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Jena B, Mohindroo J, Gupta K, Singh N. Quantitative studies on B-mode ultrasound and point shear wave elastography of kidneys in nonazotemic dogs. Vet Radiol Ultrasound 2024; 65:227-237. [PMID: 38363187 DOI: 10.1111/vru.13346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 12/13/2023] [Accepted: 01/29/2024] [Indexed: 02/17/2024] Open
Abstract
Renal diseases in dogs can be diagnosed effectively using B-mode ultrasound. Point shear wave elastography (pSWE) has demonstrated usefulness in diagnosing renal diseases in human medicine. However, its application in veterinary medicine is in its nascent stage. It was hypothesized that establishing pSWE reference values in nonazotemic dogs would prove valuable in differentiating renal diseases. In light of this, a single-center, quantitative study with an objective to normalize B-mode ultrasound parameters and pSWE values of the kidney in nonazotemic dogs was conducted. A total of 198 animals presented with clinical signs of anorexia, vomiting, weight loss, and dehydration were enrolled in the study spanning 2 years. Among them, 52 nonazotemic dogs were included as subjects for the study. B-mode ultrasound quantitative parameters, including length (L), breadth (B), height (H), cortical thickness (RCT), and medulla thickness (RMT) of the kidneys, as well as the diameter of the aorta (Ao), were normalized. Additionally, calculated parameters such as L:Ao, B:Ao, H:Ao, RCT:Ao, and corticomedullary ratios were worked out. Point shear wave elastography values were obtained from the cranial and caudal poles of renal cortices using ElastPQ stiffness software. The pSWE values of kidneys in nonazotemic dogs were normalized. The mean ± standard error values were 1.04 ± 0.08 m/s (95% confidence interval: 0.88-1.19 m/s) and 4.18 ± 0.62 kPa (95% confidence interval: 2.93-5.42 kPa). In conclusion, B-mode ultrasound quantitative parameters, ratios, and pSWE values were normalized in nonazotemic dogs, which may prove valuable in differentiating renal pathologies in canine patients.
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Affiliation(s)
- Biswadeep Jena
- Department of Veterinary Surgery and Radiology, College of Veterinary Sciences, Guru Angad Dev Veterinary and Animal Science University, Ludhiana, Punjab, India
| | - Jitender Mohindroo
- Department of Veterinary Surgery and Radiology, College of Veterinary Sciences, Guru Angad Dev Veterinary and Animal Science University, Ludhiana, Punjab, India
| | - Kuldip Gupta
- Department of Veterinary Pathology, College of Veterinary Sciences, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Navdeep Singh
- Department of Veterinary Surgery and Radiology, College of Veterinary Sciences, Guru Angad Dev Veterinary and Animal Science University, Ludhiana, Punjab, India
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2
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Mahadappa P, Jeyaraja K, Thirunavakkarasu PS, Krishnaswamy N. Association between systolic blood pressure and target organ damage in naturally occurring cases of systemic hypertension in the dog. Top Companion Anim Med 2024; 58:100843. [PMID: 37979614 DOI: 10.1016/j.tcam.2023.100843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 10/17/2023] [Accepted: 11/13/2023] [Indexed: 11/20/2023]
Abstract
Chronic elevation in the systolic blood pressure (SBP) adversely affects the lifespan in the dog by causing injury to the eye, heart, kidney and brain. Understanding the association between SBP and target organ damage (TOD) helps in risk categorization and treatment planning. Therefore, a prospective study was undertaken to find the association between SBP and renal resistive index (RI) in naturally occurring cases of canine systemic hypertension. Based on the ACVIM guidelines 2018, dogs (n=135) were categorized into four risk groups of SBP, viz., A (minimal), B (low), C (moderate), and D (high). Ophthalmoscopy and echocardiography were used to assess ocular and cardiac changes, respectively. Nephrosonography, urinalysis, and RI were used to assess kidney damage. Odds ratio (OR) was used to quantify the risk of TOD for different categories of SBP. One-way Anova with Tukey's post-hoc test was used to test the effect of different SBP risk groups on urine protein creatinine ratio (UPC) and RI as well as the effect of number of TOD on the RI. Pearson's correlation test was done to see the relation of SBP with UPC and RI. Tortuous retinal vessels were common in group B with an OR of 11 (95% CI: 0.59-207). Retinal hemorrhage and left ventricular hypertrophy were common in group D with an OR of 13 (95% CI: 0.67-234) and 11 (95% CI: 0.61-207), respectively. A significant strong positive correlation of SBP with UPC (R2=0.65) and RI (R2=0.58) was observed. The renal RI significantly increased when the number of TOD was ≥ 2. It was concluded that SBP and RI are associated with the number and severity of TOD and might be valuable in risk classification in hypertensive dogs.
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Affiliation(s)
- Priyanka Mahadappa
- Indian Veterinary Research Institute, Hebbal Campus, Bengaluru, 560024, India.
| | - K Jeyaraja
- Madras Veterinary College, TANUVAS, Chennai, 600007, India
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Fulton EA, Weir W, Czopowicz M, McBrearty AR. The relationships between sediment findings and culture results and the presence of proteinuria in canine urine samples. J Small Anim Pract 2023; 64:749-758. [PMID: 37632274 DOI: 10.1111/jsap.13669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/10/2023] [Accepted: 07/12/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVES To assess relationships between urine sediment and microbial culture findings and the presence of proteinuria in canine urine samples, and to assess the change in the percentage of proteinuric samples and urine protein-to-creatinine ratio when urine abnormalities resolve. MATERIALS AND METHODS Canine urine samples collected via cystocentesis and submitted for culture and contemporaneous urinalysis (including urine protein-to-creatinine ratio) were retrospectively identified. Dogs receiving corticosteroids were excluded. Associations between haematuria (red blood cells>5/high-power field), pyuria (white blood cells>5/high-power field), presence of microorganisms on microscopy, active sediment, and positive culture and proteinuria (urine protein-to-creatinine ratio>0.5) were investigated. Patient characteristics were considered possible confounders. In dogs with repeat urinalysis, the associations between active sediment and positive culture resolution on proteinuria and urine protein-to-creatinine ratio were assessed. RESULTS One hundred and ninety-two of 491 samples were proteinuric (39.1%). Age was positively associated with proteinuria. In the multivariable analysis corrected for age, active sediment was the only variable significantly associated with proteinuria (adjusted odds ratio: 2.12; 95% confidence interval: 1.44 to 3.11); however, only 49.8% of samples with active sediment were proteinuric. Neither resolution of active sediment nor positive culture were associated with reduced proportions of proteinuric samples (from 57.9% to 42.1% and from 40.0% to 25.0%, respectively) or significant reductions in urine protein-to-creatinine ratio (median change: -0.16 and -0.14, respectively). CLINICAL SIGNIFICANCE Attributing proteinuria to urinalysis abnormalities or a positive urine culture in canine cystocentesis samples is not supported by our findings, and could result in alternative causes of proteinuria (e.g. renal proteinuria) being overlooked.
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Affiliation(s)
- E A Fulton
- School of Biodiversity, One Health and Veterinary Medicine, The University of Glasgow Small Animal Hospital, 464 Bearsden Road, Glasgow, G61 1QH, Scotland
| | - W Weir
- School of Biodiversity, One Health and Veterinary Medicine, The University of Glasgow Small Animal Hospital, 464 Bearsden Road, Glasgow, G61 1QH, Scotland
| | - M Czopowicz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159c, 02-776, Warsaw, Poland
| | - A R McBrearty
- The University of Glasgow Small Animal Hospital and Vets Now, Glasgow, Scotland
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Fulton EA, McBrearty AR, Shaw DJ, Ridyard AE. Response and survival of dogs with proteinuria (UPC > 2.0) treated with angiotensin converting enzyme inhibitors. J Vet Intern Med 2023; 37:2188-2199. [PMID: 37815154 PMCID: PMC10658551 DOI: 10.1111/jvim.16864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 08/24/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Angiotensin-converting enzyme inhibitors (ACEi) are a recommended treatment for glomerular proteinuria. Frequency of response to ACEi and the association of achieving proposed urine protein-to-creatinine ratio (UPC) targets on survival is unknown. OBJECTIVES To determine response rates to ACEi therapy and whether a positive response is associated with improved survival. ANIMALS Eighty-five dogs with proteinuria (UPC > 2.0). METHODS Retrospective study including dogs (UPC > 2.0) prescribed an ACEi for treatment of proteinuria. Baseline creatinine, albumin, cholesterol, UPC, and systolic blood pressure were recorded, and cases reviewed to track UPC. Treatment response was defined as achieving a UPC of <0.5 or reduction of ≥50% from baseline within 3 months. Outcome data were collected to determine overall and 12-month survival. RESULTS Thirty-five (41%) dogs responded to ACEi treatment. Treatment response was statistically associated with both median survival time (664 days [95% confidence interval (CI): 459-869] for responders compared to 177 [95% CI: 131-223] for non-responders) and 12-month survival (79% responders alive compared to 28% non-responders). Baseline azotemia or hypoalbuminemia were also associated with a worse prognosis, with odds ratios of death at 12 months of 5.34 (CI: 1.85-17.32) and 4.51 (CI: 1.66-13.14), respectively. In the 25 dogs with normal baseline creatinine and albumin, response to treatment was associated with 12-month survival (92% responders alive compared to 54% non-responders, P = .04). CONCLUSIONS AND CLINICAL IMPORTANCE When the UPC is >2.0, achieving recommended UPC targets within 3 months appears to be associated with a significant survival benefit. Response to treatment is still associated with survival benefit in dogs with less severe disease (no azotemia or hypoalbuminemia).
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Affiliation(s)
- Emily A. Fulton
- The University of Glasgow Small Animal Hospital, School of Biodiversity, One Health and Veterinary Medicine, 464 Bearsden RoadGlasgow G61 1QHUnited Kingdom
| | - Alix R. McBrearty
- VetsNow Hospital Glasgow, 123‐145 North StreetGlasgow G3 7DAUnited Kingdom
| | - Darren J. Shaw
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush CampusRoslin EH25 9RGUnited Kingdom
| | - Alison E. Ridyard
- The University of Glasgow Small Animal Hospital, School of Biodiversity, One Health and Veterinary Medicine, 464 Bearsden RoadGlasgow G61 1QHUnited Kingdom
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Ogawa M, Nohara H, Hsu HH, Ishizaka M, Miyagawa Y, Takemura N. Association between glomerular filtration rate and plasma N-terminal pro-atrial natriuretic peptide concentration in dogs. J Small Anim Pract 2023; 64:568-573. [PMID: 37345758 DOI: 10.1111/jsap.13626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 03/16/2023] [Accepted: 04/21/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVES To investigate the association between plasma N-terminal pro-atrial natriuretic peptide concentration and glomerular filtration rate in dogs. MATERIALS AND METHODS Dogs were classified into four categories by bodyweight. Dogs were divided into four groups (Groups 1 to 4) based on glomerular filtration rate estimates using plasma iohexol clearance per bodyweight category. Generalised linear models were built to explore the relationship between plasma N-terminal pro-atrial natriuretic peptide concentration and glomerular filtration rate and the effect of confounders on plasma N-terminal pro-atrial natriuretic peptide concentration. RESULTS Fifty-three dogs were included (Group 1, 25; Group 2, seven; Group 3, five; and Group 4, 16). The medians (interquartile range) N-terminal pro-atrial natriuretic peptide concentrations for Groups 1 to 4 were 7224 pg/mL (4766 to 10,254 mg/dL), 8958 pg/mL (4935 to 11,271 mg/dL), 9280 pg/mL (9195 to 10,384 mg/dL) and 12,683 pg/mL (9133 to 19,217 mg/dL), respectively. Group 4, estimated to have the highest reduction in glomerular filtration rate, had a higher plasma N-terminal pro-atrial natriuretic peptide concentration than Groups 1 to 3. Based on the final generalised linear model, influencing factors for plasma N-terminal pro-atrial natriuretic peptide concentration were plasma iohexol clearance (-0.136; 95% confidence interval, -0.227 to -0.046) and bodyweight (-0.058; 95% confidence interval, -0.098 to -0.018). CLINICAL SIGNIFICANCE N-terminal pro-atrial natriuretic peptide concentration is associated with the glomerular filtration rate.
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Affiliation(s)
- M Ogawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - H Nohara
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - H H Hsu
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - M Ishizaka
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Y Miyagawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - N Takemura
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
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Kalogeropoulu SK, Rauch-Schmücking H, Lloyd EJ, Stenvinkel P, Shiels PG, Johnson RJ, Fröbert O, Redtenbacher I, Burgener IA, Painer-Gigler J. Formerly bile-farmed bears as a model of accelerated ageing. Sci Rep 2023; 13:9691. [PMID: 37322151 PMCID: PMC10272202 DOI: 10.1038/s41598-023-36447-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/03/2023] [Indexed: 06/17/2023] Open
Abstract
Bear bile-farming is common in East and Southeast Asia and this farming practice often results in irreversible health outcomes for the animals. We studied long-term effects of chronic bacterial and sterile hepatobiliary inflammation in 42 Asiatic black bears (Ursus thibetanus) rescued from Vietnamese bile farms. The bears were examined under anesthesia at least twice as part of essential medical interventions. All bears were diagnosed with chronic low-grade sterile or bacterial hepatobiliary inflammation along with pathologies from other systems. Our main finding was that the chronic low-grade inflammatory environment associated with bile extraction in conjunction with the suboptimal living conditions on the farms promoted and accelerated the development of age-related pathologies such as chronic kidney disease, obese sarcopenia, cardiovascular remodeling, and degenerative joint disease. Through a biomimetic approach, we identified similarities with inflammation related to premature aging in humans and found significant deviations from the healthy ursid phenotype. The pathological parallels with inflammageing and immuno-senescence induced conditions in humans suggest that bile-farmed bears may serve as animal models to investigate pathophysiology and deleterious effects of lifestyle-related diseases.
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Affiliation(s)
- Szilvia K Kalogeropoulu
- Department of Interdisciplinary Life Sciences, Research Institute of Wildlife Ecology, University of Veterinary Medicine, 1160, Vienna, Austria
| | - Hanna Rauch-Schmücking
- Department of Interdisciplinary Life Sciences, Research Institute of Wildlife Ecology, University of Veterinary Medicine, 1160, Vienna, Austria
| | - Emily J Lloyd
- BEAR SANCTUARY Ninh Binh, FOUR PAWS Viet, Ninh Binh, 43000, Vietnam
| | - Peter Stenvinkel
- Department of Renal Medicine M99, Karolinska, University Hospital, 141 86, Stockholm, Sweden
| | - Paul G Shiels
- Davidson Bld, School of Molecular Biosciences, University of Glasgow, Glasgow, GB, UK
| | - Richard J Johnson
- Division of Renal Diseases, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Ole Fröbert
- Department of Cardiology, Faculty of Health, Örebro University, Örebro, Sweden
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
- Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Iwan A Burgener
- Division of Small Animal Internal Medicine, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210, Vienna, Austria
| | - Johanna Painer-Gigler
- Department of Interdisciplinary Life Sciences, Research Institute of Wildlife Ecology, University of Veterinary Medicine, 1160, Vienna, Austria.
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7
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Vetter CAM, Meindl AG, Lourenço BN, Coyne M, Drake C, Murphy R, Roth IG, Moorhead AR. Evaluation of renal values during treatment for heartworm disease in 27 client-owned dogs. Parasit Vectors 2023; 16:191. [PMID: 37291617 PMCID: PMC10251593 DOI: 10.1186/s13071-023-05779-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/16/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Canine heartworm disease (CHD) caused by Dirofilaria immitis remains a common preventable disease with increasing incidence in some parts of the USA. The treatment guidelines of the American Heartworm Society (AHS) currently recommend monthly macrocyclic lactone administration, 28 days of doxycycline given orally every 12 h and three injections of melarsomine dihydrochloride (1 injection on day 2 of treatment followed 30 days later by 2 injections 24 h apart). Minocycline has also been utilized when doxycycline is unavailable. The systemic effects of CHD, which particularly impact cardiac and renal function, have been described, with infected dogs often experiencing renal damage characterized by an increase in serum concentrations of renal biomarkers. Although the AHS treatment protocol for CHD has been shown to be safe and effective in most cases, the potential for complications remains. No study as of yet has evaluated changes in symmetric dimethylarginine (SDMA), a sensitive marker of renal function, during treatment for CHD. The purpose of the present study was to evaluate renal function in dogs by measuring serum creatinine and SDMA concentrations during the adulticide treatment period. METHODS Serum creatinine and SDMA concentrations were measured in 27 client-owned dogs affected by CHD at the following time points: prior to starting doxycycline or minocycline therapy (baseline), during doxycycline or minocycline therapy (interim), at the time of the first dose of melarsomine (first dose), at the time of the second dose of melarsomine (second dose) and at the dog's follow-up visit after treatment, occurring between 1 and 6 months after completion of therapy (post-treatment). Concentrations of creatinine and SDMA were compared between time points using a mixed effects linear model. RESULTS Mean SDMA concentrations following the second dose of melarsomine were significantly lower (-1.80 ug/dL, t-test, df = 99.067, t = -2.694, P-Value = 0.00829) than baseline concentrations. There were no other statistically significant differences in the concentration of either biomarker between the baseline and the other time points in CHD dogs undergoing treatment. CONCLUSIONS The results suggest that the current AHS protocol may not have a substantial impact on renal function.
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Affiliation(s)
- C Autumn M Vetter
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
| | - Alison G Meindl
- Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, CO, USA
| | - Bianca N Lourenço
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | | | | | | | - Ira G Roth
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Andrew R Moorhead
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
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Mota-Rojas D, Domínguez-Oliva A, Martínez-Burnes J, Casas-Alvarado A, Hernández-Ávalos I. Euthanasia and Pain in Canine Patients with Terminal and Chronic-Degenerative Diseases: Ethical and Legal Aspects. Animals (Basel) 2023; 13:ani13071265. [PMID: 37048521 PMCID: PMC10093422 DOI: 10.3390/ani13071265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/21/2023] [Accepted: 03/30/2023] [Indexed: 04/14/2023] Open
Abstract
Euthanasia is commonly performed in veterinary medicine to humanely induce the death of an animal when its quality of life is affected by pain or chronic degenerative diseases. The choice of euthanasia is a bilateral decision that represents a challenge for both the veterinarian and the owner of the animal due to the close emotional human-animal bond. Currently, there is legislation that can orient veterinarians concerning euthanasia and the causes that would justify this resolution. However, it is still controversial, and deciding it as the last available resort requires considering it from a medical, legal, and moral perspective. Therefore, this review aims to explore the ethical and legal implications of euthanasia in canine patients. It will analyze the reason that can justify euthanasia in animals with pain or terminal and chronic degenerative diseases, highlighting the importance of effective communication, ethical knowledge, and consideration of euthanasia as a multimodal resolution.
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Affiliation(s)
- Daniel Mota-Rojas
- Neurophysiology, Behavior and Animal Welfare Assessment, Universidad Autónoma Metropolitana (UAM), Mexico City 04960, Mexico
| | - Adriana Domínguez-Oliva
- Neurophysiology, Behavior and Animal Welfare Assessment, Universidad Autónoma Metropolitana (UAM), Mexico City 04960, Mexico
| | - Julio Martínez-Burnes
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Tamaulipas, Victoria City 87000, Mexico
| | - Alejandro Casas-Alvarado
- Neurophysiology, Behavior and Animal Welfare Assessment, Universidad Autónoma Metropolitana (UAM), Mexico City 04960, Mexico
| | - Ismael Hernández-Ávalos
- Clinical Pharmacology and Veterinary Anesthesia, Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México (UNAM), Cuautitlán 54714, Mexico
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9
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High Intake of Sodium Chloride for 28 Days Causes No Effect on Serum FGF23 Concentrations in Cats. Animals (Basel) 2022; 12:ani12223195. [PMID: 36428422 PMCID: PMC9686773 DOI: 10.3390/ani12223195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND FGF23 is an acknowledged parameter to assess kidney health. As chronic kidney failure is one of the most common diseases in aging cats, dietary influences on renal health warrant investigation. The purpose of this study was therefore to investigate potential correlations between dietary sodium chloride and FGF23. METHODS In a total of two trials, 11 cats were included. In the first trial, the cats were fed a complete and balanced control diet; in the second trial, sodium chloride was added (8 g/kg/DM)). Blood, urinary, feed, and faecal samples were analysed for major minerals. FGF23 and creatinine were measured in blood and urine samples. RESULTS Serum phosphate and FGF23 were unaffected by high sodium chloride intake, thus showing no correlation between serum FGF23 and sodium concentrations. Apparent phosphorus digestibility was significantly increased, however, by high sodium chloride intake, whereas apparent digestibility of calcium was unaffected. The present study confirms differences in FGF23 and sodium chloride interaction in cats compared with other species. Further research regarding the correlation between sodium chloride and phosphate homeostasis is warranted.
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10
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Hall GBF, Stoye DQ, Thomas EK, Culshaw GJ. Retrospective evaluation of systemic hypertension in dogs with nonassociative (primary) immune-mediated hemolytic anemia (December 2016 to April 2019): 26 cases. J Vet Emerg Crit Care (San Antonio) 2022; 32:229-235. [PMID: 35080103 DOI: 10.1111/vec.13128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/27/2020] [Accepted: 06/03/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To report the prevalence of arterial hypertension in a population of dogs with nonassociative immune-mediated hemolytic anemia (IMHA) on presentation and during hospitalization. To determine the relationships of systolic blood pressure (SBP) with mortality and a prognostic indicator, the canine hemolytic anemia objective score. DESIGN Retrospective observational study (December 2016 to April 2019). SETTING University teaching hospital. ANIMALS Twenty-six clinical dogs presenting to the ICU with nonassociative (primary) IMHA and a control group of 23 clinical dogs with idiopathic epilepsy hospitalized in the ICU for seizure treatment or monitoring. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Hypertension was defined as SBP ≥ 160 mm Hg and severe hypertension as SBP ≥ 180 mm Hg. Mean SBP was significantly increased in IMHA dogs (161 mm Hg, SD = 21) compared to ICU control dogs (138 mm Hg, SD = 14; P < 0.005). Hypertension was present in 13 of 26 (50.0%) dogs across the period of hospitalization and was severe in three of 26 (11.5%). During at least 1 day of hospitalization, 18 of 26 (69.2%) dogs were hypertensive and eight of 26 (34.6%) were severely hypertensive. Hypertension was not associated with short-term mortality or canine hemolytic anemia objective score. CONCLUSIONS In this retrospective study, hypertension was more prevalent in dogs with nonassociative IMHA than a control population of ICU-hospitalized dogs. An association between autoimmune conditions and hypertension has been previously reported in people but not within a canine population. Hypertension in dogs may have an inflammatory or autoimmune etiology. SBP should be monitored closely in canine IMHA, in case antihypertensive treatment is required.
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Affiliation(s)
- Georgina B F Hall
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, UK
| | - David Q Stoye
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | | | - Geoff J Culshaw
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, UK
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11
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López MC, Aybar V, Zatelli A, Vila A, Vega JJ, Hernando E, Jiménez A, Roura X. Is proteinuria a rare condition in apparently healthy and sick cats? A feline practice experience (2007-2018). Open Vet J 2021; 11:508-516. [PMID: 34722216 PMCID: PMC8541710 DOI: 10.5455/ovj.2021.v11.i3.24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/01/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Proteinuria is assumed to be less frequent in cats than in dogs and is mainly associated with chronic kidney disease (CKD). Aim: The current study aimed to evaluate and compare urine protein-to-creatinine (UPC) values retrospectively in cats visited for comprehensive annual health check or for presenting systemic clinical signs related to CKD. Methods: UPC ratio was retrospectively evaluated in 112 owned cats, out of which 51 (45.5%) were apparently healthy cats according to their owners who visited for comprehensive annual health checks and 61 (54.5%) sick cats, presenting systemic clinical signs suggesting CKD, such as weight loss or polyuria/polydipsia, among others. Results: Based on UPC, the present study found that 54.5% of all cats included were borderline proteinuric or proteinuric, having increased UPC (UPC ≥ 0.2), with 35.7% included in the sick group and 18.7% in the health-check group. Increased UPC was also statistically associated with azotemia and isosthenuria (urinary-specific gravity between 1,008 and 1,035) in both sick and health-check groups of cats. Conclusion: Independent of the reason for their medical visit, it could be concluded that borderline proteinuria and proteinuria were statistically mainly related to CKD in cats. Furthermore, the measurement of UPC could be very useful in the detection and management of CKD in apparently healthy cats during a medical visit for annual health check irrespective of the age.
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Affiliation(s)
- Maria Cristina López
- Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | - Andrea Zatelli
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | - Anna Vila
- Hospital Veterinario San Vicente Mártir, Universidad Católica de Valencia, Valencia, Spain
| | | | - Eduard Hernando
- Hospital Veterinario San Vicente Mártir, Universidad Católica de Valencia, Valencia, Spain
| | - Alejandro Jiménez
- Facultat de Matemàtiques, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Xavier Roura
- Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Bellaterra, Spain
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12
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Miyakawa H, Hsu HH, Ogawa M, Akabane R, Miyagawa Y, Takemura N. Association between serum fibroblast growth factor-23 concentration and development of hyperphosphatemia in normophosphatemic dogs with chronic kidney disease. J Vet Intern Med 2021; 35:2296-2305. [PMID: 34418162 PMCID: PMC8478064 DOI: 10.1111/jvim.16237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Fibroblast growth factor (FGF)-23 is increased first in the sequence of changes associated with chronic kidney disease (CKD)-mineral and bone disorder. Thus, its measurement may serve as a predictive indicator of incident hyperphosphatemia. OBJECTIVES To investigate whether serum FGF-23 concentration in normophosphatemic dogs with CKD is associated with the risk of the subsequent development of hyperphosphatemia and CKD progression. ANIMALS Forty-two normophosphatemic dogs with CKD. METHODS Blood samples and medical records were retrospectively investigated. Hyperphosphatemia was defined as a serum phosphorous concentration >5.0 mg/dL. Progression was defined as a >1.5-fold increase in serum creatinine concentration. The time periods and hazard ratios for these outcomes were assessed using Kaplan-Meier analysis, log-rank test, and univariate Cox regression analysis. The variables associated with the outcomes in the univariate analysis were included in the multivariate Cox regression model with backward selection. RESULTS Serum FGF-23 concentration >528 pg/mL was associated with a shorter time to development of hyperphosphatemia (P < .001) and CKD progression (P < .001). In multiple Cox regression analysis, increased FGF-23 concentration remained a significant variable associated with these outcomes (P < .05). CONCLUSIONS AND CLINICAL IMPORTANCE Increased FGF-23 concentration in normophosphatemic dogs with CKD was associated with significant risk of development of hyperphosphatemia, independent of CKD stage, and of the progression of CKD. Future research focusing on whether interventions that decrease FGF-23 secretion will slow the development of hyperphosphatemia and CKD progression is needed.
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Affiliation(s)
- Hirosumi Miyakawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Huai-Hsun Hsu
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Mizuki Ogawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Ryota Akabane
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Yuichi Miyagawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Naoyuki Takemura
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
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Evaluation of the progression of non-azotemic proteinuric chronic kidney disease in dogs. Res Vet Sci 2021; 138:11-18. [PMID: 34090202 DOI: 10.1016/j.rvsc.2021.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 11/23/2022]
Abstract
Proteinuria is a recognized risk factor for progression of canine chronic kidney disease (CKD). However, the prognosis of non-azotemic proteinuric CKD in dogs has been studied only to a limited extent. Moreover, the degree to which proteinuria should be decreased to delay CKD progression remains unknown. The purposes of this study were (1) to identify factors associated with disease progression and (2) to investigate the degree of proteinuria, albuminuria, and blood pressure during the course of treatment associated with the progression using time-averaged urine protein:creatinine ratio (UPC) and urine albumin:creatinine ratio (UAC) in canine non-azotemic proteinuric CKD. Twenty-one dogs with non-azotemic proteinuric CKD were included in the study. High UPC and UAC were associated with CKD progression (P < .05). Time-averaged high UPC and UAC were significantly related to progression (P < .05). The cutoff values of these time-averaged parameters for predicting the progression were 4.1 and 2.0, respectively. In dogs with non-azotemic proteinuric CKD, more severe proteinuria and albuminuria were associated with progression. The present study suggests that because UPC ≥ 4.1 and UAC ≥ 2.0 during treatment were associated with a faster progression of non-azotemic proteinuric CKD, therapeutic intervention is warranted.
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Lecavalier J, Fifle L, Javard R. Treatment of proteinuria in dogs with telmisartan: A retrospective study. J Vet Intern Med 2021; 35:1810-1818. [PMID: 33969924 PMCID: PMC8295663 DOI: 10.1111/jvim.16146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 04/17/2021] [Accepted: 04/22/2021] [Indexed: 12/14/2022] Open
Abstract
Background Use of telmisartan for the treatment of proteinuria in dogs has not been thoroughly investigated. Hypothesis/Objectives Telmisartan can be effective for the treatment of proteinuria in dogs. Animals Forty‐four client‐owned dogs with proteinuria. Methods Retrospective study. Dogs diagnosed with clinically relevant proteinuria (nonazotemic dogs with a urine protein‐to‐creatinine ratio [UPC] ≥2 and azotemic dogs with UPC ≥0.5) were separated into 3 groups: telmisartan alone, with benazepril, or with mycophenolate. The UPC was recorded before treatment and at subsequent follow‐ups (1, 3, 6, and 12 months, as available). Response to treatment was categorized as complete (UPC ˂0.5), partial (UPC decreased by ≥50% but still ≥0.5), or no response (UPC decreased by <50%). Serum creatinine and potassium concentrations and arterial pressure also were recorded. Results In the telmisartan group, treatment response (UPC ˂0.5 or decreased by ≥50%) was observed in 70%, 68%, 80%, and 60% of dogs at 1, 3, 6, and 12 months follow‐up, respectively. No significant changes were noted in serum creatinine or potassium concentrations, or in arterial blood pressure at all follow‐up times. Adverse effects consisted of mild self‐limiting gastrointestinal signs in 5 dogs. Two dogs developed clinically relevant azotemia that required discontinuation of the treatment before the first follow‐up. Conclusions and Clinical Importance Telmisartan can be considered for treatment of proteinuria in dogs, alone or in combination with other treatments for proteinuria.
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Parker VJ. Nutritional Management for Dogs and Cats with Chronic Kidney Disease. Vet Clin North Am Small Anim Pract 2021; 51:685-710. [PMID: 33773648 DOI: 10.1016/j.cvsm.2021.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The nutritional management of canine and feline chronic kidney disease and protein-losing nephropathy is discussed. Special attention is paid to assessment of body composition (body weight, body condition score, and muscle condition score) and the dysrexia that often occurs with kidney disease. Various nutrients of concern are discussed and specific dietary options are provided.
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Affiliation(s)
- Valerie J Parker
- The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH 43210, USA.
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16
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Fowler BL, Stefanovski D, Hess RS, McGonigle K. Effect of telmisartan, angiotensin-converting enzyme inhibition, or both, on proteinuria and blood pressure in dogs. J Vet Intern Med 2021; 35:1231-1237. [PMID: 33769606 PMCID: PMC8163128 DOI: 10.1111/jvim.16102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 01/22/2023] Open
Abstract
Background The use of telmisartan (TEL), an angiotensin‐receptor blocker, for the control of systemic hypertension and proteinuria in dogs has not been reported extensively in a clinical setting. Objectives To determine the effects of an angiotensin‐converting enzyme inhibitor (ACEi) alone, ACEi in combination with TEL, or TEL alone on systolic blood pressure and proteinuria in dogs with protein losing nephropathy (PLN). Animals Forty‐two client‐owned dogs being treated for PLN. Methods Retrospective observational study of medical records of dogs at a university teaching hospital from 2012 to 2018 with the use of benazepril or enalapril alone, TEL alone, or both modalities for the management of PLN. Noninvasive blood pressure and urine protein to creatinine ratio (UPC) were compared among the treatment groups over time. A multivariable mixed‐effects linear regression model followed by post hoc analysis was used to estimate the marginal means and differences between the treatment groups. Results In comparison to group ACEi alone, combination treatment of an ACEi with TEL significantly reduced (P = .007) systolic blood pressure by 13 mm Hg (95% confidence interval [95% CI]: 4‐22 mm Hg). Angiotensin‐converting enzyme inhibitor + TEL in comparison to ACEi alone showed significant (P = .01) reduction in UPC of 2.5 (95% CI: 0.6‐4.4). The UPC of group ACEi + TEL was significantly lower (P = .01) in comparison to TEL alone by 3.8 (95% CI: 0.8‐6.8). Conclusions and Clinical Importance Telmisartan can be used to treat systemic hypertension and proteinuria in dogs.
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Affiliation(s)
- Brittany L Fowler
- University of Pennsylvania Matthew J. Ryan Veterinary Hospital, Philadelphia, Pennsylvania, USA
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Lourenço BN, Coleman AE, Brown SA, Schmiedt CW, Parkanzky MC, Creevy KE. Efficacy of telmisartan for the treatment of persistent renal proteinuria in dogs: A double-masked, randomized clinical trial. J Vet Intern Med 2020; 34:2478-2496. [PMID: 33165969 PMCID: PMC7694823 DOI: 10.1111/jvim.15958] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 10/18/2020] [Accepted: 10/23/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Information regarding efficacy of the angiotensin II receptor blocker, telmisartan, for treatment of proteinuria in dogs is limited. OBJECTIVE To evaluate the antiproteinuric efficacy of telmisartan, as compared to enalapril, in dogs with chronic kidney disease and persistent, renal proteinuria. ANIMALS Thirty-nine client-owned dogs with chronic kidney disease and urinary protein-to-creatinine ratio (UPC) > 0.5 (if azotemic) or ≥ 1.0 (if nonazotemic). METHODS In this prospective, randomized, double-masked clinical trial, dogs were block randomized, according to presence or absence of azotemia and systemic arterial hypertension, to receive telmisartan (1.0 mg/kg PO q24h), or enalapril (0.5 mg/kg PO q12h), and followed for 120 days. Up-titration of study drug dosage on days 30 and 60, and addition of the other study drug at day 90, were performed if UPC > 0.5 was noted at these visits. Percentage change in UPC relative to baseline was calculated for all time points. Data are presented as median (range). RESULTS Thirty-nine (20 telmisartan-treated, 19 enalapril-treated) dogs were included. At day 30, percentage change in UPC was greater for telmisartan-treated (-65% [-95% to 104%]) vs enalapril-treated (-35% [-74% to 87%]) dogs (P = .002). Among dogs persistently proteinuric at earlier visits, telmisartan remained superior to enalapril at days 60 (P = .02) and 90 (P = .02). No difference in percentage change in UPC between study groups was observed at day 120, when combination therapy was allowed. Combination therapy resulted in relevant azotemia in 4/13 (31%) dogs. CONCLUSIONS AND CLINICAL IMPORTANCE Telmisartan might be a suitable first-line therapy for dogs with renal proteinuria.
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Affiliation(s)
- Bianca N. Lourenço
- Department of Small Animal Medicine & SurgeryCollege of Veterinary MedicineUniversity of GeorgiaAthensGeorgiaUSA
| | - Amanda E. Coleman
- Department of Small Animal Medicine & SurgeryCollege of Veterinary MedicineUniversity of GeorgiaAthensGeorgiaUSA
| | - Scott A. Brown
- Department of Small Animal Medicine & SurgeryCollege of Veterinary MedicineUniversity of GeorgiaAthensGeorgiaUSA
- Department of Physiology & PharmacologyCollege of Veterinary MedicineUniversity of GeorgiaAthensGeorgiaUSA
| | - Chad W. Schmiedt
- Department of Small Animal Medicine & SurgeryCollege of Veterinary MedicineUniversity of GeorgiaAthensGeorgiaUSA
| | - Max C. Parkanzky
- Department of Small Animal Medicine & SurgeryCollege of Veterinary MedicineUniversity of GeorgiaAthensGeorgiaUSA
| | - Kate E. Creevy
- Department of Small Animal Medicine & SurgeryCollege of Veterinary MedicineUniversity of GeorgiaAthensGeorgiaUSA
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M UniversityCollege StationTexasUSA
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18
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Miller MS, Rudinsky AJ, Klamer BG, Chew DJ, Parker VJ. Association between vitamin D metabolites, vitamin D binding protein, and proteinuria in dogs. J Vet Intern Med 2020; 34:2468-2477. [PMID: 33026128 PMCID: PMC7694856 DOI: 10.1111/jvim.15912] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/02/2020] [Accepted: 09/16/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Proteinuria has been associated with progression of renal disease and increased morbidity and mortality in dogs and people. In people, proteinuria also has been associated with hypovitaminosis D. Little is known about the relationship between vitamin D metabolism and proteinuria in dogs. OBJECTIVES To further elucidate vitamin D status in dogs with protein-losing nephropathy (PLN) and minimal to no azotemia. We hypothesized that vitamin D metabolites would be lower in dogs with PLN compared to healthy dogs. ANIMALS Twenty-three client-owned adult dogs with PLN and 10 healthy control dogs. METHODS Serum 25-hydroxyvitamin D (25[OH]D), 1,25-dihydroxyvitamin D (1,25[OH]2 D), 24,25-dihydroxyvitamin D (24,25[OH]2 D), serum vitamin D binding protein (VDBP), and urine 25(OH)D concentrations were measured. RESULTS Compared to healthy dogs, dogs with PLN had lower concentrations of all vitamin D metabolites (P < .01). Correlations (rho; 95% confidence interval [CI]) in dogs with PLN are reported. Serum 25(OH)D and 24,25(OH)2 D concentrations were positively correlated with albumin (r = 0.47; 0.07-0.74), and 24,25(OH)2 D was negatively correlated with urine protein-to-creatinine ratio (UPC; r = -0.54; -0.78 to -0.16). Urine 25(OH)D-to-creatinine ratio was negatively correlated with serum albumin concentration (r = -0.77; -0.91 to -0.50) and positively correlated with UPC (r = 0.79; 0.53-0.91). Serum VDBP concentration was positively correlated with serum albumin concentration (r = 0.53; 0.05-0.81). CONCLUSIONS AND CLINICAL IMPORTANCE Dogs with PLN have decreased serum concentrations of vitamin D metabolites. Urine 25(OH)D-to-creatinine ratio and UPC are correlated in PLN dogs. Future studies are needed to assess additional management strategies for dogs with PLN.
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Affiliation(s)
- Matthew S Miller
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Adam J Rudinsky
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Brett G Klamer
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA
| | - Dennis J Chew
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Valerie J Parker
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
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Miyagawa Y, Akabane R, Sakatani A, Ogawa M, Nagakawa M, Miyakawa H, Takemura N. Effects of telmisartan on proteinuria and systolic blood pressure in dogs with chronic kidney disease. Res Vet Sci 2020; 133:150-156. [PMID: 32992126 DOI: 10.1016/j.rvsc.2020.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 10/23/2022]
Abstract
Renal proteinuria is associated with promoted renal dysfunction and a shorter survival period in dogs with chronic kidney disease (CKD). Renin angiotensin- aldosterone system inhibitors are primarily used to treat renal proteinuria. In this retrospective, open-label study, we aimed to evaluate the anti-proteinuric and anti-hypertensive effects of telmisartan (angiotensin II receptor blocker) in dogs with proteinuric CKD. A total of 28 dogs with proteinuric CKD were included in the study, all dogs received telmisartan 1 mg/kg q24h, PO. The urine protein-to-creatinine ratio (UPC), urine albumin-to-creatinine ratio (UAC) and systolic blood pressure (SBP) decreased significantly after telmisartan administration (P < 0.05). The median rate of change in UPC, UAC and SBP at Day 120 were - 65.1%, -75.9% and - 9.7%. Ten dogs (36.7%) achieved UPC < 1.0 at Day 120, of which six dogs had UPC < 0.5. A reduction of UPC to ≥50% was achieved in 10 dogs (36%) at Day 45 and 17 dogs (61%) at Day 120. Seventeen dogs (61%) had hypertension at baseline, of which 10 dogs (59%) had SBP < 160 mmHg at Day 120. Two-way repeated measures analysis of variance did not attribute the observed changes in SBP, UPC or UAC to feeding with a renal diet. In conclusion, telmisartan therapy provides anti-proteinuric and anti-hypertensive effects in dogs with proteinuric CKD.
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Affiliation(s)
- Yuichi Miyagawa
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan.
| | - Ryota Akabane
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Atsushi Sakatani
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Mizuki Ogawa
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Masayoshi Nagakawa
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Hirosumi Miyakawa
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Naoyuki Takemura
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
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Cole LP, Jepson R, Dawson C, Humm K. Hypertension, retinopathy, and acute kidney injury in dogs: A prospective study. J Vet Intern Med 2020; 34:1940-1947. [PMID: 32677736 PMCID: PMC7517860 DOI: 10.1111/jvim.15839] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 06/08/2020] [Accepted: 06/13/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Systemic hypertension (SH) is a potential complication of acute kidney injury (AKI) in dogs. OBJECTIVE To describe the prevalence of SH and hypertensive retinopathy in dogs with AKI, to investigate the relationship between SH and severity of AKI and to assess possible factors associated with SH. ANIMALS Fifty-two dogs with AKI. METHODS Prospective observational study of dogs presenting to a tertiary referral center that fulfilled the International Renal Interest Society (IRIS) guidelines for the diagnosis of AKI. Systolic blood pressure measurement, urine protein/creatinine ratio (UPCR), urine output, presence of hypertensive retinopathy and fluid overload (FO), survival to discharge and duration of hospitalization were subsequently assessed. The prevalence of SH was calculated and the relationship between SH and recorded factors was examined by nonparametric statistics. RESULTS The prevalence of SH (≥160 mm Hg) on admission or during hospitalization was 75% (39/52) and in 56% (22/39) of cases this was severe (≥180 mm Hg). Sixteen percent (7/43) of dogs had evidence of hypertensive retinopathy and 77% (24/31) dogs had UPCR >0.5. Forty-two percent (22/52) dogs had FO on admission or during hospitalization. There was no association between SH and IRIS AKI grade, oligo/anuria, survival to discharge, duration of hospitalization or proteinuria. Dogs with FO on presentation were more likely to be hypertensive at admission compared to dogs without FO (P = .02). Dogs that did not survive to discharge were more likely to have FO (P = .007). CONCLUSIONS AND CLINICAL IMPORTANCE Systemic hypertension is common in dogs with AKI. Systemic hypertension might be associated with FO, which itself is associated with nonsurvival. Monitoring for SH and FO is therefore warranted in dogs with AKI.
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Affiliation(s)
- Laura Pearl Cole
- Clinical Science & Services, Royal Veterinary CollegeHatfieldUnited Kingdom
| | - Rosanne Jepson
- Clinical Science & Services, Royal Veterinary CollegeHatfieldUnited Kingdom
| | - Charlotte Dawson
- Clinical Science & Services, Royal Veterinary CollegeHatfieldUnited Kingdom
| | - Karen Humm
- Clinical Science & Services, Royal Veterinary CollegeHatfieldUnited Kingdom
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Lorbach SK, Hokamp JA, Quimby JM, Cianciolo RE. Clinicopathologic characteristics, pathology, and prognosis of 77 dogs with focal segmental glomerulosclerosis. J Vet Intern Med 2020; 34:1948-1956. [PMID: 33463760 PMCID: PMC7517845 DOI: 10.1111/jvim.15837] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/12/2020] [Accepted: 06/13/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Focal segmental glomerulosclerosis (FSGS) is a common cause of nonimmune complex glomerulopathy and the prognosis and clinicopathologic findings associated with this condition have not been described in dogs. OBJECTIVE To characterize the presentation and identify clinical factors associated with the survival of dogs with FSGS. ANIMALS Seventy-seven dogs diagnosed with FSGS based on evaluation of renal biopsy samples submitted to the International Veterinary Renal Pathology Service. METHODS Retrospective review of medical records of dogs biopsied for evaluation of proteinuria between January 2015 and May 2017. RESULTS The incidence of FSGS among all dogs biopsied for proteinuria was 26%. Significantly more females (48; 62.3%) than males (29; 37.7%) were affected (P = .04). At the time of biopsy, median serum creatinine concentration (SCr) was 1.2 mg/dL (range, 0.3-8.7), median serum albumin concentration (Alb) was 2.8 g/dL (range, 1.1-4.6), median systolic blood pressure was 153.5 mm Hg (range, 95-260), and median urine protein : creatinine ratio was 5.9 (range, 1.4-22). Median survival time after biopsy was 258 days (range, 26-1003) for dogs that died from all causes (n = 32). Factors that were associated with a shorter survival time included SCr ≥ 2.1 mg/dL (P < .01) and Alb < 2 g/dL (P < .01). CONCLUSIONS AND CLINICAL IMPORTANCE Most dogs with FSGS were female, and although commonly hypertensive, azotemia, severe hypoalbuminemia and ascites or edema were observed infrequently. Variables significantly associated with survival time were SCr and Alb.
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Affiliation(s)
- Sarah K. Lorbach
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Jessica A. Hokamp
- Department of Veterinary Biosciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
- International Veterinary Renal Pathology Service (IVRPS), Combined Service at The Ohio State University, Columbus, Ohio and Texas A&MCollege StationTexasUSA
| | - Jessica M. Quimby
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Rachel E. Cianciolo
- Department of Veterinary Biosciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
- International Veterinary Renal Pathology Service (IVRPS), Combined Service at The Ohio State University, Columbus, Ohio and Texas A&MCollege StationTexasUSA
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Libin MB, Weltman JG, Prittie J. A Preliminary Investigation into the Association of Chloride Concentration on Morbidity and Mortality in Hospitalized Canine Patients. VETERINARY MEDICINE-RESEARCH AND REPORTS 2020; 11:57-69. [PMID: 32766124 PMCID: PMC7369501 DOI: 10.2147/vmrr.s253759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 06/05/2020] [Indexed: 11/23/2022]
Abstract
Purpose To evaluate whole blood chloride concentration and hospital-acquired AKI in hospitalized canine patients. Secondary outcome measures included the volume-adjusted chloride load, in-hospital mortality and length of ICU stay. Patients and Methods This is a prospective, observational study. Sixty dogs admitted to the ICU and receiving IV fluid therapy for >24 hours from February 2018 to July 2019. Corrected chloride and creatinine concentrations were obtained twice daily. Total volume of IV fluid and total chloride load were recorded. Volume-adjusted chloride load (VACL) was calculated by dividing the chloride administered by the volume of fluid administered. Hospital-acquired AKI was defined as an increase in creatinine of ≥26.5 μmol/L (0.3 mg/dL) or 150% from baseline to maximum. Survival to hospital discharge or non-survival and ICU length of stay were also recorded. Results Fifteen out of 60 patients developed hospital-acquired AKI. Maximum corrected chloride was significantly different in AKI group (median 122.3 mmol/L) vs non-AKI group (median 118.1 mmol/L; p=0.0002). Six out of 60 patients developed hyperchloremia. Hyperchloremic patients were significantly more likely to develop in-hospital AKI (p=0.03). Patients hospitalized ≥2 days had a significantly higher [Cl−]max compared to those with shorter ICU stay (121.8 ± 5.9 mmol/L vs 117.5 ± 4.3 mmol/L; p=0.002). Eight out of 60 patients were non-survivors. Maximum corrected chloride and creatinine concentrations were not significantly different between survivors and non-survivors. VACL was not significantly different between AKI or mortality groups. Conclusion Maximum corrected chloride concentration was significantly higher in dogs with hospital-acquired AKI, even amongst dogs without hyperchloremia. Additionally, maximum corrected chloride concentrations were significantly higher in dogs hospitalized in the ICU longer compared to those hospitalized for fewer than two days. There was no significant difference in VACL in any of the outcome groups. Results from this study suggest alterations in chloride may be observed alongside the development of acute kidney injuries. Future studies in critically ill dogs are warranted.
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Affiliation(s)
- Madeline B Libin
- Department of Emergency and Critical Care, Animal Medical Center, New York, NY, USA
| | - Joel G Weltman
- Department of Emergency and Critical Care, Animal Medical Center, New York, NY, USA
| | - Jennifer Prittie
- Department of Emergency and Critical Care, Animal Medical Center, New York, NY, USA
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Cerna P, Archontakis PE, Cheuk HO, Gunn-Moore DA. Comparison of Doppler ultrasonic and oscillometric devices (with or without proprietary optimisations) for non-invasive blood pressure measurement in conscious cats. J Feline Med Surg 2020; 23:121-130. [PMID: 32580610 PMCID: PMC7838334 DOI: 10.1177/1098612x20932407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objectives This study compared Doppler and oscillometric (PetMAP+) devices (with or without proprietary optimisations) for the non-invasive measurement of blood pressure in conscious cats. Methods Twenty-three cats were enrolled; however, five were excluded as fewer than five measurements were obtained for each assessment. All measurements were obtained according to American College of Veterinary Internal Medicine consensus guidelines. Oscillometric device modes A and B were operated according to the manufacturer’s guidelines. Doppler and oscillometric devices were used alternately as the first device. Results Systolic arterial blood pressure (SAP) measurements were obtained by Doppler (SAPd) and oscillometry; the mean of each set of five values was used for statistical analysis. There was a significant difference between SAPd and SAP measurements in oscillometric modes A (P <0.001) and B (P <0.001). While both modes measured SAP higher than SAPd, B had a smaller bias (+15.72 mmHg) and narrower limits of agreement (LOA). There was also a significant difference between SAPd and mean arterial pressure (MAP) on oscillometric modes A (P = 0.002) and B (P <0.001). Both modes’ MAP readings were lower than SAPd and oscillometric A MAP was closer to SAPd (–14.94 mmHg), with a smaller bias and narrower LOA. Conclusions and relevance The findings support that Doppler and oscillometric devices cannot be used interchangeably, with or without proprietary optimisations. Methodology should always be taken into account and reference intervals (RIs) need to be defined for the different methodologies. Until methodology-specific RIs are published, definitive diagnosis of hypertension and sub-staging of patients with kidney disease according to the International Renal Interest Society guidelines remains challenging.
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Affiliation(s)
- Petra Cerna
- Department of Internal Medicine, Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, UK.,The University of Veterinary and Pharmaceutical Sciences Brno, Czech Republic
| | - Panos E Archontakis
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK
| | | | - Danièlle A Gunn-Moore
- Department of Internal Medicine, Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, UK.,The Roslin Institute, University of Edinburgh, Edinburgh, UK
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24
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Purswell EK, Lashnits EW, Breitschwerdt EB, Vaden SL. A retrospective study of vector-borne disease prevalence in dogs with proteinuria: Southeastern United States. J Vet Intern Med 2020; 34:742-753. [PMID: 31916316 PMCID: PMC7096618 DOI: 10.1111/jvim.15610] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/20/2019] [Indexed: 12/18/2022] Open
Abstract
Background Proteinuria is a risk factor for progressive kidney injury in dogs. Enhanced understanding of potential associations between canine vector‐borne diseases (CVBD) and proteinuria is needed. Objectives To determine the proportion of evaluated proteinuric dogs exposed to ≥1 CVBD, including Babesia spp., Ehrlichia spp., spotted‐fever group Rickettsia, Bartonella spp., Anaplasma spp., hemotropic Mycoplasma spp., Borrelia burgdorferi, and Dirofilaria immitis, and to determine if demographic or clinicopathologic differences exist between proteinuric dogs exposed to CVBD versus proteinuric dogs with no evidence of CVBD exposure. Animals Two‐hundred nine proteinuric dogs, concurrently tested for CVBD, which were examined at a single academic veterinary hospital between January 2008 and December 2015. Methods Retrospective cross‐sectional study. Demographic, clinicopathologic, and CVBD test results were extracted from medical records. A multivariable logistic regression model was used to assess associations between CVBD and selected variables. Results Based on serology and polymerase chain reaction testing, 34% of proteinuric dogs (72/209) were exposed to ≥1 CVBD. Exposure to Rickettsia spp. (19%), Ehrlichia spp. (12%), and B. burgdorferi (9%) were most common. The CVBD exposure was lower in dogs tested in autumn or spring, higher in intact dogs, and higher in dogs with lower serum albumin and higher serum creatinine concentrations. Conclusions and Clinical Importance Exposure to CVBD, particularly exposure to Rickettsia spp., Ehrlichia spp., and B. burgdorferi was found in proteinuric dogs from the southeast United States. Additional controlled prospective studies examining a potential causal relationship between CVBD and proteinuria are warranted.
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Affiliation(s)
- Emily K Purswell
- The Department of Clinical Sciences and North Carolina State University, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Erin W Lashnits
- The Department of Clinical Sciences and North Carolina State University, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Edward B Breitschwerdt
- The Department of Clinical Sciences and North Carolina State University, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Shelly L Vaden
- The Department of Clinical Sciences and North Carolina State University, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
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25
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Giapitzoglou S, Saridomichelakis MN, Leontides LS, Kasabalis D, Chatzis M, Apostolidis K, Theodorou K, Roumpeas E, Mylonakis ME. Evaluation of serum symmetric dimethylarginine as a biomarker of kidney disease in canine leishmaniosis due to Leishmania infantum. Vet Parasitol 2019; 277:109015. [PMID: 31874403 DOI: 10.1016/j.vetpar.2019.109015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 02/07/2023]
Abstract
Canine leishmaniosis (CanL)-associated chronic kidney disease is a leading cause of morbidity and mortality in Mediterranean countries. Novel renal biomarkers, such as serum symmetric dimethylarginine (sSDMA), may be useful surrogates for the detection of renal functional impairment. The objectives of this study were to investigate sSDMA concentrations in dogs with CanL, with and without azotemia, and to establish any potential association with the prevalence and severity of proteinuria, with the prevalence of decreased urine specific gravity and with the LeishVet clinical stages of CanL. Serum samples from 68 dogs with CanL (50 nonazotemic and 18 azotemic) and 17 healthy dogs were retrospectively examined. Increased sSDMA was documented in 26 % of dogs with CanL without azotemia and in 83.3 % of dogs with azotemia. Serum SDMA was significantly higher in azotemic compared to nonazotemic dogs and was associated with the presence and severity of proteinuria, the decreased urine specific gravity and the advanced clinical stages of CanL. The results of the present study indicate that sSDMA may be a useful adjunct to serum creatinine and urine protein/creatinine ratio for the detection of CanL-associated nephropathy, but it is of limited value for distinguishing among the LeishVet clinical stages of CanL.
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Affiliation(s)
- Smaro Giapitzoglou
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki (CAC-AUTh), 11 Stavrou Voutyra Str., 54627, Thessaloniki, Greece
| | - Manolis N Saridomichelakis
- Clinic of Medicine, School of Veterinary Science, University of Thessaly (CM-UTh), 224 Trikalon Str., 43132, Karditsa, Greece
| | - Leonidas S Leontides
- Laboratory of Epidemiology, Biostatistics and Animal Health Economics, School of Veterinary Science, University of Thessaly, 224 Trikalon Str., 43132, Karditsa, Greece
| | - Dimitris Kasabalis
- Clinic of Medicine, School of Veterinary Science, University of Thessaly (CM-UTh), 224 Trikalon Str., 43132, Karditsa, Greece
| | - Manolis Chatzis
- Clinic of Medicine, School of Veterinary Science, University of Thessaly (CM-UTh), 224 Trikalon Str., 43132, Karditsa, Greece
| | - Kosmas Apostolidis
- Clinic of Medicine, School of Veterinary Science, University of Thessaly (CM-UTh), 224 Trikalon Str., 43132, Karditsa, Greece
| | - Konstantina Theodorou
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki (CAC-AUTh), 11 Stavrou Voutyra Str., 54627, Thessaloniki, Greece
| | - Efstathios Roumpeas
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki (CAC-AUTh), 11 Stavrou Voutyra Str., 54627, Thessaloniki, Greece
| | - Mathios E Mylonakis
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki (CAC-AUTh), 11 Stavrou Voutyra Str., 54627, Thessaloniki, Greece.
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26
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Acierno MJ, Brown S, Coleman AE, Jepson RE, Papich M, Stepien RL, Syme HM. ACVIM consensus statement: Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats. J Vet Intern Med 2018; 32:1803-1822. [PMID: 30353952 PMCID: PMC6271319 DOI: 10.1111/jvim.15331] [Citation(s) in RCA: 243] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022] Open
Abstract
An update to the 2007 American College of Veterinary Internal Medicine (ACVIM) consensus statement on the identification, evaluation, and management of systemic hypertension in dogs and cats was presented at the 2017 ACVIM Forum in National Harbor, MD. The updated consensus statement is presented here. The consensus statement aims to provide guidance on appropriate diagnosis and treatment of hypertension in dogs and cats.
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Affiliation(s)
- Mark J Acierno
- Department of Medicine, College of Veterinary Medicine, Midwestern University, 5715 W. Utopia Rd, Glendale Arizona 85308
| | - Scott Brown
- College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Amanda E Coleman
- College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Rosanne E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Mark Papich
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Rebecca L Stepien
- Department of Medical Sciences, University of Wisconsin School of Veterinary Medicine, Madison, Wisconsin
| | - Harriet M Syme
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
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27
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Caro‐Vadillo A, Daza‐González MA, Gonzalez‐Alonso‐Alegre E, Rodríguez A, Gómez‐García J. Effect of a combination of telmisartan and amlodipine in hypertensive dogs. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2017-000471] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | | | | | - Alfonso Rodríguez
- Medicina y Cirugía AnimalUniversidad Complutense de MadridMadridSpain
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28
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Prudic RA, Saba CF, Lourenço BN, Bugbee AC. Prevalence of proteinuria in a canine oncology population. J Small Anim Pract 2018; 59:496-500. [PMID: 29608792 DOI: 10.1111/jsap.12840] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/16/2018] [Accepted: 02/23/2018] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To evaluate the point prevalence of proteinuria in dogs presenting to the University of Georgia Oncology Service for the first time. MATERIALS AND METHODS In this prospective study, 60 client-owned dogs with a confirmed cancer diagnosis were included but those with lower urinary tract neoplasia were excluded. Each dog's signalment, cancer diagnosis, previous cancer treatments, current medications and travel history were recorded. Renal values, electrolytes, packed cell volume, total solids, systolic blood pressure, urinalysis, urine protein:urine creatinine and retinal examinations were recorded. Non-proteinuric, borderline proteinuria and overt proteinuria were defined as urine protein:urine creatinine <0·2, ≥0·2 but <0·5, and ≥0·5, respectively. Urine culture was performed in dogs with active urine sediments or overt proteinuria. RESULTS Twenty-nine dogs were non-proteinuric (48·3%), 22 (36·7%) borderline proteinuric and nine (15%) overtly proteinuric. None were azotaemic. Hypertension (systolic blood pressure ≥160 mmHg) was detected in 18 (30%) dogs. Of these, six were non-proteinuric, nine borderline proteinuric, and three overtly proteinuric. Proteinuria was detected in 51% of dogs presented to our oncology service, the majority of which were classified as borderline. CLINICAL SIGNIFICANCE The high proportion of proteinuria in dogs in this study suggests that screening for proteinuria in dogs with cancer may be prudent. Larger studies are required to correlate specific cancer types and the impact of treatment with the development, magnitude and persistence of proteinuria.
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Affiliation(s)
- R A Prudic
- Department of Small Animal Medicine & Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, 30602, USA
| | - C F Saba
- Department of Small Animal Medicine & Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, 30602, USA
| | - B N Lourenço
- Department of Small Animal Medicine & Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, 30602, USA
| | - A C Bugbee
- Department of Small Animal Medicine & Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, 30602, USA
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29
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Vidal PN, Miceli DD, Arias ES, D'Anna E, García JD, Castillo VA. Decrease of nitric oxide and increase in diastolic blood pressure are two events that affect renal function in dogs with pituitary dependent hyperadrenocorticism. Open Vet J 2018; 8:86-95. [PMID: 29721437 PMCID: PMC5918129 DOI: 10.4314/ovj.v8i1.14] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/02/2018] [Indexed: 11/17/2022] Open
Abstract
Hyperadrenocorticism is a frequent disease in dogs. The excess of circulating cortisol affects different organs and metabolic pathways, producing severe adverse effects that endanger the animal’s life. Among these effects, hypertension and renal damage can be mentioned. A group of 20 dogs with pituitary dependent hyperadrenocorticism (PDH) and 12 control dogs were used to study the following parameters: cortisol and nitric oxide (NO nit/nit) concentrations, diastolic and systolic blood pressure, renal artery resistance index by Doppler ultrasound, the rate of glomerular filtration by radio-renogram excretion and the presence of proteins in urine. Dogs with PDH showed a significantly lower NO nit/nit (P<0.0001) than the controls and this correlated with high values of diastolic and systolic pressure (r = -0.87; P<0.0001 and r = -0.81; P<0.0001 respectively). Most dogs (80%) are hypertensive mainly due to an increase in diastolic pressure, which correlated positively with the UPC (r = 0.8; P<0.001) and negatively with the glomerular rate of filtration (r = -0.58; P=0.007). Systolic pressure only increased in 60% of the cases and did not correlate with the mentioned variables. In PDH the decrease of NO affects blood pressure. The diastolic pressure would seem to have the greatest impact on the kidneys, therefore its evaluation and control are important to avoid and/or control renal damage.
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Affiliation(s)
- Patricia N Vidal
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales and U. de Endocrinología, Argentina.,U. Diagnóstico por Imágenes, Hospital Escuela de Medicina Veterinaria, Argentina.,Research fellow of CONICET. Av. Chorroarín 280, (1427) C. A. Buenos Aires, Argentina
| | - Diego D Miceli
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales and U. de Endocrinología, Argentina.,U. Diagnóstico por Imágenes, Hospital Escuela de Medicina Veterinaria, Argentina.,Research fellow of CONICET. Av. Chorroarín 280, (1427) C. A. Buenos Aires, Argentina
| | - Elber Soler Arias
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales and U. de Endocrinología, Argentina
| | - Elena D'Anna
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales and U. de Endocrinología, Argentina.,U. Diagnóstico por Imágenes, Hospital Escuela de Medicina Veterinaria, Argentina
| | - Jorge D García
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales and U. de Endocrinología, Argentina
| | - Victor Alejandro Castillo
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales and U. de Endocrinología, Argentina
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30
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Pineda C, Aguilera-Tejero E, Morales MC, Belinchon-Lorenzo S, Gomez-Nieto LC, Garcia P, Martinez-Moreno JM, Rodriguez-Ortiz ME, Lopez I. Treatment of canine leishmaniasis with marbofloxacin in dogs with renal disease. PLoS One 2017; 12:e0185981. [PMID: 28982165 PMCID: PMC5641981 DOI: 10.1371/journal.pone.0185981] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 09/22/2017] [Indexed: 11/27/2022] Open
Abstract
Treatment of canine leishmaniasis (CanL) represents a challenge. Due to the high prevalence of renal disease associated to CanL, it is important to find an effective drug that does not damage the kidneys. Marbofloxacin has been shown to be effective and well tolerated in non-azotemic dogs with leishmaniasis. To evaluate the safety and efficacy of marbofloxacin in dogs with leishmaniasis and decreased renal function, 28 dogs suffering from leishmaniasis and chronic kidney disease (CKD) were treated with oral marbofloxacin at 2 mg/Kg/day for 28 days. During treatment dogs were assessed by performing weekly physical exams, measuring blood pressure and evaluating blood and urine parameters. Lymph node aspirations were also obtained at days 0 and 28. The global clinical score decreased significantly, from 6.2±3.4 to 4.7±3.1 (p = 0.0001), after treatment. Marbofloxacin also decreased parasitic load in 72% of the dogs. No significant differences in plasma creatinine, urine specific gravity, urinary concentrations of cystatin C, ferritin and urinary protein loss were detected during treatment. A transient but significant decrease in blood pressure was detected up to day 14 (from 180.1±36.6 to 166.0±32.7 mmHg; p = 0.016). Moreover, dogs showed a significant increase in plasma albumin concentration (from 15.0±5.2 to 16.6±3.9 g/L; p = 0.014) and a significant decrease in globulin concentration (from 59.0±18.1 to 54.1±18.0 g/L; p = 0.005). The results demonstrate that, in addition to being effective for treatment of CanL, marbofloxacin is a very safe drug in dogs with CKD and leishmaniasis.
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Affiliation(s)
- Carmen Pineda
- Department of Medicina y Cirugia Animal, University of Cordoba, Cordoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Escolastico Aguilera-Tejero
- Department of Medicina y Cirugia Animal, University of Cordoba, Cordoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Maria C. Morales
- Department of Medicina y Cirugia Animal, University of Cordoba, Cordoba, Spain
| | - Silvia Belinchon-Lorenzo
- LeishmanCeres Laboratory (GLP Compliance Certificated), Parasitology Unit, University of Extremadura, Caceres, Spain
| | - Luis C. Gomez-Nieto
- LeishmanCeres Laboratory (GLP Compliance Certificated), Parasitology Unit, University of Extremadura, Caceres, Spain
| | - Pablo Garcia
- Department of Medicina y Cirugia Animal, University of Cordoba, Cordoba, Spain
| | - Julio M. Martinez-Moreno
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Maria E. Rodriguez-Ortiz
- Nephrology Laboratory, Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz, Madrid, Spain
| | - Ignacio Lopez
- Department of Medicina y Cirugia Animal, University of Cordoba, Cordoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
- * E-mail:
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31
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Cole L, Jepson R, Humm K. Systemic hypertension in cats with acute kidney injury. J Small Anim Pract 2017; 58:577-581. [DOI: 10.1111/jsap.12726] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 06/15/2017] [Accepted: 06/16/2017] [Indexed: 01/24/2023]
Affiliation(s)
- L. Cole
- Department of Clinical Science and Services; The Royal Veterinary College, Hawkshead Lane, Hatfield; Hertfordshire, ALP 7TA UK
| | - R. Jepson
- Department of Clinical Science and Services; The Royal Veterinary College, Hawkshead Lane, Hatfield; Hertfordshire, ALP 7TA UK
| | - K. Humm
- Department of Clinical Science and Services; The Royal Veterinary College, Hawkshead Lane, Hatfield; Hertfordshire, ALP 7TA UK
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32
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Violette NP, Ledbetter EC. Punctate retinal hemorrhage and its relation to ocular and systemic disease in dogs: 83 cases. Vet Ophthalmol 2017; 21:233-239. [DOI: 10.1111/vop.12496] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Nathaniel P. Violette
- Department of Clinical Sciences; College of Veterinary Medicine; Cornell University; Ithaca NY 14853 USA
| | - Eric C. Ledbetter
- Department of Clinical Sciences; College of Veterinary Medicine; Cornell University; Ithaca NY 14853 USA
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33
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King JN, Font A, Rousselot JF, Ash RA, Bonfanti U, Brovida C, Crowe ID, Lanore D, Pechereau D, Seewald W, Strehlau G. Effects of Benazepril on Survival of Dogs with Chronic Kidney Disease: A Multicenter, Randomized, Blinded, Placebo-Controlled Clinical Trial. J Vet Intern Med 2017; 31:1113-1122. [PMID: 28669137 PMCID: PMC5508345 DOI: 10.1111/jvim.14726] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 02/16/2017] [Accepted: 04/06/2017] [Indexed: 01/10/2023] Open
Abstract
Background Chronic kidney disease (CKD) is an important cause of morbidity and mortality in dogs. Objective To evaluate the efficacy in prolonging survival and safety of benazepril administration to dogs with CKD. Animals Forty‐nine client‐owned dogs with CKD. Methods Dogs were randomized to benazepril (0.25 to <0.5 mg/kg) or placebo once daily for up to 2 years in a prospective, multicenter, blinded clinical trial. The primary endpoint variable was the renal survival time, defined as the time from inclusion in the study to the treatment failure endpoint of death or euthanasia or need for administration of parenteral fluids related to renal failure. Results No benefit of benazepril versus placebo was detected for renal survival time in all dogs; median (95% confidence interval (CI)) survival times were 305 (53–575) days in the benazepril group and 287 (152‐not available) in the placebo group (P = .53). Renal survival times were not significantly longer with benazepril compared to placebo for subgroups: hazard ratios (95% CI) were 0.50 (0.21–1.22) with P = .12 for initial urine protein‐to‐creatinine ratio (UPC) >0.5, and 0.38 (0.12–1.19) with P = .080 for initial UPC >0.5 plus plasma creatinine ≤440 μmol/L. Proteinuria, assessed from the UPC, was significantly (P = .0032) lower after treatment with benazepril compared to placebo. There were no significant differences between groups for clinical signs or frequencies of adverse events. Conclusions and Clinical Relevance Benazepril significantly reduced proteinuria in dogs with CKD. Insufficient numbers of dogs were recruited to allow conclusions on survival time.
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Affiliation(s)
- J N King
- Elanco Animal Health, Basel, Switzerland
| | - A Font
- Hospitar Ars Veterinaria, Barcelona, Spain
| | - J-F Rousselot
- Clinique vétérinaire du Clos des Camélias, Colombes, France
| | - R A Ash
- Grove Lodge Veterinary Group, Brighton, UK
| | - U Bonfanti
- La Vallonèa Veterinary Diagnostic Laboratory, Alessano, Italy
| | - C Brovida
- ANUBI Ospedale per Animali da Compagnia, Moncalieri/Torino, Italy
| | - I D Crowe
- Kingsway Veterinary Group, Skipton, UK
| | - D Lanore
- Clinique Vétérinaire Alliance, Bordeaux, France
| | | | - W Seewald
- Elanco Animal Health, Basel, Switzerland
| | - G Strehlau
- Elanco Animal Health, Basel, Switzerland
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34
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Martinez J, Kellogg C, Iazbik MC, Couto CG, Pressler BM, Hoepf TM, Radin MJ. The Renin-Angiotensin-Aldosterone System in Greyhounds and Non-Greyhound Dogs. J Vet Intern Med 2017; 31:988-993. [PMID: 28488321 PMCID: PMC5508314 DOI: 10.1111/jvim.14720] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 02/25/2017] [Accepted: 03/27/2017] [Indexed: 01/06/2023] Open
Abstract
Background The renin‐angiotensin‐aldosterone system (RAAS) regulates blood pressure, electrolyte homeostasis, and renal function. Blood pressure, serum sodium concentrations, and urinary albumin excretion are higher in Greyhounds than other purebred and mixed‐breed dogs. Hypothesis Alterations in the RAAS in Greyhounds are associated with hemodynamic and clinicopathologic differences observed in the breed. Animals Clinically healthy Greyhound and non‐Greyhound dogs consecutively enrolled as blood donors (n = 20/group). Methods Prospective study. Standard chemical analysis was performed on serum and urine. Serum angiotensin‐converting enzyme (ACE) activity was determined by fluorometric assay. All other RAAS hormones were determined by radioimmunoassay. Symmetric dimethylarginine (SDMA) was measured by immunoassay. Measurements were compared to blood pressure and urine albumin concentration. Data are presented as mean ± SD or median, range. Results Serum creatinine (1.5 ± 0.2 vs 1.0 ± 0.1 mg/dL, P < .001), sodium (149, 147–152 vs 148, 146–150 mEq/L, P = .017), and SDMA (16.1 ± 2.9 vs 12.2 ± 1.8 μg/dL, P < .001) were significantly higher in Greyhounds versus non‐Greyhounds, respectively. Plasma renin activity (0.69, 0.10–1.93 vs 0.65, 0.27–2.93 ng/mL/h, P = .60) and ACE activity (4.5, 2.1–8.5 vs 4.6, 2.1–11.4 activity/mL; P = .77) were similar between groups and did not correlate with higher systolic pressures and albuminuria in Greyhounds. Plasma aldosterone concentration was significantly lower in Greyhounds versus non‐Greyhounds (11, 11–52 vs 15, 11–56 pg/mL, respectively, P = .002). Conclusions and clinical importance Basal RAAS activation did not differ between healthy Greyhounds and non‐Greyhounds. Lower aldosterone concentration in Greyhounds is an appropriate physiologic response to higher serum sodium concentration and blood pressure, suggesting that angiotensin II effects in the renal tubule predominate over those of aldosterone.
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Affiliation(s)
- J Martinez
- Department of Veterinary Biosciences, Ohio State University College of Veterinary Medicine, Columbus, OH
| | - C Kellogg
- Department of Veterinary Clinical Sciences, Ohio State University College of Veterinary Medicine, Columbus, OH
| | - M C Iazbik
- Ohio State University Veterinary Medical Center, Columbus, OH
| | - C G Couto
- Department of Veterinary Clinical Sciences, Ohio State University College of Veterinary Medicine, Columbus, OH
| | - B M Pressler
- Department of Veterinary Clinical Sciences, Ohio State University College of Veterinary Medicine, Columbus, OH
| | - T M Hoepf
- Department of Veterinary Biosciences, Ohio State University College of Veterinary Medicine, Columbus, OH
| | - M J Radin
- Department of Veterinary Biosciences, Ohio State University College of Veterinary Medicine, Columbus, OH
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Braga ET, Leite JHADC, Rosa FA, Tivelli P, Araújo AM, de Almeida BFM, Ferrari HF, Ciarlini PC, Machado GF, Marcondes M. Hypertension and its correlation with renal lesions in dogs with leishmaniosis. ACTA ACUST UNITED AC 2017; 24:45-51. [PMID: 25909252 DOI: 10.1590/s1984-29612015007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 11/05/2015] [Indexed: 11/21/2022]
Abstract
To evaluate the prevalence of hypertension and its correlation with the severity of renal injury and proteinuria in dogs with leishmaniosis, sixty-six dogs were divided into two groups. Group 1 (G1) was composed of 54 dogs included in stage 1 of chronic kidney disease (CKD), and group 2 (G2) of twelve dogs in stages 2 and 3 of CKD. Prevalence of hypertension was 28.8%, comprising 22.2% of the dogs from G1 and 58.3% from G2 (P=0.011). The mean arterial blood pressure (BP) of dogs from G1 (135.7 ± 20.5) was lower than from G2 (170.0 ± 26.3) (P <0.001). Urine protein-creatinine ratio (UP/C) revealed values above 0.5 in 75.7% of the dogs, with 34% presenting hypertension. All dogs with hypertension had histopathological and laboratory evidence of glomerular disease. Although there was no statistically significant correlation between elevated BP and the severity of glomerular lesions (P=0.408), there was a statistically significant correlation between elevated BP and increased UP/C in the studied population (P=0.002). Thus, dogs with leishmaniosis and renal disease must be screened for the presence of hypertension so that treatment may be instituted as early as possible, in countries where treatment is allowed, to prevent the progression of renal damage.
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Affiliation(s)
- Eveline Tozzi Braga
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Universidade Estadual Paulista, Araçatuba, SP, Brasil
| | | | - Fernando Azadinho Rosa
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Universidade Estadual Paulista, Araçatuba, SP, Brasil
| | - Patrícia Tivelli
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Universidade Estadual Paulista, Araçatuba, SP, Brasil
| | - Amanda Mariano Araújo
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Universidade Estadual Paulista, Araçatuba, SP, Brasil
| | - Breno Fernando Martins de Almeida
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Universidade Estadual Paulista, Araçatuba, SP, Brasil
| | - Heitor Flávio Ferrari
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Universidade Estadual Paulista, Araçatuba, SP, Brasil
| | - Paulo César Ciarlini
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Universidade Estadual Paulista, Araçatuba, SP, Brasil
| | - Gisele Fabrino Machado
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Universidade Estadual Paulista, Araçatuba, SP, Brasil
| | - Mary Marcondes
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Universidade Estadual Paulista, Araçatuba, SP, Brasil
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Taylor SS, Sparkes AH, Briscoe K, Carter J, Sala SC, Jepson RE, Reynolds BS, Scansen BA. ISFM Consensus Guidelines on the Diagnosis and Management of Hypertension in Cats. J Feline Med Surg 2017; 19:288-303. [DOI: 10.1177/1098612x17693500] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Practical relevance: Feline hypertension is a common disease in older cats that is frequently diagnosed in association with other diseases such as chronic kidney disease and hyperthyroidism (so-called secondary hypertension), although some cases of apparent primary hypertension are also reported. The clinical consequences of hypertension can be severe, related to ‘target organ damage’ (eye, heart and vasculature, brain and kidneys), and early diagnosis followed by appropriate therapeutic management should help reduce the morbidity associated with this condition. Clinical challenges: Despite being a common disease, routine blood pressure (BP) monitoring is generally performed infrequently, probably leading to underdiagnosis of feline hypertension in clinical practice. There is a need to: (i) ensure BP is measured as accurately as possible with a reproducible technique; (ii) identify and monitor patients at risk of developing hypertension; (iii) establish appropriate criteria for therapeutic intervention; and (iv) establish appropriate therapeutic targets. Based on current data, amlodipine besylate is the treatment of choice to manage feline hypertension and is effective in the majority of cats, but the dose needed to successfully manage hypertension varies between individuals. Some cats require long-term adjuvant therapy and, occasionally, additional therapy is necessary for emergency management of hypertensive crises. Evidence base: These Guidelines from the International Society of Feline Medicine (ISFM) are based on a comprehensive review of the currently available literature, and are aimed at providing practical recommendations to address the challenges of feline hypertension for veterinarians. There are many areas where more data is required which, in the future, will serve to confirm or modify some of the recommendations in these Guidelines.
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Affiliation(s)
| | | | - Katherine Briscoe
- Animal Referral Hospital, 250 Parramatta Road, Homebush, Sydney, NSW 2140, Australia
| | - Jenny Carter
- PO Box 128209, Remuera, Auckland 1541, New Zealand
| | | | - Rosanne E Jepson
- Clinical Sciences and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL9 7TA, UK
| | | | - Brian A Scansen
- Associate Professor, Department of Clinical Sciences, Colorado State University, Campus Delivery 1678, Fort Collins, CO 80523, USA
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Quimby JM. Update on Medical Management of Clinical Manifestations of Chronic Kidney Disease. Vet Clin North Am Small Anim Pract 2016; 46:1163-81. [DOI: 10.1016/j.cvsm.2016.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Vaden SL, Elliott J. Management of Proteinuria in Dogs and Cats with Chronic Kidney Disease. Vet Clin North Am Small Anim Pract 2016; 46:1115-30. [DOI: 10.1016/j.cvsm.2016.06.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Willems A, Paepe D, Marynissen S, Smets P, Van de Maele I, Picavet P, Duchateau L, Daminet S. Results of Screening of Apparently Healthy Senior and Geriatric Dogs. J Vet Intern Med 2016; 31:81-92. [PMID: 27747924 PMCID: PMC5259637 DOI: 10.1111/jvim.14587] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 06/30/2016] [Accepted: 08/24/2016] [Indexed: 11/28/2022] Open
Abstract
Background There is a growing interest in health care of elderly dogs; however, scientific information about physical and laboratory examination findings in this age group is limited. Objectives To describe systolic blood pressure (SBP), and results of physical examination and laboratory tests in senior and geriatric dogs that were judged by the owner to be healthy. Animals Hundred client‐owned dogs. Methods Dogs were prospectively recruited. Owners completed a questionnaire. SBP measurement, physical, orthopedic and neurologic examination, direct fundoscopy and Schirmer tear test were performed. Complete blood count, serum biochemistry, and urinalysis were evaluated. Results Forty‐one senior and 59 geriatric dogs were included. Mean SBP was 170 ± 38 mmHg, and 53 dogs had SBP > 160 mmHg. Thirty‐nine animals were overweight. A heart murmur was detected in 22, severe calculus in 21 and 1 or more (sub)cutaneous masses in 56 dogs. Thirty‐two dogs had increased serum creatinine, 29 hypophosphatemia, 27 increased ALP, 25 increased ALT, and 23 leukopenia. Crystalluria, mostly amorphous crystals, was commonly detected (62/96). Overt proteinuria and borderline proteinuria were detected in 13 and 18 of 97 dogs, respectively. Four dogs had a positive urine bacterial culture. Frequency of orthopedic problems, frequency of (sub)cutaneous masses, and platelet count were significantly higher in geriatric compared with senior dogs. Body temperature, hematocrit, serum albumin, and serum total thyroxine concentration were significantly lower in geriatric compared with senior dogs. Conclusions and Clinical Importance Physical and laboratory abnormalities are common in apparently healthy elderly dogs. Veterinarians play a key role in implementing health screening and improving health care for elderly pets.
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Affiliation(s)
- A Willems
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - D Paepe
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - S Marynissen
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - P Smets
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - I Van de Maele
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - P Picavet
- Hill's Pet Nutrition, Inc., Brussels, Belgium
| | - L Duchateau
- Department of Comparative Physiology and Biometrics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - S Daminet
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Rossi G, Bertazzolo W, Binnella M, Scarpa P, Paltrinieri S. Measurement of proteinuria in dogs: analytic and diagnostic differences using 2 laboratory methods. Vet Clin Pathol 2016; 45:450-8. [PMID: 27564569 DOI: 10.1111/vcp.12388] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Urinary protein-to-creatinine (UPC) ratio is an early diagnostic and prognostic marker of renal disease in dogs. Pyrogallol red molybdate (PRM) and Coomassie brilliant blue (CBB) are the most popular dye-binding assays for measurement of proteinuria. Published guidelines recommend strict cut-off points to substage patients with chronic renal diseases, irrespective of the assay applied. However, analytic variability and method-dependent differences could affect substaging of patients. OBJECTIVES The aims of this study were to analytically validate the CBB assay to evaluate possible method-dependent differences with PRM in urinary protein (UP) determination, and to assess the influence of such differences in substaging according to the International Renal Interest Society (IRIS). METHODS Urine was collected from healthy and proteinuric dogs. Intra-assay and inter-assay repeatability (imprecision), linearity under dilution (LUD), and spiking recovery (inaccuracy) were determined for the CBB assay. Split samples were measured with PRM and CBB, and agreement between methods and concordance in classification according to IRIS guidelines was determined. RESULTS The CBB assay was precise (< 10%) at all urine protein concentrations after excluding outliers from the intra-assay precision assay of high urine protein concentrations. Acceptable accuracy was demonstrated with both LUD and spiking recovery test. Both UP and UPC determined by CBB were significantly higher (P < .0001) than those obtained with PRM, and both a constant and proportional bias were present. Concordance of IRIS substaging was only moderate. CONCLUSIONS The CBB is precise and accurate, but the higher UPC obtained with CBB vs PRM may affect interpretation of the IRIS guidelines.
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Affiliation(s)
- Gabriele Rossi
- Department of Veterinary Sciences and Public Health, University of Milan, Milan, Italy.
| | - Walter Bertazzolo
- Veterinary Animal Hospital "Città di Pavia", Pavia, Italy.,Veterinary Laboratory "La Vallonea", Alessano (LE), Italy
| | - Monica Binnella
- Department of Veterinary Sciences and Public Health, University of Milan, Milan, Italy
| | - Paola Scarpa
- Department of Veterinary Sciences and Public Health, University of Milan, Milan, Italy
| | - Saverio Paltrinieri
- Department of Veterinary Sciences and Public Health, University of Milan, Milan, Italy
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Martinez JT, Rogers LK, Kellogg C, Iazbik MC, Couto CG, Pressler BM, Hoepf TM, Radin MJ. Plasma Vasoprotective Eicosanoid Concentrations in Healthy Greyhounds and Non-Greyhound Dogs. J Vet Intern Med 2016; 30:583-90. [PMID: 26806473 PMCID: PMC4913591 DOI: 10.1111/jvim.13833] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 11/09/2015] [Accepted: 12/30/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Hypertension and albuminuria often coexist in Greyhounds, suggesting generalized vascular dysfunction that could contribute to the development of a variety of diseases in this breed. Eicosanoid metabolites of arachidonic acid (AA) mediate endothelial function, vascular reactivity, and proteinuria in humans and in rodent models. HYPOTHESIS The eicosanoid profile of Greyhounds is shifted toward metabolites that promote vascular dysfunction, hypertension, and proteinuria. ANIMALS Healthy Greyhounds (n = 20) and non-Greyhound (n = 20) dogs that were consecutively enrolled in a blood donor program. METHODS Prospective study. Plasma eicosanoid metabolites were assayed by liquid chromatography/electrospray ionization mass spectrometry (LC/ESI/MS) and compared to systolic blood pressure (SP) measurements and urine albumin concentration. RESULTS Isomers of hydroxyeicosatetraenoic acid (HETE) were higher in Greyhounds than non-Greyhounds (median, range in pmol/mL: 5(S)HETE 19.82, 8.55-32.95 versus 13.54, 4.33-26.27, P = .033; 8(S)HETE 9.39, 3.28-19.84 versus 5.80, 2.25-17.66, P = .002; 9(S)HETE 9.46, 2.43-13.79 versus 5.82, 1.50-17.16, P = .026; 12(S)HETE 10.17, 3.81-40.06 versus 7.24, 2.9-16.16, P = .022). Dihydroxyeicosatrienoic acid (DHET) isomers also were higher in Greyhounds compared to non-Greyhounds (mean ± SD in pmol/mL: 8,9DHET 5.78 ± 2.13 versus 4.03 ± 1.36, P = .004; 11,12DHET 11.98 ± 2.86 versus 8.90 ± 3.48, P = .004; 14,15DHET 7.23 ± 2.19 versus 5.76 ± 1.87, P = .028). Albuminuria correlated with total DHET (rs = 0.46, P = .003). SP was positively correlated with 11,12EET (rs = 0.42, P = .006) and 20(S)HETE (rs = 0.38, P = .017). SP and 8,9EET were inversely correlated (rs = -0.49, P = .001). CONCLUSIONS AND CLINICAL IMPORTANCE Plasma eicosanoid profile in Greyhounds was consistent with activation of metabolic pathways known to promote vascular dysfunction and might contribute to higher blood pressures and albuminuria. Inhibition of these eicosanoid pathways should be evaluated as therapeutic targets in Greyhounds.
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Affiliation(s)
- J T Martinez
- Department of Veterinary Biosciences, Ohio State University College of Veterinary Medicine, Columbus, OH
| | - L K Rogers
- Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH
| | - C Kellogg
- Department of Veterinary Clinical Sciences, Ohio State University College of Veterinary Medicine, Columbus, OH
| | | | - C G Couto
- Department of Veterinary Clinical Sciences, Ohio State University College of Veterinary Medicine, Columbus, OH
| | - B M Pressler
- Department of Veterinary Clinical Sciences, Ohio State University College of Veterinary Medicine, Columbus, OH
| | - T M Hoepf
- Department of Veterinary Biosciences, Ohio State University College of Veterinary Medicine, Columbus, OH
| | - M J Radin
- Department of Veterinary Biosciences, Ohio State University College of Veterinary Medicine, Columbus, OH
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Pouchelon JL, Atkins CE, Bussadori C, Oyama MA, Vaden SL, Bonagura JD, Chetboul V, Cowgill LD, Elliot J, Francey T, Grauer GF, Fuentes VL, Moise NS, Polzin DJ, Van Dongen AM, Van Israël N. Cardiovascular-renal axis disorders in the domestic dog and cat: a veterinary consensus statement. J Small Anim Pract 2015; 56:537-52. [PMID: 26331869 PMCID: PMC4584495 DOI: 10.1111/jsap.12387] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 03/14/2015] [Accepted: 06/09/2015] [Indexed: 01/16/2023]
Abstract
OBJECTIVES There is a growing understanding of the complexity of interplay between renal and cardiovascular systems in both health and disease. The medical profession has adopted the term "cardiorenal syndrome" (CRS) to describe the pathophysiological relationship between the kidney and heart in disease. CRS has yet to be formally defined and described by the veterinary profession and its existence and importance in dogs and cats warrant investigation. The CRS Consensus Group, comprising nine veterinary cardiologists and seven nephrologists from Europe and North America, sought to achieve consensus around the definition, pathophysiology, diagnosis and management of dogs and cats with "cardiovascular-renal disorders" (CvRD). To this end, the Delphi formal methodology for defining/building consensus and defining guidelines was utilised. METHODS Following a literature review, 13 candidate statements regarding CvRD in dogs and cats were tested for consensus, using a modified Delphi method. As a new area of interest, well-designed studies, specific to CRS/CvRD, are lacking, particularly in dogs and cats. Hence, while scientific justification of all the recommendations was sought and used when available, recommendations were largely reliant on theory, expert opinion, small clinical studies and extrapolation from data derived from other species. RESULTS Of the 13 statements, 11 achieved consensus and 2 did not. The modified Delphi approach worked well to achieve consensus in an objective manner and to develop initial guidelines for CvRD. DISCUSSION The resultant manuscript describes consensus statements for the definition, classification, diagnosis and management strategies for veterinary patients with CvRD, with an emphasis on the pathological interplay between the two organ systems. By formulating consensus statements regarding CvRD in veterinary medicine, the authors hope to stimulate interest in and advancement of the understanding and management of CvRD in dogs and cats. The use of a formalised method for consensus and guideline development should be considered for other topics in veterinary medicine.
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Affiliation(s)
- J L Pouchelon
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité de Cardiologie d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), Maisons-Alfort 94704, France
| | - C E Atkins
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
| | - C Bussadori
- Clinica Veterinaria Gran Sasso, Milano 20131, Italy
| | - M A Oyama
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - S L Vaden
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
| | - J D Bonagura
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - V Chetboul
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité de Cardiologie d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), Maisons-Alfort 94704, France
| | - L D Cowgill
- Department of Medicine and Epidemiology, University of California-Davis, Davis, CA 95616, USA
| | - J Elliot
- Comparative Biomedical Sciences, The Royal Veterinary College, University of London, London NW1 0TU
| | - T Francey
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern 3012, Switzerland
| | - G F Grauer
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA
| | - V Luis Fuentes
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield AL9 7TA, UK
| | - N Sydney Moise
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - D J Polzin
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA
| | - A M Van Dongen
- Department of Clinical Sciences of Companion Animals, University of Utrecht College of Veterinary Medicine, Utrecht 3584, The Netherlands
| | - N Van Israël
- ACAPULCO Animal Cardiopulmonary Consultancy, Masta, Stavelot 4970, Belgium
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Duffy ME, Specht A, Hill RC. Comparison between Urine Protein: Creatinine Ratios of Samples Obtained from Dogs in Home and Hospital Settings. J Vet Intern Med 2015; 29:1029-35. [PMID: 26059431 PMCID: PMC4895355 DOI: 10.1111/jvim.12836] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 02/25/2015] [Accepted: 04/22/2015] [Indexed: 12/17/2022] Open
Abstract
Background The urine protein:creatinine ratio (UPC) is used to quantify urine protein excretion and guide recommendations for monitoring and treatment of proteinuria. Hypothesis/Objectives Home urine samples will have lower UPCs than hospital samples. The objectives were to compare UPCs of samples collected in each setting and to determine whether environment of sample collection might affect staging, monitoring or treatment recommendations. Animals Twenty‐four client‐owned dogs. Methods Prospective, nonmasked study. Clients collected a urine sample from their dog at home and a second sample was collected at the hospital. Dogs receiving corticosteroids or angiotensin‐converting enzyme inhibitors were excluded, as were those with urine samples of inadequate volume, no protein on dipstick analysis, or active urine sediment. Samples were refrigerated after collection, dipstick and sediment evaluations were completed and each sample was frozen at −80°C within 12 hours. UPCs were performed on frozen samples within 2 months. Results From 81 paired samples, 57 were excluded. Of the remaining 24, 12/24 (50%) had higher hospital sample UPCs, 9/24 (38%) had identical UPCs, and 3/24 (12%) had lower hospital UPCs. The UPCs of hospital samples were higher than home samples for the total population (P = .005) and the subset with UPC > 0.5 (P = .001). Conclusions Setting and related circumstances of urine collection in dogs is associated with UPC differences; results are usually higher in hospital than in home samples. This difference has the potential to affect clinical interpretation.
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Affiliation(s)
- M E Duffy
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL
| | - A Specht
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL
| | - R C Hill
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL
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Paepe D, Lefebvre HP, Concordet D, van Hoek I, Croubels S, Daminet S. Simplified methods for estimating glomerular filtration rate in cats and for detection of cats with low or borderline glomerular filtration rate. J Feline Med Surg 2014; 17:889-900. [PMID: 25518848 DOI: 10.1177/1098612x14561106] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Diagnosis of early feline chronic kidney disease (CKD) is challenging. Glomerular filtration rate (GFR) is the best overall indicator of kidney function, but multisample plasma clearance methods to determine GFR are labour intensive, time consuming and stressful for feline patients. This study aimed to develop simplified methods to detect decreased GFR in cats. METHODS Data from a nine-sample combined plasma exogenous creatinine-iohexol clearance test of 73 cats were used. Limited sampling strategies were developed by comparing all sampling time combinations with the complete nine sampling times set and selecting the best sampling time combinations based on maximum relative error. By regression analysis, the ability of routine blood (serum creatinine, serum urea) and urine (urine specific gravity, urinary protein:creatinine ratio) variables to predict GFR or identify cats with low or borderline GFR was examined. Cut-off clearance marker concentrations to predict low or borderline GFR was determined at three time points after marker injection. All procedures were analysed for three clearance markers (exo-iohexol, creatinine, endo-iohexol). RESULTS For reliable estimation of GFR, at least three blood samples for clinical purposes and five blood samples for research purposes are required. Regression formulae based on routine variables did not reliably predict GFR, but accurately identified cats with low (sensitivity 96.5-98.2%; specificity 60-91.3%) or borderline (sensitivity 91.1-96%; specificity 76.5-81.8%) GFR. Clearance marker concentrations exceeding given marker cut-off concentrations also identified cats with low or borderline GFR with high sensitivities and specificities. CONCLUSIONS AND RELEVANCE These simplified methods will facilitate the detection of early kidney dysfunction in cats. Early diagnosis allows timely therapeutic intervention, and future studies must reveal whether this improves the long-term outcome of cats with CKD.
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Affiliation(s)
- Dominique Paepe
- Department of Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Hervé P Lefebvre
- University of Toulouse, INP, National Veterinary School of Toulouse, Clinical Research Unit, Toulouse, France
| | - Didier Concordet
- INRA, UMR 1331, Toxalim, National Veterinary School of Toulouse, 23 Chemin des Capelles, Toulouse, France
| | - Ingrid van Hoek
- Department of Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium Current address: Royal Canin SAS, BP 4 - 650, Avenue de la Petite Camargue, 30470, Aimargues, France
| | - Siska Croubels
- Department of Pharmacology, Toxicology and Biochemistry, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Sylvie Daminet
- Department of Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Bugbee AC, Coleman AE, Wang A, Woolcock AD, Brown SA. Telmisartan treatment of refractory proteinuria in a dog. J Vet Intern Med 2014; 28:1871-4. [PMID: 25270397 PMCID: PMC4895629 DOI: 10.1111/jvim.12471] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 05/27/2014] [Accepted: 08/27/2014] [Indexed: 01/13/2023] Open
Affiliation(s)
- A C Bugbee
- Department of Small Animal Medicine & Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA
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Gouni V, Tissier R, Misbach C, Balouka D, Bueno H, Pouchelon JL, Lefebvre HP, Chetboul V. Influence of the observer’s level of experience on systolic and diastolic arterial blood pressure measurements using Doppler ultrasonography in healthy conscious cats. J Feline Med Surg 2014; 17:94-100. [DOI: 10.1177/1098612x14532087] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to determine the influence of the observer’s level of experience on within- and between-day variability, and the percentage of successful systolic (SAP) and diastolic arterial blood pressure (DAP) measurements obtained by Doppler ultrasonography (DU) in awake cats. For this purpose, six healthy conscious cats were used and four observers with different levels of training performed 144 SAP and DAP measurements on 4 days using DU. Measurements were recorded five consecutive times, and mean values were used for statistical analysis. Only the two most skilled observers – a PhD student in cardiology and a Dipl ECVIM-CA (cardiology) – had within- and between-day coefficients of variation (CVs) for SAP ⩽16% (13–16%). Conversely, the two less experienced observers – a fifth-year student and an assistant – had high between-day CVs (61% and 73%). For DAP, only the most experienced observer (Dipl ECVIM-CA) succeeded in 100% of the attempts, with within- and between-day CVs of 11% and 4%, respectively. Conversely, DAP could not be measured by the other three observers in 8%, 19% and 56% of attempts (from the highest to the lowest level of experience); therefore, the corresponding CV values could not be calculated. In conclusion, SAP may be assessed using DU in healthy awake cats with good repeatability and reproducibility by a well-trained observer. Measurement of DAP is more difficult than of SAP, and needs a longer training period, which represents one of the limitations of DU in cats.
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Affiliation(s)
- Vassiliki Gouni
- Alfort Cardiology Unit (UCA), Central University Veterinary Hospital of Alfort (CHUVA), National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort, France
- INSERM U955, Equipe 3, Créteil, France
| | - Renaud Tissier
- INSERM U955, Equipe 3, Créteil, France
- Unit of Pharmatoxicology, National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort, France
| | - Charlotte Misbach
- Alfort Cardiology Unit (UCA), Central University Veterinary Hospital of Alfort (CHUVA), National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort, France
| | - David Balouka
- Alfort Cardiology Unit (UCA), Central University Veterinary Hospital of Alfort (CHUVA), National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort, France
| | - Hanna Bueno
- Alfort Cardiology Unit (UCA), Central University Veterinary Hospital of Alfort (CHUVA), National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort, France
| | - Jean-Louis Pouchelon
- Alfort Cardiology Unit (UCA), Central University Veterinary Hospital of Alfort (CHUVA), National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort, France
- INSERM U955, Equipe 3, Créteil, France
| | - Hervé P Lefebvre
- Clinical Research Unit, National Veterinary School of Toulouse, University of Toulouse, INP, Toulouse, France
| | - Valérie Chetboul
- Alfort Cardiology Unit (UCA), Central University Veterinary Hospital of Alfort (CHUVA), National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort, France
- INSERM U955, Equipe 3, Créteil, France
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Scansen BA, Vitt J, Chew DJ, Schober KE, Bonagura JD. Comparison of forelimb and hindlimb systolic blood pressures and proteinuria in healthy Shetland Sheepdogs. J Vet Intern Med 2014; 28:277-83. [PMID: 24433302 PMCID: PMC4858003 DOI: 10.1111/jvim.12289] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 08/01/2013] [Accepted: 11/25/2013] [Indexed: 11/29/2022] Open
Abstract
Background The prevalence of systemic hypertension (SHT) in Shetland Sheepdogs has not been reported. Hypothesis/Objectives SHT is common in Shetland Sheepdogs and positively correlated with proteinuria. Measurements of forelimb and hindlimb systolic arterial pressure (SAP) are comparable. Animals Seventy‐two clinically healthy, client‐owned Shetland Sheepdogs. Methods Forelimb and hindlimb SAP were recorded by Doppler ultrasonography. Proteinuria was quantified by urine dipstick, microalbuminuria, and protein:creatinine ratio (UPC). The relationship of UPC, anxiety, age, weight, and heart rate with forelimb SAP was evaluated. Results The mean forelimb and hindlimb SAP were 132 ± 20 and 118 ± 20 mmHg, respectively. The SAP exceeded 160 mmHg in 9 dogs, suggesting 13% prevalence of SHT. Four dogs had a UPC above 0.5; 2 of these had forelimb SAP exceeding 160 mmHg. Correlation of forelimb and hindlimb SAP was poor (r2 = 0.09; P = .011). Bland–Altman plots revealed substantial bias (−14 mmHg) between limb measurements with clinically unacceptable 95% limits of agreement (−60 to 33 mmHg). There was no correlation between forelimb SAP and UPC (P = .06) or anxiety level (P = .49). Age (P < .0001) and heart rate (P = .038) were significant predictors of forelimb SAP; weight (P = .73) was not. Conclusions Prevalence of SHT was 13% and not correlated with proteinuria. Forelimb and hindlimb SAP were poorly correlated; therefore, trends in an individual animal should be monitored using the same measurement site. Additionally, values for Doppler SAP were determined in Shetland Sheepdogs.
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Affiliation(s)
- B A Scansen
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH
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48
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de Brito Galvao JF, Nagode LA, Schenck PA, Chew DJ. Calcitriol, calcidiol, parathyroid hormone, and fibroblast growth factor-23 interactions in chronic kidney disease. J Vet Emerg Crit Care (San Antonio) 2013; 23:134-62. [PMID: 23566108 PMCID: PMC3677418 DOI: 10.1111/vec.12036] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Accepted: 02/05/2013] [Indexed: 12/13/2022]
Abstract
Objective To review the inter-relationships between calcium, phosphorus, parathyroid hormone (PTH), parent and activated vitamin D metabolites (vitamin D, 25(OH)-vitamin D, 1,25(OH)2-vitamin D, 24,25(OH)2-vitamin D), and fibroblast growth factor-23 (FGF-23) during chronic kidney disease (CKD) in dogs and cats. Data Sources Human and veterinary literature. Human Data Synthesis Beneficial effects of calcitriol treatment during CKD have traditionally been attributed to regulation of PTH but new perspectives emphasize direct renoprotective actions independent of PTH and calcium. It is now apparent that calcitriol exerts an important effect on renal tubular reclamation of filtered 25(OH)-vitamin D, which may be important in maintaining adequate circulating 25(OH)-vitamin D. This in turn may be vital for important pleiotropic actions in peripheral tissues through autocrine/paracrine mechanisms that impact the health of those local tissues. Veterinary Data Synthesis Limited information is available reporting the benefit of calcitriol treatment in dogs and cats with CKD. Conclusions A survival benefit has been shown for dogs with CKD treated with calcitriol compared to placebo. The concentrations of circulating 25(OH)-vitamin D have recently been shown to be low in people and dogs with CKD and are related to survival in people with CKD. Combination therapy for people with CKD using both parental and activated vitamin D compounds is common in human nephrology and there is a developing emphasis using combination treatment with activated vitamin D and renin-angiotensin-aldosterone-system (RAAS) inhibitors.
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49
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Di Bella A, Maurella C, Cauvin A, Schmidt JM, Tapia BB, North SM. Proteinuria in canine patients with lymphoma. J Small Anim Pract 2013; 54:28-32. [PMID: 23278758 DOI: 10.1111/jsap.12004.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To determine if proteinuria is more common in dogs with lymphoma when compared with healthy dogs and to assess the severity and frequency of proteinuria in dogs with lymphoma. METHODS Determination of urine protein:creatinine ratio in 32 dogs with lymphoma compared with 30 healthy dogs. RESULTS Canine patients with lymphoma are more likely to be proteinuric compared with healthy dogs. Proteinuria is common in dogs with lymphoma, although in most cases it is not severe. The presence of proteinuria is not linked with the stage or substage of lymphoma. CLINICAL SIGNIFICANCE Mild proteinuria is a common finding in dogs with lymphoma. The clinical impact of the proteinuria is probably low.
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Affiliation(s)
- A Di Bella
- VRCC Veterinary Referrals, 1 Bramston Way, Southfield, Laindon, Essex
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50
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Collignon CM, Heiene R, Queau Y, Reynolds BS, Craig AJ, Concordet D, Harran NX, Risøen U, Balouka D, Faucher MR, Eliassen KA, Biourge V, Lefebvre HP. Comparison of pharmacokinetic variables for creatinine and iohexol in dogs with various degrees of renal function. Am J Vet Res 2012; 73:1841-7. [PMID: 23106473 DOI: 10.2460/ajvr.73.11.1841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare pharmacokinetics and clearances of creatinine and iohexol as estimates of glomerular filtration rate (GFR) in dogs with various degrees of renal function. ANIMALS 50 Great Anglo-Francais Tricolor Hounds with various degrees of renal function. PROCEDURES Boluses of iohexol (40 mg/kg) and creatinine (647 mg/kg) were injected IV. Blood samples were collected before administration and 5 and 10 minutes and 1, 2, 4, 6, and 8 hours after administration. Plasma creatinine and iohexol concentrations were assayed via an enzymatic method and high-performance liquid chromatography, respectively. A noncompartmental approach was used for pharmacokinetic analysis. Pharmacokinetic variables were compared via a Bland-Altman plot and an ANOVA. RESULTS Compared with results for creatinine, iohexol had a significantly higher mean ± SD plasma clearance (3.4 ± 0.8 mL/min/kg vs 3.0 ± 0.7 mL/min/kg) and a significantly lower mean volume of distribution at steady state (250 ± 37 mL/kg vs 539 ± 73 mL/kg), mean residence time (80 ± 31 minutes vs 195 ± 73 minutes), and mean elimination half-life (74 ± 20 minutes vs 173 ± 53 minutes). Despite discrepancies between clearances, especially for high values, the difference was < 0.6 mL/min/kg for 34 (68%) dogs. Three dogs with a low GFR (< 2 mL/min/kg) were classified similarly by both methods. CONCLUSIONS AND CLINICAL RELEVANCE Plasma iohexol and creatinine clearances can be used interchangeably for screening patients suspected of having chronic kidney disease (ie, low GFR), but large differences may exist for dogs with a GFR within or above the reference range.
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Affiliation(s)
- Cécile M Collignon
- Unité de recherche clinique, Institut national polytechnique de Toulouse, Université de Toulouse, F-31076 Toulouse, France
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