I recommend yearly screening for all Bracco Italiano dogs. This should include bloodwork and urinalysis (including UP/C) as below.
If a dog has a family history of kidney disease, screening should be done every 6 months.
I recommend starting yearly screening at ONE YEAR OF AGE. Screening of breeding dogs should be done within 6 months of a planned breeding.
Yearly testing of apparently healthy dogs can help catch kidney disease early. Early diagnosis can provide an opportunity for medical management. Once symptoms begin, the prognosis is poor – so early diagnosis is very important.
Once there is suspicion of kidney disease, a full evaluation is indicated by your veterinarian. Find the consensus recommendation on diagnostic investigation of suspected glomerular disease. This is a good resource for veterinarians.
Bloodwork – Chemistry Analysis
Evaluate blood values such as creatinine, blood urea nitrogen, and albumin levels.
Bracchi with amyloidosis can have protein loss in the urine (which can cause low blood albumin) but normal creatinine, BUN, and SDMA values.
SDMA (Symmetric Dimethylarginine) should be used as an adjunctive test, not a stand-alone. Some Bracchi with advanced kidney disease can have normal SDMA values.
Bloodwork should always been done with a concurrent urinalysis and UP/C
More information on testing and staging and early diagnosis of kidney disease.
Urinalysis – always to include UP/C
Urinalysis evaluates the urine specific gravity (USG) of the urine. This evaluates the kidney’s ability to concentrate urine.
Urinalysis also evaluates for abnormal components in urine – such as red blood cells, white blood cells, protein, glucose, ketones, and bilirubin.
A full urinalysis should include a urine specific gravity, dipstick test, and sediment.
More information on urine collection is available here.
Urine Protein:Creatinine Ratio (UP/C)
The protein measurement on a urine dipstick is somewhat unreliable and cannot accurately quantify the amount of protein in the urine.
The UP/C is an important part of screening and monitoring kidney disease in the Bracco.
A Urine Protein:Creatinine Ratio gives a quantitative measure of the amount of protein in the urine. It is a number that can be monitored over time and in response to treatment. A normal UP/C is less than 0.4.
Kidney Biopsy
Kidney biopsy allows a pathologist to evaluate the kidney cells under a microscope. This is an invasive test (requires general anesthesia), but it allows us to reach a definitive diagnosis in most cases.
A Congo Red Stain is needed to evaluate for the presence of amyloidosis. Electron microscopy can also be used to look at the amyloid fibrils themselves.
A kidney biopsy can be done to obtain a diagnosis for a dog undergoing treatment, or post-mortem as part of a necropsy (animal autopsy).
The International Veterinary Renal Pathology Service (IVRPS) is recommended to evaluate Bracco Italiano kidney biopsies.