VETINUITY
Vetinuity identifies clinical problems, recommends diagnostics, suggests treatments, and calculates drug doses. Every recommendation cited from over 10,000 veterinary journal articles.[01]
Creatinine 2.1 mg/dL and SDMA 18 µg/dL confirmed on two samples taken two weeks apart. Staging CKD using the IRIS system is essential — it directs management decisions and establishes a prognostic baseline; early-stage identification is associated with markedly longer survival times.[1] Substage by UPC ratio and systolic blood pressure before finalizing the treatment plan.
Patient is hyporexic; 0.4 kg weight loss since last visit. Uremic nausea is the likely driver. Aggressive early nutritional support alongside IV fluids and antiemetic coverage substantially improves recovery trajectory when GI compromise accompanies systemic illness.[2]
Total T4 pending. Hyperthyroidism elevates GFR and can mask a worse stage of underlying renal disease; treating hyperthyroidism may unmask true CKD severity. Recheck creatinine and SDMA 4–6 weeks after initiating antithyroid therapy.
Required for IRIS substaging. Persistent proteinuria (UPC > 0.4) carries independent negative prognostic weight and is an indication for renoprotective therapy regardless of azotemia stage.
Hypertension accelerates glomerular injury in CKD. Target < 140 mmHg. If white-coat effect is suspected, measure on a separate low-stress visit before initiating amlodipine.
Rule out occult hyperthyroidism before staging is considered stable. A normal total T4 in a cat with comorbidities can be spuriously suppressed; free T4 by equilibrium dialysis is more sensitive if index of suspicion is high.
Assess renal architecture — cortical echogenicity and corticomedullary distinction. Small, irregular kidneys with increased echogenicity support chronic fibrosis rather than an acute injury pattern.
Per IRIS criteria, two creatinine and SDMA measurements separated by at least two weeks are required to confirm staging. Single-point values can be influenced by hydration status and lean muscle mass.
Transition to a renal diet; target serum phosphorus 2.5–4.5 mg/dL for IRIS Stage 2. Add an intestinal phosphate binder if dietary restriction alone fails to reach target after 4–8 weeks of confirmed compliance.
Initiate at 1.25–2.5 mg per cat orally twice daily (q12h). Twice-daily dosing achieves euthyroidism in significantly more cats at 2 weeks and produces fewer serious adverse effects than equivalent once-daily dosing.[3] Recheck T4 and renal values in 2–3 weeks; adjust dose in 1.25 mg increments until euthyroid.
Start amlodipine 0.625 mg/cat PO q24h. Recheck blood pressure in 7–14 days. Titrate to 1.25 mg if target not reached. Do not use benazepril as monotherapy for hypertension in CKD — combination with amlodipine is preferred when proteinuria is present.
Creatinine, SDMA, UPC, and blood pressure every 3–6 months at baseline. Advance to every 1–3 months if UPC > 0.4 or SBP > 159 mmHg at any visit.
Furosemide CRI at 1 mg/kg/h diluted into a 12 mL syringe running at 1 mL/h. Math done.
Phone camera reads analyzer printouts. Abnormal values flow into the note.
Client-ready discharge summaries generated from the medical note in seconds.
Paste your existing template. Save. Done. No drag-and-drop wizard.
Professional clinical language, not robotic filler. Notes that read the way you'd write them.
Phone in the exam room, desktop at the workstation. Everything syncs.
