Elevated creatinine and SDMA, but normal urinalysis?

[henryjones]

Hi all—looking for some insight from those of you who have dealt with CKD or possible CKD.

my cat Henry (DSH, 5.5yr) has been a pretty healthy guy apart from one incident when he was about 5mo old in which he went into sudden acute kidney failure. He rebounded within 24 hours and his kidney levels have been normal ever since.

Other than that, some mischief-related incidents. He once swallowed a piece of a toy and needed surgery to remove, but recovered well.

I recently brought him in for a regular blood work check and because I’d noticed he had been vomiting up more hairballs than usual. I thought maybe he had been dealing with stress and overgrooming, as we just had a baby 5 months ago. He has also done some inappropriate peeing (he has always been tempted by boxes, containers left out—this isn’t especially new, but he has found many of the baby’s items… tempting.)

To my surprise, his creatinine was elevated to 2.6 and SDMA 17. BUN was normal. A follow-up urinalysis revealed normal urine concentration and no clear signs of bacteria, though it was sent out for a full culture as the vet “thought she might see some bacteria.” Full urine culture showed nothing so we’re headed to a full abdominal US.

Link to blood and urine results)

I’m spiraling a little bit. Following his episode as a kitten (we still don’t know why it happened) he has been the picture of health. Even though I expected one day his kidneys may cause trouble, this came as a surprise.

Could there be any other explanation for these elevated levels *other* than kidney disease? Stress? Dehydration? Or I be mentally be preparing myself?

 

[Maurey]

Dehydration can cause elevated creatinine, and SDMA is indicative of absolutely nothing on its own. Since the urine sample is normal I’d redo bloods. Definitely have the ultrasound for peace of mind.

 

[FeebysOwner]

Hi. I am unable to read the test results but based on your description I would agree with Maurey - re-do blood work and consider an ultrasound to have a better look at the kidneys.

Other things that can impact creatinine is dehydration, stress, and cats with a high muscle mass. The SDMA might be picking up on loss of kidney function brought about by the mysterious acute kidney failure - there could be damage from that which is a little bit different from CKD. The ultrasound may shed some light on this aspect.

 

[henryjones]

Yep we got the ultrasound. Results in a day or two. The vet did mention that it’s possible only a specific part of the kidney was damaged and so he’s able to still concentrate his urine effectively? Ugh. I’m hoping against all odds that this isn’t as bad as it feels.

 

[FeebysOwner]

Good luck with the ultrasound and let us know the results! I would think that if it is damage from the acute kidney issue, then it is not as likely to be progressive as CKD would be.

My cat (17+ yo), while she has recently developed CKD, also has damage to her kidneys & ureters seen in an ultrasound that has been determined it could be related to oxalate stones that she had to have removed via surgery at age 5. A follow up ultrasound showed no changes from the first one. The vets consider the two conditions to be totally unrelated.