Retrospective Evaluation of Gastrointestinal Signs in Hypothyroid Dogs

Few observations about gastrointestinal (GI) signs in hypothyroid dogs (hypo-T dogs) are available. We aimed to evaluate the prevalence and characteristics of concurrent GI signs in hypo-T dogs, describe clinicopathological, hepato-intestinal ultrasound findings in hypo-T dogs, investigate changes in GI signs after thyroid replacement therapy (THRT). Medical records of suspected hypo-T dogs from two hospitals were retrospectively reviewed. The inclusion criteria were: (1) having symptoms and clinicopathological abnormalities related to hypothyroidism (i.e., mild anemia, hyperlipemia); (2) not being affected by systemic acute disease; (3) not having received any treatment affecting thyroid axis. Hypothyroidism had to be confirmed using low fT4 or TT4 with high TSH and/or inadequate TSH-stimulation test response; otherwise, dogs were assigned to a euthyroid group. Clinical history, GI signs, hematobiochemical parameters, and abdominal ultrasound findings were recorded. Hypo-T dogs were assigned to the GI group (at least 2 GI signs) and not-GI group (1 or no GI signs). Follow-up information 3-5 weeks after THRT was recorded. In total, 110 medical records were screened: 31 dogs were hypo-T, and 79 were euthyroid. Hypo-T dogs showed a higher prevalence of GI signs (44%), especially constipation and diarrhea (p = 0.03 and p = 0.001), than euthyroid dogs (24%) (p = 0.04). Among hypo-T dogs, no difference in hematological parameters between GI and non-GI groups was found. Hypo-T dogs had a higher prevalence of gallbladder alterations than euthyroid dogs (20/25; 80% and 32/61; 52% p = 0.04). The hypo-T GI group showed a significant improvement in the GI signs after THRT (p < 0.0001). Specific investigation for concurrent GI diseases in hypo-T dogs was lacking; however, improvement in GI signs following THRT supports this association between GI signs and hypothyroidism

Assisted feeding through an oesophagostomy tube in patients with chronic kidney disease and uraemic syndrome: impact on body condition score, renal function and survival

La dietoterapia rappresenta il primo strumento terapeutico nel paziente in presenza di danno renale acuto e malattia renale cronica. Tuttavia la maggior parte di tali pazienti non è in grado di alimentarsi volontariamente e nel quantitativo adeguato ai propri fabbisogni. Obiettivo del presente studio è di valutare BCS, parametri di funzionalità renale e sopravvivenza in pazienti in crisi uremica sottoposti o meno ad alimentazione assistita. Lo studio è stato condotto su quattordici cani con pregressa CKD e in fase di riacutizzazione o scompenso. Sette pazienti sono stati gestiti mediante impiego di feeding tube (FT), 7 mediante terapia medica tradizionale (GC). Per ciascuno dei due gruppi, BCS, creatinina, urea, e fosforo sierici e sopravvivenza, sono stati valutati a T0 e ad uno (T1) e due mesi (T2). I dati sono stati elaborati statisticamente. Il GC presentava una differenza significativa di BCS (p=0,04), creatinina (p=0,001), urea (p=0,005) e fosforo (p=0,04) a diversi controlli. Il FT presentava una differenza significativa di BCS (p=0,03), valori sierici di creatinina (p=0,006), urea (p=0,0001) e fosforo (p=0,02) ai diversi controlli. Il FT mostrava una sopravvivenza alla crisi uremica maggiore (p=0,01) del GC. Le evidenze del presente studio riportano un significativo miglioramento di BCS, parametri di funzionalità renale e sopravvivenza nei pazienti gestiti con feeding rispetto agli altri. Il feeding tube sembra rappresentare un ausilio terapeutico estremamente utile nella gestione medica del paziente in crisi uremica.Introduction – A renal diet is a fundamental part of the medical management of patients with acute and chronic kidney disease. Unfortunately, most patients are not able to eat a sufficient amount of a renal diet to achieve an adequate calorie intake. The aim of this study was to evaluate the Body Condition Score (BCS), renal function and survival rate in a group of uraemic patients managed with a feeding tube and compare the findings with those in a comparable group managed without a feeding tube. Materials and Methods – Fourteen dogs with acute-on-chronic kidney disease formed the study population. Seven dogs were managed with the use of a feeding tube (FT group) and seven were managed without a feeding tube (control group). BCS, serum creatinine, urea and phosphate concentrations and survival rate were evaluated in both groups at time 0 (T0), after 1 month (T1) and after 2 months (T2). Data were analysed statistically. Results – There were significant differences in BCS (p=0.04), creatinine (p=0.001), urea (p=0,005) phosphate (p=0.04) at the different time points in the control group. The FT group also had significant difference in BCS (p=0.03), creatinine (p=0.006), urea (p=0.0001) and phosphate (p=0.02) at the different time points. The survival rate was higher in the FT group than in the control group (p=0.01). Discussion – The results of the present study show significant improvements in BCS, renal function and survival in patients managed with a feeding tube, compared to those in which a feeding tube was not used. A feeding tube seems to be a very useful therapeutic instrument for the management of patients with uraemic syndrome

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

Urinary Cytology: Potential Role in Canine Urinary Tract Infections

The diagnosis of urinary tract infections (UTIs) requires a concomitant evaluation of clinical signs and urine culture, which is of fundamental to start an appropriate antibiotic treatment. Several factors, such as subclinical bacteriuria or pre-analytical errors, may make the interpretation of urine culture difficult. The aim of the study was to evaluate the association between the finding of neutrophils and bacteria in unstained and stained canine urine sediment and the presence of clinical signs and positive urine culture. Urine samples from 35 dogs with clinical signs of UTI and 55 asymptomatic dogs with risk factors for UTI were prospectively collected by cystocentesis, divided into three aliquots, and submitted for: (1) physical and chemical Dipstick analysis and unstained urinary sediment (casts, crystals, bacteria, leucocytes, cells, parasites); (2) stained urinary sediment (extra/intracellular bacteria, degenerated and non-degenerated neutrophils); (3) qualitative and quantitative urine culture and antimicrobial sensitivity-test. The association between unstained and stained findings of urinary sediment and urine culture was tested. Sensibility, specificity, and positive/negative predictive values in diagnosing positive urine cultures of bacteria at unstained and stained evaluation were compared. Both wet-mount bacteriuria and the cytological presence of intracellular and extracellular bacteria, neutrophils, and degenerated neutrophils were successively associated with positive urine culture (p < 0.001). The presence of intracellular bacteria was the only independent predictor of positive urine culture. Total bacterial count did not differ significantly between symptomatic and asymptomatic dogs. Detection of extracellular and intracellular bacteriuria at stained urinary sediment significantly improved the sensibility of predicting positive urine culture. Cytologic evaluation of urinary sediment may be helpful in detecting signs of active inflammation, thus enhancing the clinical relevance of a positive urine culture

Alterations of selected serum biochemical and urinary parameters in dogs with chronic enteropathy

Background: No specific study on concurrent nephropathy has been conducted in dogs with chronic enteropathy (CE), except for soft-coated Wheaten Terriers. Moreover, limited information exists regarding the urinary profile in dogs with CE.Aim: To describe, compare, and discuss the alterations in selected serum biochemical and urinary parameters in dogs with CE.Methods: Multicentric retrospective study on dogs with CE diagnosed after exclusion of extra-gastrointestinal diseases. In addition, dogs with azotemia and lower urinary tract diseases were excluded. Information on canine chronic enteropathy clinical activity index (CCECAI) score, muscular condition score (MCS), presence of glycosuria, proteinuria [urine protein-to-creatinine (UPC) ratio > 0.5], and/or cylindruria (>1–2 casts/hpf) at diagnosis were gleaned from the medical records. Dogs were retrospectively classified as food-responsive enteropathy, immunosuppressant-responsive enteropathy, or nonresponsive enteropathy based on the presence of gastrointestinal histological inflammation and the treatment response. In addition, based on the serum albumin concentration (ALB), dogs were classified as having protein-losing enteropathy (PLE).Results: Ninety CE dogs were included. Fifty-two dogs had mild-to-severely decreased MCS and 38 dogs showed altered urinary parameters. No significant associations were found between CCECAI and altered urinary parameters. No significant association was found between PLE dogs and altered urinary parameters. PLE dogs showed higher prevalence of proteinuria than non-PLE dogs (p = 0.03; OR = 2.8; 95% CI = 1–6.8).Conclusion: Despite the presence of altered urinary profile in dogs with CE, further studies are needed to explore a possible link between gastrointestinal and renal inflammation

Six-Year Prescription Pattern of Antimicrobial Use in Cats at the Veterinary Teaching Hospital of the University of Pisa

: The use of antimicrobials has greatly contributed to improving animal health. However, their inappropriate use reduces their effectiveness in treating bacterial infections and contributes to the selection of resistance. This study aimed to retrospectively evaluate the six-year pattern (2017-2022) of antimicrobial use in cats visiting the Veterinary Teaching Hospital (VTH) of the University of Pisa (Italy). The total number of prescribed antimicrobials, the number of animals for which an antimicrobial was prescribed, and the total number of antimicrobial prescriptions showed a significant time trend decrease during the study period, except for the fixed-dose combinations. The most frequently prescribed antimicrobials were amoxicillin-clavulanic acid (Synulox) (39.1%) followed by enrofloxacin (29.8%). These antimicrobials were mostly prescribed to treat infections affecting the genitourinary tract (~30%), followed by the gastrointestinal tract, skin, and respiratory system affections. Antimicrobials in empirical associations represented 13.0% of the total antimicrobial prescriptions, and the combination of amoxicillin-clavulanic acid (Synulox) with enrofloxacin accounted for the majority. The oral route represented the main route of administration of prescribed antimicrobials, followed by parenteral and topical ones. Amoxicillin-clavulanic acid (Synulox) (37.2%), ceftriaxone (2.7%), and tobramycin (2.8%) were the most prescribed antimicrobials for the oral, parenteral, and topical routes, respectively. Antimicrobial prescriptions complied with prudent use recommendations in terms of availability of diagnosis, respect to the dose range, duration of treatment, and the use of medicinal products approved for the species. On the contrary, antimicrobial susceptibility tests were used infrequently (5.2%), lacking compliance with the existing guidelines observed in companion animal practice. Overall, additional interventions are required not only to improve the responsible use of antimicrobials in our feline practice but also to implement antimicrobial stewardship programs, enhancing diagnostics such as culture and sensitivity testing in the future

Autoantibodies in COVID-19 survivors with post-COVID symptoms: a systematic review

ObjectiveThe long-lasting persistence of autoantibodies stands as one of the hypotheses explaining the multisystemic manifestations seen in individuals with post-COVID-19 condition. The current review offers restricted insights into the persistence of autoantibodies in plasma/serum in people with post-COVID symptoms.MethodsPubMed/MEDLINE, CINAHL, EMBASE, and Web of Science databases, as well as on medRxiv and bioRxiv preprint servers were searched up to January 5th, 2024. Papers investigating the presence of autoantibodies in plasma/serum samples in people with post-COVID symptoms were included. The Newcastle-Ottawa Scale (NOS) was used to assess methodological quality.ResultsFrom 162 identified records, five articles met all inclusion criteria; four studies included infected controls with no post-COVID symptoms whereas all five studies included non-infected controls (410 COVID-19 survivors with post-COVID symptoms, 223 COVID-19 survivors with no post-COVID symptoms as controls and 266 non-infected healthy controls). Four studies concluded that the presence of autoantibodies had a potential (but small) role in post-COVID-19 condition whereas one study concluded that autoantibodies were not associated. Quality assessment showed all studies had high methodological quality.ConclusionAlthough evidence suggests that persistent autoantibodies can be associated with post-COVID symptoms, the clinical relevance of their presence seems modest at this stage. Current results highlight further research to clarify the role of autoantibodies in the development of post-COVID symptoms, guiding the development of tailored diagnostic and treatment approaches to enhance patient outcomes.Systematic review registrationhttps://osf.io/vqz28

Multicentre Italian study of SARS-CoV-2 infection in children and adolescents, preliminary data as at 10 April 2020

Data on features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children and adolescents are scarce. We report preliminary results of an Italian multicentre study comprising 168 laboratory-confirmed paediatric cases (median: 2.3 years, range: 1 day-17.7 years, 55.9% males), of which 67.9% were hospitalised and 19.6% had comorbidities. Fever was the most common symptom, gastrointestinal manifestations were frequent; two children required intensive care, five had seizures, 49 received experimental treatments and all recovered

Development of real time RT-PCR for the differential diagnosis of chikungunya, dengue and Zika

As doenças causadas pelos vírus da chikungunya (CHIKV), dengue (DENV) e Zika (ZIKV), principalmente na fase aguda, induzem sintomatologias muito semelhantes entre si. O CHIKV pertence ao gênero Alphavirus da família Togaviridae, enquanto os DENV e ZIKV pertencem ao gênero Flavivirus da família Flaviviridae. A rápida implementação de tratamento, especialmente nos pacientes com dengue, diminui drasticamente o número de casos fatais. O objetivo deste trabalho foi desenvolver métodos de transcrição reversa seguida da reação em cadeia da polimerase (RT-PCR) em tempo real para diagnóstico diferencial e precoce de chikungunya, dengue e Zika. Sondas e primers específicos para CHIKV, ZIKV e os quatro sorotipos de DENV (DENV-1 a -4) foram desenhados a partir dos primeiros nucleotídeos da extremidade 5\' dos genomas virais para amplificação de fragmentos com 150, 185 e 170 pares de bases para DENV, ZIKV e CHIKV, respectivamente. Diversos protocolos foram realizados para otimização da reação de RT-PCR em tempo real considerando as concentrações de sondas, íon magnésio e temperatura de anelamento de sondas e primers. Análises de reação cruzada mostraram que os primers e as sondas selecionadas foram altamente específicos para os vírus em questão, sem reconhecimento cruzado de outros flavivírus e alfavírus, com exceção das sondas para os DENV-3 e DENV-4 que apresentaram reação cruzada com outros sorotipos. A sonda para DENV-3 reconheceu cruzadamente o DENV-1 e a sonda para DENV-4 o DENV-2. O limite de detecção da RT-PCR para dengue com sondas foi de 9,90x104, 2,42x102, 6,55x106 e 3,70x106 cópias/mL para os DENV-1 a -4, respectivamente. Contudo, o limite de detecção da RT-PCR para dengue com SYBR Green foi de 9,90x101, 2,42x101, 6,55x103 e 3,70x101 cópias/mL para os DENV-1 a -4, respectivamente, inferior àquela utilizando sondas. Os limites de detecção da RT-PCR com sondas para o ZIKV e o CHIKV foram de 1,25x100 e 5,25x100 PFU/mL, respectivamente, similares aos resultados encontrados quando realizada a RT-PCR com SYBR Green para estes mesmos vírus que foram de 1,25x101 e 5,25x100 PFU/mL, respectivamente. Amostras de soro de indivíduos assintomáticos e amostras de soro, urina ou saliva armazenadas no biorrepositório \"Banco de amostras de arbovírus\" (FCFRP Nº 006) do Laboratório de Virologia da FCFRP-USP, foram testadas com a RT-PCR com SYBR Green para dengue, observando-se uma sensibilidade de 54%, especificidade de 100%, valores preditivos positivo e negativo de 100% e 75%, respectivamente. Entretanto, quando avaliadas apenas as amostras de soro, observou-se uma sensibilidade de 82%, especificidade de 100%, valores preditivos positivo e negativo de 100% e 71% respectivamente, sugerindo que as amostras de soro são as mais indicadas para utilização no diagnóstico da dengue. Estas amostras também foram analisadas com as RT-PCRs com sondas para os vírus chikungunya e Zika, sendo todas negativas. As amostras detectadas com a RT-PCR com SYBR Green para dengue foram analisadas com a RT-PCR com sondas, sendo observada uma concordância de mais de 90% com os sorotipos previamente identificados. Conclui-se, portanto, que a detecção diferencial dos vírus é eficaz e fiel em uma única etapa e o método possui alta especificidade e sensibilidadeDiseases caused by the viruses chikungunya (CHIKV), dengue (DENV) and Zika (ZIKV), specially in the acute phase, induced very similar symptoms. The CHIKV belongs to de genus Alphavirus, family Togaviridae, while the DENV and ZIKV belong to the genus Flavivirus, family Flaviviridae. The aim of this work was to develop a real time reverse transcription followed by polymerase chain reaction (RT-PCR) for early and differential diagnosis of chikungunya, dengue and Zika. Specific primers and probes for CHIKV, ZIKV and the four DENV (DENV-1 a -4) serotypes were designed from the first nucleotides on the 5\'end of the viral genomes to amplify fragments 150, 185, 170 base pairs fragments for DENV, ZIKV and CHIKV, respectively. Several protocols were analyzed for the optimization of the real time RTPCR, considering probes concentrations, magnesium ion and the primers and probes annealing temperature. Cross-reactivity tests showed that the selected primers and probes were highly specific to the target virus without recognition of other flaviviruses and alphaviruses, except for the probes for DENV-3 and DENV-4, which showed cross-reaction with other serotypes. The probe for DENV-3 cross-reacted with DENV-1 and the probe DENV-4 with DENV-2. The limit of detection of the RT-PCR with probes for dengue was 9,90x104, 2,42x102, 6,55x106 and 3,70x106 copies/mL for DENV-1, DENV-2, DENV-3 and DENV-4, respectively. However, the limit of detection of the RT-PCR with SYBR Green for dengue was 9,90x101, 2,42x101, 6,55x103 and 3,70x101 copies/mL for DENV-1, DENV-2, DENV-3 and DENV-4 respectively. The limit of detection of the RT-PCR with probes for ZIKV and CHIKV was 1,25x100 and 5,25x100 PFU/mL, respectively, similar to that found for the RT-PCR with SYBR Green, which was 1,25x101 e 5,25x100 PFU/mL for ZIKV and CHIKV, respectively. Serum samples from asymptomatic participants and serum, urine and saliva samples stored at the samples biorepository named \"Banco de amostras de arbovírus\" (FCFRP Nº 006) of the FCFRP-USP Virology laboratory were tested with RT-PCR with SYBR Green for dengue and showed a 54% sensitivity, 100% specificity and 100% and 75% positive and negative predictive values, respectively. However, when only serum samples were analysed, it showed 82% sensitivity, 100% specificity and 100% and 71% positive and negative predictive values, respectively, suggesting that the serum samples are more suitable for dengue diagnosis. Those samples were also analyzed with the RT-PCR with probes for CHIKV and ZIKV, being all negatives. The samples detected with the RT-PCR with SYBR Green for dengue were analyzed with the RTPCR with probes, showing to detect the expected serotype in more than 90% of them. Therefore, it\'s concluded that differential virus detection is effective and faithful in a single step and the method has high specificity and sensitivit