Seeking Advice: Potential Early Stage 2 Kidney Disease in My 6.5-Year-old Dog

I posted this on r/AskVet as well, but that sub is less active. Would anyone be able to offer advice or share experiences regarding potential early stage two kidney disease in dogs? I have a 6.5-year-old mixed-breed dog, including Boxer, Cattle Dog, German Shepherd, and Staffordshire Terrier, among others. She's been part of our family since she was eight weeks old and weighs about 45 lbs. Recently, we noticed she's been struggling with urinary incontinence, leaving wet spots where she sleeps. After a visit to the vet, she was diagnosed with likely spay-related incontinence and started on Phenylpropanolamine about a week ago. During the same visit, she underwent bloodwork and a urinalysis. The vet informed us today (December 19, 2023) that her IDEXX SDMA level is 19 and her Creatinine level is 1.7. According to the IRIS staging guidelines, these results indicate early stage 2 kidney disease. | IDEXX SDMA | **19** | (Normal range: 0 - 14 μg/dL) | | Creatinine | **1.7** | (Normal range: 0.5 - 1.5 mg/dL) | The vet recommended an ultrasound and additional bloodwork, both scheduled for January 3, 2023. We've already switched her diet to Hill's Prescription Diet for kidney health, moving away from her previous Kirkland Signature Healthy Weight diet. I'm understandably worried and seeking insights from others who have dealt with early stage two kidney disease in dogs. - What has your experience been? - Do you have any recommendations or thoughts on this diagnosis? - Is my concern premature, or should I wait for the ultrasound results before taking further action? For those interested, here's a link to her blood work and urinalysis results: [Imgur Link](https://imgur.com/a/hQtpUC5)

Hi - I'm a vet not a kidney patient-owner, although hopefully owners who have been in a simar situation might comment for you.  We'd like to encorage a little more of that here. When you say, 'is my concern premature,' what specifically is it that you are concerned about?  Quality of life, length of life, the reliability of the diagnosis, that you're not doing enough, general stress or something else?

I hear of course that you are understandably and relatably worried in general about your mix-breed girl (don't tell anyone by the way, but if I had a favourite breed, the complicated mix-breed would be it!) - and hopefully other owners will comment soon to enforce that that is very normal at this stage.  But kidney disease is a wide topic and second opinions being beyond the scope of this service, please do comment here if there are specific things that you would like us to chat about from a veterinary perspective.

You can continue with the prescribed kidney health diet, as it can play a crucial role in managing kidney disease in dogs. Monitor her water intake and make sure she stays hydrated.