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Tamamoto T, Miki Y, Sakamoto M, Yoshii M, Yamada M, Sudo D, Fusato Y, Ozawa J, Satake C. Biological variation of 16 biochemical analytes estimated from a large clinicopathologic database of dogs and cats. Vet Clin Pathol 2024; 53:218-228. [PMID: 38803017 DOI: 10.1111/vcp.13357] [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: 08/29/2023] [Revised: 02/19/2024] [Accepted: 04/21/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Biochemical measurements are commonly evaluated using population-based reference intervals; however, there is a growing trend toward reassessing results with within-subject variation (CVI). OBJECTIVES We aimed to estimate the CVI of 16 biochemical analytes using a large database of dogs and cats, which refers to the results of routine health checkups. METHODS Pairs of sequential results for 16 analytes were extracted from a database of adult patients. The second result was divided by the first result to produce the ratio of sequential results (rr), and the frequency distribution of rr was plotted. From the plots, the coefficient of variation (CVrr) was calculated. Analytical variation (CVA) was calculated using quality control data, and CVI was estimated as follows:CV I = CV rr / 2 1 / 2 2 - CV A 2 1 / 2 . Estimated CVI was compared with previously reported CVI using the Bland-Altman plot analysis. RESULTS From the database, 9078 data points from 3610 dogs and 3743 data points from 1473 cats were extracted, with 5468 data pairs for dogs and 2270 for cats. Sampling intervals ranged from 10 to 1970 days (median 366) for dogs and 23 to 1862 days (median 365) for cats. Bland-Altman analysis showed most CVI plots fell within the limits of agreement; however, positive fixed biases were observed in both dogs and cats. CONCLUSIONS Our study introduces a novel approach of estimating CVI using routine health checkup data in dogs and cats. Despite biases, our method holds promise for clinical application in assessing the significance of measurement result differences.
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Affiliation(s)
| | - Yohei Miki
- FUJIFILM VET Systems Co. Ltd., Tokyo, Japan
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2
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Urbanschitz T, Huber L, Tichy A, Burgener IA, Zeugswetter FK. Short-term glycemic variability in non-diabetic, non-obese dogs assessed by common glycemic variability indices. Res Vet Sci 2024; 169:105156. [PMID: 38340380 DOI: 10.1016/j.rvsc.2024.105156] [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: 11/13/2022] [Revised: 12/14/2023] [Accepted: 01/12/2024] [Indexed: 02/12/2024]
Abstract
Glycemic variability (GV) refers to swings in blood glucose levels and is an emerging measure of glycemic control in clinical practice. It is associated with micro- and macrovascular complications and poor clinical outcomes in diabetic humans. Although an integral part of patient assessment in human patients, it is to a large extent neglected in insulin-treated diabetic dogs. This prospective pilot study was performed to describe canine within-day GV in non-diabetic dogs with the aim to provide a basis for the interpretation of daily glucose profiles, and to promote GV as an accessible tool for future studies in veterinary medicine. Interstitial glucose concentrations of ten non-diabetic, non-obese beagles were continuously measured over a 48-h period using a flash glucose monitoring system. GV was assessed using the common indices MAGE (mean amplitude of glycemic excursion), GVP (Glycemic variability percentage) and CV (coefficient of variation). A total of 2260 sensor measurements were obtained, ranging from 3.7 mmol/L (67 mg/dL) to 8.5 mmol/L (153 mg/dL). Glucose profiles suggested a meal-dependent circadian rhythmicity with small but significant surges during the feeding periods. No differences in GV indices were observed between day and night periods (p > 0.05). The MAGE (mmol/L), GVP (%) and CV (%) were 0.86 (± 0.19), 7.37 (± 1.65), 6.72 (± 0.89) on day one, and 0.83 (± 0.18), 6.95 (± 1.52), 6.72 (± 1.53) on day two, respectively. The results of this study suggest that GV is low in non-diabetic dogs and that glucose concentrations are kept within narrow ranges.
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Affiliation(s)
- Tobias Urbanschitz
- University of Veterinary Medicine Vienna Department of Small Animals and Horses Division of Small Animal Internal Medicine Veterinaerplatz 1, 1210 Vienna, Austria.
| | - Lukas Huber
- University of Veterinary Medicine Vienna Department of Small Animals and Horses Division of Small Animal Internal Medicine Veterinaerplatz 1, 1210 Vienna, Austria.
| | - Alexander Tichy
- University of Veterinary Medicine Vienna Platform for Bioinformatics and Biostatistics Veterinaerplatz 1, 1210 Vienna, Austria.
| | - Iwan Anton Burgener
- University of Veterinary Medicine Vienna Department of Small Animals and Horses Division of Small Animal Internal Medicine Veterinaerplatz 1, 1210 Vienna, Austria.
| | - Florian Karl Zeugswetter
- University of Veterinary Medicine Vienna Department of Small Animals and Horses Division of Small Animal Internal Medicine Veterinaerplatz 1, 1210 Vienna, Austria.
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Manzocchi S, van Rooyen LJ. Are analytical performance specifications derived from reference intervals of any use in the veterinary clinical laboratory? A preliminary study on the empirical biological variation model. Vet Clin Pathol 2024; 53 Suppl 1:86-95. [PMID: 38238987 DOI: 10.1111/vcp.13317] [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: 03/31/2023] [Revised: 10/09/2023] [Accepted: 10/29/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Analytical performance specifications (APS) are vital for method evaluation and quality control validation. However, the limited availability of biological variation (BV) data, regulatory guidelines, and expert opinion (EO) may present challenges in veterinary medicine. The empirical biological variation (EBV) approach, based on population reference intervals (pRI), has emerged as an alternative method to derive APS in human medicine. OBJECTIVES This study aimed to assess the practicality and usefulness of the EBV approach in deriving performance limits for various measurands in dogs and cats. METHODS Eight hematology and 13 biochemistry measurands were analyzed in dogs and cats. Estimates of combined biologic variation based on traditional biological (CVB ) and EBV-derived (CVE *) formulas were calculated and assessed for evidence of correlation. Performance limits for expanded uncertainty/total error and imprecision were compared among EO, BV, and EBV. RESULTS Strong and significant correlations were found between CVB and CVE * for both dogs (r = .86, p < .00001) and cats (r = 0.95, p < .00001). The EBV-derived APS were generally comparable to EO and BV, with a subjective criterion of 1.5% difference for imprecision and 3% for total error/expanded uncertainty. CONCLUSION The EBV approach, using pRI, shows promise as a surrogate marker for biological variation and as a practical tool for determining performance limits in dogs and cats. Assuming accurate pRI generated on analyzers with stable analytical performance, this approach could offer benefits when expert recommendations or robust BV studies are lacking or yield conflicting results. Further research is needed to explore the applicability and advantages of the EBV in veterinary medicine.
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Affiliation(s)
- Simone Manzocchi
- IDEXX Laboratories Laboratory Analytical and Method Advisor (LAMA) Team, Milan, Italy
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Oikonomidis IL, Milne E. Clinical enzymology of the dog and cat. Aust Vet J 2023; 101:465-478. [PMID: 37767749 DOI: 10.1111/avj.13291] [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: 04/04/2023] [Revised: 08/15/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023]
Abstract
Clinical enzymology studies the enzyme activity in serum or other body fluids for the diagnosis, prognosis or monitoring of a variety of diseases. Clinical enzymology has greatly benefited from advances in technology and is now an integral part of laboratory analysis. However, to maximise the clinical benefits of serum enzyme measurement, clinicians and clinical pathologists must have a good understanding of the pathophysiology behind serum enzyme alterations. They must also be aware of the preanalytical and analytical factors that can affect the accuracy of serum enzyme activity measurement. This review article first covers the basic concepts of clinical enzymology and the general mechanisms related to serum enzyme alterations. Then, the review discusses the potential effects of various preanalytical and analytical factors on enzyme activity measurement. Lastly, it explores the pathophysiology and clinical use of various serum enzymes in canine and feline medicine. The present review article aims to be a comprehensive one-stop source for clinical pathologists and small animal practitioners.
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Affiliation(s)
- I L Oikonomidis
- Easter Bush Pathology, The Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Midlothian, United Kingdom
| | - E Milne
- Easter Bush Pathology, The Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Midlothian, United Kingdom
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Rossi G, Liu KF, Kershaw H, Riddell D, Hyndman TH, Monks D, Musk GC. Biological Variation in Biochemistry Analytes in Laboratory Guinea Pigs ( Cavia porcellus). Vet Sci 2023; 10:621. [PMID: 37888573 PMCID: PMC10610888 DOI: 10.3390/vetsci10100621] [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: 09/07/2023] [Revised: 09/27/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023] Open
Abstract
Biological variation (BV) describes the physiological random fluctuation around a homeostatic set point, which is a characteristic of all blood measurands (analytes). That variation may impact the clinical relevance of the changes that are observed in the serial results for an individual. Biological variation is represented mathematically by the coefficient of variation (CV) and occurs within each individual (CVI) and between individuals in a population (CVG). Biological variation data can be used to assess whether population-based reference or subject-based reference intervals should be used for the interpretation of laboratory results through the calculation of the index of individuality (IoI). This study aimed to determine the biological variations, calculate the IoI and reference change values (RCV) of clinical chemistry analytes in an outbred strain colony of Hartley guinea pigs (GPs), and set the quality specifications for clinical chemistry analytes. Blood was collected from 16 healthy adult laboratory colony GPs via jugular venipuncture at weekly intervals over six weeks. All the samples were frozen and analyzed in a single run. Analytical, CVI, and CVG biological variations, together with the IoI and RCV, were calculated for each measurand. Based on the estimated BV, the calculated IoI was low for glucose, so individual reference intervals (RCV) should be used. The majority of the measurands should be interpreted using both population-based and subject-based reference intervals as the IoIs were intermediate.
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Affiliation(s)
- Gabriele Rossi
- School of Veterinary Medicine, Murdoch University, Murdoch, WA 6150, Australia; (K.-F.L.); (T.H.H.)
- Centre for Animal Production and Health, Murdoch University, Murdoch, WA 6150, Australia
| | - Kwei-Farn Liu
- School of Veterinary Medicine, Murdoch University, Murdoch, WA 6150, Australia; (K.-F.L.); (T.H.H.)
| | - Helen Kershaw
- Animal Care Services, University of Western Australia, Crawley, WA 6009, Australia; (H.K.); (D.R.); (G.C.M.)
| | - Dayna Riddell
- Animal Care Services, University of Western Australia, Crawley, WA 6009, Australia; (H.K.); (D.R.); (G.C.M.)
| | - Timothy H. Hyndman
- School of Veterinary Medicine, Murdoch University, Murdoch, WA 6150, Australia; (K.-F.L.); (T.H.H.)
| | - Deborah Monks
- Brisbane Bird and Exotics Veterinary Service, Greenslopes, QLD 4120, Australia;
| | - Gabrielle C. Musk
- Animal Care Services, University of Western Australia, Crawley, WA 6009, Australia; (H.K.); (D.R.); (G.C.M.)
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Selin AK, Lilliehöök I, Forkman J, Larsson A, Pelander L, Strage EM. Biological variation of biochemical urine and serum analytes in healthy dogs. Vet Clin Pathol 2023; 52:461-474. [PMID: 37316471 DOI: 10.1111/vcp.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 10/21/2022] [Accepted: 11/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Biological variation (BV) of urinary (U) biochemical analytes has not been described in absolute terms, let alone as a ratio of the U-creatinine or fractional excretion in healthy dogs. These analytes are potential diagnostic tools for different types of kidney damage and electrolyte disorders in dogs. OBJECTIVES We aimed to investigate the BV of specific gravity, osmolality, creatinine, urea, protein, glucose, chloride, sodium, potassium, calcium, and phosphate in urine from healthy pet dogs. METHODS Blood and urine samples from 13 dogs were collected once weekly for 8 weeks. Samples were analyzed in duplicate and in randomized order. For each sample, U-analyte and serum concentrations were measured, and U-analyte/U-creatinine and fractional excretion (FE) were calculated. Components of variance, estimated by restricted maximum likelihood, were used to determine within-subject variation (CVI ), between-subject variation (CVG ), and analytical variation (CVA ). Index of individuality (II) and reference change values were calculated. RESULTS CVI for all urine analytes varied between 12.6% and 35.9%, except for U-sodium, U-sodium/U-Cr, and FE-sodium, which had higher CVI s (59.5%-60.7%). For U-protein, U-sodium, U-potassium, U-sodium/U-creatinine, FE-urea, FE-glucose, FE-sodium, FE-potassium, and FE-phosphate II were low, indicating that population-based RIs were appropriate. The remaining analytes had an intermediate II, suggesting that population-based RIs should be used with caution. CONCLUSION This study presents information on the biological variation of urinary and serum biochemical analytes from healthy dogs. These data are important for an appropriate interpretation of laboratory results.
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Affiliation(s)
- Anna K Selin
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
- AniCura Albano Animal Hospital and AniCura Gärdets Animal Clinic, Stockholm, Sweden
| | - Inger Lilliehöök
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Johannes Forkman
- Department of Crop Production Ecology, Swedish University of Agriculture Sciences, Uppsala, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Lena Pelander
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Emma M Strage
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Smith SM, Carney PC, Prieto JM, Miller ML, Randolph JF, Farace G, Peterson S, Bilbrough G, Peterson ME. Biological variation of biochemical analytes determined at 8-week intervals for 1 year in clinically healthy cats. Vet Clin Pathol 2023; 52:44-52. [PMID: 36289013 DOI: 10.1111/vcp.13170] [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: 01/14/2022] [Revised: 05/09/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Biological variation helps determine whether population-based or subject-based reference intervals are more appropriate to assess changes in serial analytical values. Previous studies have investigated the biological variation of biochemical analytes weekly or with variable frequency over 5-14 weeks in cats, but none have considered biological variation at less frequent intervals over 1 year. OBJECTIVES We aimed to evaluate the long-term biological variation of 19 biochemical analytes in clinically healthy cats. METHODS A prospective, observational study in which 15 clinically healthy, client-owned cats were sampled for serum biochemical analyses every 8 weeks for 1 year. Frozen serum samples were single-batch analyzed. Restricted maximum likelihood estimation was used to determine the coefficients of variation (CV), describing variation within each cat, between cats, and the analytical variation. These CVs were used to determine the indices of individuality and reference change values (RCVs). RESULTS Albumin, alkaline phosphatase, creatine kinase, and globulin had high indices of individuality, indicating that they are best evaluated by RCVs. Phosphorus, potassium, chloride, sodium, symmetric dimethylarginine, and total CO2 had low indices of individuality, indicating that population-based reference intervals are appropriate. Alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, calcium, cholesterol, creatinine, glucose, total bilirubin, and total protein had intermediate indices of individuality, indicating that RCVs may provide additional insight into the interpretation of analyte measurements beyond the population-based reference intervals. CONCLUSIONS For many analytes, the biological variation detected was similar to that reported in prior studies. Clinicians should consider the biological variation of analytes to best interpret clinically relevant changes in serial analyte measurements.
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Affiliation(s)
- Stephanie M Smith
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Patrick C Carney
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Jennifer M Prieto
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Meredith L Miller
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - John F Randolph
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | | | | | | | - Mark E Peterson
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.,Animal Endocrine Clinic, New York, New York, USA
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Harper JA, Gal A, Burchell RK, Summers JD, Starling J, Gerber K, Gummow B. Comparison of ionised calcium measured using a portable analyser to a reference method in healthy dogs. J Small Anim Pract 2023; 64:337-342. [PMID: 36733265 DOI: 10.1111/jsap.13588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 10/31/2022] [Accepted: 12/15/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To compare the ionised calcium measured on a portable analyser (iSTAT, Abbott) to a reference method. MATERIALS AND METHODS Blood samples from 39 apparently healthy dogs were analysed in duplicate using a portable analyser and a reference method (Radiometer ABL800 FLEX). Bland-Altman plots and Passing-Bablok regression were used to assess constant and proportional bias between the two instruments. A within-assay percentage coefficient of variation and total error (TE) was calculated for both analysers. The reference interval was calculated for the portable analyser using the robust method with confidence interval bootstrapping. RESULTS The Bland-Altman plot showed a -0.036 mmol/L difference between the two instruments (95% confidence limit -0.08 to 0.01 mmol/L; limits of agreement -0.07 to 0.006 mmol/L). Neither the Bland-Altman plot nor the Passing-Bablock regression (slope -0.03; 95% confidence interval -0.08 to 0.19 and intercept 1; 95% confidence interval 0.83 to 1.2) showed significant proportional bias. The coefficient of variation for the portable analyser was 1.08%, compared to 0.78% for the reference method with a total error of 3.5% for the portable analyser. The estimated population-based reference interval for ionised calcium using the portable analyser is 1.23 to 1.42 mmol/L. CLINICAL SIGNIFICANCE For the healthy dogs in this study, compared to the reference method, the portable analyser showed no significant bias for measurement of ionised calcium. Further studies including hyper and hypocalcaemic dogs are required to determine clinical impact of the use of this analyser.
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Affiliation(s)
- J A Harper
- North Coast Specialist and Referral Centre, 5/30 Chancellor Village, Sippy Downs, Sunshine Coast, Australia
| | - A Gal
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, Carle Illinois College of Medicine, University of Illinois, Urbana, Illinois, USA
| | - R K Burchell
- North Coast Specialist and Referral Centre, 5/30 Chancellor Village, Sippy Downs, Sunshine Coast, Australia
| | - J D Summers
- Gracemere Veterinary Surgery, 22 Laurie Street, Gracemere 4702, Australia
| | - J Starling
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - K Gerber
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - B Gummow
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
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Ferriani R, Mangiagalli G, Meazzi S, Pantoli M, Barbè F, Pastore C, Rossi S. Haematological and biochemical reference intervals in healthy Ragdoll cats. J Feline Med Surg 2022; 24:e98-e108. [PMID: 35471086 PMCID: PMC11104232 DOI: 10.1177/1098612x221089695] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Breed-specific reference intervals (RIs) may be necessary to avoid misinterpretation of laboratory results. The main aim of this study was to establish haematobiochemical RIs for Ragdoll cats. METHODS Forty-two clinically healthy adult (0.8-10 years old) Ragdoll cats (Ragdoll population [RP]) and 60 non-Ragdoll cats as the control population (CP) were prospectively enrolled. Results of haematology, biochemistry and total thyroxine (TT4) were used to determine both Ragdoll-specific and general feline population RIs for each variable using Reference Value Advisor software according to the Clinical and Laboratory Standards Institute guidelines and the American Society of Veterinary Clinical Pathology guidelines. RESULTS For each analyte, RIs of the RP were calculated and compared with those obtained from the CP. Haematocrit, haemoglobin, mean cell volume, mean cell haemoglobin concentration, reticulocyte absolute count, platelet count and lymphocyte absolute number were statistically different from the CP. Biochemistry RIs revealed a statistical difference in creatinine kinase (CK), total protein, urea, creatinine, glucose, total calcium and iron. CONCLUSIONS AND RELEVANCE Haematobiochemical RIs of the general feline population must be used with caution in Ragdoll cats when it comes to iron and glucose concentrations, CK activity and absolute lymphocyte number. For these parameters, the use of breed-specific RIs is suggested. The docile and more relaxed nature of this breed may explain these differences and further investigations are necessary to better understand the results. Furthermore, investigations are needed to evaluate the possible benefits of breed-specific urea RIs.
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Affiliation(s)
- Riccardo Ferriani
- San Francesco Veterinary Hospital, Milan, Italy
- BiEsseA Veterinary Laboratory, Milan, Italy
| | | | - Sara Meazzi
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy
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Sitompul YY, Knowles T, Barrows M. The biological variation, index of individuality, and reference change value for haematological and blood chemical analytes in ferrets (Mustela putorius furo). J Exot Pet Med 2022. [DOI: 10.1053/j.jepm.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Saver AT, Steiner JM, Hetzel SJ, Lidbury JA, Suchodolski JS, Pritchard JC. Effect of withholding food on serum concentrations of cobalamin, folate, trypsin-like immunoreactivity, and pancreatic lipase immunoreactivity in healthy dogs. Am J Vet Res 2021; 82:367-373. [PMID: 33904803 DOI: 10.2460/ajvr.82.5.367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the effects of withholding food on the results for measurements of serum concentrations of cobalamin, folate, canine pancreatic lipase immunoreactivity (cPLI), and canine trypsin-like immunoreactivity (cTLI) in healthy dogs. ANIMALS 11 healthy employee- or student-owned dogs. PROCEDURES Food was withheld from the dogs for 12 hours, baseline blood samples were collected, then dogs were fed. Postprandial blood samples collected 1, 2, 4, and 8 hours later were assessed. A mixed-effects ANOVA model with fasting duration (time) as a fixed factor and dog as a random effect was fit for each analyte variable. Additionally, a mixed-effects ANOVA model controlling for the variable of time was fit to assess whether lipemia affected serum concentrations of the analytes. RESULTS The median serum cobalamin concentration was lower at 4 hours (428 ng/L) and 8 hours (429 ng/L) postprandially, compared with baseline (479 ng/L), but this difference was not clinically meaningful. Although there were no substantial differences in serum concentrations of folate, cPLI, or cTLI, postprandial changes in serum concentrations of cTLI or folate could potentially affect diagnoses in some dogs. CONCLUSIONS AND CLINICAL RELEVANCE Although results indicated that feedings rarely resulted in clinically important differences in the median serum concentrations of cobalamin, folate, cPLI, or cTLI in healthy dogs, given the further processing required for lipemic samples, withholding food for at least 8 hours is an appropriate recommendation when measuring these analytes. Similar research is needed in dogs with gastrointestinal disease to determine whether the withholding of food is necessary when measuring these analytes in affected dogs.
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Jeffery U, Jeffery ND, Creevy KE, Page R, Simpson MJ. Variation in biochemistry test results between annual wellness visits in apparently healthy Golden Retrievers. J Vet Intern Med 2021; 35:912-924. [PMID: 33528843 PMCID: PMC7995418 DOI: 10.1111/jvim.16021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 12/18/2022] Open
Abstract
Background Annual wellness testing is widely recommended for apparently healthy dogs, but there is little data to assist with distinguishing normal variation from clinically important changes. Objectives To define variability in biochemistry analytes between annual wellness tests in healthy Golden Retrievers. Animals Four hundred thirty‐four Golden Retrievers undergoing annual health assessments by their primary care veterinarians as part of a prospective cohort study. Methods Changes in 23 biochemistry analytes were calculated between year 1 and year 2 health checks for 196 dogs classified as healthy for ≥3 consecutive years. Using a direct nonparametric method, annual change intervals were constructed to define normal variability. A validation cohort of 238 dogs without a diagnosis of systemic disease for ≥3 consecutive years were compared with the reference and annual change intervals, and the proportions of dogs outside annual change intervals and a population‐based reference interval were compared by using a McNemar test. Results Annual change intervals were calculated based on 190 dogs after outlier removal. For all 23 analytes, >90% of dogs in the validation cohort were within the annual change interval. There were no significant differences in the classification by reference versus annual change intervals. Conclusions and Clinical Importance The annual change intervals met performance requirements for classification of dogs that did not develop systemic disease in the year following wellness testing as normal.
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Affiliation(s)
- Unity Jeffery
- Department of Veterinary Pathobiology, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Nick D Jeffery
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Kate E Creevy
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Rod Page
- Flint animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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13
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Zeugswetter FK, Sellner A. Flash glucose monitoring in diabetic dogs: a feasible method for evaluating glycemic control. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2020; 48:330-338. [PMID: 33086409 DOI: 10.1055/a-1239-4739] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To alleviate clinical signs and avoid life-threatening complications in dogs with diabetes mellitus, individualized treatment plans and frequent reassessments are necessary. Performing blood glucose profiles every 7-14 days following insulin adjustments and monthly thereafter, is recommended. In 2016, a factory calibrated continuous blood glucose monitoring system was presented as a possible alternative to glucometer readings. The objectives of this study were to summarize the experiences with this new technology and to show, that in combination with simple rules, already the first measurement period can improve glycemic control. MATERIAL AND METHODS The electronic database of the endocrine unit of the clinic was retrospectively searched for diabetic dogs with flash glucose monitoring. In case of repeated sensor implantations, only the first sensor was considered. The recordings of day A (starting at midnight after sensor placement) were compared to the measurements of day B (day before sensor failure) and all owners were contacted to fill in a standardized questionnaire. RESULTS The final study population consisted of 24 dogs weighing 3.4 to 36 kg. Although the clicking noise during sensor placement irritated most dogs, the application was considered easy and painless. Waiting for disinfectant evaporation and fixation of the sensor disc with forceps helped to avoid sensor detachment when removing the application device. Although transient mild to moderate skin irritations were observed in 80 % of the dogs, 95 % of the owners were highly satisfied with this new monitoring technology. Mean and maximum glucose (p = 0.043, p = 0.003) as well as glucose readings ≥ 11.1 mmol/l (p = 0.032) decreased from day A to B, whereas markers of glycemic variability did not change. CONCLUSION AND CLINICAL RELEVANCE Flash glucose monitoring is a feasible, safe method with high user satisfaction and offers a possibility to improve glycemic control in diabetic dogs.
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Affiliation(s)
- Florian K Zeugswetter
- Diabetes mellitus, sensorbasiertes Glukosemonitoring, glykämische Variabilität, MAGE
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14
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Sayag D, Chamel G, Bédard C, Beauchamp G, Couturier S, Ponce F, Rannou B. Proof-of-concept study: Evaluation of plasma and urinary electrolytes as markers of response to L-asparaginase therapy in dogs with high-grade lymphoma. Vet Clin Pathol 2020; 49:476-483. [PMID: 32955128 DOI: 10.1111/vcp.12893] [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: 03/03/2019] [Revised: 01/03/2020] [Accepted: 01/10/2020] [Indexed: 11/27/2022]
Abstract
Response to chemotherapy is one of the most important prognostic factors in dogs with lymphoma. The objective of this feasibility study was to evaluate if clinical responses to a specific cytotoxic agent (L-asparaginase) could be anticipated by measuring analyte concentrations in plasma and urine concentrations of lymphoma-bearing dogs. We hypothesized that potassium and phosphate concentrations in plasma and urine would be higher in dogs that completely responded to therapy. Plasma and urine samples of dogs with lymphoma were obtained before 12 and 24 hours after intramuscular L-asparaginase injections. Peripheral lymph node volumes were evaluated according to the Veterinary Cooperative Oncology Group standardized criteria. Plasma and urine electrolyte, calcium, phosphate, creatinine, urea, total protein, and albumin concentrations were measured, and the fractional excretions of each electrolyte were calculated. Statistical analyses compared complete vs partial responders using a linear regression model. Contrast analyses were also performed to differentiate the mean of each group, with adjustments made with the Benjamini-Hochberg procedure. Fourteen dogs were included, eight with complete responses, and six with partial responses. Plasma phosphate concentrations were significantly higher at 12 hours (P = .0003) and 24 hours (P = .009) after complete responses to therapy. This study demonstrates the potential use of plasma and urine analyte monitoring after chemotherapy induction. Plasma phosphate measurements represent a potential indicator of early responses to L-asparaginase therapy. Larger population studies are warranted to confirm these preliminary results.
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Affiliation(s)
- David Sayag
- Oncology Unit, ADVETIA Centre Hospitalier Veterinaire, Velizy Villacoublay, France.,Ecole Nationale Vétérinaire de Toulouse - Centre Hospitalier Universitaire Vétérinaire, Toulouse, France
| | - Gabriel Chamel
- University of Lyon, VetAgro Sup Campus Vétérinaire de Lyon, UR ICE, Service de Cancérologie, Marcy L'Etoile, France
| | - Christian Bédard
- Faculty of Veterinary Medicine, Université de Montreal, Saint-Hyacinthe, QC, Canada
| | - Guy Beauchamp
- Faculty of Veterinary Medicine, Université de Montreal, Saint-Hyacinthe, QC, Canada
| | - Solange Couturier
- Laboratoire de Biologie Médicale, University of Lyon, VetAgro Sup, Marcy l'Etoile, France
| | - Frédérique Ponce
- Ecole Nationale Vétérinaire de Toulouse - Centre Hospitalier Universitaire Vétérinaire, Toulouse, France
| | - Benoit Rannou
- Laboratoire de Biologie Médicale, University of Lyon, VetAgro Sup, Marcy l'Etoile, France.,Azur-Vet Lab - Centre de Vétérinaires Spécialistes AZURVET, Saint Laurent du Var, France
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15
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Irvine KL, Mans C, Friedrichs KR. Method Comparison Using 2 Point-of-Care Meters and a Reference Analyzer for Measuring Blood Triglycerides in Psittacine Birds. J Avian Med Surg 2020; 33:229-234. [PMID: 31893617 DOI: 10.1647/2018-374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Female reproductive disorders, such as chronic egg laying, are common in captive psittacine birds. While a disease diagnosis related to reproductive disorders can often be accomplished by physical examination and diagnostic imaging, monitoring of the response to environmental modification and medical treatment is more challenging. Monitoring ideally would involve measurement of luteinizing hormone or estrogen to assess ovarian activity. However, the amount of blood required for hormone analysis is greater than the small sample size that one can collect from these birds. Additionally, the lack of reference intervals limits their use as a diagnostic tool. Because plasma triglyceride increases during sustained estrogen release from the ovary, it may be used as an alternative method for assessing ovarian activity in birds. Point-of-care (POC) analyzers for measuring lipids in human plasma use very small sample volumes and have been used for measuring triglycerides in animals, including chickens. The authors therefore performed a method comparison study with 2 POC analyzers and a reference analyzer and plasma and whole blood from psittacine birds to determine whether these meters are suitable for triglyceride measurement in a known population of psittacine birds. Correlation, Deming regression, and Bland-Altman analyses were used to assess performance, and the total observed error for each meter relative to the reference analyzer was calculated. One of the meters exhibited fair performance and, with species-specific reference intervals, is likely to be clinically useful for triglyceride measurement in psittacine birds. The other meter demonstrated poor performance with unacceptable error, and its use for this purpose is strongly discouraged.
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Affiliation(s)
- Katherine L Irvine
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Christoph Mans
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Kristen R Friedrichs
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
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16
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Groth EM, Chew DJ, Lulich JP, Tommet M, Rendahl AK, Husbands BD, Furrow E. Determination of a serum total calcium concentration threshold for accurate prediction of ionized hypercalcemia in dogs with and without hyperphosphatemia. J Vet Intern Med 2019; 34:74-82. [PMID: 31693268 PMCID: PMC6979110 DOI: 10.1111/jvim.15654] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 10/14/2019] [Indexed: 01/28/2023] Open
Abstract
Background Total serum calcium (tCa) concentrations are poorly predictive of ionized calcium (iCa) status in dogs. Hypothesis There is an optimal threshold of tCa concentration that is highly predictive of ionized hypercalcemia and this threshold is higher in hyperphosphatemic dogs as compared to nonhyperphosphatemic dogs. Animals Nonhyperphosphatemic (n = 1593) and hyperphosphatemic (n = 250) adult dogs. Methods Retrospective medical record review of paired tCa and iCa concentration measurements in dogs presented to a university teaching hospital over a 5‐year period. Positive and negative predictive values, sensitivity, and specificity were calculated for tCa concentration thresholds of 11.0‐15.0 mg/dL (upper limit of laboratory reference interval = 11.5 mg/dL) in nonhyperphosphatemic and hyperphosphatemic groups. Results In nonhyperphosphatemic dogs, an optimal tCa concentration threshold of 12.0 mg/dL resulted in a positive predictive value of 93% (95% confidence interval [CI], 84%‐98%) and sensitivity of 52% (95% CI, 43%‐61%) for ionized hypercalcemia. An optimal tCa concentration threshold was not identified for hyperphosphatemic dogs. The nonhyperphosphatemic dogs had a higher prevalence of ionized hypercalcemia than the hyperphosphatemic dogs (7 versus 3%, P = .04) and a lower prevalence of ionized hypocalcemia (23 versus 62%, respectively; P < .001). Conclusions and Clinical Importance High tCa concentrations are strongly predictive of ionized hypercalcemia in nonhyperphosphatemic adult dogs and should prompt further diagnostic testing to determine the underlying cause of hypercalcemia. In this population, dogs without increased tCa concentrations rarely had ionized hypercalcemia, but iCa concentrations still should be evaluated in patients with tCa concentrations within the reference interval if there is clinical suspicion for calcium abnormalities.
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Affiliation(s)
- Elizabeth M Groth
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - Dennis J Chew
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Jody P Lulich
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - Megan Tommet
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, Minnesota
| | - Aaron K Rendahl
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, Minnesota
| | - Brian D Husbands
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - Eva Furrow
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
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Menard M, Lecoindre A, Cadoré JL, Chevallier M, Pagnon A, Hernandez J, Leal RO, Hugonnard M, Miette V, Destro M, Rannou B, Benchekroun G, Lecoindre P. Use of serum biomarkers in staging of canine hepatic fibrosis. J Vet Diagn Invest 2019; 31:665-673. [PMID: 31347473 DOI: 10.1177/1040638719866881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Accurate staging of hepatic fibrosis (HF) is important for treatment and prognosis of canine chronic hepatitis. HF scores are used in human medicine to indirectly stage and monitor HF, decreasing the need for liver biopsy. We developed a canine HF score to screen for moderate or greater HF. We included 96 dogs in our study, including 5 healthy dogs. A liver biopsy for histologic examination and a biochemistry profile were performed on all dogs. The dogs were randomly split into a training set of 58 dogs and a validation set of 38 dogs. A HF score that included alanine aminotransferase, alkaline phosphatase, total bilirubin, potassium, and gamma-glutamyl transferase was developed in the training set. Model performance was confirmed using the internal validation set, and was similar to the performance in the training set. The overall sensitivity and specificity for the study group were 80% and 70% respectively, with an area under the curve of 0.80 (0.71-0.90). This HF score could be used for indirect diagnosis of canine HF when biochemistry panels are performed on the Konelab 30i (Thermo Scientific), using reagents as in our study. External validation is required to determine if the score is sufficiently robust to utilize biochemical results measured in other laboratories with different instruments and methodologies.
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Affiliation(s)
- Maud Menard
- Internal Medicine Department, Université Paris-Est, École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France (Menard, Benchekroun)
| | - Alexis Lecoindre
- Internal Medicine Department (Lecoindre A, Cadoré, Hugonnard), VetAgro Sup Campus Vétérinaire de Lyon, Marcy l'Étoile, France
| | - Jean-Luc Cadoré
- Internal Medicine Department (Lecoindre A, Cadoré, Hugonnard), VetAgro Sup Campus Vétérinaire de Lyon, Marcy l'Étoile, France
| | | | | | - Juan Hernandez
- Internal Medicine Department, Centre Hospitalier Vétérinaire Frégis, Arcueil, France (Hernandez, Leal)
| | - Rodolpho Oliveira Leal
- Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal (Leal)
| | - Marine Hugonnard
- Internal Medicine Department (Lecoindre A, Cadoré, Hugonnard), VetAgro Sup Campus Vétérinaire de Lyon, Marcy l'Étoile, France
| | | | | | - Benoît Rannou
- Laboratoire de biologie médicale (Rannou), VetAgro Sup Campus Vétérinaire de Lyon, Marcy l'Étoile, France
| | - Ghita Benchekroun
- Internal Medicine Department, Université Paris-Est, École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France (Menard, Benchekroun)
| | - Patrick Lecoindre
- Internal Medicine Department (Lecoindre A, Cadoré, Hugonnard), VetAgro Sup Campus Vétérinaire de Lyon, Marcy l'Étoile, France
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18
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Moore AR, Freeman K. Reporting results with (Un)certainty. Vet Clin Pathol 2019; 48:259-269. [PMID: 31192474 DOI: 10.1111/vcp.12735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/24/2018] [Accepted: 11/24/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND A degree of uncertainty occurs with every measured laboratory result due to both analytical and biological variation. The tools of Total Observed error (TEO ) and dispersion based on biological variation have helped veterinary labs quantify the causes of variation that lead to measurement uncertainty (MU). International organizations recommend that the amount of MU in veterinary laboratory results be identified and communicated. The expanded measurement uncertainty (EMU), dispersion, and reporting interval adjustment have been recommended as tools to allow communication of MU to laboratory data users but are not commonly discussed in the veterinary literature. OBJECTIVE Using the vocabulary of Total Observed error and biological variation and examples from veterinary medicine, a review of the theory and application of the EMU, dispersion, and the methods for deriving an appropriate reporting interval recommended by Hawkins and Badrick, is presented. CONCLUSIONS By addressing the way that MU is communicated to users of laboratory results, the laboratory enables users to better understand the potential uncertainty associated with reported results, helps to prevent over and under-interpretation of data, and improves diagnostic accuracy and patient care.
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Affiliation(s)
- A Russell Moore
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado
| | - Kathleen Freeman
- Synlabs, TDDS, The Innovation Centre, University of Exeter, Exeter, UK
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Jahr TH, Fergestad ME, Brynildsrud O, Brun-Hansen H, Skancke E. Haematological and serum biochemical values in Norwegian sled dogs before and after competing in a 600 km race. Acta Vet Scand 2019; 61:20. [PMID: 31023353 PMCID: PMC6485113 DOI: 10.1186/s13028-019-0453-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 04/15/2019] [Indexed: 11/21/2022] Open
Abstract
Background Long-distance racing is known to cause alterations in haematological and serum biochemical parameters in sled dogs. Given that finishing status reflects the physical condition in dogs completing a race, such variations will mainly be the result of physiological adaption achieved during endurance exercise. However, changes observed in withdrawn dogs may indicate pathological conditions. The aim of this study was to reveal changes in haematological and serum biochemical values in sled dogs participating in a long-distance race, with emphasis on the withdrawn dogs. Sixty-five sled dogs participated in a clinical prospective cohort study: 46 dogs competed in the 600 km race (25 finishing and 21 withdrawn dogs), and 19 dogs served as controls. Blood sampling was performed early in the training season and after the race. Results When compared to control dogs, both withdrawn and finishing dogs showed significant increases in neutrophil count, C-reactive protein, blood urea nitrogen and sodium/potassium ratio. Significant decreases were found in erythrocytes and eosinophil cell count, and in haematocrit, haemoglobin, total protein, albumin, globulin, creatinine, potassium and calcium levels. Finishing dogs presented significant increases in white blood cells, large unstained cells, monocyte count and cortisol level compared to control dogs. In contrast, withdrawn dogs had significant elevations in alanine aminotransferase and alkaline phosphatase activity, as well as parameters associated with muscle metabolism, such as aspartate aminotransferase, creatine kinase and phosphorus concentration. Conclusions Competing sled dogs experienced minor changes in blood parameters in general, mainly revealing the same pattern among withdrawals and finishers. This might indicate that numerous changes simply reflect physiological adaption due to endurance exercise. However, the serum concentration of muscle enzymes was significantly increased only in the withdrawals, and were well above reference ranges. This reflects muscle degradation, which could be the main cause of performance failure in some of the withdrawals. Electronic supplementary material The online version of this article (10.1186/s13028-019-0453-5) contains supplementary material, which is available to authorized users.
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Warne LN, Bauquier SH, Pengelly J, Neck D, Swinney G. STANDARDS OF CARE Anaesthesia guidelines for dogs and cats. Aust Vet J 2018; 96:413-427. [PMID: 30370594 DOI: 10.1111/avj.12762] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- L N Warne
- Lecturer in Veterinary Anaesthesia, College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, Australia
| | - S H Bauquier
- Board of Directors - Regional Officer, American College of Veterinary Anesthesia and Analgesia; Senior Lecturer in Veterinary Anaesthesia, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Victoria, Australia
| | - J Pengelly
- Vice President, Veterinary Nurses Council of Australia; Chair, National Industry Advisory Group for Veterinary Nurses; Training Consultant, Animal Industries Resource Centre; Veterinary Nurse, East Port Veterinary Hospital, Port Macquarie, New South Wales, Australia
| | - D Neck
- Deputy Board Member, Veterinary Surgeons' Board of Western Australia; Cottesloe Vet, Cottesloe, Western Australia, Australia
| | - G Swinney
- Medical Affairs Veterinarian and Internal Medicine Consultant Australia and New Zealand, IDEXX Laboratories Pty Ltd, Rydalmere, New South Wales, Australia
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21
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Wright ME, Croser EL, Raidal S, Baral RM, Robinson W, Lievaart J, Freeman KP. Biological variation of routine haematology and biochemistry measurands in the horse. Equine Vet J 2018; 51:384-390. [PMID: 30194868 DOI: 10.1111/evj.13017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 09/06/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Clinical pathology results are typically interpreted by referring to population-based reference intervals. The use of individualised (subject-based) reference intervals is more appropriate for measurands with a high degree of variation between individuals. OBJECTIVES To determine the biological variation of routinely analysed equine haematology and biochemistry measurands and calculate indices of individuality and reference change values which enable production of individualised reference intervals, in a group of healthy, privately owned horses. STUDY DESIGN In a prospective cohort study, thirty-nine privately owned horses were sampled by jugular venipuncture for analysis of haematology and biochemistry measurands at weekly intervals for 6 weeks. METHODS Haematology was analysed on the day of collection. Serum was frozen and biochemistry analyses performed on thawed samples. Duplicate results were obtained and the coefficient of variation was calculated for analytical variation, within-subject variation and between-subject variation. The index of individuality and reference change value were derived for each measurand. RESULTS Haematology (red blood cell count, mean corpuscular haemoglobin and mean cell volume) and biochemistry measurands (total protein, globulins, albumin, gamma-glutamyl transferase, aspartate aminotransferase) demonstrated high individuality, indicating that individualised reference intervals are more appropriate for evaluation of these measurands. Two haematology (mean corpuscular haemoglobin concentration and platelets) and three biochemistry measurands (chloride, glucose and sodium) had low individuality, indicating that the use of traditional population-based reference intervals is appropriate for these measurands. Remaining measurands had intermediate individuality suggesting interpretation of the reference change value should occur with consideration of the population-based reference interval. MAIN LIMITATIONS The use of privately owned horses, variable management and environmental factors. CONCLUSIONS The use of individualised reference intervals is justified for many measurands in horses, supporting the use of serial sampling, consideration of biological variation and application of reference change values for improved clinical decision making and patient management in equine practice.
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Affiliation(s)
- M E Wright
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - E L Croser
- Veterinary Diagnostic Laboratory, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - S Raidal
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - R M Baral
- Paddington Cat Hospital, Paddington, New South Wales, Australia
| | - W Robinson
- Quantitative Consulting Unit, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - J Lievaart
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
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Campora C, Freeman KP, Baral R. Clinical application of biological variation data to facilitate interpretation of canine and feline laboratory results. J Small Anim Pract 2017; 59:3-9. [PMID: 29135020 DOI: 10.1111/jsap.12781] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 09/13/2017] [Accepted: 09/19/2017] [Indexed: 11/30/2022]
Abstract
Interpretation of laboratory results is based on comparison of the patient's own results against established decision thresholds or reference intervals in the context of the clinical presentation and history. Blood measurand analysis has pre-analytical, analytical and physiological sources of variation, which may complicate interpretation of results. Biological variation describes the physiological random fluctuation of blood measurands around a homeostatic set point, which varies within and between individuals. This article reviews the practical applications of biological variation in the everyday clinical setting. Examples are offered to highlight how biological variation can be used to: (1) assess the usefulness of subject-based reference intervals, (2) determine measurand homeostatic set points, (3) interpret single or serial results for diagnosis of disease and (4) evaluate changes in serial results during monitoring.
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Affiliation(s)
- C Campora
- IDEXX Laboratories, Ltd, Wetherby, West Yorkshire, LS227DN, UK
| | - K P Freeman
- IDEXX Laboratories, Ltd, Wetherby, West Yorkshire, LS227DN, UK
| | - R Baral
- Paddington Cat Hospital, Paddington, New South Wales, 2021, Australia
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Silva ÉPD, Torres MDM, Cruz TPPSD, Mendonça AJ. INFLUÊNCIA DA TEMPERATURA E DO TEMPO DE ARMAZENAMENTO SOBRE AMOSTRAS DE SORO E PLASMA CANINOS NA ANÁLISE DA ENZIMA ALANINA AMINOTRANSFERASE (ALT). CIÊNCIA ANIMAL BRASILEIRA 2017. [DOI: 10.1590/1089-6891v18e-33785] [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
Resumo Este trabalho teve como objetivo avaliar a influência do tempo e da temperatura de armazenamento sobre os valores das dosagens bioquímicas de ALT em 60 amostras de soro e plasma de cães, divididas em dois grupos: GR (grupo refrigerado, a 5 ºC) e GC (grupo congelado, a -20 ºC), por até 96 horas analisadas em seis tempos e até 60 dias, analisadas em cinco tempos, respectivamente. O estudo mostrou que o congelamento e a refrigeração não provocaram variações entre as amostras (p< 0,005). Os dados obtidos nas dosagens bioquímicas revelaram que o soro e o plasma com EDTA mantiveram-se próximos dos valores basais, ou seja, não se alteraram significantemente ao longo do tempo de conservação e nas diferentes temperaturas estudadas.
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Bartko J, Derhaschnig U, Neels T, Nabozny GH, Harcken C, Leuschner J, De Vries F, Jilma B. Selective glucocorticoid receptor modulation inhibits cytokine responses in a canine model of mild endotoxemia. Pharmacol Res 2017; 125:215-223. [PMID: 28923543 DOI: 10.1016/j.phrs.2017.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 08/07/2017] [Accepted: 09/12/2017] [Indexed: 12/24/2022]
Abstract
Selective glucocorticoid receptor modulators (GRMs) promise to reduce adverse events of glucocorticoids while maintaining anti-inflammatory potency. The present study tested the anti-inflammatory activity of two novel non-steroidal GRMs (GRM1: BI 607812 BS, GRM2: BI 653048 BS*H3PO4) in comparison to prednisolone in a canine model of low dose endotoxemia. This study compared the anti-inflammatory and pharmacokinetic profile of escalating daily oral doses of GRM1 (1, 2.5, 5 and 10mg/kg) and GRM2 (0.1, 0.25 and 1mg/kg) with prednisolone (0.25 and 0.5mg/kg) and placebo after intravenous infusion of endotoxin (0.1μg/kg) to Beagle dogs. This was followed by a 14-day evaluation study of safety and pharmacokinetics. Endotoxin challenge increased TNF-α ∼2000-fold and interleukin-6 (IL-6) 100-fold. Prednisolone and both GRMs suppressed peak TNF-α and IL-6 by 71-82% as compared with placebo. The highest doses of GRM1 and GRM2 reduced the mean body temperature increase by ∼30%. The endotoxin-induced rise in plasma cortisol was strongly suppressed in all treatment groups. Pharmacokinetics of both GRMs were non-linear. Adverse effects of endotoxemia such as vomiting were mitigated by GRM2 and prednisolone, indicating an antiemetic effect. During the 14-day treatment period, the adverse event profile of both GRMs appeared to be similar to prednisolone. Both GRMs had anti-inflammatory effects comparable to prednisolone and showed good safety profiles. Compounds targeting the glucocorticoid receptor selectively may provide an alternative to traditional glucocorticoids in the treatment of inflammatory disease.
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Affiliation(s)
- Johann Bartko
- Department of Clinical Pharmacology, Medical University of Vienna, Austria; Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria
| | - Ulla Derhaschnig
- Department of Clinical Pharmacology, Medical University of Vienna, Austria; Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Tania Neels
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | | | | | - Jost Leuschner
- LPT Laboratory of Pharmacology and Toxicology GmbH & Co. KG, Germany
| | | | - Bernd Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Austria.
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Cohn-Urbach M, Ruaux CG, Nemanic S. Estimates of biologic variation in specific feline pancreatic lipase concentrations in cats without clinical or ultrasonographic evidence of pancreatitis. Vet Clin Pathol 2017; 46:615-619. [DOI: 10.1111/vcp.12528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Margaret Cohn-Urbach
- Department of Veterinary Clinical Sciences; Oregon State University; Corvallis OR USA
| | - Craig G. Ruaux
- Department of Veterinary Clinical Sciences; Oregon State University; Corvallis OR USA
| | - Sarah Nemanic
- Department of Veterinary Clinical Sciences; Oregon State University; Corvallis OR USA
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27
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Freeman KP, Baral RM, Dhand NK, Nielsen SS, Jensen AL. Recommendations for designing and conducting veterinary clinical pathology biologic variation studies. Vet Clin Pathol 2017; 46:211-220. [PMID: 28370056 DOI: 10.1111/vcp.12475] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | | | - Navneet K. Dhand
- Faculty of Veterinary Science; The University of Sydney; Sydney NSW Australia
| | - Søren Saxmose Nielsen
- Department of Large Animal Sciences; University of Copenhagen; Frederiksberg C Denmark
| | - Asger L. Jensen
- Department of Veterinary Clinical and Animal Sciences; University of Copenhagen; Frederiksberg C Denmark
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28
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Falkenö U, Hillström A, von Brömssen C, Strage EM. Biological variation of 20 analytes measured in serum from clinically healthy domestic cats. J Vet Diagn Invest 2016; 28:699-704. [PMID: 27638843 DOI: 10.1177/1040638716666602] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The applications of data on biological variation include assessment of the utility of population-based reference intervals, evaluation of the significance of change in serial results, and setting of analytical quality specifications. We investigated the biological variation of 19 biochemistry analytes and total T4, measured in serum from 7 clinically healthy domestic cats sampled once weekly for 5 weeks. Samples were frozen and analyzed in random order in the same analytical run. Results were analyzed for outliers, and the components of variance, subsequently generated by restricted maximum likelihood, were used to determine within-subject and between-subject variation (CVI and CVG, respectively), as well as analytical variation (CVA) for each analyte. Indices of individuality, reference change values, and analytical performance goals were calculated. The smallest CVI and CVG were found for calcium, chloride, and sodium, whereas the largest values were calculated for bile acids. Nine analytes (albumin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, cholesterol, creatinine, phosphate [phosphorus], total protein, total T4) demonstrated high individuality, indicating limited utility of population-based reference intervals. Individuality was low, and population-based reference intervals were thereby considered appropriate for 5 analytes (bile acids, calcium, fructosamine, glucose, potassium). The intermediate individuality observed for 4 analytes (creatine kinase, iron, magnesium, urea) indicated that population-based reference intervals should be used with caution.
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Affiliation(s)
- Ulrika Falkenö
- Clinical Pathology Laboratory, University Animal Hospital (Falkenö, Hillström, Strage), Swedish University of Agricultural Sciences, Uppsala, SwedenDepartment of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences (Strage), Swedish University of Agricultural Sciences, Uppsala, SwedenDepartment of Economics (von Brömssen), Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Anna Hillström
- Clinical Pathology Laboratory, University Animal Hospital (Falkenö, Hillström, Strage), Swedish University of Agricultural Sciences, Uppsala, SwedenDepartment of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences (Strage), Swedish University of Agricultural Sciences, Uppsala, SwedenDepartment of Economics (von Brömssen), Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Claudia von Brömssen
- Clinical Pathology Laboratory, University Animal Hospital (Falkenö, Hillström, Strage), Swedish University of Agricultural Sciences, Uppsala, SwedenDepartment of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences (Strage), Swedish University of Agricultural Sciences, Uppsala, SwedenDepartment of Economics (von Brömssen), Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Emma M Strage
- Clinical Pathology Laboratory, University Animal Hospital (Falkenö, Hillström, Strage), Swedish University of Agricultural Sciences, Uppsala, SwedenDepartment of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences (Strage), Swedish University of Agricultural Sciences, Uppsala, SwedenDepartment of Economics (von Brömssen), Swedish University of Agricultural Sciences, Uppsala, Sweden
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Affiliation(s)
- Jessica A. Hokamp
- Department of Veterinary Pathobiology; College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; College Station TX USA
| | - Mary B. Nabity
- Department of Veterinary Pathobiology; College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; College Station TX USA
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Scruggs JL, Flatland B, McCormick KA, Reed A. Biological variation of thromboelastrography variables in 10 clinically healthy horses. J Vet Emerg Crit Care (San Antonio) 2015; 26:80-4. [PMID: 26479874 DOI: 10.1111/vec.12410] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 01/21/2014] [Accepted: 09/04/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the utility of population-based reference intervals (PRIs) for interpreting thromboelastography (TEG) variables in horses using biological variation data. DESIGN Prospective cohort biologic variation study conducted over a 5-week period. SETTING Veterinary teaching hospital and research facility. ANIMALS Ten clinically healthy horses randomly selected from a veterinary school research and teaching herd. INTERVENTIONS Horse health was determined using physical examination, CBC, and biochemical and coagulation profiles prior to the start of the study. Subsequently, once weekly blood sampling for TEG testing was performed for 5 weeks. MEASUREMENTS AND MAIN RESULTS The 4 TEG variables reaction time (R), clot formation time (K), angle, and maximum amplitude (MA) were measured, and coefficient of variation representing within- and between-horse biological variation (CVi and CVg , respectively) and coefficient of variation representing analytical variation (CVa ) were calculated using a nested ANOVA after removing outlier data. The CVi , CVg , and CVa for R were 26.8%, 5.2%, and 5.9%; for K were 31.0%, 0.0%, and 5.9%; for angle were 9.4%, 6.2%, and 21.7%; and for MA were 3.4%, 4.1%, and 4.4%, respectively. Index of individuality (IOI) was then calculated for each variable using the formula {( CVi² + CVa²/CVg²)}¹/². IOI for R was 5.3, for angle was 3.8, and for MA was 1.4; IOI was not assessed for K. CONCLUSIONS PRIs are appropriate for TEG variables, R, angle, and MA when interpreting results from individual horses based on calculated IOI values equal to or greater than 1.4. PRIs are likely appropriate when interpreting K, but IOI could not be calculated for this variable.
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Affiliation(s)
- Jennifer L Scruggs
- Departments of Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, TN, 37996
| | - Bente Flatland
- Departments of Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, TN, 37996
| | - Karen A McCormick
- Large Animal Clinical Sciences, University of Tennessee, Knoxville, TN, 37996
| | - Ann Reed
- College of Veterinary Medicine and the Office of Information Technology, University of Tennessee, Knoxville, TN, 37996
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Kang MH, Kim DH, Jeong IS, Choi GC, Park HM. Evaluation of four portable blood glucose meters in diabetic and non-diabetic dogs and cats. Vet Q 2015; 36:2-9. [DOI: 10.1080/01652176.2015.1092617] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Ruaux C, Scollan K, Suchodolski JS, Steiner JM, Sisson DD. Biologic variability in NT-proBNP and cardiac troponin-I in healthy dogs and dogs with mitral valve degeneration. Vet Clin Pathol 2015; 44:420-30. [PMID: 26108974 DOI: 10.1111/vcp.12268] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The N-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) and cardiac troponin-I are candidate biomarkers for cardiac disease in dogs. The degree of biologic variation in these biomarkers has not previously been reported in healthy dogs or dogs with mitral regurgitation. OBJECTIVES The purpose of the study was to derive estimates of intrinsic biologic variability and reference change values for NT-proBNP and cardiac troponin-I in healthy dogs and dogs with mitral regurgitation grade IB and II according to the International Small Animal Cardiac Health Council (ISACHC) grading system. METHODS Plasma and sera were collected weekly for up to 7 weeks from 12 control dogs and 9 dogs with mitral regurgitation. NT-proBNP and troponin-I (C-TnI) concentrations were determined. Indices of biologic variation such as reciprocal index of individuality (r-IoI) and reference change values (RCV) were calculated in both the groups. RESULTS Individuality was high in control dogs and dogs with grade IB and II mitral valve regurgitation for both C-TnI (r-IoI 1.6 and 2) and NT-proBNP (1.5 and 2.7), while the 2-sided RCV for NT-proBNP was significantly lower in dogs with mitral regurgitation (52.5% vs 99.4%, P<0.01.). CONCLUSIONS High individuality of these cardiac biomarkers suggests that, following diagnosis, these assays are best interpreted by serial determination in individual canine patients rather than by comparison to a population-based reference interval. The smaller RCV values for dogs with mitral regurgitation suggest that smaller relative changes in NT-proBNP are clinically meaningful in these patients.
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Affiliation(s)
- Craig Ruaux
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
| | - Katherine Scollan
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Jörg M Steiner
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - D David Sisson
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
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Baral RM, Dhand NK, Freeman KP, Krockenberger MB, Govendir M. Biological variation and reference change values of feline plasma biochemistry analytes. J Feline Med Surg 2013; 16:317-25. [DOI: 10.1177/1098612x13508770] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This is the first report concerning biological variation and reference change values of feline plasma biochemistry components in the peer-reviewed literature. Biological variation refers to inherent physiological variation of analytes. The ratio of individual biological variation to group biological variation is referred to as an analyte’s index of individuality. This index determines the suitability of an analyte to be assessed in relation to population- or subject-based reference intervals. A subject-based reference interval is referred to as a reference change value or critical difference, and is calculated from individual biological variation. Fourteen cats were sampled for plasma biochemistry analysis once weekly for 6 weeks. Samples were stored and then tested at the same time. Results were assessed in duplicate and coefficients of variation for each analyte were isolated to distinguish variation within each subject, between all subjects and by the analyser. From these results, an index of individuality and reference change values were determined for each analyte. Five plasma biochemistry analytes (alkaline phosphatase, alanine aminotransferase, cholesterol, creatinine and globulin) had high individuality and, therefore, subject-based reference intervals are more appropriate; only one analyte (sodium) had low individuality, indicating that population-based reference intervals are appropriate. Most analytes had intermediate individuality so population-based reference intervals should be assessed in relation to subject-based reference intervals. The results of this study demonstrate high individuality for most analytes and, therefore, that population-based reference intervals are of limited utility for most biochemical analytes in cats.
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Affiliation(s)
- Randolph M Baral
- Paddington Cat Hospital, Paddington, NSW, Australia
- Faculty of Veterinary Science, The University of Sydney, Sydney, NSW Australia
| | - Navneet K Dhand
- Faculty of Veterinary Science, The University of Sydney, Sydney, NSW Australia
| | | | | | - Merran Govendir
- Faculty of Veterinary Science, The University of Sydney, Sydney, NSW Australia
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