Q: How do I diagnose CRF early or in its most treatable stages?
A: Annual or semi-annual health examinations that include clinicopathologic evaluations in middle-aged and older patients are
an excellent way to document trends compatible with declining renal function. Data flow charts facilitate observation of trends
and are recommended. Decreases in body weight, packed cell volume, and urine-specific gravity over time, for example, can
occur in patients with subclinical renal dysfunction. Conversely, increases in serum urea nitrogen, creatinine, phosphorus
and microalbuminuria/proteinuria (even when these increases remain within the laboratory normal range) might be early indicators
of declining renal function. In patients with diminished urine concentrating ability, urine should be cultured periodically
due to the diminished antibacterial properties of minimally concentrated urine. An ultrasound examination of the kidneys is
indicated if trends in the above data are compatible with developing renal insufficiency failure.
Dr. Grauer earned his DVM degree from Iowa State University in 1978. He then completed his postgraduate training (internship,
residency and MS degree) at Colorado State University between 1978 and 1982. Dr. Grauer obtained his specialty board certification
in internal medicine in 1983. After his postgraduate training, Dr. Grauer was a member of the faculty at the School of Veterinary
Medicine, University of Wisconsin for seven years and then returned to the Department of Clinical Sciences at Colorado State
University where he served as professor and section chief of small animal medicine until 2000. Dr. Grauer also has served
as president and chairman of the Board of Regents of the American College of Veterinary Internal Medicine. Currently, Dr.
Grauer is professor and head of the Department of Clinical Sciences at the College of Veterinary Medicine, Kansas State University.
His interests in clinical medicine and research involve the small animal urinary system.