Applying children's enuresis treatment with amitriptyline for canine post-spaying urinary incontinence: A pilot estriol-controlled randomized clinical trial

Urinary incontinence due to urethral sphincter mechanism incompetence (USMI) affects up to 20% of bitches that undergo spaying surgery. Amitriptyline is a tricyclic antidepressant whose urinary retention is a reported side effect. This study aimed to assess the efficacy and safety of amitriptyline when compared to estriol orally. Fifteen bitches with a clinical diagnosis of post-spaying UI were evaluated during 60 days in a non-blinded randomized clinical trial. All patients were enrolled after clinical evaluation consisting of anamnesis, physical examination, and complementary exams (complete blood count, biochemical parameters, urinalysis, and abdominal ultrasound). The amitriptyline (AMT) group consisted of 8 bitches, which received the initial dose of 1 mg/kg every 12 h, whereas the estriol (EST) group consisted of 7 bitches which were initially treated with 1 mg/animal every 24 h. Patients underwent clinical evaluation at 7 days, and then at 21 and 60 days of treatment to assess safety and efficacy, as well as adjustments of dose when necessary. A urinary incontinence scale was used to assess the level of incontinence and therapeutic response to treatment. During the period of the study, estriol was fully effective in 71% of cases and amitriptyline in 62%. Both drugs proved safe in the medical treatment of USMI, with adverse effects such as somnolence (AMT, n = 5/8) and male attraction (EST, n = 1/7). The results support the amitriptyline recommendation as a substitute for estriol in USMI treatment.

Comparison of serum creatinine, point-of-care symmetric dimethylarginine and renal imaging with glomerular filtration rate measured by renal scintigraphy in healthy and early chronic kidney diseased cats

The aim of this study was to evaluate routinely used tests to diagnose cats in early stages of chronic kidney disease (CKD) and to describe a model for evaluating these variables simultaneously. Apparently healthy cats were screened using serum creatinine (sCr), point-of-care symmetric dimethylarginine (POC SDMA), urinalysis, urine protein/creatinine ratio (UPC) and imaging evaluation. Those parameters were compared to glomerular filtration rate (GFR) assessed by renal scintigraphy. Forty-four cats were included and consisted of 14 (31.8%) healthy cats (absence of abnormalities in renal morphology and sCr less than 1.6 mg/dL), 20 (45.5%) cats classified as CKD I (presence of abnormalities in renal morphology and sCr less than 1.6 mg/dL) and ten (22.7%) as CKD II (sCr equal to or greater than 1.6 mg/dL, with or without abnormalities in renal morphology). A large number (40.9%) of apparently healthy cats presented reduction in GFR, which included half of CKD I patients. Point-of-care SDMA was not a good predictor for decreased GFR, nor was it correlated with the variables GFR and sCr. Glomerular filtration rate was significantly lower in CKD I and II groups in comparison with healthy cats, but there was no significant difference between the CKD I and II groups. Multivariate logistic regression model identified three variables that affected the odds of a cat having decreased GFR (< 2.5 mL/min/kg): sCr (OR = 18.3; p = 0.019; CI = 1.6-207.2), and the ultrasonographic findings 'reduced corticomedullary definition' (OR = 19.9; p = 0.022; CI = 1.6-254.0) and 'irregular contour' (OR = 65.6; p = 0.003; CI = 4.2-1038.2). Renal ultrasonography evaluation should always be considered for screening early CKD in apparently healthy cats.

Sedation Effect of Acepromazine and Butorphanol in Dopplervelocimetric Parameters in Great Abdominal Arteries and Femoral Artery in Dogs

Background: Doppler ultrasound is a non-invasive diagnostic imaging technique that allows vascular anatomical and dynamics evaluation. Each artery has flow velocity profiles and different Doppler spectrum. The purpose of this study was to determine if sedation with acepromazine and butorphanol in dogs alters Doppler velocimetric values and diameter from abdominal aorta, celiac, mesenteric cranial, renal, external iliac and femoral arteries of healthy dogs.Materials, Methods & Results: Twenty healthy female dogs, aged 1 to 5 years, with body weight ranging from 10 to 25 kg, were evaluated with Doppler ultrasound in order to obtain: peak systolic velocity, end diastolic velocity, time average medium velocity, time average maximum velocity, resistive index, pulsatility index, and diameter from abdominal aorta, celiac, mesenteric cranial, renal, external iliac and femoral arteries. The same animals were sedated with acepromazine (0.02 mg/kg) and buthorphanol (0.4 mg/kg) and the same parameters were reevaluated. The heart rate was also measured. The study was approved by the Animal Ethics Committee of UFRGS, under the 25552 protocol, and the owners signed an informed consent form. Statistical analysis was performed with pared t test.The heart rate was statistically significant different, 98 ± 20.13 bpm before and 79 ± 17.74 after sedation. The exam was done before and after sedation in all selected vessels, except the celiac and cranial mesenteric artery, which were possible only in 35% and 45% respectively. All measured arteries exhibit difference in at least two of the analyzed parameters, except femoral artery, that only diameter was different.Discussion: Each vessel was selected because of its importance, and each of them has its own characteristic waveform. Changes in patterns of flow velocity of the celiac artery and mesenteric can help to determine the physiological condition of the gastrointestinal tract; in the case of renal arteries are associated with diseases involving parenchyma and; thrombosis in the aorta and the iliac and femoral arteries may be difficult to evaluate without the Doppler image. Examination of the AC and AMC before and after sedation not could be performed in all animals, maybe because the present work was carried out with only fasting requirement, without using dimethicone, and one of the difficulties encountered was the presence of gas in the gastrointestinal tract. Another factor that may have contributed to these findings is that the acute stress of containment and other environmental factors can cause release of vasopressin and leads to vasoconstriction of the splanchnic vascular bed. The dopplervelocimetric data found in celiac, mesenteric cranial, renal and femoral arteries in non-sedated animals was similar to what was described by other authors. Although all dogs demonstrated relaxation during the exam, this sedation protocol alters the values found with Doppler ultrasound in the selected vessels, except femoral artery, which caused only increase of diameter. The Doppler differences found can be a consequence of a decrease in heart rate associated with longer cycle length, and therefore, larger diastolic volume with vessels that stayed with same diameter, or in case of caudal abdominal aorta, that reduced the diameter. This study compared the dopplervelocimetric values to the ones described by other authors in non-sedated animals and demonstrated that although acepromazine and buthorphanol are a good option to sedate dogs to perform ultrasound exam, they alter the Doppler values from aorta abdominal, celiac, cranial mesenteric, renal, external iliac arteries and the femoral artery diameter.