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Differential Diagnosis: Proteinuria in Cats

Barry Hedgespeth, BVSc, North Carolina State University

Karyn Harrell, DVM, DACVIM, North Carolina State University

Urology & Nephrology

|April/May 2021|Peer Reviewed

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Differential Diagnosis: Proteinuria in Cats

Following are differential diagnoses for cats 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
    • Infectious
      • Bacterial (eg, chronic bacterial infection, mycoplasmal polyarthritis, endocarditis)
      • Viral (eg, FIV, feline infectious peritonitis, FeLV)
      • Protozoal (eg, toxoplasmosis) 
      • Fungal (eg, cryptococcosis, other systemic fungal infection)
    • Inflammatory
      • Acute pancreatitis
      • Cholangiohepatitis
      • Chronic progressive polyarthritis
      • Systemic lupus erythematosus
      • Other immune-mediated diseases
    • Neoplastic
      • Leukemia
      • Lymphoma
      • Mastocytosis
    • Miscellaneous
      • Acromegaly
      • Drug reactions
      • Diabetes mellitus
      • Corticosteroids (endogenous/spontaneous hyperadrenocorticism and exogenous)
      • Hyperthyroidism
      • Systemic hypertension
    • Familial
      • Membranous nephropathy
      • Amyloidosis (Abyssinian, Siamese)
  • Tubulointerstitial
    • Chronic kidney disease
    • Acute kidney injury
      • Toxins (eg, NSAIDs, acetaminophen, ethylene glycol, lilies [Lilium and Hemerocallis spp], heavy metal ingestion [eg, lead, mercury, arsenic, thallium], insect or snake bite)
      • Hypotension

Postrenal

  • Bacterial cystitis
  • Idiopathic cystitis/FLUTD
  • Urolithiasis
  • Neoplasia (eg, urothelial carcinoma, other)
  • Prostatitis (rare in cats)
  • Vaginitis
  • Pyometra

References

For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

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