Veterinary Guide to Proteinuria in Dogs 2025 ⚕️🐕🐾

By Dr. Duncan Houston BVSc

🧬 What Is Proteinuria?

Proteinuria is excess protein in a dog’s urine—normally, healthy kidneys retain protein. It can signal urinary tract inflammation or serious kidney/glomerular disease.

📌 Why It Matters

• Protein is vital—its loss indicates kidney or urinary issues.
• Persistent proteinuria damages the kidneys and worsens disease prognosis.
• May also reflect bleeding, infection, hypertension, or systemic disease.

🔍 Common Causes

• Transient/postural: exercise or stress; usually resolves.
• Lower urinary tract: UTIs, cystitis, prostatitis, vaginitis.
• Kidney/glomerular: glomerulonephritis, amyloidosis, familial nephropathies.
• Secondary/systemic: hypertension, Cushing’s, diabetes, infection, pancreatitis.
• Neoplastic: multiple myeloma leading to Bence-Jones proteinuria.

👀 Signs to Watch

• Often silent, detected during routine exams.
• May accompany thirst, urination changes, and appetite loss.
• Possible lethargy, vomiting, diarrhea, foul breath, swelling.
• Advanced signs in nephrotic syndrome: edema, hypercholesterolemia.

🧪 How We Diagnose It

1. Dipstick urinalysis: quick check for protein, but may give false positives if blood/inflammation is present.
2. Urine protein: creatinine ratio (UPC): quantifies protein loss; >0.5 in dogs is significant.
3. Urine sediment & culture: rule out infection/inflammation.
4. Bloodwork + BP: creatinine, SDMA, albumin, cholesterol, blood pressure.
5. Imaging & advanced testing: abdominal ultrasound, infectious screens, endocrine testing; biopsy if renal proteinuria persists.

🛠️ Treatment Strategies

1. Address the Underlying Cause

• UTIs treated with antibiotics often resolves proteinuria.
• Manage systemic diseases like hypertension, Cushing’s, and diabetes.
• Treat neoplasias like myeloma per oncology protocols.

2. Reduce Glomerular Pressure

• ACE inhibitors (enalapril/benazepril): first-line therapy.
• ARBs (telmisartan): promising alternative or add-on.

3. Dietary & Supportive Care

• Renal diets: moderate protein, low sodium, supplemented with omega‑3 fatty acids.
• Omega‑3s reduce proteinuria and improve kidney health.
• Manage hypertension, monitor electrolytes, and hydration.
• Corticosteroids or immunosuppressants only if immune-mediated glomerulonephritis is diagnosed via biopsy.

📅 Monitoring & Prognosis

• Repeat UPC 4–8 weeks after starting therapy.
• During therapy, recheck UPC, chemistry, and BP every 2–3 months.
• Prognosis depends on cause—UTIs resolve fully; chronic kidney/glomerular issues require lifelong care.

🏡 At-Home Tips for Owners

• Collect clean urine samples for monitoring, using home dipsticks or Ask A Vet guidance.
• Feed consistent, vet-approved renal diets and limit treats.
• Keep meds on schedule; track thirst, appetite, urination, and weight weekly.
• Use non-slip mats, calm routines, and monitor for swelling or lethargy.
• Ensure regular check-ups even after improvement.

📱 Ask A Vet Ecosystem Integration

• Telehealth support: remote dipstick interpretation, UPC planning, medication adjustments.

🎓 Case Highlight: “Bailey” the Beagle

“Bailey,” an 8‑year‑old Beagle, presented with trace protein, then UPC 0.8, and hypertension. After 4 weeks of enalapril, telmisartan addition, and renal diet guided by Woopf, UPC dropped to 0.3, and BP fell to 150 mmHg. Bailey regained energy and appetite—owner reports “She’s back to her playful self!” 🐾

🔚 Key Takeaways

1. Proteinuria is a sign, not a diagnosis; investigate causes early.
2. Use UPC to quantify and guide management.
3. Treat UTIs, hypertension, and endocrine disorders accordingly.
4. ACE inhibitors and ARBs are effective; dietary support boosts results.
5. Regular monitoring preserves kidney health—Ask A Vet is here to assist.

Dr Duncan Houston BVSc, Ask A Vet founder. Download the Ask A Vet app for expert remote monitoring, dietary planning, and kidney support—because protein loss doesn’t have to be permanent! 🐶💙