Differential Diagnosis: Proteinuria in Dogs

Barry Hedgespeth, BVSc, North Carolina State University

Karyn Harrell, DVM, DACVIM (SAIM), North Carolina State University

ArticleLast Updated April 20211 min readPeer Reviewed
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A golden cocker spaniel with a soft, wavy coat gazes directly at the camera, showcasing its expressive brown eyes and prominent nose. The background is blurred, emphasizing the dog's features in a natural outdoor setting.

Following are differential diagnoses for dogs 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

    • Infection

      • Bacterial (eg, anaplasmosis, borreliosis, bartonellosis, brucellosis, endocarditis, pyelonephritis, pyometra, pyoderma, Rocky Mountain spotted fever, other chronic infections)

      • Protozoal (eg, babesiosis, hepatozoonosis, leishmaniasis, trypanosomiasis)

      • Viral (eg, canine adenovirus type 1)

      • Parasitic (eg, dirofilariasis, schistosomiasis)

      • Fungal (eg, blastomycosis, coccidioidomycosis, histoplasmosis, phaeohyphomycosis)

    • Inflammatory

      • Chronic dermatitis

      • Inflammatory bowel disease

      • Acute pancreatitis 

      • Periodontal disease

      • Polyarthritis

      • Systemic lupus erythematosus

      • Other immune-mediated disease

    • Neoplastic

      • Leukemia

      • Lymphoma

      • Mastocytosis

      • Primary erythrocytosis/polycythemia vera

      • Systemic histiocytosis

    • Congenital or familial

      • Amyloidosis (eg, beagle, English foxhound, shar-pei)

      • Hereditary nephritis (eg, bull terrier, cocker spaniel, Dalmatian, Samoyed)

      • Podocytopathy (soft-coated wheaten terrier)

      • Membranoproliferative glomerulonephritis (Bernese mountain dog)

      • Atrophic glomerulopathy (rottweiler)

    • Miscellaneous 

      • Corticosteroids (endogenous/spontaneous hyperadrenocorticism or exogenous)

      • Diabetes mellitus

      • Systemic hypertension 

      • Hyperlipidemia

      • Drug reactions (eg, sulfonamide [eg, sulfa-/trimethoprim] therapy, masitinib)

      • Chronic insulin infusion

      • Congenital C3 deficiency

      • Cyclic hematopoiesis (ie, gray collie syndrome)

  • Tubulointerstitial

    • Chronic kidney disease (including congenital/familial conditions such as renal dysplasia and polycystic kidney disease)

    • Acute kidney injury

      • Leptospirosis

      • Toxins (eg, NSAIDs, grapes, raisins, currants, ethylene glycol, vitamin D3, aminoglycosides, amphotericin B, sulfonamide [eg, sulfa-/trimethoprim] therapy, tyrosine kinase inhibitors [toceranib phosphate, masitinib mesylate] heavy metal ingestion [eg, lead, mercury, arsenic, thallium], insect or snake bite)

    • Fanconi syndrome

    • Interstitial nephritis

Postrenal

  • Urinary

    • Bacterial cystitis

    • Urolithiasis

    • Neoplasia (eg, urothelial carcinoma)

  • Extra-urinary

    • Prostatitis

    • Vaginitis

    • Pyometra