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This Atlas of Renal Lesions in Proteinuric Dogs is a seminal work that is the product of a huge amount of effort by a dedicated cadre of veterinary pathologists and nephrologists. However, it is noteworthy that it has only recently become possible to prepare such an atlas because during the last decade veterinary pathologists have had the opportunity to routinely evaluate appropriate specimens from proteinuric dogs using adequate methods of examination. This opportunity occurred because of the confluence of 3 important trends: (1) increased availability of informative specimens, (2) greater ability to perform adequately revealing tissue examinations, and (3) improved integration of the clinical and pathologic findings to better support clinical decision-making.

Several key factors contributed to the increased availability of informative specimens. One of these was the emergence of a heightened clinical awareness of the potential value of detecting and managing proteinuria and hypertension, which are common clinical manifestations of canine glomerular diseases. Publication of ACVIM Forum Consensus Statements regarding proteinuria (in 2004) and hypertension (in 2007) both reflected this heightened awareness and armed clinicians with specific guidelines for diagnosis and treatment of these problems. Another key factor contributing to greater availability of informative specimens was increased use of renal biopsy to obtain an antemortem diagnosis and guide therapeutic decisions. Increased emphasis on detecting proteinuria no doubt led to more frequent identification of appropriate indications for renal biopsy.  In addition, renal specimens obtained by biopsy are diagnostically more informative than postmortem samples. The first of these is that biopsy specimens frequently exhibit earlier stages in the pathogenesis of the animal’s nephropathy, which makes it easier for the pathologist to discern the fundamental nature of the initial abnormality. Second, biopsy specimens typically are relatively small pieces of tissue that are, when handled properly and promptly placed in appropriate fixatives / preservatives, devoid of artifacts, which makes it possible for the pathologist to confidently identify even very subtle lesions that might otherwise be obscured by or confused with postmortem changes.

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