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Nutritional Management of Cats and Dogs with Diabetes Mellitus. Vet Clin North Am Small Anim Pract 2023; 53:657-674. [PMID: 36858905 DOI: 10.1016/j.cvsm.2023.01.007] [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: 03/02/2023]
Abstract
This article reviews the nutritional assessment and management of diabetic dogs and cats. It discusses how to determine appropriate nutritional goals for individual patients, including comorbid patients with diabetes. Considerations for macronutrient and micronutrient modifications will be reviewed.
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Gibbs NH, Heseltine JC, Rishniw M, Nabity MB. Use of urinalysis during baseline diagnostics in dogs and cats: an open survey. J Small Anim Pract 2023; 64:88-95. [PMID: 36336823 PMCID: PMC10099574 DOI: 10.1111/jsap.13567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/22/2022] [Accepted: 09/06/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To describe how veterinarians utilise and perform urinalyses for dogs and cats. MATERIALS AND METHODS A survey, developed and distributed through the Veterinary Information Network, enlisted veterinarians who perform urinalyses for dogs and cats. Participants were directed to question banks based on whether urinalyses were performed in-house, by an outside diagnostic laboratory, or using an in-house automated instrument. Participants using multiple methods were directed to questions that related to the chosen methods. RESULTS A total of 1059 predominantly first-opinion clinicians from the USA and Canada completed the survey. Participants performed urinalyses much less frequently than blood work during a routine examination. The most common factors preventing participants from performing a urinalysis with blood work included clients' financial constraints, difficulty obtaining urine and lack of perceived diagnostic need. The most common reasons for submission to a diagnostic laboratory included efficiency, more trusted results and convenience. Speed of obtaining results was the most common reason for performing urinalyses in-house. Of the participants who performed in-house urinalyses, fewer always performed a manual sediment examination (79%) as compared with urine-specific gravity (99%) and manual dipstick (87%). CLINICAL SIGNIFICANCE This survey documents that urinalysis is often not used in senior patients as recommended by recent clinical guidelines for dogs and cats which can result in decreased diagnosis and impaired management of subclinical disease. There is significant variability in urinalysis methods despite veterinary guidelines promoting standardisation, and this could lead to inaccurate results.
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Affiliation(s)
- N H Gibbs
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA.,Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, 47907, USA
| | - J C Heseltine
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - M Rishniw
- Veterinary Information Network, Davis, CA, USA
| | - M B Nabity
- Department of Veterinary Pathobiology, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
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Miyakawa H, Hsu HH, Ogawa M, Akabane R, Miyagawa Y, Takemura N. Association between serum fibroblast growth factor-23 concentration and development of hyperphosphatemia in normophosphatemic dogs with chronic kidney disease. J Vet Intern Med 2021; 35:2296-2305. [PMID: 34418162 PMCID: PMC8478064 DOI: 10.1111/jvim.16237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Fibroblast growth factor (FGF)-23 is increased first in the sequence of changes associated with chronic kidney disease (CKD)-mineral and bone disorder. Thus, its measurement may serve as a predictive indicator of incident hyperphosphatemia. OBJECTIVES To investigate whether serum FGF-23 concentration in normophosphatemic dogs with CKD is associated with the risk of the subsequent development of hyperphosphatemia and CKD progression. ANIMALS Forty-two normophosphatemic dogs with CKD. METHODS Blood samples and medical records were retrospectively investigated. Hyperphosphatemia was defined as a serum phosphorous concentration >5.0 mg/dL. Progression was defined as a >1.5-fold increase in serum creatinine concentration. The time periods and hazard ratios for these outcomes were assessed using Kaplan-Meier analysis, log-rank test, and univariate Cox regression analysis. The variables associated with the outcomes in the univariate analysis were included in the multivariate Cox regression model with backward selection. RESULTS Serum FGF-23 concentration >528 pg/mL was associated with a shorter time to development of hyperphosphatemia (P < .001) and CKD progression (P < .001). In multiple Cox regression analysis, increased FGF-23 concentration remained a significant variable associated with these outcomes (P < .05). CONCLUSIONS AND CLINICAL IMPORTANCE Increased FGF-23 concentration in normophosphatemic dogs with CKD was associated with significant risk of development of hyperphosphatemia, independent of CKD stage, and of the progression of CKD. Future research focusing on whether interventions that decrease FGF-23 secretion will slow the development of hyperphosphatemia and CKD progression is needed.
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Affiliation(s)
- Hirosumi Miyakawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Huai-Hsun Hsu
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Mizuki Ogawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Ryota Akabane
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Yuichi Miyagawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Naoyuki Takemura
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
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Evaluation of the progression of non-azotemic proteinuric chronic kidney disease in dogs. Res Vet Sci 2021; 138:11-18. [PMID: 34090202 DOI: 10.1016/j.rvsc.2021.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 11/23/2022]
Abstract
Proteinuria is a recognized risk factor for progression of canine chronic kidney disease (CKD). However, the prognosis of non-azotemic proteinuric CKD in dogs has been studied only to a limited extent. Moreover, the degree to which proteinuria should be decreased to delay CKD progression remains unknown. The purposes of this study were (1) to identify factors associated with disease progression and (2) to investigate the degree of proteinuria, albuminuria, and blood pressure during the course of treatment associated with the progression using time-averaged urine protein:creatinine ratio (UPC) and urine albumin:creatinine ratio (UAC) in canine non-azotemic proteinuric CKD. Twenty-one dogs with non-azotemic proteinuric CKD were included in the study. High UPC and UAC were associated with CKD progression (P < .05). Time-averaged high UPC and UAC were significantly related to progression (P < .05). The cutoff values of these time-averaged parameters for predicting the progression were 4.1 and 2.0, respectively. In dogs with non-azotemic proteinuric CKD, more severe proteinuria and albuminuria were associated with progression. The present study suggests that because UPC ≥ 4.1 and UAC ≥ 2.0 during treatment were associated with a faster progression of non-azotemic proteinuric CKD, therapeutic intervention is warranted.
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Bhamarasuta C, Premratanachai K, Mongkolpinyopat N, Yothapand P, Vejpattarasiri T, Dissayabutra T, Trisiriroj M, Sutayatram S, Buranakarl C. Iron status and erythropoiesis response to darbepoetin alfa in dogs with chronic kidney disease. J Vet Med Sci 2021; 83:601-608. [PMID: 33563860 PMCID: PMC8111353 DOI: 10.1292/jvms.20-0574] [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: 11/22/2022] Open
Abstract
Iron metabolism, hepcidin and some blood profiles were investigated in 13 healthy and 31
chronic kidney disease (CKD) dogs. The study consisted of 2 experiments, experiment I
included healthy dogs (CONT) and CKD dogs (stage 2, 3 and 4), while experiment II
consisted of anemic CKD dogs subjected to 28-day darbepoetin alfa treatment. The response
to darbepoetin alfa could divide anemic CKD dogs into responder (RP) and non-responder
(NRP) subgroups. The results from experiment I showed that packed cell volume (PCV) and
plasma albumin concentration were significantly lower in CKD dogs of all stages while the
total iron binding capacity (TIBC) was lower in only CKD stage 3 and 4 compared with dogs
in CONT group. The PCV was related to both TIBC and albumin when considering among all
dogs or only in CKD dogs. The hepcidin concentration in CKD dogs with anemia was lower
than those without anemia (P<0.05). In experiment II before
darbepoetin alfa treatment, RP subgroup had significantly higher iron and TIBC compared
with NRP subgroup (P<0.05), the iron concentration was decreased only
in RP subgroup after darbepoetin alfa treatment (P<0.05). The percent
increase in PCV was correlated with initial TIBC (P<0.01). Plasma
hepcidin concentration was not different between CONT and CKD groups and between RP and
NRP subgroups both before and after darbepoetin alfa treatment. It is concluded that TIBC
and plasma iron concentration play role on anemia and erythropoietic response to
darbepoetin alfa treatment in CKD dogs.
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Affiliation(s)
- Chayanont Bhamarasuta
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Henri Dunant Rd., Pathumwan, Bangkok, 10330, Thailand
| | - Kanyavee Premratanachai
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Henri Dunant Rd., Pathumwan, Bangkok, 10330, Thailand
| | - Nitchanan Mongkolpinyopat
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Henri Dunant Rd., Pathumwan, Bangkok, 10330, Thailand
| | - Pamila Yothapand
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Henri Dunant Rd., Pathumwan, Bangkok, 10330, Thailand
| | - Thitapa Vejpattarasiri
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Henri Dunant Rd., Pathumwan, Bangkok, 10330, Thailand
| | - Thasinas Dissayabutra
- STAR unit of Renal Biochemistry and Stone Disease, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Henri Dunant Rd., Pathumwan, Bangkok, 10330, Thailand
| | - Monkon Trisiriroj
- The Small Animal Teaching Hospital, Faculty of Veterinary Science, Chulalongkorn University, Henri Dunant Rd., Pathumwan, Bangkok, 10330, Thailand
| | - Saikaew Sutayatram
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Henri Dunant Rd., Pathumwan, Bangkok, 10330, Thailand
| | - Chollada Buranakarl
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Henri Dunant Rd., Pathumwan, Bangkok, 10330, Thailand
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Roura X, Cortadellas O, Day MJ, Benali SL, Zatelli A. Canine leishmaniosis and kidney disease: Q&A for an overall management in clinical practice. J Small Anim Pract 2020; 62:E1-E19. [PMID: 33107613 DOI: 10.1111/jsap.13237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 12/19/2022]
Affiliation(s)
- X Roura
- Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
| | - O Cortadellas
- Hospital Clínico Veterinario, Universidad CEU Cardenal Herrera, 46115, Valencia, Spain
| | - M J Day
- School of Veterinary and Life Sciences, Murdoch University, 6150, Murdoch, Australia
| | - S L Benali
- Laboratorio La Vallonea, 20017, Milano, Italy
| | | | - A Zatelli
- Dipartimento di Medicina Veterinaria, Università degli Studi di Bari "Aldo Moro", 70010, Bari, Italy
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Miyagawa Y, Akabane R, Sakatani A, Ogawa M, Nagakawa M, Miyakawa H, Takemura N. Effects of telmisartan on proteinuria and systolic blood pressure in dogs with chronic kidney disease. Res Vet Sci 2020; 133:150-156. [PMID: 32992126 DOI: 10.1016/j.rvsc.2020.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 10/23/2022]
Abstract
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.
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Affiliation(s)
- Yuichi Miyagawa
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan.
| | - Ryota Akabane
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Atsushi Sakatani
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Mizuki Ogawa
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Masayoshi Nagakawa
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Hirosumi Miyakawa
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Naoyuki Takemura
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
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Zatelli A, D’Ippolito P, Roura X, Zini E. Short-term effects of dietary supplementation with amino acids in dogs with proteinuric chronic kidney disease. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2017; 58:1287-1293. [PMID: 29203938 PMCID: PMC5680804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This retrospective study investigated the impact of amino acid supplementation on body weight, serum albumin, creatinine and urea concentrations, and urine protein-to-creatinine (UPC) ratio in proteinuric dogs with chronic kidney disease (CKD). Forty-six client-owned azotemic dogs with spontaneous proteinuric CKD already on a renal diet and in therapy with enalapril were included. After approximately 1 month of treatment (baseline), 29 dogs received oral amino acid supplementation daily (group A) and 17 dogs did not (group B). The parameters under investigation were determined at baseline and after 4 to 8 weeks in both groups. Compared to baseline, body weight and serum albumin increased (P < 0.01, P < 0.05, respectively) at follow-up in group A, but did not change in group B. Serum creatinine concentration did not change in both groups; urea concentration (P < 0.05) and UPC ratio (P < 0.01) decreased in group B, but not in group A. Supplementation with amino acids increased body weight and serum albumin concentration in these dogs but it might have prevented a decrease in proteinuria and urea concentration.
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Affiliation(s)
- Andrea Zatelli
- Address all correspondence to Dr. Andrea Zatelli; e-mail:
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Plasma alpha-tochopherol determined by HPLC in dogs at different stages of chronic kidney disease: a retrospective study. Vet Res Commun 2017; 41:195-199. [PMID: 28488081 DOI: 10.1007/s11259-017-9690-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 05/01/2017] [Indexed: 01/02/2023]
Abstract
The aim of the present study was to investigate retrospectively the plasma concentration of alpha-tocopherol in dogs with naturally acquired chronic kidney disease (CKD), at different stages of severity. Forty dogs (CKD group) with different stages of CKD (IRIS 1 n=12, IRIS 2 n=8, IRIS 3 n=11, IRIS 4 n=9) and 20 clinically healthy dogs were considered. Plasma alpha-tocopherol was assessed in both groups through high performance liquid chromatography (HPLC). Dogs of CKD group showed significantly lower (p=0.0002) levels of plasma alpha-tocopherol compared with clinically healthy dogs. A significant difference (p<0.04) in the number of patients with plasma alpha-tocopherol > or ≤ 21.5 ppm was found in CKD patients at different stages of severity. No significant correlation between plasma levels of alpha-tocopherol and plasma creatinine was found. In the present study, dogs affected by spontaneous CKD showed significantly lower plasma concentrations of alpha-tocopherol compared with clinically healthy dogs. Plasma alpha-tocopherol deficiency seems to be more severe in IRIS stage 1 and 4, compared with IRIS stage 2 and 3. The finding of marked alpha-tocopherol deficiency in patients in IRIS stage 1 should encourage further studies on the early use of prescription renal diet and antioxidant in this group of patients.
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Zatelli A, Roura X, D'Ippolito P, Berlanda M, Zini E. The effect of renal diet in association with enalapril or benazepril on proteinuria in dogs with proteinuric chronic kidney disease. Open Vet J 2016; 6:121-7. [PMID: 27540513 PMCID: PMC4980477 DOI: 10.4314/ovj.v6i2.8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 07/20/2016] [Indexed: 11/22/2022] Open
Abstract
Treating proteinuria in dogs reduces the progression of chronic kidney disease (CKD); renal diets and angiotensin-converting enzyme (ACE)-inhibitors are cornerstones of treatment. Whether different ACE-inhibitors have distinct kidney protective effects is unknown; it is therefore hypothesized that renal diets and enalapril or benazepril have different beneficial effects in proteinuric CKD dogs. Forty-four dogs with proteinuric CKD (IRIS stages 1-4) were enrolled in the study and were fed renal diet for 30 days. Thereafter, they were randomly assigned to one of 2 groups. Dogs in group A (n=22) received enalapril (0.5 mg/kg, q12h) and in group B (n=22) benazepril (0.5 mg/kg, q24h); in both groups, dogs were fed the same renal diet. After randomization, dogs were monitored for 120 days. Body weight and body condition score (BCS), serum concentrations of creatinine, blood urea nitrogen (BUN), albumin and total proteins, and urine protein-to-creatinine (UPC) ratio were compared at different time-points. After 30 days of renal diet, creatinine, BUN and UPC ratio decreased significantly (p<0.0001). Compared to randomization, body weight, BCS, albumin, total proteins, creatinine and BUN did not vary during follow-up in the 44 dogs and differences between group A and B were not observed. However, the UPC ratio of group A at day 60, 90 and 150 was significantly lower than in group B and compared to randomization (p<0.05). In group B it did not vary overtime. It is concluded that the renal diet is beneficial to decrease creatinine, BUN and UPC ratio in proteinuric CKD dogs. Enalapril further ameliorates proteinuria if administered along with renal diet.
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Affiliation(s)
- A Zatelli
- Medical Consultancy Services, G. Calì Street 60, TBX1424 TàXbiex, Malta
| | - X Roura
- Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Spain
| | - P D'Ippolito
- Medical Consultancy Services, G. Calì Street 60, TBX1424 TàXbiex, Malta
| | - M Berlanda
- Department of Animal Medicine, Production and Health, viale dell'Università 16, 35020 Legnaro (PD), University of Padova, Italy
| | - E Zini
- Department of Animal Medicine, Production and Health, viale dell'Università 16, 35020 Legnaro (PD), University of Padova, Italy; Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland; Istituto Veterinario di Novara, Strada Provinciale 9, 28060 Granozzo con Monticello (NO), Italy
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