White-coat effect on systemic blood pressure in retired racing Greyhounds

Effects of Changing Veterinary Handling Techniques on Canine Behaviour and Physiology Part 1: Physiological Measurements

Signs of distress in dogs are often normalized during routine veterinary care, creating an animal welfare concern. We sought to test whether targeted interventions during veterinary visits affect physiological indicators of stress in dogs. Some 28 dogs were examined within four visits across 8 weeks. All dogs received the same care during the first visit and were then randomized into control and intervention groups for visits 2-4. In the intervention group, 14 dogs underwent procedures designed to reduce stress and to enlist their collaboration during examination. The 14 dogs in the control group received routine care. At each visit, heart rate (HR), serum cortisol (CORT), neutrophil lymphocyte ratio (NLR), and creatine kinase (CK) were measured. A composite stress index based on the summed standardized scores for these markers was constructed. No differences in HR, NLR, and CK parameters between groups were found, and both groups had a decrease in CORT by visit four. However, the intervention group showed a greater overall decrease in CORT between the first and fourth visit than the control group (p < 0.04). The composite stress index differed between the first and fourth visits for the intervention group, but not for the control group (Intervention p = 0.03; Control p= 0.288). There was a tendency for the composite stress index to worsen at visit four vs. visit one for the control group. The findings suggest that dogs that participated in adaptive, collaborative exams and procedures designed to minimize fear had a greater reduction in stress over time compared to those receiving standard care.

Dose-response of benazepril on biomarkers of the classical and alternative pathways of the renin-angiotensin-aldosterone system in dogs

Angiotensin-converting enzyme inhibitors (ACEI) such as benazepril are commonly prescribed in both humans and dogs with heart disease to mitigate the renin-angiotensin-aldosterone system (RAAS); however, the dose-dependent effects of benazepril on comprehensive RAAS components remain unknown. In this study, nine purpose-bred healthy dogs received three different dosages of oral benazepril (0.125 mg/kg, 0.25 mg/kg, or 0.5 mg/kg) in a randomized crossover design following induction of RAAS activation by consuming a low-sodium diet. Blood samples were collected at serial time intervals after benazepril dosing to measure plasma benazeprilat (active metabolite of benazepril) and serum RAAS biomarkers. Blood pressure and echocardiogram were performed at baseline and after each benazepril administration. Time-weighted averages for RAAS biomarkers for 12 h post-dose and hemodynamic variables were compared between dosing groups using Wilcoxon rank-sum testing. Compared to the lowest dosage of benazepril (0.125 mg/kg), the highest dosage (0.5 mg/kg) resulted in lower time-weighted average values of angiotensin (Ang) II (- 38%, P = 0.004), Ang1-5 (- 53%, P = 0.001), ACE-S (surrogate for ACE activity; - 59%, P = 0.0002), and ALT-S (surrogate for alternative RAAS activity; - 22%, P = 0.004), and higher values of AngI (+ 78%, P = 0.014) and PRA-S (surrogate for plasma renin activity; + 58%, P = 0.040). There were no relevant differences between dosing groups for blood pressure or echocardiographic variables. Knowledge of dose-dependent alterations in biomarkers of the classical and alternative RAAS pathways could help inform clinical trials for dosage optimization in both dogs and humans.

Evaluation of blood pressure and NT-proBNP in pugs with and without clinical signs of Brachycephalic Obstructive Airway Syndrome

Brachycephalic Obstructive Airway Syndrome (BOAS) is a pathologic condition of the upper airways, frequently occurring in dogs of brachycephalic breeds including pugs. It has been suspected that BOAS may be associated with cardiovascular changes and an increased risk for hypertension. The cardiac biomarker NT-proBNP can help to differentiate cardiac from non-cardiac respiratory distress. A possible influence of BOAS on NT-proBNP values has not been investigated, however. The aim of the current study was to examine blood pressure and NT-proBNP levels in pugs with and without clinical signs of BOAS and compare them to values of mesocephalic dogs. For this purpose, NT-proBNP values of 42 pugs and six mesocephalic dogs and blood pressure measurements of 34 pugs and four mesocephalic dogs were explored in the present study. Pugs were examined for clinical signs of BOAS at rest and after a submaximal fitness test, and a functional BOAS grading was applied. Blood pressure (BP) was measured at the beginning and end of the study day and NT-proBNP values were obtained before and after exercise. Measured values of pugs with different degrees of clinical impairment due to BOAS were compared among each other as well as to the CG. In terms of systolic, mean, diastolic BP, and NT-pro BNP, there were no relevant differences between pugs and the CG and no obvious connection between the severity of BOAS symptoms and measured values. BP values of all groups were lower at the second measurement at the end of the study day. NT-proBNP measurements were higher after exercise. BP and NT-proBNP values in all groups were in agreement with commonly used reference ranges. In conclusion, the study adds evidence, that BP and NT-proBNP values did not differ between mesocephalic dogs and pugs with different levels of severity of BOAS but between the measurement times. Thus, in the present study, excitement and exercise seemed to have a greater influence on BP and NT-proBNP values than presence of BOAS symptoms or breed. Discovered values show that the commonly used reference ranges for BP and NT-proBNP are applicable in pugs. This indicates that NT-proBNP can be used to differentiate between cardiac and non-cardiac respiratory distress even in pugs with clinical symptoms of BOAS.

Vector-borne disease and its relationship to hematologic abnormalities and microalbuminuria in retired racing and show-bred greyhounds

Background

Reference intervals for platelets and white blood cell (WBCs) counts are lower in greyhounds than other breeds. Proteinuria is common. Vector‐borne diseases (VBD) cause thrombocytopenia, leukopenia, and proteinuria. Racing greyhounds are commonly exposed to vectors that carry multiple organisms capable of chronically infecting clinically healthy dogs.

Hypothesis/Objectives

Vector‐borne disease prevalence is higher in retired racing greyhounds than in show‐bred greyhounds. Occult infection contributes to breed‐related laboratory abnormalities.

Animals

Thirty National Greyhound Association (NGA) retired racing and 28 American Kennel Club (AKC) show‐bred greyhounds.

Methods

Peripheral blood was tested for Anaplasma, Babesia, Bartonella, Ehrlichia, hemotropic Mycoplasma, and Rickettsia species using PCR. Antibodies to Anaplasma, Babesia, Bartonella, Ehrlichia, and Rickettsia species and Borrelia burgdorferi were detected using immunofluorescence and ELISA assays. Complete blood counts, semiquantitative platelet estimates, and microalbuminuria concentration were determined.

Results

Seven of 30 NGA and 1/28 AKC greyhounds tested positive for ≥1 VBD (P = .05). More positive tests were documented in NGA (10/630) than in AKC dogs (1/588; P = .02). Exposure to Bartonella species (3/30), Babesia vogeli (2/30), Ehrlichia canis (1/30), and infection with Mycoplasma hemocanis (3/30) occurred in NGA dogs. Platelet counts or estimates were >170 000/μL. White blood cell counts <4000/μL (4/28 AKC; 5/30 NGA, P > .99; 1/8 VBD positive; 8/51 VBD negative, P = .99) and microalbuminuria (10/21 AKC; 5/26 NGA, P = .06; 1/8 VBD positive; 14/25 VBD negative, P = .41) were not associated with VBD.

Conclusions and Clinical Importance

The prevalence of thrombocytopenia and B. vogeli exposure was lower than previously documented. Larger studies investigating the health impact of multiple VBD organisms are warranted.

Influence of clinical setting and cat characteristics on indirectly measured blood pressure and pulse rate in healthy Birman, Norwegian Forest, and Domestic Shorthair cats

BACKGROUND

Measured indirect blood pressure (BP) results in cats in a clinical environment might be affected by stress and characteristics of the cats.

HYPOTHESIS

To investigate the influence of clinical setting, cat characteristics, and life situation on BP and pulse rate (PR) in healthy cats.

ANIMALS

Ninety-four healthy Domestic Shorthair, Birman and Norwegian Forest cats.

METHODS

Blood pressure measured by high-definition oscillometry in 3 settings: cat placed in its own carrier with veterinarian present; cat placed in carrier with owner alone present; and cat placed on table with veterinarian present. Statistical analyses were performed using mixed linear models.

RESULTS

Systolic BP (SBP) did not differ among settings. Higher mean arterial pressure (MAP), diastolic BP (DBP), and PR were found when measurements were performed with cat placed on table, rather than in carrier. Coefficients of variation (CVs) higher for SBP, MAP, DBP, and PR when measured with cat placed on table than in carrier. Birman cats had lower BP than other breeds. Systolic BP, MAP, DBP, and PR increased with age. Cats allowed outdoors had lower PR than cats living strictly indoors.

CONCLUSION AND CLINICAL IMPORTANCE

No difference in SBP was found among settings, but measuring BP with the cat placed on the examination table gave higher MAP, DBP, PR, and CV than measuring BP with the cat in its carrier. Breed affected BP, with lower BP in Birman cats than other breeds. Blood pressure increased with age. Pulse rate was lower in cats allowed outdoors than cats living strictly indoors.

Impact of equipment and handling on systolic blood pressure measurements in conscious dogs in an animal hospital environment

Background

Situational hypertension and differences between devices complicate interpretations of systolic blood pressure (SBP) measurements in dogs.

Hypothesis/Objectives

To evaluate if time point of in‐clinic SBP measurement, type of oscillometric device, and operator affect SBP measurements in conscious dogs.

Animals

Sixty‐seven privately owned dogs with or without chronic kidney disease, divided into 2 study samples (A and B).

Methods

Cross‐sectional diagnostic study. In part A, SBP measurements in dogs were performed using 2 different devices (HDO and petMap) after acclimatization at 3 standardized time points during a clinical visit. In part B, SBP measurements (HDO) were performed in dogs by a trained final year veterinary student and by the owner alone, at the same occasion.

Results

For all dogs, there was no difference in mean SBP (mSBP) among the 3 time points for HDO (P = .12) or petMAP (P = .67). However, intraindividual mSBP differences of up to 60 mm Hg between time points were documented. Mean SBP obtained with petMAP was on average 14 (95% CI: 8‐20) mm Hg higher than mSBP obtained with HDO, and this difference increased with increasing SBP. Mean SBP measurements obtained by the trained student were 7 (95% CI: 2‐11) mm Hg higher than mSBP measurements obtained by the owner.

Conclusions and Clinical Importance

According to the results of this study, time point of in‐clinic SBP measurement in dogs is of minor importance, and instructing owners to perform measurements might reduce suspected situational hypertension. Differences in mSBP measured with HDO and petMAP underscore the need for validation of BP devices used clinically.

Investigation of the effects of veterinarians' attire on ratings of trust, confidence, and comfort in a sample of pet owners in Canada

OBJECTIVE

To examine companion animal owners' perceptions of appropriate veterinarian attire and investigate potential associations between a veterinarian's attire and clients' ratings of trust in, confidence in, and comfort with a veterinarian.

SAMPLE

449 pet owners.

PROCEDURES

Participants were randomly assigned to complete a questionnaire containing photos of a male or female model veterinarian photographed in 8 attire types (formal attire, white dress shirt with black pants, white casual shirt with khaki pants, surgical scrubs, white casual shirt with jeans, surgical scrub top with jeans, surgical scrub top with khaki pants, and white laboratory coat with khaki pants). Participants were asked to rate their trust in, confidence in, and comfort with the pictured individual on a response scale of 1 (low) to 7 (high), rank photos according to their preferences for attire, and provide input on the importance of attire and other appearance-related subjects. Attire and gender of photographed individual and participant demographics were investigated for associations with trust, confidence, and comfort scores.

RESULTS

Most (317/445 [71%]) respondents indicated veterinarians' attire was important. Attire type was significantly associated with respondents' trust, confidence, and comfort scores. Model veterinarian gender and participant education level were also associated with trust and comfort scores.

CONCLUSIONS AND CLINICAL RELEVANCE

Veterinarians' attire is a form of nonverbal communication that is likely to inform clients' first impressions and may influence clients' trust in, confidence in, and comfort with a veterinarian. Veterinary personnel and veterinary management should consider how attire and general appearance represent staff members or their practice.

Comparison of Simultaneous Measurements of Forelimb and Hindlimb Systolic Blood Pressure in Conscious Dogs

Blood pressure is commonly measured in veterinary medicine. Previous studies have used indirect measurements to compare the forelimb and hindlimb blood pressure in dogs, and yielded contradictory results. Notably in these studies, the measurement of both limbs was not performed simultaneously. In this study, Doppler ultrasonography was used to measure systolic arterial pressure (SAP) and pulse rate (PR) simultaneously on the median palmar artery of forelimb and the medial plantar artery of hindlimb in 108 conscious dogs. The optimal cuff size was selected using 30-40% of the limb circumference. The SAP of forelimb and hindlimb were 149.5 ± 28.5 mm Hg and 152.3 ± 31.1 mm Hg. The PR of forelimb and hindlimb were 113.9 ± 31.7 beats per minute (bpm) and 113.1 ± 31.2 bpm, respectively. The SAP and PR of the forelimb and hindlimb correlated significantly (Pearson R² = 0.696, P < .001; Pearson R² = 0.966, P < .001). There was no significant difference in SAP and PR between the forelimb and hindlimb (P = .1; P = .184). There was no significant difference in the SAP and PR of the forelimb and hindlimb using Doppler device measurement in conscious dogs. Both sites of blood pressure measurement could be adequate for analyzing trends in blood pressure.

Effect of attire on client perceptions of veterinarians

This study examined the effect that veterinarian attire and gender had on clients' perceptions of veterinarians in a large academic specialty hospital. Clients volunteered to answer a survey in the small animal waiting area over a 3-month period. The survey consisted of demographic information, information about the nature of their appointment with their pet, and questions regarding clients' levels of comfort with and the perceived trustworthiness of a Caucasian male and Caucasian female model in four different types of attire: surgical scrubs, surgical scrubs with white lab coat, business casual, and business casual with white lab coat. Relevant effects of interest were estimated using linear mixed models. Five hundred and five clients participated in the survey, yielding a total of 6217 completed survey questions. Clients perceived veterinarians wearing white lab coats as more competent and reported more comfort with those veterinarians (P < 0.0001). When comparing surgical scrubs with no white lab coat to business attire with no white lab coat, surgical scrubs resulted in higher perceived competence and comfort levels (P < 0.0001). Wearing a white lab coat over both surgical scrubs and business casual increased clients' perceived competency and comfort levels compared to not wearing a white lab coat.

Effects of telmisartan on proteinuria and systolic blood pressure in dogs with chronic kidney disease

Renal proteinuria is associated with promoted renal dysfunction and a shorter survival period in dogs with chronic kidney disease (CKD). Renin angiotensin- aldosterone system inhibitors are primarily used to treat renal proteinuria. In this retrospective, open-label study, we aimed to evaluate the anti-proteinuric and anti-hypertensive effects of telmisartan (angiotensin II receptor blocker) in dogs with proteinuric CKD. A total of 28 dogs with proteinuric CKD were included in the study, all dogs received telmisartan 1 mg/kg q24h, PO. The urine protein-to-creatinine ratio (UPC), urine albumin-to-creatinine ratio (UAC) and systolic blood pressure (SBP) decreased significantly after telmisartan administration (P < 0.05). The median rate of change in UPC, UAC and SBP at Day 120 were - 65.1%, -75.9% and - 9.7%. Ten dogs (36.7%) achieved UPC < 1.0 at Day 120, of which six dogs had UPC < 0.5. A reduction of UPC to ≥50% was achieved in 10 dogs (36%) at Day 45 and 17 dogs (61%) at Day 120. Seventeen dogs (61%) had hypertension at baseline, of which 10 dogs (59%) had SBP < 160 mmHg at Day 120. Two-way repeated measures analysis of variance did not attribute the observed changes in SBP, UPC or UAC to feeding with a renal diet. In conclusion, telmisartan therapy provides anti-proteinuric and anti-hypertensive effects in dogs with proteinuric CKD.

Hypertension, retinopathy, and acute kidney injury in dogs: A prospective study

BACKGROUND

Systemic hypertension (SH) is a potential complication of acute kidney injury (AKI) in dogs.

OBJECTIVE

To describe the prevalence of SH and hypertensive retinopathy in dogs with AKI, to investigate the relationship between SH and severity of AKI and to assess possible factors associated with SH.

ANIMALS

Fifty-two dogs with AKI.

METHODS

Prospective observational study of dogs presenting to a tertiary referral center that fulfilled the International Renal Interest Society (IRIS) guidelines for the diagnosis of AKI. Systolic blood pressure measurement, urine protein/creatinine ratio (UPCR), urine output, presence of hypertensive retinopathy and fluid overload (FO), survival to discharge and duration of hospitalization were subsequently assessed. The prevalence of SH was calculated and the relationship between SH and recorded factors was examined by nonparametric statistics.

RESULTS

The prevalence of SH (≥160 mm Hg) on admission or during hospitalization was 75% (39/52) and in 56% (22/39) of cases this was severe (≥180 mm Hg). Sixteen percent (7/43) of dogs had evidence of hypertensive retinopathy and 77% (24/31) dogs had UPCR >0.5. Forty-two percent (22/52) dogs had FO on admission or during hospitalization. There was no association between SH and IRIS AKI grade, oligo/anuria, survival to discharge, duration of hospitalization or proteinuria. Dogs with FO on presentation were more likely to be hypertensive at admission compared to dogs without FO (P = .02). Dogs that did not survive to discharge were more likely to have FO (P = .007).

CONCLUSIONS AND CLINICAL IMPORTANCE

Systemic hypertension is common in dogs with AKI. Systemic hypertension might be associated with FO, which itself is associated with nonsurvival. Monitoring for SH and FO is therefore warranted in dogs with AKI.

Hyperkalemia during general anesthesia in two Greyhounds

CASE DESCRIPTION

A 36-kg (79-lb) castrated male Greyhound (dog 1) and a 25-kg (55 lb) spayed female Greyhound (dog 2) underwent general anesthesia for dental care with similar perianesthetic protocols on multiple occasions from 2013 to 2016. Both dogs had periodontal disease but were otherwise deemed healthy. Both dogs developed clinically relevant hyperkalemia, with signs including loss of P waves on ECG tracings, during multiple anesthetic events.

CLINICAL FINDINGS

Dog 1 developed hyperkalemia during 2 of 2 anesthetic events, with ECG changes noted during the first event. Dog 2 developed hyperkalemia during 3 of 4 anesthetic events, with ECG changes identified during the second and third events. Serum potassium concentration for both dogs was within the reference range prior to and between anesthetic events. No underlying etiopathogenesis for hyperkalemia was identified for either dog.

TREATMENT AND OUTCOME

In each hyperkalemic event, the clinician stopped the dental procedure and continued to provide supportive care and monitoring while the dog recovered from anesthesia. The ECG changes resolved, and serum potassium concentration returned to the reference range rapidly after inhalant anesthetic administration was discontinued. The dogs were discharged from the hospital without further complications.

CLINICAL RELEVANCE

Hyperkalemia in anesthetized Greyhounds resulted in serious cardiac conduction abnormalities, which could be potentially fatal if not recognized and promptly treated. Further investigation into the etiopathogenesis, prevention and treatment strategies, and genetic or familial components of this condition is indicated.

2019 AAHA Canine Life Stage Guidelines*

The guidelines are an update and extension of the AAHA Canine Life Stage Guidelines published in 2012. A noteworthy change from the earlier guidelines is the division of the dog’s lifespan into five stages (puppy, young adult, mature adult, senior, and end of life) instead of the previous six. This simplified grouping is consistent with how pet owners generally perceive their dog’s maturation and aging process and provides a readily understood basis for an evolving, lifelong healthcare strategy. The guidelines provide the following recommendations for managing 10 health-related factors at each of the first four canine life stages: lifestyle effect on the patient’s safety, zoonotic and human safety risk, behavior, nutrition, parasite control, vaccination, dental health, reproduction, breed-specific conditions, and a baseline diagnostic profile.

Indirect Doppler flow systolic blood pressure measurements taken with and without headphones in privately-owned, conscious dogs

Objective

The purpose of this study was to assess the effect of headphone use and covariates on indirect radial Doppler flow systolic arterial blood pressure (BP) measurements in dogs.

Methods

Between May and August 2018, 100 privately-owned dogs were enrolled. Blood pressure was measured in lateral recumbency, with and without headphones, using a randomized crossover design. The initial BP, mean of BP 2-6, weight, BCS, MCS, anxiety score, and heart rate were recorded. Mixed effects crossover analyses and Spearman rank correlation coefficients were determined.

Results

Eighty-four dogs completed the study. Eleven dogs were removed due to excessive anxiety, 10 of which were in the non-headphone first group. The number of dogs diagnosed as hypertensive did not differ between measurement types (19 vs. 18), with seven dogs categorized as hypertensive during both periods. Significant differences in BP were identified (F[1, 80] = 4.3, P = 0.04) due to higher results for measurements taken without headphones for BP 1, but not BP 2-6. Systolic BP was positively correlated with anxiety score, age, and weight.

Conclusions and Clinical Relevance

Though BP 1 was significantly higher when taken without headphones, this pattern did not persist for BP 2-6. Lack of association between BP 2-6 results and measurement type could reflect exclusion of dogs most sensitive to white coat hypertension, acclimation to technique, or improved sound quality of headphones. Given significantly higher BP 1 results and disproportionate exclusion of dogs due to anxiety when measurements first were taken without headphones, use of headphones is recommended to improve accuracy of results.

ACVIM consensus statement: Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats

An update to the 2007 American College of Veterinary Internal Medicine (ACVIM) consensus statement on the identification, evaluation, and management of systemic hypertension in dogs and cats was presented at the 2017 ACVIM Forum in National Harbor, MD. The updated consensus statement is presented here. The consensus statement aims to provide guidance on appropriate diagnosis and treatment of hypertension in dogs and cats.

Catestatin, vasostatin, cortisol, and visual analog scale scoring for stress assessment in healthy dogs

The neuroendocrine glycoprotein chromogranin A is a useful biomarker for stress in humans. Chromogranin A epitopes catestatin and vasostatin can be measured in dogs using radioimmunoassays. The objective of this study was to evaluate catestatin and vasostatin as canine stress biomarkers in a clinical setting. Blood and saliva were collected from 33 healthy dogs that were familiar with sampling procedures and the animal hospital environment (control group) and 30 healthy dogs that were unacquainted (stress group). During sampling, stress behavior was scored by the same observer using visual analog scale (VAS). Plasma was analyzed for catestatin and vasostatin, serum for cortisol, and saliva for catestatin. Differences between groups were analyzed using two-sample t-tests and P<0.05 was considered significant. Stress behavior VAS score in the control group was significantly lower than in the stress group during blood (P=0.002) and saliva (P=0.0009) sampling. Serum cortisol and saliva catestatin concentrations in the stress group were higher than the control group (P=0.003 and P<0.0001, respectively). Serum cortisol concentrations were correlated with those of saliva (r=0.34, P=0.04) and plasma catestatin (r=0.29, P=0.03). Plasma catestatin and vasostatin did not differ significantly between groups. In conclusion, concentrations of saliva catestatin, and serum cortisol, and stress behavior VAS scores were significantly higher in the stress group. The results indicate that saliva catestatin may be useful as a biomarker for acute psychological stress in dogs.

The Renin-Angiotensin-Aldosterone System in Greyhounds and Non-Greyhound Dogs

Background

The renin‐angiotensin‐aldosterone system (RAAS) regulates blood pressure, electrolyte homeostasis, and renal function. Blood pressure, serum sodium concentrations, and urinary albumin excretion are higher in Greyhounds than other purebred and mixed‐breed dogs.

Hypothesis

Alterations in the RAAS in Greyhounds are associated with hemodynamic and clinicopathologic differences observed in the breed.

Animals

Clinically healthy Greyhound and non‐Greyhound dogs consecutively enrolled as blood donors (n = 20/group).

Methods

Prospective study. Standard chemical analysis was performed on serum and urine. Serum angiotensin‐converting enzyme (ACE) activity was determined by fluorometric assay. All other RAAS hormones were determined by radioimmunoassay. Symmetric dimethylarginine (SDMA) was measured by immunoassay. Measurements were compared to blood pressure and urine albumin concentration. Data are presented as mean ± SD or median, range.

Results

Serum creatinine (1.5 ± 0.2 vs 1.0 ± 0.1 mg/dL, P < .001), sodium (149, 147–152 vs 148, 146–150 mEq/L, P = .017), and SDMA (16.1 ± 2.9 vs 12.2 ± 1.8 μg/dL, P < .001) were significantly higher in Greyhounds versus non‐Greyhounds, respectively. Plasma renin activity (0.69, 0.10–1.93 vs 0.65, 0.27–2.93 ng/mL/h, P = .60) and ACE activity (4.5, 2.1–8.5 vs 4.6, 2.1–11.4 activity/mL; P = .77) were similar between groups and did not correlate with higher systolic pressures and albuminuria in Greyhounds. Plasma aldosterone concentration was significantly lower in Greyhounds versus non‐Greyhounds (11, 11–52 vs 15, 11–56 pg/mL, respectively, P = .002).

Conclusions and clinical importance

Basal RAAS activation did not differ between healthy Greyhounds and non‐Greyhounds. Lower aldosterone concentration in Greyhounds is an appropriate physiologic response to higher serum sodium concentration and blood pressure, suggesting that angiotensin II effects in the renal tubule predominate over those of aldosterone.

Results of Screening of Apparently Healthy Senior and Geriatric Dogs

Background

There is a growing interest in health care of elderly dogs; however, scientific information about physical and laboratory examination findings in this age group is limited.

Objectives

To describe systolic blood pressure (SBP), and results of physical examination and laboratory tests in senior and geriatric dogs that were judged by the owner to be healthy.

Animals

Hundred client‐owned dogs.

Methods

Dogs were prospectively recruited. Owners completed a questionnaire. SBP measurement, physical, orthopedic and neurologic examination, direct fundoscopy and Schirmer tear test were performed. Complete blood count, serum biochemistry, and urinalysis were evaluated.

Results

Forty‐one senior and 59 geriatric dogs were included. Mean SBP was 170 ± 38 mmHg, and 53 dogs had SBP > 160 mmHg. Thirty‐nine animals were overweight. A heart murmur was detected in 22, severe calculus in 21 and 1 or more (sub)cutaneous masses in 56 dogs. Thirty‐two dogs had increased serum creatinine, 29 hypophosphatemia, 27 increased ALP, 25 increased ALT, and 23 leukopenia. Crystalluria, mostly amorphous crystals, was commonly detected (62/96). Overt proteinuria and borderline proteinuria were detected in 13 and 18 of 97 dogs, respectively. Four dogs had a positive urine bacterial culture. Frequency of orthopedic problems, frequency of (sub)cutaneous masses, and platelet count were significantly higher in geriatric compared with senior dogs. Body temperature, hematocrit, serum albumin, and serum total thyroxine concentration were significantly lower in geriatric compared with senior dogs.

Conclusions and Clinical Importance

Physical and laboratory abnormalities are common in apparently healthy elderly dogs. Veterinarians play a key role in implementing health screening and improving health care for elderly pets.

Catestatin, vasostatin, cortisol, temperature, heart rate, respiratory rate, scores of the short form of the Glasgow composite measure pain scale and visual analog scale for stress and pain behavior in dogs before and after ovariohysterectomy

Background

The stress reaction induced by surgery and associated pain may be detrimental for patient recovery and should be minimized. The neuropeptide chromogranin A (CGA) has shown promise as a sensitive biomarker for stress in humans. Little is known about CGA and its derived peptides, catestatin (CST) and vasostatin (VS), in dogs undergoing surgery. The objectives of this study were to investigate and compare concentrations of CGA epitopes CST and VS, cortisol, body temperature, heart rate, respiratory rate, scores of the short form of the Glasgow composite measure pain scale (CMPS-SF) and visual analog scales (VAS) for stress and pain behavior in dogs before and after ovariohysterectomy.

Methods

Thirty healthy privately owned female dogs admitted for elective ovariohysterectomy were included. Physical examination, CMPS-SF, pain behavior VAS, and stress behavior VAS were recorded and saliva and blood samples were collected before surgery, 3 h after extubation, and once at recall 7–15 days after surgery. Dogs were premedicated with morphine and received carprofen as analgesia for 7 days during the postoperative period.

Results

At 3 h after extubation, CMPS-SF and pain behavior VAS scores had increased (p < 0.0001) and stress behavior VAS scores, temperature, respiratory rate (p < 0.0001), plasma CST concentrations (p = 0.002) had decreased significantly compared to before surgery. No significant differences were observed in the subjective and physiological parameters between before surgery and at recall, but plasma CST (p = 0.04) and serum cortisol (p = 0.009) were significantly lower at recall. Plasma VS, saliva CST, and heart rate did not differ significantly at any observed time.

Conclusion

Study parameters for evaluating surgery-induced stress and pain changed in dogs subjected to ovariohysterectomy. To further evaluate CST and VS usefulness as pain biomarkers, studies on dogs in acute painful situations are warranted.

Systolic arterial blood pressure estimated by mitral regurgitation velocity, high definition oscillometry, and Doppler ultrasonography in dogs with naturally occurring degenerative mitral valve disease

INTRODUCTION

To determine if systolic blood pressure estimated by mitral regurgitation (MR) velocity can be used interchangeably with that estimated by high definition oscillometry (HDO) and Doppler ultrasonography (DU) in dogs with naturally occurring mitral valve disease (MVD).

ANIMALS

Forty-nine client-owned dogs with naturally occurring MVD.

MATERIALS AND METHODS

This is a retrospective study. Medical records were reviewed and dogs with MR caused by degenerative MVD were included if systolic blood pressure was estimated from MR velocity determined by continuous wave Doppler (CW), DU and HDO at the same visit. A Pearson product moment correlation coefficient was determined for each combination of measures and tested for significance with a paired t-test. Limits of agreement between 2 measures were determined by the 95% confidence interval of the average difference of the means and illustrated by Bland-Altman plots.

RESULTS

Systolic pressure estimated from CW was significantly but only moderately correlated to DU (r = 0.42, p=0.0015) and HDO (r = 0.40, p=0.0021). Pressure estimated from DU was significantly but only moderately correlated to HDO (r = 0.57, p≤0.0001). Limits of agreement were wide for all measures including DU and CW (-61.9to 44.6 mmHg), HDO and CW (-65.2to 26.9 mmHg), and HDO and DU (-63.1 to 42.06 mmHg).

DISCUSSION

Systolic blood pressure estimated by CW cannot be used interchangeably with HDO or DU in dogs with naturally occurring MVD.

Plasma Vasoprotective Eicosanoid Concentrations in Healthy Greyhounds and Non-Greyhound Dogs

BACKGROUND

Hypertension and albuminuria often coexist in Greyhounds, suggesting generalized vascular dysfunction that could contribute to the development of a variety of diseases in this breed. Eicosanoid metabolites of arachidonic acid (AA) mediate endothelial function, vascular reactivity, and proteinuria in humans and in rodent models.

HYPOTHESIS

The eicosanoid profile of Greyhounds is shifted toward metabolites that promote vascular dysfunction, hypertension, and proteinuria.

ANIMALS

Healthy Greyhounds (n = 20) and non-Greyhound (n = 20) dogs that were consecutively enrolled in a blood donor program.

METHODS

Prospective study. Plasma eicosanoid metabolites were assayed by liquid chromatography/electrospray ionization mass spectrometry (LC/ESI/MS) and compared to systolic blood pressure (SP) measurements and urine albumin concentration.

RESULTS

Isomers of hydroxyeicosatetraenoic acid (HETE) were higher in Greyhounds than non-Greyhounds (median, range in pmol/mL: 5(S)HETE 19.82, 8.55-32.95 versus 13.54, 4.33-26.27, P = .033; 8(S)HETE 9.39, 3.28-19.84 versus 5.80, 2.25-17.66, P = .002; 9(S)HETE 9.46, 2.43-13.79 versus 5.82, 1.50-17.16, P = .026; 12(S)HETE 10.17, 3.81-40.06 versus 7.24, 2.9-16.16, P = .022). Dihydroxyeicosatrienoic acid (DHET) isomers also were higher in Greyhounds compared to non-Greyhounds (mean ± SD in pmol/mL: 8,9DHET 5.78 ± 2.13 versus 4.03 ± 1.36, P = .004; 11,12DHET 11.98 ± 2.86 versus 8.90 ± 3.48, P = .004; 14,15DHET 7.23 ± 2.19 versus 5.76 ± 1.87, P = .028). Albuminuria correlated with total DHET (rs = 0.46, P = .003). SP was positively correlated with 11,12EET (rs = 0.42, P = .006) and 20(S)HETE (rs = 0.38, P = .017). SP and 8,9EET were inversely correlated (rs = -0.49, P = .001).

CONCLUSIONS AND CLINICAL IMPORTANCE

Plasma eicosanoid profile in Greyhounds was consistent with activation of metabolic pathways known to promote vascular dysfunction and might contribute to higher blood pressures and albuminuria. Inhibition of these eicosanoid pathways should be evaluated as therapeutic targets in Greyhounds.

Cardiovascular-renal axis disorders in the domestic dog and cat: a veterinary consensus statement

OBJECTIVES

There is a growing understanding of the complexity of interplay between renal and cardiovascular systems in both health and disease. The medical profession has adopted the term "cardiorenal syndrome" (CRS) to describe the pathophysiological relationship between the kidney and heart in disease. CRS has yet to be formally defined and described by the veterinary profession and its existence and importance in dogs and cats warrant investigation. The CRS Consensus Group, comprising nine veterinary cardiologists and seven nephrologists from Europe and North America, sought to achieve consensus around the definition, pathophysiology, diagnosis and management of dogs and cats with "cardiovascular-renal disorders" (CvRD). To this end, the Delphi formal methodology for defining/building consensus and defining guidelines was utilised.

METHODS

Following a literature review, 13 candidate statements regarding CvRD in dogs and cats were tested for consensus, using a modified Delphi method. As a new area of interest, well-designed studies, specific to CRS/CvRD, are lacking, particularly in dogs and cats. Hence, while scientific justification of all the recommendations was sought and used when available, recommendations were largely reliant on theory, expert opinion, small clinical studies and extrapolation from data derived from other species.

RESULTS

Of the 13 statements, 11 achieved consensus and 2 did not. The modified Delphi approach worked well to achieve consensus in an objective manner and to develop initial guidelines for CvRD.

DISCUSSION

The resultant manuscript describes consensus statements for the definition, classification, diagnosis and management strategies for veterinary patients with CvRD, with an emphasis on the pathological interplay between the two organ systems. By formulating consensus statements regarding CvRD in veterinary medicine, the authors hope to stimulate interest in and advancement of the understanding and management of CvRD in dogs and cats. The use of a formalised method for consensus and guideline development should be considered for other topics in veterinary medicine.

World Small Animal Veterinary Association Renal Pathology Initiative: Classification of Glomerular Diseases in Dogs

Evaluation of canine renal biopsy tissue has generally relied on light microscopic (LM) evaluation of hematoxylin and eosin-stained sections ranging in thickness from 3 to 5 µm. Advanced modalities, such as transmission electron microscopy (TEM) and immunofluorescence (IF), have been used sporadically or retrospectively. Diagnostic algorithms of glomerular diseases have been extrapolated from the World Health Organization classification scheme for human glomerular disease. With the recent establishment of 2 veterinary nephropathology services that evaluate 3-µm sections with a panel of histochemical stains and routinely perform TEM and IF, a standardized objective species-specific approach for the diagnosis of canine glomerular disease was needed. Eight veterinary pathologists evaluated 114 parameters (lesions) in renal biopsy specimens from 89 dogs. Hierarchical cluster analysis of the data revealed 2 large categories of glomerular disease based on the presence or absence of immune complex deposition: The immune complex-mediated glomerulonephritis (ICGN) category included cases with histologic lesions of membranoproliferative or membranous patterns. The second category included control dogs and dogs with non-ICGN (glomerular amyloidosis or focal segmental glomerulosclerosis). Cluster analysis performed on only the LM parameters led to misdiagnosis of 22 of the 89 cases-that is, ICGN cases moved to the non-ICGN branch of the dendrogram or vice versa, thereby emphasizing the importance of advanced diagnostic modalities in the evaluation of canine glomerular disease. Salient LM, TEM, and IF features for each pattern of disease were identified, and a preliminary investigation of related clinicopathologic data was performed.

Ischemic stroke in Greyhounds: 21 cases (2007-2013)

OBJECTIVE

To determine the prevalence of ischemic stroke in Greyhounds and determine whether affected dogs had coagulation abnormalities and hypertension.

DESIGN

Multi-institutional, retrospective study.

ANIMALS

21 dogs.

PROCEDURES

Medical records (including diagnostic testing results) and MRI images of the brain were reviewed for Greyhounds with ischemic stroke that had been evaluated at 4 institutions. The proportion of Greyhounds with ischemic stroke was compared with the proportion of non-Greyhound dogs with ischemic stroke. Demographic information for dogs evaluated at each institution was obtained to determine the proportion of Greyhounds in the hospital populations.

RESULTS

21 Greyhounds with ischemic stroke were identified. Abnormalities in coagulation were not identified in the 14 Greyhounds that underwent such testing. Systemic hypertension was identified in 6 of 14 Greyhounds that underwent such testing. No other abnormalities were identified by means of other routine diagnostic tests for Greyhounds. For all institutions combined, the prevalence of ischemic stroke in Greyhounds was 0.66% (21/3,161 Greyhounds). Greyhounds were significantly more likely to be evaluated because of ischemic stroke, compared with all other dog breeds combined (OR, 6.6; 95% confidence interval, 4.2 to 10.2).

CONCLUSIONS AND CLINICAL RELEVANCE

Results of this study suggested that Greyhounds were predisposed to ischemic stroke, compared with all other breeds combined. Coagulation abnormalities did not seem to contribute to ischemic stroke. Hypertension may have contributed to the development of ischemic stroke. Greyhounds with ischemic stroke should undergo measurement of systolic arterial blood pressure. Antihypertensive treatments may be warranted for such dogs.

Chromogranin A and cortisol at intraoperative repeated noxious stimuli: Surgical stress in a dog model

Objectives:

Biomarkers representing sympathetic tone and the surgical stress response are measured to objectively evaluate surgical techniques and anaesthetic protocols. If a part of the intraoperative procedure is repeated on the contralateral organ, one animal may potentially serve as its own control and, if so, may minimize the problem of individual differences of the stress response to anaesthesia and surgery. This study aimed to investigate the use of chromogranin A for measurement of the intraoperative sympathetic tone. Additional aims were to investigate chromogranin A and cortisol as indicators of the intraoperative surgical stress response caused by repeated noxious stimuli in dogs subjected to ovariohysterectomy and thereby to investigate the possibility of one dog serving as its own control.

Methods:

Experiments were carried out on 10 dogs subjected to ovariohysterectomy. Perioperative blood samples (0–6) were collected after premedication, immediately before induction of anaesthesia (0), after induction of anaesthesia and before incision (1), before (2) and after (3) removal of the first ovary, after a 15-min pause before removal of the second ovary (4), after removal of the second ovary (5) and after closing the abdomen (6). Plasma chromogranin A and cortisol were analysed.

Results:

Plasma chromogranin A did not change. Plasma cortisol concentration did not change between before anaesthesia and opening of the abdomen. Plasma cortisol increased at removal of the first ovary. Cortisol did not change at removal of the second ovary but remained increased compared to initial sample.

Conclusion:

The results suggest chromogranin A is a poor indicator of intraoperative sympathetic tone during elective surgery in dogs. Cortisol measurement was useful for assessment of intraoperative noxious stimuli. However, at these test conditions, neither plasma chromogranin A nor plasma cortisol was useful for assessment of repeated intraoperative noxious stimuli where one dog served as its own control.

Comparison of forelimb and hindlimb systolic blood pressures and proteinuria in healthy Shetland Sheepdogs

Background

The prevalence of systemic hypertension (SHT) in Shetland Sheepdogs has not been reported.

Hypothesis/Objectives

SHT is common in Shetland Sheepdogs and positively correlated with proteinuria. Measurements of forelimb and hindlimb systolic arterial pressure (SAP) are comparable.

Animals

Seventy‐two clinically healthy, client‐owned Shetland Sheepdogs.

Methods

Forelimb and hindlimb SAP were recorded by Doppler ultrasonography. Proteinuria was quantified by urine dipstick, microalbuminuria, and protein:creatinine ratio (UPC). The relationship of UPC, anxiety, age, weight, and heart rate with forelimb SAP was evaluated.

Results

The mean forelimb and hindlimb SAP were 132 ± 20 and 118 ± 20 mmHg, respectively. The SAP exceeded 160 mmHg in 9 dogs, suggesting 13% prevalence of SHT. Four dogs had a UPC above 0.5; 2 of these had forelimb SAP exceeding 160 mmHg. Correlation of forelimb and hindlimb SAP was poor (r² = 0.09; P = .011). Bland–Altman plots revealed substantial bias (−14 mmHg) between limb measurements with clinically unacceptable 95% limits of agreement (−60 to 33 mmHg). There was no correlation between forelimb SAP and UPC (P = .06) or anxiety level (P = .49). Age (P < .0001) and heart rate (P = .038) were significant predictors of forelimb SAP; weight (P = .73) was not.

Conclusions

Prevalence of SHT was 13% and not correlated with proteinuria. Forelimb and hindlimb SAP were poorly correlated; therefore, trends in an individual animal should be monitored using the same measurement site. Additionally, values for Doppler SAP were determined in Shetland Sheepdogs.

Effects of an iodine-restricted food on client-owned cats with hyperthyroidism

The objective of this prospective, multicentre, non-controlled, open-label study was to evaluate the effects of an iodine-restricted food on circulating total thyroxine (TT4) concentrations and clinical parameters in client-owned cats with hyperthyroidism. Two hundred and twenty-five cats were enrolled in the study and adapted to the iodine-restricted food. Data from physical examinations, questionnaires completed by veterinarians and owners, and circulating concentrations of TT4, urea and creatinine were recorded at weeks 0, 4 and 8. The study group included 136 female and 89 male cats (median age 15 years, range 4-21 years). Group 1 (n = 113) had been on previous anti-thyroid medication, while group 2 (n = 112) consisted of newly diagnosed cats. No differences were found between the two groups at any time point. Circulating TT4 concentrations had decreased (P <0.0001) at week 4 and did not change significantly from week 4 to week 8. Circulating TT4 concentration was within the reference range in 56/88 cats at week 4 and in 51/68 cats at week 8. Clinical parameters (vomiting, polyuria, polydipsia, hyperactivity, polyphagia, weight loss, hair coat quality, and quality of life) had improved (P <0.0001) by week 4. Circulating creatinine concentration decreased (P = 0.001) from week 0 to week 4. Side effects associated with feeding the iodine-restricted food were not observed. In conclusion, in client-owned cats with hyperthyroidism an iodine-restricted food is a valuable management option to normalise circulating TT4 concentrations, and improve clinical signs of hyperthyroidism within 4 weeks. This applies to newly diagnosed cats, as well as to previously diagnosed cats receiving anti-thyroid drugs.

Interpreting Stress Responses during Routine Toxicity Studies

Stress often occurs during toxicity studies. The perception of sensory stimuli as stressful primarily results in catecholamine release and activation of the hypothalamic–pituitary–adrenal (HPA) axis to increase serum glucocorticoid concentrations. Downstream effects of these neuroendocrine signals may include decreased total body weights or body weight gain; food consumption and activity; altered organ weights (e.g., thymus, spleen, adrenal); lymphocyte depletion in thymus and spleen; altered circulating leukocyte counts (e.g., increased neutrophils with decreased lymphocytes and eosinophils); and altered reproductive functions. Typically, only some of these findings occur in a given study. Stress responses should be interpreted as secondary (indirect) rather than primary (direct) test article–related findings. Determining whether effects are the result of stress requires a weight-of-evidence approach. The evaluation and interpretation of routinely collected data (standard in-life, clinical pathology, and anatomic pathology endpoints) are appropriate and generally sufficient to assess whether or not changes are secondary to stress. The impact of possible stress-induced effects on data interpretation can partially be mitigated by toxicity study designs that use appropriate control groups (e.g., cohorts treated with vehicle and subjected to the same procedures as those dosed with test article), housing that minimizes isolation and offers environmental enrichment, and experimental procedures that minimize stress and sampling and analytical bias.

This article is a comprehensive overview of the biological aspects of the stress response, beginning with a Summary (Section 1) and an Introduction (Section 2) that describes the historical and conventional methods used to characterize acute and chronic stress responses. These sections are followed by reviews of the primary systems and parameters that regulate and/or are influenced by stress, with an emphasis on parameters evaluated in toxicity studies: In-life Procedures (Section 3), Nervous System (Section 4), Endocrine System (Section 5), Reproductive System (Section 6), Clinical Pathology (Section 7), and Immune System (Section 8). The paper concludes (Section 9) with a brief discussion on Minimizing Stress-Related Effects (9.1.), and a final section explaining why Parameters routinely measured are appropriate for assessing the role of stress in toxicology studies (9.2.).

AAHA canine life stage guidelines

Guidelines are offered to guide the veterinary practitioner in designing a comprehensive, individualized wellness plan for each stage of a dog's life. Life stages are defined by both age and breed characteristics for practical purposes. Each patient visit should use an individualized approach to patient handling, preventive care, and early disease detection. Environment, behavior, nutrition, parasite control, vaccinations, dental care, zoonotic disease control, safety, and reproductive health should be addressed.