Hyperadrenocorticisme bij de fret: een overzicht van de huidige kennis aan de hand van twee klinische cases

Hyperadrenocorticism is a frequently occurring disease in middle-aged ferrets. It is caused by a neoplasm of the adrenal cortex. Otherwise than in dogs and cats, hyperadrenocorticism in the ferret is always independent of adrenocorticotropic hormone (ACTH). The tumor of the adrenal cortex can be removed surgically, mostly with satisfying results. After surgery, a regression of symptoms occurs after two to eight weeks, and the animals are without symptoms after five to eight months. In recent years, there has been a growing interest in using a chemical therapy aimed at decreasing hormone production through the administration of GnRH agonists. These agonists initially cause a temporary increase of the sex steroids, and then a long-term decrease of them through desensitization of the GnRH receptors. A deslorelin implant seems to be a promising alternative for the surgical treatment of hyperadrenocorticism in ferrets. Some authors even recommend it as a standard preventive treatment after neutering in both genders and for every ferret over four years of age. Moreover, it is an excellent alternative for surgical castration

Analytical validation of a human particle-enhanced nephelometric assay for cystatin C measurement in feline serum and urine

Background: In people and dogs, Cystatin C (CysC), a renal glomerular and tubular marker, seems superior to serum creatinine to estimate the glomerular filtration rate (GFR). A particle-enhanced nephelometric immunoassay is available to measure human CysC, but there are no reports in cats. Objective: The goal of this study was the validation of the human CysC nephelometric assay with feline serum and urine, and to perform a pilot study comparing serum and urine CysC between healthy cats and cats with chronic kidney disease (CKD). Methods: Western blot analysis was used to assess cross-reactivity between the polyclonal rabbit anti-human CysC antibody and feline CysC. Imprecision and linearity were determined for feline serum and urine CysC. Serum and urine CysC were measured in 10 healthy and 10 CKD cats. Results: Cross-reactivity between the polyclonal rabbit anti-human CysC antibody and feline CysC was demonstrated. Intra- and inter-assay coefficients of variation in feline serum and urine were 1.3% and 0.4%, and 12.5%, and 4.1%, respectively. Cats with CKD had a significantly higher serum CysC concentration (1.24 [0.63-2.99] vs 0.79 [0.43-1.05]mg/L; P=.02) and urine CysC/urinary Creatinine (uCr) ratio (565.6 [0-1311] vs < 0.049/uCr mg/mol; P=.005) compared with healthy cats. Conclusions: The human nephelometric assay showed satisfactory validation results for feline CysC. Cats with CKD had a significantly higher sCysC concentration and uCysC/uCr ratio compared with healthy cats. Additional studies are necessary to evaluate CysC as an early marker of renal damage in cats

Routine health screening: findings in apparently healthy middle-aged and old cats

Study rationale: Veterinary practitioners often perform geriatric health screening in cats. Unfortunately, scientific information regarding clinical and laboratory abnormalities and normal blood pressure values in elderly cats is scarce. This prospective study evaluated routine health screening tests in apparently healthy middle-aged and old cats. Protocol: One hundred cats of 6 years and older underwent blood pressure measurement, physical examination, blood and urine analysis, indirect fundoscopy and bilateral Schirmer tear tests. Findings: Mean systolic blood pressure (SBP) was 133.6 +/- 21.5 mmHg. Increased SBP (> 160 mmHg) was observed in eight cats, submandibular lymphadenopathy in 32, gingivitis in 72, heart murmur in 11, thyroid goitre in 20, increased creatinine in 29, hyperglycaemia in 25, increased total thyroxine in three, feline immunodeficiency virus positivity in 14, crystalluria in 41, borderline proteinuria in 25 and overt proteinuria in two. Mean tear production was very similar for both eyes and none of the cats had ocular lesions secondary to hypertension. Clinical significance: Old cats (> 10 years) had significantly higher SBP, heart rate, murmur frequency, thrombocyte count, urine protein:creatinine ratio and serum urea and bilirubin concentrations, and significantly lower body condition score, haematocrit, albumin and total calcium concentrations than middle-aged cats (6-10 years). The common occurrence of physical examination and laboratory abnormalities in apparently healthy old cats underlines the need for regular health checks and the development of age-dependent laboratory reference intervals

Routine kidney variables, glomerular filtration rate and urinary cystatin C in cats with diabetes mellitus, cats with chronic kidney disease and healthy cats

Objectives: Diabetic kidney disease (DKD) is a frequent and serious complication in human diabetic patients, but data are limited in cats. This study was undertaken to assess whether diabetic cats are susceptible to DKD. Methods: Kidney function was compared between 36 cats with diabetes mellitus (DM), 10 cats with chronic kidney disease (CKD) and 10 age-matched healthy cats by measuring routine kidney variables (serum creatinine [sCreat], serum urea [sUrea], urine specific gravity [USG], urinary protein:creatinine ratio [UPC]), urinary cystatin C:creatinine ratio and glomerular filtration rate (GFR). Urinary cystatin C (uCysC) was measured with a human particle-enhanced nephelometric immunoassay, validated to measure feline cystatin C, in all but two diabetic cats. GFR was evaluated by exo-iohexol clearance in 17 diabetic cats, all cats with CKD and all healthy cats. Results: Diabetic cats had significantly (mean SD) lower sCreat (123 +/- 38 vs 243 +/- 80 mu mol/l), sUrea (11 +/- 3 vs 18 +/- 7 mmol/l) and urinary cystatin C:creatinine ratio (6 +/- 31 vs 173 +/- 242 mg/mol), and a significantly higher USG (1.033 +/- 0.012 vs 1.018 +/- 0.006) and GFR (2.0 +/- 0.7 vs 0.8 +/- 0.3 ml/min/kg) compared with cats with CKD. Compared with healthy cats, diabetic cats only had significantly lower USG (1.033 +/- 0.012 vs 1.046 +/- 0.008). Proteinuria (UPC >0.4) was present in 39% of diabetic cats, in 30% of cats with CKD and in none of the healthy cats. However, the UPC did not differ statistically between the three groups. Conclusions and relevance: Based on evaluation of routine kidney variables, GFR and uCysC as a tubular marker at a single time point, a major impact of feline DM on kidney function could not be demonstrated

The in- and out-of-hospital management of HF patients: results from a nationwide Belgian survey.

We conducted a nationwide survey to describe the in-and out-of-hospital flow (diagnosis, treatment and follow-up) of patients with heart failure with reduced ejection fraction (HFrEF). A survey was developed with five dedicated HF cardiologists. The data are all self-reported by cardiologists. The response rate was 84%. Presence of a dedicated HF cardiologist or HF nurse was indicated by 49% and 46% of the hospitals respectively. Devices ( 75% of the target dose seems easier for angiotensin converting enzyme inhibitor/angiotensin receptor blockers (ACEI/ARB) (22%) and mineralocorticoid receptor antagonists (25%), compared to β-blockers (10%) and angiotensin receptor neprilysin inhibitors (7%). 62%, 49% and 4% of the cardiologists indicated to use subtypes of angiotensin converting enzyme inhibitors, angiotensin receptor blockers and β-blockers respectively not validated in the HF population. In the acute setting, dedicated HF cardiologists (23%) are less influenced by blood parameters for decongestion compared to non-dedicated HF cardiologists (39%). They tend to change patients more to guideline-recommended drugs (60% vs 47%). Six minutes walk test and ergospirometry are significantly more used by dedicated compared to non-dedicated HF cardiologists for HF drug change (17% and 29% vs 2% and 4%). This survey showed that a minority of hospitals have HF care. Those that do, report a higher implementation of guideline-recommended diagnosis, treatment and follow-up of HF patients. Competent authorities could use this survey as a tool to improve HF care