Differential Diagnosis: Proteinuria in Dogs
Barry Hedgespeth, BVSc, North Carolina State University
Karyn Harrell, DVM, DACVIM (SAIM), North Carolina State University
Following are differential diagnoses for dogs presented with proteinuria.
Prerenal
Hemoglobinuria
Myoglobinuria
Light chain immunoglobulins (multiple myeloma, lymphoma)
Renal
Functional or physiologic
Congestive heart failure
Strenuous exercise
Fever
Seizure
Exposure to extreme temperatures
Glomerular
Infection
Bacterial (eg, anaplasmosis, borreliosis, bartonellosis, brucellosis, endocarditis, pyelonephritis, pyometra, pyoderma, Rocky Mountain spotted fever, other chronic infections)
Protozoal (eg, babesiosis, hepatozoonosis, leishmaniasis, trypanosomiasis)
Viral (eg, canine adenovirus type 1)
Parasitic (eg, dirofilariasis, schistosomiasis)
Fungal (eg, blastomycosis, coccidioidomycosis, histoplasmosis, phaeohyphomycosis)
Inflammatory
Chronic dermatitis
Inflammatory bowel disease
Acute pancreatitis
Periodontal disease
Polyarthritis
Systemic lupus erythematosus
Other immune-mediated disease
Neoplastic
Leukemia
Lymphoma
Mastocytosis
Primary erythrocytosis/polycythemia vera
Systemic histiocytosis
Congenital or familial
Amyloidosis (eg, beagle, English foxhound, shar-pei)
Hereditary nephritis (eg, bull terrier, cocker spaniel, Dalmatian, Samoyed)
Podocytopathy (soft-coated wheaten terrier)
Membranoproliferative glomerulonephritis (Bernese mountain dog)
Atrophic glomerulopathy (rottweiler)
Miscellaneous
Corticosteroids (endogenous/spontaneous hyperadrenocorticism or exogenous)
Diabetes mellitus
Systemic hypertension
Hyperlipidemia
Drug reactions (eg, sulfonamide [eg, sulfa-/trimethoprim] therapy, masitinib)
Chronic insulin infusion
Congenital C3 deficiency
Cyclic hematopoiesis (ie, gray collie syndrome)
Tubulointerstitial
Chronic kidney disease (including congenital/familial conditions such as renal dysplasia and polycystic kidney disease)
Acute kidney injury
Leptospirosis
Toxins (eg, NSAIDs, grapes, raisins, currants, ethylene glycol, vitamin D3, aminoglycosides, amphotericin B, sulfonamide [eg, sulfa-/trimethoprim] therapy, tyrosine kinase inhibitors [toceranib phosphate, masitinib mesylate] heavy metal ingestion [eg, lead, mercury, arsenic, thallium], insect or snake bite)
Fanconi syndrome
Interstitial nephritis
Postrenal
Urinary
Bacterial cystitis
Urolithiasis
Neoplasia (eg, urothelial carcinoma)
Extra-urinary
Prostatitis
Vaginitis
Pyometra