SUCCESSFUL MANAGEMENT OF ACUTE BABESIOSIS IN A DOG

Canine babesiosis is a tick-borne disease caused by Babesia spp. Dogs with uncomplicated babesiosis typically show pale mucous membranes, fever, anorexia, depression, water-hammer pulse, and splenomegaly. The complicated form can include acute renal failure, cerebral babesiosis, coagulopathy, icterus and hep- atopathy, immune-mediated hemolytic anemia (IMHA), acute respiratory distress syndrome (ARDS), hemo- concentration. This case report describes the presentation, diagnosis, and management of acute systemic inflammatory response syndrome (SIRS) in a dog affected by Babesia canis. A Border Collie, intact male, 8-years-old, was presented in emergency setting showing weakness, anorexia and ’pigmenturia’ started 2 days before. The dog was used as cattle dog in Piedmont region and recently moved to Tuscany. Dog showed fever (38.

Evaluation of urinary γ-glutamyl transferase and serum creatinine in non-azotaemic hospitalised dogs

Urinary and blood biomarkers for diagnosis of acute kidney injury (AKI) in hospitalised dogs were evalueted. This prospective study included 97 dogs, classified according to the International Renal Interest Society classification into no AKI and AKI grade 1 (48-hour increase in serum creatinine≥0.3 mg/dl and/or urinary production <1 ml/kg/hour for at least six hours). A total of 62 of 97 dogs (64 per cent) were classified as AKI 1. A statistically significant difference was found between no AKI and AKI 1 in urine protein to creatinine ratio, urinary γ-glutamyl transferase (uGGT) and uGGT/cu (P<0.0001). Thirteen of 97 dogs (13.4 per cent) that developed increased creatinine and change in AKI grade showed high mortality (n=9/13; 69.2 per cent). The receiver operating characteristic (ROC) curve analysis of uGGT/cu index as a marker for AKI grade 1 had an area under the ROC curve of 0.78; optimal cut-off point was 57.50 u/g, with sensitivity and specificity of 75.4 per cent and 75.6 per cent, respectively. Overall intensive care unit mortality was 23.7 per cent (23/97), 13.4 per cent (13/97) of which died during hospitalisation and 10.3 per cent (10/97) within 28 days after discharge. uGGT is an acceptable marker for distinguishing between AKI 1 and no AKI

Evaluation of a prognostic scoring system for dogs managed with hemodialysis

Objective: To investigate prognostic models in a cohort of dogs with acute kidney injury (AKI) and acute on chronic kidney disease (AKI/CKD) managed by hemodialysis. Design: Retrospective study from July 2011 to November 2014. Setting: University Veterinary Teaching Hospital. Animals: Forty dogs with historical, clinical, imaging, and laboratory findings consistent with AKI or AKI/CKD managed with intermittent hemodialysis were included. Interventions: Scoring system models previously established by Segev et al for outcome prediction in dogs with AKI were applied to all dogs. Results: Models A, B, and C correctly classified outcomes in 68%, 83%, and 85% of cases, respectively. In our cohort Model A showed sensitivity of 58% and specificity of 86%, Model B showed sensitivity of 79% and specificity of 87%, Model C showed sensitivity of 86% and specificity of 84%. The presence of anuria (P < 0.0002), respiratory complications (P < 0.0001), disseminated intravascular coagulation (DIC) (P = 0.0004), grade of AKI (P = 0.0023), pancreatitis (P = 0.0001), and systemic inflammatory response syndrome (SIRS) (P = 0.0001) was significantly higher in nonsurvivors compared with survivors. Conclusions: In our cohort of patients, Segev's model C showed the best sensitivity and specificity for predicting prognosis, while model A had lower sensitivity. In our cohort of dialysis patients, the presence of respiratory complications, DIC, SIRS, and pancreatitis at hospitalization, were correlated with a poor prognosis

Serum Total Thyroxine Evaluation in Critically Ill Feline Patients

This retrospective case control study compared serum total thyroxine (tT4) concentrations in hospitalized critical cats (CCs) and non-hospitalized cats with non-thyroidal chronic diseases (chronic group, CG) and evaluated the relationship between the serum tT4 concentration of CCs and systemic inflammation (systemic inflammatory response syndrome (SIRS)), disease severity (Acute Patient Physiologic and Laboratory Evaluation (APPLEfast)), and prognosis. Cats with previously suspected or diagnosed thyroid disease were excluded. Serum tT4 was evaluated in surplus serum samples at the time of admission for CCs and CGs. The APPLEfast score of the CC group was calculated at admission. The systemic inflammatory response syndrome (SIRS) in CCs was determined using proposed criteria. Cats were divided into survivors and non-survivors according to the discharge outcome. Forty-nine cats were retrospectively included. Twenty-seven cats died during hospitalization. The CG group was composed of 37 cats. The CC group showed a significantly lower tT4 compared to the CG group (1.3 ± 0.7 vs. 2 ± 0.9; p < 0.0001). Among SIRS, APPLEfast, and tT4, only tT4 was associated with mortality (p = 0.04). The tT4 cut-off point for mortality was 1.65 mug/dL (sensitivity 81%, specificity 57%, odds ratio (OR) 5.6). Twenty-five cats (51%) had SIRS that was not associated with tT4. Non-thyroidal illness syndrome can occur in critically ill cats and the evaluation of tT4 in hospitalized cats could add prognostic information

Valutazione di indici di funzionalità respiratoria nel cane: indicatori prognostici e diagnostici

L’emogas arterioso insieme alla radiografia toracica rappresentano i gold standard per la valutazione rispettivamente degli scambi gassosi e del parenchima polmonare (Ferguson et al., 2012; Proulx, 1999). Lo scopo del presente lavoro è quello di valutare alcuni indici di funzionalità respiratoria, PaO2, P[A-a]O2, PaO2/FiO2, SO2, PCO2, HCO3- e pH, in una popolazione eterogenea di cani, valutare l’aspetto radiografico polmonare e la pulsiossimetria. Sono stati arruolati tutti i pazienti appartenenti alla specie canina pervenuti presso l’Ospedale, per varie cause, affetti o meno da patologie, appartenenti a varie razze.. Gli animali sono stai divisi in tre categorie in base all’età: animali giovani, adulti e anziani; in base al peso: normopeso, sottopeso, sovrappeso e in base al sesso: maschi interi, femmine intere, maschi castrati, femmine sterilizzate. Gli indici di funzionalità respiratoria sono stati ricavati mediante prelievo arterioso dall’arteria dorsale del piede. Per ciascun paziente è stata inoltre valutata la saturazione dell’ossigeno, SpO2. ed è stata eseguita una radiografia toracica. È risultata una differenza significativa per i valori di P[A-a]O2 tra i pazienti adulti e i pazienti anziani, mostrando questi ultimi una mediana più alta. All’interno dei gruppi suddivisi in base al sesso, sono state riscontrate differenze significative tra i valori di PaO2, PaO2/FiO2, per i maschi interi e le femmine intere. Una differenza significativa tra i valori di PaO2/FiO2 e P[A-a]O2 è stata riscontrata per le categorie di pattern polmonare. La mediana dei valori di PaO2/FiO2 risulta significativamente più bassa nel gruppo pattern alveolare. La differenza significativa riscontrata tra i vari indici considerati per le categorie di ammissione suggerisce come la patologia sottostante possa determinare una alterazione degli scambi

RETROSPECTIVE OBSERVATION OF 64 DOGS WITH RENAL FAILURE MANAGED BY HEMODIALYSIS

Acute Kidney Injury (AKI) is a severe disease associated with a sudden onset of renal parenchymal injury most typically characterized by generalized failure. AKI may to be severe and culminated with the requirement for renal replacement therapy (RRT) or death. The aim of this study was to evaluate potential prognostic factors (clinical and laboratory parameters), intra/inter dialysis complications and mortality rate in a cohort of dogs with AKI and AKI/CKD managed by hemodialysis (HD) at Department of Veterinary Science of University of Pisa between 2012 and 2015. We included 64 dogs with anamnestic, clinical, imaging and laboratory findings of AKI or acute on chronic kidney disease (AKI/CKD) managed by hemodialysis. All Dogs were also divided into two groups: survivors and non-survivors. Survivors were defined as patients remaining not dependent by dialysis for at least 30 days after discharge from the hospital. Data were statistically analyzed with GraphPad Prism® for Mac. In our cohort 43/64 were males and 21/64 were females. Mean age and body weight were 5.5 ± SD 3.3 years and 26.7 kg±1SD 1.6 kg respectively. At presentation 26/64 dogs were anuric (<0.5 ml/kg/h), 15/64 were oliguric (1ml/kg/h). 29/64 dogs were in AKI stage 5 (SrCr>10mg/dl), 29/64 were in AKI 4 (SrCr 5-10 mg/dL), 2/64 were in AKI 3 (SrCr 2.6-5mg/dL), 1/64 were in AKI 2 (SrCr 1.6-2.5) and 3/64 were in AKI 1 (SrCr<1.6mg/dL). Most of etiology of AKI in this dogs were: Leptospira infection (14/64), Leishmania infection (5/64), toxicity (8/64), ethylene glycol (3/64), pancreatitis (4/64), heart stroke (2/64), snake bite (2/64), uretheral obstruction (2/64), pyometra (3/64), unknown (17/64) and other causes (4/64). Non-survivors dogs were 37/6, while survivors were 27/64. T-Test unpaired showed significant difference at presentation in serum creatinine (p=0.047), phosphorus (p=0.0468), and ionic calcium (p=0.042) between survivors and non-survivors. No significant difference was found in serum urea, albumin, C-reactive protein (CRP) and potassium between survivors and non-survivors. In our cohort the overall survival rate was 42.2% and it showed similar to previously data reported. Serum creatinine, phosphorous and ionized calcium seemed to have a significant prognostic relevance, while serum urea, CRP and potassium did not seem to affect prognosis significantly

Nucleated Erythrocytes and Anemia in Dogs with Systemic Inflammatory Response Syndrome: Could They Affect Outcome?

During Systemic Inflammatory Response Syndrome (SIRS) a release of inflammatory mediators occurs and hematological modifications are common. The study’s aim was to evaluate anemia and nucleated RBC (NRBCs) in canine SIRS compared to the severity of illness and outcome. This retrospective study included the following dogs: 90 with SIRS, 50 healthy, 50 with chronic diseases. SIRS grading was based on how many criteria were fulfilled. APPLEfast score was allocated in SIRS dogs. Mortality rate was assessed at 7 and 15 days after admission. Hemolytic or hemorrhagic disorders were excluded. SIRS grading and APPLEfast score groups were compared to the outcome. Types of anemia and NRBCs counts were evaluated in three study populations and to the outcome. APPLEfast scores >25 (p=0.03) and SIRS grading >2 (p=0.001) were associated with poor outcome. In SIRS group, anemia was present in 56/90 dogs. The most frequent types of anemia were mild (45%) or moderate (43%), microcytic (55%) or normocytic (41%), and normochromic (93%). Anemia and its severity were associated with poor outcome (p=0.0197). SIRS group showed worse anemia patterns than the other two groups (p<0.001). The presence of NRBCs occurred in 22/90 of SIRS dogs and was associated with poor outcome (p=0.005). NRBCs count were significantly higher in the SIRS group than healthy dogs (p=0.0007). Mild-moderate, micro-normocytic normochromic anemia is a frequent finding in canine SIRS. Our results suggest that circulating NRBCs and their amount could be an additional negative prognostic value