1
|
Xavier RGC, Santana CH, da Silva PHS, Paraguassú AO, Nicolino RR, Freitas PMC, Santos RDL, Silva ROS. Association between bacterial pathogenicity, endometrial histological changes and clinical prognosis in canine pyometra. Theriogenology 2024; 214:118-123. [PMID: 37865019 DOI: 10.1016/j.theriogenology.2023.10.007] [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: 06/17/2023] [Revised: 08/29/2023] [Accepted: 10/07/2023] [Indexed: 10/23/2023]
Abstract
Despite the high frequency and clinical relevance of canine pyometra, its pathogenesis remains poorly understood. In this study, the clinical data, histopathological alterations, and microbiological findings of 39 dogs with pyometra were analyzed to assess possible associations. The mean age of the affected animals was 9.6 ± 3.8 years; 76.3 % (29/38) had open cervix pyometra, 88 % (22/25) had tachypnea, 71 % (27/38) had anorexia, and 60.5 % (23/38) had leukocytosis. Histopathological analysis revealed that 66.5 % (26/39) of the uteri had a high degree of inflammation (score 4). Third-degree hyperplasia of the endometrial epithelium (72 %, 28/39) and intralesional or intrauterine bacteria (66.5 %, 26/39) were identified in most animals. Bacterial isolates were obtained from 82 % (32/39) of the uterine contents and five bacterial species were identified. Escherichia coli, classified in phylogroup B2, is associated with virulent adhesion genes (fimH, focG, and papC), and serum resistance (traT) was the most common isolate. There was an association between the detection of papC in E. coli isolates and higher necrosis scores. Additionally, the necrosis score was positively associated with the length of hospitalization, with each point increase in the necrosis score leading to two more days of hospitalization. These results suggest that papC-positive E. coli play an important role in the severity of pyometra in dogs. The present study revealed the possibility of using this virulence gene to better understand the prognosis of the disease in an affected animal.
Collapse
Affiliation(s)
- Rafael Gariglio Clark Xavier
- Escola de Veterinária, Universidade Federal de Minas Gerais, Antônio Carlos Avenue, 6627, Belo Horizonte, MG, 31.270-901, Brazil
| | - Clarissa Helena Santana
- Escola de Veterinária, Universidade Federal de Minas Gerais, Antônio Carlos Avenue, 6627, Belo Horizonte, MG, 31.270-901, Brazil
| | - Paloma Helena Sanches da Silva
- Escola de Veterinária, Universidade Federal de Minas Gerais, Antônio Carlos Avenue, 6627, Belo Horizonte, MG, 31.270-901, Brazil
| | - Amanda Oliveira Paraguassú
- Escola de Veterinária, Universidade Federal de Minas Gerais, Antônio Carlos Avenue, 6627, Belo Horizonte, MG, 31.270-901, Brazil
| | - Rafael Romero Nicolino
- Escola de Veterinária, Universidade Federal de Minas Gerais, Antônio Carlos Avenue, 6627, Belo Horizonte, MG, 31.270-901, Brazil
| | - Patrícia Maria Coletto Freitas
- Escola de Veterinária, Universidade Federal de Minas Gerais, Antônio Carlos Avenue, 6627, Belo Horizonte, MG, 31.270-901, Brazil
| | - Renato de Lima Santos
- Escola de Veterinária, Universidade Federal de Minas Gerais, Antônio Carlos Avenue, 6627, Belo Horizonte, MG, 31.270-901, Brazil
| | - Rodrigo Otávio Silveira Silva
- Escola de Veterinária, Universidade Federal de Minas Gerais, Antônio Carlos Avenue, 6627, Belo Horizonte, MG, 31.270-901, Brazil.
| |
Collapse
|
2
|
Xavier RGC, Santana CH, de Castro YG, de Souza TGV, do Amarante VS, Santos RL, Silva ROS. Canine Pyometra: A Short Review of Current Advances. Animals (Basel) 2023; 13:3310. [PMID: 37958065 PMCID: PMC10647846 DOI: 10.3390/ani13213310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/13/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Pyometra, characterized by the accumulation of purulent exudate in the uterus, is the most prevalent reproductive disease in canines. While the disease often begins with mild local symptoms, it can escalate into peritonitis, sepsis, and multi-organ dysfunction, thereby posing a significant threat to life. Despite the high incidence and recognized significance of canine pyometra, gaps persist in our understanding of its epidemiology, etiology, and pathogenesis. Recent studies have, however, broadened our comprehension of this disease, shedding light on potential new infection sources, etiologies, and the application of clinical predictive biomarkers and new therapeutic protocols. This study aimed to review the current understanding of canine pyometra, with particular emphasis on the latest research concerning its etiology and epidemiology. Furthermore, it addressed key research questions and proposed directions for future investigations into various facets of canine pyometra.
Collapse
|
3
|
McCallin AJ, Turner JWC, Kreisler RE. Pyometra management in the private practice setting. Top Companion Anim Med 2022; 50:100695. [PMID: 35918019 DOI: 10.1016/j.tcam.2022.100695] [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: 09/21/2021] [Revised: 07/13/2022] [Accepted: 07/27/2022] [Indexed: 10/16/2022]
Abstract
Current management practices of pyometra in the private practice setting are not well documented. The goal of this study was to understand pyometra management in the private practice setting, and the current relationship private practices have with high quality, high volume, spay-neuter (HQHVSN) clinics regarding referral for pyometra surgery. An anonymous electronic survey was piloted and distributed using SurveyMonkey via email, social media, and the Independent Veterinary Practitioners Association targeting veterinarians who see companion animals. A total of 153 responses were received from June-July 2021, with respondents distributed throughout the United States. Practices performed a median of 10 spay and neuters per week, with the median spay cost being $350 (IQR 250-500) for dogs and $250 (IQR 180-350) for cats. The median cost of a pyometra surgery was $1000 (IQR 700-1500) for dogs and $750 (IQR 450-1000) for cats. All practices treated pyometra at least sometimes, despite the disruption (major 19%, moderate 47%, mild 29%, none 5%) to their day. All pyometra presentations were accepted for treatment at least sometimes: BAR/QAR (98%), depressed or non-ambulatory (88%), and obtunded or lateral (62%) with mean estimated survival of 96%, 74%, and 31%, respectively. The majority (56%) of clients were reported to sometimes have trouble paying for all recommended services, while it was less often reported that clients often (31%) or rarely (13%) had trouble. Private practices willing to refer only did so always 20% of the time and sometimes 36% of the time. Private practices will do what they can to treat most pyometras that present at their practice within a timely manner before referring elsewhere. There is currently inconsistent utilization of HQHVSN clinics as a potential referral resource due to location or appointment availability.
Collapse
Affiliation(s)
- Ashlee J McCallin
- College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
| | - Jennifer W-C Turner
- Department of Primary Care, Animal Health Institute, College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
| | - Rachael E Kreisler
- Department of Primary Care, Animal Health Institute, College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
| |
Collapse
|
4
|
Gasser B, Uscategui RAR, Maronezi MC, Pavan L, Simões APR, Martinato F, Silva P, Crivellenti LZ, Feliciano MAR. Clinical and ultrasound variables for early diagnosis of septic acute kidney injury in bitches with pyometra. Sci Rep 2020; 10:8994. [PMID: 32488080 PMCID: PMC7265446 DOI: 10.1038/s41598-020-65902-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 05/12/2020] [Indexed: 01/26/2023] Open
Abstract
The aetiology of septic acute kidney injury (AKI) is not completely elucidated. Early identification of AKI in septic patients is considered to improve survival rate since it allows rapid treatment onset. We evaluated clinical, haematological, urinary, B-mode, spectral Doppler, and contrast-enhanced ultrasound variables in 20 bitches with pyometra as sepsis models and 12 healthy controls. All animals with pyometra presented some degree of renal damage on histological examination; however, sequential organ failure assessment (SOFA) classified only 40% cases with sepsis. AKI derived from systemic infection was identified in 57% of cases with hypoperfusion and in 22% with inflammation, being an affection of multifactorial origin. Among the evaluated parameters, urinary protein/creatinine ratio >0.15, serum albumin <2.94 mg/dL, time-averaged minimum velocity <21.5 cm/s, renal length/aorta diameter ratio >5.93, pulsatility index >1.53, haematocrit <45%, time-averaged maximum velocity <45.7 cm/s, haemoglobin <16 g/dL, leukocytes >12.53 × 103/uL, and cortical contrast peak intensity <69%, in the order of accuracy, are significant indicators of septic AKI with an accuracy >80%. Thus, AKI is a very prevalent condition in septic patients, derived mainly from changes in renal perfusion and inflammation. Additionally, reviewing the SOFA score parameters is suggested to identify renal failure.
Collapse
Affiliation(s)
- Beatriz Gasser
- School of Agrarian Sciences and Veterinary Medicine, São Paulo State University "Julio de Mesquita Filho", Jaboticabal, São Paulo, Brazil.
| | | | - Marjury Cristina Maronezi
- School of Agrarian Sciences and Veterinary Medicine, São Paulo State University "Julio de Mesquita Filho", Jaboticabal, São Paulo, Brazil
| | - Letícia Pavan
- School of Agrarian Sciences and Veterinary Medicine, São Paulo State University "Julio de Mesquita Filho", Jaboticabal, São Paulo, Brazil
| | - Ana Paula Rodrigues Simões
- School of Agrarian Sciences and Veterinary Medicine, São Paulo State University "Julio de Mesquita Filho", Jaboticabal, São Paulo, Brazil
| | - Fernanda Martinato
- School of Agrarian Sciences and Veterinary Medicine, São Paulo State University "Julio de Mesquita Filho", Jaboticabal, São Paulo, Brazil
| | - Priscila Silva
- School of Agrarian Sciences and Veterinary Medicine, São Paulo State University "Julio de Mesquita Filho", Jaboticabal, São Paulo, Brazil
| | | | | |
Collapse
|
5
|
Liu DJX, Meyer E, Broeckx BJG, Daminet S, Delanghe JR, Stock E, Bogaerts E, Hesta M, Vanderperren K. Variability of serum concentrations of cystatin C and urinary retinol-binding protein, neutrophil gelatinase-associated lipocalin, immunoglobulin G, and C-reactive protein in dogs. J Vet Intern Med 2018; 32:1659-1664. [PMID: 30216550 PMCID: PMC6189346 DOI: 10.1111/jvim.15293] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 05/08/2018] [Accepted: 06/27/2018] [Indexed: 12/20/2022] Open
Abstract
Background Markers of kidney dysfunction and damage have potential to detect chronic kidney disease (CKD) in early stages. However, data on long‐term variation of these markers in healthy dogs is lacking and is crucial for the interpretation of results. Hypothesis/Objectives To determine temporal variations of serum cystatin C (sCysC) and urinary retinol‐binding protein (uRBP), neutrophil gelatinase‐associated lipocalin (uNGAL), immunoglobulin G (uIgG), and C‐reactive protein (uCRP) in healthy dogs. Animals Eight clinically healthy adult Beagles were evaluated. Methods Longitudinal observational study. Serum cystatin C was determined by particle‐enhanced nephelometric immunoassay. Urinary retinol‐binding protein, uNGAL, uIgG and uCRP were determined by ELISA and concentrations were indexed to urinary creatinine. Within‐ and between‐dog variance components (VC) and within‐dog coefficients of variation (CV) were determined from blood and urine collected at eight time points over 1.5 years. Results Urinary C‐reactive protein (uCRP) concentrations were consistently below the detection limit (5.28 ng/mL). Mean ± within‐dog standard deviation for sCysC, uRBP/c, uNGAL/c and uIgG/c was 0.15 ± 0.01 mg/L, 0.09 ± 0.03 mg/g, 2.32 ± 2.03 μg/g and 12.47 ± 10.98 mg/g, respectively. Within‐dog CV for sCysC, uRBP/c, uNGAL/c and uIgG/c was 8.1%, 33.7%, 87.2% and 88.1%, respectively. Conclusions and clinical importance Serum cystatin C, uRBP/c, uNGAL/c and uIgG/c exhibit a wide range of long‐term within‐dog variability. Researchers and veterinarians might need to take this into account when interpreting their results. To assess their diagnostic and predictive ability, future studies need to establish reference ranges for healthy dogs and dogs with CKD.
Collapse
Affiliation(s)
- D J X Liu
- Department of Veterinary Medical Imaging and Small Animal Orthopedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - E Meyer
- Department of Pharmacology, Toxicology and Biochemistry, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - B J G Broeckx
- Department of Nutrition, Genetics and Ethology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - S Daminet
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - J R Delanghe
- Department of Clinical Chemistry, Microbiology and Immunology, Faculty of Health Medicine and Life Sciences, Ghent University, Ghent, Belgium
| | - E Stock
- Department of Veterinary Medical Imaging and Small Animal Orthopedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - E Bogaerts
- Department of Veterinary Medical Imaging and Small Animal Orthopedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - M Hesta
- Department of Nutrition, Genetics and Ethology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - K Vanderperren
- Department of Veterinary Medical Imaging and Small Animal Orthopedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| |
Collapse
|
6
|
Kuleš J, Bilić P, Beer Ljubić B, Gotić J, Crnogaj M, Brkljačić M, Mrljak V. Glomerular and tubular kidney damage markers in canine babesiosis caused by Babesia canis. Ticks Tick Borne Dis 2018; 9:1508-1517. [DOI: 10.1016/j.ttbdis.2018.07.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/06/2018] [Accepted: 07/21/2018] [Indexed: 02/06/2023]
|
7
|
Rebordão MR, Alexandre-Pires G, Carreira M, Adriano L, Carneiro C, Nunes T, Mateus L, Ferreira-Dias G. Bacteria causing pyometra in bitch and queen induce neutrophil extracellular traps. Vet Immunol Immunopathol 2017; 192:8-12. [PMID: 29042016 DOI: 10.1016/j.vetimm.2017.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 08/22/2017] [Accepted: 09/02/2017] [Indexed: 12/18/2022]
Abstract
Neutrophils are capable of releasing their DNA in response to infectious agents to form neutrophil extracellular traps (NETs) to destroy pathogens. Even though pyometra in queens and bitches is a common disease, its pathogenesis is not fully understood. The aim of this study was to assess the presence of NETs in the endometrium of queens and bitches suffering from pyometra. Pyometra and normal uteri were obtained after ovariohysterectomy from adult queens and bitches in diestrus. Uterine contents were evaluated for bacterial isolation and identification and for NETs presence. Escherichia coli were isolated in 5/5 queens and 4/5 bitches, and Streptococcus spp in one bitch. Sterile glass coverslips were placed on the endometrium surface to obtain material for NETs that were evaluated by immunocytochemistry (histone, neutrophil elastase or myeloperoxidase), fluorescence microscopy or scanning electron microscopy. NETs in endometrium content were positively stained by DNA histone DAPI, myeloperoxidase and by neutrophil elastase. NETs were spread in all observed queen and bitch endometria of pyometra cases. Ultrastructure images of NETs depicted clusters of globular material with fine filaments deposited on or around thick filaments and trapped bacteria. To the best of our knowledge these are the first findings confirming NETs endometrial presence in queen and bitch pyometra. Nevertheless, the precise role of NETs in pyometra in the bitch and queen, either to contribute to the defeat of infection or to its persistence remains to be unraveled.
Collapse
Affiliation(s)
- M R Rebordão
- CIISA, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal; Clínica Veterinária das Nogueiras, R. Estádio 6, 3030-318 Coimbra, Portugal; Coimbra College of Agriculture, Bencanta, 3045-601 Coimbra, Portugal
| | - G Alexandre-Pires
- CIISA, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal
| | - M Carreira
- Clínica Veterinária das Nogueiras, R. Estádio 6, 3030-318 Coimbra, Portugal
| | - L Adriano
- Clínica Veterinária das Nogueiras, R. Estádio 6, 3030-318 Coimbra, Portugal
| | - C Carneiro
- CIISA, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal
| | - T Nunes
- Faculty of Sciences, Microscopy Center, University of Lisbon, Campo Grande C2, 1749-016 Lisbon, Portugal
| | - L Mateus
- CIISA, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal
| | - G Ferreira-Dias
- CIISA, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal.
| |
Collapse
|
8
|
Théron ML, Piane L, Lucarelli L, Henrion R, Layssol-Lamour C, Palanché F, Concordet D, Braun JPD, Trumel C, Lavoué R. Effects of storage conditions on results for quantitative and qualitative evaluation of proteins in canine urine. Am J Vet Res 2017; 78:990-999. [DOI: 10.2460/ajvr.78.8.990] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
9
|
Cianciolo R, Hokamp J, Nabity M. Advances in the evaluation of canine renal disease. Vet J 2016; 215:21-9. [PMID: 27198066 DOI: 10.1016/j.tvjl.2016.04.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 04/05/2016] [Accepted: 04/23/2016] [Indexed: 01/11/2023]
Abstract
Many recent advances in the evaluation of dogs with kidney disease have improved our diagnostic algorithms and have impacted our therapeutic strategies. Non-invasive techniques, such as urinary and serologic biomarker evaluation, can help a clinician diagnose and treat a patient that cannot undergo a renal biopsy for clinical or financial reasons. Some biomarkers might help localize the affected structure (glomerulus vs. tubule) and indicate the type or severity of injury present. Although more research is needed, studies indicate that some biomarkers (e.g. urine protein to creatinine ratio and urinary immunoglobulins) can be useful in predicting adverse outcomes. Importantly, the sensitivity and specificity of biomarkers for renal injury should be established and clinicians need to understand the limitations of these assays. If a renal biopsy is performed, then it should be evaluated by a specialty diagnostic service with expertise in nephropathology. A panel of special stains, immunofluorescence for the detection of immunoglobulins and complement factors, and transmission electron microscopy can be routinely employed in cases of glomerular disease. These advanced diagnostics can be used to detect immune deposits in order to definitively diagnose immune complex mediated glomerular disease. Integrating the results of biomarker assays and comprehensive renal biopsy evaluation, the clinician can make informed therapeutic decisions, such as whether or not to immunosuppress a patient.
Collapse
Affiliation(s)
- Rachel Cianciolo
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA.
| | - Jessica Hokamp
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, TX, USA
| | - Mary Nabity
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, TX, USA
| |
Collapse
|
10
|
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
| |
Collapse
|
11
|
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: 26] [Impact Index Per Article: 3.3] [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.
Collapse
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
| |
Collapse
|
12
|
Lavoué R, Trumel C, Smets PMY, Braun JP, Aresu L, Daminet S, Concordet D, Palanché F, Peeters D. Characterization of Proteinuria in Dogue de Bordeaux Dogs, a Breed Predisposed to a Familial Glomerulonephropathy: A Retrospective Study. PLoS One 2015; 10:e0133311. [PMID: 26181659 PMCID: PMC4504498 DOI: 10.1371/journal.pone.0133311] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 06/24/2015] [Indexed: 01/06/2023] Open
Abstract
Dogue de Bordeaux dog has been reported to be predisposed to a familial glomerulonephropathy that displays some morphological modifications reported in focal and segmental glomerulosclerosis. Prevalence of quantitatively abnormal renal proteinuria was recently reported to be 33% in this breed. The nature of the proteinuria was assessed by sodium dodecyl sulfate-agarose gel electrophoresis and determinations of urinary markers (urinary retinol-binding protein, urinary N-acetyl-β-glucosaminidase, urinary albumin and urinary immunoglobulin G) on stored specimens. Diagnostic performances of sodium dodecyl sulfate-agarose gel electrophoresis to identify dogs with elevated urinary biomarkers were assessed. Samples from 102 adult Dogue de Bordeaux dogs (47 non-proteinuric [urine protein-to-creatinine ratio ≤ 0.2], 20 borderline-proteinuric [0.2< urine protein-to-creatinine ratio ≤ 0.5] and 35 proteinuric dogs [urine protein-to-creatinine ratio >0.5]) were used, of which 2 were suffering from familial glomerulonephropathy. The electrophoretic protein patterns, for all but one proteinuric dog, were indicative of a glomerular origin and, in all dogs, the urinary albumin concentration related to creatinine concentration and the urinary immunoglobulin G concentration related to creatinine concentration were above the upper limit of the reference interval established for the breed. Sensitivity and specificity of sodium dodecyl sulfate-agarose gel electrophoresis identifying dogs with elevated urinary albumin concentration were 94% and 92%, respectively, while diagnostic performance of sodium dodecyl sulfate-agarose gel electrophoresis in detecting dogs with elevated urinary immunoglobulin G concentration yielded sensitivity and specificity of 90% and 74%, respectively. These results suggest that all proteinuric and some borderline-proteinuric Dogue de Bordeaux dogs likely have underlying glomerular lesions and that sodium dodecyl sulfate-agarose gel electrophoresis and urinary markers might be useful to screen dogs with borderline-proteinuria. Additional investigations are warranted to assess if these findings are related to the familial glomerulonephropathy.
Collapse
Affiliation(s)
- Rachel Lavoué
- Internal Medicine Unit, Institut National Polytechnique, Ecole Nationale Vétérinaire de Toulouse (INP-ENVT), Toulouse, France
- * E-mail:
| | - Catherine Trumel
- Université de Toulouse, UPS, INP, ENVT, UMS006, Laboratoire Central de Biologie Médicale, Toulouse, France
- INSERM, UMS 006, Laboratoire Central de Biologie Médicale, Toulouse, France
| | - Pascale M. Y. Smets
- Department of Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Jean-Pierre Braun
- Université de Toulouse, UPS, INP, ENVT, UMS006, Laboratoire Central de Biologie Médicale, Toulouse, France
- INSERM, UMS 006, Laboratoire Central de Biologie Médicale, Toulouse, France
| | - Luca Aresu
- Department of Comparative Biomedicine and Food Science, University of Padova, Padova, Italy
| | - Sylvie Daminet
- Department of Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Didier Concordet
- UMR 1331 Toxalim, INRA, Institut National Polytechnique, Ecole Nationale Vétérinaire de Toulouse (INP-ENVT), Toulouse, France
| | - Florence Palanché
- Université de Toulouse, UPS, INP, ENVT, UMS006, Laboratoire Central de Biologie Médicale, Toulouse, France
| | - Dominique Peeters
- Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| |
Collapse
|
13
|
Urinary ferritin and cystatin C concentrations at different stages of kidney disease in leishmaniotic dogs. Res Vet Sci 2015; 99:204-7. [PMID: 25639693 DOI: 10.1016/j.rvsc.2015.01.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 12/12/2014] [Accepted: 01/10/2015] [Indexed: 12/12/2022]
Abstract
Traditional analytes do not detect early renal disease; therefore there is a need to find new early markers of chronic kidney disease (CKD) in dogs to avoid the progression to irreversible renal damage. Our objective was to evaluate the presence of ferritin and cystatin C in urine of dogs with CKD and to relate their concentrations with the severity of the disease. Samples obtained from dogs naturally infected with Leishmania infantum were classified into four groups on the basis of the results of urinary protein/creatinine ratio and serum creatinine. This study shows that ferritin and cystatin C concentrations were increased in the urine of dogs with renal damage. Cystatin C value in urine only increased in severe stages of CKD with serum creatinine values >1.4 mg/dL, while the urinary ferritin concentration increased in dogs with proteinuria and serum creatinine <1.4 mg/dL, being, therefore, a renal biomarker earlier than creatinemia.
Collapse
|
14
|
Brandt LE, Ehrhart EJ, Scherman H, Olver CS, Bohn AA, Prenni JE. Characterization of the canine urinary proteome. Vet Clin Pathol 2014; 43:193-205. [DOI: 10.1111/vcp.12147] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Laura E. Brandt
- Department of Microbiology, Immunology and Pathology; Colorado State University; Fort Collins CO USA
| | - E. J. Ehrhart
- Department of Microbiology, Immunology and Pathology; Colorado State University; Fort Collins CO USA
- Animal Cancer Center; Colorado State University; Fort Collins CO USA
| | - Hataichanok Scherman
- Proteomics and Metabolomics Facility; Colorado State University; Fort Collins CO USA
| | - Christine S. Olver
- Department of Microbiology, Immunology and Pathology; Colorado State University; Fort Collins CO USA
| | - Andrea A. Bohn
- Department of Microbiology, Immunology and Pathology; Colorado State University; Fort Collins CO USA
| | - Jessica E. Prenni
- Department of Biochemistry and Molecular Biology; Colorado State University; Fort Collins CO USA
- Proteomics and Metabolomics Facility; Colorado State University; Fort Collins CO USA
| |
Collapse
|
15
|
Cobrin AR, Blois SL, Kruth SA, Abrams-Ogg ACG, Dewey C. Biomarkers in the assessment of acute and chronic kidney diseases in the dog and cat. J Small Anim Pract 2013; 54:647-55. [PMID: 24152019 DOI: 10.1111/jsap.12150] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
In both human and veterinary medicine, diagnosing and staging renal disease can be difficult. Measurement of glomerular filtration rate is considered the gold standard for assessing renal function but methods for its assessment can be technically challenging and impractical. The main parameters used to diagnose acute and chronic kidney disease include circulating creatinine and urea concentrations, and urine-specific gravity. However, these parameters can be insensitive. Therefore, there is a need for better methods to diagnose and monitor patients with renal disease. The use of renal biomarkers is increasing in human and veterinary medicine for the diagnosis and monitoring of acute and chronic kidney diseases. An ideal biomarker would identify site and severity of injury, and correlate with renal function, among other qualities. This article will review the advantages and limitations of renal biomarkers that have been used in dogs and cats, as well as some markers used in humans that may be adapted for veterinary use. In the future, measuring a combination of biomarkers will likely be a useful approach in the diagnosis of kidney disorders.
Collapse
Affiliation(s)
- A R Cobrin
- Ontario Veterinary College Department of Clinical Studies, University of Guelph, Guelph, Ontario, Canada, N1G 2W1
| | | | | | | | | |
Collapse
|
16
|
De Loor J, Daminet S, Smets P, Maddens B, Meyer E. Urinary biomarkers for acute kidney injury in dogs. J Vet Intern Med 2013; 27:998-1010. [PMID: 23952327 DOI: 10.1111/jvim.12155] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 05/23/2013] [Accepted: 07/10/2013] [Indexed: 11/29/2022] Open
Abstract
Routinely, kidney dysfunction and decreased glomerular filtration rate (GFR) are diagnosed by the evaluation of changes in the serum creatinine (SCr) and blood urea nitrogen (BUN) concentrations. However, neither of these tests is sensitive or specific enough for the early diagnosis of impaired kidney function because they are both affected by other renal and nonrenal factors. Furthermore, kidney injury can be present in the absence of kidney dysfunction. Renal reserve enables normal GFR even when nephrons are damaged. Renal biomarkers, especially those present in urine, may be useful for the study of both acute and chronic nephropathies. The aim of this review is to describe the current status of urinary biomarkers as diagnostic tools for kidney injury in dogs with particular focus on acute kidney injury (AKI). The International Renal Interest Society (IRIS) canine AKI grading system and the implementation of urinary biomarkers in this system also are discussed. The discovery of novel urinary biomarkers has emerged from hypotheses about the pathophysiology of kidney injury, but few proteomic urine screening approaches have been described in dogs. Lack of standardization of biomarker assays further complicates the comparison of novel canine urinary biomarker validation results among studies. Future research should focus on novel biomarkers of renal origin and evaluate promising biomarkers in different clinical conditions. Validation of selected urinary biomarkers in the diagnosis of canine kidney diseases must include dogs with both renal and nonrenal diseases to evaluate their sensitivity, specificity as well as their negative and positive predictive values.
Collapse
Affiliation(s)
- J De Loor
- Department of Pharmacology, Toxicology and Biochemistry, Ghent University, Merelbeke, Belgium
| | | | | | | | | |
Collapse
|
17
|
Martínez-Subiela S, García-Martínez JD, Tvarijonaviciute A, Tecles F, Caldin M, Bernal LJ, Cerón JJ. Urinary C reactive protein levels in dogs with leishmaniasis at different stages of renal damage. Res Vet Sci 2013; 95:924-9. [PMID: 23932765 DOI: 10.1016/j.rvsc.2013.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 07/08/2013] [Indexed: 11/18/2022]
Abstract
The objectives of the study were to validate a time-resolved immunofluorometric assay for C reactive protein (CRP) quantification in urine of dogs and to investigate the influence that the presence of proteinuria and azotemia could have on serum and urinary CRP (uCRP) values in dogs with leishmaniasis. Samples obtained from dogs naturally infected with Leishmania infantum were classified into four groups on the basis of the results of urinary protein/creatinine ratio and serum creatinine (sCr). In addition, 7 dogs were monitored at initial diagnosis and after a follow up visit. The assay showed good analytical performance based on precision, accuracy and limit of detection results. Results of the study suggested that CRP is present in urine of dogs with leishmaniasis and renal damage since uCRP/creatinine ratio was significantly increased in dogs with proteinuria, being the highest values observed in dogs with proteinuria and elevated sCr, and that the measurement of uCRP could be a tool to detect and evaluate the possible kidney damage associated with this disease.
Collapse
Affiliation(s)
- Silvia Martínez-Subiela
- Animal Medicine and Surgery Department, Veterinary School, Campus of Excelence Mare Nostrum, University of Murcia, 30100 Espinardo, Murcia, Spain
| | | | | | | | | | | | | |
Collapse
|
18
|
Defauw P, Schoeman J, Smets P, Goddard A, Meyer E, Liebenberg C, Daminet S. Assessment of renal dysfunction using urinary markers in canine babesiosis caused by Babesia rossi. Vet Parasitol 2012; 190:326-32. [DOI: 10.1016/j.vetpar.2012.07.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 07/18/2012] [Accepted: 07/20/2012] [Indexed: 11/15/2022]
|
19
|
Smets PMY, Lefebvre HP, Meij BP, Croubels S, Meyer E, Van de Maele I, Daminet S. Long-term follow-up of renal function in dogs after treatment for ACTH-dependent hyperadrenocorticism. J Vet Intern Med 2012; 26:565-74. [PMID: 22463105 DOI: 10.1111/j.1939-1676.2012.00915.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 01/20/2012] [Accepted: 02/08/2012] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Systemic hypertension and proteinuria are frequent complications in dogs with Cushing's syndrome and do not always resolve after treatment of hypercortisolism. Therefore, dogs with Cushing's syndrome may be at risk for renal dysfunction before and after treatment. HYPOTHESIS/OBJECTIVES To assess renal function in dogs with ACTH-dependent hyperadrenocorticism (ADHAC) before and after treatment. ANIMALS A total of 19 dogs with ADHAC and 12 control dogs. METHODS Renal function was assessed before and at 1, 3, 6, and 12 months after treatment. Twelve dogs were treated with trilostane and 7 dogs by transsphenoidal hypophysectomy. Routine renal markers were measured and urinary albumin (uALB), immunoglobulin G (uIgG), and retinol-binding protein (uRBP) were assessed by ELISA. Urinary N-acetyl-β-D-glucosaminidase (uNAG) was determined colorimetrically. All urinary markers were indexed to urinary creatinine concentration (c). Plasma clearance of creatinine (Cl(creat)), exo-iohexol (Cl(exo)), and endo-iohexol (Cl(endo)) was used to measure glomerular filtration rate (GFR). Data were analyzed using a general linear model. RESULTS Serum creatinine and urea concentrations increased post-treatment, but remained within reference ranges. Plasma Cl(creat) and Cl(endo) were significantly lower post-treatment, whereas Cl(exo) was not different. Urinary protein-to-creatinine ratio (UPC), uALB/c, uIgG/c, and uRBP/c were decreased post-treatment, but at 12 months 5/13 dogs remained proteinuric. Urinary NAG/c did not change significantly. CONCLUSIONS AND CLINICAL IMPORTANCE A decrease in GFR and persistent proteinuria post-treatment may warrant the clinician's attention. Future research including renal histopathology of dogs with persistent proteinuria or low GFR is needed to further assess renal outcome.
Collapse
Affiliation(s)
- P M Y Smets
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | | | | | | | | | | | | |
Collapse
|
20
|
Smets PMY, Lefebvre HP, Aresu L, Croubels S, Haers H, Piron K, Meyer E, Daminet S. Renal function and morphology in aged Beagle dogs before and after hydrocortisone administration. PLoS One 2012; 7:e31702. [PMID: 22393368 PMCID: PMC3290534 DOI: 10.1371/journal.pone.0031702] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Accepted: 01/17/2012] [Indexed: 11/19/2022] Open
Abstract
Objectives of this study were to evaluate glomerular filtration rate (GFR), renal structural changes and proteinuria in aged Beagle dogs before and after hydrocortisone (HC) administration. Eleven Beagle dogs ≥10 years old were treated with either hydrocortisone (HC group, n = 6) or placebo (control group, n = 5). Urinary markers, GFR and kidney biopsies were evaluated before (T0), during (T16 wks) and after discontinuing HC administration (T24 wks). Results indicate that HC administration causes a significant increase in GFR. At all time points except T16 wks, proteinuria was higher in the control group than in the HC group, and there was no significant difference in urinary markers between groups. At T16 wks, proteinuria, urinary albumin-to-creatinine (c) ratio, immunoglobulin G/c and retinol-binding protein/c were higher compared to baseline in the HC group. At T0, rare to mild renal lesions were detected in all HC dogs and rare to moderate changes in all control dogs. Glomerulosclerosis progressed in both groups until T24 wks. Tubular atrophy was detected in three HC dogs at T16 wks and T24 wks, but also in five control dogs throughout the study. At every time point, five HC dogs and all control dogs had rare to moderate interstitial inflammation. Rare to mild interstitial fibrosis was found in up to three HC dogs at T16 wks and T24 wks, and severe fibrosis in one HC dog at T24 wks. Up to four control dogs had rare to mild fibrosis at all time points. These findings indicate that clinically healthy, aged Beagle dogs may have considerable renal lesions and proteinuria, which could have implications for experimental or toxicological studies. Additional research is needed to elucidate glucocorticoid effects on renal structure, but functional changes such as hyperfiltration and proteinuria warrant attention to kidney function of canine patients with Cushing's syndrome or receiving exogenous glucocorticoids.
Collapse
Affiliation(s)
- Pascale M Y Smets
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan, Merelbeke, Belgium.
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Nabity M, Lees G, Cianciolo R, Boggess M, Steiner J, Suchodolski J. Urinary Biomarkers of Renal Disease in Dogs with X-Linked Hereditary Nephropathy. J Vet Intern Med 2012; 26:282-93. [DOI: 10.1111/j.1939-1676.2012.00891.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 11/01/2011] [Accepted: 01/09/2012] [Indexed: 01/19/2023] Open
Affiliation(s)
- M.B. Nabity
- Departments of Veterinary Pathobiology and Small Animal Clinical Sciences; College of Veterinary Medicine; Texas A&M University; College Station; TX
| | - G.E. Lees
- Departments of Veterinary Pathobiology and Small Animal Clinical Sciences; College of Veterinary Medicine; Texas A&M University; College Station; TX
| | - R. Cianciolo
- Department of Population Health and Pathobiology; North Carolina State University; Raleigh; NC
| | - M.M. Boggess
- Department of Statistics; Texas A&M University; College Station; TX
| | - J.M. Steiner
- Departments of Veterinary Pathobiology and Small Animal Clinical Sciences; College of Veterinary Medicine; Texas A&M University; College Station; TX
| | - J.S. Suchodolski
- Departments of Veterinary Pathobiology and Small Animal Clinical Sciences; College of Veterinary Medicine; Texas A&M University; College Station; TX
| |
Collapse
|
22
|
Thoen ME, Kerl ME. Characterization of acute kidney injury in hospitalized dogs and evaluation of a veterinary acute kidney injury staging system. J Vet Emerg Crit Care (San Antonio) 2011; 21:648-57. [PMID: 22316258 DOI: 10.1111/j.1476-4431.2011.00689.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Accepted: 09/27/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To retrospectively apply standards characterizing acute kidney injury (AKI) used in human medicine to a population of critically ill hospitalized dogs in order to identify dogs with potential AKI based on subtle increases in plasma creatinine concentration. DESIGN Retrospective study. SETTING University Veterinary Medical Teaching Hospital. ANIMALS One hundred and sixty-four client-owned dogs admitted to the intensive care unit. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Medical records of 164 dogs meeting the study inclusion criteria were reviewed to identify age, results of creatinine measurements, discharge status, length of stay, performance of general anesthesia, number of diagnoses, and calculated survival prediction index scores (SPI2). A veterinary AKI (VAKI) staging system was retrospectively applied to classify dogs based on increase in creatinine concentration from baseline as follows: stage 0 (S0; <150%), stage 1 (S1; 150-199% or ≥26.5 μmol/L [≥0.3 mg/dL]), stage 2 (S2; 200-299%), or stage 3 (S3; ≥300%). Of the dogs evaluated, 140/164 were VAKI stage S0, 19/164 were classified as S1, 3/164 as S2, and 2/164 were S3. Mortality rate was greater for S1-3 (13/24; 54.2%) compared to S0 dogs (22/140; 15.7%) (P < 0.0001). Length of stay, general anesthesia, and number of diagnoses were not associated with survival. In a logistic regression model, stage and age were jointly, significantly associated with mortality (P = 0.0002 and P = 0.0330, respectively). Mean SPI2 scores were not different between S0 (0.52) and S1 (0.59) dogs (P = 0.23). Only 4/19 (21%) of S1 dogs had a peak plasma creatinine concentration above the laboratory reference interval. CONCLUSIONS Dogs meeting VAKI stage 1-3 criteria were less likely to survive to discharge. Small increases in plasma creatinine concentration may be clinically relevant even when absolute values are within reference intervals.
Collapse
Affiliation(s)
- Meredith E Thoen
- Department of Veterinary Medicine and Surgery, University of Missouri, College of Veterinary Medicine, Columbia, MO 65211, USA
| | | |
Collapse
|
23
|
Maddens B, Heiene R, Smets P, Svensson M, Aresu L, van der Lugt J, Daminet S, Meyer E. Evaluation of kidney injury in dogs with pyometra based on proteinuria, renal histomorphology, and urinary biomarkers. J Vet Intern Med 2011; 25:1075-83. [PMID: 21848947 DOI: 10.1111/j.1939-1676.2011.0772.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Proteinuria is a feature of pyometra-associated renal dysfunction, but its prevalence and clinical relevance are not well characterized. OBJECTIVES To define which subset of dogs with pyometra has clinically relevant kidney injury by quantification of proteinuria; light, immunofluorescence, and electron microscopic examination of kidney biopsy specimens; and measurement of urinary biomarkers. ANIMALS Forty-seven dogs with pyometra. Ten clinically healthy intact bitches of comparable age. METHODS Prospective study. Routine clinicopathological variables including urinary protein to creatinine ratio (UPC) were analyzed. Validated assays were used to quantify urinary biomarkers for glomerular (urinary albumin, urinary immunoglobulin G, urinary C-reactive protein, urinary thromboxane B(2)) and tubular function (urinary retinol-binding protein, urinary N-acetyl-β-d-glucosaminidase). Kidney biopsy specimens from 10 dogs with pyometra and dipstick urine protein concentrations of 2+ or 3+ were collected during ovariohysterectomy. Urinalysis was repeated within 3 weeks after surgery in 9 of the 10 dogs. RESULTS UPC (median, range) was significantly higher in dogs with pyometra (0.48, 0.05-8.69) compared with healthy bitches (0.08, 0.02-0.16) (P < .01). Twenty-two of 47 dogs with pyometra had UPC>0.5, 12 had UPC>1.0, and 7 had UPC>2.0. Glomerulosclerosis and tubulointerstitial nephritis were common kidney biopsy findings in proteinuric dogs with pyometra. Dogs with glomerulosclerosis (5/10), either global or focal and segmental, had UPC>1.0 at ovariohysterectomy and afterward. Dogs with structural glomerular and tubular changes mostly had urinary biomarker to creatinine ratios above the 75th percentile. CONCLUSION Dogs with pyometra and UPC>1.0 or high ratios of urinary biomarkers appear likely to have clinically relevant renal histologic lesions and require monitoring after ovariohysterectomy. Future studies should evaluate the role of pyometra-associated pathogenic mechanisms in causing or exacerbating focal and segmental glomerulosclerosis in dogs.
Collapse
Affiliation(s)
- B Maddens
- Department of Pharmacology, Toxicology and Biochemistry, Ghent University, Merelbeke, Belgium.
| | | | | | | | | | | | | | | |
Collapse
|