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Franco-Martinez L, Muñoz-Prieto A, Busato F, Karveliene B, Stadaliene I, Ceron JJ, Carrillo JD, Garcia-Martinez JD, Dabrowski R, Pardo-Marín L, Martinez-Subiela S, Tvarijonaviciute A. Evaluation of the presence of gingivitis as confounding factor in assessing inflammatory status in serum and saliva of dogs with diabetes mellitus. BMC Vet Res 2024; 20:116. [PMID: 38521919 PMCID: PMC10960392 DOI: 10.1186/s12917-024-03962-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/28/2024] [Indexed: 03/25/2024] Open
Abstract
The aim of this study was to evaluate the changes in the serum and salivary inflammatory markers induced by Diabetes mellitus (DM) in dogs and to assess the possible confounding effect of gingivitis. A panel of 13 cytokines was measured in the serum and saliva of dogs diagnosed with DM and compared with healthy dogs without gingivitis (control group 1; CG1) and dogs with gingivitis but otherwise healthy (control group 2; CG2). The results of the present study showed statistically significantly higher levels of IL-8, KC-like and MCP1 in the serum of dogs with DM compared to CG1 dogs. In the case of saliva, the DM group presented statistically higher GM-CSF, IL6, IL15, and MCP1 levels compared to CG1, and lower KC-like chemokine compared to CG2. Finally, gingivitis produced changes in saliva, with salivary levels of GM-CSF, IL-6, IL-7, IL-15, IP-10, KC-like, IL-10, IL-18, MCP1, TNFα being statistically significantly higher in the saliva of CG2 dogs compared to CG1. The results of the present study indicate that dogs with DM have altered cytokine levels in serum and saliva compared to healthy dogs. In addition, this study highlights the importance of taking oral health into account when determining cytokines in dogs, as gingivitis can significantly alter their concentrations. .
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Affiliation(s)
- Lorena Franco-Martinez
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Ed. 16, Espinardo, Murcia, 30100, Spain
| | - Alberto Muñoz-Prieto
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Ed. 16, Espinardo, Murcia, 30100, Spain
| | - Francesca Busato
- Division of Internal Medicine, San Marco Veterinary Clinic, Veggiano, PD, Italy
| | - Birute Karveliene
- Dr. L. Kriaučeliūnas Small Animals Clinic, Faculty of Veterinary, Veterinary Academy, Lithuanian University of Health Sciences, Tilžės str. 18, Kaunas, 47181, Lithuania
| | - Inga Stadaliene
- Dr. L. Kriaučeliūnas Small Animals Clinic, Faculty of Veterinary, Veterinary Academy, Lithuanian University of Health Sciences, Tilžės str. 18, Kaunas, 47181, Lithuania
| | - Jose J Ceron
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Ed. 16, Espinardo, Murcia, 30100, Spain
| | - Juana D Carrillo
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Murcia, Spain
| | - Juan D Garcia-Martinez
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Murcia, Spain
| | - Roman Dabrowski
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Gleboka 30, Lublin, 20-612, Poland
| | - Luis Pardo-Marín
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Ed. 16, Espinardo, Murcia, 30100, Spain
| | - Silvia Martinez-Subiela
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Ed. 16, Espinardo, Murcia, 30100, Spain.
| | - Asta Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Ed. 16, Espinardo, Murcia, 30100, Spain
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Seigner S, Weber K, Dorsch R. [Urinalysis in dogs and cats, part 1: physical and chemical urinalysis]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2023; 51:168-181. [PMID: 37567179 DOI: 10.1055/a-2107-0361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
The urinalysis of dogs and cats is an important part of the diagnostic evaluation of urinary tract diseases as well as for the identification of systemic diseases. A routine urinalysis consists of a physical and chemical examination of the urine as well as an examination of the urine sediment. Various urine collection methods (free-catch, catheterization, cystocentesis) are available. Each method has multiple advantages and disadvantages. The appropriate method must be chosen individually for each patient depending on the emphasis of the examination. The urine should ideally be examined within 30 minutes of collection as it is prone to change due to time and storage. Physical examination of the urine consists of the determination of urine color, clarity, and specific gravity which provides information regarding the concentration of the urine. The latter is determined by refractometry and needs to be interpreted in the context of the hydration status of the patient. Chemical examination of the urine consists of the determination of the pH value and the presence of blood/hemoglobin/myoglobin, protein, glucose, bilirubin, urobilinogen, nitrite, and ketones. The use of commercially available urine dipsticks is common. These must be stored and used according to the manufacturer's instructions and when interpreting the results, veterinary aspects need to be taken into consideration. The physical and chemical examinations of the urine represent rapid and readily performable methods that provide important information for the diagnosis or the exclusion of numerous diseases.
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Affiliation(s)
- Sandra Seigner
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
| | - Karin Weber
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
| | - Roswitha Dorsch
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
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O'Kell AL, Davison LJ. Etiology and Pathophysiology of Diabetes Mellitus in Dogs. Vet Clin North Am Small Anim Pract 2023; 53:493-510. [PMID: 36854636 DOI: 10.1016/j.cvsm.2023.01.004] [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: 02/27/2023]
Abstract
Canine diabetes results from a wide spectrum of clinical pathophysiological processes that cause a similar set of clinical signs. Various causes of insulin deficiency and beta cell loss, insulin resistance, or both characterize the disease, with genetics and environment playing a role. Understanding the genetic and molecular causes of beta cell loss will provide future opportunities for precision medicine, both from a therapeutic and preventative perspective. This review presents current knowledge of the etiology and pathophysiology of canine diabetes, including the importance of disease classification. Examples of potential targets for future precision medicine-based approaches to therapy are discussed.
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Affiliation(s)
- Allison L O'Kell
- Department of Small Animal Clinical Sciences, University of Florida, 2015 Southwest 16th Avenue, Gainesville, FL 32610, USA.
| | - Lucy J Davison
- Royal Veterinary College, Clinical Sciences and Services, Hawkshead Lane, Hertfordshire AL9 7TA, UK.
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Ferreira CS, Vendramini THA, Amaral AR, Rentas MF, Ernandes MC, da Silva FL, Oba PM, de Oliveira Roberti Filho F, Brunetto MA. Metabolic variables of obese dogs with insulin resistance supplemented with yeast beta-glucan. BMC Vet Res 2022; 18:14. [PMID: 34980115 PMCID: PMC8722019 DOI: 10.1186/s12917-021-03106-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/14/2021] [Indexed: 11/19/2022] Open
Abstract
Background Obesity is one of the most common nutritional disorders in dogs and cats and is related to the development metabolic comorbidities. Weight loss is the recommended treatment, but success is difficult due to the poor satiety control. Yeast beta-glucans are known as biological modifiers because of their innumerable functions reported in studies with mice and humans, but only one study with dogs was found. This study aimed to evaluate the effects of a diet supplemented with 0.1% beta-glucan on glucose, lipid homeostasis, inflammatory cytokines and satiety parameters in obese dogs. Fourteen dogs composed three experimental groups: Obese group (OG) with seven dogs with body condition score (BCS) 8 or 9; Lean group (LG) included seven non-obese dogs with a BCS of 5; and Supplemented Obese group (SOG) was the OG dogs after 90 days of consumption of the experimental diet. Results Compared to OG, SOG had lower plasma basal glycemic values (p = 0.05) and reduced serum cholesterol and triglyceride levels. TNF-α was lower in SOG than in OG (p = 0.05), and GLP-1 was increased in SOG compared to OG and LG (p = 0.02). Conclusion These results are novel and important for recognizing the possibility of using beta-glucan in obesity prevention and treatment.
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Affiliation(s)
- Chayanne Silva Ferreira
- Rio Verde University, Fazenda Fontes do Saber, PO Box 104, Rio Verde, Goiás, 75901-970, Brazil
| | - Thiago Henrique Annibale Vendramini
- Department of Animal Nutrition and Production, School of Veterinary Medicine and Animal Science, University of São Paulo, 87, Prof. Orlando Marques de Paiva Ave, São Paulo, São Paulo, 05508270, Brazil
| | - Andressa Rodrigues Amaral
- Department of Animal Nutrition and Production, School of Veterinary Medicine and Animal Science, University of São Paulo, 87, Prof. Orlando Marques de Paiva Ave, São Paulo, São Paulo, 05508270, Brazil
| | - Mariana Fragoso Rentas
- Department of Animal Nutrition and Production, School of Veterinary Medicine and Animal Science, University of São Paulo, 87, Prof. Orlando Marques de Paiva Ave, São Paulo, São Paulo, 05508270, Brazil
| | - Mariane Ceschin Ernandes
- Department of Animal Nutrition and Production, School of Veterinary Medicine and Animal Science, University of São Paulo, 87, Prof. Orlando Marques de Paiva Ave, São Paulo, São Paulo, 05508270, Brazil
| | - Flavio Lopes da Silva
- Grandfood Industria e Comercio LTDA, Luiz Augusto de Oliveira Hwy, km 204, Dourado, São Paulo, 13590-000, Brazil
| | - Patricia Massae Oba
- Department of Animal Nutrition and Production, School of Veterinary Medicine and Animal Science, University of São Paulo, 87, Prof. Orlando Marques de Paiva Ave, São Paulo, São Paulo, 05508270, Brazil
| | | | - Marcio Antonio Brunetto
- Department of Animal Nutrition and Production, School of Veterinary Medicine and Animal Science, University of São Paulo, 87, Prof. Orlando Marques de Paiva Ave, São Paulo, São Paulo, 05508270, Brazil.
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Saint-Pierre LM, Hopper K, Epstein SE. Retrospective evaluation of the prognostic utility of plasma lactate concentration and serial lactate measurements in dogs and cats presented to the emergency room (January 2012 - December 2016): 4863 cases. J Vet Emerg Crit Care (San Antonio) 2021; 32:42-49. [PMID: 34343401 DOI: 10.1111/vec.13106] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/24/2020] [Accepted: 03/29/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the prognostic significance of plasma lactate concentration, plasma lactate clearance, and delta lactate in dogs and cats presented to an emergency room (ER). DESIGN Retrospective study. SETTING University teaching hospital. ANIMALS A total of 8,321 animals with a plasma lactate concentration measured with 4,863 presenting to the ER and 1,529 dogs and 444 cats having a measurement within 4 hours of admission. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Plasma lactate concentration of dogs and cats presented to a university teaching hospital was retrospectively evaluated. Of dogs and cats with a plasma lactate concentration measured within 4 hours of admission to the ER, hyperlactatemia was common, and the prevalence of hyperlactatemia for dogs 78% (361/462) and cats 67% (78/116) was highest when evaluated within the first 30 minutes following admission. The distribution of patient's plasma lactate concentration was significantly higher in non-survivors compared to survivors at all time points evaluated (P < 0.001). Both lactate clearance (P = 0.010) and delta lactate (P = 0.013) were significantly different between survivors and nonsurvivors. A delta lactate > 4.5 mmol/L was 100% (95% CI: 95 to 100%) specific for nonsurvival in patients with hyperlactatemia measured within 1 hour of admission to the ER. The most common cause of hyperlactatemia was shock in dogs (24%) and urinary tract diseases in cats (22%). Shock was associated with the highest mortality rate in both dogs (61%) and cats (77%). Hyperlactatemia was significantly associated with increased mortality for dogs with shock (P = 0.001), respiratory diseases (P = 0.022), diabetes mellitus (P = 0.018), and liver dysfunction (P = 0.006). CONCLUSIONS Hyperlactatemia was associated with mortality in both dogs and cats when measured at any time point in the 4 hours following admission to the ER. Serial lactate measurement may also be a valuable tool to guide clinical management decisions.
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Affiliation(s)
- Laurence M Saint-Pierre
- Veterinary Medical Teaching Hospital, University of California Davis, Davis, California, USA
| | - Kate Hopper
- Department of Surgical and Radiological Sciences, University of California Davis, Davis, California, USA
| | - Steven E Epstein
- Department of Surgical and Radiological Sciences, University of California Davis, Davis, California, USA
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Kolodziejski PA, Pruszynska-Oszmalek E, Nowak T, Lukomska A, Sassek M, Wlodarek J, Nogowski L, Cieslak A, Nowak KW. Serum spexin concentration, body condition score and markers of obesity in dogs. J Vet Intern Med 2021; 35:397-404. [PMID: 33426749 PMCID: PMC7848318 DOI: 10.1111/jvim.16019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 12/08/2020] [Accepted: 12/14/2020] [Indexed: 12/23/2022] Open
Abstract
Background Spexin (SPX) is a peptide hormone that regulates body weight, adipose tissue metabolism, and food intake. Hypothesis Serum SPX concentration correlates with body condition score (BCS) and markers of obesity in dogs. Animals Fifty‐seven dogs of varying body condition assessed using a 5‐point BCS. Methods Prospective, nonblinded, observational cohort study. Serum SPX concentration was measured using commercially available radioimmunoassay (RIA) in dogs with varying BCS. Spexin mRNA and protein expression were detected using real‐time quantitative polymerase chain reaction and immunofluorescence staining. Results Serum SPX concentration was lower in dogs with BCS4 (8.56 +/‐ 2.86) and BCS5 (6.7 +/‐ 2.12) compared to BCS2 (11.96 +/‐ 2.23) and BCS3 (10.51 +/‐ 2.19; BCS2 vs BCS5, P < .001 and BCS2 vs BCS4, P = .005; BCS3 vs BCS5, P = .002). Spexin mRNA was detected in adipose tissue, liver and pancreas. Spexin protein was expressed in adipose tissue and liver but not in pancreas. There were negative correlations between SPX and serum concentration of insulin (P < .05); leptin (P < .01), triglycerides (P < .01), total cholesterol (P < .01), nonesterified fatty acids (P < .01), and fructosamine (P < .01). There was a positive correlation between SPX and serum concentration of adiponectin (P < .01). Conclusions and Clinical Importance Spexin could be involved in pathogenesis of obesity in dogs, and might be considered as a potential marker for obesity.
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Affiliation(s)
- Pawel Antoni Kolodziejski
- Department of Animal Physiology, Biochemistry and Biostructure Faculty of Veterinary Medicine and Animal Science, Poznan University of Life Sciences, Poznan, Poland
| | - Ewa Pruszynska-Oszmalek
- Department of Animal Physiology, Biochemistry and Biostructure Faculty of Veterinary Medicine and Animal Science, Poznan University of Life Sciences, Poznan, Poland
| | - Tomasz Nowak
- Department of Genetics and Animal Breeding, Animal Reproduction Unit, Faculty of Veterinary Medicine and Animal Science, Poznan University of Life Sciences, Poznan, Poland
| | - Anna Lukomska
- Department of Preclinical Sciences and Infectious Diseases, Faculty of Veterinary Medicine and Animal Sciences, Poznan University of Life Sciences, Poznan, Poland
| | - Maciej Sassek
- Department of Animal Physiology, Biochemistry and Biostructure Faculty of Veterinary Medicine and Animal Science, Poznan University of Life Sciences, Poznan, Poland
| | - Jan Wlodarek
- Department of Preclinical Sciences and Infectious Diseases, Faculty of Veterinary Medicine and Animal Sciences, Poznan University of Life Sciences, Poznan, Poland
| | - Leszek Nogowski
- Department of Animal Physiology, Biochemistry and Biostructure Faculty of Veterinary Medicine and Animal Science, Poznan University of Life Sciences, Poznan, Poland
| | - Adam Cieslak
- Department of Animal Nutrition, Poznan University of Life Sciences, Poznan, Poland
| | - Krzysztof W Nowak
- Department of Animal Physiology, Biochemistry and Biostructure Faculty of Veterinary Medicine and Animal Science, Poznan University of Life Sciences, Poznan, Poland
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Silva DD, Cecci GRM, Biz G, Chiaro FN, Zanutto MS. Evaluation of a flash glucose monitoring system in dogs with diabetic ketoacidosis. Domest Anim Endocrinol 2021; 74:106525. [PMID: 32799040 DOI: 10.1016/j.domaniend.2020.106525] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 07/10/2020] [Accepted: 07/12/2020] [Indexed: 11/29/2022]
Abstract
The flash glucose monitoring system (FGMS) Freestyle Libre provides estimates of blood glucose by constantly measuring the glucose concentration of the interstitial fluid through a sensor inserted in the subcutaneous space. The aim of this study was to evaluate the applicability and accuracy of the FGMS in dogs with diabetic ketoacidosis (DKA). Seven dogs with DKA examined at the Veterinary Hospital of the State University of Londrina were included in this study. The sensor was placed on the dorsal cervical region, shortly after the diagnosis of DKA was confirmed and maintained for 5 d. The measurement of blood glucose was performed simultaneously with the veterinary portable blood glucose meter (PBGM) AlphaTRAK 2 every 2 to 4 h and with the hexokinase method every 12 h. The PBGM's precision was evaluated following the ISO15197:2013 criteria. Blood glucose estimates were strongly associated (r = 0.89; P < 0.0001), and the mean absolute relative difference in relation to the PBGM was 25.2% (-70.4% to 101.9%). The evaluation of these data using the consensus error grid analysis showed that 95.4% and 94.8% of the samples were in Zones A and B (clinically acceptable) using the PBGM and the hexokinase method as a reference, respectively. The ISO15197:2013 criteria were not met. There was no difference in the accuracy of the device among days (P = 0.74); however, there was a difference between the hydration status (P = 0.019) and blood glucose ranges (hypoglycemic, euglycemic, and hyperglycemic; P < 0.0001), in which it was less precise in measuring the blood glucose range in hypoglycemic dogs. Therefore, it can be concluded that in spite of the fact that the device did not meet the ISO 15197:2013 criteria, the FGMS evaluated presents good clinical precision and can be a valuable tool in treating dogs with diabetic DKA.
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Affiliation(s)
- D D Silva
- Department of Veterinary Clinics, State University of Londrina, Paraná, Brazil.
| | - G R M Cecci
- Department of Veterinary Clinics, State University of Londrina, Paraná, Brazil
| | - G Biz
- Department of Statistics, State University of Londrina, Paraná, Brazil
| | - F N Chiaro
- Department of Veterinary Clinics, State University of Londrina, Paraná, Brazil
| | - M S Zanutto
- Department of Veterinary Clinics, State University of Londrina, Paraná, Brazil
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The Serum and Saliva Proteome of Dogs with Diabetes Mellitus. Animals (Basel) 2020; 10:ani10122261. [PMID: 33271797 PMCID: PMC7760505 DOI: 10.3390/ani10122261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 01/11/2023] Open
Abstract
This study aims to evaluate the changes in salivary and serum proteomes that occur in canine diabetes mellitus type-1 (DM) through a high-throughput quantitative proteomic analysis. The proteomes of 10 paired serum and saliva samples from healthy controls (HC group, n = 5) and dogs with untreated DM (DM group, n = 5) were analyzed using Tandem Mass Tags (TMT)-based proteomic approach. Additionally, 24 serum samples from healthy controls and untreated DM were used to validate haptoglobin in serum. The TMT analysis quantified 767 and 389 proteins in saliva and serum, respectively. Of those, 16 unique proteins in serum and 26 in saliva were differently represented between DM and HC groups. The verification of haptoglobin in serum was in concordance with the proteomic data. Our results pointed out changes in both saliva and serum proteomes that reflect different physiopathological changes in dogs with DM. Although some of the proteins identified here, such as malate dehydrogenase or glyceraldehyde-3-phosphate dehydrogenase, were previously related with DM in dogs, most of the proteins modulated in serum and saliva are described in canine DM for the first time and could be a source of potential biomarkers of the disease. Additionally, the molecular function, biological process, pathways and protein class of the differential proteins were revealed, which could improve the understanding of the disease's pathological mechanisms.
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9
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Azevedo CN, Lidbury JA, Jeffery U. Effects of marked hypertriglyceridemia and lipid clearance techniques on canine biochemistry testing. J Vet Diagn Invest 2019; 31:546-553. [PMID: 31238801 DOI: 10.1177/1040638719858690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Triglyceride concentrations in dogs with hyperlipidemic disorders can exceed concentrations used by assay manufacturers for interference testing. High-speed centrifugation or the polar solvent LipoClear reduce triglyceride concentrations, but efficacy requires evaluation in veterinary species. We determined the effect of marked hypertriglyceridemia on canine biochemistry testing; assessed the ability of high-speed centrifugation or LipoClear to correct lipemic interferences; and determined if LipoClear introduces inaccuracy into biochemistry assays. Fifteen pooled canine serum samples were aliquoted and spiked with equal volumes of water or Intralipid [triglyceride concentration 33.9 mmol/L (3,000 mg/dL)]. Intralipid aliquots underwent lipid removal by high-speed centrifugation or LipoClear treatment, and a water-spiked aliquot underwent LipoClear treatment. Biochemistry panels were performed using a Vitros 4600 chemistry analyzer. Results were compared by paired t-test or Wilcoxon test. Total observed errors were considered clinically acceptable if below veterinary allowable total error (TEa) guidelines. Statistically significant (p ≤ 0.05) interferences were introduced by Intralipid for 15 of 15 analytes. Median observed error exceeded TEa for potassium and enzymatic carbon dioxide, neither of which were identified by the manufacturer as susceptible to lipemic interference. After centrifugation, median observed error exceeded TEa for potassium and chloride. LipoClear treatment resulted in median errors that exceeded TEa for total protein, chloride, and phosphorus. Given that severe lipemia can occur in dogs with primary or secondary hyperlipidemia, veterinary laboratories should perform their own interference testing at triglyceride concentrations relevant to their patient population and provide this information to clinicians to ensure optimal case management.
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Affiliation(s)
- Carolina N Azevedo
- Department of Veterinary Pathobiology (Azevedo, Jeffery), College of Veterinary Medicine, Texas A&M University, College Station, TX.,Department of Small Animal Clinical Sciences (Lidbury), College of Veterinary Medicine, Texas A&M University, College Station, TX
| | - Jonathan A Lidbury
- Department of Veterinary Pathobiology (Azevedo, Jeffery), College of Veterinary Medicine, Texas A&M University, College Station, TX.,Department of Small Animal Clinical Sciences (Lidbury), College of Veterinary Medicine, Texas A&M University, College Station, TX
| | - Unity Jeffery
- Department of Veterinary Pathobiology (Azevedo, Jeffery), College of Veterinary Medicine, Texas A&M University, College Station, TX.,Department of Small Animal Clinical Sciences (Lidbury), College of Veterinary Medicine, Texas A&M University, College Station, TX
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Rosenstein PG, Tennent-Brown BS, Hughes D. Clinical use of plasma lactate concentration. Part 1: Physiology, pathophysiology, and measurement. J Vet Emerg Crit Care (San Antonio) 2018. [PMID: 29533512 DOI: 10.1111/vec.12708] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To review the current literature with respect to the physiology, pathophysiology, and measurement of lactate. DATA SOURCES Data were sourced from veterinary and human clinical trials, retrospective studies, experimental studies, and review articles. Articles were retrieved without date restrictions and were sourced primarily via PubMed, Scopus, and CAB Abstracts as well as by manual selection. HUMAN AND VETERINARY DATA SYNTHESIS Lactate is an important energy storage molecule, the production of which preserves cellular energy production and mitigates the acidosis from ATP hydrolysis. Although the most common cause of hyperlactatemia is inadequate tissue oxygen delivery, hyperlactatemia can, and does occur in the face of apparently adequate oxygen supply. At a cellular level, the pathogenesis of hyperlactatemia varies widely depending on the underlying cause. Microcirculatory dysfunction, mitochondrial dysfunction, and epinephrine-mediated stimulation of Na+ -K+ -ATPase pumps are likely important contributors to hyperlactatemia in critically ill patients. Ultimately, hyperlactatemia is a marker of altered cellular bioenergetics. CONCLUSION The etiology of hyperlactatemia is complex and multifactorial. Understanding the relevant pathophysiology is helpful when characterizing hyperlactatemia in clinical patients.
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Affiliation(s)
- Patricia G Rosenstein
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
| | - Brett S Tennent-Brown
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
| | - Dez Hughes
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
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Zager E, Fletcher DJ, Goggs R. Evaluation of the association between strong ion acid-base disturbances and mortality in dogs: a retrospective study. Vet Med Sci 2018; 4:206-217. [PMID: 29635886 PMCID: PMC6090410 DOI: 10.1002/vms3.101] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Acid-base abnormalities are frequently encountered in veterinary emergency and critical care, but information regarding the prognostic value of these findings is limited. Several systems for analysing acid-base disturbances have been reported, but the prognostic abilities of these systems have not been compared in dogs. The objectives of this retrospective study were to determine if the commonly used acid-base interpretation methods (Henderson-Hasselbalch, Stewart and semi-quantitative) have prognostic value, and to compare the performance of the three methods. Electronic medical records were searched to create a database containing point-of-care blood-gas, electrolyte and serum chemistry values for 1024 dogs assessed at a university teaching hospital. Dogs with contemporaneous blood-gas analysis, blood lactate and serum biochemistry samples were eligible for study, and only the first recorded analyses for each patient visit were included. Components of the Henderson-Hasselbalch, Stewart and semi-quantitative methods were calculated. To assess prognostic ability and to compare analysis system performance, receiver-operating characteristic (ROC) curves for survival to hospital discharge were created. Of the 1024 dogs identified, case fatality rate was 23.8%. Area under the ROC curve did not exceed 0.63 for any calculated variable. Performance of all three analysis systems was similar. While some acid-base abnormalities identified were associated with mortality, no individual abnormality or system output yielded sensitive and specific cut-off values for mortality prediction, and no interpretation method outperformed the others. This study suggests that initial acid-base abnormalities have limited prognostic utility and that various analysis systems can be used to assess acid-base disturbances in critically ill dogs.
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Affiliation(s)
- Erik Zager
- Department of Clinical SciencesCornell University College of Veterinary MedicineIthacaNew YorkUSA
| | - Daniel J. Fletcher
- Department of Clinical SciencesCornell University College of Veterinary MedicineIthacaNew YorkUSA
| | - Robert Goggs
- Department of Clinical SciencesCornell University College of Veterinary MedicineIthacaNew YorkUSA
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12
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Guo C, Wang Q, Yang L, Wang H, Wang D, Tang X. Selective naked eye and turn-on fluorescence for detection of D-3-HB based on an erbium complex. J Photochem Photobiol A Chem 2018. [DOI: 10.1016/j.jphotochem.2017.07.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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O'Kell AL, Garrett TJ, Wasserfall C, Atkinson MA. Untargeted metabolomic analysis in naturally occurring canine diabetes mellitus identifies similarities to human Type 1 Diabetes. Sci Rep 2017; 7:9467. [PMID: 28842637 PMCID: PMC5573354 DOI: 10.1038/s41598-017-09908-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/31/2017] [Indexed: 12/13/2022] Open
Abstract
While predominant as a disease entity, knowledge voids exist regarding the pathogenesis of canine diabetes. To test the hypothesis that diabetic dogs have similar metabolomic perturbations to humans with type 1 diabetes (T1D), we analyzed serum metabolomic profiles of breed- and body weight-matched, diabetic (n = 6) and healthy (n = 6) dogs by liquid chromatography-mass spectrometry (LC-MS) profiling. We report distinct clustering of diabetic and control groups based on heat map analysis of known and unknown metabolites. Random forest classification identified 5/6 dogs per group correctly with overall out of bag error rate = 16.7%. Diabetic dogs demonstrated significant upregulation of glycolysis/gluconeogenesis intermediates (e.g., glucose/fructose, C6H12O6, keto-hexose, deoxy-hexose, (P < 0.01)), with significant downregulation of tryptophan metabolism metabolites (e.g., picolinic acid, indoxyl sulfate, anthranilate, (P < 0.01)). Multiple amino acids (AA), AA metabolites, and bile acids were also significantly lower in diabetic versus healthy dogs (P < 0.05) with the exception of the branched chain AA valine, which was elevated in diabetic animals (P < 0.05). Metabolomic profiles in diabetic versus healthy dogs shared similarities with those reported in human T1D (e.g., alterations in glycolysis/gluconeogensis metabolites, bile acids, and elevated branched chain AA). Further studies are warranted to evaluate the utility of canine diabetes to provide novel mechanistic insights to the human disorder.
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Affiliation(s)
- Allison L O'Kell
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, The University of Florida, Gainesville, Florida, USA
| | - Timothy J Garrett
- Department of Pathology, Immunology, and Laboratory Medicine, The University of Florida, Gainesville, Florida, USA
| | - Clive Wasserfall
- Department of Pathology, Immunology, and Laboratory Medicine, The University of Florida, Gainesville, Florida, USA
| | - Mark A Atkinson
- Department of Pathology, Immunology, and Laboratory Medicine, The University of Florida, Gainesville, Florida, USA.
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14
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Gillespie Í, Rosenstein PG, Hughes D. Update: Clinical Use of Plasma Lactate. Vet Clin North Am Small Anim Pract 2016; 47:325-342. [PMID: 27914760 DOI: 10.1016/j.cvsm.2016.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Lactate is an essential, versatile metabolic fuel in cellular bioenergetics. In human emergency and critical care, lactate is used as a biomarker and therapeutic endpoint and evidence is growing in veterinary medicine supporting its clinical utility. Lactate production is a protective response providing ongoing cellular energy during tissue hypoperfusion or hypoxia and mitigating acidosis. Hence, hyperlactatemia is closely associated with disease severity but it is an epiphenomenon as the body attempts to protect itself. This article reviews lactate biochemistry, kinetics, pathophysiology, some practical aspects of measuring lactate, as well as its use in diagnosis, prognosis, and monitoring.
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Affiliation(s)
- Íde Gillespie
- Emergency and Critical Care Service, UVet Werribee Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Melbourne, Victoria 3030, Australia
| | - Patricia G Rosenstein
- Emergency and Critical Care Service, UVet Werribee Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Melbourne, Victoria 3030, Australia
| | - Dez Hughes
- Emergency and Critical Care Service, UVet Werribee Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Melbourne, Victoria 3030, Australia.
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15
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Zeugswetter FK, Pagitz M, Friedrich MS. Hypochloremia in cats - prevalence and associated diseases. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2016; 44:237-44. [PMID: 27074163 DOI: 10.15654/tpk-150647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 01/07/2016] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To describe the prevalence and possible causes of hypochloremia in the local hospital cat population. MATERIAL AND METHODS Retrospective study consisting of two parts. Data were collected from the local electronic medical records database using the search terms "chloride" and "cats" (part A), and "blood gas analysis" and "cats" (part B). The medical records of the hypochloremic cats were then reviewed to determine prior treatment or infusions and to identify major underlying disease processes. Part A included an age and gender matched non-hypochloremic control group, whereas in part B acid-base status was assessed. RESULTS Hypochloremia was detected in 367 (27%) of 1363 blood samples. The application of a correction formula to adjust for free water changes decreased the number of hypochloremic cats to 253 (19%). Only a minority had received glucocorticoids or loop diuretics and the prevalence of vomiting was 44%. Common associated disorders were gastrointestinal and respiratory diseases, as well as azotemia and diabetes mellitus. Polyuria/polydipsia, dehydration, prednisolone or furosemide pretreatment, azotemia and diabetes mellitus increased, whereas fluid therapy and the diagnosis of neoplasia decreased the prevalence of hypochloremia. An inverse correlation was found between corrected chloride and standardized base excess (rs = -0.597, p = 0.001) as well as anion gap (rs = -0.4, p = 0.026). 99% of the hypochloremic cats had derangements of acid-base balance. CONCLUSION Hypochloremia is a common electrolyte disorder in the local cat population. The correction formula is necessary to adjust for changes in plasma osmolality. Although associated with metabolic alkalosis, most of the hypochloremic cats have a normal or decreased pH. The inverse correlation of chloride and anion gap als well as the high proportion of azotemic or diabetic animals support the concept of compensatory acidosis induced hypochloremia. CLINICAL RELEVANCE Hypochloremia should prompt the clinician to performe blood-gas analysis. Diabetes mellitus (especially ketoacidosis) and renal disease should be included in current algorithms for the evaluation of hypochloremic patients.
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Affiliation(s)
- Florian K Zeugswetter
- Florian K. Zeugswetter, University of Veterinary Medicine Vienna, University Clinic for Small Animals, Internal Medicine, Veterinärplatz 1, 1210 Vienna, Austria,
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16
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Gorman L, Sharkey LC, Armstrong PJ, Little K, Rendahl A. Serum Beta Hydroxybutyrate Concentrations in Cats with Chronic Kidney Disease, Hyperthyroidism, or Hepatic Lipidosis. J Vet Intern Med 2016; 30:611-6. [PMID: 26773702 PMCID: PMC4913593 DOI: 10.1111/jvim.13826] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 10/30/2015] [Accepted: 12/14/2015] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Ketones, including beta hydroxybutyrate (BHB), are produced in conditions of negative energy balance and decreased glucose utilization. Serum BHB concentrations in cats are poorly characterized in diseases other than diabetes mellitus. HYPOTHESIS Serum BHB concentrations will be increased in cats with chronic kidney disease (CKD), hyperthyroidism (HT), or hepatic lipidosis (HL). ANIMALS Twenty-eight client-owned cats with CKD, 34 cats with HT, and 15 cats with HL; 43 healthy cats. METHODS Prospective observational study. Serum BHB concentrations were measured at admission in cats with CKD, HT, and HL, for comparison with a reference interval established using healthy cats. Results of dipstick urine ketone measurement, when available, were compared to BHB measurement. RESULTS Beta hydroxybutyrate was above the reference interval (<0.11 mmol/L) in 6/28 cats (21%) with CKD, 7/34 cats (20%) with HT, and 11/15 cats (73%) with HL, significantly exceeding the expected 2.5% above the reference interval for healthy cats (P < .001 for all groups). Elevations were mild in CKD and HT groups (median BHB 0.1 mmol/L for both groups, 80th percentile 0.12 and 0.11 mmol/L, respectively), but more marked in HL cats (median BHB 0.2 mmol/L, 80th percentile 0.84 mmol/L). None of 11 cats with increased serum BHB concentration having urine dipstick analysis performed within 24 h of sampling for BHB were ketonuric. CONCLUSIONS AND CLINICAL IMPORTANCE Increases in serum BHB concentrations occur in cats with CKD, HT, and HL, and might provide an useful index of catabolism.
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Affiliation(s)
- L Gorman
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - L C Sharkey
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - P J Armstrong
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - K Little
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - A Rendahl
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
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17
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Walsh ES, Drobatz KJ, Hess RS. Use of intravenous insulin aspart for treatment of naturally occurring diabetic ketoacidosis in dogs. J Vet Emerg Crit Care (San Antonio) 2015; 26:101-7. [PMID: 26379102 DOI: 10.1111/vec.12375] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 04/09/2014] [Accepted: 07/28/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To characterize the utility and safety of IV insulin aspart in the treatment of diabetes ketoacidosis (DKA) in dogs and to determine the times to resolution of hyperglycemia, ketonemia, and acidemia in dogs treated with IV insulin aspart. DESIGN Prospective noncontrolled single arm study of dogs with DKA between February 2010 and March 2011. SETTING University teaching hospital. ANIMALS Six dogs with spontaneous DKA and blood glucose (BG) concentration >13.8 mmol/L (250 mg/dL), pH between 7.0 and 7.35, and blood beta-hydroxybutyrate >2.0 mmol/L were treated with an IV continuous rate infusion (CRI) of aspart insulin. The time to biochemical resolution of DKA was defined as the time interval from when the IV CRI of aspart insulin began until marked hyperglycemia (BG concentration >13.8 mmol/L [250 mg/dL]), acidemia (venous pH <7.35), and ketonemia (beta-hydroxybutyrate concentration >2.0 mmol/L) resolved. Aspart insulin was administered as an IV CRI at an initial dose of 0.09 U/kg/h. The dose was adjusted according to a previously published protocol. MEASUREMENTS AND MAIN RESULTS The median time to biochemical resolution of DKA in dogs treated with insulin aspart was 28 hours (range, 20-116 h). Mean BG concentration decreased significantly from the time IV fluid resuscitation began (32.0 mmol/L [576 mg/dL]; range, 14.9-38.9 mmol/L [268-700 mg/dL]) until 6 hours later when IV aspart insulin CRI began (20.1 mmol/L [363 mg/dL]; range, 9.4-26.1 mmol/L [169-470 mg/dL], P = 0.03). No adverse effects were observed in association with IV insulin aspart administration. Median cost of hospitalization was US$3,477 (range, US$1,483-10,469). Median total units per kilogram of administered IV insulin aspart was 2.97 U/kg (range, 2.04-10.52 U/kg). CONCLUSIONS Intravenous CRI of insulin aspart is a safe and effective treatment for DKA in dogs. IV fluid resuscitation is recommended prior to insulin administration.
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Affiliation(s)
- Eric S Walsh
- Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, PA, 19104
| | - Kenneth J Drobatz
- Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, PA, 19104
| | - Rebecka S Hess
- Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, PA, 19104
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18
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Wagner J, Rieker T, Siegling-Vlitakis C. [Blood gas analysis in dogs in veterinary practice. A review]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2015; 43:260-273. [PMID: 26235495 DOI: 10.15654/tpk-141021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 06/17/2015] [Indexed: 06/04/2023]
Abstract
Blood gas analysis is useful to obtain information about acid-base state and gas exchange of the lung. Interpretation is based on the Henderson-Hasselbalch equation. This approach has its limitations especially in interpretation of complex disturbances of acid-base status and has been complemented by base excess and anion gap. Peter Stewart described a model of quantitative approach to the acid-base disturbances which has been further developed and is known as the strong ion approach. This model differs from the traditional approach in the assessment of metabolic disorders of acid base status. Both models complement each other but also have their advantages and disadvantages. For simple disorders of the acid-base state the Henderson-Hasselbalch approach can be used, however in complex disturbances of acid-base balance, especially with abnormalities of serum albumin and phosphate concentrations, the strong ion approach is recommended. With the understanding of both models and of the clinical presentation of blood gas abnormalities, optimal case management and therapy can be provided.
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Affiliation(s)
- J Wagner
- Dr. med. vet. Judith Wagner, Kleintierklinik am Hochberg, Zuppingerstraße 10/1, 88213 Ravensburg, E-Mail:
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Kumar P, Kumari RR, Kumar M, Kumar S, Chakrabarti A. Current practices and research updates on diabetes mellitus in canine. Vet World 2014. [DOI: 10.14202/vetworld.2014.952-959] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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20
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Hopper K, Epstein SE, Kass PH, Mellema MS. Evaluation of acid-base disorders in dogs and cats presenting to an emergency room. Part 2: Comparison of anion gap, strong ion gap, and semiquantitative analysis. J Vet Emerg Crit Care (San Antonio) 2014; 24:502-8. [DOI: 10.1111/vec.12214] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 07/04/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Kate Hopper
- Departments of Veterinary Surgical and Radiological Sciences; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
| | - Steven E. Epstein
- Departments of Veterinary Surgical and Radiological Sciences; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
| | - Philip H. Kass
- Population, Health and Reproduction; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
| | - Matthew S. Mellema
- Departments of Veterinary Surgical and Radiological Sciences; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
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21
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Bresciani F, Pietra M, Corradini S, Giunti M, Fracassi F. Accuracy of capillary blood 3-β-hydroxybutyrate determination for the detection and treatment of canine diabetic ketoacidosis. J Vet Sci 2014; 15:309-16. [PMID: 24675829 PMCID: PMC4087234 DOI: 10.4142/jvs.2014.15.2.309] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 02/21/2014] [Indexed: 11/20/2022] Open
Abstract
In human medicine, diagnosis of diabetic ketoacidosis (DKA) is usually based on measurement of capillary 3-β-hydroxybutyrate (3-HB) with a hand held ketone sensor. This study was conducted to determine if measurement of capillary 3-HB could be useful for the diagnosis and monitoring of canine DKA. Fifteen dogs with diabetic ketosis and 10 with DKA were evaluated. Paired measurements of 3-HB of capillary and venous blood samples were analysed by the electrochemical sensor and reference method. Use of capillary 3-HB measurement during DKA management was then evaluated through simultaneous measurements of capillary 3-HB, urinary AcAc and venous blood gas analysis. Good agreement between capillary and venous 3-HB measurement was detected by the electrochemical sensor and reference method. Monitoring treatment of DKA revealed a significant correlation between capillary 3-HB and acidosis markers, while no significant correlation was observed between AcAc and acidosis markers. A cut-off value of capillary blood 3-HB >3.8 mmol/L for diagnosis of DKA resulted in 70% and 92% sensitivity and specificity. The electrochemical sensor accurately measures 3-HB concentration in both capillary and venous blood samples, is accurate in diagnosing canine DKA, and appears to reflect the patient's metabolic status during DKA treatment.
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Affiliation(s)
- Francesca Bresciani
- Department of Veterinary Medical Sciences, University of Bologna, 40126 Bologna, Italy
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22
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O’Neill S, Drobatz K, Satyaraj E, Hess R. Evaluation of cytokines and hormones in dogs before and after treatment of diabetic ketoacidosis and in uncomplicated diabetes mellitus. Vet Immunol Immunopathol 2012; 148:276-83. [DOI: 10.1016/j.vetimm.2012.06.027] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 06/14/2012] [Accepted: 06/30/2012] [Indexed: 11/28/2022]
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Weingart C, Lotz F, Kohn B. Validation of a portable hand-held whole-blood ketone meter for use in cats. Vet Clin Pathol 2012; 41:114-8. [PMID: 22250845 DOI: 10.1111/j.1939-165x.2011.00389.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Urinary dipsticks are the most frequent method used for screening of ketones in animals, but this method has many drawbacks. In human medicine, portable meters that measure ketones in whole blood have largely replaced urinary dipsticks. OBJECTIVE The aim of this prospective study was to validate a portable whole-blood ketone meter for use in cats. METHODS Sixty-two cats (11 clinically healthy, 51 with diabetes mellitus) were included in the study. The concentration of β-hydroxybuyrate (β-HB) was measured in venous and capillary blood with a hand-held ketone meter (Precision Xceed; assay range 0-8 mmol/L) and compared with a spectrophotometric method. Precision, accuracy, and the effects of hematocrit and anticoagulants were evaluated. RESULTS Between-run precision using low- and high-concentration control solutions was 8.1% and 2.6%, respectively; within-run coefficient of variation determined using 12 feline blood samples was 2.8%. In the 62 cats, β-HB concentrations measured with the portable ketone meter ranged from 0-7.4 mmol/L (median 0.9 mmol/L). When β-HB concentrations measured by the portable meter were < 4.0 mmol/L there was good agreement with the reference method, but concentrations > 4.0 mmol/L were lower than those obtained by the reference method in 20 of 24 cats (83%). There was good correlation between capillary and venous measurements. Results were not affected by hematocrits from 0.17 to 0.50 L/L, but EDTA was not a suitable anticoagulant. CONCLUSION Measurement of β-HB concentration in peripheral or capillary blood by an easy-to-use portable ketone meter was suitable for detecting ketonemia in cats. Underestimation of β-HB concentration was observed at higher values, but results were sufficiently high to aid in diagnosing diabetic ketoacidosis.
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Affiliation(s)
- Christiane Weingart
- Small Animal Clinic, Faculty of Veterinary Medicine, Freie Universität Berlin, Oertzenweg 19b, 14163 Berlin, Germany
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Weingart C, Lotz F, Kohn B. Measurement of β-hydroxybutyrate in cats with nonketotic diabetes mellitus, diabetic ketosis, and diabetic ketoacidosis. J Vet Diagn Invest 2011; 24:295-300. [DOI: 10.1177/1040638711428332] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus (DM). The standard method of detection of ketone bodies is the dipstick method, which detects semiquantitatively acetoacetate, but not β-hydroxybutyrate (β-HB). The objectives of the current study were to assess the diagnostic utility of β-HB to diagnose diabetic ketosis (DK) and DKA in cats and to establish a cut-off value for the diagnosis of DKA. Sixty-two cats were included in the study. Eleven cats were healthy (group 1); in the remainder of cats (51), a diagnosis of DM was based on hyperglycemia, glucosuria, and increased fructosamine concentrations. Nineteen of 51 cats suffered from nonketotic diabetes mellitus (group 2). In 11 cats, plasma ketone bodies were detected with the dipstick method (diabetic ketosis, group 3). In 21 cats, plasma ketone bodies and metabolic acidosis were present (DKA, group 4). Plasma β-HB was measured in all cats by an enzymatic method (spectrophotometry). A cut-off value for the diagnosis of DKA was calculated based on the receiver operating characteristic curve. In healthy cats, the β-HB concentration ranged from 0 to 0.1 mmol/l; in cats of group 2, from 0 to 0.9 mmol/l (median: 0.1 mmol/l); in cats of group 3, from 0.6 to 6.8 mmol/l (median: 1.7 mmol/l); and in cats of group 4, from 3.8 to 12.2 mmol/l (median: 7.9 mmol/l). A cut-off value of 2.4 mmol/l revealed 100% sensitivity and 87% specificity to diagnose DKA. Beta-hydroxybutyrate is a useful parameter for the diagnosis of diabetic ketosis and DKA in cats.
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Affiliation(s)
- Christiane Weingart
- Clinic of Small Animals (Weingart, Kohn), Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Institute for Biometrics and Data Processing (Lotz), Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Fabian Lotz
- Clinic of Small Animals (Weingart, Kohn), Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Institute for Biometrics and Data Processing (Lotz), Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Barbara Kohn
- Clinic of Small Animals (Weingart, Kohn), Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Institute for Biometrics and Data Processing (Lotz), Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
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25
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Tvarijonaviciute A, Ceron JJ, Caldin M. Serum butyrylcholinesterase activity in dogs with diabetes mellitus. Vet J 2011; 192:494-7. [PMID: 21820337 DOI: 10.1016/j.tvjl.2011.06.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 06/20/2011] [Accepted: 06/23/2011] [Indexed: 10/17/2022]
Abstract
Increased serum butyrylcholinesterase (BChE) activity is a feature of diabetes mellitus (DM) in humans and rats. The objective of this study was to evaluate serum BChE activity in diabetic dogs. The activity of the enzyme was assessed in three cohorts of animals: (1) dogs with naturally occurring DM (n=74); (2) clinically normal dogs (n=74); and (3) dogs with various other diseases (n=74). A statistically significant increase in BChE activity was found in the diabetic dogs (7.59 ± 2.9 kUI/L) compared with the clinically normal animals (6.12 ± 1.94 kUI/L; P<0.05), and with the dogs with other diseases (5.55 ± 2.06 kUI/L; P<0.01). Such increased activity could be the result of the altered glucose and lipid metabolism that occurs in DM.
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Affiliation(s)
- A Tvarijonaviciute
- Department of Animal Medicine and Surgery, Veterinary School, University of Murcia, 30100 Murcia, Spain
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Abstract
Diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome are two serious and potentially life-threatening complications of diabetes mellitus. Understanding pathophysiology is crucial to the proper management of veterinary patients with these disorders. This article reviews the biochemical alterations contributing to these conditions, and discusses traditional and controversial management strategies.
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Affiliation(s)
- Mauria A O'Brien
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, 1008 West Hazelwood Drive, Urbana, IL 61802, USA.
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Di Tommaso M, Aste G, Rocconi F, Guglielmini C, Boari A. Evaluation of a portable meter to measure ketonemia and comparison with ketonuria for the diagnosis of canine diabetic ketoacidosis. J Vet Intern Med 2009; 23:466-71. [PMID: 19645834 DOI: 10.1111/j.1939-1676.2009.0302.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The diagnosis of canine diabetic ketoacidosis (DKA) usually is based on measurement of urinary acetoacetate (ketonuria). In humans, this test is less sensitive and specific than blood 3-beta-hydroxybutyrate (ketonemia) evaluation. HYPOTHESIS Ketonemia measurement using a portable meter is more accurate than ketonuria determination with a dipstick to diagnose canine DKA. ANIMALS Seventy-two client-owned diabetic dogs with ketonemia, ketonuria, or both. METHODS Prospective observational study. Based on blood bicarbonate concentration and anion gap, dogs were divided into 2 groups: patients with DKA (n= 25); patients with diabetic ketosis (n= 47). Sensitivity, specificity, and positive and negative likelihood ratio (LR) at different cut-off points were determined for both ketonemia and ketonuria. Receiver operating characteristic (ROC) analysis was used to assess the accuracy of each diagnostic test to diagnose DKA. RESULTS With regard to ketonemia, cut-off values of 2.3 and 4.3 mmol/L revealed 100% sensitivity and 100% specificity, respectively, whereas cut-off values of 2.8 and 3.5 mmol/L showed a -LR of 0.05 and a + LR of 13.16, respectively. With regard to ketonuria, a cut-off value of 1+ revealed 92% sensitivity, 40% specificity, and -LR of 0.20, whereas a cut-off value of 3+ revealed 44% sensitivity, 94% specificity, and +LR of 6.89. The areas under the ROC curves for the ketonemia and ketonuria tests were significantly different (0.97 and 0.81, respectively, P= .003). CONCLUSIONS AND CLINICAL IMPORTANCE Measurement of ketonemia is accurate and more effective than measurement of ketonuria to diagnose canine DKA.
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Affiliation(s)
- M Di Tommaso
- Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
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29
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Kang JH, Na KJ, Mo IP, Chang D, Yang MP. Juvenile diabetes mellitus accompanied by exocrine pancreatic insufficiency in a dog. J Vet Med Sci 2009; 70:1337-40. [PMID: 19122401 DOI: 10.1292/jvms.70.1337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 6-month-old male crossbred dog weighing 0.78 kg was presented with acute bilateral immature cataracts, intermittent diarrhea and growth retardation. The clinical manifestations and laboratory findings were suggestive of concurrent juvenile diabetes mellitus (DM) and exocrine pancreatic insufficiency (EPI). Moreover, the DM was associated with a decreased level of serum insulin-like growth factor I. Histological examination revealed a markedly lower number of pancreatic islets and acinar cells. This case shows that juvenile-onset DM can occur simultaneously with EPI and result in growth retardation, acute cataract formation and a high cortisol concentration.
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Affiliation(s)
- Ji-Houn Kang
- College of Veterinary Medicine, Chungbuk National University, Chungbuk, Republic of Korea
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30
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Johnson CA. Glucose homeostasis during canine pregnancy: Insulin resistance, ketosis, and hypoglycemia. Theriogenology 2008; 70:1418-23. [PMID: 18823654 DOI: 10.1016/j.theriogenology.2008.09.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2008] [Accepted: 08/25/2008] [Indexed: 12/27/2022]
Abstract
Through a variety of mechanisms, pregnancy causes insulin resistance, which suppresses the intracellular transport of glucose and increases blood glucose concentrations. In the extreme, gestational diabetes (GDM) mellitus may develop. In addition to insulin resistance, pregnant bitches have decreased ability to produce glucose via gluconeogenesis, glycogenolysis and lipolysis, because the normal multi-factorial responses to hypoglycemia are blunted late in pregnancy. Simply fasting late-pregnant bitches is sufficient to cause blood glucose and insulin concentrations to decrease and ketones to increase. The purpose of this paper is to review the clinical implications of pregnancy-associated changes in glucose homeostasis in bitches.
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Affiliation(s)
- C A Johnson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, E. Lansing, MI 48824-1314, USA.
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