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Weng X, Yan L, Chen J, Shen Q, Qiu M, Wang Q, Yang J, Wen W, Yu G. Establishing an animal model for peritoneal catheter malfunction caused by omental wrapping using negative pressure suction: in vitro and in vivo exploration. Ren Fail 2024; 46:2369695. [PMID: 38938162 DOI: 10.1080/0886022x.2024.2369695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/13/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND This study aims to establish a simplified and effective animal model of catheter malfunction caused by omental wrapped using negative pressure suction. METHOD The peritoneal dialysis catheter outlet was linked to a negative-pressure (0-75mmHg) suction pump to intensify the negative pressure. Different negative pressures were tested for model construction in vitro. In vivo, a model of peritoneal catheter malfunction caused by omental wrapped was constructed in five beagles after catheter placement. Catheter drainage conditions and related complications were monitored before and after the model establishment. RESULTS In the vitro experiment, the overall success rate of constructed models was 90% (36/40). The total malfunction rate was higher in 62.5 mmHg (10/10) and 75 mmHg (10/10) than in 12.5 mmHg (8/10) and 37.5 mmHg (8/10). The outflow velocity of dialysate at 62.5 mmHg was significantly lower than that at 12.5 mmHg and 37.5 mmHg, without a statistically significant difference compared to 75 mmHg. In the in vivo experiment, catheter outflow velocity increased, and residual fluid volume decreased after omental wrapped (99.6 ± 6.7 ml/min vs. 32.6 ± 4.6 ml/min at initial five minutes, p < 0.0001; 69.2 ± 16.3 ml vs. 581.0 ± 109.4 ml, p < 0.001). And the outflow velocity was finally below 2 ml/min. No severe related complications (such as infection, organ damage, or bleeding) were observed through laparoscopic examination and dialysate tests seven days post-operation. CONCLUSION Utilizing negative pressure suction to increase negative pressure around catheter tip is a simple, safe, and effective method for establishing an animal model of omental wrapped leading to catheter malfunction.
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Affiliation(s)
- Xiaoxue Weng
- Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, Fujian Province, China
- Department of Nephrology, 900th Hospital of Joint Logistics Support Force, Fuzhou, Fujian Province, China
| | - Lingling Yan
- Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, Fujian Province, China
- Department of Nephrology, 900th Hospital of Joint Logistics Support Force, Fuzhou, Fujian Province, China
| | - Jiejian Chen
- Department of Nephrology, 900th Hospital of Joint Logistics Support Force, Fuzhou, Fujian Province, China
| | - Qingyi Shen
- Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, Fujian Province, China
- Department of Nephrology, 900th Hospital of Joint Logistics Support Force, Fuzhou, Fujian Province, China
| | - Miaohua Qiu
- Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, Fujian Province, China
- Department of Nephrology, 900th Hospital of Joint Logistics Support Force, Fuzhou, Fujian Province, China
| | - Qiang Wang
- Department of Nephrology, 900th Hospital of Joint Logistics Support Force, Fuzhou, Fujian Province, China
| | - Jingbao Yang
- Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, Fujian Province, China
- Department of Nephrology, 900th Hospital of Joint Logistics Support Force, Fuzhou, Fujian Province, China
| | - Wen Wen
- Department of Respiratory, Fuzong Clinical Medical College of Fujian Medical University, 900th Hospital of Joint Logistics Support Force, Fuzhou, Fujian Province, China
- Dongfang Hospital of Xiamen University, Fuzhou, Fujian Province, China
| | - Guoqing Yu
- Department of Nephrology, 900th Hospital of Joint Logistics Support Force, Fuzhou, Fujian Province, China
- Dongfang Hospital of Xiamen University, Fuzhou, Fujian Province, China
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Foster JD. Nephrology in Veterinary Medicine. KIDNEY360 2023; 4:1641-1649. [PMID: 37840194 PMCID: PMC10695652 DOI: 10.34067/kid.0000000000000273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 10/09/2023] [Indexed: 10/17/2023]
Abstract
Veterinary nephrology is a specialized field of veterinary medicine providing a high level of care for animals with all types of kidney disease. Veterinarians complete extensive training to become board-certified in veterinary nephrology-urology. Companion animal nephrology is the most advanced field; however, all species are afflicted by a variety of renal disorders. Most naturally occurring animal kidney diseases have similar disorders found in people; where veterinary research is lacking, clinical management is often modified from standard of care in people. Veterinarians have become adept at scaling down procedures to safely perform them on dogs and cats weighing only a few kilograms. Advanced diagnostics (renal biopsy, cystoscopy, fluoroscopic studies, etc. ) and therapeutics (renal replacement therapy, interventional endourology, etc. ) are commonly performed within the practice of veterinary nephrology-urology. Collaboration between veterinary and human nephrologists may advance both disciplines and improve care for people and animals alike.
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Crosby J, Humm K, Cook SD. Retrospective evaluation of the use of small-bore wire-guided catheters for the management of peritoneal effusion in cats and dogs. J Vet Emerg Crit Care (San Antonio) 2023; 33:91-97. [PMID: 36452983 PMCID: PMC10099829 DOI: 10.1111/vec.13265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/01/2022] [Accepted: 01/30/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To describe the use of small-bore wire-guided catheters in the management of peritoneal effusion in cats and dogs and to detail any associated adverse events. DESIGN Retrospective study. SETTING University teaching hospital ANIMALS: Forty-five client-owned animals that had peritoneal catheters placed for management of peritoneal effusion between July 2010 and June 2021. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Forty-five cases were included (25 dogs and 20 cats). Twenty-eight animals had the catheter placed to aid management of a uroabdomen, 8 of which recovered without surgical management, 11 had the catheter placed to allow autotransfusion of hemoabdomen, 3 had peritonitis, and 3 had ascites secondary to cardiac disease. Twenty-seven cases (15 dogs and 12 cats) received sedation (n = 24) or local anesthesia alone (n = 3) to facilitate catheter placement, and 6 cases had the catheter placed while under general anesthesia. Median length of catheter persistence was 24 hours (range: 2-144 h). The most common adverse events reported were impaired drainage (n = 7) and leakage at the insertion site (n = 4). CONCLUSIONS Peritoneal catheters can be inserted percutaneously for management of peritoneal effusion. Indications include stabilization and conservative management of uroabdomen, and autotransfusion. They can often be placed with minimal or no sedation and adverse events appear infrequent in occurrence.
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Affiliation(s)
- Jilli Crosby
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
| | - Karen Humm
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
| | - Simon D Cook
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
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Pereira AC, Geraldes SS, Maia SR, de Azevedo MGP, da Silva GG, de Souza BN, García HDM, Melchert A, Brandão CVS, de Souza FF, Guimarães-Okamoto PTC. Applicability of the drainage effectiveness of Blake drains and Tenckhoff catheters in the peritoneal dialysis of healthy rabbits (Oryctolagus cuniculus). J Vet Emerg Crit Care (San Antonio) 2022; 32:748-755. [PMID: 36161461 DOI: 10.1111/vec.13252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 11/24/2021] [Accepted: 12/03/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the efficacy of dialysate drainage between Tenckhoff (TC) catheter and Blake (BL) in peritoneal dialysis (PD) in healthy rabbits. DESIGN Prospective experimental study. SETTING University Teaching Hospital and University research laboratory. ANIMALS Twenty healthy, male, New Zealand rabbits. INTERVENTIONS PD via the TC catheter and the BL abdominal drain was compared during 3 consecutive days of dialysis delivery. MEASUREMENTS AND MAIN RESULTS One session of PD was performed per day for 3 consecutive days (S1: first session, S2: second session, S3: third session) and each session included 4 cycles of infusion, dwell of dialysate in the abdomen, and drainage. Data collection included daily urea, creatinine, alanine aminotransferase, albumin, and potassium, in addition to hematological parameters (eg, RBC, HCT, hemoglobin, WBC, and platelet count). Statistical analysis using a mixed linear model with multiple comparisons was performed. The BL drain resulted in an increase in volume drained (ml/kg) when compared to TC catheter on S2 (third and fourth cycles) and S3 (first and second cycles). CONCLUSIONS The BL drain proved to be superior to the TC catheter, being capable of draining a larger volume of dialysate during the drainage processes in the peritoneal PD of healthy rabbits. The TC catheter had major complications with regard to fluid retention in the abdomen, representing reduced drainage efficiency, while the BL drain showed a greater tendency for the peritoneal fluid to leak.
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Affiliation(s)
- Ana Camila Pereira
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, Brazil
| | - Silvano S Geraldes
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, Brazil
| | - Suellen R Maia
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, Brazil
| | - Maria Gabriela P de Azevedo
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, Brazil
| | - Gustavo G da Silva
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, Brazil
| | - Bruna N de Souza
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, Brazil
| | - Henry David M García
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, Brazil
| | - Alessandra Melchert
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, Brazil
| | - Cláudia Valéria S Brandão
- Department of Veterinary Surgery, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, Brazil
| | - Fabiana F de Souza
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, Brazil
| | - Priscylla T C Guimarães-Okamoto
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, Brazil
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McFadzean W, Macfarlane P, Khenissi L, Murrell JC. Repeated hyperkalaemia during two separate episodes of general anaesthesia in a nine-year-old, female neutered greyhound. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2018-000658] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
There is an increasing awareness of the development of hyperkalaemia during anaesthesia in otherwise healthy veterinary patients. In the human literature 63 per cent of in-hospital hyperkalaemic episodes are associated with drug administration. Anecdotal veterinary reports have suggested that a genetic component may also play a role, with greyhounds seemingly more susceptible to the development of hyperkalaemia under anaesthesia. This case report identifies the repeated development of hyperkalaemia, and its treatment, during two separate episodes of general anaesthesia in a nine-year-old, female neutered greyhound. The first episode of hyperkalaemia (7.89 mmol/l) was identified due to bradycardia and second-degree atrioventricular block on electrocardiogram. Treatment was with intravenous calcium gluconate, insulin, glucose and fluid therapy. The second episode (6.60 mmol/l) was associated with spiked T-waves, and treatment was with insulin and glucose infusions to allow completion of the anaesthetic and surgery. Possible causes and treatments are discussed, and the need for reporting of such cases is highlighted.
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Ross LA, Labato MA. Current techniques in peritoneal dialysis. J Vet Emerg Crit Care (San Antonio) 2013; 23:230-40. [PMID: 23566109 DOI: 10.1111/vec.12035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Accepted: 02/02/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To provide a current overview of the technique of peritoneal dialysis in dogs and cats. CLINICAL IMPLICATION Peritoneal dialysis is the process by which water and solutes move between blood in the peritoneal capillaries and fluid (dialysate) instilled into the peritoneal cavity, across the semipermeable membrane of the peritoneum. The primary indication for peritoneal dialysis (PD) in animals is for treatment of renal failure to correct water, solute, and acid-base abnormalities and to remove uremic toxins. SUMMARY Peritoneal dialysis is a modality of renal replacement therapy commonly used in human medicine for the treatment of chronic kidney disease and end-stage kidney failure. Peritoneal dialysis utilizes the peritoneum as a membrane across which fluids and uremic solutes are exchanged. Dialysate is instilled into the peritoneal cavity and, through the process of diffusion and osmosis, water, toxins, electrolytes, and other small molecules are allowed to equilibrate.
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Affiliation(s)
- Linda A Ross
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
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Abstract
Practical relevance: Treatment of feline chronic kidney disease (CKD) tends to focus on minimising the adverse effects of reduced renal function, rather than addressing an underlying cause. Despite this, and the progressive nature of CKD, treatment can improve quality of life and enable many cats to have long survival times. Evidence base: Strong evidence supports the provision of renal diets, which are protein and phosphorus restricted; compliance is improved by gradual dietary transition. Additional phosphorus restriction is achieved by the use of phosphate binding agents, although it is unknown if these yield similar survival benefits to those provided by renal diets. Interventions to control hypokalaemia and hypertension in affected cats are important to prevent serious complications. Administration of benazepril to cats with proteinuric kidney disease has been shown to significantly improve their appetite but not their survival. As CKD progresses, many cats will benefit from treatment to control clinical signs of uraemic gastroenteritis and anaemia.
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Affiliation(s)
- Rachel M Korman
- Feline Friendly Practice, Veterinary Specialist Services, Underwood 4009, Australia
| | - Joanna D White
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, New Zealand
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Eatroff AE, Langston CE, Chalhoub S, Poeppel K, Mitelberg E. Long-term outcome of cats and dogs with acute kidney injury treated with intermittent hemodialysis: 135 cases (1997-2010). J Am Vet Med Assoc 2013; 241:1471-8. [PMID: 23176239 DOI: 10.2460/javma.241.11.1471] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the long-term outcome for small animal patients with acute kidney injury (AKI) treated with intermittent hemodialysis (IHD). DESIGN Retrospective case series. ANIMALS 42 cats and 93 dogs treated with IHD for AKI. PROCEDURES Medical records of cats and dogs treated with IHD for AKI from January 1997 to October 2010 were reviewed. Standard methods of survival analysis with Kaplan-Meier product limit curves were used. The log-rank, Mann-Whitney, and Kruskal-Wallis tests were used to determine whether outcome, number of IHD treatments, or duration of hospitalization was different when dogs and cats were classified according to specific variables. RESULTS The overall survival rate at the time of hospital discharge was 50% (21/42) for cats and 53% (49/93) for dogs. The overall survival rate 30 days after hospital discharge was 48% (20/42) for cats and 42% (39/93) for dogs. The overall survival rate 365 days after hospital discharge was 38% (16/42) for cats and 33% (31/93) for dogs. For all-cause mortality, the median survival time was 7 days (95% confidence interval, 0 to 835 days) for cats and 9 days (95% confidence interval, 0 to 55 days) for dogs. CONCLUSIONS AND CLINICAL RELEVANCE Cats and dogs with AKI treated with IHD have survival rates similar to those of human patients. Although there was a high mortality rate prior to hospital discharge, those patients that survived to discharge had a high probability of long-term survival.
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Affiliation(s)
- Adam E Eatroff
- Bobst Hospital, The Animal Medical Center, 510 E 62nd St, New York, NY 10065, USA.
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