Glomerulopathy in dogs with congenital portosystemic shunts

Computed Tomographic Hepatic Volumetry in Dogs with Congenital Portosystemic Shunts

CTHV is a non-invasive and accurate method for assessing liver volume in dogs. CTHV has not been studied in each type of extrahepatic PSS in dogs. This study aimed to use CTHV to compare liver volumes in dogs with different types of PSSs that had been confirmed by computed tomography angiography. Dogs with PSSs were retrospectively included and categorized into IH, EHPC, EHPA, or EHPP shunt groups. Manual CTHV was performed, and the normalized liver volume (nLV) and the difference in nLV from the estimated liver volume calculated based on body weight (LV%diff) was calculated. The study included 57 dogs: 20 IH, 21 EHPC, 9 EHPA, and 7 EHPP. The median nLV (cm3/kg) and LV%diff (%) for each group were as follows: IH 17.3 (-40.4%); EHPC 16.9 (-60.3%); EHPA 15.1 (-56.7%); and EHPP 17.2 (-59.2%), respectively. There were no significant differences in nLV among the PSS types. However, LV%diff was significantly more pronounced in the EHPC and EHPA groups compared with the IH group. Additionally, smaller dogs exhibited more severe microhepatia, with a significant positive correlation between LV%diff and body weight (p < 0.01). These findings suggest that microhepatia severity varies by shunt type and is more severe in smaller dogs, highlighting the need for further research to understand the underlying mechanisms.

Computed tomographic measures of renomegaly vary among dogs with different types of congenital portosystemic shunts

Renomegaly has been reported in dogs with congenital portosystemic shunts (PSS). However, no study has objectively evaluated the degree of renomegaly in dogs with different types of PSS. The purpose of this retrospective, analytical, cross-sectional study was to determine kidney size (renal length-to-L2 vertebral body ratio; RL/L2 ratio) using CT in dogs with different types of PSS and correlate with clinical information. A medical record search for dogs with a PSS diagnosed using CT between 2016 and 2020 was conducted. Breed, age, sex, body weight, and biochemistry results were recorded. Kidney and L2 vertebral body lengths were measured using multiplanar reformatted CT images, and the RL/L2 ratio was calculated. Dogs were categorized into four groups based on PSS morphology for comparisons: intrahepatic (IH; n = 19), extrahepatic portocaval (EHPC; n = 20), extrahepatic portoazygos (EHPA; n = 7), or extrahepatic portophrenic (EHPP, n = 7). The RL/L2 ratio (mean ± SD) was largest in IH (3.55 ± 0.38) and EHPC (3.55 ± 0.38), followed by EHPP (3.10 ± 0.23), and EHPA (2.78 ± 0.18). RL/L2 ratio was significantly larger in EHPC and IH (vs. EHPA and EHPP [P < .01]). Significant correlations between kidney size and creatinine, alkaline phosphatase, albumin, total protein, and ammonia were present. Renomegaly was observed in 86.8% of dogs with PSS overall, but it was uncommon in dogs with EHPA and less common in dogs with EHPP, as these two groups showed clinical signs later in life, made evident by older age at presentation. The authors suggest that the severity of hepatic dysfunction and the shunted blood volume may influence the development of renomegaly in dogs with PSS.

Congenital Portosystemic Shunts: Current Diagnosis and Management

Congenital portosystemic shunts are increasingly recognized in several settings and at any age. The following are some of the most common presentations: prenatal ultrasound, neonatal cholestasis, incidental finding on abdominal imaging, or systemic complications such as unexplained cardiopulmonary or neurological disease, or the presence of liver nodules in a noncirrhotic liver. The purpose of the present review is to summarize clinical presentation and current recommendations for management, and highlight areas of future research. Illustrative examples from the veterinary literature complement our current lack of knowledge of this rare malformation often masquerading as a multisystem disease.

Association between excess body weight and urine protein concentration in healthy dogs

BACKGROUND

Markedly overweight people can develop progressive proteinuria and kidney failure secondary to obesity-related glomerulopathy (ORG). Glomerular lesions in dogs with experimentally induced obesity are similar to those in people with ORG.

OBJECTIVES

The aim of this study was to evaluate if urine protein and albumin excretion is greater in overweight and obese dogs than in dogs of ideal body condition.

METHODS

Client-owned dogs were screened for underlying health conditions. These dogs were assigned a body condition score (BCS) using a 9-point scoring system. Dogs with a BCS of ≥ 6 were classified as being overweight/obese, and dogs with a BCS of 4 or 5 were classified as being of ideal body weight. The urine protein:creatinine ratio (UPC) and urine albumin:creatinine ratio (UAC) were then determined, and compared between 20 overweight/obese dogs and 22 ideal body weight control dogs.

RESULTS

Median UPC (0.04 [range, 0.01-0.14; interquartile range, 0.07]) and UAC (0.41 [0-10.39; 3.21]) of overweight/obese dogs were not significantly different from median UPC (0.04 [0.01-0.32; 0.07]) and UAC (0.18 [0-7.04; 1.75]) in ideal body weight dogs.

CONCLUSIONS

Clinicopathologic abnormalities consistent with ORG were absent from overweight/obese dogs in this study.

A review of immunologic diseases of the dog

The following review is based on notes used in the teaching of clinical immunology to veterinary students. Immune diseases of the dog are placed into six different categories: (1) type I or allergic conditions; (2) type II or auto- and allo-antibody diseases; (3) type III or immune complex disorders; (4) type IV or cell-mediated immune diseases; (5) type V conditions or gammopathies; and (6) type VI or immunodeficiency disorders. Separate discussions of transplantation immunology and the use of drugs to regulate unwanted immune responses are also included.