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Nephrotic Syndrome in Dogs

By: Dr. Bari Spielman

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Nephritic syndrome is characterized by the combination of protein in the urine, low protein level in the blood, high cholesterol and abnormal fluid accumulation in any part of the body (edema). In addition, systemic hypertension (high blood pressure) and thromboembolism (blockage of blood vessels with blood clots) are commonly associated.

Nephrotic syndrome most often occurs secondary to glomerulonephritis or amyloidosis. The clinical signs associated with the nephrotic syndrome may initially be mild, but as the disorder progresses, signs can be devastating to the patient. Depending on the specific case, certain diagnostics and therapeutics are recommended and tailored to that individual.

Several diseases/disorders appear similar to the nephrotic syndrome. These include:

  • Severe liver disorders such as inflammation of the liver (hepatitis), cancer, infection and cirrhosis often cause severe hypoalbuminemia and in turn, ascites or edema.

  • Protein losing enteropathy, which are intestinal disorders that cause profound protein loss. These include inflammatory bowel disease, lymphangiectasia and cancer and can cause severe hypoproteinemia and fluid accumulation.

  • Proteinuria is commonly seen with inflammatory urinary tract diseases such as bacterial bladder infection, infection or inflammation within the kidney, stones within the urinary tract and cancer. These disorders are often accompanied by an active or inflammatory urinalysis. It is important to differentiate these from the nephrotic syndrome.

  • Proteinuria is the hallmark of glomerulonephritis and amyloidosis. These disorders are most often associated with an inactive or non-inflammatory urinalysis.

  • Hypertension second to other systemic disorders needs to be ruled out, including hyperadrenocorticism (Cushing's disease), primary kidney disease and heart disease.

  • Thromboembolic complications need to be differentiated from other disorders that cause thrombosis, such as hyperadrenocorticism.

  • When the patient with nephrotic syndrome is in kidney failure, other causes of increased thirst and urination, to include hyperadrenocorticism (Cushing's disease), diabetes mellitus and liver disease, need to be ruled out.

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