased dietary sodium may have a negative effect on the kidneys independent of any effect on blood pressure.     

Renal Calculi in Dogs and Cats: Prevalence, Mineral Type, Breed, Age, and Gender Interrelationships (1981–1993)

Three hundred seventeen specimens of urinary calculi of renal origin from 214 female dogs and 103 male dogs, and 71 specimens of urinary calculi of renal origin from 38 female cats and 33 male cats were submitted for mineral analysis between July 1, 1981, and December 31, 1993. Among dogs, 45 breeds were affected with renal calculi. Thirty-three breeds and a crossbred group were represented among females, but 8 breeds and the crossbred group accounted for 81% of the total. Among male dogs, 30 breeds and a crossbred group were represented, but 7 breeds and the crossbred group accounted for 69% of the total. Among cats, 10 breeds and a crossbred group were represented. Dogs and cats with renal calculi were older than those of 2 comparison population groups. More than one-half of the renal calculi in both dogs and cats were from the 1st known episode of urolithiasis. The risk of formation of renal calculi was found to be higher for cats than for dogs, when compared to other stone-forming cats and dogs (approximately 4.95 per 100 stone-forming cats and 2.88 per 100 stone-forming dogs). Among dogs, breeds at highest risk of developing renal calculi were Miniature Schnauzers, Shih Tzus, Lhasa Apsos, Yorkshire Terriers, and female Pugs. Also at high risk were male Dalmatians and male Basset Hounds. Among small dogs, females generally were at higher risk of developing renal calculi than were males. Regardless of size, terrier breed males generally were at higher risk of developing renal calculi. Breeds of dogs at low risk for development of renal calculi included crossbreds, German Shepherd Dogs, Labrador Retrievers, Golden Retrievers, and female Dachshunds. When only 1 kidney was involved, the risk of left renal calculus was greatest for both dogs and cats, but bilateral renal involvement was relatively common in both species (19% and 9%, respectively). Among dogs, specimens composed of 1 mineral substance (eg, struvite) occurred more often in males (58.3%) than in females (37.9%). Female dogs formed renal calculi containing struvite or oxalate more often than did males; males formed calculi containing urate more often than did females. Calculi containing oxalate, apatite, or some combination of these minerals predominated among cats; only 1 specimen from 38 female cats and only 4 specimens from 33 male cats contained neither oxalate nor apatite. Crossbred cats were significantly less likely to have renal calculi than were other breeds. A single renal calculus specimen was identified in several uncommon breeds including Tonkinese and Birman cats, and Affenpinscher, Clumber Spaniel, English Shepherd, and Field Spaniel dogs. No significant differences were observed between male and female dogs or between male and female cats with regard to mineral type of the specimen and the presence of urinary tract infection.     

Renal biopsy: a retrospective study of methods and complications in 283 dogs and 65 cats

Renal biopsy often is required to establish a definitive diagnosis in dogs and cats with renal disease. In this retrospective study, we determined the complications of renal biopsy as well as factors that may be associated with development of complications and procurement of adequate renal biopsy specimens in 283 dogs and 65 cats. Data extracted from medical records at 4 institutions were evaluated using logistic regression. Proteinuria was the most common indication for renal biopsy in dogs. Complications were reported in 13.4 and 18.5% of dogs and cats, respectively. The most common complication was severe hemorrhage; hydronephrosis and death were uncommon. Dogs that developed complications after renal biopsy were more likely to have been 4 to < 7 years of age and > 9 years, to weigh < or = 5 kg, and to have serum creatinine concentrations > 5 mg/dL. The majority of biopsies from both dogs (87.6%) and cats (86.2%) were considered to be of satisfactory quality. Biopsies from dogs were more likely to be of high quality if they were obtained when the patient was under general anesthesia and more likely to contain only renal cortex if they were obtained by surgery. We concluded that renal biopsy is a relatively safe procedure, with a low frequency of severe complications. Hospital practices and patient variables have the potential to impact both the quality of the specimen obtained and the rate of complications.     

Cardiac troponin I is elevated in dogs and cats with azotaemia renal failure and in dogs with non-cardiac systemic disease

OBJECTIVE: To determine if dogs and cats with renal failure, or other severe non-cardiac disease, and no antemortem evidence of cardiac disease on basic clinical evaluation, have elevated levels of cardiac troponin I (cTnI). DESIGN: Cross-sectional study using 56 dogs and 14 cats with primary non-cardiac disease (39 dogs with azotaemic renal failure, 14 cats with azotaemic renal failure, 17 dogs with non-cardiac systemic disease); 7/25 dogs and 6/14 cats had murmurs detected on physical examination. Serum or heparinised plasma was collected and analysed for cTnI. RESULTS: Cardiac troponin I concentrations were elevated above reference intervals in 70% of dogs and 70% of cats with azotaemic renal failure and in 70% of dogs with a variety of systemic non-cardiac diseases. Cardiac troponin I concentrations did not correlate with the degree of azotaemia, presence of murmurs, hypertension or type of non-cardiac illness. CONCLUSIONS: Cardiac troponin I concentration is often elevated in dogs and cats with azotaemic renal failure and in dogs with other systemic non-cardiac illness, suggesting that these conditions often result in clinically inapparent myocardial injury or possibly altered elimination of cTnI.     

Duplex Doppler Estimation of Intrarenal Pourcelot Resistive Index in Dogs and Cats With Renal Disease

In human beings, intrarenal blood flow impedance, expressed as the resistive index (Rl) and obtained by duplex Doppler ultrasonography, has been used to aid in diagnosis and prognosis of renal failure. Higher than normal values for Rl were obtained in 3 of 4 dogs with acute tubular necrosis (ATN) and in 5 of 10 dogs with glomerulonephrosis (GN). Normalization of Rl was observed in 2 dogs with ATN evaluated serially during treatment. Increased Rl values were obtained in 9 of 10 cats with nonobstructive renal disease and in 2 of 5 cats with obstructive renal disease. Normalization of Rl was observed in 3 cats with renal failure in which treatment was effective (1 with obstruction; 2 with nonobstructive disease). The magnitude of increase in Rl did not correlate with the magnitude of concurrent renal dysfunction. These results suggest that duplex Doppler evaluation of intrarenal Rl is more useful as an ancillary diagnostic technique in azotemic dogs with ATN than in those with GN and in azotemic cats with nonobstructive than in those with obstructive disease.     

DOPPLER ULTRASONOGRAPHIC ESTIMATION OF RENAL AND OCULAR RESISTIVE AND PULSATILITY INDICES IN NORMAL DOGS AND CATS

Resistive index (RI) and pulsatility index (PI) are indirect measurements of blood flow resistance that may be used to evaluate vascular changes in renal and ophthalmologic diseases. To our knowledge, no reports are available describing values for renal and ocular PI index in the unsedated dog and ocular RI and PI indices in the unsedated cat. The purpose of this study was to measure normal values for both intrarenal and ocular RI and PI within the same subject in unsedated clinically normal dogs and cats. Twenty-seven dogs and 10 cats were considered healthy by means of physical examination, CBC, biochemical profile, urinalysis, and ultrasonography. Systolic blood pressure was measured by Doppler ultrasonography. Intrarenal and ocular arteries were scanned by pulsed Doppler ultrasonography to calculate RI and PI. No significant differences were noted between the values obtained for the right vs. the left kidney and eye. The upper values of these indices were calculated as mean+2 standard deviations resulting in 0.72 and 1.52 for dog renal RI and PI; 0.7 and 1.29 for cat renal RI and PI; 0.76 and 1.68 for dog ocular RI and PI; and 0.72 and 1.02 for cat ocular RI and PI.     

Ultrasound-assisted drainage and alcoholization of hepatic and renal cysts: 22 cases

Twenty-two dogs and cats with symptomatic renal or hepatic cysts that had undergone ultrasound-assisted drainage and alcoholization were retrospectively evaluated. Common presenting complaints were anorexia, reluctance to move, and vomiting. Abdominal pain was observed in all cases. Systemic hypertension was identified in four dogs and four cats with renal cysts. Cyst drainage and alcoholization were achieved without complications in 19 animals, and all clinical signs resolved after the procedure. In three cases, transient bleeding was observed during alcoholization, and the procedure was interrupted. Blood pressure normalized in the four dogs with renal cysts, but it remained elevated in the four cats.     

Nephroliths and ureteroliths: a new stone age

Nephroliths may obstruct the renal pelvis or ureter, predispose to pyelonephritis, or result in compressive injury of the renal parenchyma leading to progressive chronic kidney disease. Indications for removal of nephroliths in dogs include obstruction, recurrent infection, progressive nephrolith enlargement, presence of clinical signs (renal pain), and patients with nephroliths in a solitary functional kidney. The most common indication for removal of upper tract uroliths in cats is ureteral obstruction caused by ureteroliths. Nonobstructive nephroliths in cats are not usually treated unless they move into the ureter resulting in ureteral obstruction.

The treatment approach to nephroliths and ureteroliths is different for dogs versus cats. Surgical removal of nephroliths or ureteroliths by nephrotomy and ureterotomy respectively is associated with potential for complications in more than 30% of cats treated by ureterotomy; therefore, minimally invasive options should also be considered. Extracorporeal shock wave lithotripsy (ESWL) treatment of nephroliths results in small “passable” stone fragments in most dogs, whereas ESWL does not work effectively in cats. Ureteral stents are effective for relief of ureteral obstruction by ureteroliths in both dogs and cats. Ureteral stents may be left in place long-term to relieve ureteral obstruction by ureteroliths. Post-operative morbidity and mortality are substantially lower for ureteral stent placement compared to open surgical ureterotomy in cats.     

Use of continuous renal replacement therapy for treatment of dogs and cats with acute or acute-on-chronic renal failure: 33 cases (2002–2006)

Objective: To describe the indications, clinical features, outcomes and complications associated with use of continuous renal replacement therapy (CRRT) in 17 client-owned dogs and 16 client-owned cats with acute or acute-on-chronic renal failure refractory to aggressive medical management.
Series summary: Twenty-nine percent of dogs and 44% of cats had evidence of pre-existing chronic kidney disease (CKD). Median duration of CRRT was 16.3 hours (range 0.3–83.0 hours) in dogs and 11.5 hours (range 1.0–35.5 hours) in cats. Median canine blood urea nitrogen (BUN) improved from 41.0 mmol/L (115.0 mg/dL) to 11.8 mmol/L (33.0 mg/dL) and creatinine from 636.5 mmol/L (7.2 mg/dL) to 274 mmol/L (3.1 mg/dL). Median feline BUN improved from 46.4 mmol/L (130 mg/dL) to 13.9 mmol/L (39.0 mg/dL) and creatinine from 1069.6 mmol/L (12.1 mg/dL) to 291.7 mmol/L (3.3 mg/dL). Metabolic acidosis resolved in 80% of affected dogs and 71% of affected cats. Hyperkalemia resolved in 100% of affected dogs and 88% of affected cats. Complications noted with CRRT included iatrogenic hypokalemia, iatrogenic metabolic alkalosis, clinical hypocalcemia, total hypercalcemia, filter clotting, anemia, hypothermia, and neurologic complications. Forty-one percent of dogs and 44% of cats survived to discharge. No dogs and only 1 cat developed newly diagnosed CKD.
New or unique information provided: CRRT can be a viable option for the management of acute or acute-on-chronic renal failure in dogs and cats that are refractory to aggressive medical management. The frequency of complications associated with CRRT in this study warrants further experience with this modality before its widespread use can be recommended.     

Duplex Doppler Estimation of Pourcelot Resistive Index in Arcuate Arteries of Sedated Normal Cats

Renal failure is an important cause of morbidity and mortality in feline patients. In human patients, intrarenal blood flow values obtained with duplex Doppler ultrasonography have been used to aid in the diagnosis and prognosis of renal failure. The purpose of this report is to present values for resistance to intrarenal blood flow in normal cats, derived by duplex Doppler ultrasonography. Ten mature clinically healthy conditioned domestic shorthaired cats were screened for normal renal anatomy and function by CBC, serum biochemical profile, urinalysis, urine protein/creatinine ratio, endogenous creatinine clearance, and renal B-mode ultrasonography; and for normal systemic blood pressure with Doppler pressure cuff measurement. Subsequently, the cats were sedated with ketamine hydrochloride, and values for mean intrarenal (arcuate artery) resistance to blood flow were determined by duplex Doppler ultrasonography, and expressed as the Pourcelot resistive index, a ratio of systolic to diastolic flow commonly used in duplex Doppler sonography in human patients. After duplex Doppler sonographic examination, histological normalcy of the kidneys was verified by evaluation of ultrasound-guided percutaneous renal biopsy. Based on the obtained resistive indices, 95% confidence intervals for normal values were calculated as follows: left kidney, 0.52 to 0.60; right kidney, 0.55 to 0.63. No statistically significant difference was noted between the values obtained for the right versus the left kidney. J Vet Intern Med 1996;10:28–33. Copyright © 1996 by the American College of Veterinary Internal Medicine .     

Isolation of Thermophilic Campylobacters from Norwegian Dogs and Cats

A total of 147 dogs and 85 cats was surveyed for faecal carriage of thermophilic Campylobacters. Isolates were obtained from 33 (22.4 %) of the dogs and from 10 (11.8 %) of the cats investigated. The isolation rates recorded for diarrhoeic and non-diarrhoeic dogs and cats were not significantly different. Likewise, Campylobacters were isolated with about equal frequencies from puppies and mature dogs as well as from bitches and male dogs. Nineteen canine and 7 feline strains were biotyped and serotyped. A large majority (88.5 %) of these 26 strains belonged to serotypes previously recovered from human G. coli and C. laridis constituted 7.7 % and 3.8 %, respectively. Three strains belonged to serotypes previously recovered from human patients in Norway.     

Effect of enalapril on blood pressure, renal function, and the renin-angiotensin-aldosterone system in cats with autosomal dominant polycystic kidney disease

OBJECTIVE: To evaluate blood pressure, renal function, and the renin-angiotensin-aldosterone system (RAAS) in cats with autosomal dominant polycystic kidney disease (ADPKD) and to assess the effect of enalapril on these variables. ANIMALS: 6 cats with ADPKD and 6 age-matched healthy cats. PROCEDURE: To measure blood pressure and heart rate, a radiotelemetry catheter was placed in the left femoral artery of each cat. Baseline data collection included 24-hour blood pressure, heart rate, and motor activity. Blood was then collected for analysis of RAAS status and renal function. Enalapril (0.5 mg/kg of body weight, p.o., q 24 h) was administered for 1 week, and data collection was repeated. RESULTS: Differences in baseline blood pressure, heart rate, motor activity, RAAS status, and renal function were not detected between cats with ADPKD and control cats. Hypertension was not documented in cats with ADPKD. Blood pressure was significantly reduced for 15 to 17 hours after treatment with enalapril in both groups. Administration of enalapril also resulted in significant increases in plasma renin activity and significant decreases in angiotensin converting enzyme activity and atrial natriuretic peptide concentration but only minimal changes in glomerular filtration rate and effective renal plasma flow in both groups of cats. CONCLUSIONS AND CLINICAL RELEVANCE: Although hypertension is common in humans with ADPKD, cats with ADPKD were normotensive. Treatment with enalapril (0.5 mg/kg, p.o., q 24 h) significantly reduced blood pressure in normotensive healthy cats and cats with ADPKD, and resulted in predictable changes in RAAS enzyme activities and hormone concentrations. Enalapril had minimal effects on renal function.     

Blood pressure assessment in healthy cats and cats with hypertensive retinopathy

OBJECTIVE: To determine whether there was an association between hypertensive retinopathy and high systolic, diastolic, and mean arterial blood pressures in cats. ANIMALS: 181 cats. PROCEDURE: Systolic, diastolic, and mean arterial blood pressures were measured by use of a noninvasive oscillometric technique. The range of blood pressure measurements in healthy cats from various age groups was determined. Associations among systolic, diastolic, and mean arterial blood pressure; hypertensive retinopathy; hyperthyroidism; left ventricular cardiac hypertrophy; chronic renal failure; and serum biochemical abnormalities were determined. RESULTS: All blood pressure measurements increased with age in healthy cats. The frequency of hypertensive retinopathy also increased with age and with blood pressure, and hypertensive retinopathy was particularly found in cats with systolic blood pressures > 168 mm Hg. There was an increased risk for hypertensive retinopathy in cats that were female, > 10 years old, and neutered. The risk of chronic renal failure also increased as blood pressure, particularly systolic blood pressure, increased. CONCLUSIONS AND CLINICAL RELEVANCE: Hypertensive retinopathy was common in cats > or = 10 years of age and was associated with systolic blood pressures > 168 mm Hg when measured by the noninvasive oscillometric technique.     

Toxicity of aminoglycoside antibiotics.

In cats, aminoclycosides cause vestibular damage followed in a few days by renal damage. The reverse is true in the dog, except that streptomycin causes vestibular damage prior to renal damage. To avoid toxicities, therapeutic doses of aminoglycosides should not be given longer than a week and they should be given cautiously in animals with renal impairment. Failure of the kidneys to eliminate aminoglycosides will result in very high blood levels, even with therapeutic doses, that can cause further renal and vestibular damage. The oral administration of aminoglycosides is seldom dangerous when normal therapeutic doses are employed. Although it is remote, the possibility exists that animals with renal impairment and intestinal obstruction may become intoxicated. Kanamycin is less nephrotoxic to dogs than neomycin and it is less destructive to the auditory nerve than vestibular damage than streptomycin. Gentamicin in cats is twice as toxic to the vestibular apparatus as streptomycin and more toxic to the cochlea than streptomycin or dihydrostreptomycin. Neomycin is more toxic than kanamycin, gentamicin, and streptomycin to both cats and dogs. Amikacin causes renal damage in dogs similar to other aminoglycosides. It also causes vestibular damage.     

Hypertension in Cats With Chronic Renal Failure or Hyperthyroidism

The Doppler ultrasonic recording technique was used to measure systolic and diastolic blood pressures indirectly in 28 cats with naturally occurring renal failure, 39 cats with hyperthyroidism, and 33 clinically normal cats. The mean systolic and diastolic blood pressures in the normal cats were 118.4 +/- 10.6 mm Hg and 83.8 +/- 12.2 mm Hg, respectively. In the cats with chronic renal failure, both the systolic (146.6 +/- 25.4 mm Hg) and diastolic (96.6 +/- 15.2 mm Hg) blood pressures were significantly higher (P less than 0.0001 and P less than 0.01, respectively) than in the normal cats. Elevations in systolic and/or diastolic blood pressure were recorded in 17 (61%) of the 28 cats with chronic renal failure. In the 39 untreated hyperthyroid cats, both the mean systolic (167.9 +/- 28.9 mm Hg) and diastolic (111.6 +/- 21.5 mm Hg) pressures also were significantly higher (P less than 0.0001) than normal. Increased systolic and/or diastolic blood pressure was recorded in 34 (87%) of the 39 hyperthyroid cats. In seven cats with hyperthyroidism that were reevaluated two to four months after successful treatment of the hyperthyroid state, there was a significant fall in mean systolic pressure (P less than 0.05) from a pretreatment value of 159.5 +/- 15.4 mm Hg to a posttreatment value of 132.0 +/- 1.62 mm Hg. Overall, the results of this study indicate that mild to moderate hypertension is common in cats with chronic renal failure and in cats with untreated hyperthyroidism. In addition, the hypertension appears to be reversible following successful treatment of the hyperthyroid state.     

Early diagnosis of renal disease and renal failure.

The main goal of early diagnosis of renal disease and renal failure in dogs and cats is to enable timely application of therapeutic interventions that may slow or halt disease progression. Strategies for early diagnosis of renal disease use urine tests that detect proteinuria that is a manifestation of altered glomerular permselectivity or impaired urine-concentrating ability as well blood tests to evaluate plasma creatinine concentration. Animals with progressive renal disease should be carefully investigated and treated appropriately.Animals with mild, possibly nonprogressive, renal disease should be monitored adequately to detect any worsening trends,which should lead to further investigation and treatment even if the increments of change are small.     

Measurement of capillary blood glucose concentrations by pet owners: a new tool in the management of diabetes mellitus

Recently a new method for capillary blood sampling from the ears of dogs and cats was described, which allows the measurement of glucose concentration by means of portable glucose meters. The authors of this report evaluated the suitability of this method for use by pet owners and the potential technical problems. The owners of seven healthy dogs and seven healthy cats were asked to perform two glucose curves (measuring blood glucose concentration every 2 hours for a total of 12 hours). All dog owners and three cat owners were able to perform a reliable blood glucose curve. The most frequently encountered problems were inadequate formation of a blood drop due to excessive digital pressure on the pinna, repeatedly depressing the plunger of the lancet device instead of allowing the negative pressure to slowly build up, and failure to fill the test strip up to the mark. The authors conclude that these steps of the procedure need to be stressed during technique demonstration and that home monitoring of blood glucose concentrations may serve as a new tool in the management of diabetic dogs and cats.     

Evaluation of the utility and accuracy of body fluids containing red blood cells to determine canine and feline blood types

Objective

To examine the accuracy of using body fluids macroscopically suspected to contain erythrocytes to determine the blood type in dogs and cats by use of an immunochromatographic cartridge (ICC), compared to systemic blood as the reference standard.

Design

Prospective study.

Setting

University teaching hospital.

Animals

Thirty client-owned dogs and 8 cats.

Interventions

Dogs and cats with a sanguineous or serosanguineous body fluid (SBF) that also required a blood sample were eligible for inclusion. PCV and blood type were determined in all blood and fluid samples. For body fluids with a low PCV and discordant blood type results compared to systemic blood, sample concentration and repeat blood typing from the fluid was performed when enough sample was available.

Measurement and Main Results

Body fluid samples consisted of 16 pleural (11 dogs; 5 cats), 12 peritoneal (10 dogs; 2 cats), and 4 canine pericardial effusions, 3 urine samples, and 1 each of feces and epistaxis from dogs and a seroma sample from a cat. Median (range) manual PCV of blood and fluid samples was 34% (14%–66%) and 6% (0.5%–70%) for dogs and 28% (14%–48%) and 14% (0.5%–19%) for cats, respectively. Dogs were correctly classified as being DEA 1 negative, DEA 1 positive, and DEA 1 weak positive when using body fluid for blood typing 13 of 14, 4 of 9, and 5 of 7, respectively. All reference blood type to fluid blood type (FBT) discordant results had a body fluid PCV equal to or below 2%. Subsequently concentrated body fluid samples had a PCV above 8% and repeat FBT matched reference blood type (RBT). All cats were classified as type A by all RBTs and FBTs.

Conclusions

Body fluids containing erythrocytes may be utilized to blood type dogs if sufficiently concentrated and type A cats.     

Sensitivity,specificity, and predictive values of reagent test strip estimations of blood urea nitrogen

Azostix-reagent-tests(R) strips (Ames, Miles, Inc., Diagnostic Division, Elkhart, IN) were used to measure blood urea nitrogen values in blood samples from 125 dogs and cats at the North Carolina State University, College of Veterinary Medicine. Results of the tests were compared with standard serum urea nitrogen results. Sensitivity, specificity, and negative predictive values were high (86.4, 90.3, and 96.5%, respectively). Positive predictive value was low, 65.5% of the dogs and cats with elevated blood urea nitrogen values were correctly classified as abnormal The test performs well when the prevalence of abnormal values is near 50%.     

Proteinuria: measurement and interpretation

Proteinuria is a general term that describes the presence of any type of protein in the urine (e.g., albumin, globulins, mucoproteins, and Bence-Jones proteins); however, albumin is the predominate protein in urine in healthy dogs and cats as well as dogs and cats with renal disease. Proteinuria can arise from several different physiologic and pathologic causes, but persistent proteinuria associated with normal urine sediment is consistent with kidney disease. The urine dipstick colorimetric test is the usual first-line screening test for the detection of proteinuria, but false-positive reactions are common. When proteinuria of renal origin is suspected, the next diagnostic steps are quantitation and longitudinal monitoring via the urine protein/creatinine ratio. The recent availability of a species-specific albumin enzyme-linked immunosorbent assay technology that enables detection of low concentrations of canine and feline albuminuria has both increased diagnostic capability and stimulated discussion about what level of proteinuria/albuminuria is normal. Beyond being an important diagnostic marker, proteinuria is associated with kidney disease progression in both dogs and cats: the greater the magnitude of the proteinuria, the greater the risk of renal disease progression and mortality. Treatments that have attenuated proteinuria in dogs and cats have also been associated with slowed kidney disease progression and/or improved survival. For these reasons, screening for renal proteinuria and longitudinal assessment of renal proteinuria has recently received renewed interest.