Haematological and biochemical values in North American Scottish deerhounds

OBJECTIVE

Sighthounds, including deerhounds, have unique physiological traits that result in laboratory test results that may lie outside reference intervals for the general dog population. Although reference intervals for most analytes are thought to be similar among sighthounds, breed-specific reference intervals are available mainly for greyhounds. The aim of this study was to establish reference intervals for haematology and serum biochemical profiles in deerhounds.

METHODS

Venous blood samples were collected from healthy deerhounds. Haematological and biochemical analytes were examined and reference intervals were established using the 5th and 95th percentiles.

RESULTS

The reference intervals obtained from 96 dogs for platelets, reticulocytes, total thyroxine, chloride, gamma glutamyl transferase, bilirubin and glucose were lower than the general dog population. Reference intervals for mean cell volume, potassium, urea, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and cholesterol were higher than the general dog population. Reference intervals for eosinophils and globulin were wider than that of the general population.

CLINICAL SIGNIFICANCE

These results confirm that differences in haematological and biochemical values exist in the deerhound. Some appear to be shared by all sighthounds but others may be unique to this breed.

Efficacy, tolerance, and safety of mammalian target of rapamycin inhibitors as rescue immunosuppressants in liver transplantation

BACKGROUND

Mammalian target of rapamycin (mTOR) inhibitors behave as potent immunosuppressants which have the advantages, with respect to calcineurin inhibitors (CNI: cyclosporine or tacrolimus), of no nephrotoxicity and inhibition of cell proliferation. They are particularly suitable for patients with renal insufficiency or neoplasias.

MATERIALS AND METHODS

Twenty-two liver transplant patients were immunosuppressed with everolimus or sirolimus as rescue therapy after CNI treatment: 7 hepatocellular carcinomas; 5 de novo malignancies; 4 renal insufficiencies; 4 chronic rejections; and 2 acute rejection episodes.

RESULTS

There were 16.7% tumor recurrences, and 25% improvements in renal function, 75% in chronic rejection, and 50% in acute rejection. There was no incidence of rejection, kidney failure, gastrointestinal intolerance, hydrocarbon intolerance, hypertension, or arterial or venous thrombosis. We observed incidences of 50% for hypercholesterolemia, 31.8% for hypertriglyceridemia, 22.7% for thrombocytopenia, 18.2% for leukopenia, and 9.1% for anemia. The intercurrent infection rate was 13.6%, including oral thrush in 13.6%. Lower limb edema occurred in 13.6%, with 1 case of facial edema and 1 of alopecia.

CONCLUSIONS

mTOR inhibitors were safe immunosuppressive drugs whose side effects were controlled and easily managed. They have advantages with respect to CNI due to their slight effects on kidney function and lack of promotion of diabetes mellitus. Although their long-term effectiveness for control of neoplastic diseases is yet to be seen, they can be used safely in these patients with no incidence of rejection. Their effectiveness to control chronic rejection seems significant, but it is doubtful for steroid-resistant acute rejection episodes.

Serum cardiac troponin I concentration in retired racing greyhounds

BACKGROUND

Cardiac troponin I (cTnI) is a polypeptide found specifically in cardiac muscle tissue that has been used as a diagnostic and prognostic indicator of cardiomyopathy. Increases in cTnI are associated with myocardial pathologic processes. However, high serum cTnI concentrations have been observed in normal Greyhounds.

HYPOTHESIS

We hypothesized that Greyhounds have cTnI concentrations higher than non-Greyhound dogs, and that a separate reference range should be established for Greyhounds.

ANIMALS

Blood samples were collected from the jugular vein from a group of 20 healthy Greyhound blood donors.

METHODS

Analysis of serum cTnI was performed with an immunoassay system with a detection level of 0.01 ng/mL, as described previously. The Greyhound values were compared with 2 groups of Boxers with and without arrhythmogenic right ventricular cardiomyopathy (ARVC), and to a group of non-Boxer control dogs from a previous study.

RESULTS

The mean cTnI concentration in Greyhounds was significantly higher (P < .0001) than that in non-Greyhound control dogs, although not significantly different from normal Boxers (P= .50), or Boxers with ARVC (P= .58). Greyhound serum cTnI concentrations were in the range found in Boxers with ARVC. The proposed reference range for cTnI in Greyhounds is 0.05-0.16 ng/mL.

CONCLUSIONS AND CLINICAL IMPORTANCE

Greyhounds have a reference range for serum cTnI concentrations that differs from that of other previously published reference ranges for dogs of other breeds. Until a broader database and more precise reference range can be established, caution should be exercised in interpreting serum cTnI concentrations in Greyhounds with suspected cardiac disease.

Simultaneous liver-kidney transplant for combined renal and hepatic end-stage disease

INTRODUCTION

After the first combined liver-kidney transplantation (CLKT) reported by Margreiter in 1984, it became clear that renal failure was no longer an absolute contraindication.

OBJECTIVE

Our goal was to assess our results with combined liver-kidney transplant. Among 875 liver transplants performed between May 1986 and October 2002, there were 17 cases (1.96%) of combined liver-kidney transplant.

RESULTS

With a mean follow-up of 42.2+/-29 months (range, 1-90), six patients had died (mortality: 37.5%). There were four (25%) operative in-hospital deaths, and two late mortality cases (beyond the month 6 after hospital discharge). The causes were sepsis (four cases, three postoperative and one in later follow-up), refractory heart failure (one postoperative), and recurrent liver disease (HCV-induced severe recurrence) during follow-up one). Actuarial survival (calculated for those who survived the postoperative period) was 80%, 71%, and 60% at 12, 36, and 60 months. Actuarial mean survival time was 60 months (95%IC:47-78). Neither the sex, the UNOS status, the etiology of liver disease, the etiology of renal failure, the type of hepatectomy (piggy back vs others) or the type of immunosuppression (P=.83) were related to long-term survival according to the log-rank test. A control group of 48 patients was constructed with subjects who underwent liver transplantation immediately before or after the combined transplant. A total (two cases after the CLKT and one case prior to). There were no differences in survival.

CONCLUSION

Combined liver-kidney transplant represents a proper therapeutic option for patients with simultaneously failing organs based on long- and short-term outcomes.