• Open Access

Consensus Recommendations for the Diagnostic Investigation of Dogs with Suspected Glomerular Disease

Authors

  • IRIS Canine GN Study Group Diagnosis Subgroup,

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    • All members of the IRIS Canine GN Study Group Diagnosis Subgroup contributed equally in the preparation of this manuscript.
  • M.P. Littman,

    chair, Corresponding author
    1. University of Pennsylvania School of Veterinary Medicine, Department of Clinical Studies - Philadelphia, Philadelphia, PA
    • Corresponding author: M.P. Littman, VMD, DACVIM, Chair, Professor of Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104-6010; e-mail: merylitt@vet.upenn.edu.

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  • S. Daminet,

    1. Ghent University College of Veterinary Medicine, Department of Companion Animals, Merelbeke, Belgium
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  • G.F. Grauer,

    1. Kansas State University College of Veterinary Medicine, Department of Clinical Sciences, Manhattan, KS
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  • G.E. Lees,

    1. Texas A&M University College of Veterinary Medicine and Biomedical Sciences, Department of Small Animal Clinical Sciences, College Station, TX
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  • A.M. van Dongen

    1. University of Utrecht College of Veterinary Medicine, Department of Clinical Sciences of Companion Animals, Utrecht, The Netherlands
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  • A preliminary form of these recommendations was presented at the 2011 ACVIM Forum, June 15, Denver, CO.

Abstract

Background

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.

Objective

To seek consensus among renal specialists for the evaluation of dogs with proteinuria because of suspected glomerular disease.

Methods

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.

Results

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.

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