Raw fed Bengal with elevated SDMA, creatinine and lipase

[Ginalouis]

Hello all, I was hoping to get some more info on creatinine and lipase levels in raw fed Bengal cats. I recently took my boy to a vet to get his shots and make sure he’s doing well. Turns out he has high levels of creatinine lipase and SDMA. Everything else is clear. Urinalysis came back clear as well. I was told to put him on a kidney diet but based on what I’ve been reading online I feel like my vet might be basing everything off a kibble based diet. My boy has no symptoms of pancreatitis or kidney problems but dr says he can’t her neutered until after 4 weeks of monitoring him. Do you think I should be concerned for his health ?

 

[LTS3]

Hello all, I was hoping to get some more info on creatinine and lipase levels in raw fed Bengal cats. I recently took my boy to a vet to get his shots and make sure he’s doing well. Turns out he has high levels of creatinine lipase and SDMA. Everything else is clear. Urinalysis came back clear as well. I was told to put him on a kidney diet but based on what I’ve been reading online I feel like my vet might be basing everything off a kibble based diet. My boy has no symptoms of pancreatitis or kidney problems but dr says he can’t her neutered until after 4 weeks of monitoring him. Do you think I should be concerned for his health ?

Blood work values were established years ago when people mainly fed dry food. Raw diets have only been popular in the past decade or so and many vets don't take into account how a high protein raw diet affects kidney values. This might be helpful: Looking for the links with info about elevated BUN/crea in raw fed cats

 

[10thomer]

Hello all, I was hoping to get some more info on creatinine and lipase levels in raw fed Bengal cats. I recently took my boy to a vet to get his shots and make sure he’s doing well. Turns out he has high levels of creatinine lipase and SDMA. Everything else is clear. Urinalysis came back clear as well. I was told to put him on a kidney diet but based on what I’ve been reading online I feel like my vet might be basing everything off a kibble based diet. My boy has no symptoms of pancreatitis or kidney problems but dr says he can’t her neutered until after 4 weeks of monitoring him. Do you think I should be concerned for his health ?

I'm a little late to this thread but wanted to comment in case this might be helpful! Couple of questions for you and then I'll give you my current two cents:
1. What was your cat's urine specific gravity? What was his urine protein?
2. How old is your cat? How much does he weigh?
3. Any symptoms you think are important to share? Has your cat ever had IBD?
4. Is your cat currently on any medications?

A little backstory, I've been in a similar situation to you. From the ages of 4-6, one of my cat's labs has been as follows:

• Creatinine: ~2.2 (so about 194umol/L on your scale)
• BUN: Was normal (in the middle of the range) for a while until I switched him from Blue Buffalo to Tiki Cat, then it went just slightly above the reference range (38)
• SMDA: Was 15 when we tested it once (he was having a pancreatic/IBD flare up at this point), then dropped back to 14
• USG: Ranges from 1.019 (had low blood sodium at this point so I think this is what caused it to be this low) to 1.030
• His lipase was always normal, but when we took him to an internal medicine specialist, his Spec fPL levels (more specific biomarker for pancreatitis) were 2x baseline, suggesting he had chronic pancreatitis

My cat has always been fairly muscle-y and is quite large (13-15lbs is a healthy weight for him). He has IBD and pancreatitis so he absolutely does not eat any dry food because that will set off his vomiting (which is why we took him into the vet to get the labs when he was 4 y.o.). My vets have been confused by these numbers, and they have not been confident enough to diagnose him with CKD. As LTS3 mentioned above, a lot of these ranges were established by cats on high carb, dry foods that are species inappropriate.

So I absolutely have no authority to diagnose your cat, but I can provide some perspective on the lab values because I've done a significant amount of secondary research because of my own cat.

• Creatinine can mean CKD, but can also be higher for cats with more muscle mass, larger overall size, higher protein/raw diet, and sometimes pancreatitis can cause elevated creatinine levels.
• SDMA is a bit of a controversial biomarker, as human nephrologists don't believe that SDMA is much value in evaluating kidney disease in humans and no independent research has confirmed that it's an earlier read on kidney disease that I'm aware of. It will increase with CKD, but can also increase because of low grade inflammation, IBD, and protein intake so it's a highly sensitive but not specific biomarker.
• Elevated lipase can mean all sorts of things including pancreatitis, administration of corticosteroids, liver disease, kidney failure, and abdominal infections.

With the information you provided above, my initial hunch is that you want to be on the lookout for 3 things:
1. It's possible that your cat has mild chronic pancreatitis for some reason, this may explain the mildly elevated creatinine, SDMA, and lipase. If you're concerned about this, a Spec fPL test can be run.
2. Your cat is just on a higher protein/lower carb diet than the cats that were used to establish these biomarker ranges and you have nothing to be concerned about (although I'm not sure if this explains the lipase levels)
3. Your cat does indeed have very early CKD.

If you provide answers to the above questions I can help you come up with some questions/requests for your vet!