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Melco A, Pritchard JC, Hetzel SJ, Saver A, Cavasin JP, Steiner JM. The effect of feeding on serum concentrations of cobalamin, folate, trypsin-like immunoreactivity, and pancreatic lipase immunoreactivity in dogs with signs of chronic gastrointestinal disease. J Vet Intern Med 2024; 38:1465-1474. [PMID: 38580455 PMCID: PMC11099692 DOI: 10.1111/jvim.17064] [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: 10/25/2023] [Accepted: 03/22/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND It is unknown if serum concentrations of cobalamin, folate, canine pancreatic lipase immunoreactivity (cPLI), and canine trypsin-like immunoreactivity (cTLI) obtained postprandially are equivalent to measurements obtained after withholding food in dogs with suspected gastrointestinal disease. HYPOTHESIS/OBJECTIVES Measurements of serum concentrations of cobalamin, folate, cPLI, and cTLI postprandially will be equivalent to measurements after 12 hours of withholding food in dogs with signs of chronic gastrointestinal disease. Changes observed will not alter clinical interpretation. ANIMALS 51 client-owned dogs with signs of gastrointestinal disease. METHODS Prospective single arm clinical trial. Serum concentrations of cobalamin, folate, cPLI and cTLI 2, 4, and 8 hours postprandially were compared by equivalence testing to values after withholding food for 12 hours (baseline). RESULTS Mean serum cobalamin concentrations 2 hours (498.1 ± 213.1 ng/L; P = 0.024) and 4 hours (501.9 ± 207.4 ng/L; P = 0.008) postprandial were equivalent to baseline (517.3 ± 211.5 ng/L). Mean serum cTLI 2 hours (31.3 ± 14 μg/L; P < 0.001) and 4 hours (29.6 ± 13.1 μg/L; P = 0.027) postprandial were equivalent to baseline (31.1 ± 15 μg/L). Mean serum folate concentration 2 hours postprandial (15 ± 7.7 μg/L) was equivalent to baseline (13.7 ± 8.3 μg/L; P < 0.001). Equivalence could not be assessed for cPLI due to results below the lower limit of quantification. Feeding altered the clinical interpretation in 27% (cobalamin), 35% (folate), 20% (cTLI), and 12% (cPLI) of dogs. CONCLUSIONS AND CLINICAL IMPORTANCE The clinical interpretation for a substantial number of samples changed after feeding, therefore withholding food before sample collection is prudent.
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Affiliation(s)
- Ashley Melco
- Department of Medical SciencesSchool of Veterinary Medicine, University of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Jessica C. Pritchard
- Department of Medical SciencesSchool of Veterinary Medicine, University of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Scott J. Hetzel
- Department of Biostatistics and Medical InformaticsSchool of Medicine and Public Health, University of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Alexander Saver
- Department of Medical SciencesSchool of Veterinary Medicine, University of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Joao Pedro Cavasin
- Gastrointestinal LaboratoryCollege of Veterinary Medicine and Biomedical Sciences, Texas A&M UniversityCollege StationTexasUSA
| | - Jörg M. Steiner
- Gastrointestinal LaboratoryCollege of Veterinary Medicine and Biomedical Sciences, Texas A&M UniversityCollege StationTexasUSA
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An Y, Kim S, Kwon D, Lee K, Yoon H. Computed tomographic measurements of pancreatic thickness in clinically normal dogs. Front Vet Sci 2023; 10:1254672. [PMID: 38026648 PMCID: PMC10652753 DOI: 10.3389/fvets.2023.1254672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Pancreatic thickness is an indicator for evaluating pancreatic diseases. The transverse and cross-sectional pancreatic thickness observed on computed tomography (CT) may differ. This study aimed to provide a normal reference range for pancreatic thickness on the transverse plane based on body weight (BW) and assess pancreatic thickness to aorta (P/Ao) ratio. In addition, we aimed to establish the normal short and long dimensions of the pancreas based on cross-sectional image through the long axis of the pancreas using multiplanar reconstruction (MPR). The short dimension to aorta (S/Ao) and long dimension to aorta (L/Ao) ratios were also established in clinically normal dogs. The pancreatic thickness was measured using CT results of 205 clinically normal dogs. The pancreatic thickness on the transverse plane and the short and long dimensions in the cross-sectional image of the pancreas were measured using MPR. The diameter of the Ao was measured on the transverse plane and the P/Ao, S/Ao, and L/Ao ratios were calculated. Our study showed that the mean normal pancreatic thicknesses (mean ± standard deviation [SD]) of the pancreatic body, left and right lobe in the transverse plane were 10.92 ± 2.54 mm, 8.92 ± 2.26 mm and 9.96 ± 2.24 mm, respectively. The P/Ao ratios of the pancreatic body, left and right lobes were 1.85 ± 0.33, 1.50 ± 0.27 and 1.68 ± 0.29, respectively. The mean short dimension (mean ± SD) in the cross-sectional image of the pancreatic body, left and right lobe were 8.98 ± 1.97 mm, 7.99 ± 1.89 mm and 8.76 ± 2.03 mm, respectively. In conclusion, pancreatic thickness increased with BW, while the P/Ao, S/Ao, and L/Ao ratios could be used regardless of BW.
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Affiliation(s)
- Yoojin An
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Jeollabuk-do, Republic of Korea
| | - Sungsoo Kim
- VIP Animal Medical Center, Seoul, Republic of Korea
| | - Danbee Kwon
- Bundang Leaders Animal Medical Center, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Kichang Lee
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Jeollabuk-do, Republic of Korea
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Jeollabuk-do, Republic of Korea
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Higuchi K, Yamada K, Kihara T, Makino K, Sasaki K, Shindo T, Shikama H, Sato H, Onoue S. Polylysine-Containing Hydrogel Formulation of Fuzapladib, Inhibitor of Leukocyte-Function Associated Antigen-1 (LFA-1) Activation, for Sustained Release. Molecules 2023; 28:5325. [PMID: 37513199 PMCID: PMC10383447 DOI: 10.3390/molecules28145325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/07/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
The aim of the present study was to develop an injectable hydrogel (HG) formulation of fuzapladib sodium (FZP), an animal drug for acute pancreatitis (AP), with the use of polyethyleneoxide (PEO) and polylysine (pLys), a cationic polymer. A mixture of pLys and FZP was added to PEO to prepare an HG formulation, and the formulation was optimized by release test and viscosity measurements. Circular dichroism (CD) and infrared absorption (IR) spectral analyses were applied to clarify the intermolecular interactions between FZP and pLys. The pharmacokinetic behavior of FZP was evaluated after a subcutaneous administration of FZP samples (2.0 mg-FZP/kg) to rats. Although the immediate release of FZP was observed for the HG formulation, the addition of pLys at a 20-fold amount of FZP or higher led to the sustained release of FZP. Considering release behavior, the concentration of pLys was optimized as 100-fold that of FZP in the HG formulation. CD and IR spectroscopic analyses of FZP and/or pLys demonstrated an intermolecular interaction between FZP and pLys, as evidenced by the slight spectral transition. After a subcutaneous administration of HG formulation containing pLys to rats, compared with FZP alone, significant differences were observed in the pharmacokinetic behavior with a decrease of Cmax from 2.3 to 0.9 mg/mL and slower elimination kinetics. HG formulation using pLys might be a viable dosage option for FZP for the treatment of AP in animals.
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Affiliation(s)
- Koji Higuchi
- Laboratory of Biopharmacy, School of Pharmaceutical Sciences, University of Shizuoka, 52-1, Yada, Suruga-ku, Shizuoka-shi 422-8526, Shizuoka, Japan
- Healthcare Business Headquarters, Ishihara Sangyo Kaisha, Ltd., 2-3-1, Nishishibukawa, Kusatsu-shi 525-0025, Shiga, Japan
| | - Kohei Yamada
- Laboratory of Biopharmacy, School of Pharmaceutical Sciences, University of Shizuoka, 52-1, Yada, Suruga-ku, Shizuoka-shi 422-8526, Shizuoka, Japan
| | - Tsubasa Kihara
- Laboratory of Biopharmacy, School of Pharmaceutical Sciences, University of Shizuoka, 52-1, Yada, Suruga-ku, Shizuoka-shi 422-8526, Shizuoka, Japan
| | - Keisuke Makino
- Laboratory of Biopharmacy, School of Pharmaceutical Sciences, University of Shizuoka, 52-1, Yada, Suruga-ku, Shizuoka-shi 422-8526, Shizuoka, Japan
| | - Kenta Sasaki
- Healthcare Business Headquarters, Ishihara Sangyo Kaisha, Ltd., 2-3-1, Nishishibukawa, Kusatsu-shi 525-0025, Shiga, Japan
| | - Takeshi Shindo
- Healthcare Business Headquarters, Ishihara Sangyo Kaisha, Ltd., 2-3-1, Nishishibukawa, Kusatsu-shi 525-0025, Shiga, Japan
| | - Hiroshi Shikama
- Healthcare Business Headquarters, Ishihara Sangyo Kaisha, Ltd., 2-3-1, Nishishibukawa, Kusatsu-shi 525-0025, Shiga, Japan
| | - Hideyuki Sato
- Laboratory of Biopharmacy, School of Pharmaceutical Sciences, University of Shizuoka, 52-1, Yada, Suruga-ku, Shizuoka-shi 422-8526, Shizuoka, Japan
| | - Satomi Onoue
- Laboratory of Biopharmacy, School of Pharmaceutical Sciences, University of Shizuoka, 52-1, Yada, Suruga-ku, Shizuoka-shi 422-8526, Shizuoka, Japan
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Edge-Hughes L, Kramer AL, Acciani R. Select Manual Assessment Techniques and Clinical Reasoning Skills Used in Canine Physical Rehabilitation Before Engaging in Manual Therapy Treatment. Vet Clin North Am Small Anim Pract 2023; 53:743-756. [PMID: 36997409 DOI: 10.1016/j.cvsm.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Manual therapy is a cornerstone of physical therapy and canine physical rehabilitation. Although veterinary literature has tackled the topic of manual therapy treatments in animal patients, less attention has been paid to the assessment techniques and clinical reasoning skills that guide a practitioner toward determining if, when, and where manual therapies will be most effective. This article tackles the topics of clinical reasoning, the functional diagnosis, observational skills, and physical evaluation techniques that serve as prerequisites to the use of manual therapeutics.
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Affiliation(s)
- Laurie Edge-Hughes
- The Canine Fitness Centre Ltd, 4515 Manhattan Road. Southeast, Calgary, AB T2G 4B3, Canada.
| | - Amy Lee Kramer
- Beach Animal Rehabilitation Center, 18837 Hawthorne Boulevard, Torrance, CA 90504, USA
| | - Ria Acciani
- Advanced Canine Rehabilitation Center, 166 Mountainview Road, Warren, NJ 07059, USA
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Cueni C, Hofer‐Inteeworn N, Kümmerle‐Fraune C, Müller C, Kook PH. Progression of lipase activity and pancreatic lipase immunoreactivity in dogs hospitalized for acute pancreatitis and correlation with clinical features. J Vet Intern Med 2022; 37:70-79. [PMID: 36468410 PMCID: PMC9889606 DOI: 10.1111/jvim.16591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Lipase activity and pancreatic lipase immunoreactivity (PLI) have not been compared in dogs hospitalized for acute pancreatitis (AP). OBJECTIVES To describe the progression of lipase activity and PLI, and correlations with clinicopathologic features in dogs with AP. ANIMALS Thirty-nine dogs with AP based on clinical signs and lipase activity >350 U/L (reference interval [RI], 24-108 U/L). METHODS Retrospective study. Lipase activity (LIPC Roche), PLI (SpecPL), and clinical signs were recorded daily. Admission (d1) data (clinical, laboratory, and ultrasound [US] findings), and clinical signs during hospitalization (d2-d3) were assessed for correlation with lipases. RESULTS Median (range) duration of clinical signs before presentation was 2 days (1-7 days). Median (range) lipase activity and PLI at d1 were 1070 U/L (range, 357-1500 U/L) and 1111 μg/L (range, 292-1500 μg/L). Strong correlation between assays at d1 (rs 0.96; P < .0001; n = 39), remained equally strong on d2 (rs 0.964; P < .0001; n = 39), and d3 (rs 0.966; P < .0001; n = 22). On d2, lipase activity and PLI were within RI in 13/39 (33%) and 18/39 (46%) of cases. Lipase activities were minimally increased (median, 124 U/L) in 5 dogs with d2 PLI <200 μg/L. On d3, 4 more dogs had normal lipase activity and PLI, and the nature and magnitude of change were always the same for both assays. Clinical signs were not associated with lipases. Only a hyperechoic mesentery, but not an US diagnosis of AP, correlated significantly with lipase activity and PLI. CONCLUSIONS AND CLINICAL IMPORTANCE Lipase decreases rapidly to near or within RI within 2 days of treatment in the majority of dogs with AP. Both lipase assays yielded virtually identical results. Mesenteric echogenicity may be an early marker of AP in dogs.
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Affiliation(s)
- Claudia Cueni
- Clinic for Small Animal Internal MedicineVetsuisse Faculty, University of ZurichZurichSwitzerland
| | - Natalie Hofer‐Inteeworn
- Clinic for Small Animal Internal MedicineVetsuisse Faculty, University of ZurichZurichSwitzerland
| | - Claudia Kümmerle‐Fraune
- Clinic for Small Animal Internal MedicineVetsuisse Faculty, University of ZurichZurichSwitzerland
| | - Claudia Müller
- Clinic for Small Animal Internal MedicineVetsuisse Faculty, University of ZurichZurichSwitzerland
| | - Peter Hendrik Kook
- Clinic for Small Animal Internal MedicineVetsuisse Faculty, University of ZurichZurichSwitzerland
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Khan S, Freeman P. Bayesian clinical reasoning in the first opinion approach to a dog with suspected thoracolumbar pain. J Small Anim Pract 2022; 63:853-857. [PMID: 35751435 PMCID: PMC10084187 DOI: 10.1111/jsap.13528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 01/25/2022] [Accepted: 05/25/2022] [Indexed: 11/29/2022]
Abstract
Whilst multi-planar imaging has allowed advances in diagnosis and treatment of canine spinal cord disorders, it is sometimes inaccessible to pet owners leading to a reliance on imaging modalities and ancillary tests that are more readily available. For this reason, this essay considers how Bayesian clinical reasoning may aid in deciding which tests, if any, are most useful for the diagnosis of spinal disease in clinical practice and choosing reasonable empiric therapies.
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Affiliation(s)
- S Khan
- Queen's Veterinary School Hospital, Cambridge, CB3 0ES, UK
| | - P Freeman
- Queen's Veterinary School Hospital, Cambridge, CB3 0ES, UK
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Cridge H, Scott N, Steiner JM. Risk Factors and Clinical Presentation in Dogs with Increased Serum Pancreatic Lipase Concentrations—A Descriptive Analysis. Animals (Basel) 2022; 12:ani12121581. [PMID: 35739917 PMCID: PMC9219463 DOI: 10.3390/ani12121581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Over the past several years, there has been an increasing importance placed on clinical presentation as part of a diagnosis of pancreatitis, and yet there is comparatively little data investigating the full array of clinical signs that may be seen in dogs with pancreatitis. Our study showed that dogs with increased pancreatic lipase immunoreactivity concentrations could display a wide range of clinical signs, which may be related to pancreatitis or a concurrent disease. Non-specific clinical signs, such as anorexia, were prevalent. Additionally, overt abdominal pain was infrequently reported, and veterinarians should be cautious in ruling out pancreatitis due to a lack of abdominal pain alone. Additionally, limited data is available on potential risk factors for pancreatitis in dogs; this information could be important in the development of disease prevention strategies. In our study, the most common concurrent disease was hepatobiliary abnormalities. Additional studies are needed to determine whether this is a causative or associative relationship. Drug use reflected common prescribing practices, and anti-epileptic drug use was low despite prior studies documenting clear associations between phenobarbital and potassium bromide and drug-associated pancreatitis. Adult maintenance diets, in addition to human foods and dog treats, were commonly fed prior to the development of an increased pancreatic lipase concentration. Abstract Limited data exist regarding the full array of clinical signs seen in dogs with pancreatitis and potential risk factors for the disease. Laboratory submissions from the Gastrointestinal Laboratory at Texas A&M University were retrospectively reviewed for dogs with an increased serum pancreatic lipase immunoreactivity (cPLI) concentration (≥400 µg/L), and an internet-based survey was distributed to the attending veterinarian and/or technician on each case. The survey contained questions related to (i) clinical signs, (ii) prior gastrointestinal upset, (iii) comorbidities, (iv) pre-existing medical therapies, and (v) dietary history. One hundred and seventy (170) survey responses were recorded. The top three clinical signs reported were inappetence (62%), diarrhea (53%), and vomiting (49%). Abdominal pain was noted in only 32% of dogs, likely associated with poor pain detection. Additionally, the majority of dogs (71%) had prior episodes of gastrointestinal upset within the past 12 months, lending support for the commonality of recurrent acute pancreatitis, or acute on chronic disease. Hepatobiliary abnormalities (24%) were the most common concurrent disease, and endocrine disorders were seen in a low proportion of respondents (5–8%). Adult maintenance diets (65%), dog treats (40%), and human foods (29%) were commonly consumed by dogs prior to the discovery of increased cPLI concentration.
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Affiliation(s)
- Harry Cridge
- Department of Small Animal Clinical Sciences, Michigan State University College of Veterinary Medicine, East Lansing, MI 48824, USA
- Correspondence:
| | - Nicole Scott
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA; (N.S.); (J.M.S.)
| | - Jörg M. Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA; (N.S.); (J.M.S.)
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Hammes K, Kook PH. Effects of medical history and clinical factors on serum lipase activity and ultrasonographic evidence of pancreatitis: Analysis of 234 dogs. J Vet Intern Med 2022; 36:935-946. [PMID: 35438226 PMCID: PMC9151483 DOI: 10.1111/jvim.16426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/31/2022] [Accepted: 04/02/2022] [Indexed: 12/19/2022] Open
Abstract
Background Lipase measurements and ultrasonographic (US) evidence of pancreatitis correlate poorly. Objectives Identify explanations for discrepant lipase and pancreatic US results. Animals Two hundred and thirty‐four dogs with gastrointestinal signs. Methods A retrospective study was conducted, in which lipase activity and US were performed within 30 hours. Medical history, clinical examination results, lipase activity, and US results were recorded. Results Lipase and US results were weakly correlated (rs = .25, P < .001). At both evaluated time cut‐offs, median lipase activities were significantly higher with shorter durations of clinical signs before presentation (≤2 days, 334 U/L; >2 days, 118 U/L; P = .03; ≤7 days, 334 U/L; >7 days, 99 U/L; P = .004), but US was not significantly more frequently positive. For both cut‐offs (>216/≤216 U/L, >355/≤355 U/L; reference range, 24‐108 U/L), median disease duration was significantly shorter (3 vs 4 days) with higher lipases. Previous pancreatitis episodes were significantly associated with an US diagnosis of pancreatitis (P = .04), but median lipase activities were not significantly higher (386 U/L vs 153 U/L; P = .06) in these dogs. Pancreatic US was significantly more often positive when the request contained “suspicion of pancreatitis” (P < .001) or “increased lipase” (P = .01). Only changes in pancreatic morphology, echogenicity, and peripancreatic mesentery were significantly associated with a positive US diagnosis, and also had significantly higher lipase activities. Conclusions and Clinical Importance Duration of clinical signs before presentation differently affects laboratory and US evidence of pancreatitis. Previous pancreatitis episodes and information given to radiologists influence US results. These findings can be helpful for future studies on pancreatitis in dogs.
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Affiliation(s)
- Karen Hammes
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Peter H Kook
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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