犬口腔内悪性黒色腫に対するシクロフォスファミドとピロキシカム併用メトロノーム化学療法の有用性に関する研究

学位の種別:課程博士University of Tokyo(東京大学

Ultrasonographic kidney length-to-abdominal aortic diameter for the diagnosis of feline chronic kidney disease: A preliminary study

Background and Aim: Chronic kidney disease (CKD) is one of the most important diseases in cats. This study aimed to compare the ultrasonographic kidney length-to-abdominal aortic diameter (K/AO) ratio between healthy and CKD cats and investigate the correlation between K/AO and blood results. Materials and Methods: Fifteen healthy cats and 15 CKD cats were included in this clinically prospective study. All cats were evaluated for radiographic and ultrasonographic K, radiographic K-to-second lumbar length ratio (K/L2), and K/AO, indirect systolic blood pressure and plasma creatinine (Cr), blood urea nitrogen (BUN), and symmetric dimethyl arginine (SDMA). Results: The radiographic and ultrasonographic kidney lengths of CKD were significantly shorter than those of healthy cats (p < 0.05 and p < 0.05, respectively). The average K/L2 and K/AO were significantly lower in CKD than in healthy cats (p < 0.01 and p < 0.001, respectively). The K/AO had a strong negative correlation with plasma Cr (r = −0.7682, p < 0.0001), BUN (r = −0.6175, p < 0.001), and SDMA (r = −0.589, p < 0.001). However, K/L2 had a moderate negative correlation with plasma Cr (r = −0.5866, p < 0.001), BUN (r = −0.4884, p < 0.01), and SDMA (r = −0.5404, p < 0.01). The optimal cutoff value of K/AO (<10.71) had higher sensitivity and specificity than K/L2 for identifying feline CKD. Conclusion: Kidney length-to-abdominal aortic diameter could be a better and more promising parameter than the K/L2 ratio for evaluating kidney size in cats with CKD

Hematological and blood biochemistry parameters as prognostic indicators of survival in canine multicentric lymphoma treated with COP and L-COP protocols

Background and Aim: Hematological and blood chemistry parameters are crucial for evaluating and monitoring canine multicentric lymphoma during chemotherapy. Pre-treatment hematological and blood chemistry parameters can be used as prognostic survival outcomes for this disease. Therefore, this study aimed to investigate the effect of hematological and blood chemistry parameters pre-treatment and 4 weeks post-treatment on the survival outcomes of dogs treated with either a combination of cyclophosphamide, vincristine, and prednisolone (COP) or a combination of COP with L-asparaginase (L-COP) protocols. Materials and Methods: We conducted a retrospective study. Medical records and hematological and blood chemistry parameters of 41 dogs with multicentric lymphoma treated with L-COP (n = 26) and the COP protocols (n = 15) were obtained from the hospital information system. Most cases were classified as high-grade lymphoma based on the Kiel cytological classification. The effects of hematological and blood chemistry parameters on survival outcomes were investigated using the Cox proportional hazard regression model. The median survival time (MST) for each hematological and blood chemistry parameter affecting survival outcome was established and compared using the Kaplan–Meier product limit method with the log-rank test. Results: Dogs with high-grade multicentric lymphoma that were treated with the COP protocol and had monocytosis at pre-treatment had a significantly shorter MST than dogs with normal monocyte counts (p = 0.033). In addition, dogs with azotemia, both pre-treatment and 4 weeks post-treatment, had a significantly shorter MST than dogs with normal serum creatinine levels (p = 0.012). Dogs with high-grade multicentric lymphoma treated with the L-COP protocol who had hypoalbuminemia (serum albumin concentration <2.5 mg/dL) at both pre-treatment and 4 weeks post-treatment had a significantly shorter MST than dogs with normal serum albumin levels (p < 0.001). Furthermore, dogs with leukocytosis at 4 weeks post-treatment had a significantly shorter MST than those with a normal total white blood cell count (p = 0.024). Conclusion: Serum albumin level can serve as a simple negative prognostic indicator of survival outcomes in dogs with high-grade multicentric lymphoma treated with the L-COP protocol. Dogs with hypoalbuminemia pre-treatment and 4 weeks post-treatment tended to have a shorter MST than those with normal serum albumin concentrations

Renal shear wave elastography and urinary procollagen type III amino-terminal propeptide (uPIIINP) in feline chronic kidney disease

Abstract Background Chronic kidney disease (CKD) is one of the most common diseases occurring in cats. It is characterized by renal fibrosis, which is strongly correlated with impairment of renal function. Since renal biopsy is not performed routinely in clinical practice, the non-invasive method of ultrasonographic shear-wave elastography (SWE) was used to determine renal parenchymal stiffness. Currently, urinary procollagen type III amino-terminal propeptide (uPIIINP) is a renal fibrosis biomarker in humans. Moreover, PIIINP is increasingly applied for identification of fibrosis in various organs in animals. Results The Young’s modulus (E) value on SWE, uPIIINP, and renal function were evaluated in 23 CKD cats and 25 healthy cats (HC). The renal cortical E values were significantly higher than those of the renal medulla in both groups (P < 0.001). The E values of the renal cortex and medulla were significantly higher in CKD cats than in HC (P < 0.001 and P < 0.01, respectively). The E values, especially of the cortex, showed a significant positive correlation with concentrations of plasma creatinine (P < 0.001), blood urea nitrogen (P < 0.05), while they had a negative correlation with urine specific gravity (P < 0.001) and urine osmolality per plasma osmolality ratio (P < 0.01). The uPIIINP to creatinine ratios (uPIIINP/Cr) were significantly higher in CKD cats than in HC (P < 0.01) and were highly correlated with renal cortical E values (P < 0.001). Conclusions SWE might be an additively useful and non-invasive diagnostic imaging tool to evaluate renal parenchymal stiffness, which correlates with renal functional impairment in CKD cats. Moreover, the uPIIINP/Cr might be a promissing biomarker for adjunctive assessing the renal fibrosis in feline CKD

Renal ultrasonographic shear-wave elastography and urinary procollagen type III amino-terminal propeptide in chronic kidney disease dogs

Background and Aim: Renal fibrosis is a well-established pathological alteration associated with chronic kidney disease (CKD) in several species and progresses as CKD advances. Although a renal biopsy is the gold standard for determining renal fibrosis, it is an invasive, impractical method for clinical practice. In humans, ultrasonographic shear-wave elastography (SWE), a novel advanced diagnostic imaging tool, can evaluate renal parenchyma stiffness, and urinary procollagen type III amino-terminal propeptide (uPIIINP), a promising renal fibrosis biomarker in humans, has increasingly been use applied to reduce the biopsies. This study compares renal tissue elasticity observed through SWE Young's modulus (E) values between healthy dogs (HD) and those with CKD. Materials and Methods: The E value acquired by SWE, uPIIINP levels, and renal function were evaluated in 15 CKD dogs and 15 HD. Results: The renal cortical E values were significantly higher than the renal medullary E values in both groups (p<0.001). Renal cortical and medullary E values in CKD dogs were significantly higher than in HD (p<0.01). Cortical E values had greater significant correlations with renal functional parameters than the medullary E values and had a significant positive correlation with concentrations of plasma creatinine (Cr) (p<0.001); blood urea nitrogen (p<0.01); urine protein Cr ratio (p<0.01); and fractional excretions of sodium (p<0.05), potassium (p<0.05), chloride (p<0.05), and magnesium (p<0.001) while they had a negative correlation with urine specific gravity (p<0.05) and urine osmolality to plasma osmolality ratio (p<0.05). The uPIIINP to Cr (uPIIINP/Cr) ratios of CKD dogs were higher than those of HD (p<0.001). Moreover, the uPIIINP/Cr levels presented significant correlations with the renal cortical E values (p<0.01) and also the renal functional parameters. Conclusion: SWE offers a complementary, non-invasive diagnostic imaging tool for evaluating renal tissue stiffness in CKD dogs with renal function deterioration. In addition, uPIIINP levels are associated with renal function and structural changes in dogs. Therefore, the uPIIINP level might be a non-invasive, complementary, and promising biomarker for evaluating renal fibrosis in canine CKD

Comparison of computed tomographic ocular biometry in brachycephalic and non-brachycephalic cats

Background and Aim: Ocular biometry has been used to evaluate ocular parameters; however, several factors need to be considered. In humans, age and sex have been shown to affect ocular biometry. The main factor that affects feline ocular biometry is the head circumference. At present, several reports have revealed that canine ocular biometry differs among dog breeds. However, there are no reports on normal ocular biometry in cats using computed tomography (CT). Therefore, this study aimed to explore feline ocular parameters between brachycephalic (B) and non-brachycephalic (NB) cats using CT and to evaluate the influence of age or sex of cats on ocular biometry. Materials and Methods: Twenty-four normal cats were divided into two groups: B (n=12) and NB (n=12). Each group had an equal number of designated males and females. CT was performed under mechanical restraint without general anesthesia and intravenous contrast enhancement. Ocular biometry, dimensions of the internal structure, including attenuation numbers and extra-ocular structures, were evaluated and compared. Results: B-cats had a significantly wider globe width (GW) than NB-cats (p<0.05). In addition, globe length (GL) and GW were significantly correlated with the age of the cats. Significant correlation between GL and age was observed in all cats (r=0.4867; p<0.05), NB-cats (r=0.8692; p<0.05), and B-cats (r=0.4367; p<0.05), whereas the correlation between GW and age was observed in B-cats only (r=0.7251; p<0.05). For extra-ocular structures, NB-cats had significantly greater orbital depth than B-cats (p<0.05), and orbital diameter was significantly correlated with age in all cats and B-cats (p<0.05). Conclusion: CT can be used for ocular biometric evaluation in cats with different skull types. GW was wider in B-cats, whereas the orbital depth was greater in NB-cats. Moreover, GW, GL, and orbital diameter were affected by the age of the cats. This information will be useful for further ocular diagnosis and treatment, especially in prosthetic surgical procedures

Radiographic lumbosacral vertebral abnormalities and constipation in cats

Background and Aim: Lumbosacral intervertebral disk disease (IVDD) in cats usually develops concurrent with constipation, spondylosis deformans, and sacralization. However, the prevalence of lumbar IVDD in cats was considered low, and there was less information on the incidence of non-traumatic lumbosacral vertebral abnormalities that may affect large bowel dysfunction. This study aimed to retrospectively investigate the relationship between non-traumatic lumbosacral vertebral abnormalities, both congenital and acquired, and large bowel dysfunction in cats. Materials and Methods: Of 3108 cats that were presented to the Diagnostic Imaging Unit, the Small Animal Teaching Hospital, Faculty of Veterinary Science, Chulalongkorn University, between March 2016 and February 2018, 1365 cats met the inclusion criteria. All abdominal radiographs were reviewed, and all subsequent data were recorded, including the presence of congenital or acquired lumbosacral lesions, number of lumbar vertebrae, and length of the second, fifth, and last lumbar vertebrae, including the type of lumbar abnormalities. Moreover, radiographic information relating to constipation and megacolon was also collected. Results: Non-traumatic lumbosacral vertebral abnormalities were observed in 29.74% of cats. The most common congenital lumbosacral vertebral abnormalities were six lumbar vertebrae, sacralization, and lumbarization, whereas most common acquired lumbosacral abnormalities were bone spur, narrowing disk space, spondylosis deformans, and lumbosacral degeneration, respectively. Cats with abnormal lumbosacral vertebrae are prone to have more problems with the large bowel (p=0.0057; odds ratio=1.731). Moreover, congenital and acquired lumbosacral abnormalities were also at risk of large bowel abnormalities (p=0.0069; odds ratio=1.920 and p<0.0001; odds ratio=4.107, respectively). Conclusion: This study revealed the evidence and distribution of the variation in feline lumbar anatomy and also elucidated that cats with abnormal lumbar vertebral columns were more likely to have problems with distal gastrointestinal tracts than those without

Thoracic Vertebral Length-to-Height Ratio, a Promising Parameter to Predict the Vertebral Heart Score in Normal Welsh Corgi Pembroke Dogs

The vertebral heart score (VHS) is the sum of the ratio of the cardiac dimensions to the number of thoracic vertebrae, starting from the fourth thoracic vertebra (T4) to the intervertebral disk space (IVS). Breed-specific VHSs, in most cases, were different from the original reference value. Characteristics of the thoracic vertebrae and IVS may influence this variation. This study was conducted to investigate the characteristics of the T4 and IVS on the thoracic radiographs of Corgis in comparison with other small-to-medium breed dogs to evaluate the Corgi-specific VHSs in healthy dogs. The ratio of the T4’s length/height (T4L/H) was significantly different among dog breeds but not the IVS between the T4 and T5. The T4L/H was highest in the Shih Tzu and lowest in Beagle dogs. The Corgi-specific VHS obtained from the ventrodorsal radiograph was significantly higher than that from the dorsoventral radiograph, but a significant difference was not observed between the right and left lateral radiographs. In contrast, the Corgi-specific VHS derived from the right lateral thoracic radiograph was significantly lower than the reference value. This may be correlated with the characteristics of the thoracic vertebrae of Corgis, which were slightly higher than those of the other breeds