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Johnson TW, Holt J, Kleyman A, Zhou S, Sammut E, Bruno VD, Gaupp C, Stanzani G, Martin J, Arina P, Deutsch J, Ascione R, Singer M, Dyson A. Development and translation of thiometallate sulfide donors using a porcine model of coronary occlusion and reperfusion. Redox Biol 2024; 73:103167. [PMID: 38688060 PMCID: PMC11070758 DOI: 10.1016/j.redox.2024.103167] [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: 02/15/2024] [Revised: 04/12/2024] [Accepted: 04/22/2024] [Indexed: 05/02/2024] Open
Abstract
Sulfide-releasing compounds reduce reperfusion injury by decreasing mitochondria-derived reactive oxygen species production. We previously characterised ammonium tetrathiomolybdate (ATTM), a clinically used copper chelator, as a sulfide donor in rodents. Here we assessed translation to large mammals prior to clinical testing. In healthy pigs an intravenous ATTM dose escalation revealed a reproducible pharmacokinetic/pharmacodynamic (PK/PD) relationship with minimal adverse clinical or biochemical events. In a myocardial infarction (1-h occlusion of the left anterior descending coronary artery)-reperfusion model, intravenous ATTM or saline was commenced just prior to reperfusion. ATTM protected the heart (24-h histological examination) in a drug-exposure-dependent manner (r2 = 0.58, p < 0.05). Blood troponin T levels were significantly (p < 0.05) lower in ATTM-treated animals while myocardial glutathione peroxidase activity, an antioxidant selenoprotein, was elevated (p < 0.05). Overall, our study represents a significant advance in the development of sulfides as therapeutics and underlines the potential of ATTM as a novel adjunct therapy for reperfusion injury. Mechanistically, our study suggests that modulating selenoprotein activity could represent an additional mode of action of sulfide-releasing drugs.
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Affiliation(s)
- Thomas W Johnson
- Translational Biomedical Research Centre (TBRC), Faculty of Health Science, University of Bristol, UK
| | - James Holt
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
| | - Anna Kleyman
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
| | - Shengyu Zhou
- Institute of Pharmaceutical Science, King's College London, London, UK; Centre for Pharmaceutical Medicine Research, King's College London, London, UK
| | - Eva Sammut
- Translational Biomedical Research Centre (TBRC), Faculty of Health Science, University of Bristol, UK
| | - Vito Domenico Bruno
- Translational Biomedical Research Centre (TBRC), Faculty of Health Science, University of Bristol, UK
| | - Charlotte Gaupp
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
| | - Giacomo Stanzani
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
| | - John Martin
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
| | - Pietro Arina
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
| | - Julia Deutsch
- Translational Biomedical Research Centre (TBRC), Faculty of Health Science, University of Bristol, UK
| | - Raimondo Ascione
- Translational Biomedical Research Centre (TBRC), Faculty of Health Science, University of Bristol, UK
| | - Mervyn Singer
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK.
| | - Alex Dyson
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK; Institute of Pharmaceutical Science, King's College London, London, UK; Centre for Pharmaceutical Medicine Research, King's College London, London, UK.
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Cortellini S, DeClue AE, Giunti M, Goggs R, Hopper K, Menard JM, Rabelo RC, Rozanski EA, Sharp CR, Silverstein DC, Sinnott-Stutzman V, Stanzani G. Defining sepsis in small animals. J Vet Emerg Crit Care (San Antonio) 2024; 34:97-109. [PMID: 38351524 DOI: 10.1111/vec.13359] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To discuss the definitions of sepsis in human and veterinary medicine. DESIGN International, multicenter position statement on the need for consensus definitions of sepsis in veterinary medicine. SETTING Veterinary private practice and university teaching hospitals. ANIMALS Dogs and cats. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Sepsis is a life-threatening condition associated with the body's response to an infection. In human medicine, sepsis has been defined by consensus on 3 occasions, most recently in 2016. In veterinary medicine, there is little uniformity in how sepsis is defined and no consensus on how to identify it clinically. Most publications rely on modified criteria derived from the 1991 and 2001 human consensus definitions. There is a divergence between the human and veterinary descriptions of sepsis and no consensus on how to diagnose the syndrome. This impedes research, hampers the translation of pathophysiology insights to the clinic, and limits our abilities to optimize patient care. It may be time to formally define sepsis in veterinary medicine to help the field move forward. In this narrative review, we present a synopsis of prior attempts to define sepsis in human and veterinary medicine, discuss developments in our understanding, and highlight some criticisms and shortcomings of existing schemes. CONCLUSIONS This review is intended to serve as the foundation of current efforts to establish a consensus definition for sepsis in small animals and ultimately generate evidence-based criteria for its recognition in veterinary clinical practice.
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Affiliation(s)
- Stefano Cortellini
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK
| | - Amy E DeClue
- Fetch Specialty and Emergency Veterinary Center, Greenville, South Carolina, USA
| | - Massimo Giunti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Robert Goggs
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, USA
| | - Kate Hopper
- Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Julie M Menard
- Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Elizabeth A Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
| | - Deborah C Silverstein
- Department of Clinical Studies and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Wahldén L, Stanzani G, Cutler S, Barfield D, Manson KC, Wilson HE, Thomas EK. Evaluation of Therapeutic Use of Antifibrinolytics in Cats. J Am Anim Hosp Assoc 2023; 59:177-183. [PMID: 37432789 DOI: 10.5326/jaaha-ms-7349] [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] [Accepted: 05/01/2023] [Indexed: 07/13/2023]
Abstract
Limited data are available regarding the use of the antifibrinolytic drugs tranexamic acid (TXA) and epsilon aminocaproic acid (EACA) in cats. This study aimed to evaluate the indications for the use of TXA and EACA in cats and to describe dosing regimens used, occurrence of adverse events, and patient outcomes. This was a retrospective multicenter study. Medical databases were searched for feline patients billed for TXA or EACA between 2015 and 2021. Thirty-five cats met the inclusion criteria; 86% received TXA and 14% received EACA. The most common indication was nontraumatic hemorrhage (54%), followed by traumatic hemorrhage (17%) and elective surgery (11%). The median dose was 10 mg/kg for TXA and 50 mg/kg for EACA. Overall, 52% of cats survived to discharge. Potential adverse events were noted in 7/35 (20%) patients. Of these, 29% survived to discharge. No standardized dosing regimen was identified; rather, dose, dosing interval, and duration of administration varied markedly between patients. Administration was potentially associated with severe adverse events, although the retrospective design makes it difficult to establish a causal association with antifibrinolytic use. This study provides a base for future prospective studies by giving an insight into the use of antifibrinolytic drugs in cats.
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Affiliation(s)
- Lotta Wahldén
- From AniCura Regiondjursjukhuset Bagarmossen, Stockholm, Sweden (L.W.)
- Dick White Referrals, Cambridgeshire, UK (L.W., G.S., E.K.T.)
| | | | - Simone Cutler
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, UK (S.M.C.)
| | - Dominic Barfield
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK (D.B.)
| | - Katrina C Manson
- Cummings School of Veterinary Medicine, Tufts University, Grafton, Massachusetts (K.C.M.)
| | - Helen E Wilson
- Langford Vets, University of Bristol, Bristol, UK (H.E.W.)
| | - Emily K Thomas
- Dick White Referrals, Cambridgeshire, UK (L.W., G.S., E.K.T.)
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Ferro L, Ciccarelli S, Stanzani G, Nappi L, Angelini F, Leo C. Appetite Stimulant and Anti-Emetic Effect of Mirtazapine Transdermal Ointment in Cats Affected by Lymphoma Following Chemotherapy Administration: A Multi-Centre Retrospective Study. Animals (Basel) 2022; 12:ani12020155. [PMID: 35049778 PMCID: PMC8772540 DOI: 10.3390/ani12020155] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Feline cancer patients’ owners are increasingly willing to undertake oncologic treatment, such as chemotherapy. Concerns regarding worsening quality of life are common since chemotherapy could cause toxicities, such as vomiting, nausea, anorexia, and consequently weight loss. In humans, mirtazapine effectively prevents chemotherapy-induced nausea and vomiting, improving the quality of life in people receiving chemotherapy. Recently, the use of mirtazapine transdermal ointment has been evaluated in cats with non-cancer diseases. This study describes the use of transdermal mirtazapine administration in cats diagnosed with lymphoma and receiving chemotherapy. Patients included in the study did not receive any prophylactic anti-emetics other than transdermal mirtazapine. Data regarding patients, type of chemotherapy, and incidence of weight loss and gastrointestinal toxicities were retrospectively evaluated. Transdermal mirtazapine was well tolerated, and substantial weight loss was not observed in the 14 days following chemotherapy administration. These results support further studies assessing the impact of mirtazapine in preventing chemotherapy-induced gastrointestinal toxicity in cats. Abstract In humans, mirtazapine can prevent chemotherapy-induced nausea and vomiting (CINV) and improve cancer patients’ quality of life (QoL). This drug is being increasingly used as an appetite stimulant in cats. The hypothesis of this retrospective study was that mirtazapine could reduce the incidence of CINV and weight loss in feline patients affected by lymphoma. The objectives were to report the use of mirtazapine transdermal ointment and assess the incidence of gastrointestinal (GI) toxicity and weight loss in cats diagnosed with lymphoma and receiving chemotherapy. Transdermal mirtazapine was topically administered to the inner surface of the pinna (2 mg/cat/daily) for 14 days following chemotherapy administration. Data recorded from 20 patients were collected. Different grades of GI toxicity were shown in 8/20 (40%) patients. Body weight (BW), body condition score (BCS), and muscle condition score (MCS) improved in 12/20 (60%), 6/20 (30%), and 2/20 (10%) cats, respectively. Mirtazapine-induced adverse events (AEs) occurred in 4/20 (20%) cats and did not require mirtazapine discontinuation. Substantial weight loss was not encountered, suggesting that patients had an adequate food intake after chemotherapy administration. Transdermal mirtazapine ointment was considered safe and well tolerated.
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Affiliation(s)
- Livia Ferro
- Anicura Istituto Veterinario Novara, 28060 Granozzo con Monticello, Italy;
- Correspondence: ; Tel.: +39-333-326-4604
| | - Stefano Ciccarelli
- Department of Veterinary Medicine, University of Bari “Aldo Moro”, 370100 Valenzano, Italy;
| | | | - Lisa Nappi
- Anicura Centro Oncologico Veterinario, 40037 Sasso Marconi, Italy;
| | | | - Chiara Leo
- Anicura Istituto Veterinario Novara, 28060 Granozzo con Monticello, Italy;
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Arulkumaran N, Pollen SJ, Tidswell R, Gaupp C, Peters VBM, Stanzani G, Snow TAC, Duchen MR, Singer M. Selective mitochondrial antioxidant MitoTEMPO reduces renal dysfunction and systemic inflammation in experimental sepsis. Br J Anaesth 2021; 127:577-586. [PMID: 34332740 DOI: 10.1016/j.bja.2021.05.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/04/2021] [Accepted: 05/27/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Excess mitochondrial reactive oxygen species (mROS) in sepsis is associated with organ failure, in part by generating inflammation through the NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome. We determined the impact of a mitochondrial-targeted antioxidant (MitoTEMPO) on mitochondrial dysfunction in renal proximal tubular epithelial cells, peritoneal immune cell function ex vivo, and organ dysfunction in a rat model of sepsis. METHODS The effects of MitoTEMPO were assessed ex vivo using adenosine triphosphate and lipopolysaccharide-stimulated rat peritoneal immune cells and fresh rat kidney slices exposed to serum from septic rats. We assessed mROS production and phagocytotic capacity (flow cytometry), mitochondrial functionality (multiphoton imaging, respirometry), and NLRP3 inflammasome activation in cell culture. The effect of MitoTEMPO on organ dysfunction was evaluated in a rat model of faecal peritonitis. RESULTS MitoTEMPO decreased septic serum-induced mROS (P<0.001) and maintained normal reduced nicotinamide adenine dinucleotide redox state (P=0.02) and mitochondrial membrane potential (P<0.001) in renal proximal tubular epithelial cells ex vivo. In lipopolysaccharide-stimulated peritoneal immune cells, MitoTEMPO abrogated the increase in mROS (P=0.006) and interleukin-1β (IL-1β) (P=0.03) without affecting non-mitochondrial oxygen consumption or the phagocytotic-induced respiratory burst (P>0.05). In vivo, compared with untreated septic animals, MitoTEMPO reduced systemic IL-1β (P=0.01), reduced renal oxidative stress as determined by urine isoprostane levels (P=0.04), and ameliorated renal dysfunction (reduced serum urea (P<0.001) and creatinine (P=0.05). CONCLUSIONS Reduction of mROS by a mitochondria-targeted antioxidant reduced IL-1β, and protected mitochondrial, cellular, and organ functionality after septic insults.
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Affiliation(s)
- Nishkantha Arulkumaran
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK.
| | - Sean J Pollen
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
| | - Robert Tidswell
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
| | - Charlotte Gaupp
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
| | - Vera B M Peters
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
| | - Giacomo Stanzani
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
| | - Timothy A C Snow
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
| | - Michael R Duchen
- Department of Cell and Development Biology, University College London, London, UK
| | - Mervyn Singer
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
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Eiras-Diaz A, FrykforsvonHekkel A, Hanot E, Stanzani G, Florey J, Miller R, Llabres-Diaz F. CT findings, management and short-term outcome of dogs with pyothorax: 101 cases (2010 to 2019). J Small Anim Pract 2021; 62:959-966. [PMID: 34254321 DOI: 10.1111/jsap.13374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 02/09/2021] [Accepted: 04/29/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To describe diagnosis, CT findings, management and short-term outcome of a large population of canine pyothorax cases. METHODS Retrospective analysis of 101 canine pyothorax cases at two UK referral centres. Medical records and CT images were reviewed. Dogs were included if pre- and post-contrast CT was performed within 48 hours of presentation. RESULTS CT abnormalities included pleural thickening (84.1%), pannus (67.3%), pneumothorax (61.4%), mediastinal effusion (28.7%), pulmonary (13.8%) and mediastinal (7.9%) abscessation, foreign body presence (7.9%), foreign body tracts (6.9%) and pneumonia (6.9%). Seventy-one percent of dogs were managed surgically, of which 90.2% survived, and 29% were managed medically, of which 72.4% survived. Overall mortality was 14.8% and 86.6% of these dogs died within 48 hours of admission. All dogs with evidence of a foreign body on CT underwent surgery. CLINICAL SIGNIFICANCE Mortality in our population was low and most dogs that died did so within 48 hours of hospitalisation, regardless of management type.
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Affiliation(s)
- A Eiras-Diaz
- Dick White Referrals, Newmarket, Station Farm, London Road, Cambridgeshire, CB8 0UH, UK.,Southfields Veterinary Specialists, 1 Bramston Way, Basildon, SS15 6TP, UK
| | - A FrykforsvonHekkel
- Queen Mother Hospital for Animals, Royal Veterinary College, University of London, North Mymms, AL9 7TA, UK
| | - E Hanot
- Dick White Referrals, Newmarket, Station Farm, London Road, Cambridgeshire, CB8 0UH, UK
| | - G Stanzani
- Dick White Referrals, Newmarket, Station Farm, London Road, Cambridgeshire, CB8 0UH, UK.,Bloomsbury Institute for Intensive Care Medicine, University College London, Gower Street, London, WC1E 6BT, UK
| | - J Florey
- Dick White Referrals, Newmarket, Station Farm, London Road, Cambridgeshire, CB8 0UH, UK
| | - R Miller
- Dick White Referrals, Newmarket, Station Farm, London Road, Cambridgeshire, CB8 0UH, UK
| | - F Llabres-Diaz
- Queen Mother Hospital for Animals, Royal Veterinary College, University of London, North Mymms, AL9 7TA, UK
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Kleyman A, Cesar A, Stanzani G, Arulkumaran N, Khaliq W, Andreis DT, Bollen Pinto B, Waugh M, Singer M. Correction to: Dysregulated expression of the b2-adrenergic receptor insepsis. Intensive Care Med Exp 2021; 9:7. [PMID: 33595727 PMCID: PMC7889773 DOI: 10.1186/s40635-021-00375-x] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via the original article.
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Affiliation(s)
- A Kleyman
- University College London, Bloomsbury Institute of Intensive Care Medicine, London, UK.
| | - A Cesar
- University College London, Bloomsbury Institute of Intensive Care Medicine, London, UK
| | - G Stanzani
- University College London, Bloomsbury Institute of Intensive Care Medicine, London, UK
| | - N Arulkumaran
- University College London, Bloomsbury Institute of Intensive Care Medicine, London, UK
| | - W Khaliq
- Intensive Care Unit, University Hospital Lewisham, London, UK
| | - D T Andreis
- University College London, Bloomsbury Institute of Intensive Care Medicine, London, UK
| | - B Bollen Pinto
- Anesthesiology, Hôpitaux Universitaires de Genève (HUG), Genève, Switzerland
| | - M Waugh
- University College London, Bloomsbury Institute of Intensive Care Medicine, London, UK
| | - M Singer
- University College London, Bloomsbury Institute of Intensive Care Medicine, London, UK
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Stilwell C, Bazelle J, Walker D, Stanzani G, Florey J. Detrusor urethral dyssynergy in dogs: 35 cases (2007-2019). J Small Anim Pract 2020; 62:468-477. [PMID: 33345305 DOI: 10.1111/jsap.13286] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/06/2020] [Accepted: 11/26/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To evaluate clinical presentation, diagnosis, treatment and outcome of dogs diagnosed with detrusor urethral dyssynergy. MATERIALS AND METHODS Multicentre (n = 3 UK referral clinics), retrospective, observational study. Database searches were performed (2007 to 2019) to identify dogs with detrusor urethral dyssynergy. Dogs with structural abnormalities or detectable neurological disorders affecting micturition were excluded. Clinical presentation, diagnostic procedures, treatment and outcome were evaluated. RESULTS Thirty-five dogs were included. Middle-aged, large-breed, male neutered dogs were most frequently documented. Four female dogs were included. Fifteen breeds, including Labrador retrievers (8/35; 22.9%), golden retrievers (5/35;14.3%) and cross-breeds (5/35; 14.3%) were identified. Median duration of clinical signs was 152 days (range 0 to 1095). All dogs were dysuric at presentation with 17/35 (48.6%) reported to have an altered stream of urine and 17/35 (48.6%) to be stranguric. Follow-up data were available for 34 dogs (median 136 days, range 4 to 2188). Response was classified as good (20/34; 58.8%), partial (7/34; 20.5%) or poor (7/34; 20.5%). Overall time to response was known for 21 of 34 dogs (partial n = 6, good n = 15) with a median of 11 days (range 1 to 155). Four dogs had surgical intervention (castration n = 4, cystostomy tube n = 2). Three dogs were euthanased due to partial (n = 1) or poor (n = 2) response. Medications were discontinued in 11 of 20 (55.0%) dogs with a good response to therapy, two of these relapsed. CLINICAL SIGNIFICANCE Detrusor urethral dyssynergy is an uncommon micturition disorder in dogs, in particular females. Medical therapy with or without surgery resulted in a favourable prognosis in the majority of dogs, although many require long-term medication.
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Affiliation(s)
- C Stilwell
- Dick White Referrals, Cambridge, CB8 0UH, UK
| | - J Bazelle
- Davies Vet Specialists, Hitchin, SG5 3HR, UK
| | - D Walker
- Anderson Moores, Winchester, SO21 2LL, UK
| | - G Stanzani
- Dick White Referrals, Cambridge, CB8 0UH, UK
| | - J Florey
- Dick White Referrals, Cambridge, CB8 0UH, UK
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Valiente P, Trehy M, White R, Nelissen P, Demetriou J, Stanzani G, de la Puerta B. Complications and outcome of cats with congenital extrahepatic portosystemic shunts treated with thin film: Thirty-four cases (2008-2017). J Vet Intern Med 2019; 34:117-124. [PMID: 31742779 PMCID: PMC6979105 DOI: 10.1111/jvim.15649] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 01/12/2019] [Accepted: 10/08/2019] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Congenital extrahepatic portosystemic shunts (CEHPSS) are rare in cats. Outcome after attenuation of CEHPSS with thin film has been described in a small number of cases. OBJECTIVES To describe the clinical presentation, postoperative complications, and outcome of cats treated with thin film to attenuate CEHPSS. ANIMALS Thirty-four cats with CEHPSS were identified from the database of 3 institutions over 9 years. METHODS Retrospective study. Medical records were reviewed to identify cats with a diagnosis of a CEHPSS that underwent surgical attenuation. Congenital extrahepatic portosystemic shunts were suspected from clinical signs, clinicopathologic findings, and diagnostic imaging, and confirmed at exploratory laparotomy. Cats treated with thin film band attenuation were included. Postoperative complications and follow-up were recorded. RESULTS Complications were recorded in 11 of 34 cats. Deaths related to CEHPSS occurred in 6 of 34; 4 cats did not survive to discharge. Persistent seizures were the cause of death in 4 cats. Seizures were recorded in 8 of 34 cats after surgery; all these cats received preoperative antiepileptic drugs. Serum bile acid concentrations normalized in 25 of 28 of the cats for which data was available. Three cats had persistently increased serum bile acid concentrations and underwent a second exploratory laparotomy. One had a patent shunt, the other 2 had multiple acquired portosystemic shunts. Median follow-up was 8 months (0.5-84 months). CONCLUSIONS AND CLINICAL IMPORTANCE Congenital extrahepatic portosystemic shunts attenuation using thin film in cats carries a good short- and mid-term prognosis if they survive the postoperative period. Seizures were the most common cause of death.
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Affiliation(s)
| | - Mary Trehy
- North Downs Specialist Referrals, Bletchingley, United Kingdom
| | - Rob White
- School of Veterinary Medicine and Science, University of Nottingham, Leicestershire, United Kingdom
| | | | | | - Giacomo Stanzani
- Division of Medicine, Bloomsbury Institute for Intensive Care Medicine, University College London, London, United Kingdom
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Lombardi A, Maggi S, Stanzani G, Vitale V, Bersigotti L, Romano C, Vittori J, Pastore E, Amanti C. Oncological outcomes in oncoplastic breast surgery: a single institution analysis. G Chir 2019; 40:417-420. [PMID: 32003721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Oncoplastic surgery is a well-acknowledged technique that combines conserving treatment in breast cancer with plastic surgery reconstruction. The aim of our analysis is to evaluate the safety of this surgical procedure in the setting of invasive primary breast cancer, and then compare breast oncoplastic surgery with the Veronesi quadrantectomy.We have analyzed 1541 patients who underwent breast surgery for primary breast tumor between October 2004 and May 2018 at Sant'Andrea University Hospital in Rome: 880 women experienced the breast oncoplastic approach, while 660 patients received conservative surgery alone. The median follow-up time was 14 years with a completeness of 70% (1067 pts vs 1554). The statistic comparison across these subpopulations suggested that there are no statistically significant results in term of Overall Survival, Disease Related Survival, Local recurrence or positive margins. Therefore oncoplastic surgery for primary invasive breast cancer represents a feasible procedure and an oncological safe surgical option.
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Skulberg R, Cortellini S, Chan DL, Stanzani G, Jepson RE. Description of the Use of Plasma Exchange in Dogs With Cutaneous and Renal Glomerular Vasculopathy. Front Vet Sci 2018; 5:161. [PMID: 30073173 PMCID: PMC6060235 DOI: 10.3389/fvets.2018.00161] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 03/29/2018] [Accepted: 06/26/2018] [Indexed: 01/26/2023] Open
Abstract
Cutaneous and renal glomerular vasculopathy (CRGV) is a rare disease affecting dogs, with a recent apparent increase in prevalence since 2012 in the UK. This disease is characterized by a vasculopathy affecting small vessels of the kidney and skin, leading to thrombotic microangiopathy. The underlying etiology remains unknown although clinicopathological and histological findings resemble features of certain forms of thrombotic microangiopathy in people, for which plasma exchange (PEX) is considered an important component of therapy. The objective of the present study is to describe the use of PEX as adjunctive treatment in dogs diagnosed with CRGV. A retrospective review of dogs diagnosed with CRGV between 2014 and 2016 treated with PEX was performed. Clinical records were reviewed and data relating to signalment, diagnostic tests and management strategies were summarized. Information and complications relating to PEX were recorded. Six dogs were diagnosed with CRGV (n = 2 ante-mortem, n = 4 post-mortem) and underwent PEX as part of their therapy. All dogs had cutaneous lesions and were azotemic with oliguria or anuria. All dogs underwent at least one PEX cycle; one dog had a single cycle PEX, three dogs two cycles PEX, and two dogs had one cycle PEX and one cycle of prolonged intermittent renal replacement treatment. Complications seen during PEX therapy included hypothermia (n = 4), tachycardia (n = 2), hypotension (n = 2), and hypocalcemia (n = 6). Two dogs survived to discharge, the remaining four dogs were euthanized. The positive outcome in two dogs treated with PEX despite the reported high mortality rate once acute kidney injury with oliguria/anuria occurs does not confirm success of this treatment. However, survival in two dogs that were initially oligoanuric highlights that further consideration and evaluation of PEX for this patient group is warranted for this specific disease. Additional studies are urgently needed to identify the underlying etiology of CRGV before more targeted therapies can be developed. Based on our findings, further evaluation of the role of PEX in this specific disease are warranted.
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Affiliation(s)
- Ragnhild Skulberg
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| | - Stefano Cortellini
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| | - Daniel L Chan
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| | - Giacomo Stanzani
- Division of Medicine, Bloomsbury Institute for Intensive Care Medicine, University College London, London, United Kingdom
| | - Rosanne E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
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Antonelli MS, Mallel G, Pecoraro A, Vitale V, Maggi S, Lombardi A, Stanzani G, Amanti C. Adenomyoepithelioma of the breast: case report and literature review. G Chir 2018; 39:255-257. [PMID: 30039795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Adenomyoepithelioma are uncommon tumors. The majority of them occur in women in the fifth and sixth decades who usually present with a self-palpated, solitary breast mass or a lesion identified on mammography. We report the case of adenomyoepithelioma of the breast with malignant transformation of both myoepitheliel and epithelial components diagnosed as malignancy during the preoperative stage in a seventy-six year old woman.
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Lee KCL, Baker L, Mallett S, Riddell A, Chowdary P, Alibhai H, Chang YM, Priestnall S, Stanzani G, Davies N, Mookerjee R, Jalan R, Agarwal B. Hypercoagulability progresses to hypocoagulability during evolution of acetaminophen-induced acute liver injury in pigs. Sci Rep 2017; 7:9347. [PMID: 28839178 PMCID: PMC5571150 DOI: 10.1038/s41598-017-09508-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 07/26/2017] [Indexed: 02/06/2023] Open
Abstract
Increases in prothrombin time (PT) and international normalised ratio (INR) characterise acute liver injury (ALI) and failure (ALF), yet a wide heterogeneity in clotting abnormalities exists. This study defines evolution of coagulopathy in 10 pigs with acetaminophen (APAP)-induced ALI compared to 3 Controls. APAP administration began at 0 h and continued to ‘ALF’, defined as INR >3. In APAP pigs, INR was 1.05 ± 0.02 at 0 h, 2.15 ± 0.43 at 16 h and > 3 at 18 ± 1 h. At 12 h thromboelastography (TEG) demonstrated increased clot formation rate, associated with portal vein platelet aggregates and reductions in protein C, protein S, antithrombin and A Disintegrin and Metalloprotease with Thrombospondin type 1 repeats–13 (ADAMTS-13) to 60%, 24%, 47% and 32% normal respectively. At 18 ± 1 h, INR > 3 was associated with: hypocoagulable TEG profile with heparin-like effect; falls in thrombin generation, Factor V and Factor VIII to 52%, 19% and 17% normal respectively; further decline in anticoagulants; thrombocytopenia; neutrophilia and endotoxemia. Multivariate analysis, found that ADAMTS-13 was an independent predictor of a hypercoagulable TEG profile and platelet count, endotoxin, Protein C and fibrinogen were independent predictors of a hypocoagulable TEG profile. INR remained normal in Controls. Dynamic changes in coagulation occur with progression of ALI: a pro-thrombotic state progresses to hypocoagulability.
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Affiliation(s)
- Karla Chui Luan Lee
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hertfordshire, UK. .,Liver Failure Group, Institute of Liver and Digestive Health, University College London Medical School Royal Free Campus, London, UK.
| | - Luisa Baker
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hertfordshire, UK
| | - Susan Mallett
- Department of Anaesthesia, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
| | - Anne Riddell
- Katherine Dormandy Haemophilia and Thrombosis Centre, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
| | - Pratima Chowdary
- Katherine Dormandy Haemophilia and Thrombosis Centre, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
| | - Hatim Alibhai
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hertfordshire, UK
| | - Yu-Mei Chang
- Department of Research Support, The Royal Veterinary College, University of London, Hertfordshire, UK
| | - Simon Priestnall
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, University of London, Hertfordshire, UK
| | - Giacomo Stanzani
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hertfordshire, UK
| | - Nathan Davies
- Liver Failure Group, Institute of Liver and Digestive Health, University College London Medical School Royal Free Campus, London, UK
| | - Rajeshwar Mookerjee
- Liver Failure Group, Institute of Liver and Digestive Health, University College London Medical School Royal Free Campus, London, UK
| | - Rajiv Jalan
- Liver Failure Group, Institute of Liver and Digestive Health, University College London Medical School Royal Free Campus, London, UK
| | - Banwari Agarwal
- Department of Intensive Care Medicine, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
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Drozdzynska MJ, Chang YM, Stanzani G, Pelligand L. Evaluation of the dynamic predictors of fluid responsiveness in dogs receiving goal-directed fluid therapy. Vet Anaesth Analg 2017; 45:22-30. [PMID: 29203173 DOI: 10.1016/j.vaa.2017.06.001] [Citation(s) in RCA: 20] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 05/15/2017] [Accepted: 06/06/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Goal-directed fluid therapy (GDFT) based on pulse pressure variation (PPV) was used in anaesthetized dogs undergoing abdominal surgeries. The aims were 1) to evaluate the success rate of the PPV ≥13% in detecting fluid responsiveness [delta stroke volume (ΔSV) ≥10%]; 2) to assess the correlation between PPV, systolic pressure variation (SPV), Plethysmograph Variability Index (PVI) and central venous pressure (CVP) and 3) to establish the threshold value for the PVI that would predict a PPV value of ≥13% and indirectly discriminate responders from nonresponders to fluid therapy. STUDY DESIGN Clinical, prospective, interventional study. ANIMALS A total of 63 client-owned dogs scheduled for abdominal procedures. METHODS PPV and SPV were calculated manually from the invasive blood pressure trace on the Datex monitor. PVI was recorded from the Masimo pulse oximeter. Fluid challenge (10 mL kg-1 Compound Sodium Lactate) was performed when PPV was ≥13% and/or mean arterial pressure (MAP) < 60 mmHg. Fluid responsiveness was assessed by the transoesophageal Doppler probe. Cardiovascular parameters (heart rate, MAP, PPV, SPV, PVI, SV and if available, CVP) were measured before and after each fluid intervention. RESULTS PPV ≥ 13% reliably predicted fluid responsiveness in 82.9% of cases. There was positive correlation between PPV and SPV (r = 0.84%), PPV and logPVI (r = 0.46) as well as SPV and logPVI (r = 0.45). Noninvasive PVI value ≥13% should predict PPV threshold value (13%) with 97% sensitivity and 68% specificity. There was no statistically significant correlation between PPV and CVP. CONCLUSIONS PPV is a useful clinical tool to detect occult hypovolaemia and predict cardiovascular response to fluid challenge. Use of PPV is recommended as a part of GDFT in dogs undergoing abdominal procedures.
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Affiliation(s)
- Maja J Drozdzynska
- Department of Clinical Sciences and Services, Royal Veterinary College, University of London, London, UK.
| | - Yu-Mei Chang
- Research Support Office (RSO), Royal Veterinary College, University of London, London, UK
| | - Giacomo Stanzani
- Department of Clinical Sciences and Services, Royal Veterinary College, University of London, London, UK
| | - Ludovic Pelligand
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
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Holm LP, Hawkins I, Robin C, Newton RJ, Jepson R, Stanzani G, McMahon LA, Pesavento P, Carr T, Cogan T, Couto CG, Cianciolo R, Walker DJ. Cutaneous and renal glomerular vasculopathy as a cause of acute kidney injury in dogs in the UK. Vet Rec 2015; 176:384. [PMID: 25802439 PMCID: PMC4413843 DOI: 10.1136/vr.102892] [Citation(s) in RCA: 18] [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] [Accepted: 01/21/2015] [Indexed: 11/04/2022]
Abstract
To describe the signalment, clinicopathological findings and outcome in dogs presenting with acute kidney injury (AKI) and skin lesions between November 2012 and March 2014, in whom cutaneous and renal glomerular vasculopathy (CRGV) was suspected and renal thrombotic microangiopathy (TMA) was histopathologically confirmed. The medical records of dogs with skin lesions and AKI, with histopathologically confirmed renal TMA, were retrospectively reviewed. Thirty dogs from across the UK were identified with clinicopathological findings compatible with CRGV. These findings included the following: skin lesions, predominantly affecting the distal extremities; AKI; and variably, anaemia, thrombocytopaenia and hyperbilirubinaemia. Known causes of AKI were excluded. The major renal histopathological finding was TMA. All thirty dogs died or were euthanised. Shiga toxin was not identified in the kidneys of affected dogs. Escherichia coli genes encoding shiga toxin were not identified in faeces from affected dogs. CRGV has previously been reported in greyhounds in the USA, a greyhound in the UK, without renal involvement, and a Great Dane in Germany. This is the first report of a series of non-greyhound dogs with CRGV and AKI in the UK. CRGV is a disease of unknown aetiology carrying a poor prognosis when azotaemia develops.
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Affiliation(s)
- L P Holm
- Anderson Moores Veterinary Specialists, The Granary, Bunstead Barns, Poles Lane, Hursley, Winchester, Hampshire SO21 2LL, UK
| | - I Hawkins
- Bridge Pathology, Horner Court, 637 Gloucester Road, Horfield, Bristol BS7 0BJ, UK
| | - C Robin
- Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK
| | - R J Newton
- Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK
| | - R Jepson
- Department of Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire AL9 7TA, UK
| | - G Stanzani
- Department of Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire AL9 7TA, UK
| | - L A McMahon
- Anderson Moores Veterinary Specialists, The Granary, Bunstead Barns, Poles Lane, Hursley, Winchester, Hampshire SO21 2LL, UK
| | - P Pesavento
- Department of PMI, University of California, Davis, School of Veterinary Medicine, 4206 VM3A, 1 Shields Avenue, Davis, California 95616, USA
| | - T Carr
- Martin and Carr, The Old Well, Station Road, Pershore, Worcestershire WR10 2DB, UK
| | - T Cogan
- School of Veterinary Sciences, University of Bristol, Langford, Bristol BS40 5DU, UK
| | - C G Couto
- Couto Veterinary Consultants, Hilliard, Ohio 43026, USA
| | - R Cianciolo
- International Veterinary Renal Pathology Service, Department of Veterinary Biosciences, The Ohio State University, 301 Goss Laboratory, 1925 Coffey Rd, Columbus, Ohio, USA
| | - D J Walker
- Anderson Moores Veterinary Specialists, The Granary, Bunstead Barns, Poles Lane, Hursley, Winchester, Hampshire SO21 2LL, UK
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Abstract
Continuous renal replacement therapy is an emerging technique for the treatment of acute kidney injury (AKI). Data regarding its use in cats are limited. This report describes the use of a novel continuous renal replacement therapy (CRRT) system for the treatment of AKI in a cat. A 1.3-year-old cat developed uraemic signs following the administration of a non-steroidal anti-inflammatory agent for the treatment of a suspect traumatic episode. CRRT was provided with a Prismaflex Gambro machine used in continuous venovenous haemodiafiltration mode, with an AN-69 surface-treated membrane, synthetic colloid priming and heparin anticoagulation. Two treatment cycles were performed, totalling 51 h of CRRT. The treatment was effective in controlling uraemic signs, and no major complications were noted. Owing to financial constraints the owners declined further CRRT treatments, and on day 8 of hospitalisation, owing to the lack of significant clinical improvement, humane euthanasia was performed. The set-up detailed in this report provides a viable option for the initial treatment of cats with AKI.
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Affiliation(s)
- Giacomo Stanzani
- Department of Veterinary Clinical Science and Services, The Royal Veterinary College, North Mymms, Hatfield, UK
| | - Rosanne E Jepson
- Department of Veterinary Clinical Science and Services, The Royal Veterinary College, North Mymms, Hatfield, UK
| | - Daniel L Chan
- Department of Veterinary Clinical Science and Services, The Royal Veterinary College, North Mymms, Hatfield, UK
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Lee KCL, Palacios Jimenez C, Alibhai H, Chang YM, Leckie PJ, Baker LA, Stanzani G, L Priestnall S, Mookerjee RP, Jalan R, Davies NA. A reproducible, clinically relevant, intensively managed, pig model of acute liver failure for testing of therapies aimed to prolong survival. Liver Int 2013; 33:544-51. [PMID: 23331547 DOI: 10.1111/liv.12042] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Accepted: 11/01/2012] [Indexed: 12/14/2022]
Abstract
BACKGROUND A clinically relevant, translational large animal model of acute liver failure (ALF) is required for testing of novel therapies to prolong survival in acute liver failure, to permit spontaneous liver recovery or to act as a bridge to transplantation. AIMS The aim was to establish a pig model of acetaminophen-induced ALF that mimics the human clinical syndrome, is managed as in a human intensive care unit and has a predictable survival time. METHODS Nine female pigs were anaesthetised and instrumented for continuous intensive care monitoring and management using: target-driven protocols for treatment of cardiovascular collapse, metabolic acidosis and electrolyte abnormalities; intermittent positive pressure ventilation; and continuous renal replacement therapy. Six animals were induced to ALF with acetaminophen (paracetamol). Three animals acted as controls. RESULTS Irreversible acute liver failure, defined as rise in prothrombin time >3 times normal, occurred 19.3 ± 1.8 h after the onset of acetaminophen administration. Death occurred predictably 12.6 ± 2.7 h thereafter, with acute hepatocellular necrosis in all animals. Clinical progression of liver failure mimicked the human condition including development of coagulopathy, intracranial hypertension, hyperammonaemia, cardiovascular collapse, elevation in creatinine, metabolic acidosis and hyperlactataemia. In addition, cardiovascular monitoring clearly demonstrated progressive cardiac dysfunction in ALF. CONCLUSIONS A reproducible, clinically relevant, intensively managed, large animal model of acute liver failure, with death as a result of multi-organ failure, has been successfully validated for translational studies of disease progression and therapies designed to prolong survival in man.
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Affiliation(s)
- Karla C L Lee
- Department of Veterinary Clinical Sciences, Royal Veterinary College, University of London, UK.
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Serra VF, Stanzani G, Smith G, Otto CM. Point seroprevalence of canine influenza virus H3N8 in dogs participating in a flyball tournament in Pennsylvania. J Am Vet Med Assoc 2011; 238:726-30. [PMID: 21401429 DOI: 10.2460/javma.238.6.726] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the seroprevalence of antibody against canine influenza virus H3N8 in a group of pet dogs that participate in flyball in Pennsylvania. DESIGN-SEROLOGIC SURVEY: Animals-Dogs attending a flyball tournament in Downingtown, Pa, from November 13 to 14, 2009. Procedures-Blood samples were collected from dogs following owner consent. Medical, travel, and activity history of the dogs for the previous 10.5 months was obtained from owners. Serum was harvested and submitted to Cornell University Diagnostic Laboratory for measurement of antibody against canine influenza virus H3N8 via hemagglutination inhibition testing. RESULTS Serum samples were obtained from 100 of 256 dogs participating in the flyball event. Although 3 of the 100 (3%) samples had positive results for antibody against canine influenza, none of the associated dogs had respiratory signs of infection (eg, coughing, sneezing, or nasal or ocular discharge) in the 10.5 months prior to testing. Eleven dogs had a history of respiratory signs, but none of those dogs had antibody against canine influenza H3N8. In addition, none of the study dogs had been vaccinated against canine influenza H3N8. CONCLUSIONS AND CLINICAL RELEVANCE Although canine influenza is considered enzootic in certain areas of the country (eg, Pennsylvania or New York), this study identified a low seroprevalence in dogs considered at high risk for infection given their life conditions and geographic origins. More research is warranted to elucidate the prevalence of exposure to the H3N8 virus in competitive sporting dogs and determine whether vaccination is warranted in such dogs.
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Affiliation(s)
- Verna F Serra
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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