1
|
Foster JD. Nephrology in Veterinary Medicine. KIDNEY360 2023; 4:1641-1649. [PMID: 37840194 PMCID: PMC10695652 DOI: 10.34067/kid.0000000000000273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 10/09/2023] [Indexed: 10/17/2023]
Abstract
Veterinary nephrology is a specialized field of veterinary medicine providing a high level of care for animals with all types of kidney disease. Veterinarians complete extensive training to become board-certified in veterinary nephrology-urology. Companion animal nephrology is the most advanced field; however, all species are afflicted by a variety of renal disorders. Most naturally occurring animal kidney diseases have similar disorders found in people; where veterinary research is lacking, clinical management is often modified from standard of care in people. Veterinarians have become adept at scaling down procedures to safely perform them on dogs and cats weighing only a few kilograms. Advanced diagnostics (renal biopsy, cystoscopy, fluoroscopic studies, etc. ) and therapeutics (renal replacement therapy, interventional endourology, etc. ) are commonly performed within the practice of veterinary nephrology-urology. Collaboration between veterinary and human nephrologists may advance both disciplines and improve care for people and animals alike.
Collapse
|
2
|
Wilkinson SL. Urine Output Monitoring and Acute Kidney Injury in Non-mammalian Exotic Animal Critical Care. Vet Clin North Am Exot Anim Pract 2023; 26:673-710. [PMID: 37516459 DOI: 10.1016/j.cvex.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2023]
Abstract
Acute kidney injury (AKI) is a sudden, severe decrease in kidney function which can occur in any species. There are various causes of AKI, some of which are seen in domestic species and some that are unique to birds, reptiles, and amphibians. These species present unique challenges with AKI management, such as differences in anatomy and physiology, intravenous and urinary catheterization, repeated blood sampling, and their tendency to present in advanced states of illness. This article will discuss AKI, diagnosis, treatment, and prognosis for non-mammalian exotic species.
Collapse
Affiliation(s)
- Stacey Leonatti Wilkinson
- Avian and Exotic Animal Hospital of Georgia, 118 Pipemakers Circle Suite 110, Pooler, GA 31322, USA.
| |
Collapse
|
3
|
Palm CA, Kopecny L, Woerde DJ, Culp WTN. Bilateral external jugular vein anomalies preventing hemodialysis catheter placement in a cat with anuria secondary to Lilium species intoxication. JFMS Open Rep 2023; 9:20551169231178257. [PMID: 37457858 PMCID: PMC10338655 DOI: 10.1177/20551169231178257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Abstract
Case series summary A 2-year-old female spayed Abyssinian cat was evaluated for lethargy and inappetence that first occurred approximately 4 days prior. In addition, urination had not been observed by the owner for 5 days. A Lilium species plant had been brought into the house approximately 5 days before initial evaluation, and intoxication was therefore suspected. Bloodwork revealed anemia, severe azotemia and hyperkalemia. As the cat was anuric with severe azotemia, hyperkalemia and fluid overload, intermittent hemodialysis was recommended. Attempts were made to place a hemodialysis catheter into the external jugular veins bilaterally, but after initial successful venipuncture, the instrumentation would not pass into either vein. During fluoroscopic angiography, no internal jugular veins or external jugular veins caudal to the thoracic inlet were visualized and venous drainage from the head occurred via the vertebral veins. Owing to the anomalous anatomy in the cervical region, a hemodialysis catheter could not be placed into either jugular vein. Alternative sites for the placement of an extracorporeal catheter were discussed with the owner, but humane euthanasia was elected. Relevance and novel information To the authors' knowledge, this is the first report of a cat with bilateral external jugular vein anomalies resulting in blind endings that did not communicate with the vena cava. This was discovered during attempts to place a hemodialysis catheter for the management of anuric renal failure secondary to Lilium species intoxication. While this anatomical variation is likely uncommon, it is an important differential to consider when faced with challenging external jugular vein catheterizations in feline patients.
Collapse
Affiliation(s)
- Carrie A Palm
- Department of Veterinary Medicine & Epidemiology, University of California-Davis, School of Veterinary Medicine, Davis, CA, USA
| | - Lucy Kopecny
- Veterinary Medical Teaching Hospital, University of California-Davis, School of Veterinary Medicine, Davis, CA, USA
| | - Dennis J Woerde
- Veterinary Medical Teaching Hospital, University of California-Davis, School of Veterinary Medicine, Davis, CA, USA
| | - William TN Culp
- Department of Veterinary Surgical & Radiological Sciences, University of California-Davis, School of Veterinary Medicine, Davis, CA, USA
| |
Collapse
|
4
|
Wilkinson SL. Urine Output Monitoring and Acute Kidney Injury in Mammalian Exotic Animal Critical Care. Vet Clin North Am Exot Anim Pract 2023:S1094-9194(23)00023-3. [PMID: 37302935 DOI: 10.1016/j.cvex.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Acute kidney injury (AKI) is a sudden, severe decrease in kidney function which can occur in any species. There are various causes of AKI, some of which are seen in domestic species and some that are unique to exotics. Exotic animals present unique challenges with AKI management such as differences in anatomy and physiology, intravenous and urinary catheterization, repeated blood sampling, and their tendency to present in advanced states of illness. This article will discuss AKI, diagnosis, treatment, and prognosis for exotic companion mammals. The following article will discuss the same in non-mammalian patients.
Collapse
Affiliation(s)
- Stacey Leonatti Wilkinson
- Avian and Exotic Animal Hospital of Georgia, 118 Pipemakers Circle Suite 110, Pooler, GA 31322, USA.
| |
Collapse
|
5
|
Brückner M. Laparoscopic repositioning of an obstructed ventriculoperitoneal shunt catheter with laparoscopy-assisted partial omentectomy and omentopexy. Vet Surg 2019; 49 Suppl 1:O71-O75. [PMID: 31814142 DOI: 10.1111/vsu.13362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/21/2019] [Accepted: 11/13/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the use of laparoscopy for repositioning of a ventriculoperitoneal shunt (VPS) catheter. STUDY DESIGN Case report. ANIMAL One 11-month-old male cairn terrier weighing 5.5 kg. METHODS The dog had placement of a VPS system for primary hydrocephalus at 4 months of age. Poor functioning of the shunt system was suspected because of deteriorating neurological signs. A contrast study of the VPS system provided evidence of a distal shunt obstruction, and repeated brain computed tomography (CT) was consistent with persistent hydrocephalus. RESULTS Laparoscopy was used to free the abdominal catheter of the shunt system and perform a partial omentectomy and omentopexy of the remaining omentum. Concurrently, the dog was sterilized. Recovery was routine, and follow-up CT 1 year after repositioning revealed that the hydrocephalus had substantially improved. Results of a contrast study of the VPS system also provided evidence that it was functional. CONCLUSION Ventriculoperitoneal shunt systems are placed in dogs with primary and secondary hydrocephalus, and complications are quite common, including obstruction, bleeding, infection, and overshunting or undershunting. This is the first published clinical case report in which the repositioning of a VPS catheter with partial omentectomy and omentopexy in a dog are described. CLINICAL SIGNIFICANCE Future studies may be performed to determine whether laparoscopy can be considered as a treatment to assist with safe placement of VPS systems, avoiding misplacement of the shunt system and iatrogenic damage to the viscera and vessels.
Collapse
Affiliation(s)
- Michael Brückner
- Evidensia Specialistdjursjukhuset Helsingborg, Helsingborg, Sweden
| |
Collapse
|
6
|
Bland SK, Clark ME, Côté O, Bienzle D. A specific immunoassay for detection of feline kidney injury molecule 1. J Feline Med Surg 2019; 21:1069-1079. [PMID: 30461328 PMCID: PMC10814266 DOI: 10.1177/1098612x18812494] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to design and carry out a preliminary evaluation of a urine point-of-care test for kidney injury molecule 1 (KIM-1) in healthy and diseased cats. METHODS Part of the feline KIM-1 gene was amplified, ligated into a plasmid with a signal peptide and monomeric human IgGFc, and transfected into a mammalian cell line. Supernatant was purified and tested for the fusion protein by gel electrophoresis and Western blot. Mice were immunized three times with purified proteins, and hybridomas were generated from splenocytes. Antibodies were tested by ELISA for detection of recombinant KIM-1 and naturally occurring KIM-1 in disease-state urine. Next, a lateral flow assay (LFA) with capture and detection antibodies was constructed, and tested with 34 urine samples from healthy and diseased cats. Antibodies were also tested for reactivity with formalin-fixed paraffin-embedded kidney tissue. RESULTS Three antibodies were assessed. Antibodies detected between 0.4 and 60 ng/ml feline KIM-1 fusion protein in the LFA. Urine samples from healthy cats yielded faint bands in the LFA corresponding to optical density (OD) values of 4.8-8.8. Samples from cats with suspected or confirmed acute kidney injury (AKI) had OD values ranging from 1.6-20.5. Urine KIM-1 varied over multiple days in cats with sepsis or urethral obstruction despite normalizing serum creatinine concentration. In tissue sections, KIM-1 antibodies labeled tubular cells with morphological features of injury. CONCLUSIONS AND RELEVANCE A practical patient-side assay for detection of KIM-1 in feline urine has been developed. Preliminary results show marked though transient increases in cats with sepsis and urethral obstruction-associated AKI, and expression in injured tubules. Although initial data indicating that the LFA is sensitive and specific for KIM-1 in cats with AKI are promising, values associated with different types of injury, urine collection, urine storage and specific gravity need to be investigated.
Collapse
Affiliation(s)
- S Karlyn Bland
- Department of Pathobiology, University of Guelph, Guelph, ON, Canada
| | - Mary Ellen Clark
- Department of Pathobiology, University of Guelph, Guelph, ON, Canada
| | | | - Dorothee Bienzle
- Department of Pathobiology, University of Guelph, Guelph, ON, Canada
| |
Collapse
|
7
|
Legatti SAM, El Dib R, Legatti E, Botan AG, Camargo SEA, Agarwal A, Barretti P, Paes AC. Acute kidney injury in cats and dogs: A proportional meta-analysis of case series studies. PLoS One 2018; 13:e0190772. [PMID: 29370180 PMCID: PMC5784898 DOI: 10.1371/journal.pone.0190772] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 12/15/2017] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Risk of mortality in the setting of acute kidney injury (AKI) in cats and dogs remains unclear. OBJECTIVES To evaluate the incidence of mortality in cats and dogs with AKI based on etiology (i.e. infectious versus non-infectious; receiving dialysis versus conservative treatment). MATERIALS AND METHODS Ovid Medline, EMBASE, and LILACS were searched up to July 2016. Articles were deemed eligible if they were case series studies evaluating the incidence of all-cause mortality in cats and dogs with AKI, regardless of etiology or the nature of treatment. RESULTS Eighteen case series involving 1,201animalsproved eligible. The pooled proportions for overall mortality were: cats53.1% [95% CI 0.475, 0.586; I2 = 11,9%, p = 0.3352]; dogs 45.0% [95% CI 0.33, 0.58; I2 = 91.5%, P < 0.0001]. A non-significant increase in overall mortality risk was found among dialysed animals relative to those managed with conservative treatment, independent of animal type and the etiology of their AKI. The pooled proportions for overall mortality according to etiology, regardless of treatment type, were: AKI due infectious etiology for cats and dogs, 19.2% [95% CI 0.134, 0.258; I2 = 37.7%, P = 0.0982]; AKI due non-infectious etiology for cats and dogs, 59.9% [95% CI 0.532, 0.663; I2 = 51.0%, P = 0.0211]. CONCLUSION Our findings suggest higher rates of overall mortality in cats and dogs with AKI due to non-infectious etiologies relative to infectious etiologies, and showed non-significant differences in terms of higher rates associated with dialysis compared to conservative management. Further investigations regarding optimal time to initiate dialysis and the development of clinical models to prognosticate the course of disease and guide optimal treatment initiation for less severe cases of AKI in cats and dogs is warranted.
Collapse
Affiliation(s)
- Sabrina Almeida Moreira Legatti
- Department of Veterinary Hygiene and Public Health, School of Veterinary Medicine and Animal Science, Unesp – Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Regina El Dib
- Department of Anaesthesiology, Botucatu Medical School, Unesp – Univ Estadual Paulista, Botucatu, São Paulo, Brazil
- McMaster Institute of Urology, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
| | - Emerson Legatti
- School of Veterinary Medicine and Animal Science, Unesp – Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Andresa Graciutti Botan
- Institute of Science and Technology, Department of Biosciences and Oral Diagnosis, Unesp – Univ Estadual Paulista, São José dos Campos, São Paulo, Brazil
| | - Samira Esteves Afonso Camargo
- Institute of Science and Technology, Department of Biosciences and Oral Diagnosis, Unesp – Univ Estadual Paulista, São José dos Campos, São Paulo, Brazil
| | - Arnav Agarwal
- Schoolof Medicine, University of Toronto, Toronto, Canada
| | - Pasqual Barretti
- Department of Internal Medicine, Botucatu Medical School, Unesp – Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Antônio Carlos Paes
- Department of Veterinary Hygiene and Public Health, School of Veterinary Medicine and Animal Science, Unesp – Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| |
Collapse
|
8
|
Bland SK, Schmiedt CW, Clark ME, DeLay J, Bienzle D. Expression of Kidney Injury Molecule-1 in Healthy and Diseased Feline Kidney Tissue. Vet Pathol 2017; 54:490-510. [DOI: 10.1177/0300985817690213] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sensitive markers to detect acute kidney injury (AKI) in cats are lacking. Kidney injury molecule-1 (KIM-1) is a promising marker of acute tubular injury in humans, and sequence and structure of feline KIM-1 have been determined. KIM-1 is shed into urine of cats with natural AKI. The objectives of this study were to characterize temporal and cellular expression of KIM-1 in kidneys from cats without and with experimental and natural AKI using histopathology and immunohistochemistry. Tissue sections from 8 cats without kidney disease, 3 to 4 cats with experimentally induced AKI on each day 1, 3, 6, and 12 after unilateral ischemia/reperfusion, and 9 cats with natural AKI were assessed. In sections from cats without kidney disease, patterns of periodic acid–Schiff and aquaporin-1 staining allowed identification of 3 distinct segments of the proximal tubule. KIM-1 staining was absent in segments 1 (S1) and S2, and faint in S3. Injury of S3 in cats with experimental and natural AKI was characterized by cell loss and necrosis, and remaining intact cells had cytoplasmic blebs and reduced brush borders. In experimental AKI, intensity of KIM-1 expression increased in proportion to the severity of injury and was consistently present in S3 but only transiently in other segments. Vimentin was absent in proximal tubules of healthy cats but expressed in injured S3. These findings indicate that S3 is the proximal tubular segment most susceptible to ischemic injury and that KIM-1 is a sensitive tissue indicator of AKI in cats.
Collapse
Affiliation(s)
- S. K. Bland
- Department of Pathobiology, University of Guelph, Guelph, Ontario, Canada
| | - C. W. Schmiedt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - M. E. Clark
- Department of Pathobiology, University of Guelph, Guelph, Ontario, Canada
| | - J. DeLay
- Animal Health Laboratory, University of Guelph, Guelph, Ontario, Canada
| | - D. Bienzle
- Department of Pathobiology, University of Guelph, Guelph, Ontario, Canada
| |
Collapse
|
9
|
Ross LA, Labato MA. Current techniques in peritoneal dialysis. J Vet Emerg Crit Care (San Antonio) 2013; 23:230-40. [PMID: 23566109 DOI: 10.1111/vec.12035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Accepted: 02/02/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To provide a current overview of the technique of peritoneal dialysis in dogs and cats. CLINICAL IMPLICATION Peritoneal dialysis is the process by which water and solutes move between blood in the peritoneal capillaries and fluid (dialysate) instilled into the peritoneal cavity, across the semipermeable membrane of the peritoneum. The primary indication for peritoneal dialysis (PD) in animals is for treatment of renal failure to correct water, solute, and acid-base abnormalities and to remove uremic toxins. SUMMARY Peritoneal dialysis is a modality of renal replacement therapy commonly used in human medicine for the treatment of chronic kidney disease and end-stage kidney failure. Peritoneal dialysis utilizes the peritoneum as a membrane across which fluids and uremic solutes are exchanged. Dialysate is instilled into the peritoneal cavity and, through the process of diffusion and osmosis, water, toxins, electrolytes, and other small molecules are allowed to equilibrate.
Collapse
Affiliation(s)
- Linda A Ross
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
| | | |
Collapse
|
10
|
Li R, Mugford A, Humm K. Acute kidney injury in dogs and cats 2. Management, treatment and outcome. IN PRACTICE 2013. [DOI: 10.1136/inp.f3640] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
11
|
Eatroff AE, Langston CE, Chalhoub S, Poeppel K, Mitelberg E. Long-term outcome of cats and dogs with acute kidney injury treated with intermittent hemodialysis: 135 cases (1997-2010). J Am Vet Med Assoc 2013; 241:1471-8. [PMID: 23176239 DOI: 10.2460/javma.241.11.1471] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the long-term outcome for small animal patients with acute kidney injury (AKI) treated with intermittent hemodialysis (IHD). DESIGN Retrospective case series. ANIMALS 42 cats and 93 dogs treated with IHD for AKI. PROCEDURES Medical records of cats and dogs treated with IHD for AKI from January 1997 to October 2010 were reviewed. Standard methods of survival analysis with Kaplan-Meier product limit curves were used. The log-rank, Mann-Whitney, and Kruskal-Wallis tests were used to determine whether outcome, number of IHD treatments, or duration of hospitalization was different when dogs and cats were classified according to specific variables. RESULTS The overall survival rate at the time of hospital discharge was 50% (21/42) for cats and 53% (49/93) for dogs. The overall survival rate 30 days after hospital discharge was 48% (20/42) for cats and 42% (39/93) for dogs. The overall survival rate 365 days after hospital discharge was 38% (16/42) for cats and 33% (31/93) for dogs. For all-cause mortality, the median survival time was 7 days (95% confidence interval, 0 to 835 days) for cats and 9 days (95% confidence interval, 0 to 55 days) for dogs. CONCLUSIONS AND CLINICAL RELEVANCE Cats and dogs with AKI treated with IHD have survival rates similar to those of human patients. Although there was a high mortality rate prior to hospital discharge, those patients that survived to discharge had a high probability of long-term survival.
Collapse
Affiliation(s)
- Adam E Eatroff
- Bobst Hospital, The Animal Medical Center, 510 E 62nd St, New York, NY 10065, USA.
| | | | | | | | | |
Collapse
|
12
|
Bennett AJ, Reineke EL. Outcome following gastrointestinal tract decontamination and intravenous fluid diuresis in cats with known lily ingestion: 25 cases (2001–2010). J Am Vet Med Assoc 2013; 242:1110-6. [DOI: 10.2460/javma.242.8.1110] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
13
|
Stafford JR, Bartges JW. A clinical review of pathophysiology, diagnosis, and treatment of uroabdomen in the dog and cat. J Vet Emerg Crit Care (San Antonio) 2013; 23:216-29. [DOI: 10.1111/vec.12033] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Accepted: 02/02/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | - Joseph W. Bartges
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; The University of Tennessee; Knoxville; TN; 37996
| |
Collapse
|
14
|
Dupré G, Čoudek K. Laparoscopic-assisted placement of a peritoneal dialysis catheter with partial omentectomy and omentopexy in dogs: an experimental study. Vet Surg 2013; 42:579-85. [PMID: 23373768 DOI: 10.1111/j.1532-950x.2013.01097.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 08/01/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe a technique of laparoscopic-assisted placement of a peritoneal dialysis (PD) catheter with simultaneously performed partial omentectomy and omentopexy. STUDY DESIGN Pilot experimental study. ANIMALS Beagle dogs (n = 6). METHODS After placement of 1 sub-umbilical laparoscope portal and 1 instrument portal in the left cranial abdominal quadrant, laparoscopic-assisted partial omentectomy, and omentopexy were performed, and a modified Tenckhoff PD catheter was placed under laparoscopic guidance. A modified dialysis protocol was used twice daily for 4 days. The feasibility of the procedure, surgical duration, operative complications, and dialysis efficacy were evaluated. Postoperative pain and inflammation were graded (0-3). RESULTS The procedure was successfully performed in all dogs with a median operating time of 25 minutes. No operative complications occurred. Procedure-related postoperative pain and inflammation were minimal. Eight consecutive PD procedures were successfully performed, and no leakage or obstruction was observed. CONCLUSIONS Laparoscopic-assisted partial omentectomy and omentopexy can be performed at the same time as PD catheter placement with minimal morbidity.
Collapse
Affiliation(s)
- Gilles Dupré
- Department of Small Animals and Horses, Clinic for Small Animal Surgery, Ophthalmology, Dentistry, Physiotherapy and Rehabilitation, University of Veterinary Medicine Vienna, Vienna, Austria.
| | | |
Collapse
|
15
|
Monaghan K, Nolan B, Labato M. Feline acute kidney injury: 2. Approach to diagnosis, treatment and prognosis. J Feline Med Surg 2012; 14:785-93. [PMID: 23087004 PMCID: PMC11112173 DOI: 10.1177/1098612x12464460] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PRACTICAL RELEVANCE Feline acute kidney injury (AKI) is a commonly recognized problem in small animal practice that requires prompt diagnosis and directed therapy. There are many treatment methods with which practitioners should be familiar, including medical options, surgical interventions and renal replacement therapy (dialysis). It is important to know which option is most appropriate for each cause and stage of AKI to deliver the most effective therapy. CLINICAL CHALLENGES AKI can cause vague clinical signs, but a vast array of life-threatening sequelae. Rapid recognition of potential complications and knowledge of treatment options is imperative for successful management. Feline patients also require an understanding of their unique physiology as it relates to the therapeutic plan. AUDIENCE This two-part review article is directed at small animal practitioners as well as specialists. Part 2 discusses the diagnosis of AKI in cats using physical examination findings, clinicopathologic results and imaging modalities. The treatment of AKI and its sequelae is also reviewed, with information on recent advances in this area. EVIDENCE BASE While there is very limited data comparing the outcomes of various treatment options, there is literature addressing the use of several medications, as well as renal replacement therapy, in cats.
Collapse
Affiliation(s)
- Kelly Monaghan
- Department of Medical Sciences, University of Wisconsin-Madison, School of Veterinary Medicine, Madison, Wisconsin, USA.
| | | | | |
Collapse
|