Differential Diagnosis: Proteinuria in Dogs

Barry Hedgespeth, BVSc, North Carolina State University

Karyn Harrell, DVM, DACVIM (SAIM), North Carolina State University

ArticleLast Updated April 20211 min readPeer Reviewed
featured image

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