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Da Riz F, Pichard D, Maurey C, Kurtz M, Canonne M, Lavoué R, Trumel C, Buronfosse T, Desquilbet L, Benchekroun G. Phosphocalcic metabolism and its potential association with biomarkers of kidney disease in dogs with spontaneous hyperadrenocorticism. Vet J 2024; 305:106146. [PMID: 38788995 DOI: 10.1016/j.tvjl.2024.106146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/17/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024]
Abstract
The pathogenesis of increased serum phosphate concentration and proteinuria in dogs with spontaneous hyperadrenocorticism (HAC) is unclear. A potential link between proteinuria and calcium/phosphate metabolism has never been studied in dogs with HAC. The aims of the study were: (1) To evaluate calcium/phosphate metabolism in dogs with spontaneous HAC and compare to healthy dogs as well as to dogs with non-HAC illness; (2) to look for associations between markers of calcium/phosphate metabolism and biomarkers of kidney disease in dogs with HAC. Fifty-four dogs were included in the study, classified as HAC (n=27), non-HAC disease (n=17), and healthy (n=10). Serum calcium, phosphate, 25(OH)Vitamin D, 1,25(OH)2Vitamin D, plasma intact parathyroid hormone concentration (iPTH), FGF23, and urinary fractional excretion of calcium and phosphate were evaluated in all dogs at diagnosis and compared between each group. The correlation between these variables and urine protein-to-creatinine ratio (UPC) and urinary N-acetylglucosaminidase-to-creatinine ratio (uNAG/C) was evaluated in the HAC group. Medians [range] of serum phosphate concentration, urinary fractional excretion of calcium (FE(Ca)), and iPTH were significantly higher in dogs with HAC than in dogs with non-HAC illness (P<0.01) and healthy dogs (P<0.01). Increased 1,25(OH)2Vitamin D/25(OH)Vitamin D was also observed (P<0.001). In HAC group, UPC was significantly negatively correlated with 25(OH)Vitamin D (r(s): -0.54; P<0.01). Urinary NAG/C was significantly positively correlated with serum phosphate (r(s): 0.46; P=0.019). Increased serum phosphate, urinary excretion of calcium, and hyperparathyroidism were observed in dogs with HAC. Vitamin D metabolism may be shifted towards increased 1-alpha hydroxylation.
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Affiliation(s)
- F Da Riz
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort F-94700, France
| | - D Pichard
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort F-94700, France
| | - C Maurey
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort F-94700, France
| | - M Kurtz
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort F-94700, France
| | - M Canonne
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort F-94700, France; Ecole nationale vétérinaire d'Alfort, Univ Paris Est Créteil, INSERM, IMRB, Maisons-Alfort 94700, France
| | - R Lavoué
- IRSD, Université de Toulouse, INRAE, ENVT, Toulouse, France
| | - C Trumel
- CREFRE, Université de Toulouse, INRAE, ENVT, Toulouse, France
| | - T Buronfosse
- VetAgro Sup, Service de Biochimie, Marcy l'Etoile 69280, France
| | - L Desquilbet
- Ecole nationale vétérinaire d'Alfort, Univ Paris Est Créteil, INSERM, IMRB, Maisons-Alfort 94700, France
| | - G Benchekroun
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort F-94700, France; Ecole nationale vétérinaire d'Alfort, Univ Paris Est Créteil, INSERM, IMRB, Maisons-Alfort 94700, France.
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Fulton EA, Weir W, Czopowicz M, McBrearty AR. The relationships between sediment findings and culture results and the presence of proteinuria in canine urine samples. J Small Anim Pract 2023; 64:749-758. [PMID: 37632274 DOI: 10.1111/jsap.13669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/10/2023] [Accepted: 07/12/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVES To assess relationships between urine sediment and microbial culture findings and the presence of proteinuria in canine urine samples, and to assess the change in the percentage of proteinuric samples and urine protein-to-creatinine ratio when urine abnormalities resolve. MATERIALS AND METHODS Canine urine samples collected via cystocentesis and submitted for culture and contemporaneous urinalysis (including urine protein-to-creatinine ratio) were retrospectively identified. Dogs receiving corticosteroids were excluded. Associations between haematuria (red blood cells>5/high-power field), pyuria (white blood cells>5/high-power field), presence of microorganisms on microscopy, active sediment, and positive culture and proteinuria (urine protein-to-creatinine ratio>0.5) were investigated. Patient characteristics were considered possible confounders. In dogs with repeat urinalysis, the associations between active sediment and positive culture resolution on proteinuria and urine protein-to-creatinine ratio were assessed. RESULTS One hundred and ninety-two of 491 samples were proteinuric (39.1%). Age was positively associated with proteinuria. In the multivariable analysis corrected for age, active sediment was the only variable significantly associated with proteinuria (adjusted odds ratio: 2.12; 95% confidence interval: 1.44 to 3.11); however, only 49.8% of samples with active sediment were proteinuric. Neither resolution of active sediment nor positive culture were associated with reduced proportions of proteinuric samples (from 57.9% to 42.1% and from 40.0% to 25.0%, respectively) or significant reductions in urine protein-to-creatinine ratio (median change: -0.16 and -0.14, respectively). CLINICAL SIGNIFICANCE Attributing proteinuria to urinalysis abnormalities or a positive urine culture in canine cystocentesis samples is not supported by our findings, and could result in alternative causes of proteinuria (e.g. renal proteinuria) being overlooked.
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Affiliation(s)
- E A Fulton
- School of Biodiversity, One Health and Veterinary Medicine, The University of Glasgow Small Animal Hospital, 464 Bearsden Road, Glasgow, G61 1QH, Scotland
| | - W Weir
- School of Biodiversity, One Health and Veterinary Medicine, The University of Glasgow Small Animal Hospital, 464 Bearsden Road, Glasgow, G61 1QH, Scotland
| | - M Czopowicz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159c, 02-776, Warsaw, Poland
| | - A R McBrearty
- The University of Glasgow Small Animal Hospital and Vets Now, Glasgow, Scotland
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Williams JG, Hess RS. Concurrent disorders of cats with diabetes mellitus and arterial systolic hypertension. J Feline Med Surg 2023; 25:1098612X231187691. [PMID: 37470682 PMCID: PMC10812060 DOI: 10.1177/1098612x231187691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
OBJECTIVES The aim of the present study was to report the concurrent disorders and treatment success of cats with diabetes mellitus (DM) and arterial systolic hypertension (SH). METHODS A retrospective longitudinal study was conducted of 17 cats with DM and SH that were examined at a university teaching hospital between 1 January 2011 and 31 December 2021. The medical records of diabetic cats were searched for the keywords 'hypertension', 'blood pressure', 'amlodipine', 'benazepril' and 'telmisartan' to identify cats with SH, which was defined as systemic arterial blood pressure (SABP) ⩾160 mmHg, documented at least twice, over several days. Comorbidities, including chronic kidney disease and hyperthyroidism, were recorded. Medications used for the treatment of SH and the SABP response to treatment were also noted. RESULTS Most cats (13/17, 76%) with DM and SH had at least one other documented concurrent illness that could contribute to SH, including chronic kidney disease (12/17 cats, 71%), hyperthyroidism (4/17, 23%) and functional adrenocortical mass secreting either aldosterone alone (1/17, 6%) or glucocorticoids, and possibly also aldosterone (1/17, 6%). Out of 17 cats, 15 (88%) were treated with amlodipine, and none were treated with an angiotensin converting enzyme inhibitor or an angiotensin II receptor blocker. Mean SABP at the time of diagnosis of SH was 210 ± 23 mmHg and was significantly higher than the mean SABP at the first and second follow-up examinations after the introduction of amlodipine treatment (175 ± 33 mmHg, P = 0.008 and 172 ± 26 mmHg, P = 0.01, respectively). CONCLUSIONS AND RELEVANCE Cats with DM and SH should be evaluated for the presence of chronic kidney disease, hyperthyroidism and functional adrenal masses. Treatment with amlodipine appears to be effective in lowering SABP in cats with DM and SH.
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Affiliation(s)
- Jonathon G Williams
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecka S Hess
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Lawrence-Mills SJ, Hughes D, Hezzell MJ, Butler M, Neal C, Foster RR, Welsh GI, Finch N. The microvascular endothelial glycocalyx: An additional piece of the puzzle in veterinary medicine. Vet J 2022; 285:105843. [PMID: 35654338 PMCID: PMC9587354 DOI: 10.1016/j.tvjl.2022.105843] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 04/29/2022] [Accepted: 05/25/2022] [Indexed: 01/01/2023]
Abstract
The endothelial glycocalyx (eGlx) is a critically important structure lining the luminal surface of endothelial cells. There is increasing evidence, in human patients and animal models, for its crucial role in the maintenance of health. Moreover, its damage is associated with the pathogenesis of multiple disease states. This review provides readers with an overview of the eGlx; summarising its structure, essential functions, and evidence for its role in disease. We highlight the lack of studies regarding the eGlx in cats and dogs, particularly in naturally occurring diseases. Importantly, we discuss techniques to aid its study, which can be applied to veterinary species. Finally, we present targeted therapies aimed at preserving, and in some cases, restoring damaged eGlx.
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Affiliation(s)
- Sara J Lawrence-Mills
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol, UK; current affiliation The Royal Veterinary College, University of London, North Mimms, UK.
| | - David Hughes
- Bristol Veterinary School, University of Bristol, Langford, UK
| | | | - Matthew Butler
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol, UK
| | - Chris Neal
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rebecca R Foster
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gavin I Welsh
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol, UK
| | - Natalie Finch
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol, UK; Bristol Veterinary School, University of Bristol, Langford, UK; Langford Vets, Langford House, Langford, UK
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The Relevance of Screening for Vector-Borne Diseases in Dogs with Proteinuria Living in an Endemic Region: A Retrospective Study. Vet Sci 2022; 9:vetsci9060266. [PMID: 35737318 PMCID: PMC9228354 DOI: 10.3390/vetsci9060266] [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] [Received: 04/28/2022] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 11/18/2022] Open
Abstract
This study aims to assess the main causes of proteinuria in dogs from the region of Lisbon (Portugal), estimating the relevance of screening for canine vector-borne diseases (CVBDs). A cross-sectional retrospective study was conducted. Medical records from proteinuric dogs (urinary protein−creatinine ratio > 0.5) presented to a Veterinary Teaching Hospital over a two-year period were reviewed for signalment, established diagnosis, proteinuria origin, and CVBD screening results. A total of 106 dogs were included. The median age was 9.5 years old (IQR: 7−12). Proteinuria was considered of renal origin in 76% of cases (46% of them had a presumptive diagnosis of glomerulonephritis secondary to CVBD, 27% chronic kidney disease, 26% systemic disease possible to induce proteinuria, and 1% leptospirosis). Proteinuria was classified as post-renal or mixed-origin in 17% and 7% of cases, respectively. About 35% of proteinuric dogs were positive for at least one CVBD. Of them, 84% were seropositive for one CVBD, while 16% tested positive for two or more. Among dogs testing positive for CVBD, 89% were seropositive for Leishmania infantum. This study showed that about one-third of proteinuric dogs tested positive for CVBDs, highlighting the relevance of their screening in dogs with proteinuria living in endemic regions.
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MIYAGAWA Y, AKABANE R, OGAWA M, NAGAKAWA M, MIYAKAWA H, TAKEMURA N. Serum cystatin C concentration can be used to evaluate glomerular filtration rate in small dogs. J Vet Med Sci 2021; 82:1828-1834. [PMID: 33177264 PMCID: PMC7804046 DOI: 10.1292/jvms.20-0201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 10/13/2020] [Indexed: 11/22/2022] Open
Abstract
Serum cystatin C levels (CysC) are used in human medicine to document progressive kidney failure. Although CysC are not thought to be useful for the diagnosis of kidney dysfunction in dogs, there has been no specific consideration of body weight as a confounding issue. The aim of this study was to assess that the utility of CysC for the diagnosis of decreased glomerular filtration rate (GFR) in smaller vs. larger dogs. In clinically healthy dogs, serum creatinine (Cre) and CysC correlate directly with body weight; we found that dogs weighing <20 kg had significantly lower CysC than those weighing ≥20 kg (0.27 ± 0.07 vs. 0.34 ± 0.05 mg/l, respectively, P<0.001). In dogs weighing <20 kg, CysC had superior diagnostic accuracy for the detection of mildly decreased plasma iohexol clearance (PCio) (<1.8 ml/min/kg) compared with Cre (sensitivity 100% vs. 80.9% and specificity 100% vs. 85.7%); this was not true for dogs weighing ≥20 kg. Additionally, using a cut-off PCio of <1.8 ml/min/kg, the area under receiver-operating characteristics curve (AUC) of CysC was significantly higher than that of Cre in dogs weighing <20 kg (P<0.05); this was not true for dogs weighing ≥20 kg (P=0.695). In conclusion, CysC is a useful marker for the detection of a mild decreasing GFR compared with Cre in dogs weighing <20 kg.
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Affiliation(s)
- Yuichi MIYAGAWA
- The Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, 1-7-1 Kyonan cho, Musashino-shi,
Tokyo 180-8602, Japan
| | - Ryota AKABANE
- The Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, 1-7-1 Kyonan cho, Musashino-shi,
Tokyo 180-8602, Japan
| | - Mizuki OGAWA
- The Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, 1-7-1 Kyonan cho, Musashino-shi,
Tokyo 180-8602, Japan
| | - Masayoshi NAGAKAWA
- The Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, 1-7-1 Kyonan cho, Musashino-shi,
Tokyo 180-8602, Japan
| | - Hirosumi MIYAKAWA
- The Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, 1-7-1 Kyonan cho, Musashino-shi,
Tokyo 180-8602, Japan
| | - Naoyuki TAKEMURA
- The Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, 1-7-1 Kyonan cho, Musashino-shi,
Tokyo 180-8602, Japan
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García San José P, Arenas Bermejo C, Clares Moral I, Cuesta Alvaro P, Pérez Alenza MD. Prevalence and risk factors associated with systemic hypertension in dogs with spontaneous hyperadrenocorticism. J Vet Intern Med 2020; 34:1768-1778. [PMID: 32614466 PMCID: PMC7517838 DOI: 10.1111/jvim.15841] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 12/14/2022] Open
Abstract
Background Systemic hypertension (SH) is common in dogs with hyperadrenocorticism (HAC) however there are not many studies assessing its prevalence and risk factors. Objectives To determine the prevalence and severity of SH in dogs with HAC and its association with clinical and laboratory findings to identify potential risk factors. Animals Sixty‐six client owned dogs with spontaneous HAC. Methods Retrospective cross‐sectional study. Medical records of dogs with HAC were reviewed. Systolic blood pressure (SBP) was measured using Doppler ultrasonography. Clinical signs, physical examination findings and clinicopathologic data (CBC, serum biochemistry and electrolytes, urinalysis and urinary culture, and adrenal function tests) were reviewed for analysis. Results Prevalence of SH (≥150 mm Hg) was 82% (54/66) and prevalence of severe SH (≥180 mm Hg) was 46% (30/66). All dogs with thrombocytosis had SH (P = .002), and a platelet count ≥438 × 103/μL was 100% specific and 61.1% sensitive to predict SH (AUC = .802, P = .001). Median potassium levels were lower in hypertensive dogs (4.1 mEq/L, range 3.1‐5.4 mEq/L) than in normotensive ones (4.5 mEq/L, range 4.0‐5.0 mEq/L) (P = .007). Dogs with UPC ≥ 0.5 had higher median SBP than those without proteinuria (P = .03). Dogs with concurrent diabetes mellitus seemed to have a reduced risk of SH (OR = .118, 95%CI = .022‐.626, P = .02). Conclusions and Clinical Importance Systemic hypertension is common in dogs with HAC and is frequently severe. Blood pressure should be routinely assessed in these dogs, especially if thrombocytosis, proteinuria or low potassium concentrations are present.
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Affiliation(s)
- Paula García San José
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | | | - Irene Clares Moral
- Veterinary Teaching Hospital Complutense, Complutense University of Madrid, Madrid, Spain
| | - Pedro Cuesta Alvaro
- Data Processing Center, Department of Political and Public Administration Sciences II, Political Sciences Faculty, Complutense University of Madrid, Madrid, Spain
| | - María Dolores Pérez Alenza
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
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Pérez-López L, Boronat M, Melián C, Brito-Casillas Y, Wägner AM. Animal Models and Renal Biomarkers of Diabetic Nephropathy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1307:521-551. [PMID: 32329028 DOI: 10.1007/5584_2020_527] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Diabetes mellitus (DM) is the first cause of end stage chronic kidney disease (CKD). Animal models of the disease can shed light on the pathogenesis of the diabetic nephropathy (DN) and novel and earlier biomarkers of the condition may help to improve diagnosis and prognosis. This review summarizes the most important features of animal models used in the study of DN and updates the most recent progress in biomarker research.
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Affiliation(s)
- Laura Pérez-López
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria, Spain
| | - Mauro Boronat
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria, Spain
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain
| | - Carlos Melián
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria, Spain
- Department of Animal Pathology, Veterinary Faculty, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Arucas, Las Palmas, Spain
| | - Yeray Brito-Casillas
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria, Spain
| | - Ana M Wägner
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria, Spain.
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain.
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Pelander L, Häggström J, Larsson A, Syme H, Elliott J, Heiene R, Ljungvall I. Comparison of the diagnostic value of symmetric dimethylarginine, cystatin C, and creatinine for detection of decreased glomerular filtration rate in dogs. J Vet Intern Med 2019; 33:630-639. [PMID: 30791142 PMCID: PMC6430914 DOI: 10.1111/jvim.15445] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 01/23/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Early detection of decreased glomerular filtration rate (GFR) in dogs is challenging. Current methods are insensitive and new biomarkers are required. OBJECTIVE To compare overall diagnostic performance of serum symmetric dimethylarginine (SDMA) and serum cystatin C to serum creatinine, for detection of decreased GFR in clinically stable dogs, with or without chronic kidney disease (CKD). ANIMALS Ninety-seven client-owned dogs: 67 dogs with a diagnosis or suspicion of CKD and 30 healthy dogs were prospectively included. METHODS Prospective diagnostic accuracy study. All dogs underwent physical examination, systemic arterial blood pressure measurement, urinalysis, hematology and blood biochemistry analysis, cardiac and urinary ultrasound examinations, and scintigraphy for estimation of glomerular filtration rate (mGFR). Frozen serum was used for batch analysis of SDMA and cystatin C. RESULTS The area under the curve of creatinine, SDMA, and cystatin C for detection of an mGFR <30.8 mL/min/L was 0.98 (95% confidence interval [CI], 0.93-1.0), 0.96 (95% CI, 0.91-0.99), and 0.87 (95% CI, 0.79-0.93), respectively. The sensitivity of both creatinine and SDMA at their prespecified cutoffs (115 μmol/L [1.3 mg/dL] and 14 μg/dL) for detection of an abnormal mGFR was 90%. The specificity was 90% for creatinine and 87% for SDMA. When adjusting the cutoff for cystatin C to correspond to a diagnostic sensitivity of 90% (0.49 mg/L), specificity was lower (72%) than that of creatinine and SDMA. CONCLUSIONS AND CLINICAL IMPORTANCE Overall diagnostic performance of creatinine and SDMA for detection of decreased mGFR was similar. Overall diagnostic performance of cystatin C was inferior to both creatinine and SDMA.
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Affiliation(s)
- Lena Pelander
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Harriet Syme
- Department of Clinical Science and Services, The Royal Veterinary College, Hertfordshire, United Kingdom
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, The Royal Veterinary College, London, United Kingdom
| | - Reidun Heiene
- ABC Dyreklinikk Lillehammer AS, Hamarvegen 68A, 26 13 Lillehammer, Norway
| | - Ingrid Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Acierno MJ, Brown S, Coleman AE, Jepson RE, Papich M, Stepien RL, Syme HM. ACVIM consensus statement: Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats. J Vet Intern Med 2018; 32:1803-1822. [PMID: 30353952 PMCID: PMC6271319 DOI: 10.1111/jvim.15331] [Citation(s) in RCA: 265] [Impact Index Per Article: 44.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022] Open
Abstract
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.
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Affiliation(s)
- Mark J Acierno
- Department of Medicine, College of Veterinary Medicine, Midwestern University, 5715 W. Utopia Rd, Glendale Arizona 85308
| | - Scott Brown
- College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Amanda E Coleman
- College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Rosanne E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Mark Papich
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Rebecca L Stepien
- Department of Medical Sciences, University of Wisconsin School of Veterinary Medicine, Madison, Wisconsin
| | - Harriet M Syme
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
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Liu DJX, Meyer E, Broeckx BJG, Daminet S, Delanghe JR, Stock E, Bogaerts E, Hesta M, Vanderperren K. Variability of serum concentrations of cystatin C and urinary retinol-binding protein, neutrophil gelatinase-associated lipocalin, immunoglobulin G, and C-reactive protein in dogs. J Vet Intern Med 2018; 32:1659-1664. [PMID: 30216550 PMCID: PMC6189346 DOI: 10.1111/jvim.15293] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 05/08/2018] [Accepted: 06/27/2018] [Indexed: 12/20/2022] Open
Abstract
Background Markers of kidney dysfunction and damage have potential to detect chronic kidney disease (CKD) in early stages. However, data on long‐term variation of these markers in healthy dogs is lacking and is crucial for the interpretation of results. Hypothesis/Objectives To determine temporal variations of serum cystatin C (sCysC) and urinary retinol‐binding protein (uRBP), neutrophil gelatinase‐associated lipocalin (uNGAL), immunoglobulin G (uIgG), and C‐reactive protein (uCRP) in healthy dogs. Animals Eight clinically healthy adult Beagles were evaluated. Methods Longitudinal observational study. Serum cystatin C was determined by particle‐enhanced nephelometric immunoassay. Urinary retinol‐binding protein, uNGAL, uIgG and uCRP were determined by ELISA and concentrations were indexed to urinary creatinine. Within‐ and between‐dog variance components (VC) and within‐dog coefficients of variation (CV) were determined from blood and urine collected at eight time points over 1.5 years. Results Urinary C‐reactive protein (uCRP) concentrations were consistently below the detection limit (5.28 ng/mL). Mean ± within‐dog standard deviation for sCysC, uRBP/c, uNGAL/c and uIgG/c was 0.15 ± 0.01 mg/L, 0.09 ± 0.03 mg/g, 2.32 ± 2.03 μg/g and 12.47 ± 10.98 mg/g, respectively. Within‐dog CV for sCysC, uRBP/c, uNGAL/c and uIgG/c was 8.1%, 33.7%, 87.2% and 88.1%, respectively. Conclusions and clinical importance Serum cystatin C, uRBP/c, uNGAL/c and uIgG/c exhibit a wide range of long‐term within‐dog variability. Researchers and veterinarians might need to take this into account when interpreting their results. To assess their diagnostic and predictive ability, future studies need to establish reference ranges for healthy dogs and dogs with CKD.
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Affiliation(s)
- D J X Liu
- Department of Veterinary Medical Imaging and Small Animal Orthopedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - E Meyer
- Department of Pharmacology, Toxicology and Biochemistry, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - B J G Broeckx
- Department of Nutrition, Genetics and Ethology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - S Daminet
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - J R Delanghe
- Department of Clinical Chemistry, Microbiology and Immunology, Faculty of Health Medicine and Life Sciences, Ghent University, Ghent, Belgium
| | - E Stock
- Department of Veterinary Medical Imaging and Small Animal Orthopedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - E Bogaerts
- Department of Veterinary Medical Imaging and Small Animal Orthopedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - M Hesta
- Department of Nutrition, Genetics and Ethology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - K Vanderperren
- Department of Veterinary Medical Imaging and Small Animal Orthopedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Smith RE, Granick JL, Stauthammer CD, Polzin DJ, Heinrich DA, Furrow E. Clinical Consequences of Hypertriglyceridemia-Associated Proteinuria in Miniature Schnauzers. J Vet Intern Med 2017; 31:1740-1748. [PMID: 28941297 PMCID: PMC5697203 DOI: 10.1111/jvim.14833] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/27/2017] [Accepted: 08/21/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Primary hypertriglyceridemia is a common condition in older Miniature Schnauzers that recently has been associated with proteinuria and underlying glomerular pathology, particularly glomerular lipid thromboemboli. Consequences of glomerular disease can include hypertension, thromboembolic disease, and cardiac disease. The incidence of these sequelae in Miniature Schnauzers with hypertriglyceridemia-associated proteinuria (HTGP) is unknown. OBJECTIVE To investigate prevalence of hypertension, decreased antithrombin III activity, and cardiac disease in Miniature Schnauzers with and without HTGP. ANIMALS Thirty-two Miniature Schnauzers ≥7 years old. METHODS Prospective case-control study. Data collected from dogs included a CBC, biochemistry panel, urinalysis, urine protein-to-creatinine ratio, urine cortisol-to-creatinine ratio, serum total thyroxine concentration, fasting serum triglyceride concentration, indirect blood pressure, antithrombin III activity, and serum cardiac troponin I concentration. Results from dogs with HTGP (serum triglyceride concentration ≥ 100 mg/dL and urine protein-to-creatinine ratio >0.5) were statistically compared to normotriglyceridemic, nonproteinuric dogs. RESULTS Eighteen of the 32 dogs (56%) had primary hypertriglyceridemia. Of those dogs, 8 of 18 had proteinuria. None of the HTGP dogs were azotemic or hypoalbuminemic. Serum albumin concentration, alkaline phosphatase activity, and cholesterol concentration were significantly increased in dogs with HGTP compared to those without HGTP. No increased risk of hypertension, decreased antithrombin III activity, or cardiac disease was noted. Limited data from 8 dogs with HTGP showed no development of hypoalbuminemia or azotemia over a median follow-up period of 18 months. CONCLUSIONS AND CLINICAL IMPORTANCE Geriatric Miniature Schnauzers with HGTP may have a good prognosis overall, and are not typically azotemic or hypoalbuminemic.
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Affiliation(s)
- R E Smith
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - J L Granick
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - C D Stauthammer
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - D J Polzin
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - D A Heinrich
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - E Furrow
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
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Muñoz J, Soblechero P, Duque FJ, Macías-García B, Ruiz P, Zaragoza C, Barrera R. Effects of Oral Prednisone Administration on Serum Cystatin C in Dogs. J Vet Intern Med 2017; 31:1765-1770. [PMID: 28921665 PMCID: PMC5697201 DOI: 10.1111/jvim.14820] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/20/2017] [Accepted: 08/01/2017] [Indexed: 11/27/2022] Open
Abstract
Background Oral administration of glucocorticoid alters serum cystatin C (sCysC) concentration in humans. Objective To determine if oral administration of prednisone alters sCysC in dogs without pre‐existing renal disease. Animals Forty six dogs were included: 10 dogs diagnosed with steroid responsive meningitis arteritis (SRMA; group A), 20 dogs diagnosed of pituitary‐dependent hyperadrenocorticism (PDH; group B), and 16 healthy control dogs (group C). Methods Retrospective observational study. SRMA diagnosed dogs were administered prednisone 4 mg/kg/24 h PO 7 days, reducing the dose to 2 mg/kg/24 h 7 days before medication withdrawal. In group A, sampling was performed at days 0, 7, 14 and a final control at day 21. Blood and urine samples were collected in the 3 groups, and in group A, sampling was performed at all time points (days 1, 7, 14, and 21). Results In group A, sCysC was significantly higher at day 7 compared to the control group (0.4 ± 0.04 mg/L vs. 0.18 ± 0.03 mg/L mean ± SEM respectively P < 0.01); sCysC values decreased to basal at day 14 when the dose was decreased and after 1 week of withdrawal of prednisone (0.27 ± 0.03 mg/L for group A at day 14 and 0.15 ± 0.02 mg/L at day 21; P > 0.05). Dogs with PDH included in group B did not have significant differences in sCysC (0.22 ± 0.03 mg/L) compared to control (P > 0.05). Conclusions and Clinical Importance Oral administration of prednisone unlike altered endogenous glucocorticoid production, increases sCysC in dogs in a dose‐dependent fashion.
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Affiliation(s)
- J Muñoz
- Animal Medicine Department, Faculty of Veterinary Sciences, University of Extremadura, Cáceres, Spain
| | - P Soblechero
- Animal Medicine Department, Faculty of Veterinary Sciences, University of Extremadura, Cáceres, Spain
| | - F J Duque
- Animal Medicine Department, Faculty of Veterinary Sciences, University of Extremadura, Cáceres, Spain
| | - B Macías-García
- Assisted Reproduction Unit, Minimally Invasive Surgery Centre JesúsUsón, Cáceres, Spain
| | - P Ruiz
- Animal Medicine Department, Faculty of Veterinary Sciences, University of Extremadura, Cáceres, Spain
| | - C Zaragoza
- Animal Medicine Department, Faculty of Veterinary Sciences, University of Extremadura, Cáceres, Spain
| | - R Barrera
- Animal Medicine Department, Faculty of Veterinary Sciences, University of Extremadura, Cáceres, Spain
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