All members of the IRIS Canine GN Study Group Diagnosis Subgroup contributed equally in the preparation of this manuscript.
Consensus Recommendations for the Diagnostic Investigation of Dogs with Suspected Glomerular Disease
Article first published online: 25 NOV 2013
Copyright © 2013 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Special Issue: International Renal Interest Society Consensus Clinical Practice Guidelines for Glomerular Disease in Dogs
Volume 27, Issue Supplement s1, pages S19–S26, November/December 2013
How to Cite
IRIS Canine GN Study Group Diagnosis Subgroup, Littman, M.P., Daminet, S., Grauer, G.F., Lees, G.E. and van Dongen, A.M. (2013), Consensus Recommendations for the Diagnostic Investigation of Dogs with Suspected Glomerular Disease. Journal of Veterinary Internal Medicine, 27: S19–S26. doi: 10.1111/jvim.12223
A preliminary form of these recommendations was presented at the 2011 ACVIM Forum, June 15, Denver, CO.
- Issue published online: 25 NOV 2013
- Article first published online: 25 NOV 2013
- Manuscript Received: 11 SEP 2013
- Manuscript Revised: 11 SEP 2013
- Manuscript Accepted: 11 SEP 2013
- Protein-losing nephropathy;
The International Renal Interest Society (IRIS) offers guidelines for chronic kidney disease and acute kidney injury. As dogs with glomerular disease may present differently and require different treatment than those with whole nephron or tubular disease, the IRIS Canine Glomerulonephritis (GN) Study Group was convened to formulate guidelines for these cases. The Diagnosis Subgroup was asked to make recommendations for diagnostic evaluation of such cases.
To seek consensus among renal specialists for the evaluation of dogs with proteinuria because of suspected glomerular disease.
After reviewing the literature, subgroup members discussed and wrote the draft paper and recommendations, which members of the IRIS Canine GN Study Group voted upon by electronic secret ballot, with comments noted. Consensus was declared if votes showed strong or general agreement from 85% of the respondents.
Diagnostic tests were categorized as essential, recommended, or potentially helpful, with prioritization dependent on case characteristics, eg, for cases with uncomplicated proteinuria versus complicated with hypoalbuminemia, azotemia, or both. Consensus was reached with 86–100% agreement on all questions posed. All cases should have basic examinations including blood pressure measurement, blood, and urine testing, and a search for infectious diseases relevant to their environs. The majority ranked imaging (chest radiographs, abdominal ultrasonogram) and renal biopsy procured and interpreted by experienced personnel as essential evaluations in complicated cases, but a few respondents deemed these to be essential in uncomplicated cases as well.
Conclusions and Clinical Importance
Strong consensus about recommendations for diagnostic evaluation of dogs with suspected glomerular protein loss was attained. These guidelines help clinicians characterize disease processes for more informed therapeutic decision-making.