@dr.nicolefein: Proteinuria is not a diagnosis. It’s a starting point. In this first episode of the series, I break down how I approach proteinuria clinically and how to categorize it before jumping to conclusions. Think in three buckets: • Pre-renal – often transient and related to systemic factors like stress, fever, inflammation, hypertension, corticosteroid exposure, or in rare cases overflow proteinuria from gammopathies • Post-renal – inflammation, infection, hemorrhage, or contamination distal to the kidney • Renal – intrinsic kidney disease, most commonly glomerular A urine dipstick is just a screening tool. If you see protein, confirm and quantify with a urine protein:creatinine ratio, ideally using pooled samples collected over multiple days. Always interpret in the context of sediment, blood pressure, and baseline lab work. Clinical pearl: if total protein is low but globulins are normal and albumin is decreased, start thinking renal loss over GI loss. Proteinuria matters because persistent protein loss accelerates kidney damage, even in patients that appear clinically stable. Next week we’ll narrow the focus to renal proteinuria and protein-losing nephropathy. Save this for your next proteinuric case and let me know what questions you have below. #veterinarian #veterinaryspecialists #internalmedicine #medicinemonday #thefeinvet

Dr. Nicole Fein
Dr. Nicole Fein
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Monday 02 March 2026 15:01:28 GMT
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futuredoctormegdvm
futuredoctormegdvm :
Where were you before my renal exam 8 hours ago diva💔
2026-03-03 00:06:26
45
aishamainacc22
𑣲 ˚.Aisha.⋆ֹ :
I want to be a veterinarian really bad but I don't know where to start. I'm still in high school
2026-03-02 15:06:39
22
kimberleygayaf
🏳️‍🌈KimberleyGayAf🏳️‍🌈❌ :
Smart women are so attractive!! I love how you talk to your patients btw.
2026-03-02 15:08:56
19
atommom
Ali :
Respectfully - Dr. Hillary Duff 🫶🏼
2026-03-05 14:17:47
4
bethc229
Beth :
Drop the skincare routine sis.
2026-03-02 15:24:16
3
littlecustomadventures
Little Custom Adventures :
am I going to be a vet? nope but im still watching ❤️
2026-03-02 15:22:31
56
chloevictoriahughes
Chloe Victoria Hughes :
You’re my favourite influencer ✨✨✨✨
2026-03-02 19:01:08
2
jesskelly007
Jessica Kelly :
New GP vet here - what are your thoughts on microalbumin? If you have proteinuria but your microalbumin levels are normal on the UA, do you still need to do a UPC? This has been confusing me.
2026-03-02 15:45:56
1
matildathepittie
Tilly :
Thank you for everything that you share. i am a beautiful dog, mom, and I have a dog's my whole life. and their ashes sit on my bar. i lost a doberman blab mix at six years old due to renal failure. that was hard. i also lost a puppy at six months old due to lectosclerosis. that was very hard. it's the other ones had a long and beautiful life.
2026-03-02 19:48:50
2
pcb554
pb :
I feel like I would be able to have much better compliance in diagnosing/treating proteinuria if running a UPC wasn’t so dang expensive
2026-03-02 22:41:18
25
jgarcia12120
Justin :
My wife is a vet and I can’t wait to casually bring this up tonight like I know what I’m talking about😂
2026-03-03 00:12:05
9
lou14410
Louise 🧡 :
Amazing, thank you so much. I love medicine but what frustrates me is working in general Practice most of the time all the diagnostics needed to get to an answer are not fundable 😭 so frustrating having interesting medicine places that I can never get to the bottom of
2026-03-04 07:48:49
2
talienaah
Tali :
Thanks for dealing with so many different things so I (a neurologist) don’t need to. 🫶
2026-03-02 23:52:14
4
rachellynn_19xx
Rachel_LynnXX :
I LOVE YOUR VIDEOS. Would love to work with you
2026-03-03 23:11:52
1
pickltickl
camryn :
is this true for cats as well? my cat had 4+ proteinuria - no other abnormalities on UA/cbc/chem, fiv/felv/hw neg, fecal nops and my doc said it can be a normal finding in cats
2026-03-03 05:50:44
1
naomimathew881
naomimathew881 :
Do you by chance have a podcast on Spotify where you do your lectures? For on the go learning! 🥰 Love having these from an internist!
2026-03-03 06:38:21
1
huskygem602
Carly :
These are so helpful to review right before I start clinics in May! Medicine is my 2nd rotation!
2026-03-03 17:05:21
1
onlyrealdanicapatrick
Danica Patrick :
Sweetheart of vets 🥰💙
2026-03-02 20:11:26
1
janraijmakers2
janraijmakers2 :
i love k9☺️
2026-03-13 13:10:42
1
cougarqueen1970
𝙈𝙨.𝘾𝙤𝙪𝙜𝙖𝙧 ❤️ :
your amazing 🥰
2026-03-03 00:38:40
1
tjr2369
Imawsomethx :
Most beautiful vet ever. But mainly and above that.. YOU TAKE such good care of all babies and all the kisses and baby voices not for social
2026-03-03 00:45:09
1
kendal.redding
Twindal.kendal :
I started to learn this at work today!!
2026-03-02 22:50:35
1
debo.dragon
Debo Dragon :
idk if you will respond but is pet insurance worth getting?
2026-03-03 22:53:05
2
thatsmrscarter
Annie Carter :
As a human with nephrotic syndrome, this is all very familiar 🤣
2026-03-03 03:22:26
1
touchedbykasandra
Kasandra, Licensed Esthetician :
You’re amazing!
2026-03-02 15:23:28
1
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