The SDMA Test – Dog And Cat Owner Feedback & Comments
Ron Hines DVM PhD
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What is your pet’s name? Where do you live? How old is your pet? Were the SDMA test results consistent? Did SDMA levels go up before creatinine levels went up? What were its creatinine levels? Where other laboratory or urine tests abnormal? Was your pet ill at the time of the test? When that illness passed, did the pet’s SDMA levels go down? Was a special diet recommended? Did SDMA levels return to normal on the new diet? Would your dog or cat eat it? Did the pet’s weight on the new diet change? What medications were recommended? Anything else you would like to add?
Updates in green Dr. H. comments in purple
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November 29, 2023
Dear Dr. Hines,
Thanks so much for your articles. I am an NIH Medical Scientist and appreciate all of the details as well as your professional opinion. It is unfortunate that veterinary test marketing and $ can impact an owner’s decisions on next steps for their pets, particularly those who do not have much medical knowledge or who can advocate well for their pets. I just finished reading your article about the SDMA test. Much appreciated. Thanks again. Keep on fighting.
Best,
C. K., Washington DC-Baltimore area
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June 20, 2023
Hi Dr. Hines, I have a question for you regarding the SDMA test. There was a link to an article by Yeramilli, et al., “Prognostic value of symmetric dimethylarginine to creatinine ratio in dogs and cats with chronic kidney disease”. It said that the higher the SDMA:SCr ratio was, the shorter the expected lifespan would be. Assuming an elevated SDMA:SCr ratio of over 10 would be quite serious. Example: a cat’s bloodwork shows an SDMA of 24.5 ug/dL and a SCr of 2.6 mg/dL. The SMMA:SCr ratio is 9.4. If the SCr dropped to 2.0 and the SDMA dropped to 24.0, the SDMA:SCr ratio jumps to 24/2=12.0, which according to them would indicate the possibility of less than 12 months more to live. This makes no sense to me. If both the Creatinine and SDMA values improve by dropping, how is it logical to interpret that as the cat’s condition is worsening simply based upon the ratio? Maybe you can explain this to me because it is not logical to my way of thinking. I believe that you are right that SDMA is more of a marker of a cat’s overall health than just a measure of CKD and that we should depend upon Creatinine and BUN for kidney evaluation and other tests to determine the health of other organs.
Thanks., M.F.
6-21-23 Dear M, Thank you for your perceptive email. Unfortunately, truth takes the back seat to the generation of money in today’s world. IDEXX Laboratories revenue for the twelve months ending March 31, 2023, was $3.431B. There’s no way that a few perceptive folks like you and a veterinarian of modest means like myself are going to make much difference. The industry funded – Renal Interest Society, with its finger to the wind, grasped that long ago. Sweeping your observations under the rug sells a lot more lucrative laboratory tests and prescription cat food than it would if they made any efforts to developed better age-related, and body weight related creatinine normals tables for cats and dogs. I believe that people with a financial interest in the outcomes should never be the scientific juries on anything. The RIS conveniently makes that information difficult to discover.
Best wishes, RSH
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June 1, 2021
We have an 8-yr-old golden retriever who has been very healthy her entire life. I agreed to have our vet do preventative screening bloodwork on her during her last vet appt. Her SDMA was slightly elevated (17). No other numbers were out of range in her blood or urine. Six weeks later we had it checked again. The SDMA # remained slightly elevated (19). Everything else was normal. Our vet wants me to put her on renal Diet RX food. I don’t intend to do so at this juncture. Even if she does have early stage CKD, it seems it must be very early and the RX diet would likely do more harm than good by scaling back too much on protein. I am going to be cognizant regarding not give her any treats that are high in phosphorous. Our dog gets EXTREMELY STRESSED when we go to the vet or groomer. Could that account for her elevated SDMA level? At the moment, I am on the fence about repeating her bloodwork in another few months, or just waiting a full year.
A.M. ajm***@gmail.com
Strenuous exercise is known to elevate kidney-health markers such as creatinine in humans. (read here and here) No one knows if it elevates SDMA as well because human nephrologist do not believe that the SDMA kidney test is worth running.
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October 19, 2020
Hello,
My cat’s name is Hakeem. He is 5 years old and eats Dr. Pierson’s raw food recipe. His case puzzles our vet. Hakeem’s SDMA test is in the normal range but his creatinine is 2.1 ( Antech 0.6-2.4) and his BUN is 28 (Antech 14-36). His creatinine and BUN are logically elevated since he eats NO carbs. IDEXX says that 4% of the cats have this low SDMA combined with high creatinine, which they cannot explain. So, this test will not be reliable for us. I am VERY confused our vet discarded the SDMA results altogether. This puzzle is not discussed very much on the Internet. It would seem vets, and vets at Idexx too, are so unfamiliar with cats that don’t eat carb-stuffed kibble, that they are biased in their analysis. Cheers from Delphine, Hakeem, and younger brother Mehdi and thank you for your interest in my black, Caribbean panther… Enjoy your evening!
Delphine from Martinique Provenance : Courrier pour Windows 10
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October 1, 2020
You asked about SDMA levels in chronic kidney disease in cats and how they change over time. My cat Penney was diagnosed with CKD in early 2018. [ ] She is still doing well and has not lost any weight since her diagnosis. Her blood phosphorus still very low at 3.6 on her last test without using a phosphate binder. She is now about 14.5 years old and my vet says she still has excellent muscle.
Here are her Creatinine and SDMA values: 
Her SDMA has really bounced around. I’ve read your articles and do wonder how useful it is as an indicator of her CKD progression. Hope this helps!
A. H., Portland, Oregon
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February 7, 2020
Hi Ron,
My 17 year old Boston’s kidney values suddenly went through the roof. Creatinine 1.1 to 3.9, BUN 33 to 134, Phosphorus 4.7 to 11.2 . Oddly, her SDMA went down, from 10 to 8. This may be due to the things I have been giving her that have been shown in studies to be nephro-protective when the kidneys are damaged in various ways: Berberine (a lot of rats died proving this) and milk thistle combo, L-carnitine, krill oil for omega 3s, fisetin, and pyridoxal 5 phosphate. She also had a triple strength IV stem cell injection (VetStem) a couple of months ago. Two questions for you:
How reliable is the SDMA when it goes down? Is there enough phosphorus in pyridoxal 5 phosphate to cause trouble? It is thought to be great for kidneys. Forgot to mention I give Licorice lots of curcumin (Theracurmin). There have been a number of studies about curcumin preventing kidney damage.
Thanks, Rob.S., Riverside, CA
See Licorice’s Idexx lab report here
3-5-20 update: “The SDMA test was for s**t. It was 8 PM when she died in my arms Sunday morning.” Rob S.
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June 18, 2019
Hello Dr Hines
Our dog’s name is Nyawela Busveld Lehabah. We live in France on the Swiss/German border. Our dog is a 2-years-old Rhodesian Ridgeback. I breed them. I feed them a raw meat diet. An ultrasound of our dog’s kidneys showed one smaller than the other. Our dog’s SDMA level went up when his creatine level was only 1.1 mg/dl. His urinalysis was normal and he showed no signs of illness. Our veterinarian recommended Royal Canine Renal Support diet. Along with an additional 100 mg/kg of additional water throughout the day. When we switched to this diet, his SDMA levels went back down to 9. We added taurine to the diet on the advice of our veterinarian. Now the dog’s SDMA level is back up to 16/mg/dl. I wonder if the SDMA level is a valid gauge of kidney function or if the taurine supplement made the SDMA values go up.
P.B. Haute Saone, France
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