Assessment of Hydroxyethyl Starch (6% HES 130/0.4) Kidney Storage in Critically Ill Dogs: A Post-mortem Prospective Study

Evaluation of the safety and effect of lyophilized canine-specific albumin to increase serum albumin concentration and colloid osmotic pressure in healthy dogs

OBJECTIVE

To evaluate the safety of repeated administration of a lyophilized canine-specific albumin (CSA) product and to quantify its effect on serum albumin concentrations and colloid osmotic pressure (COP) in healthy dogs.

DESIGN

Prospective study.

SETTING

University research facility.

ANIMALS

Six healthy, adult, purpose-bred Beagles.

INTERVENTIONS

Dogs received 1 g/kg of 16% CSA intravenously on days 1, 2, and 14 and were observed, with serial measurement of vital parameters during and for 2 hours after each infusion, to monitor for adverse events or evidence of a hypersensitivity reaction. Serum albumin concentration and COP were measured at predetermined time points before and after each infusion.

RESULTS

One dog experienced a single episode of vomiting approximately 1 hour after completion of the second infusion. No other adverse reactions were observed during the 28-day study period. Serum albumin concentration was increased by a mean of 0.57 g/dL (5.7 g/L) (P = 0.003) when measured 2 hours after the first CSA infusion, and albumin concentration remained significantly higher than baseline at 24 hours after infusion, with a mean difference of 0.42 g/dL (4.2 g/dL) (P < 0.001). The second and third CSA infusions similarly increased serum albumin concentration at 2 hours (P = 0.001 and P = 0.001, respectively) and 24 hours (P = 0.012 and P = 0.007, respectively) after infusion. COP increased by a mean of 2.03 mm Hg at 2 hours after the first infusion (P = 0.013) and remained significantly higher than baseline at 24 hours after infusion, with a mean difference of 1.52 mm Hg (P = 0.002). The second CSA infusion similarly increased COP at 2 hours (P < 0.001) and 24 hours (P = 0.017) after infusion. The third CSA infusion increased COP at 2 hours after infusion (P = 0.004) but did not achieve statistical significance at 24 hours after infusion (P = 0.053).

CONCLUSIONS

A 1-g/kg dose of lyophilized CSA was effective at increasing serum albumin concentration and COP. Repeated infusions of CSA appear safe in healthy dogs.

2024 AAHA Fluid Therapy Guidelines for Dogs and Cats

Fluids are drugs used in veterinary patients capable of producing beneficial therapeutic or inadvertent harmful effects within the body's intravascular, interstitial, and intracellular fluid spaces. The individualized design of a fluid therapy plan requires careful patient assessment and targeted selection of proper fluid types, administration routes, and rates, along with adjustments during therapy tailored specifically as per the individual patient's fluid requirement and therapeutic response. Personalized fluid prescriptions and vigilant patient monitoring help avoid patient morbidity from body fluid deficiencies, fluid excess, and electrolyte derangements and support better patient outcomes. These guidelines provide an overview of fluid dynamics within the fluid spaces of the body, describe various types of fluids and their uses, and outline recommendations for fluid administration for resuscitation, rehydration, and maintenance purposes. The guidelines also outline approaches to fluid therapy for anesthetized patients and reiterate the recommendations of reduced fluid rates in this population of patients. Additionally, the guidelines include practical fluid therapy strategies for patients with various common disorders. The goal of these guidelines is to help veterinary professionals safely and effectively prescribe and administer fluid therapy for canine and feline patients.

International Renal Interest Society best practice consensus guidelines for the diagnosis and management of acute kidney injury in cats and dogs

Acute kidney injury (AKI) is defined as an injury to the renal parenchyma, with or without a decrease in kidney function, as reflected by accumulation of uremic toxins or altered urine production (i.e., increased or decreased). AKI might result from any of several factors, including ischemia, inflammation, nephrotoxins, and infectious diseases. AKI can be community- or hospital-acquired. The latter was not previously considered a common cause for AKI in animals; however, recent evidence suggests that the prevalence of hospital-acquired AKI is increasing in veterinary medicine. This is likely due to a combination of increased recognition and awareness of AKI, as well as increased treatment intensity (e.g., ventilation and prolonged hospitalization) in some veterinary patients and increased management of geriatric veterinary patients with multiple comorbidities. Advancements in the management of AKI, including the increased availability of renal replacement therapies, have been made; however, the overall mortality of animals with AKI remains high. Despite the high prevalence of AKI and the high mortality rate, the body of evidence regarding the diagnosis and the management of AKI in veterinary medicine is very limited. Consequently, the International Renal Interest Society (IRIS) constructed a working group to provide guidelines for animals with AKI. Recommendations are based on the available literature and the clinical experience of the members of the working group and reflect consensus of opinion. Fifty statements were generated and were voted on in all aspects of AKI and explanatory text can be found either before or after each statement.