The Core Renal Panel: A Foundational SOP
This protocol defines the essential, high-yield components of an initial renal screen and provides a clear framework for confident interpretation.
Establishing a Consistent, High-Yield Baseline
Inconsistent or incomplete workups for suspected kidney disease can lead to delayed diagnosis and increased costs. This Standard Operating Procedure (SOP) defines the Tashikin Core Renal Panel—a foundational, non-negotiable baseline for any canine or feline patient where renal function is in question. Following this protocol ensures no critical signal is missed and provides a clear path from initial suspicion to a confident clinical assessment.
Phase 1: The Four Pillars of the Core Renal Panel
Complete Urinalysis (with USG)
Rationale: This is the most direct and cost-effective window into kidney function. The Urine Specific Gravity (USG) is the absolute pivot point for the entire workup, while sediment and chemistry can reveal concurrent issues like infection or proteinuria.
Essential Chemistry: CREA, BUN, PHOS
Rationale: Creatinine and BUN are the cornerstones of identifying azotemia, while Phosphorus is a key secondary marker that is critical for accurate IRIS staging and guiding management.
The Early Signal: SDMA
Rationale: SDMA is an integral part of a modern renal panel. As a more sensitive biomarker for GFR decline, it provides the unique ability to detect kidney disease months to years before creatinine becomes elevated, fundamentally changing the timeline for intervention.
The Vital Sign: Blood Pressure
Rationale: Systemic hypertension is both a cause and a consequence of CKD. Measuring blood pressure is a non-negotiable component of a complete renal assessment and is required for proper IRIS staging.
Phase 2: A Step-by-Step Interpretation Framework
Evaluate the USG: The First Decision
Action: Is the urine adequately concentrated? (>1.030 in dogs, >1.035 in cats). This single data point immediately determines the significance of any azotemia found.
Rationale: If azotemia is present with an inadequate USG, renal disease is the leading differential. If the USG is high, pre-renal causes are more likely. This is the first and most important dot to connect.
Integrate SDMA: The Early Insight
Action: Is the SDMA elevated (>14 µg/dL), even if Creatinine is normal? Pay special attention if the USG is also borderline.
Rationale: An elevated SDMA in a non-azotemic patient is a critical red flag. It provides the confidence to diagnose early-stage kidney disease (IRIS Stage 1) and initiate proactive management long before irreversible damage occurs.
Complete the Picture: Staging & Management Clues
Action: Assess Phosphorus levels and blood pressure to fully stage the disease according to IRIS guidelines. Quantify any proteinuria with a UPC ratio.
Rationale: A complete workup goes beyond diagnosis to staging. These secondary markers provide the crucial information needed to create a comprehensive, individualized management plan that addresses all facets of the disease.