Condition reference
Renal standardizationGlomerular disease classification (dogs)
Explore the linked guideline and related drug references. A matching drug entry does not establish a treatment recommendation.
WSAVA guideline
WSAVA Renal Pathology Initiative: Classification of Glomerular Diseases in Dogs
The classification itself: 8 pathologists scored 114 parameters in 89-dog biopsies (84 proteinuric UPC >2.0 + 5 Greyhound controls); hierarchical cluster analysis (Ward's linkage, L2) produced 8 clusters in two branches — ICGN: MPGN (clusters 5–6) and MGN (clusters 7–8); non-ICGN: FSGS (clusters 2–3) and amyloidosis (cluster 4) (pp. 1, 6–7). Table 7 gives the LM+TEM+IF criteria per category; "type III MPGN (Burkholder variant)" is abandoned for mixed MPGN / mixed MGN (p. 20). The scheme is a modifiable prototype awaiting outcome validation (pp. 18, 21).
WSAVA Renal Pathology Initiative — Cianciolo et al., Vet Pathol 2016;53:113–135
Key findings
- Validation design: 114 parameters (LM 76, TEM 30, IF 8) on 89 dogs (73 Texas + 11 Utrecht; 59 prospective; core 72/wedge 16/punch 1); a curated 59-parameter set reproduced clusters except 1 case (MPGN→MGN) (p. 6).
- Cluster composition: ICGN n=46 — MPGN 5 (10) + 6 (13) = 23/89 (26%); MGN 7 (13) + 8 (10) = 23/89 (26%); non-ICGN n=43 incl. controls — FSGS 2 (13) + 3 (13) = 26/89 (29%); amyloid 4 = 12/89 (13%); 7 non-ICGN cases equivocal for immune complexes (pp. 6–7).
- LM-only misclassification: 22/89 (25%) — 8 MGN (7 of 10 cluster 8; 1 of 14 cluster 7 [as printed]) moved non-ICGN despite unequivocal deposits; all 13 cluster-3 + 1/13 cluster-2 FSGS moved ICGN-side; LM parameter count 35 (p. 6) vs 31 (p. 8) [verify] (pp. 8, 20).
- FSGS (Table 7): LM = solidification of a tuft portion by extracellular matrix; TEM = extensive foot process effacement (all proteinuric dogs — not specific) ± few/rare mostly mesangial deposits (19/26 lacked, 7 had); IF lacks granular IgG/LLC/C3; glomerular lipidosis only in FSGS (3/26, 12%) (pp. 9–11, 21).
- Amyloidosis: LM = mesangial expansion by congophilic material, apple-green birefringence (PAS pink, TRI blue-peach, JMS-negative); TEM = nonbranching 8–15 nm fibrils, no deposits; IF negative; minimal cases rest on TEM fibrils + negative IF; detected on 8-µm Congo red sections (pp. 3, 12, 19, 21).
- MPGN: LM = global diffuse endocapillary hypercellularity (cells internal to GBM) + mesangial hypercellularity + GBM double contours (JMS/PAS); neutrophils 1–5/glomerulus in all but 1 case; TEM subendothelial deposits 23/23, mesangial 20/23; subepithelial deposits = mixed MPGN; IF granular IgG/IgM/C3 all, IgA never positive (pp. 13–16, 21).
- MGN: endocapillary hypercellularity absent-to-minimal; defining TEM = subepithelial regularly spaced deposits (22/23); GBM remodeling (spikes/holes) outranks wall thickening; TRI red nodules 22/23; 7/23 subendothelial deposits = mixed MGN; IF granular IgG/IgM/C3 all (pp. 16–17, 20, 21).
- Scoring conventions: whole-slide lesions 0–4; individual glomeruli (4–32/case) as % affected — focal (<) vs diffuse; sclerosis <25 / 25–50 / 51–75 / >75%; segmental vs global; TEM deposits 0/1/2 from 9–26 images; IF 0/1/2 granular above background (pp. 3–4).
- WHO abandonment: WHO terms never validated for dogs; WHO reorganizing (C3 glomerulopathies, ISN/RPS lupus) — "type III MPGN (Burkholder variant)" dropped; IgA rare, no C3-only cases in cohort (p. 20); Table 7 titled "5 Common Categories" vs 4 headings [as printed; verify] (p. 21).
Drugs named in WSAVA’s own guideline text
As printed in WSAVA’s document, not this app’s own extracted data — see “Related drugs in this reference” below for that.
— [dose not printed in source]
Select patients likely to benefit — rationale for the ICGN/non-ICGN split (p. 21)
— [dose not printed in source]
For the 7 deposit-positive FSGS cases if standard therapies fail (p. 19)
— [dose not printed in source]
Only in the hypertension definition (p. 2)
Recommendations
Classify two-tier: ICGN (MPGN, MGN ± mixed) vs non-ICGN (FSGS, amyloidosis) per Table 7
Cluster-derived (pp. 6–7, 21)
Diagnose MGN on remodeling + subepithelial deposits, not thickening alone
Study finding (pp. 16–17, 20)
Label mixed MPGN / mixed MGN; abandon "type III MPGN (Burkholder variant)"
Explicit (p. 20)
Separate endocapillary vs mesangial hypercellularity with PAS/JMS; avoid 5-µm sections
Study finding (pp. 13, 19–20)
Score 0–4; % glomeruli (focal/diffuse); segmental/global; sclerosis 25% bands
Scoring scheme (pp. 3–4, 21)
Amyloid: 8-µm Congo red + polarization; minimal cases = TEM fibrils + negative IF
Methods (pp. 3, 12, 19)
Examine every glomerulus (FSGS focal; humans ~20–25 needed)
Benchmark (p. 19)
Keep full IF panel; scheme is modifiable prototype
Discussion (pp. 18, 20–21)
Related drugs in this reference (6)
The quoted line under each drug is its own already-extracted indication text that matched this condition — the reason it’s listed, not a paraphrase. Open a drug for its full species/route breakdown, calculator, and complete adverse-effect list.
Showing 6 of 6 linked drug records. Open a record for species, route and source details.
ASPIRIN
“Analgesia/antipyresis/anti-inflammatory (buffered products); antiplatelet adjunct (IMHA, glomerular disease, heartworm post-adulticide thromboprophylaxis)”
Source dose preview: 10 mg/kg (buffered), q12h, PO (Dog)
Adverse-effect notes: **GI ulceration/bleeding** — Dogs relatively sensitive even at antiplatelet doses · Toxicity (tinnitus-analog, CNS, acid-base, hyperthermia) — Overdose/accumulation
BENAZEPRIL
“CHF, hypertension, proteinuric CKD/glomerular disease”
Source dose preview: 0.25–0.5 mg/kg, q24h (up to q12h), PO (Dog)
Adverse-effect notes: GI distress — Most likely · Azotemia — Possible, especially with high-dose diuretics
CHLORAMBUCIL
“Lymphocytic leukemia, multiple myeloma, polycythemia vera, macroglobulinemia; immunosuppression (glomerulonephritis 0.1–0.2 mg/kg q24–48h; alternative in IMHA/i…”
Source dose preview: 0.1–0.2 mg/kg, q24–48h, PO (Dog)
Adverse-effect notes: Myelosuppression (mild, gradual) — Lower than cyclophosphamide — the point of choosing it · GI toxicity, anorexia — Occasional
CYCLOPHOSPHAMIDE
“Combination chemotherapy (lymphoma/CHOP, leukemias, carcinomas, sarcomas); immunosuppression (SLE, pemphigus, rheumatoid arthritis, glomerulonephritis, IMHA — c…”
Source dose preview: 50 mg/m² PO 4 days/week, OR 250 mg/m² PO/IV q3 wk; IV 100–300 mg/m² per protocol, Per protocol, PO/IV (Dog)
Adverse-effect notes: Myelosuppression — Dose-limiting · GI (anorexia, vomiting, diarrhea) — Common
ENALAPRIL
“CHF (vasodilator, with furosemide/pimobendan), proteinuria/glomerular disease, adjunct hypertension”
Source dose preview: 0.5 mg/kg, q24h initially, up to q12h, PO (Dog)
Adverse-effect notes: GI distress (anorexia, vomiting, diarrhea) — Most common · Lethargy, inappetence — Reported
MYCOPHENOLATE
“IMHA, myasthenia gravis, glomerulonephritis, pemphigus foliaceous — usually when other agents (azathioprine, steroids) fail”
Source dose preview: 10–20 mg/kg (up to 22–39 mg/kg/day for pemphigus, divided), q8–12h, PO (Dog)
Adverse-effect notes: Diarrhea, vomiting, anorexia, lethargy — Most common, dose-related (more at 30 mg/kg than 10 mg/kg) · Lymphopenia, increased dermal infection rates — Reported
From user-supplied full PDF (23 pp.; `text/ext_renal_cianciolo2016_FULL.txt`) + summary #10; cites = PDF pages; numbers as printed; [verify]: LM-only count 35 vs 31; "1 of 14" cluster 7 vs 13 (Table 6); Table 7 "5 Categories" vs 4 headings. Feline disease, doses, outcomes not covered.