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Fortuna L, Syme HM. Factors associated with thrombotic disease in dogs with renal proteinuria: A retrospective of 150 cases. J Vet Intern Med 2024; 38:228-237. [PMID: 38147488 PMCID: PMC10800230 DOI: 10.1111/jvim.16973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 12/01/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Knowledge of additional risk factors for thrombotic disease (TD) among dogs with renal proteinuria is limited; these might differ for TD affecting the systemic arterial (AT), systemic venous (VT), and pulmonary circulation (PT). HYPOTHESIS/OBJECTIVES To compare signalment and clinicopathological data between dogs with renal proteinuria with or without TD, and between dogs with AT, VT, and PT. ANIMALS One hundred fifty client-owned dogs with renal proteinuria, 50 of which had TD. METHODS Retrospective case-controlled study. A database search (2004-2021) identified proteinuric dogs (UPC > 2) with and without TD. Clinicopathological data were obtained from the records. TD and non-TD (NTD) groups were compared by binary logistic regression, and AT, VT, and PT groups by multinomial regression. Normal data presented as mean ± SD, non-normal data presented as median [25th, 75th percentiles]. RESULTS Cavalier King Charles Spaniels were overrepresented in the TD group (OR = 98.8, 95% CI 2.09-4671, P = .02). Compared to NTD cases, TD cases had higher concentration of neutrophils (11.06 [8.92, 16.58] × 109 /L vs 7.31 [5.63, 11.06] × 109 /L, P = .02), and lower concentration of eosinophils (0 [0, 0.21] × 109 /L vs 0.17 [0.04, 0.41] × 109 /L, P = .002) in blood, and lower serum albumin (2.45 ± 0.73 g/dL vs 2.83 ± 0.73 g/dL, P = .04). AT cases had higher serum albumin concentrations than VT cases (2.73 ± 0.48 g/dL vs 2.17 ± 0.49 g/dL, P = .03) and were older than PT cases (10.6 ± 2.6 years vs 7.0 ± 4.3 years, P = .008). VT cases were older (9.1 ± 4.2 years vs 7.0 ± 4.3 years, P = .008) and had higher serum cholesterol concentration (398 [309-692 mg/dL] vs 255 [155-402 mg/dL], P = .03) than PT cases. CONCLUSIONS AND CLINICAL IMPORTANCE Differences between thrombus locations could reflect differences in pathogenesis.
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Affiliation(s)
- Luca Fortuna
- Department of Clinical Science and ServicesThe Royal Veterinary CollegeHatfieldUnited Kingdom
| | - Harriet M. Syme
- Department of Clinical Science and ServicesThe Royal Veterinary CollegeHatfieldUnited Kingdom
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Geddes RF, Davison LJ, Elliott J, Syme HM, O'Neill DG. Risk factors for upper urinary tract uroliths and ureteral obstruction in cats under referral veterinary care in the United Kingdom. J Vet Intern Med 2023; 37:567-577. [PMID: 36860138 PMCID: PMC10061198 DOI: 10.1111/jvim.16659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/03/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Cats presenting with upper urinary tract uroliths (UUTUs) and ureteral obstruction ("obstructive UUTU") are typically younger than cats with idiopathic CKD that often have incidental nephroliths. HYPOTHESIS Cats with upper urinary tract urolith have 2 clinical phenotypes; a more aggressive phenotype at risk of obstructive UUTU at a young age and a more benign phenotype in older cats, with reduced risk of obstructive UUTU. OBJECTIVES Identify risk factors for UUTU and for obstructive UUTU. ANIMALS Eleven thousand four hundred thirty-one cats were referred for care over 10 years; 521 (4.6%) with UUTU. METHODS Retrospective VetCompass observational cross-sectional study. Multivariable logistic regression models were performed to identify risk factors for a diagnosis of UUTU vs no UUTU and additionally, obstructive UUTU vs nonobstructive UUTU. RESULTS Risk factors for UUTU included female sex (odds ratio [OR] 1.6, confidence interval [CI] 1.3-1.9; P < .001), British shorthair, Burmese, Persian, Ragdoll or Tonkinese (vs non-purebred ORs 1.92-3.31; P < .001) breed and being ≥4 years (ORs 2.1-3.9; P < .001). Risk factors for obstructive UUTU were female sex (OR 1.8, CI 1.2-2.6; P = .002), having bilateral uroliths (OR 2.0, CI 1.4-2.9; P = .002) and age, with the odds of obstructive UUTU increasing as age at diagnosis of UUTU decreased (≥12 years, reference category; 8-11.9 years, OR 2.7, CI 1.6-4.5; 4-7.9 years, OR 4.1, CI 2.5-7.0; 0-3.9 years, OR 4.3, CI 2.2-8.6; P < 0.001). CONCLUSIONS AND CLINICAL IMPORTANCE Cats diagnosed with UUTU at a younger age have a more aggressive phenotype with higher risk of obstructive UUTU compared to cats over 12 years of age diagnosed with UUTU.
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Affiliation(s)
- Rebecca F Geddes
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, United Kingdom
| | - Lucy J Davison
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, United Kingdom
| | - Jonathan Elliott
- Comparative Biological Sciences, Royal Veterinary College, Royal College Street, Camden, London NW1 0TU, United Kingdom
| | - Harriet M Syme
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, United Kingdom
| | - Dan G O'Neill
- Pathobiology and Population Science, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, United Kingdom
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Broughton SE, O'Neill DG, Syme HM, Geddes RF. Ionized hypercalcemia in 238 cats from a referral hospital population (2009-2019). J Vet Intern Med 2023; 37:80-91. [PMID: 36645022 PMCID: PMC9889682 DOI: 10.1111/jvim.16627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/15/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Ionized calcium concentration ([iCa]) is more sensitive for detecting calcium disturbances than serum total calcium concentration but literature on ionized hypercalcemia in cats is limited. Urolithiasis is a possible adverse consequence of hypercalcemia. HYPOTHESIS/OBJECTIVES To describe clinical details of diagnoses associated with ionized hypercalcemia in cats and association with urolithiasis. ANIMALS Cats (238) seen between 2009 and 2019 at a referral hospital with [iCa] above the normal reference interval. METHODS Observational cross-sectional study. Signalment, serum biochemical and imaging findings were reviewed for cats with ionized hypercalcemia considered to be clinically relevant (>1.41 mmol/L). Data were summarized by cause of hypercalcemia (i.e., diagnosis). RESULTS Diagnoses for the 238 cats with [iCa] >1.41 mmol/L included: acute kidney injury (AKI; 13%), malignancy-associated (10.1%), idiopathic hypercalcemia (IHC; 10.1%), chronic kidney disease/renal diet-associated (8.4%), iatrogenic (5.5%), primary hyperparathyroidism (2.1%), vitamin D toxicity (2.1%) and granulomatous disease (1.7%). In 112 cases (47.1%), no cause for ionized hypercalcemia could be determined (n = 95), hypercalcemia was transient (n = 12), or the cat was juvenile (<1 year; n = 5). Urolithiasis was identified in 83.3% of AKI, 72.7% of iatrogenic, 61.1% of CKD/renal diet-associated and 50% of IHC cases that were imaged (<50% for other diagnoses). Diagnoses with a high proportion of concurrent total hypercalcemia included primary hyperparathyroidism (100%), vitamin D toxicity (100%), malignancy-associated (71.4%), granulomatous disease (66.7%) and IHC (65.2%). CONCLUSIONS AND CLINICAL IMPORTANCE Ionized hypercalcemia was most commonly associated with kidney diseases, neoplasia or IHC. The proportion of urolithiasis cases varied by diagnosis.
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Affiliation(s)
- Sophie E. Broughton
- Department of Clinical Science and Services, Royal Veterinary CollegeUniversity of LondonLondonUK
| | - Dan G. O'Neill
- Pathobiology and Population Sciences, The Royal Veterinary CollegeHertsUK
| | - Harriet M. Syme
- Department of Clinical Science and Services, Royal Veterinary CollegeUniversity of LondonLondonUK
| | - Rebecca F. Geddes
- Department of Clinical Science and Services, Royal Veterinary CollegeUniversity of LondonLondonUK
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Lawson JS, Syme HM, Antrobus PR, Karttunen JM, Stewart SE, Karet Frankl FE, Williams TL. Urinary extracellular vesicles as a source of protein-based biomarkers in feline chronic kidney disease and hypertension. J Small Anim Pract 2023; 64:3-11. [PMID: 35799320 PMCID: PMC10084206 DOI: 10.1111/jsap.13536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/04/2022] [Accepted: 06/14/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To validate a methodology for isolating feline urinary extracellular vesicles and characterise the urinary extracellular vesicle population and proteome in cats with normal renal function and cats with normotensive or hypertensive chronic kidney disease. METHODS Feline urinary extracellular vesicles were isolated using three different methods (precipitation alone, precipitation followed by size exclusion chromatography and ultrafiltration followed by size exclusion chromatography, which were compared via transmission electron microscopy and nanoparticle tracking analysis. Cats with normal renal function (n=9), normotensive chronic kidney disease (n=10) and hypertensive chronic kidney disease (n=9) were identified and urinary extracellular vesicles isolated from patient urine samples via ultrafiltration followed by size exclusion chromatography. Extracellular vesicle size and concentration were determined using nanoparticle tracking analysis, and subsequently underwent proteomic analysis using liquid chromatography with tandem mass spectrometry to identify differences in protein expression between categories. RESULTS Urinary extracellular vesicle preparations contained particles of the expected size and morphology, and those obtained by ultrafiltration + size exclusion chromatography had a significantly higher purity (highest particle: protein ratio). The urinary extracellular vesicle proteomes contained extracellular vesicle markers and proteins originating from all nephron segments. Urinary extracellular vesicle concentration and size were unaffected by renal disease or hypertension. There were no differentially expressed proteins detected when comparing urinary extracellular vesicles derived from cats in the healthy category with the combined chronic kidney disease category, but five differentially expressed proteins were identified between the normotensive chronic kidney disease and hypertensive chronic kidney disease categories. CLINICAL SIGNIFICANCE Feline urinary extracellular vesicles can be successfully isolated from stored urine samples. Differentially expressed urinary extracellular vesicle proteins were discovered in cats with hypertensive chronic kidney disease, and warrant further investigation into their utility as biomarkers or therapeutic targets.
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Affiliation(s)
- J S Lawson
- Clinical Sciences and Services, The Royal Veterinary College, Hatfield, AL9 7TA, UK
| | - H M Syme
- Cambridge Institute for Medical Research, University of Cambridge, Keith Peters Building, Cambridge, CB2 0XY, UK
| | - P R Antrobus
- Cambridge Institute for Medical Research, University of Cambridge, Keith Peters Building, Cambridge, CB2 0XY, UK
| | - J M Karttunen
- Department of Veterinary Medicine, The Queen's Veterinary School Hospital, University of Cambridge, Cambridge, CB3 0ES, UK
| | - S E Stewart
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Victoria, 3086, Australia
| | - F E Karet Frankl
- Cambridge Institute for Medical Research, University of Cambridge, Keith Peters Building, Cambridge, CB2 0XY, UK.,Department of Medical Genetics and Division of Renal Medicine, University of Cambridge and Cambridge University Hospitals Foundation Trust, Cambridge, UK
| | - T L Williams
- Department of Veterinary Medicine, The Queen's Veterinary School Hospital, University of Cambridge, Cambridge, CB3 0ES, UK
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Mullowney D, Chang YM, Glanemann B, Syme HM. Treatment failure in hyperthyroid cats after radioiodine (I-131) injection. J Vet Intern Med 2021; 35:1688-1696. [PMID: 33999452 PMCID: PMC8295673 DOI: 10.1111/jvim.16161] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 12/17/2022] Open
Abstract
Background There is limited published information on the outcome for cats where total thyroxine concentration (TT4) remains elevated after treatment with radioactive iodine (RAI). Objective To determine the frequency of, and predictors for, subsequent treatment failure in cats for which TT4 remains elevated at hospital discharge, and to report clinical outcomes for cats requiring repeat treatment. Animals One hundred twenty‐one cats with TT4 ≥40 nmol/L after treatment with RAI (out of an original, treated study sample of 959 cats). Methods Retrospective study. Data regarding signalment, weight, TT4 concentration (before RAI treatment, at discharge, and percentage change), day of sampling, and I‐131 dose were acquired. Logistic regression was performed to evaluate predictors of treatment failure. Results In the 87 cats for which classification was possible, 35 (40%) became euthyroid without further treatment. All TT4 variables and weight normalized RAI dose were independently predictive of subsequent treatment failure. In multivariate analysis, TT4 concentration at discharge (P < .001) and weight normalized RAI dose (P = .04) remained in the final model. All 28 cats with TT4 concentration ≥150 nmol/L at discharge ultimately failed treatment, compared with 13/40 (32.5%) and 11/19 (57.9%) cats with TT4 concentrations of 40‐100 nmol/L and 100‐150 nmol/L, respectively. Of the 52 cats that failed treatment, 14 were subsequently managed medically, 12 underwent thyroidectomy (4 with carcinoma), 14 had repeat RAI treatment which was successful in 12/14 (86%) cats, and 13 had no further treatment. Conclusions and Clinical Importance Cats with TT4 >150 nmol/L at discharge after RAI might be candidates for immediate repeat treatment.
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Affiliation(s)
- Deirdre Mullowney
- Department of Veterinary Clinical Sciences, Royal Veterinary College, University of London, Hertfordshire AL9 7TA, United Kingdom
| | - Yu-Mei Chang
- Research Support Office, The Royal Veterinary College, London, United Kingdom
| | - Barbara Glanemann
- Department of Veterinary Clinical Sciences, Royal Veterinary College, University of London, Hertfordshire AL9 7TA, United Kingdom
| | - Harriet M Syme
- Department of Veterinary Clinical Sciences, Royal Veterinary College, University of London, Hertfordshire AL9 7TA, United Kingdom
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Aguiar J, Crossley VJ, Davison LJ, Fowkes RC, Syme HM. Long-term effect of neutering on plasma luteinising hormone concentration in cats. J Feline Med Surg 2020; 23:867-874. [PMID: 33269622 DOI: 10.1177/1098612x20977788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The objectives of this study were to validate a commercially available luteinising hormone (LH) cat ELISA, to determine whether the increases in plasma LH concentration that occur after neutering are maintained throughout cats' lives and if other factors such as calendar seasons in both intact and neutered cats, and neutering age in neutered cats, influence plasma LH concentrations. METHODS Stored plasma samples from client-owned cats were used for the measurement of LH concentrations. Clinical data, including age, sex, age at neutering and medical history, were reviewed. Two populations were included in this study: (1) a senior and geriatric cat population (⩾9 years old), including 18 intact and 18 neutered cats matched for age, sex and month of sample collection; and (2) an adult cat population (2-8 years old), including 45 neutered cats. LH concentrations were measured using a commercially available feline ELISA. RESULTS Senior and geriatric neutered cats had higher plasma LH concentrations than age-matched intact cats (P <0.001). Calendar season did not influence plasma LH concentrations in the adult (P = 0.727) or senior/geriatric (P = 0.745) cats included in this study. No influence of age at neutering was observed on plasma LH concentrations (P = 0.296). CONCLUSIONS AND RELEVANCE Neutering causes a significant long-term increase in LH concentrations in cats and further studies are required to determine the consequences on feline health.
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Affiliation(s)
- Joana Aguiar
- Clinical Sciences and Services, Royal Veterinary College, University of London, London, UK
| | - Victoria J Crossley
- Clinical Sciences and Services, Royal Veterinary College, University of London, London, UK
| | - Lucy J Davison
- Clinical Sciences and Services, Royal Veterinary College, University of London, London, UK
| | - Robert C Fowkes
- Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
| | - Harriet M Syme
- Clinical Sciences and Services, Royal Veterinary College, University of London, London, UK
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Lawson JS, Syme HM, Wheeler-Jones CPD, Elliott J. Investigation of the transforming growth factor-beta 1 signalling pathway as a possible link between hyperphosphataemia and renal fibrosis in feline chronic kidney disease. Vet J 2020; 267:105582. [PMID: 33375963 PMCID: PMC7814380 DOI: 10.1016/j.tvjl.2020.105582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/30/2020] [Accepted: 11/16/2020] [Indexed: 11/30/2022]
Abstract
Chronic kidney disease (CKD) is associated with development of hyperphosphataemia. Severity of renal fibrosis has been correlated with degree of hyperphosphataemia. Transforming growth factor-β1 (TGF-β1) is a major pro-fibrotic mediator in CKD. A phosphate restricted diet did not affect urinary active TGF-β1 excretion in cats. Increased extracellular phosphate had no pro-fibrotic effect on feline renal cells.
Chronic kidney disease (CKD) is common in geriatric cats, and is characterised in the majority of cases by tubulointerstitial inflammation and fibrosis. Hyperphosphataemia is a frequent complication of CKD and is independently associated with severity of renal fibrosis and disease progression. Transforming growth factor-beta 1 (TGF-β1) signalling is thought to be a convergent pathway which mediates the progression of renal fibrosis in CKD. The aims of this study were to explore the interaction between increased extracellular phosphate and the TGF-β1 signalling pathway by investigating: (a) the effect of a commercially available, phosphate-restricted, diet on urinary TGF-β1 excretion in cats with CKD; and (b) the role of increased extracellular phosphate in regulating proliferation, apoptosis, and expression of genes related to TGF-β1 signalling and extracellular matrix (ECM) production in feline proximal tubular epithelial cells (FPTEC) and cortical fibroblasts from cats with azotaemic CKD (CKD-FCF). The dietary intervention study revealed no effect of dietary phosphate restriction on urinary active TGF-β1 excretion after 4–8 weeks (P = 0.98), despite significantly decreasing serum phosphate (P < 0.001). There was no effect of increased growth media phosphate concentration (from 0.95 mM to 2 mM and 3.5 mM) on proliferation (P = 0.99) and apoptotic activity in FPTEC (P = 0.22), or expression of genes related to ECM production and the TGF-β1 signalling pathway in FPTEC and CKD-FCF (P > 0.05). These findings suggest the beneficial effects of dietary phosphate restriction on progression of feline CKD may not occur through modulation of renal TGF-β1 production, and do not support a direct pro-fibrotic effect of increased extracellular phosphate on feline renal cells.
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Affiliation(s)
- J S Lawson
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London, UK.
| | - H M Syme
- Clinical Sciences and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts, UK
| | - C P D Wheeler-Jones
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London, UK
| | - J Elliott
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London, UK
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Hindar C, Chang YM, Syme HM, Jepson RE. The association of bacteriuria with survival and disease progression in cats with azotemic chronic kidney disease. J Vet Intern Med 2020; 34:2516-2524. [PMID: 33016500 PMCID: PMC7694865 DOI: 10.1111/jvim.15918] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/13/2020] [Accepted: 09/18/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Cats with chronic kidney disease (CKD) have an increased prevalence of positive urine cultures (PUC). Limited information is available regarding the prognosis of cats with CKD and concurrent PUC. OBJECTIVE To determine the association of PUC with survival time and disease progression in cats with CKD. ANIMALS Medical records of 509 cats diagnosed with azotemic CKD between 1997 and 2018. METHODS Cats were classified as having "no-PUC" or "PUC." The PUC cats were further classified as having 1 or multiple PUC, and also were classified based on the presence or absence of clinical signs of urinary tract infection (UTI). Progression of CKD was defined as a plasma creatinine concentration increase of ≥25% within 365 days of CKD diagnosis; PUC also must have occurred within this time frame. Survival time and frequency of CKD progression were compared between groups. RESULTS No significant difference in survival time was found between cats with no-PUC and cats with any number of PUC (P = .91), or between cats with no-PUC, 1 PUC or multiple PUC (P = .37). Also, no significant difference was found in the frequency of CKD progression between PUC and no-PUC cats (P = .5), or among no-PUC, 1 PUC and multiple PUC cats (P = .22). When assessing cats with clinical signs of lower UTI, no significant difference was found in the frequency of CKD progression between cats with true UTI, subclinical bacteriuria or no-PUC (P = .8). CONCLUSIONS AND CLINICAL IMPORTANCE When treated with antibiotics, PUC in cats with CKD do not affect disease progression or survival time.
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Affiliation(s)
- Camilla Hindar
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom
| | - Yu-Mei Chang
- Research Support Office, Royal Veterinary College, University of London, London, United Kingdom
| | - Harriet M Syme
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom
| | - Rosanne E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom
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Lawson JS, Syme HM, Wheeler-Jones CPD, Elliott J. Characterisation of Crandell-Rees Feline Kidney (CRFK) cells as mesenchymal in phenotype. Res Vet Sci 2019; 127:99-102. [PMID: 31683198 PMCID: PMC6863388 DOI: 10.1016/j.rvsc.2019.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 10/21/2019] [Indexed: 11/19/2022]
Abstract
The Crandell-Rees Feline Kidney Cell (CRFK) is an immortalised cell line derived from the feline kidney that is utilised for the growth of certain vaccinal viruses. Confusion exists as to whether CRFK are epithelial or mesenchymal in phenotype. The aim of this study was to characterise CRFK cells via immunofluorescence, enzyme cytochemistry, western blotting, RT-qPCR for S100A4 and comparison to primary feline proximal tubular epithelial cells (FPTEC) and feline cortical fibroblasts (FCF). CRFK cells were of fusiform morphology and appeared similar to FCF. CRFK expressed the mesenchymal intermediate filament (IF) protein vimentin together with two cell adhesion molecules associated with feline fibroblasts (CD29 and CD44), and lacked expression of the epithelial IF cytokeratin, myogenic IF desmin and endothelial marker von Willebrand factor (vWF). In addition, CRFK did not demonstrate brush border enzyme activity typical of FPTEC. S100A4 gene expression, implicated in both neoplastic transformation and epithelial to mesenchymal transition, was highly upregulated in CRFK in comparison to the primary feline renal cells. CRFK appear phenotypically similar to fibroblasts, rather than tubular epithelial cells, and may have undergone neoplastic transformation or epithelial-to-mesenchymal transition after extensive passaging. This finding may have potential implications for future research utilising this cell line.
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Affiliation(s)
- J S Lawson
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London NW1 0TU, UK.
| | - H M Syme
- Clinical Sciences and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts, AL9 7TA, UK
| | - C P D Wheeler-Jones
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London NW1 0TU, UK
| | - J Elliott
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London NW1 0TU, UK
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Covey HL, Chang YM, Elliott J, Syme HM. Changes in thyroid and renal function after bilateral thyroidectomy in cats. J Vet Intern Med 2019; 33:508-515. [PMID: 30758070 PMCID: PMC6430951 DOI: 10.1111/jvim.15450] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 01/28/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Iatrogenic hypothyroidism might worsen the prognosis of cats with azotemic CKD after thyroidectomy. Varying thyroxine concentrations influence utility of creatinine in assessing renal function. Symmetric dimethylarginine (SDMA) has limited studies in cats with changing thyroid status. OBJECTIVES Thyroid status is stable 6 months post-thyroidectomy. Symmetric dimethylarginine and creatinine are linearly associated without influence from total thyroxine concentration (tT4). ANIMALS Electronic records of 2 first opinion practices were searched using the term "thyroidectomy" to include 81 client-owned cats that had undergone bilateral thyroidectomy. METHODS Retrospective cross-sectional study assessing thyroid hormone concentrations of 68 cats within 6 months of surgery. A longitudinal study of thyroid status in 23 cats with >18 months follow-up post-thyroidectomy. A generalized estimating equation assessed the associations of bodyweight, tT4 and creatinine concentrations on SDMA concentration. RESULTS Sixty-eight cats had follow-up within 6 months. Fifteen cats (22%) had persistent, or recurrent, hyperthyroidism and 33 cats (49%) were hypothyroid. Twenty-three of the euthyroid/hypothyroid cats had long-term follow-up (595-1955 days); 4 cats (17%) remained hypothyroid, 19 cats (83%) were euthyroid (often transiently), and 9 of 23 cats (44%) developed recurrent hyperthyroidism. Symmetric dimethylarginine and creatinine were linearly associated, but hyperthyroid cats had higher SDMA concentrations, relative to creatinine (P = .003). CONCLUSIONS AND CLINICAL IMPORTANCE Cats have changes in thyroid function for years after bilateral thyroidectomy, with a high incidence of recurrent hyperthyroidism. Both SDMA and creatinine are affected by thyroxine concentrations, and the effect is greater in hyperthyroid cats.
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Affiliation(s)
- Heather L Covey
- Department of Clinical Science and Services, Small Animal Medicine and Surgery Group, The Royal Veterinary College, Hertfordshire, United Kingdom
| | - Yu-Mei Chang
- Research Support Office, The Royal Veterinary College, London, United Kingdom
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, The Royal Veterinary College, London, United Kingdom
| | - Harriet M Syme
- Department of Clinical Science and Services, Small Animal Medicine and Surgery Group, The Royal Veterinary College, Hertfordshire, United Kingdom
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Finch NC, Syme HM, Elliott J. Development of an estimated glomerular filtration rate formula in cats. J Vet Intern Med 2018; 32:1970-1976. [PMID: 30378177 PMCID: PMC6271324 DOI: 10.1111/jvim.15325] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 04/18/2018] [Accepted: 08/15/2018] [Indexed: 12/04/2022] Open
Abstract
Background Estimated glomerular filtration rate (eGFR) formulas are routinely used in human patients to provide a more accurate evaluation of GFR compared to serum creatinine concentration alone. Similar formulas do not exist for cats. Objectives To validate a prediction formula for eGFR in cats based on adjusting serum creatinine concentration. Animals Client‐owned cats with various levels of renal function. Methods The study was cross‐sectional. Glomerular filtration rate was determined by iohexol clearance. Variables including signalment, biochemical markers, and noninvasive measurements considered to represent surrogate markers of muscle mass were evaluated with the reciprocal of serum creatinine concentration in a multivariable regression model. The derived eGFR formula was subsequently tested in another group of cats and agreement with GFR assessed. Results The formula was developed in 55 cats. Only a single morphometric measurement (pelvic circumference) along with the reciprocal of serum creatinine concentration (creatinine−1) independently predicted GFR in the final multivariate model. The derived eGFR formula was 0.408 + (243.11 × creatinine−1 [μmol/L]) ‐ (0.014 × pelvic circumference [cm]). When the formula was tested in another 25 cats it was not found to offer any advantage over creatinine−1 alone in its relationship with GFR (eGFR, R2 = 0.44, P < .001 vs reciprocal of creatinine, R2 = 0.45, P < .001). Furthermore, agreement between eGFR and GFR was poor. Conclusions and Clinical Importance An eGFR formula for cats that adjusted serum creatinine concentration for a marker of muscle mass was developed. The formula did not provide a reliable estimate of GFR, and therefore, its routine use cannot be recommended.
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Affiliation(s)
- Natalie C Finch
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Harriet M Syme
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Jonathan Elliott
- Veterinary Basic Sciences, Royal Veterinary College, London, United Kingdom
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12
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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13
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Lawson JS, Liu HH, Syme HM, Purcell R, Wheeler-Jones CPD, Elliott J. The cat as a naturally occurring model of renal interstitial fibrosis: Characterisation of primary feline proximal tubular epithelial cells and comparative pro-fibrotic effects of TGF-β1. PLoS One 2018; 13:e0202577. [PMID: 30138414 PMCID: PMC6107233 DOI: 10.1371/journal.pone.0202577] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 08/06/2018] [Indexed: 01/08/2023] Open
Abstract
Chronic kidney disease (CKD) is common in both geriatric cats and aging humans, and is pathologically characterised by chronic tubulointerstitial inflammation and fibrosis in both species. Cats with CKD may represent a spontaneously occurring, non-rodent animal model of human disease, however little is known of feline renal cell biology. In other species, TGF-β1 signalling in the proximal tubular epithelium is thought to play a key role in the initiation and progression of renal fibrosis. In this study, we first aimed to isolate and characterise feline proximal tubular epithelial cells (FPTEC), comparing them to human primary renal epithelial cells (HREC) and the human proximal tubular cell line HK-2. Secondly, we aimed to examine and compare the effect of human recombinant TGF-β1 on cell proliferation, pro-apoptotic signalling and genes associated with epithelial-to-mesenchymal transition (EMT) in feline and human renal epithelial cells. FPTEC were successfully isolated from cadaverous feline renal tissue, and demonstrated a marker protein expression profile identical to that of HREC and HK-2. Exposure to TGF-β1 (0-10 ng/ml) induced a concentration-dependent loss of epithelial morphology and alterations in gene expression consistent with the occurrence of partial EMT in all cell types. This was associated with transcription of downstream pro-fibrotic mediators, growth arrest in FPTEC and HREC (but not HK-2), and increased apoptotic signalling at high concentrations of TGF- β1. These effects were inhibited by the ALK5 (TGF-β1RI) antagonist SB431542 (5 μM), suggesting they are mediated via the ALK5/TGF-β1RII receptor complex. Taken together, these results suggest that TGF-β1 may be involved in epithelial cell dedifferentiation, growth arrest and apoptosis in feline CKD as in human disease, and that cats may be a useful, naturally occurring model of human CKD.
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Affiliation(s)
- Jack S. Lawson
- Comparative Biomedical Sciences, The Royal Veterinary College, London, United Kingdom
- * E-mail:
| | - Hui-Hsuan Liu
- Comparative Biomedical Sciences, The Royal Veterinary College, London, United Kingdom
| | - Harriet M. Syme
- Clinical Sciences and Services, The Royal Veterinary College, North Mymms, Hatfield, Herts, United Kingdom
| | - Robert Purcell
- Comparative Biomedical Sciences, The Royal Veterinary College, London, United Kingdom
| | | | - Jonathan Elliott
- Comparative Biomedical Sciences, The Royal Veterinary College, London, United Kingdom
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14
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Boag AM, Christie MR, McLaughlin KA, Syme HM, Graham P, Catchpole B. A longitudinal study of autoantibodies against cytochrome P450 side-chain cleavage enzyme in dogs (Canis lupus familiaris) affected with hypoadrenocorticism (Addison's disease). Vet Immunol Immunopathol 2018; 202:41-45. [PMID: 30078597 DOI: 10.1016/j.vetimm.2018.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 05/09/2018] [Accepted: 05/25/2018] [Indexed: 01/02/2023]
Abstract
Autoantibodies directed against the P450 side chain cleavage enzyme (P450scc) have been recently described in dogs affected with hypoadrenocorticism, consistent with an immune-mediated pathogenesis of this endocrinopathy. In human autoimmune Addison's disease, autoantibodies may have a predictive value, being detectable before clinical signs developing, and have been shown to persist for a period of time after diagnosis. Furthermore, an autoantibody positive status post-diagnosis has been associated with successful remission of Addison's disease following B-cell depletion, suggesting active immunopathology in these cases. The current study was designed to investigate changes in serum P450scc autoantibody status over time in dogs diagnosed with spontaneous hypoadrenocorticism. P450scc autoantibodies were measured using a species-specific radioimmunoprecipitation assay in an initial cohort of 213 dogs, indicating a prevalence of 24%. Thirty two of these dogs had repeat samples (n = 80 in total) available for analysis. Five dogs were consistently P450scc autoantibody positive in all samples, for up to 425 days following first sampling. Three dogs were initially autoantibody positive, then became seronegative at later time points. One dog, a 1 year old female entire standard poodle, was initially negative for P450scc autoantibodies, but seroconverted 18 months after diagnosis. The remaining 23 dogs with multiple samples available were consistently P450scc autoantibody negative. Persistence was not associated with sex (p = .673). This study demonstrates persistence of P450scc autoantibodies in a subset of dogs affected with hypoadrenocorticism and seroconversion over one year post-diagnosis. P450scc autoantibody reactivity in human autoimmune Addison's disease has been associated with sex, with females having a higher prevalence, possibly due to P450scc expression in the ovary acting as an additional source of antigenic stimulation. However, there was no sex difference in autoantibody persistence in the dogs affected with hypoadrenocorticism. Autontibody persistence in dogs with hypoadrenocorticism might represent persistent pathology, due to residual antigenic stimulation and autoimmune inflammation in the adrenal gland.
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Affiliation(s)
- Alisdair M Boag
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, United Kingdom; The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, United Kingdom
| | | | - Kerry A McLaughlin
- Oxford Centre for Diabetes, Endocrinology & Metabolism, University of Oxford, Oxford, United Kingdom
| | - Harriet M Syme
- Department of Clinical Sciences and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, United Kingdom
| | - Peter Graham
- Faculty of Medicine and Health Sciences, University of Nottingham, Sutton Bonington, Leicestershire, United Kingdom
| | - Brian Catchpole
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, United Kingdom.
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15
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Lawson JS, Syme HM, Wheeler-Jones CPD, Elliott J. Characterisation of feline renal cortical fibroblast cultures and their transcriptional response to transforming growth factor β1. BMC Vet Res 2018. [PMID: 29523136 PMCID: PMC5845201 DOI: 10.1186/s12917-018-1387-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background Chronic kidney disease (CKD) is common in geriatric cats, and the most prevalent pathology is chronic tubulointerstitial inflammation and fibrosis. The cell type predominantly responsible for the production of extra-cellular matrix in renal fibrosis is the myofibroblast, and fibroblast to myofibroblast differentiation is probably a crucial event. The cytokine TGF-β1 is reportedly the most important regulator of myofibroblastic differentiation in other species. The aim of this study was to isolate and characterise renal fibroblasts from cadaverous kidney tissue of cats with and without CKD, and to investigate the transcriptional response to TGF-β1. Results Cortical fibroblast cultures were successfully established from the kidney tissue of cats with normal kidney function (FCF) and cats with chronic kidney disease (CKD-FCF). Both cell types expressed the mesenchymal markers vimentin, CD44 and CD29, and were negative for the epithelial marker cytokeratin, mesangial cell marker desmin and endothelial cell marker vWF. Only CKD-FCF expressed VCAM-1, a cell marker associated with inflammation. Incubation with TGF-β1 (0–10 ng/ml) induced a concentration dependent change in cell morphology, and upregulation of myofibroblast marker gene α-SMA expression alongside collagen 1α1, fibronectin, TGF-β1 and CTGF mRNA. These changes were blocked by the TGF-β1 receptor 1 antagonist SB431542 (5 μM). Conclusions FCF and CKD-FCF can be cultured via a simple method and represent a model for the investigation of the progression of fibrosis in feline CKD. The findings of this study suggest TGF-β1 may be involved in fibroblast-myofibroblast transition in feline CKD, as in other species.
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Affiliation(s)
- J S Lawson
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London, NW1 0TU, UK.
| | - H M Syme
- Clinical Sciences and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts, AL9 7TA, UK
| | - C P D Wheeler-Jones
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London, NW1 0TU, UK
| | - J Elliott
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London, NW1 0TU, UK
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16
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Geddes RF, Jepson RE, Forcada Y, Elliott J, Syme HM. Associations between single nucleotide polymorphisms in the calcium sensing receptor and chronic kidney disease-mineral and bone disorder in cats. Vet J 2018; 235:34-41. [PMID: 29704936 DOI: 10.1016/j.tvjl.2018.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 02/14/2018] [Accepted: 02/15/2018] [Indexed: 11/26/2022]
Abstract
Feline chronic kidney disease (CKD) is associated with high variability in severity of CKD-mineral and bone disorder (CKD-MBD). The calcium sensing receptor (CaSR) regulates circulating parathyroid hormone (PTH) and calcium concentrations. Single nucleotide polymorphisms (SNPs) in the CaSR are associated with severity of secondary renal hyperparathyroidism and total calcium concentrations in human patients receiving haemodialysis. The objective of this study was to explore associations between polymorphisms in the feline CaSR (fCaSR) and biochemical changes observed in CKD-MBD. Client owned cats (≥9years) were retrospectively included. SNP discovery was performed in 20 cats with azotaemic CKD and normal or dysregulated calcium concentrations. Non-pedigree cats (n=192) (125 with azotaemic CKD and 66 healthy), Persians (n=40) and Burmese (n=25) were genotyped for all identified SNPs using KASP. Biochemical parameters from the date of CKD diagnosis or from first visit to the clinic (healthy cats) were used. Associations between genotype and ionized calcium, total calcium, phosphate, PTH and FGF-23 were performed for non-pedigree cats using logistic regression. Sequence alignment against the fCaSR sequence revealed eight novel exonic SNPs. KASP genotyping had high accuracy (99.6%) and a low failure rate (<6%) for all SNPs. Allele frequencies varied between breeds. In non-pedigree cats, one synonymous SNP CaSR:c.1269G>A was associated with logPTH concentration (adjusted for plasma creatinine concentration), with a recessive model having the best fit (G/G vs A/A-G/A, P=0.031). Genetic variation in the fCaSR is unlikely to explain the majority of the variability in presence and severity of CKD-MBD in cats.
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Affiliation(s)
- R F Geddes
- Department of Clinical Sciences and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA, UK.
| | - R E Jepson
- Department of Clinical Sciences and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA, UK
| | - Y Forcada
- Department of Clinical Sciences and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA, UK
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, 4 Royal College Street, London, NW1 0TU, UK
| | - H M Syme
- Department of Clinical Sciences and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA, UK
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17
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Abstract
Objectives The aim of this study was to describe the variability in renal function markers in non-azotaemic and azotaemic cats, and also the rate of change in the markers. Methods Plasma creatinine concentration and its reciprocal, glomerular filtration rate (GFR) and urine specific gravity (USG) were studied as markers of renal function in client-owned cats. GFR was determined using a corrected slope-intercept iohexol clearance method. Renal function testing was performed at baseline and a second time point. The within-population variability (coefficient of variation; CV%) was determined at the baseline time point. Within-individual variability (CV%) and rate of change over time were determined from the repeated measurements. Results Twenty-nine cats were included in the study, of which five had azotaemic chronic kidney disease. The within-individual variability (CV%) in creatinine concentration was lower in azotaemic cats than in non-azotaemic cats (6.81% vs 8.82%), whereas the within-individual variability in GFR was higher in azotaemic cats (28.94% vs 19.98%). The within-population variability was greatest for USG (67.86% in azotaemic cats and 38.00% in non-azotaemic cats). There was a negative rate of change in creatinine concentration in azotaemic and non-azotaemic cats (–0.0265 and –0.0344 µmol/l/day, respectively) and a positive rate of change of GFR in azotaemic and non-azotaemic cats (0.0062 and 0.0028 ml/min/day, respectively). Conclusions and relevance The within-individual variability data suggest creatinine concentration to be the more useful marker for serial monitoring of renal function in azotaemic cats. In contrast, in non-azotaemic cats, GFR is a more useful marker for serial monitoring of renal function. The majority of cats with azotaemic CKD did not have an appreciable decline in renal function during the study.
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Affiliation(s)
| | - Harriet M Syme
- Department of Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, UK
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal College Street, London, UK
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18
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Bijsmans ES, Doig M, Jepson RE, Syme HM, Elliott J, Pelligand L. Factors Influencing the Relationship Between the Dose of Amlodipine Required for Blood Pressure Control and Change in Blood Pressure in Hypertensive Cats. J Vet Intern Med 2018; 30:1630-1636. [PMID: 27717190 PMCID: PMC5032874 DOI: 10.1111/jvim.14562] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 07/02/2016] [Accepted: 07/18/2016] [Indexed: 11/30/2022] Open
Abstract
Background Hypertension is a common problem in elderly cats. In most cats, systolic blood pressure (SBP) of <160 mmHg is achieved in response to amlodipine besylate at either 0.625 or 1.25 mg q24h. The individual cat factors determining dose requirement dose have not been explored. Aims To determine whether individual cat factors influence the dose of amlodipine required to achieve adequate blood pressure control and to determine whether factors other than the prescribed dose of drug alter the achieved plasma amlodipine concentrations. Methods Fifty‐nine hypertensive cats that required 0.625 mg (A) and 41 cats that required 1.25 mg (B) amlodipine to reach a target SBP of <160 mmHg were identified, and plasma amlodipine concentrations were determined. Comparisons were made between groups, and multivariable linear regression models were performed to investigate predictors of antihypertensive response. Results Cats that required a greater dose of amlodipine had significantly higher SBP at diagnosis of hypertension (A: (median [25th, 75th percentile]) 182 [175,192] mmHg; B: 207 [194,217] mmHg, P < .001), but comparable blood pressure was achieved after treatment. Plasma amlodipine concentrations were directly related to the dose of amlodipine administered. At diagnosis, cats in group B had significantly lower plasma potassium concentration (A: 4.1 [3.8,4.5]; B: 3.8 [3.6,4.2] mEq/L, P < .01). Weight did not differ between groups. The decrease in SBP was directly and independently associated with the SBP at diagnosis and the plasma amlodipine concentration. Conclusions and Clinical Importance Cats with higher blood pressure at diagnosis might require a greater dose of amlodipine to control their blood pressure adequately. Differences in amlodipine pharmacokinetics between cats do not seem to play a role in the antihypertensive response.
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Affiliation(s)
- E S Bijsmans
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK.
| | - M Doig
- ABS Laboratories Ltd, Welwyn Garden City, Hertfordshire, UK
| | - R E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, Hertfordshire, UK
| | - H M Syme
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, Hertfordshire, UK
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
| | - L Pelligand
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, Hertfordshire, UK
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19
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Crossley VJ, Debnath A, Chang YM, Fowkes RC, Elliott J, Syme HM. Breed, Coat Color, and Hair Length as Risk Factors for Hyperthyroidism in Cats. J Vet Intern Med 2017; 31:1028-1034. [PMID: 28612380 PMCID: PMC5508346 DOI: 10.1111/jvim.14737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 02/28/2017] [Accepted: 04/11/2017] [Indexed: 12/19/2022] Open
Abstract
Background Hyperthyroidism is very common in older cats, but the etiopathogenesis is poorly understood. Decreased risk of hyperthyroidism has been reported in certain colorpoint breeds, and this observation previously has been hypothesized to result from relatively greater tyrosine availability for thyroid hormone production because of limited ability to convert tyrosine to melanin pigment. However, studies investigating a potential link between coat pigmentation and risk of hyperthyroidism are limited. Objective To identify associations between coat phenotype and hyperthyroidism by investigation of breed, coat color, and hair length as risk factors for the disease. Animals Data were used from 4,705 cats aged ≥10 years, referred to a single veterinary teaching hospital (2006–2014) in the United Kingdom. Methods Retrospective, epidemiological, cross‐sectional study using Bayesian multivariable logistic regression to assess risk factors for hyperthyroidism. Results Burmese (odds ratio [OR], 0.01; 0.00–0.23; P = .004), Tonkinese (OR, 0.05; 0.00–0.95; P = .046), Persian (OR, 0.21; 0.10–0.44; P < .001), Siamese (OR, 0.27; 0.12–0.61; P = .002), Abyssinian (OR, 0.04; 0.00–0.74; P = .031), and British shorthair (OR, 0.47; 0.28–0.79; P = .004) breeds had decreased risk of hyperthyroidism compared to domestic shorthairs. Longhaired, nonpurebred cats (OR, 1.30; 1.03–1.64; P = .028) were at increased risk of hyperthyroidism. Coat color/pattern was not associated with hyperthyroidism in nonpurebred cats. Conclusions and Clinical Importance We identified decreased risk of hyperthyroidism in the Tonkinese, Abyssinian, and British shorthair breeds, identified an association between risk of hyperthyroidism and hair length, and confirmed decreased risk in Burmese, Siamese, and Persian breeds. Additional studies are warranted to further investigate these findings.
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Affiliation(s)
- V J Crossley
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK
| | - A Debnath
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK
| | - Y M Chang
- Research Support Office, Royal Veterinary College, University of London, London, UK
| | - R C Fowkes
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
| | - H M Syme
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK
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20
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Bijsmans ES, Jepson RE, Wheeler C, Syme HM, Elliott J. Plasma N-Terminal Probrain Natriuretic Peptide, Vascular Endothelial Growth Factor, and Cardiac Troponin I as Novel Biomarkers of Hypertensive Disease and Target Organ Damage in Cats. J Vet Intern Med 2017; 31:650-660. [PMID: 28387019 PMCID: PMC5435049 DOI: 10.1111/jvim.14655] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/06/2016] [Accepted: 12/12/2016] [Indexed: 12/22/2022] Open
Abstract
Background In the absence of ocular target organ damage (ocular‐TOD), diagnosis of hypertension is challenging in cats. Biomarkers would provide additional support for the diagnosis of hypertension. Hypothesis Vascular endothelial growth factor (VEGF), N‐terminal probrain natriuretic peptide (NT‐proBNP), cardiac troponin I (cTnI), and urine protein‐to‐creatinine ratio (UPC) are predictors of systemic hypertension, will be increased in cats with hypertension with or without ocular‐TOD, and will decrease with antihypertensive treatment. Methods Plasma VEGF, NT‐proBNP, and cTnI concentrations and UPC were determined in healthy geriatric cats, normotensive cats with chronic kidney disease (CKD), hypertensive cats with evidence of hypertensive retinopathy (HT‐ocular‐TOD), and hypertensive cats without hypertensive ocular‐TOD (HT‐noTOD). Comparisons among groups were performed. Multivariable binary logistic regression models were built to identify independent biomarkers of hypertension and ocular‐TOD. Receiver operator characteristic (ROC) curves were drawn to assess clinical use. Results Cats with HT‐ocular‐TOD had significantly higher VEGF than all other groups (P < .05) and significantly higher NT‐proBNP than healthy cats (P < .001). Healthy cats had significantly lower cTnI than all other groups (P < .05). No differences were found among groups for UPC (P = .08). Cardiac troponin I and VEGF were independent predictors of hypertension (P < .05), but none of the biomarkers were independent predictors of ocular‐TOD. N‐terminal probrain natriuretic peptide concentrations decreased with antihypertensive treatment (P < .001). The ROC curves indicated that none of the biomarkers met the criteria to function as diagnostic tests for the diagnosis of hypertension or associated ocular‐TOD. Conclusions and Clinical Significance Despite statistical significance and changes with ocular‐TOD, antihypertensive treatment, or both, VEGF, NT‐proBNP, and cTnI did not function as useful diagnostic tests for hypertension. Persistently increased systolic blood pressure (SBP) measurements in combination with fundoscopy remains the preferred method for diagnosis of feline hypertension.
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Affiliation(s)
- E S Bijsmans
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - R E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - C Wheeler
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - H M Syme
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
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21
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Geddes RF, Biourge V, Chang Y, Syme HM, Elliott J. The Effect of Moderate Dietary Protein and Phosphate Restriction on Calcium-Phosphate Homeostasis in Healthy Older Cats. J Vet Intern Med 2016; 30:1690-1702. [PMID: 27527663 PMCID: PMC5032885 DOI: 10.1111/jvim.14563] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 06/25/2016] [Accepted: 07/18/2016] [Indexed: 12/12/2022] Open
Abstract
Background Dietary phosphate and protein restriction decreases plasma PTH and FGF‐23 concentrations and improves survival time in azotemic cats, but has not been examined in cats that are not azotemic. Hypothesis Feeding a moderately protein‐ and phosphate‐restricted diet decreases PTH and FGF‐23 in healthy older cats and thereby slows progression to azotemic CKD. Animals A total of 54 healthy, client‐owned cats (≥ 9 years). Methods Prospective double‐blinded randomized placebo‐controlled trial. Cats were assigned to test diet (protein 76 g/Mcal and phosphate 1.6 g/Mcal) or control diet (protein 86 g/Mcal and phosphate 2.6 g/Mcal) and monitored for 18 months. Changes in variables over time and effect of diet were assessed by linear mixed models. Results A total of 26 cats ate test diet and 28 cats ate control diet. There was a significant effect of diet on urinary fractional excretion of phosphate (P = 0.045), plasma PTH (P = 0.005), and ionized calcium concentrations (P = 0.018), but not plasma phosphate, FGF‐23, or creatinine concentrations. Plasma PTH concentrations did not significantly change in cats fed the test diet (P = 0.62) but increased over time in cats fed the control diet (P = 0.001). There was no significant treatment effect of the test diet on development of azotemic CKD (3 of 26 (12%) test versus 3 of 28 (11%) control, odds ratio 1.09 (95% CI 0.13–8.94), P = 0.92). Conclusions and Clinical Importance Feeding a moderately protein‐ and phosphate‐restricted diet has effects on calcium‐phosphate homeostasis in healthy older cats and is well tolerated. This might have an impact on renal function and could be useful in early chronic kidney disease.
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Affiliation(s)
- R F Geddes
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hatfield, UK.
| | | | - Y Chang
- Department of Comparative Biological Sciences, Royal Veterinary College, Camden, London, UK
| | - H M Syme
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hatfield, UK
| | - J Elliott
- Department of Comparative Biological Sciences, Royal Veterinary College, Camden, London, UK
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Williams TL, Dillon H, Elliott J, Syme HM, Archer J. Serum Cystatin C Concentrations in Cats with Hyperthyroidism and Chronic Kidney Disease. J Vet Intern Med 2016; 30:1083-9. [PMID: 27155206 PMCID: PMC5084826 DOI: 10.1111/jvim.13956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 02/24/2016] [Accepted: 04/13/2016] [Indexed: 12/03/2022] Open
Abstract
Background Currently, no test can accurately predict the development of azotemia after treatment of hyperthyroidism. Serum cystatin C concentrations (sCysC) might be less influenced by changes in body muscle mass and so better indicate the presence of concurrent chronic kidney disease (CKD) in hyperthyroidism. Hypotheses sCysC will be higher in hyperthyroid cats that develop azotemia compared with hyperthyroid cats that remain nonazotemic after treatment; sCysC will be higher in nonhyperthyroid cats with azotemic CKD than healthy older cats and, sCysC will decrease after treatment of hyperthyroidism. Animals Ninety‐one cats treated in first opinion practice. Methods Case–control study. sCysC were compared between hyperthyroid cats which developed azotemia within 4 months of successful treatment of hyperthyroidism (pre‐azotemic group) and hyperthyroid cats which remained nonazotemic after treatment (nonazotemic group), and between nonhyperthyroid cats with azotemic CKD and healthy older cats. sCysC were also compared between hyperthyroid cats before treatment and at time of establishment of euthyroidism. Data are presented as median [25th, 75th percentile]. Results Baseline sCysC were not different between the pre‐azotemic and nonazotemic groups (1.9 [1.4, 2.3] mg/L versus 1.5 [1.1, 2.2] mg/L, respectively; P = .22). sCysC in nonhyperthyroid cats with azotemic CKD and healthy older cats were not significantly different (1.5 [1.0, 1.9] mg/L versus 1.2 [0.8, 1.4] mg/L, respectively; P = .16). sCysC did not change significantly after treatment of hyperthyroidism (pretreatment 1.8 [1.2, 2.3] mg/L, after treatment 1.6 [1.1, 2.4] mg/L; P = .82). Conclusions and Clinical Importance sCysC do not appear to be a reliable marker of renal function in hyperthyroid cats.
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Affiliation(s)
- T L Williams
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - H Dillon
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - H M Syme
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - J Archer
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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Finch NC, Syme HM, Elliott J. Risk Factors for Development of Chronic Kidney Disease in Cats. J Vet Intern Med 2016; 30:602-10. [PMID: 26948860 PMCID: PMC4864943 DOI: 10.1111/jvim.13917] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 12/21/2015] [Accepted: 02/02/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Identification of risk factors for development of chronic kidney disease (CKD) in cats may aid in its earlier detection. HYPOTHESIS/OBJECTIVES Evaluation of clinical and questionnaire data will identify risk factors for development of azotemic CKD in cats. ANIMALS One hundred and forty-eight client-owned geriatric (>9 years) cats. METHODS Cats were recruited into the study and followed longitudinally for a variable time. Owners were asked to complete a questionnaire regarding their pet at enrollment. Additional data regarding dental disease were obtained when available by development of a dental categorization system. Variables were explored in univariable and multivariable Cox regression models. RESULTS In the final multivariable Cox regression model, annual/frequent vaccination (P value, .003; hazard ratio, 5.68; 95% confidence interval, 1.83-17.64), moderate dental disease (P value, .008; hazard ratio, 13.83; 95% confidence interval, 2.01-94.99), and severe dental disease (P value, .001; hazard ratio, 35.35; 95% confidence interval, 4.31-289.73) predicted development of azotemic CKD. CONCLUSION Our study suggests independent associations between both vaccination frequency and severity of dental disease and development of CKD. Further studies to explore the pathophysiological mechanism of renal injury for these risk factors are warranted.
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Affiliation(s)
- N C Finch
- Bristol Renal, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - H M Syme
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Herts, UK
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
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Lawson JS, Syme HM, Wheeler-Jones CPD, Elliott J. Urinary active transforming growth factor β in feline chronic kidney disease. Vet J 2016; 214:1-6. [PMID: 27387717 PMCID: PMC4949776 DOI: 10.1016/j.tvjl.2016.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 01/05/2016] [Accepted: 02/03/2016] [Indexed: 12/14/2022]
Abstract
Feline urinary active transforming growth factor beta 1 (aTGF-β1) was measured in healthy and azotaemic cats. There was no cross-sectional association between aTGF-β1 and development of chronic kidney disease. Elevations in aTGF-β1 preceded development of azotaemia in a longitudinal study. Urinary aTGF-β1 concentrations reflected severity of renal pathology.
The cytokine transforming growth factor beta 1 (TGF-β1) has been widely implicated in the development and progression of renal fibrosis in chronic kidney disease (CKD) in humans and in experimental models. The aims of this study were to assess the association between urinary active TGF-β1 and (a) development of CKD in a cross-sectional study, (b) deterioration of renal function over 1 year in a longitudinal study, and (c) renal histopathological parameters in cats. A human active TGF-β1 ELISA was validated for use in feline urine. Cross-sectional analysis revealed no significant difference in urinary active TGF-β1:creatinine ratio (aTGF-β1:UCr) between groups with differing renal function. Longitudinally, non-azotaemic cats that developed CKD demonstrated a significant (P = 0.028) increase in aTGF-β1:UCr approximately 6 months before the development of azotaemia, which remained elevated (P = 0.046) at diagnosis (approximately 12 months prior, 8.4 pg/mg; approximately 6 months prior, 22.2 pg/mg; at CKD diagnosis, 24.6 pg/mg). In the histopathology study, aTGF-β1:UCr was significantly higher in cats with moderate (P = 0.02) and diffuse (P = 0.005) renal fibrosis than in cats without fibrosis. Cats with moderate renal inflammation had significantly higher urinary active aTGF-β1 concentrations than cats with mild (P = 0.035) or no inflammatory change (P = 0.004). The parameter aTGF-β1:UCr was independently associated with Log urine protein:creatinine ratio in a multivariable analysis of clinicopathological parameters and interstitial fibrosis score in a multivariable analysis of histopathological features. These results suggest that urinary aTGF-β1 reflects the severity of renal pathology. Increases in urinary aTGF-β1 followed longitudinally in individual cats may indicate the development of CKD.
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Affiliation(s)
- J S Lawson
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London, NW1 0TU, UK.
| | - H M Syme
- Clinical Sciences and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts, AL9 7TA, UK
| | - C P D Wheeler-Jones
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London, NW1 0TU, UK
| | - J Elliott
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London, NW1 0TU, UK
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Boag AM, Christie MR, McLaughlin KA, Syme HM, Graham P, Catchpole B. Autoantibodies against Cytochrome P450 Side-Chain Cleavage Enzyme in Dogs (Canis lupus familiaris) Affected with Hypoadrenocorticism (Addison's Disease). PLoS One 2015; 10:e0143458. [PMID: 26618927 PMCID: PMC4664467 DOI: 10.1371/journal.pone.0143458] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 11/04/2015] [Indexed: 12/15/2022] Open
Abstract
Canine hypoadrenocorticism likely arises from immune-mediated destruction of adrenocortical tissue, leading to glucocorticoid and mineralocorticoid deficiency. In humans with autoimmune Addison's disease (AAD) or autoimmune polyendocrine syndrome (APS), circulating autoantibodies have been demonstrated against enzymes associated with adrenal steroid synthesis. The current study investigates autoantibodies against steroid synthesis enzymes in dogs with spontaneous hypoadrenocorticism. Coding regions of canine CYP21A2 (21-hydroxylase; 21-OH), CYP17A1 (17-hydroxylase; 17-OH), CYP11A1 (P450 side-chain cleavage enzyme; P450scc) and HSD3B2 (3β hydroxysteroid dehydrogenase; 3βHSD) were amplified, cloned and expressed as 35S-methionine radiolabelled recombinant protein. In a pilot study, serum samples from 20 dogs with hypoadrenocorticism and four unaffected control dogs were screened by radio-immunoprecipitation assay. There was no evidence of reactivity against 21-OH, 17-OH or 3βHSD, but five dogs with hypoadrenocorticism showed immunoreactivity to P450scc compared with controls. Serum samples were subsequently obtained from 213 dogs diagnosed with hypoadrenocorticism and 110 dogs from a hospital control population. Thirty control dogs were randomly selected to establish a threshold for antibody positivity (mean + 3 × standard deviation). Dogs with hypoadrenocorticism were more likely to be P450scc autoantibody positive than hospital controls (24% vs. 1.2%, respectively; p = 0.0016). Sex was significantly associated with the presence of P450scc autoantibodies in the case population, with 30% of females testing positive compared with 17% of males (p = 0.037). Significant associations with breed (p = 0.015) and DLA-type (DQA1*006:01 allele; p = 0.017) were also found. This cross-sectional study indicates that P450scc autoantibodies are present in a proportion of dogs affected with hypoadrenocorticism.
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Affiliation(s)
- Alisdair M. Boag
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, United Kingdom
| | - Michael R. Christie
- Division of Diabetes & Nutritional Sciences, King’s College London, Hodgkin Building, Guy’s Campus, London, United Kingdom
- School of Life Sciences, University of Lincoln, Lincoln, United Kingdom
| | - Kerry A. McLaughlin
- Division of Diabetes & Nutritional Sciences, King’s College London, Hodgkin Building, Guy’s Campus, London, United Kingdom
| | - Harriet M. Syme
- Department of Clinical Sciences and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, United Kingdom
| | - Peter Graham
- Faculty of Medicine and Health Sciences, University of Nottingham, Sutton Bonington, Leicestershire, United Kingdom
| | - Brian Catchpole
- Department of Pathology and Pathogen Biology, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, United Kingdom
- * E-mail:
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Bijsmans ES, Jepson RE, Syme HM, Elliott J, Niessen SJM. Psychometric Validation of a General Health Quality of Life Tool for Cats Used to Compare Healthy Cats and Cats with Chronic Kidney Disease. J Vet Intern Med 2015; 30:183-91. [PMID: 26567089 PMCID: PMC4913638 DOI: 10.1111/jvim.13656] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 08/19/2015] [Accepted: 09/30/2015] [Indexed: 11/28/2022] Open
Abstract
Background Numerous validated psychometric tools are available to assess impact of disease on a human's quality of life (QoL). To date, no psychometrically validated general health‐related QoL tool exists for cats. Hypothesis/Objectives To develop and validate a tool for assessment of owner‐perceived QoL in cats (CatQoL) and to use this tool to compare QoL between healthy cats and those with chronic kidney disease (CKD). Animals/Subjects Total of 204 owners of young healthy cats (YH, n = 99; <9 years), older healthy cats (OH, n = 35), and cats diagnosed with CKD (CKD, n = 70) completed the CatQoL. Methods Discussions with a focus group and 2 pilot surveys informed design of 16 QoL questions grouped into 4 domains. Each item scored according to frequency and importance, and item‐weighted‐impact‐scores were calculated. The validity of the tool was assessed using principal components analysis and Cronbach's α. The average item‐weighted‐impact‐score (AWIS) was compared among groups and domains. Results Sixteen‐item CatQoL showed good internal consistency reliability (Cronbach's α, 0.77) and unidimensionality with significant loadings (0.2–0.7) and communalities (>0.3). Young healthy cats had significantly higher AWIS (median [IQR], 1.25 [0.63, 1.88]) than OH (0.56 [−0.06, 1.00]) and CKD cats (−0.06 [−0.81, 0.88]), P < .001). CKD cats had significantly lower AWIS for eating domain (YH: 2.00 [1.00, 3.00]; OH: 2.00 [0.67, 3.00]; CKD : 1.00 [0.00, 2.67]) when compared with the YH group and OH group, and all groups differed significantly in their management domain (YH: −0.50 [−1.00, 0.00]; OH: −1.00 [−1.88, −0.50]; CKD : −1.50 [−2.50, −1.00], P < .001). Conclusions and Clinical Importance The CatQoL was validated for use in cats, and can be used as additional assessment parameter in clinical and research settings.
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Affiliation(s)
- E S Bijsmans
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
| | - R E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hatfield, Hertfordshire, UK
| | - H M Syme
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hatfield, Hertfordshire, UK
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
| | - S J M Niessen
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hatfield, Hertfordshire, UK
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Sent U, Gössl R, Elliott J, Syme HM, Zimmering T. Comparison of Efficacy of Long-term Oral Treatment with Telmisartan and Benazepril in Cats with Chronic Kidney Disease. J Vet Intern Med 2015; 29:1479-87. [PMID: 26474314 PMCID: PMC4895689 DOI: 10.1111/jvim.13639] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 06/12/2015] [Accepted: 09/10/2015] [Indexed: 12/12/2022] Open
Abstract
Background The efficacy and benefits of telmisartan in cats with chronic kidney disease (CKD) have not previously been reported. Hypothesis Long‐term treatment of cats with CKD using telmisartan decreases urine protein‐to‐creatinine ratio (UP/C) similar to benazepril. Animals Two‐hundred and twenty‐four client‐owned adult cats with CKD. Methods Prospective, multicenter, controlled, randomized, parallel group, blinded clinical trial with noninferiority design. Cats were allocated in a 1 : 1 ratio to either telmisartan (1 mg/kg; n = 112) or benazepril (0.5–1.0 mg/kg; n = 112) PO q24 h. The primary endpoint was prospectively defined as the change in proteinuria (benazepril:telmisartan) based on a log transformed weighted average of UP/C change from baseline (AUC 0→t/t) as a percentage compared using a confidence interval (CI) approach. Changes of UP/C from baseline were assessed on all study days and corrected for multiple comparisons. Results Telmisartan proved noninferior to benazepril in controlling proteinuria (CI, −0.035 to 0.268). At Day 180, UP/C compared to baseline in the telmisartan group was significantly lower (−0.05 ± 0.31; P = .016), whereas in the benazepril group the change (−0.02 ± 0.48) was not statistically significant (P = .136). Similar results were obtained at all assessment points with significant decrease in UP/C occurring with telmisartan but not benazepril. Conclusion and Clinical Importance Both telmisartan and benazepril were well tolerated and safe. Telmisartan proved to be noninferior to benazepril and significantly decreased proteinuria relative to baseline at all assessment points whereas benazepril did not.
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Affiliation(s)
- U Sent
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany
| | - R Gössl
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - H M Syme
- Department of Clinical Sciences and Services, Royal Veterinary College, Herts, UK
| | - T Zimmering
- Boehringer Ingelheim Animal Health GmbH, Ingelheim, Germany
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Geddes RF, Elliott J, Syme HM. Relationship between Plasma Fibroblast Growth Factor-23 Concentration and Survival Time in Cats with Chronic Kidney Disease. J Vet Intern Med 2015; 29:1494-501. [PMID: 26403212 PMCID: PMC4895675 DOI: 10.1111/jvim.13625] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 05/26/2015] [Accepted: 08/26/2015] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Fibroblast growth factor-23 (FGF-23) and parathyroid hormone (PTH) are commonly increased in cats with azotemic chronic kidney disease (CKD). Both are predictors of survival time in human patients, but these relationships have not previously been examined in the cat. OBJECTIVES To investigate the relationship between plasma FGF-23 and PTH concentrations at diagnosis of CKD in cats with survival time and with disease progression over 12 months. ANIMALS 214 azotemic, client-owned cats (≥9 years). METHODS Retrospective study: Biochemical and urinary variables at diagnosis of azotemic CKD, including plasma FGF-23 and PTH concentrations were assessed as predictors of survival time (all-cause mortality) using Cox regression, and as predictors of CKD progression over 12 months using logistic regression. RESULTS In the final multivariable Cox regression model, survival was negatively associated with plasma creatinine (P = .002) and FGF-23 concentrations (P = .014), urine protein-to-creatinine ratio (P < .001) and age (P < .001). Survival was positively associated with PCV (P = .004). In the final multivariable logistic regression model, independent predictors of CKD progression included logFGF-23 and age. Neither plasma phosphate nor PTH was found to be an independent predictor of survival time or of CKD progression. CONCLUSIONS AND CLINICAL IMPORTANCE Plasma FGF-23 concentration is a novel prognostic indicator in cats with CKD, independent of other factors including plasma creatinine and phosphate concentrations. Further work is required to assess if FGF-23 contributes directly to CKD progression, but regardless these findings may make FGF-23 a useful biomarker for predicting poorer outcomes in cats with CKD.
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Affiliation(s)
- R F Geddes
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hatfield, UK
| | - J Elliott
- Department of Comparative Biological Sciences, Royal Veterinary College, Camden, London, UK
| | - H M Syme
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hatfield, UK
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Threlfall AJ, Boag AM, Soutter F, Glanemann B, Syme HM, Catchpole B. Analysis of DLA-DQB1 and polymorphisms in CTLA4 in Cocker spaniels affected with immune-mediated haemolytic anaemia. Canine Genet Epidemiol 2015; 2:8. [PMID: 26401336 PMCID: PMC4579385 DOI: 10.1186/s40575-015-0020-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 04/30/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cocker spaniels are predisposed to immune-mediated haemolytic anaemia (IMHA), suggesting that genetic factors influence disease susceptibility. Dog leukocyte antigen (DLA) class II genes encode major histocompatibility complex (MHC) molecules that are involved in antigen presentation to CD4(+) T cells. Several DLA haplotypes have been associated with autoimmune disease, including IMHA, in dogs, and breed specific differences have been identified. Cytotoxic T lymphocyte antigen 4 (CTLA4) is a critical molecule involved in the regulation of T-cell responses. Single nucleotide polymorphisms (SNPs) in the CTLA4 promoter have been shown to be associated with several autoimmune diseases in humans and more recently with diabetes mellitus and hypoadrenocorticism in dogs. The aim of the present study was to investigate whether DLA-DQB1 alleles or CTLA4 promoter variability are associated with risk of IMHA in Cocker spaniels. RESULTS There were a restricted number of DLA-DQB1 alleles identified, with a high prevalence of DLA-DQB1*007:01 in both groups. A high prevalence of DLA-DQB1 homozygosity was identified, although there was no significant difference between IMHA cases and controls. CTLA4 promoter haplotype diversity was limited in Cocker spaniels, with all dogs expressing at least one copy of haplotype 8. There was no significant difference comparing haplotypes in the IMHA affected group versus control group (p = 0.23). Homozygosity for haplotype 8 was common in Cocker spaniels with IMHA (27/29; 93 %) and in controls (52/63; 83 %), with no statistically significant difference in prevalence between the two groups (p = 0.22). CONCLUSIONS DLA-DQB1 allele and CTLA4 promoter haplotype were not found to be significantly associated with IMHA in Cocker spaniels. Homozygosity for DLA-DQB1*007:01 and the presence of CTLA4 haplotype 8 in Cocker spaniels might increase overall susceptibility to IMHA in this breed, with other genetic and environmental factors involved in disease expression and progression.
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Affiliation(s)
- Anna J Threlfall
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hatfield, AL9 7TA Hertfordshire UK
| | - Alisdair M Boag
- The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Campus, Midlothian, EH25 9RG UK
| | - Francesca Soutter
- Department of Pathology and Pathogen Biology, Royal Veterinary College, North Mymms, Hatfield, AL9 7TA Hertfordshire UK
| | - Barbara Glanemann
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hatfield, AL9 7TA Hertfordshire UK
| | - Harriet M Syme
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hatfield, AL9 7TA Hertfordshire UK
| | - Brian Catchpole
- Department of Pathology and Pathogen Biology, Royal Veterinary College, North Mymms, Hatfield, AL9 7TA Hertfordshire UK
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Bijsmans ES, Jepson RE, Chang YM, Syme HM, Elliott J. Changes in systolic blood pressure over time in healthy cats and cats with chronic kidney disease. J Vet Intern Med 2015; 29:855-61. [PMID: 25917326 PMCID: PMC4895402 DOI: 10.1111/jvim.12600] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 01/07/2015] [Accepted: 03/24/2015] [Indexed: 01/11/2023] Open
Abstract
Background Hypertension is a common problem in older cats, most often associated with chronic kidney disease (CKD). Cross‐sectional studies have suggested that blood pressure in cats increases with age. Hypothesis/Objectives To determine whether blood pressure in cats increases with age and whether this occurs independently of the presence of CKD. To investigate risk factors for developing hypertension. Animals/Subjects Two hundred and sixty‐five cats with CKD and 133 healthy cats ≥9 years were retrospectively identified. Methods Four groups were created according to status at initial evaluation (CKD or healthy) and blood pressure at the last included visit (normotensive [NT] or developed hypertension [DH]): Healthy‐NT, Healthy‐DH, CKD‐NT and CKD‐DH. Systolic blood pressure (SBP) over time slopes were compared with 0 and between groups. Risk factors for the development of hypertension were investigated, and associations of biochemical and clinical variables with SBP were examined. Results Cats that were hypertensive at CKD diagnosis (n = 105) were not included in further analyses. Twenty‐seven cats with CKD and 9 healthy cats developed hypertension ≥3 months after diagnosis of CKD or their first visit. Systolic blood pressure significantly increased with age in all cats (P < .001). Healthy cats were at less risk than cats with CKD to become hypertensive (hazard ratio 0.2, P < .001), with creatinine being an independent risk factor for the development of hypertension. Conclusions and Clinical Importance The high prevalence of hypertension in azotemic cats in this study shows the importance of monitoring of SBP in elderly cats, and in particular in cats with CKD.
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Affiliation(s)
- E S Bijsmans
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
| | - R E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hatfield, Hertfordshire, UK
| | - Y M Chang
- Research Support Office, Royal Veterinary College, University of London, London, UK
| | - H M Syme
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hatfield, Hertfordshire, UK
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
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Finch NC, Heiene R, Elliott J, Syme HM, Peters AM. Determination of extracellular fluid volume in healthy and azotemic cats. J Vet Intern Med 2014; 29:35-42. [PMID: 25406506 PMCID: PMC4858083 DOI: 10.1111/jvim.12506] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 07/22/2014] [Accepted: 10/21/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Methods for determining extracellular fluid volume (ECFV) are important clinically for cats. Bromide dilution has been studied in cats to estimate ECFV. Markers of GFR also distribute in ECFV and can be used for its measurement. HYPOTHESIS/OBJECTIVES The primary objective was to develop a method of determining ECFV from iohexol clearance in cats and evaluate agreement with that determined using bromide dilution. Additional objectives were to compare ECFV between azotemic and nonazotemic cats and evaluate appropriate methods of standardizing ECFV. ANIMALS Client-owned cats with varying renal function. METHODS Validation of ECFV determined from slope-intercept iohexol clearance was performed in 18 healthy nonazotemic cats. ECFV was then determined using the validated method and bromide dilution and agreement assessed. Appropriateness of standardization to body weight (BW) and body surface area (BSA) was evaluated. RESULTS Extracellular fluid volume determined from slope-intercept iohexol clearance and bromide dilution was 0.84 ± 0.32 L and 0.85 ± 0.19 L (mean ± SD), respectively. There were wide limits of agreement between the methods (-0.58 to 0.54 L) and therefore, agreement was considered to be poor. ECFV did not differ significantly between azotemic and nonazotemic cats (P = .177). BSA was found to be the best method for standardizing ECFV measurement in cats. CONCLUSIONS AND CLINICAL IMPORTANCE This study developed a method for determining ECFV from slope-intercept iohexol clearance which provides simultaneous assessment of renal function and an estimate of ECFV. ECFV does not differ between azotemic and nonazotemic cats, which suggests fluid volume loss or overload is not an important clinical feature in cats with mild chronic kidney disease.
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Affiliation(s)
- N C Finch
- Royal Veterinary College, London, UK
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Williams TL, Elliott J, Syme HM. Effect on renal function of restoration of euthyroidism in hyperthyroid cats with iatrogenic hypothyroidism. J Vet Intern Med 2014; 28:1251-5. [PMID: 24773059 PMCID: PMC4857944 DOI: 10.1111/jvim.12359] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 02/18/2014] [Accepted: 03/12/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Iatrogenic hypothyroidism is associated with an increased incidence of azotemia after treatment of hyperthyroidism, and decreased survival time in azotemic hyperthyroid cats. HYPOTHESIS Restoration of euthyroidism will decrease plasma creatinine concentrations. ANIMALS Nineteen client-owned, methimazole- or carbimazole-treated, hyperthyroid cats with documented iatrogenic hypothyroidism (based on subnormal plasma total thyroxine concentrations [TT4] and increased plasma thyroid-stimulating hormone concentrations). METHODS Prospective interventional study. Doses of antithyroid medication were reduced until euthyroidism was restored (TT4 10-40 nmol/L). Plasma creatinine concentration and selected other clinicopathologic variables were evaluated before and after restoration of euthyroidism and compared by nonparametric statistics. Data are presented as median [25th, 75th percentile]. RESULTS Restoration of euthyroidism was associated with a significant decrease in plasma creatinine concentrations (2.61 [1.90, 3.26] mg/dL versus 2.07 [1.42, 2.82] mg/dL; P < .001) and body weight (4.03 [3.59, 4.53] kg versus 3.89 [3.34, 4.18] kg; P = .019), and a significant increase in packed cell volume (30 [28, 39]% versus 34 [29, 39]%; P = .038), heart rate (174 [163, 201] bpm versus 190 [164, 202] bpm; P = .009), and plasma alkaline phosphatase activity (26.6 [17.0, 33.0] IU/L versus 38.0 [23.5, 46.5] IU/L; P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE Restoration of euthyroidism in medically treated hyperthyroid cats with iatrogenic hypothyroidism causes a reduction in plasma creatinine concentrations, and thus might improve renal function; however, this could be influenced by concurrent changes in body weight.
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Affiliation(s)
- T L Williams
- Department of Veterinary Clinical Sciences, Royal Veterinary College, North Mymms, UK
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Jepson RE, Syme HM, Elliott J. Plasma renin activity and aldosterone concentrations in hypertensive cats with and without azotemia and in response to treatment with amlodipine besylate. J Vet Intern Med 2013; 28:144-53. [PMID: 24428319 PMCID: PMC4895535 DOI: 10.1111/jvim.12240] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 08/21/2013] [Accepted: 09/23/2013] [Indexed: 12/17/2022] Open
Abstract
Background Role of renin‐angiotensin aldosterone system (RAAS) in feline systemic hypertension is poorly understood. Objectives Examine plasma renin activity (PRA) and plasma aldosterone concentrations (PAC) in normotensive and hypertensive cats with variable renal function and in response to antihypertensive therapy. Animals One hundred and ninety‐six cats >9 years from first opinion practice. Methods PRA, PAC, and aldosterone‐to‐renin ratio (ARR) were evaluated in cats recruited prospectively and grouped according to systolic blood pressure (SBP) and renal function (nonazotemic normotensive [Non‐Azo‐NT], nonazotemic hypertensive [Non‐Azo‐HT], azotemic normotensive [Azo‐NT], azotemic hypertensive [Azo‐HT]). Changes in PRA and PAC were evaluated with antihypertensive therapy (amlodipine besylate). Results Plasma renin activity (ng/mL/h; P = .0013), PAC (pg/mL; P < .001), and ARR (P = 0.0062) differed significantly among groups. PRA (ng/mL/h) was significantly lower in hypertensive (Non‐Azo‐HT; n = 25, median 0.22 [25th percentile 0.09, 75th percentile 0.39], Azo‐HT; n = 44, 0.33 [0.15, 0.48]) compared with Non‐Azo‐NT cats (n = 57, 0.52 [0.28, 1.02]). Azo‐HT cats had significantly higher PAC (n = 22, 149.8 [103.1, 228.7]) than normotensive cats (Non‐Azo‐NT; n = 26, 45.4 [19.6, 65.0], Azo‐NT; n = 18, 84.1 [38.6, 137.8]). ARR was significantly higher in Azo‐HT (n = 20, 503.8 [298.8, 1511]) than Azo‐NT cats (n = 16, 97.8 [77.0, 496.4]). Significant increase in PRA was documented with antihypertensive therapy (pretreatment [n = 20] 0.32 [0.15–0.46], posttreatment 0.54 [0.28, 1.51]), but PAC did not change. Conclusions and Clinical Importance Hypertensive cats demonstrate significantly increased PAC with decreased PRA. PRA significantly increases with antihypertensive therapy. Additional work is required to determine the role of plasma aldosterone concentration in the pathogenesis of hypertension and whether this relates to autonomous production or activation of RAAS without demonstrable increase in PRA.
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Affiliation(s)
- R E Jepson
- Department of Clinical Sciences and Services, Royal Veterinary College, Nr Hatfield, UK
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Williams TL, Elliott J, Berry J, Syme HM. Investigation of the pathophysiological mechanism for altered calcium homeostasis in hyperthyroid cats. J Small Anim Pract 2013; 54:367-73. [PMID: 23790052 DOI: 10.1111/jsap.12102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate possible pathophysiological mechanisms (reduced plasma calcitriol concentrations and/or presence of concurrent or masked chronic kidney disease) for hypocalcaemiain hyperthyroid cats. METHODS Prospective cohort study. Routine plasma biochemical parameters, plasma parathyroid hormone and calcitriol concentrations, ionized calcium concentrations, and venous pH, were measured at diagnosis and following treatment of hyperthyroidism. Linear regression analysis was used to determine predictors of ionized calcium concentration. RESULTS Hyperthyroid cats (n=45) had lower ionized calcium concentrations than healthy geriatric cats (n=52), however, ionized calcium concentrations were higher in hyperthyroid cats with concurrent or masked chronic kidney disease than non-azotaemic hyperthyroid cats. Plasma calcitriol concentrations were higher in hyperthyroid cats than control cats. Plasma total thyroxine concentration and venous pH were independent predictors of ionized calcium concentration. Plasma total thyroxine concentration was also a predictor of ionized calcium concentration after adjustment for plasma parathyroid hormone and calcitriol concentrations. CLINICAL SIGNIFICANCE Hypocalcaemia in hyperthyroid cats is not associated with the presence of concurrent or masked chronic kidney disease or reduced plasma calcitriol concentrations. Increased thyroid hormone concentrations might influence ionized calcium concentrations through a mechanism, yet to be determined, that is independent of control by parathyroid hormone and calcitriol.
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Affiliation(s)
- T L Williams
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, UK
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Juvet F, Giger U, Battersby I, Menaut P, Syme HM, Mooney CT. Erythrocyte pyruvate kinase deficiency in three West Highland white terriers in Ireland and the UK. Ir Vet J 2013; 66:12. [PMID: 23842571 PMCID: PMC3718623 DOI: 10.1186/2046-0481-66-12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Accepted: 06/10/2013] [Indexed: 11/10/2022] Open
Abstract
Erythrocyte pyruvate kinase (PK) deficiency is described for the first time in three apparently unrelated West Highland white terriers (WHWT) from Ireland and the UK. All three dogs were diagnosed with markedly regenerative but persistent anaemia and had been treated for presumed immune-mediated haemolytic anaemia (IMHA) before hereditary erythrocyte PK-deficiency was confirmed by breed-specific DNA mutation analysis. This hereditary erythroenzymopathy causes haemolytic anaemia and affects several canine breeds with varying degrees of severity. Although eventually causing osteosclerosis, haemosiderosis and death, PK-deficient dogs can adapt to their anaemia for many years.PK-deficiency should be considered in anaemic WHWTs worldwide particularly in dogs with haemolytic anaemia where evidence for an immune-mediated, infectious or toxic underlying cause is lacking.
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Affiliation(s)
- Florence Juvet
- University College Dublin Veterinary Hospital, School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland.
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Williams TL, Elliott J, Syme HM. Renin-angiotensin-aldosterone system activity in hyperthyroid cats with and without concurrent hypertension. J Vet Intern Med 2013; 27:522-9. [PMID: 23517505 DOI: 10.1111/jvim.12062] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 01/08/2013] [Accepted: 01/28/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Hypertension is present in some hyperthyroid cats at diagnosis or can develop after treatment for hyperthyroidism. Activation of the renin-angiotensin-aldosterone system (RAAS) could be involved in the pathogenesis of hypertension. HYPOTHESIS Hyperthyroid cats that develop hypertension before or after treatment for hyperthyroidism will have greater RAAS activation than normotensive cats. ANIMALS Ninety-nine hyperthyroid cats. METHODS Retrospective case-control study. Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were measured in untreated hyperthyroid hypertensive cats (HT-Pre group), initially normotensive hyperthyroid cats that develop hypertension after treatment (HT-Post group), and hyperthyroid cats that are normotensive (NT group). Data are presented as median [25th, 75th percentile]. RESULTS Baseline PRA was not significantly different among the 3 groups (HT-Pre group 1.50 [0.05, 2.37] ng/mL/h, HT-Post group 0.66 [0.17, 2.31] ng/mL/h, NT group 1.11 [0.57, 2.18] ng/mL/h; P = .44). PRA decreased significantly after treatment in the NT group (1.09 [0.53, 2.47] versus 0.22 [0.05, 0.76] ng/mL/h; P < .001) and the HT-Post group (0.71 [0.17, 2.33] versus 0.28 [0.07, 0.57] ng/mL/h; P = .006). Baseline PAC was not significantly different among the 3 groups (HT-Pre group 72.2 [40.0, 145.6] pg/mL, HT-Post group 69.7 [43.3, 142.6] pg/mL, NT group 109.0 [68.2, 184.6] pg/mL; P = .10). PAC decreased significantly after treatment in the NT group (114.4 [56.6, 204.1] versus 59.5 [32.4, 98.2] pg/mL; P < .001) but did not change significantly in the HT-Post group (61.2 [44.9, 124.0] versus 58.4 [42.0, 97.7] pg/mL; P = .59). CONCLUSIONS AND CLINICAL IMPORTANCE RAAS activation occurs in hyperthyroid cats, but is not associated with the development of hypertension. PAC is not influenced by changes in PRA in hyperthyroid cats that develop hypertension after treatment, perhaps indicating RAAS dysfunction in these cats.
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Affiliation(s)
- T L Williams
- Department of Veterinary Clinical Sciences, Royal Veterinary College, North Mymms, UK.
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Geddes RF, Finch NC, Syme HM, Elliott J. The role of phosphorus in the pathophysiology of chronic kidney disease. J Vet Emerg Crit Care (San Antonio) 2013; 23:122-33. [DOI: 10.1111/vec.12032] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 02/02/2013] [Indexed: 12/19/2022]
Affiliation(s)
- Rebecca F. Geddes
- Department of Veterinary Clinical Sciences; Royal Veterinary College; Hawkshead Lane, North Mymms; Hatfield; AL9 7TA; UK
| | - Natalie C. Finch
- Department of Veterinary Basic Sciences; Royal Veterinary College; Royal College Street; Camden; London; NW1 0TU; UK
| | - Harriet M. Syme
- Department of Veterinary Clinical Sciences; Royal Veterinary College; Hawkshead Lane, North Mymms; Hatfield; AL9 7TA; UK
| | - Jonathan Elliott
- Department of Veterinary Basic Sciences; Royal Veterinary College; Royal College Street; Camden; London; NW1 0TU; UK
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Jepson RE, Coulton GR, Cowan ML, Markwell P, Syme HM, Elliott J. Evaluation of mass spectrometry of urinary proteins and peptides as biomarkers for cats at risk of developing azotemia. Am J Vet Res 2013; 74:333-42. [DOI: 10.2460/ajvr.74.2.333] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Finch NC, Syme HM, Elliott J. Parathyroid hormone concentration in geriatric cats with various degrees of renal function. J Am Vet Med Assoc 2012; 241:1326-35. [DOI: 10.2460/javma.241.10.1326] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
OBJECTIVES To identify breed-associated risk factors for urolithiasis in dogs from the UK. METHODS Records of all canine uroliths submitted to Hills Pet Nutrition UK for analysis at the University of Minnesota Urolith Centre over 10 years (1997 to 2006) were reviewed. The results, along with the request forms completed by the submitting veterinarian, were analysed. The most commonly affected breeds, age and gender of the dogs were identified for each of the most common types of uroliths (struvite, calcium oxalate, urate, cystine and mixed). Pearson's chi-squared tests were performed to assess whether certain breeds of dogs were over-represented relative to a reference population (from an insurance database). RESULTS The records of 14,008 urolith submissions were analysed. The relative frequency of struvite remained stable over time, whereas calcium oxalate decreased over the study period. Breeds found to be significantly over-represented for calcium oxalate uroliths included the Chihuahua, miniature poodle and Yorkshire terrier. Staffordshire bull terriers and English bulldogs were at increased risk for cystine uroliths. CLINICAL SIGNIFICANCE Associations between breed, gender, age and urolith formation were similar to those reported elsewhere. However, temporal trends and novel breed predispositions were identified.
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Affiliation(s)
- K Roe
- The Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, West Midlands, B90 4NH
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Abstract
Objective To review the clinical features of stone disease in dogs and cats for a non-veterinary audience. Methods Relevant peer-reviewed scientific reports were reviewed. Results Lower urinary tract stones are more common in dogs and cats than they are in humans. In addition to struvite stones, calcium oxalate, urate and cystine stones are all commonly found in the bladder and the urethra. The genetic basis for stone disease in some breeds of dog has been elucidated. The small size of cats creates technical challenges when managing ureterolithiasis. Conclusions Naturally occurring stone disease in companion animals is a valuable area for further study. The structure of the canine genome might facilitate the identification of novel disease loci in breeds of dog predisposed to stone formation.
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Affiliation(s)
- Harriet M Syme
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK
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Chakrabarti S, Syme HM, Brown CA, Elliott J. Histomorphometry of feline chronic kidney disease and correlation with markers of renal dysfunction. Vet Pathol 2012; 50:147-55. [PMID: 22773469 DOI: 10.1177/0300985812453176] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chronic kidney disease is common in geriatric cats, but most cases have nonspecific renal lesions, and few studies have correlated these lesions with clinicopathological markers of renal dysfunction. The aim of this study was to identify the lesions best correlated with renal function and likely mediators of disease progression in cats with chronic kidney disease. Cats were recruited through 2 first-opinion practices between 1992 and 2010. When postmortem examinations were authorized, renal tissues were preserved in formalin. Sections were evaluated by a pathologist masked to all clinicopathological data. They were scored semiquantitatively for the severity of glomerulosclerosis, interstitial inflammation, and fibrosis. Glomerular volume was measured using image analysis; the percentage of glomeruli that were obsolescent was recorded. Sections were assessed for hyperplastic arteriolosclerosis and tubular mineralization. Kidneys from 80 cats with plasma biochemical data from the last 2 months of life were included in the study. Multivariable linear regression (P < .05) was used to assess the association of lesions with clinicopathological data obtained close to death. Interstitial fibrosis was the lesion best correlated with the severity of azotemia, hyperphosphatemia, and anemia. Proteinuria was associated with interstitial fibrosis and glomerular hypertrophy, whereas higher time-averaged systolic blood pressure was associated with glomerulosclerosis and hyperplastic arteriolosclerosis.
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Affiliation(s)
- S Chakrabarti
- Department of Veterinary Basic Sciences, Royal Veterinary College, Camden, London, UK.
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Chakrabarti S, Syme HM, Elliott J. Clinicopathological variables predicting progression of azotemia in cats with chronic kidney disease. J Vet Intern Med 2012; 26:275-81. [PMID: 22269057 DOI: 10.1111/j.1939-1676.2011.00874.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 11/17/2011] [Accepted: 12/15/2011] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is common in geriatric cats, but often appears to be stable for long periods of time. OBJECTIVES To describe CKD progression and identify risk factors for progression in newly diagnosed azotemic cats. ANIMALS A total of 213 cats with CKD (plasma creatinine concentration > 2 mg/dL, urine specific gravity < 1.035) were followed up until progression occurred or for at least 1 year; 132, 73, and 8 cats were in International Renal Interest Society (IRIS) stages 2, 3, and 4, respectively. METHODS Progression was defined as a 25% increase in plasma creatinine concentration. Logistic regression was used to assess variables at diagnosis that were associated with progression within 1 year. Changes in IRIS stage during follow-up also were described. Cases that remained in stages 2 or 3, but did not have renal function assessed in the last 60 days of life, were excluded from analysis of the proportion reaching stage 4. RESULTS Of the cats, 47% (101) progressed within 1 year of diagnosis. High plasma phosphate concentration and high urine protein-to-creatinine ratio (UPC) predicted progression in all cats. Low PCV and high UPC independently predicted progression in stage 2 cats, whereas higher plasma phosphate concentration predicted progression in stage 3 cats; 19% (18/94) of cats diagnosed in stage 2; and 63% (34/54) of cats diagnosed in stage 3 reached stage 4 before they died. CONCLUSIONS Proteinuria, anemia, and hyperphosphatemia may reflect more progressive kidney disease. Alternatively, they may be markers for mechanisms of progression such as tubular protein overload, hypoxia, and nephrocalcinosis.
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Affiliation(s)
- S Chakrabarti
- Department of Veterinary Basic Sciences, Royal Veterinary College, London, UK.
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Finch NC, Syme HM, Elliott J, Peters AM, Gerritsen R, Croubels S, Heiene R. Glomerular filtration rate estimation by use of a correction formula for slope-intercept plasma iohexol clearance in cats. Am J Vet Res 2011; 72:1652-9. [DOI: 10.2460/ajvr.72.12.1652] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Crawford C, Kennedy-Lydon TM, Callaghan H, Sprott C, Simmons RL, Sawbridge L, Syme HM, Unwin RJ, Wildman SSP, Peppiatt-Wildman CM. Extracellular nucleotides affect pericyte-mediated regulation of rat in situ vasa recta diameter. Acta Physiol (Oxf) 2011; 202:241-51. [PMID: 21624094 DOI: 10.1111/j.1748-1716.2011.02310.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM We hypothesized that extracellular nucleotides, established as being released from renal tubular epithelial cells, act at pericytes to regulate vasa recta capillary diameter. METHODS A rat live kidney slice model and video imaging techniques were used to investigate the effects of extracellular nucleotides on in situ (subsurface) vasa recta diameter at pericyte and non-pericyte sites. In addition, RT-qPCR was used to quantify P2 receptor mRNA expression in isolated vasa recta. RESULTS Extracellular ATP, UTP, benzylbenzyl ATP (BzATP) or 2-methylthioATP (2meSATP) evoked a significantly greater vasoconstriction of subsurface vasa recta at pericytes than at non-pericyte sites. The rank order of agonist potency was BzATP = 2meSATP > ATP = UTP. The vasoconstriction evoked at pericyte sites by ATP was significantly attenuated by the P2 receptor antagonists suramin, pyridoxal phosphate-6-azo(benzene-2,4-disulfonic acid) (PPADS) or Reactive Blue-2 (RB-2). UTP-evoked vasoconstriction at pericytes was attenuated by suramin or RB-2 but not PPADS. Interestingly, suramin or PPADS, when applied in the absence of a P2 receptor agonist, evoked a weak but significant vasoconstriction of vasa recta at pericyte sites, suggesting tonic vasodilation by nucleotides. Significant levels of P2X(1, 3 and 7) and P2Y(4 and 6) receptor mRNA were detected in vasa recta. CONCLUSION Extracellular nucleotides act at pericytes to cause vasoconstriction of in situ vasa recta. Pharmacological characterization, supported by RT-qPCR data, suggests that P2X(1 and 7) and P2Y(4) receptors mediate nucleotide-evoked vasoconstriction of vasa recta by pericytes. We propose that nucleotides released from renal tubular epithelial cells, in close proximity to vasa recta capillaries, are key in regulating renal medullary blood flow.
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Affiliation(s)
- C Crawford
- Urinary System Physiology Unit, Department of Veterinary Basic Sciences, Royal Veterinary College, London, UK
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Connolly DJ, Hezzell MJ, Fuentes VL, Chang YM, Swan R, Syme HM. The effect of protease inhibition on the temporal stability of NT-proBNP in feline plasma at room temperature. J Vet Cardiol 2011; 13:13-9. [DOI: 10.1016/j.jvc.2010.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 10/25/2010] [Accepted: 11/01/2010] [Indexed: 11/16/2022]
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Abstract
UNLABELLED CLINICAL PRESENTATION AND INVESTIGATIONS: An 11-week-old female domestic shorthair kitten presented with a history of constipation since weaning. Abdominal distension was noted on physical examination and abdominal radiographs revealed a large volume of faeces in the descending and transverse colon. Colonoscopy was unremarkable and euthanasia was performed at the owners' request. DIAGNOSIS The histological diagnosis of large intestinal hypoganglionosis was made post mortem. SIGNIFICANCE This appears to be the first reported case of congenital hypoganglionosis in a kitten with histopathological confirmation of the diagnosis. It may potentially be a more common cause of constipation in kittens and young cats than has previously been suspected.
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Affiliation(s)
- Kirsty A M Roe
- Royal Veterinary College, Royal College Street, London NW1 0TU, UK.
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Jepson RE, Syme HM, Markwell P, Miyazaki M, Yamashita T, Elliott J. Measurement of urinary cauxin in geriatric cats with variable plasma creatinine concentrations and proteinuria and evaluation of urine cauxin-to-creatinine concentration ratio as a predictor of developing azotemia. Am J Vet Res 2010; 71:982-7. [DOI: 10.2460/ajvr.71.8.982] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Jepson RE, Vallance C, Syme HM, Elliott J. Assessment of urinary N-acetyl-β-D-glucosaminidase activity in geriatric cats with variable plasma creatinine concentrations with and without azotemia. Am J Vet Res 2010; 71:241-7. [DOI: 10.2460/ajvr.71.2.241] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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