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Hamelink TL, Ogurlu B, Pamplona CC, Castelein J, Bennedsgaard SS, Qi H, Weiss T, Lantinga VA, Pool MBF, Laustsen C, Jespersen B, Leuvenink HGD, Ringgaard S, Borra RJH, Keller AK, Moers C. Magnetic resonance imaging as a noninvasive adjunct to conventional assessment of functional differences between kidneys in vivo and during ex vivo normothermic machine perfusion. Am J Transplant 2024; 24:1761-1771. [PMID: 38615901 DOI: 10.1016/j.ajt.2024.04.001] [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: 02/27/2024] [Revised: 03/26/2024] [Accepted: 04/07/2024] [Indexed: 04/16/2024]
Abstract
Normothermic machine perfusion (NMP) is increasingly considered for pretransplant kidney quality assessment. However, fundamental questions about differences between in vivo and ex vivo renal function, as well as the impact of ischemic injury on ex vivo physiology, remain unanswered. This study utilized magnetic resonance imaging (MRI), alongside conventional parameters to explore differences between in vivo and ex vivo renal function and the impact of warm ischemia on a kidney's behavior ex vivo. Renal MRI scans and samples were obtained from living pigs (n = 30) in vivo. Next, kidney pairs were procured and exposed to minimal, or 75 minutes of warm ischemia, followed by 6 hours of hypothermic machine perfusion. Both kidneys simultaneously underwent 6-hour ex vivo perfusion in MRI-compatible NMP circuits to obtain multiparametric MRI data. Ischemically injured ex vivo kidneys showed a significantly altered regional blood flow distribution compared to in vivo and minimally damaged organs. Both ex vivo groups showed diffusion restriction relative to in vivo. Our findings underscore the differences between in vivo and ex vivo MRI-based renal characteristics. Therefore, when assessing organ viability during NMP, it should be considered to incorporate parameters beyond the conventional functional markers that are common in vivo.
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Affiliation(s)
- Tim L Hamelink
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | - Baran Ogurlu
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Carolina C Pamplona
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Johannes Castelein
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Haiyun Qi
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Weiss
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Veerle A Lantinga
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Merel B F Pool
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Christoffer Laustsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Bente Jespersen
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Henri G D Leuvenink
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Steffen Ringgaard
- Department of Clinical Medicine, MR Research Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Ronald J H Borra
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Anna K Keller
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Cyril Moers
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Silva-Del-Rio N, Solórzano LC, Lago A, Lobo RR, Goff JP, Weiss WP, Tempelman RJ. Relative availability of five inorganic magnesium sources in non-pregnant non-lactating Holstein cows. J Dairy Sci 2024:S0022-0302(24)01052-X. [PMID: 39098497 DOI: 10.3168/jds.2024-25106] [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: 04/29/2024] [Accepted: 07/13/2024] [Indexed: 08/06/2024]
Abstract
Inorganic sources of Mg are commonly used in dairy cow diets, but their availability varies significantly. This study assessed the relative availability of 4 commonly used inorganic Mg sources and a novel alkalinizing proprietary mineral blend [PMB; Multesium (GLC Minerals, LLC, Green Bay, WI, USA)]. The study was a duplicated 6 × 6 Latin square, with 12 nonlactating, non-pregnant Holstein dairy cows assigned to a square based on BW and parity. Cows were fed 90% of their voluntary DMI (diet contained 0.21% Mg). Each experimental period lasted 7 d. On d 2 of each period, urinary catheters were fitted. Total urine collection started on d 3 for 48 h with samples collected and measured every 12 h. On d 4, 30 g of Mg were administered as boluses with gelatin capsules: negative control (one empty capsule), magnesium oxide (MgO), magnesium sulfate (MgSO4), calcium magnesium hydroxide [CaMg(OH)4], calcium magnesium carbonate [CaMg(CO3)2], and PMB [a blend of Ca and Mg sources that includes CaMg(CO3)2, CaMg(OH)4, and MgO]. Blood samples were collected at 0, 1, 2, 3, 12, and 24 h after treatment administration on d 4 of each treatment period. Urine and blood samples were analyzed for Mg and Ca concentration. Statistical analyses were conducted with PROC GLIMMIX including treatment, time, period, square, treatment × time, treatment × period, and time × period as fixed effects, and cow nested within square as a random effect in the model. Urinary Mg excretion for 4 of the Mg sources studied [PMB, MgO, CaMg(OH)4, and MgSO4] increased significantly, representing an increase of at least 40.8% relative to control. The supplementation of CaMg(CO3)2 did not significantly increase relative to control. There were no significant changes in blood Mg concentration with treatment; but, a significant treatment × time effect was observed. Calcium-rich sources [PMB, CaMg(OH)4, CaMg(CO3)2] had lower blood Mg concentrations at 12 or 24 h after treatment than control and CaMg(CO3)2. Based on urinary Mg excretion 24 h after treatment, 4 of the Mg sources evaluated (including PMB) showed a similar availability, however, the availability of the commercial CaMg(CO3)2 source included in our study was similar to the negative control (no-supplemented cows).
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Affiliation(s)
- N Silva-Del-Rio
- Veterinary Medicine Teaching and Research Center, 18830 Road 112, Tulare, CA 93274; Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616.
| | | | - A Lago
- DairyExperts Inc., Tulare, CA 93274
| | - R R Lobo
- Veterinary Medicine Teaching and Research Center, 18830 Road 112, Tulare, CA 93274
| | - J P Goff
- College of Veterinary Medicine, Iowa State University, Ames, IA 50011
| | - W P Weiss
- Department of Animal Sciences, Ohio Agricultural Research and Development Center, The Ohio State University, Wooster, OH 44691
| | - R J Tempelman
- Department of Animal Science, Michigan State University, East Lansing, MI 48824
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Guida SJ, Bazzle L. Rebound hyperkalemia in a dog with albuterol toxicosis after cessation of potassium supplementation. J Vet Emerg Crit Care (San Antonio) 2023; 33:715-721. [PMID: 37943086 DOI: 10.1111/vec.13352] [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: 04/12/2022] [Revised: 09/03/2022] [Accepted: 09/23/2022] [Indexed: 11/10/2023]
Abstract
OBJECTIVE To describe the presentation of rebound hyperkalemia as a delayed side effect of albuterol toxicity in a dog. CASE SUMMARY A 3-year-old female neutered mixed-breed dog was presented for albuterol toxicosis that led to a severe hypokalemia, hyperlactatemia, and hyperglycemia. The dog also experienced sinus tachycardia and generalized weakness. Treatment was instituted with intravenous fluid therapy and potassium supplementation, and the dog was monitored with a continuous electrocardiogram. Resolution of hypokalemia was documented 12 hours after initial presentation, at which time fluid therapy and potassium supplementation were discontinued. There were no further periods of sinus tachycardia, but instead the dog developed ventricular ectopy with rapid couplets (instantaneous rates of 300/min). An echocardiogram revealed normal cardiac size and function. Twenty-four hours after presentation, the patient developed severe hyperkalemia, despite discontinuation of fluids and potassium supplementation for 12 hours. Serial venous and urinary electrolytes were performed for determination of the fractional excretion of electrolytes. These data confirmed rebound hyperkalemia (7.0 mmol/L), consistent with a markedly increased fractional excretion of potassium, and secondary to the release of potassium from inside the cells. Fluid therapy with dextrose supplementation was provided until 36 hours postpresentation. The hyperkalemia resolved, and the dog was discharged after 44 hours of hospitalization. NEW OR UNIQUE INFORMATION PROVIDED This case documents rebound hyperkalemia following treatment of albuterol toxicosis in a dog. This case highlights the importance of understanding the distribution of total body potassium when treating serum hypokalemia. Transcellular shifts of potassium, as in the case of albuterol toxicosis, can lead to rebound hyperkalemia even after discontinuation of potassium supplementation. This case further explores the utility of fractional excretion of electrolytes in elucidating the etiology and management of electrolyte disturbances.
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Affiliation(s)
- Samantha J Guida
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia, USA
| | - Lisa Bazzle
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia, USA
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Effect of sampling time on urinary electrolytes following oral furosemide administration in dogs with myxomatous mitral valve disease. J Vet Cardiol 2022; 41:57-69. [DOI: 10.1016/j.jvc.2022.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 11/23/2022]
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de Lima CS, Ferreira KRG, Borin-Crivellenti S, Maia SR, Santana AE, Crivellenti LZ. Renal Magnesium Handling: A Comparison Between Dogs With Chronic Kidney Disease and Healthy Elderly Dogs. Top Companion Anim Med 2021; 46:100588. [PMID: 34610438 DOI: 10.1016/j.tcam.2021.100588] [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: 02/05/2021] [Revised: 09/22/2021] [Accepted: 09/30/2021] [Indexed: 11/19/2022]
Abstract
Chronic kidney disease (CKD) and aging are known to possibly cause a progressive reduction in glomerular filtration rate, which may be associated with an increase in fractional excretion of electrolytes due to an adaptive response of the remaining functioning nephrons. However, the behavior of magnesium excretion has not been studied in CKD and healthy elderly dogs. The objective was to evaluate the fractional excretion of magnesium (FEMg) in dogs with (CKD) compared to healthy elderly dogs. Sixteen healthy elderly dogs and 43 dogs with CKD were divided into 3 groups (CKD 2 [n = 14], CKD 3 [n = 17], CKD 4 [n = 12]), in accordance with the current International Renal Interest Society (IRIS) criteria that were used in this study. Blood samples were obtained by jugular venipuncture and urine samples were obtained by cystocentesis. The FEMg was evaluated at a single time point in both urine and blood samples. FEMg was significantly higher in dogs with CKD compared to healthy elderly dogs, especially in advanced stages. This preliminary study demonstrates that FEMg may be altered in dogs with CKD. Further research is warranted to elucidate magnesium's potential role in cardiovascular and arterial calcification in dogs with CKD as observed in humans with CKD.
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Affiliation(s)
- Charles Silva de Lima
- Veterinary Teaching Hospital/Animal Science Graduate Program, Franca University (UNIFRAN), Franca, São Paulo, Brazil
| | | | - Sofia Borin-Crivellenti
- Graduate Program in Veterinary Science (PPGCV)/College of Veterinary Medicine (FAMEV), Federal University of Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil
| | - Suellen Rodrigues Maia
- Veterinary Medicine Graduate Program/School of Veterinary Medicine and Animal Science (FMVZ), Paulista State University (UNESP), Botucatu, São Paulo, Brazil
| | | | - Leandro Zuccolotto Crivellenti
- Graduate Program in Veterinary Science (PPGCV)/College of Veterinary Medicine (FAMEV), Federal University of Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil.
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Alterations of Serum Biochemical and Urinary Parameters in a Canine Population before and after Intravenous Contrast Administration. Vet Sci 2021; 8:vetsci8080146. [PMID: 34437469 PMCID: PMC8402808 DOI: 10.3390/vetsci8080146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 11/17/2022] Open
Abstract
Intravenous iodinated contrast (IVIC) medium is routinely administered to dogs. Scattered information exists regarding the serum biochemical or urinary profiles associated with the administration of IVIC in dogs. The aim of the study was to describe, compare, and discuss from the perspective of previous studies the alterations in serum biochemical and urinary parameters before (T0) and within one week (T1) of the IVIC administration during routine computed tomography (CT) scan evaluation of 22 dogs. Mature dogs presenting for CT scan evaluation for preoperative oncology staging/surgical planning were included. T1 evaluation was performed within one week of IVIC administration. Statistically significant differences in serum total protein, albumin, chloride, calcium, and phosphorus concentrations, urine protein to creatinine ratio, and urine specific gravity were found between T1 and T0. At T1, the serum creatinine concentration was within reference ranges in all dogs but one. An increase in the urine protein to creatinine ratio was observed in four samples, one of which was non-proteinuric at T0. Changes in biochemistry and urine parameters between T0 and T1 were not considered clinically significant.
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Lo HC, Winter JC, Merle R, Gehlen H. Symmetric dimethylarginine and renal function analysis in horses with dehydration. Equine Vet J 2021; 54:670-678. [PMID: 34110650 DOI: 10.1111/evj.13484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Acute dehydration caused by a variety of diseases in horses can lead to acute kidney injury. However, current renal biomarkers usually indicate renal damage late in the course of the disease. A novel biomarker would be helpful to diagnose renal disease earlier. OBJECTIVES (1) To estimate the correlation of serum symmetric dimethylarginine (SDMA) concentrations with the degree of dehydration, traditional renal biomarkers and renal function analysis, and (2) to determine the value of SDMA as a prognostic and early biomarker of renal injury in horses. STUDY DESIGN Prospective cohort. METHODS Serum SDMA, creatinine and urea concentrations and renal function analysis were measured in 41 horses with dehydration at 4 time points until 48 h after admission. Horses were grouped according to their dehydration level into mildly, moderately and severely dehydrated groups. RESULTS Serum SDMA concentrations at admission correlated with creatinine concentrations (r = .412, P < .001). Differences in SDMA concentrations at admission were detected among dehydration levels but not between survivors and nonsurvivors. Significant correlations of SDMA concentrations with other markers of renal function analysis and short-term outcome were not observed. MAIN LIMITATIONS Besides the small sample size and low statistical power, missing urine samples at specific time points were also 1 of the main limitations. Only 1 of the horses developed acute kidney injury, which made the evaluation of the predictive value of SDMA difficult. CONCLUSIONS SDMA concentrations correlated significantly with creatinine concentrations in dehydrated horses. Further research is needed to reveal the application of SDMA in horse.
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Affiliation(s)
- Hsiao-Chien Lo
- Equine Clinic: Surgery and Radiology, Free University of Berlin, Berlin, Germany
| | - Judith C Winter
- Equine Clinic: Surgery and Radiology, Free University of Berlin, Berlin, Germany
| | - Roswitha Merle
- Institute for Veterinary Epidemiology and Biostatistics, Free University of Berlin, Berlin, Germany
| | - Heidrun Gehlen
- Equine Clinic: Surgery and Radiology, Free University of Berlin, Berlin, Germany
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Cervone M, Blondel M, Moissonnier P, Chabanne L. Multiple endocrine neoplasia type 2‐like syndrome in a crossbred dog. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Mario Cervone
- Département clinique des animaux de compagnie de loisir et de sport Campus vétérinaire de Lyon Université de Lyon, VetAgro Sup Marcy l'Etoile France
| | - Margaux Blondel
- Surgery Unit, Lyon Veterinary Teaching Hospital Université de Lyon VetAgro Sup Marcy l'Etoile France
| | - Pierre Moissonnier
- Surgery Unit, Lyon Veterinary Teaching Hospital Université de Lyon VetAgro Sup Marcy l'Etoile France
| | - Luc Chabanne
- Département clinique des animaux de compagnie de loisir et de sport Campus vétérinaire de Lyon Université de Lyon, VetAgro Sup Marcy l'Etoile France
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Tang PK, Geddes RF, Chang YM, Jepson RE, Bijsmans E, Elliott J. Risk factors associated with disturbances of calcium homeostasis after initiation of a phosphate-restricted diet in cats with chronic kidney disease. J Vet Intern Med 2020; 35:321-332. [PMID: 33368694 PMCID: PMC7848342 DOI: 10.1111/jvim.15996] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Dietary phosphate restriction improves survival in cats with chronic kidney disease (CKD). However, feeding a phosphate-restricted diet may disrupt calcium homeostasis leading to hypercalcemia in some cats. OBJECTIVES To identify risk factors associated with increasing plasma total calcium (tCa) concentration after transition to a phosphate-restricted diet and to explore its role in CKD-mineral and bone disorder (CKD-MBD) in cats. ANIMALS Seventy-one geriatric (≥9 years) euthyroid client-owned cats with International Renal Interest Society (IRIS) stage 2 to 3 azotemic CKD. METHODS Retrospective cross-sectional cohort study. Changes in plasma tCa concentration in the first 200 days of diet transition were assessed using linear regression. Binary logistic regressions were performed to identify risk factors for increasing calcium concentration. Changes in clinicopathological variables associated with CKD-MBD over time were explored using linear mixed model and generalized linear mixed model analyses. RESULTS Lower baseline plasma potassium (odds ratio [OR] = 1.19 per 0.1 mmol/L decrease; P = .003) and phosphate (OR = 1.15 per 0.1 mmol/L decrease; P = .01) concentrations remained independent risk factors for increasing plasma tCa concentration. Plasma creatinine (β = .069 ± .029 mg/dL; P = .02), symmetric dimethylarginine (β = .64 ± .29 μg/dL; P = .03), phosphate (β = .129 ± .062 mg/dL; P = .04), and ln[FGF23] (β = .103 ± .035 pg/mL; P = .004) concentrations had significantly increased rates of change in cats with increasing plasma tCa concentration over time. CONCLUSION AND CLINICAL IMPORTANCE Lower plasma potassium or phosphate concentrations or both at the time of transition of cats with CKD to a phosphate-restricted diet are independently associated with increased risk of an increase in plasma tCa concentration. Increasing plasma tCa concentration is associated with progression of CKD.
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Affiliation(s)
- Pak-Kan Tang
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
| | - Rebecca F Geddes
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK
| | - Yu-Mei Chang
- Research Support Office, Royal Veterinary College, University of London, London, UK
| | - Rosanne E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK
| | | | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
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Parker VJ, Rudinsky AJ, Benedict JA, Beizaei A, Chew DJ. Effects of calcifediol supplementation on markers of chronic kidney disease-mineral and bone disorder in dogs with chronic kidney disease. J Vet Intern Med 2020; 34:2497-2506. [PMID: 33128421 PMCID: PMC7694821 DOI: 10.1111/jvim.15949] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 10/11/2020] [Accepted: 10/19/2020] [Indexed: 12/18/2022] Open
Abstract
Background Chronic kidney disease‐mineral and bone disorder (CKD‐MBD) in dogs is associated with hypovitaminosis D, increased parathyroid hormone (PTH), and increased fibroblast growth factor‐23 (FGF‐23) concentrations. Best practice for vitamin D metabolite supplementation in CKD‐MBD remains unknown. Objective To provide an extended‐release calcifediol supplement to dogs with CKD and to measure its effects on variables indicative of CKD‐MBD. Animals Ten dogs with International Renal Interest Society stages 2 and 3 CKD. Methods In a prospective study, dogs received a calcifediol supplement for 84 days. Serum 25‐hydroxyvitamin D (25[OH]D), 1,25‐dihydroxyvitamin D (1,25[OH]2D), 24,25‐dihydroxyvitamin D (24,25[OH]2D), creatinine, calcium, phosphorus, PTH, plasma FGF‐23 concentrations, and urine profiles were measured monthly during supplementation. Urine calcium to creatinine (UCa/Cr) ratios and fractional excretion of calcium, phosphorus, and sodium were determined. Results All serum vitamin D metabolite concentrations increased significantly by day 84 (P < .001): [25(OH)D (median 249.9 ng/mL; range, 149.7‐469.9 ng/mL) compared to baseline (median 50.2 ng/mL; range, 31.3‐66.0 ng/mL); 1,25(OH)2D (median 66.1 pg/mL; range, 56.9‐88.1 pg/mL) compared to baseline (median 37.3 pg/mL; range, 29.3‐56.7 pg/mL); 24,25(OH)2D (median 81.4 ng/mL; range, 22.1‐151.7 ng/mL) compared to baseline (median 15.4 ng/mL; range, 6.9‐40.6 ng/mL)]. There were no significant differences in calcium, phosphorus, PTH concentrations, UCa/Cr or fractional excretion of calcium. No dog developed ionized hypercalcemia. Plasma FGF‐23 concentrations increased by day 84 (median 1219 pg/mL; range, 229‐8824 pg/mL) compared to baseline (median 798 pg/mL; range, 103‐4.145 pg/mL) (P < .01). Conclusions and Clinical Importance Calcifediol supplementation for 84 days was well‐tolerated in dogs with IRIS stages 2 and 3 CKD. It remains to be determined how long‐term supplementation would affect CKD progression and QOL.
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Affiliation(s)
- Valerie J Parker
- Veterinary Clinical Sciences, The Ohio State University Veterinary Medical Center, Columbus, Ohio, USA
| | - Adam J Rudinsky
- Veterinary Clinical Sciences, The Ohio State University Veterinary Medical Center, Columbus, Ohio, USA
| | - Jason A Benedict
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Azadeh Beizaei
- EirGen Pharma LTD, R&D Center, IDA Business and Technology Park, Waterford, Ireland
| | - Dennis J Chew
- Veterinary Clinical Sciences, The Ohio State University Veterinary Medical Center, Columbus, Ohio, USA
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RENAL EVALUATION IN CHOLOEPUS SPECIES. J Zoo Wildl Med 2020; 50:983-987. [PMID: 31926532 DOI: 10.1638/2018-0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2019] [Indexed: 11/21/2022] Open
Abstract
Two species of sloths in the family Megalonychidae, Hoffmann's (Choloepus hoffmanni) and Linnaeus's (Choloepus didactylus) two-toed sloths, are commonly held in zoological institutions. Despite frequent published reports of urinary tract disease in these species, reports of diagnostics are mostly limited to descriptions of hematology and serum chemistry. In this study, repeated urinalysis, urinary chemistry, serum chemistry, and radiographs were collected opportunistically from six Hoffmann's and five Linnaeus's sloths. Proteinuria, bacteriuria, low urine specific gravity, and crystalluria were common in the absence of other signs of urinary tract pathology.
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Ferreira DOL, Santarosa BP, Surian SRS, Takahira RK, Chiacchio SB, Amorim RM, Dias A, Gonçalves RC. Low performance of vitamin C compared to ammonium chloride as an urinary acidifier in feedlot lambs. CIÊNCIA ANIMAL BRASILEIRA 2020. [DOI: 10.1590/1809-6891v21e-60098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Obstructive urolithiasis is highly prevalent disease in feedlot sheep. Urinary acidification is effective for disease prevention. Forty-five healthy 3-4 month-old male Santa Inês crossbred feedlot lambs were distributed into three groups of 15 animals each. Ammonium chloride (GA) at 400 mg/kg/day/animal, vitamin C (GC) at 4 mg/kg/day/animal, and a combination of the two (GAC) were administered orally for 21 d. Blood and urine samples were taken 7 d before beginning treatment (M0), immediately before (M1), and weekly for 21 d (M2, M3, and M4) for renal function tests, levels of Ca, P, and Mg in serum and urine, urinalysis, and fractional excretion (FE) analysis in these minerals. In groups GA and GAC, pH decreased in M2 and remained acidic throughout the experiment. A significant decrease in serum P and a urinary increase in Ca and Mg occurred in GA. The FE of Ca increased during treatments, but there was no interference with Mg. The FE of P was significantly lower in GA. Ammonium chloride was an effective urinary acidifier in sheep, but vitamin C administered orally did not provide stable results. Thus, based on our results, vitamin C supplementation may not effective for urinary acidification to prevent obstructive urolithiasis.
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Effects of the long-term feeding of diets enriched with inorganic phosphorus on the adult feline kidney and phosphorus metabolism. Br J Nutr 2018; 121:249-269. [PMID: 30572965 PMCID: PMC6390406 DOI: 10.1017/s0007114518002751] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Renal disease has a high incidence in cats, and some evidence implicates dietary P as well. To investigate this further, two studies in healthy adult cats were conducted. Study 1 (36 weeks) included forty-eight cats, stratified to control or test diets providing 1·2 or 4·8 g/1000 kcal (4184 kJ) P (0 or approximately 3·6 g/1000 kcal (4184 kJ) inorganic P, Ca:P 1·2, 0·6). Study 2 (29 weeks) included fifty cats, stratified to control or test diets, providing 1·3 or 3·6 g/1000 kcal (4184 kJ) P (0 or approximately 1·5 g/1000 kcal (4184 kJ) inorganic P, Ca:P 1·2, 0·9). Health markers, glomerular filtration rate (GFR) and mineral balance were measured regularly, with abdominal ultrasound. Study 1 was halted after 4 weeks as the test group GFR reduced by 0·4 (95 % CI 0·3, 0·5) ml/min per kg, and ultrasound revealed changes in renal echogenicity. In study 2, at week 28, no change in mean GFR was observed (P >0·05); however, altered renal echogenicity was detected in 36 % of test cats. In agreement with previous studies, feeding a diet with Ca:P <1·0, a high total and inorganic P inclusion resulted in loss of renal function and changes in echogenicity suggestive of renal pathology. Feeding a diet containing lower total and inorganic P with Ca:P close to 1·0 led to more subtle structural changes in a third of test cats; however, nephrolithiasis occurred in both diet groups, complicating data interpretation. We conclude that the no observed adverse effects level for total dietary P in adult cats is lower than 3·6 g/1000 kcal (4184 kJ), however the effect of inorganic P sources and Ca:P require further investigation.
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Mendonça FS, Pedreira RS, Loureiro BA, Putarov TC, Monti M, Carciofi AC. Hydroxyproline and starch consumption and urinary supersaturation with calcium oxalate in cats. Anim Feed Sci Technol 2018. [DOI: 10.1016/j.anifeedsci.2018.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ennulat D, Ringenberg M, Frazier KS. Toxicologic Pathology Forum Opinion Paper*: Recommendations for a Tiered Approach to Nonclinical Mechanistic Nephrotoxicity Evaluation. Toxicol Pathol 2018; 46:636-646. [DOI: 10.1177/0192623318788302] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Nephrotoxicity is one of the more common causes of attrition in nonclinical drug development. Like most tissues, the kidney has a limited number of ways of responding to toxicological insults from diverse mechanistic pathways, which can limit the ability to determine mechanisms of renal injury using the assays routinely performed in preclinical toxicologic studies. In situations where the renal injury is unusual in morphology or if a therapeutic margin is low, additional investigative techniques may be needed to identify a potential mechanism of toxicity in order to inform clinical risk assessment or establish human relevance and translatability of the toxicity. While routine microscopic evaluation can suggest a specific pathogenesis, understanding the mechanism of renal injury often requires additional hypothesis-driven investigations and specialized techniques to obtain the data necessary to identify a nephrotoxic mechanism. Nonclinical mechanistic investigations can be resource-intensive and often yield limited new information. Although there are multiple avenues to investigate renal toxicity, no single mechanistic study or prescriptive battery of tests will identify the pathophysiologic basis for every potential mechanism of renal injury. To aid the nonclinical investigator, we outline a tiered approach for prioritizing investigations to provide a rational and linear road map for the exploration of mechanisms of drug-induced kidney injury. [Box: see text]
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Oka T, Hamano T, Sakaguchi Y, Yamaguchi S, Kubota K, Senda M, Yonemoto S, Shimada K, Matsumoto A, Hashimoto N, Mori D, Monden C, Takahashi A, Obi Y, Yamamoto R, Takabatake Y, Kaimori JY, Moriyama T, Horio M, Matsui I, Isaka Y. Proteinuria-associated renal magnesium wasting leads to hypomagnesemia: a common electrolyte abnormality in chronic kidney disease. Nephrol Dial Transplant 2018; 34:1154-1162. [DOI: 10.1093/ndt/gfy119] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Hypomagnesemia (Hypo-Mg) predicts mortality and chronic kidney disease (CKD) progression. However, in CKD, its prevalence, kidney-intrinsic risk factors, and the effectiveness of oral magnesium (Mg) therapy on serum Mg levels is uncertain.
Methods
In a cross-sectional study enrolling pre-dialysis outpatients with CKD, the prevalence of electrolyte abnormalities (Mg, sodium, potassium, calcium and phosphorus) was compared. In an open-label randomized controlled trial (RCT), we randomly assigned CKD patients to either the magnesium oxide (MgO) or control arm. The outcome was serum Mg levels at 1 year.
Results
In 5126 patients, Hypo-Mg was the most common electrolyte abnormality (14.7%) with similar prevalence across stages of CKD. Positive proteinuria was a risk factor of Hypo-Mg (odds ratio 2.2; 95% confidence interval 1.2–4.0). However, stratifying the analyses by diabetes mellitus (DM), it was not significant in DM (Pinteraction = 0.04). We enrolled 114 patients in the RCT. Baseline analyses showed that higher proteinuria was associated with higher fractional excretion of Mg. This relationship between proteinuria and renal Mg wasting was mediated by urinary tubular markers in mediation analyses. In the MgO arm, higher proteinuria or tubular markers predicted a significantly lower 1-year increase in serum Mg. In patients with a urinary protein-to-creatinine ratio (uPCR) <0.3 g/gCre, serum Mg at 1 year was 2.4 and 2.0 mg/dL in the MgO and control arms, respectively (P < 0.001), with no significant between-group difference in patients whose uPCR was ≥0.3 g/gCre (Pinteraction=0.001).
Conclusions
Proteinuria leads to renal Mg wasting through tubular injuries, which explains the high prevalence of Hypo-Mg in CKD.
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Affiliation(s)
- Tatsufumi Oka
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takayuki Hamano
- Department of Inter-Organ Communication Research in Kidney Disease, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yusuke Sakaguchi
- Department of Inter-Organ Communication Research in Kidney Disease, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Satoshi Yamaguchi
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Keiichi Kubota
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masamitsu Senda
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Sayoko Yonemoto
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Karin Shimada
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ayumi Matsumoto
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Nobuhiro Hashimoto
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Daisuke Mori
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Chikako Monden
- Department of Internal Medicine, Kisei Hospital, Osaka, Japan
| | - Atsushi Takahashi
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshitsugu Obi
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine School of Medicine, Irvine, CA, USA
| | | | - Yoshitsugu Takabatake
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Jun-Ya Kaimori
- Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | - Masaru Horio
- Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Isao Matsui
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshitaka Isaka
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
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Troìa R, Gruarin M, Grisetti C, Serafini F, Magna L, Monari E, Giunti M, Dondi F. Fractional excretion of electrolytes in volume-responsive and intrinsic acute kidney injury in dogs: Diagnostic and prognostic implications. J Vet Intern Med 2018; 32:1372-1382. [PMID: 29770972 PMCID: PMC6060310 DOI: 10.1111/jvim.15146] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 02/24/2018] [Accepted: 04/12/2018] [Indexed: 12/19/2022] Open
Abstract
Background The value of fractional excretion (FE) of electrolytes to characterize and prognosticate acute kidney injury (AKI) is poorly documented in dogs. Objectives To evaluate the diagnostic and prognostic roles of FE of electrolytes in dogs with AKI. Animals Dogs (n = 135) with AKI treated with standard care (February 2014‐December 2016). Methods Prospective study. Clinical and laboratory variables including FE of electrolytes, were measured upon admission. Dogs were graded according to the AKI‐IRIS guidelines and grouped according to AKI features (volume‐responsive, VR‐AKI; intrinsic, I‐AKI) and outcome (survivors/non‐survivors). Group comparison and regression analyses with hazard ratios (HR) evaluation for I‐AKI and mortality were performed. P < .05 was considered significant. Results Fifty‐two of 135 (39%) dogs had VR‐AKI, 69/135 (51%) I‐AKI and 14/135 (10%) were unclassified. I‐AKI dogs had significantly higher FE of electrolytes, for example, FE of sodium (FENa, %) 2.39 (range 0.04‐75.81) than VR‐AKI ones 0.24 (range 0.01‐2.21; P < .001). Overall, case fatality was 41% (55/135). Increased FE of electrolytes were detected in nonsurvivors, for example, FENa 1.60 (range 0.03‐75.81) compared with survivors 0.60 (range 0.01‐50.45; P = .004). Several risk factors for death were identified, including AKI‐IRIS grade (HR = 1.39, P = .002), FE of electrolytes, for example, FENa (HR = 1.03, P < .001), and urinary output (HR = 5.06, P < .001). Conclusions and Clinical Importance Fractional excretion of electrolytes performed well in the early differentiation between VR‐AKI and I‐AKI, were related to outcome, and could be useful tools to manage AKI dogs in clinical practice.
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Affiliation(s)
- Roberta Troìa
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Via Tolara di Sopra 50, Ozzano dell'Emilia, Bologna, Italy
| | - Marta Gruarin
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Via Tolara di Sopra 50, Ozzano dell'Emilia, Bologna, Italy
| | - Chiara Grisetti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Via Tolara di Sopra 50, Ozzano dell'Emilia, Bologna, Italy
| | - Federica Serafini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Via Tolara di Sopra 50, Ozzano dell'Emilia, Bologna, Italy
| | - Luca Magna
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Via Tolara di Sopra 50, Ozzano dell'Emilia, Bologna, Italy
| | - Erika Monari
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Via Tolara di Sopra 50, Ozzano dell'Emilia, Bologna, Italy
| | - Massimo Giunti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Via Tolara di Sopra 50, Ozzano dell'Emilia, Bologna, Italy
| | - Francesco Dondi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Via Tolara di Sopra 50, Ozzano dell'Emilia, Bologna, Italy
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Martorelli CR, Kogika MM, Chacar FC, Caragelasco DS, de Campos Fonseca Pinto ACB, Lorigados CAB, Andrade LC. Urinary Fractional Excretion of Phosphorus in Dogs with Spontaneous Chronic Kidney Disease. Vet Sci 2017; 4:vetsci4040067. [PMID: 29240673 PMCID: PMC5753647 DOI: 10.3390/vetsci4040067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/04/2017] [Accepted: 12/11/2017] [Indexed: 11/16/2022] Open
Abstract
The increase of urinary fractional excretion of phosphorus (uFEP) may indicate phosphorus retention before the onset of hyperphosphatemia in the early stages of chronic kidney disease (CKD). The hypothesis of this study is whether uFEP may increase during the early stage of CKD as a compensatory mechanism to prevent hyperphosphatemia as well as whether hyperphosphatemia in the late stages is associated with increase or decrease in uFEP in dogs with naturally occurring CKD; therefore, the aim of this study was to determine the uFEP in CKD dogs with different stages. Forty-nine CKD dogs were included, and they were divided into stage 1 (serum creatinine < 1.4 mg/dL), stage 2 (serum creatinine 1.5 to 2.0 mg/dL), stage 3 (serum creatinine 2.1 to 5.0 mg/dL) and stage 4 (serum creatinine > 5.0 mg/dL), according to the IRIS staging criteria. The stage 3 was subdivided into stage 3-A (serum creatinine 2.1 to 3.5 mg/dL) and stage 3-B (serum creatinine 3.6 to 5.0 mg/dL). The control group comprised 10 dogs, and uFEP ≤ 40% was considered as normal. A progressive increase in uFEP along the progression of CKD was found. However, similar results of uFEP levels were observed in late CKD, since there were no differences between stages 3 (A, B) and 4. Interestingly, some CKD dogs with stage 4 showed normal or reduced uFEP, besides hyperphosphatemia; conversely, some dogs in early CKD had increased uFEP values and normophosphatemia. Our findings suggest that uFEP may act as a compensatory mechanism to avoid the onset of hyperphosphatemia in early CKD, but not in later stages. uFEP assessment may be considered as an additional tool for the diagnostic and monitoring of phosphate disorders in dogs with CKD, since it may help to identify disturbances of phosphorus balance. More studies are needed to elucidate the role of uFEP in phosphorus homeostasis in dogs with CKD.
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Affiliation(s)
- Cínthia Ribas Martorelli
- Department of Veterinary Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, São Paulo, SP 05508-270, Brazil.
| | - Márcia Mery Kogika
- Department of Veterinary Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, São Paulo, SP 05508-270, Brazil.
| | - Fernanda Chicharo Chacar
- Department of Veterinary Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, São Paulo, SP 05508-270, Brazil.
| | - Douglas Segalla Caragelasco
- Department of Veterinary Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, São Paulo, SP 05508-270, Brazil.
| | - Ana Carolina Brandão de Campos Fonseca Pinto
- Department of Veterinary Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, São Paulo, SP 05508-270, Brazil.
| | - Carla Aparecida Batista Lorigados
- Department of Veterinary Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, São Paulo, SP 05508-270, Brazil.
| | - Lúcia Conceição Andrade
- Division of Nephrology, School of Medicine, University of São Paulo, Av. Dr. Arnaldo, 455, São Paulo, SP 01246-903, Brazil.
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Azarpeykan S, Dittmer KE, Marshall JC, Perera KC, Gee EK, Acke E, Thompson KG. Evaluation and Comparison of Vitamin D Responsive Gene Expression in Ovine, Canine and Equine Kidney. PLoS One 2016; 11:e0162598. [PMID: 27632366 PMCID: PMC5025205 DOI: 10.1371/journal.pone.0162598] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 08/25/2016] [Indexed: 01/15/2023] Open
Abstract
The aim of this study was to determine the relative abundance and relationship of vitamin D responsive and calcium transporting transcripts (TRPV5, TRPV6, calD9k, calD28k, PMCA, NCX1, CYP27B1, CYP24A1, and VDR) in ovine, canine and, equine kidney using quantitative real-time PCR (RT-qPCR), and then perform a comparison between the three species. Renal tissue samples were harvested post-mortem from 10 horses, 10 sheep, and five dogs. Primers were designed for each gene. For each sample total RNA was extracted, cDNA synthesised, and RT-qPCR was performed. RT-qPCR data were normalised and statistical comparison was performed. Due to their consistent correlation with each other in each species, TRPV6, calD9k/calD28k, and PMCA appeared to be the main pathways involved in active transepithelial calcium transport in the kidney of sheep, dogs and horses. The results indicate that all of the studied genes were expressed in the renal tissue of studied species, although the expression levels and correlation of transcripts with each other were different from species to species. All vitamin D responsive and calcium transporting transcripts were highly correlated with VDR in equine kidney, but not in sheep and dogs. The CYP27B1 and CYP24A1 mRNAs showed a different renal expression pattern and correlation in horses compared with sheep and dogs. Given the high urinary calcium concentration and low serum 1,25(OH)2D concentration in horses, it could be expected that CYP27B1 expression would be lower than CYP24A1 in the horse, and this did not appear to be the case. The findings suggest that despite low serum vitamin D concentrations, vitamin D still plays a significant role in calcium metabolism in horses, especially given the strong correlations between VDR and vitamin D responsive transcripts in these animals.
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Affiliation(s)
- Sara Azarpeykan
- Institute of Veterinary, Animal and Biomedical Science (IVABS), Massey University, Palmerston North, New Zealand
- * E-mail:
| | - Keren E. Dittmer
- Institute of Veterinary, Animal and Biomedical Science (IVABS), Massey University, Palmerston North, New Zealand
| | - Jonathan C. Marshall
- Institute of Fundamental Sciences (IFS), Massey University, Palmerston North, New Zealand
| | - Kalyani C. Perera
- Institute of Veterinary, Animal and Biomedical Science (IVABS), Massey University, Palmerston North, New Zealand
| | - Erica K. Gee
- Institute of Veterinary, Animal and Biomedical Science (IVABS), Massey University, Palmerston North, New Zealand
| | - Els Acke
- Institute of Veterinary, Animal and Biomedical Science (IVABS), Massey University, Palmerston North, New Zealand
| | - Keith G. Thompson
- Institute of Veterinary, Animal and Biomedical Science (IVABS), Massey University, Palmerston North, New Zealand
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Hokamp JA, Cianciolo RE, Boggess M, Lees GE, Benali SL, Kovarsky M, Nabity MB. Correlation of Urine and Serum Biomarkers with Renal Damage and Survival in Dogs with Naturally Occurring Proteinuric Chronic Kidney Disease. J Vet Intern Med 2016; 30:591-601. [PMID: 26833584 PMCID: PMC4913609 DOI: 10.1111/jvim.13832] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 09/06/2015] [Accepted: 12/29/2015] [Indexed: 01/11/2023] Open
Abstract
Background Urine protein loss is common in dogs with chronic kidney disease (CKD). Hypothesis/Objectives To evaluate new biomarkers of glomerular and tubulointerstitial (TI) damage compared with histology and as survival indicators in dogs with naturally occurring, proteinuric CKD. Animals One hunderd and eighty dogs with naturally occurring kidney disease. Methods Retrospective study using urine, serum, and renal biopsies from dogs with kidney disease, 91% of which had proteinuric CKD. Biomarkers were evaluated and correlated with pathologic renal damage, and significant associations, sensitivities, and specificities of biomarkers for renal disease type were determined. Results Fractional excretions of immunogloblin M (IgM_FE) and immunoglobulin G (IgG_FE) correlated most strongly with glomerular damage based on light microscopy (r = 0.58 and 0.56, respectively; P < .01). Serum creatinine (SCr) correlated most strongly with TI damage (r = 0.70, P < .01). Urine IgM/creatinine and urine NAG/creatinine had the highest sensitivity (75%) and specificity (78%) for detection of immune complex‐mediated glomerulonephritis. Although individually most biomarkers were significantly associated with decreased survival time (P < .05), in a multivariate analysis, SCr, IgM_FE, and glomerular damage based on transmission electron microscopy (TEM) were the only biomarkers significantly associated with survival time (SCr: P = .001; IgM_FE: P = .008; TEM: P = .017). Conclusions and Clinical Importance Novel urine biomarkers and FEs are useful for detection of glomerular and TI damage in dogs with proteinuric CKD and might predict specific disease types and survival.
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Affiliation(s)
- J A Hokamp
- Department of Veterinary Pathobiology, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, TX
| | - R E Cianciolo
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH
| | - M Boggess
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ
| | - G E Lees
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, TX
| | - S L Benali
- Dipartimento di Sanità Pubblica, Patologia Comparata e Igiene Veterinaria, Facoltà di Medicina Veterinaria, Viale dell'Università, Padua, Italy
| | - M Kovarsky
- Department of Veterinary Pathobiology, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, TX
| | - M B Nabity
- Department of Veterinary Pathobiology, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, TX
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Lester SJ, Mollat WH, Bryant JE. Overview of Clinical Pathology and the Horse. Vet Clin North Am Equine Pract 2015. [DOI: 10.1016/j.cveq.2015.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Brown N, Segev G, Francey T, Kass P, Cowgill LD. Glomerular filtration rate, urine production, and fractional clearance of electrolytes in acute kidney injury in dogs and their association with survival. J Vet Intern Med 2015; 29:28-34. [PMID: 25594609 PMCID: PMC4858109 DOI: 10.1111/jvim.12518] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 09/16/2014] [Accepted: 11/06/2014] [Indexed: 12/02/2022] Open
Abstract
Background Acute kidney injury (AKI) is common in dogs. Few studies have assessed sequential changes in indices of kidney function in dogs with naturally occurring AKI. Objective To document sequential changes of conventional indices of renal function, to better define the course of AKI, and to identify a candidate marker for recovery. Animals Ten dogs with AKI. Methods Dogs were prospectively enrolled and divided into surviving and nonsurviving dogs. Urine production was measured with a closed system for 7 days. One and 24‐hour urinary clearances were performed daily to estimate solute excretion and glomerular filtration rate (GFR). Solute excretion was calculated as an excretion ratio (ER) and fractional clearance (FC) based on both the 1‐ and 24‐hour urine collections. Results Four dogs survived and 6 died. At presentation, GFR was not significantly different between the outcome groups, but significantly (P = .03) increased over time in the surviving, but not in the nonsurviving dogs. Fractional clearance of Na decreased significantly over time (20.2–9.4%, P < .0001) in the surviving, but not in the nonsurviving dogs. The ER and FC of solutes were highly correlated (r, 0.70–0.95). Conclusion and Clinical Impact Excretion ratio might be used in the clinical setting as a surrogate marker to follow trends in solute excretion. Increased GFR, urine production, and decreased FC of Na were markers of renal recovery. The FC of Na is a simple, noninvasive, and cost‐effective method that can be used to evaluate recovery of renal function.
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Affiliation(s)
- N Brown
- Internal Medicine Service, Animal Referral Hospital, Homebush West, NSW, Australia
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Bhanugopan MS, Fulkerson WJ, Hyde M, Fraser DR. Effect of dietary potassium supplementation on the calcium absorption capacity in the rumen and abomasum and fractional excretion of urinary minerals in sheep. ANIMAL PRODUCTION SCIENCE 2015. [DOI: 10.1071/an12366] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this study was to determine the effect of potassium (K) supplementation on the calcium (Ca) absorption capacity from the rumen and abomasum of sheep. The Ca absorption capacity from the rumen and abomasum of sheep was measured using stable strontium (Sr) as a Ca-analogue tracer method. The sheep, cannulated at either the rumen or abomasum, were randomly allocated to one of two groups (control or K-supplemented) and fed in individual metabolism pens twice daily with a diet comprising oaten hay, lucerne chaff and barley fortified with or without potassium carbonate (K2CO3). The K content of the diet of the K-supplemented animals was 3.1% of dry matter compared with 1.4% for the control animals. The animals were fed their respective diets for a period of 2 weeks. The fractional absorption capacity (FC) of Ca was estimated before, during and after the treatment period. Supplementation with K decreased the FC of Ca in both the rumen and abomasum during treatment and increased the FC of Ca in the abomasum post-treatment. Supplementation with K also increased the fractional excretion of K in the urine, but decreased the fractional excretion of Ca and magnesium (Mg) (P < 0.05), showing that K supplementation significantly affected Ca and Mg metabolism. Results suggest that renal conservation of Ca and Mg is an important mechanism controlling the Ca and Mg pool for vital functions of the body. In times of high demand for these minerals during lactation and pregnancy, high K in the diets may predispose sheep to hypomagnesaemia and hypocalcaemia, which in turn will have a negative impact on productivity and economic returns.
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Giunti M, Troia R, Bergamini PF, Dondi F. Prospective evaluation of the acute patient physiologic and laboratory evaluation score and an extended clinicopathological profile in dogs with systemic inflammatory response syndrome. J Vet Emerg Crit Care (San Antonio) 2014; 25:226-33. [PMID: 25427754 DOI: 10.1111/vec.12257] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 10/06/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the prognostic value of the acute patient physiologic and laboratory evaluation (APPLE) score and relevant clinicopathological markers in dogs with systemic inflammatory response syndrome (SIRS). DESIGN Prospective observational cohort study. SETTING Veterinary teaching hospital. ANIMALS Thirty-three dogs with SIRS admitted to the intensive care unit (ICU) were compared to 35 healthy control dogs. Dogs with SIRS were divided into septic (n = 20) and nonseptic (n = 13) etiologies and as survivors (alive to discharge, n = 22) and nonsurvivors (n = 11: died, n = 6, or humanely euthanized, n = 5). MEASUREMENTS AND MAIN RESULTS For all dogs, physiological and laboratory parameters were prospectively collected for the calculation of the APPLE fast score. No difference between septic and nonseptic SIRS dogs was detected for any parameter evaluated. Survivors had significantly higher total protein, albumin concentrations, antithrombin activity (ATA), and base excess (BE), as well as significantly lower lactate, urea, creatinine concentrations, urinary protein to creatinine ratio and APPLE fast score compared to nonsurvivors. Higher values of creatinine, lactate, anion gap, alanine transaminase (ALT), and APPLE fast score were significantly associated with an increased risk of death in SIRS dogs, while higher values of total protein, albumin, ATA, and BE were associated with a significantly reduced risk of mortality. When a multivariate binary logistic regression analysis was performed, the APPLE fast score was the only significant parameter retained. CONCLUSIONS The determination of the APPLE fast score in clinical setting, as well as the measurement of APP, ATA, lactate, BE, anion gap, ALT, urinary proteins, and electrolytes may be beneficial for a better assessment of dogs with SIRS. Identified parameters were significantly related with the presence of SIRS and their evaluation should be considered for the assessment of disease severity, and guidance of the decision-making process in critically ill dogs.
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Affiliation(s)
- Massimo Giunti
- From the Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Ozzano dell'Emilia, Bologna, Italy
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Mochel JP, Fink M, Bon C, Peyrou M, Bieth B, Desevaux C, Deurinck M, Giraudel JM, Danhof M. Influence of feeding schedules on the chronobiology of renin activity, urinary electrolytes and blood pressure in dogs. Chronobiol Int 2014; 31:715-30. [DOI: 10.3109/07420528.2014.897711] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Mesa‐Sánchez I, Purzycka K, Isidoro‐Ayza M, Ruiz de Gopegui‐Fernández R. Fanconi syndrome in a Bichon Maltese dog: a quantitative approach to acid–base analysis. VETERINARY RECORD CASE REPORTS 2014. [DOI: 10.1136/vetreccr-2013-000022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Ignacio Mesa‐Sánchez
- Veterinary FacultyDepartment of Animal Medicine and SurgeryUniversitat Autònoma de BarcelonaBarcelona08193Spain
| | - Katarzyna Purzycka
- Veterinary FacultyDepartment of Animal Medicine and SurgeryUniversitat Autònoma de BarcelonaBarcelona08193Spain
| | - Marcos Isidoro‐Ayza
- Veterinary FacultyServei de Diagnòstic de Patologia VeterinàriaUniversitat Autònoma de BarcelonaBarcelona08193Spain
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Murahata Y, Yamamoto A, Miki Y, Hikasa Y. Antagonistic effects of atipamezole, yohimbine and prazosin on medetomidine-induced diuresis in healthy cats. J Vet Med Sci 2013; 76:173-82. [PMID: 24107430 PMCID: PMC3982822 DOI: 10.1292/jvms.13-0398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
This study aimed to investigate and compare the antagonistic effects of atipamezole, yohimbine and prazosin on medetomidine-induced diuresis in healthy cats. Five cats were repeatedly used in each of the 9 groups. One group was not medicated. Cats in the other groups received 40 µg/kg medetomidine intramuscularly and saline (as the control), 160 µg/kg prazosin, or 40, 160 or 480 µg/kg atipamezole or yohimbine intravenously 0.5 hr later. Volume, pH and specific gravity of urine; plasma arginine vasopressin (AVP) level; and creatinine, osmolality and electrolyte levels in both urine and plasma were measured. Both atipamezole and yohimbine, but not prazosin, antagonized medetomidine-induced diuresis. The antidiuretic effect of atipamezole was more potent than that of yohimbine, but was not dose dependent, in contrast to the effect of yohimbine at the tested doses. Both atipamezole and yohimbine reversed medetomidine-induced decreases in both urine specific gravity and osmolality and increases in plasma osmolality and free-water clearance. Antidiuresis of either atipamezole or yohimbine was not related to the area under the curve for AVP level, although the highest dose of both atipamezole and yohimbine initially and temporarily increased plasma AVP levels, suggesting that this may partly influence the antidiuretic effects of both agents. The diuretic effect of medetomidine in cats may be mediated by α2-adrenoceptors, but not α1-adrenoceptors. Atipamezole and yohimbine can be used as antagonistic agents against medetomidine-induced diuresis in healthy cats.
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Affiliation(s)
- Yusuke Murahata
- Laboratory of Veterinary Internal Medicine, Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101 Koyama-Minami, Tottori 680-8553, Japan
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Mochel JP, Fink M, Peyrou M, Desevaux C, Deurinck M, Giraudel JM, Danhof M. Chronobiology of the renin-angiotensin-aldosterone system in dogs: relation to blood pressure and renal physiology. Chronobiol Int 2013; 30:1144-59. [DOI: 10.3109/07420528.2013.807275] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pressler BM. Clinical approach to advanced renal function testing in dogs and cats. Vet Clin North Am Small Anim Pract 2013; 43:1193-208, v. [PMID: 24144085 DOI: 10.1016/j.cvsm.2013.07.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Serum creatinine concentration is insensitive for detecting kidney injury and does not assist in differentiation between glomerular versus tubular damage. Advanced renal function tests, including glomerular filtration rate testing, determining fractional excretion of electrolytes, and assay of urine biomarkers, may allow earlier detection of reduced renal function mass, differentiation of renal from non-renal causes of azotemia, and assist with localization of damage. This article reviews the principles, indications, and limitations of these tests and describes their use in sample clinical scenarios.
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Affiliation(s)
- Barrak M Pressler
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon Tharp Street, Columbus, OH 43210, USA.
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MOCHEL JP, PEYROU M, FINK M, STREHLAU G, MOHAMED R, GIRAUDEL JM, PLOEGER B, DANHOF M. Capturing the dynamics of systemic Renin-Angiotensin-Aldosterone System (RAAS) peptides heightens the understanding of the effect of benazepril in dogs. J Vet Pharmacol Ther 2012; 36:174-80. [DOI: 10.1111/j.1365-2885.2012.01406.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Butterworth KA, Pellegrini-Masini AM, Barton MH. Diagnosis and management of hypoaldosteronism without hypoadrenocorticism in an alpaca. J Am Vet Med Assoc 2012; 240:748-51. [PMID: 22380814 DOI: 10.2460/javma.240.6.748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION Primary hypoaldosteronism without concurrent hypoadrenocorticism was diagnosed in an 8-year-old female alpaca with acute onset of weakness progressing to recumbency within 6 hours after onset. CLINICAL FINDINGS Hematologic testing at admission revealed profound hyponatremia, hypochloremia, and acidemia with a normal blood potassium concentration. Further diagnostic testing, including an ACTH stimulation test, led to a diagnosis of hypoaldosteronism in conjunction with normal cortisol production. TREATMENT AND OUTCOME The hembra responded well to i.v. polyionic fluid therapy with sodium supplementation and was managed successfully long term with free access to saline (0.9% NaCl) solution in addition to water ad libitum. CLINICAL RELEVANCE To our knowledge, this is the first reported case of hypoaldosteronism in an alpaca. Hypoaldosteronism should be considered in alpacas as a possible differential diagnosis for refractory hyponatremia or for hyponatremia in which an underlying etiology is not determined.
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Affiliation(s)
- Kelly A Butterworth
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
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Normal vitamin D receptor function with increased expression of 25-hydroxyvitamin D3-24-hydroxylase in Corriedale sheep with inherited rickets. Res Vet Sci 2011; 91:362-9. [DOI: 10.1016/j.rvsc.2010.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 08/30/2010] [Accepted: 09/23/2010] [Indexed: 01/08/2023]
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Robinson R, Schwendenwein I, Wacek S, Nell B, Mosing M. Plasma volume and electrolyte changes following intravenous infusion of hypertonic hydroxyethyl starch versus mannitol in healthy dogs. Vet J 2011; 190:268-272. [DOI: 10.1016/j.tvjl.2010.10.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 10/19/2010] [Accepted: 10/22/2010] [Indexed: 11/17/2022]
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Sacco S, Lopes R. Urolitíase: estudo comparativo em bovinos Guzerá oriundos de propriedades com e sem o problema. PESQUISA VETERINÁRIA BRASILEIRA 2011. [DOI: 10.1590/s0100-736x2011000300004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Diversos fatores podem contribuir para a formação de cálculos urinários, dentre estes, o desequilíbrio nutricional e a dureza da água consumida pelos ruminantes. O objetivo deste estudo foi identificar as características de propriedades que predispõem à urolitíase, através da avaliação da água, da dieta e determinações séricas e urinárias de cálcio, fósforo, magnésio, cloretos, sódio, potássio, cálculo da excreção fracionada (EF) dos eletrólitos, e da creatinina, proteína total, albumina e globulinas séricas. Foram colhidas amostras de sangue e urina de bovinos, Guzerá, criados semi intensivamente, distribuídos por dois grupos. O primeiro denominado grupo urolitíase (Gu), composto de animais com histórico, sinais clínicos e confirmação ultrassonográfica que apresentavam urolitíase; o segundo: grupo controle (Gc), sem histórico, nem sintomas da doença. Os bovinos do grupo urolitíase consumiam água com dureza total na concentração de 166,0mg CaCO3/L. A dieta dos animais do Gu apresentava maior concentração de fósforo e relação Ca:P inadequada. Os teores de fósforo sérico e urinário dos animais do Gu foram maiores do que os do Gc, assim como a concentração sérica de magnésio (p<0,05). Não houve aumento nas concentrações de creatinina no grupo urolitíase, mas ocorreu hipoproteinemia por hipoglobulinemia (p<0,05). As EFs de cálcio, fósforo e sódio não diferiram entre os grupos (p>0,05), mas houve diminuição significativa nas EFs de magnésio, cloretos e de potássio do grupo urolitíase (p<0,05). A união destes fatores contribuiu para a ocorrência da urolitíase, sendo dureza total da água e a alta concentração de fósforo na dieta os principais fatores na gênese dos cálculos em bovinos.
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Cameron K, Gallagher A. Syndrome of inappropriate antidiuretic hormone secretion in a cat. J Am Anim Hosp Assoc 2010; 46:425-32. [PMID: 21041336 DOI: 10.5326/0460425] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 3-year-old, spayed female, domestic shorthaired cat was presented for evaluation of liver disease. Following anesthesia, laparoscopy, and medical therapy, the cat developed severe hyponatremia that was unresponsive to fluid therapy. Further evaluation of serum and urine osmolality determined that the cat fulfilled the criteria for syndrome of inappropriate antidiuretic hormone secretion. Treatment with fluid restriction resulted in resolution of the hyponatremia and clinical signs associated with the electrolyte imbalance.
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Affiliation(s)
- Kristin Cameron
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Duckpond Drive, Phase II, Virginia Tech (0442), Blacksburg, Virginia 24061, USA
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Driver TL, Swenson CL. Pathology in practice. "Urine" sample collected by cystocentesis probably fluid aspirated from a prostatic cyst. J Am Vet Med Assoc 2010; 236:957-9. [PMID: 20433393 DOI: 10.2460/javma.236.9.957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Timothy L Driver
- Department of Pathobiology and Diagnostic Investigation and the Diagnostic Center for Population and Animal Health, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
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van Hoek I, Meyer E, Duchateau L, Peremans K, Smets P, Daminet S. Retinol-Binding Protein in Serum and Urine of Hyperthyroid Cats before and after Treatment with Radioiodine. J Vet Intern Med 2009; 23:1031-7. [DOI: 10.1111/j.1939-1676.2009.0364.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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