Urine analysis- kidney issues?

Greatly appreciated if any vets/ techs are able to comment on this!!! Will attach photos. So my eldest dog Baxter ( 11 years old ) is a Shih Tzu x Bichon mix. He has had symptoms of diabetes or something going on for over a year but never showed “ medical signs “ so the vets said to wait it out. I stopped the urinalysis that I was doing every few months as nothing ever changed. Here we are over a year later. As if the past 2 months he has gone downhill. He tried to attack me the other night multiple times ( has always been reactive due to an incident when young but started thriving months ago on anxiety meds, has not attempted to bite since. ) I was trying to look at his skin and he was obviously in discomfort when I moved his one leg. Warning nip. He has patches on his ears, chin, feet, and underarm of raw skin, many spots look black. I decided to check them out more thoroughly as I noticed the past 2 weeks he has been nibbling at his one leg nonstop. Used to do it out of anxiety but has had no anxiety since the meds. Turns out he has a bump on the underside of this leg now ( suspected scab ) and is biting it open. It doesn’t look awful. That being said, I sat down and put two and two together. The past few months he has been screaming at me whenever I go to get water, excessively thirsty. The past month he also started having urinary accidents in my room. Daily, nightly, around the clock. Now he has them multiple times a day. If he has more water and drinks as much as I will let him ( as he will stand and drink loads ) he will have nonstop accidents in my room if in there or around the house. He whines to me still to go, I think he can control it, but just constantly had the urge to go. Fast forward. My vet tech friend recommended an at home urine test kit. I have an appointment scheduled for the end of this month ( soonest available ) and they are going to do a urinalysis and possibly other testing. As I won’t trust anything for certain unless it comes directly from their vet. But I figured these might give me peace of mind. Tested my other dogs also and some plain water and those were accurate. The results, if accurate, do greatly concern me. I tested each urine output multiple times, followed the directions to a T, and tested his urine at different times throughout the day. A photo is attached of the most recent results and the most accurate as far as he hasn’t been drinking nonstop since I try to lessen it around bedtime. The results from what I see; protein in the urine, ketones, and a concerning amount of something gravity? I had no clue what any of this means other than ketones and protein are not good. I did some research ( I know I know Dr. Google sucks ) and I have come to the conclusion that it all looks like possible kidney disease. It said the gravity whatever is often a telltale sign for kidney disease and indicates a further work up, and his are off the charts if I read it right/ high as high can be. Ketones I know are often associated with diabetes but every strip has shown perfect glucose so I am not concerned about diabetes. Again will let vet further evaluate. what is your guys take? Can anyone read this test strip better than I can? Can someone elaborate on what these individual things mean and your assumed possibility for a diagnosis? If it is possibly kidney disease, what are the typical steps for care and the average lifespan? I want to know all the info I can get! Dos and donts food wise etc etc etc. Thank you.

Hello!  - and my goodness, what a stressful case.  You have continual drinking of water, inflamed / sore / chewed skin, an apparently very high specific gravity (please note that these are not to be relied on on dipsticks; your vet would normally get the correct measurement using something called a refractometer) and possible ketones.  Where did the sample come from - how did you catch it? - how about the glucose sticks?  Are they in date / being used correctly?  How long has the urine sat for?  This can make a massive difference to the readings. Some of the signs that you are relating are concerning - especially the really sore skin that is constantly being chewed and the ongoing drinking.  If those ketones are correct then this is extremely concerning too, whether or not the glucose is high.  Diabetics don't necessarily have high urine glucose all the time.  Furthermore, Ketones can be just as worrying whatever the reason for their being raised as they may cause internal damage.  Sometimes fluids can be needed. I would strongly advise calling your veterinary team and asking for the case to be triaged to see whether or not they or the emergency vets will see you today in light of the signs.    Explain that you are seeing drinking and urinating a lot, severe skin disease - constantly licking and scratching - and high ketones on a urine test. I think that the priority is in making sure that they are happy that your dog is safe right now; the clinical outcomes of various different possibilities can wait for diagnosis.

Please note that there is a reasonable chance of this being an emergency.