Urinary capillariosis in six dogs from Italy

Canine urinary capillariosis is caused by the nematode Pearsonema plica. P. plica infection is seldomly detected in clinical practice mainly due to diagnostic limitations. This report describes six cases of urinary capillariosis in dogs from Italy. Recurrent cystitis was observed in one dog, whereas another patient was affected by glomerular amyloidosis. In the remaining animals, the infection was considered an incidental finding. Immature eggs of the parasite were observed with urine sediment examination in 3/6 patients. Increased awareness of the potential pathogenic role of P. plica and clinical disease presentation could help identify infected animals

Acute and long-term effects of ACE inhibition on renal haemodynamics in glomerular and interstitial nephropathies

Background Angiotensin-converting enzyme (ACE) inhibitors are the drugs of choice for the treatment of hypertension in patients with non-diabetic nephropathies. However, not every trial has reported better results with ACE inhibitors (ACE-I) than with other drugs. This study investigates whether the acute and chronic effects of ACE inhibition on renal and glomerular haemodynamics are similar in glomerular and interstitial nephropathies. Methods We studied 20 hypertensive patients, on their usual diet, with mild-to-moderate chronic renal failure secondary to non-diabetic nephropathy. After a three-week wash out period, we determined plasma clearances of para-amino-hippurate and inulin before, and after acute oral administration of either enalapril or ramipril. This same test was carried out after one and two years of treatment with the same drug. Results Acute ACE inhibition causes a decrease of renal perfusion, glomerular filtration and pressure with an increase of afferent resistances. Long-term ACE inhibition is associated only with a decrease in renal perfusion, with a non-significant tendency to higher filtration fraction and lower afferent resistances. All the renal haemodynamic modifications mentioned above are present only in patients with glomerular diseases. Conclusions Renal and glomerular haemodynamic responses are not similar after acute and chronic ACE inhibition. Only patients with glomerular diseases show acute or long-term responses to ACE inhibition

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.

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

Clinical utility of urine kidney injury molecule-1 (KIM-1) and gamma-glutamyl transferase (GGT) in the diagnosis of canine acute kidney injury

The aim of the present study was to evaluate the sensitivity and specificity of urine KIM-1 and urine GGT for the detection of naturally-occurring AKI, compared to healthy control dogs, dogs with stable chronic kidney disease (CKD), and dogs with lower urinary tract disorders (LUTD). The study included AKI grade 1 (n = 21), AKI grade 2 to 5 (n = 11), stable CKD (n = 11), LUTD (n = 15), and healthy dogs (n = 37). Urine KIM-1 (ng/mg) and GGT (U/l) were normalized to urine creatinine (uCr). Statistically significant difference in KIM/uCr (p = 0.0007) and GGT/uCr (p < 0.0001) was found among the study groups. Area under the curve (AUC) for KIM-1/uCr and GGT/uCr as predictors of AKI was 0.81 and 0.91 respectively. Values of KIM-1/uCr of 0.73 ng/mg and of GGT/uCr of 54.33 showed the best combination of sensitivity and specificity (75% and 75.6%; 85.7% and 89.1% respectively). A significant positive correlation (p < 0.0001) between KIM-1/uCr and GGT/uCr was found. Both urine KIM-1/uCr and GGT/uCr seemed to be potentially good markers for the diagnosis of AKI. Dogs with AKI showed significantly higher levels of urine KIM-1/uCr and urine GGT/uCr, compared with healthy dogs. Caution should be used in the evaluation of elevated urine KIM-1/uCr and GGT/uCr in dogs with pre-existing CKD and/or LUTD. Urine KIM-1/uCr and GGT/uCr might have a significant clinical utility, as complementary test, particularly in diagnosis early, non-azotemic stages of AKI

Evaluation of Erythrocytes, Platelets, and Serum Iron Profile in Dogs with Chronic Enteropathy

The aim of this study is to evaluate iron status, erythrocyte, and platelet modifications in dogs with chronic enteropathy (CE). Dogs were grouped as food-responsive diarrhea (FRD, n = 11), antibiotic-responsive diarrhea (ARD, n = 5), and steroid-responsive diarrhea (SRD, n = 6) relating to therapeutic-response. Clinical and haematological findings, evidence of gastrointestinal blood loss, and iron metabolism were evaluated before and after treatment. A mild normocytic or microcytic anemia and thrombocytosis were identified, respectively in 18.0% and 31.8% of CE dogs. No significant differences between pre- and posttreatment of hematocrit, haemoglobin, and mean corpuscular volume, platelet count and mean platelet volume were found. Statistical analysis pointed out significant differences between pre- and posttreatment in serum iron (P < .03) and unsaturated iron binding capacity (UIBC) (P < .01). No significant correlations were found between these parameters and canine Inflammatory Bowel Disease activity index and pattern of CE as well

Serum levels of Ochratoxin A in dogs with chronic kidney disease (CKD): a retrospective study

Ochratoxin A (OTA) is a mycotoxin produced by secondary metabolism of several fungi belonging to the genera Aspergillus and Penicillium. OTA is potentially nephrotoxic, neurotoxic, immunotoxic and carcinogenic in several animal species and in humans. This toxin has been detected in several human food and animal feed. The aim of this study was to determine OTA in blood samples of healthy and affected by chronic kidney disease (CKD) dogs. CKD group showed higher incidence of OTA-positivity than healthy dogs (96% vs. 56%) and a significantly higher median value of OTA plasma concentration (0.008 ng/ml vs. 0.144 ng/ml). No significant correlation was observed between OTA levels and creatinine values in CKD dogs. This is first study regarding OTA detection in plasma samples of healthy and CKD dogs; the presence of this toxin is higher in nephropatic patients but is not yet clear, if it is correlated with progression of the disease