Effect of domperidone (leisguard®) on antibody titers, inflammatory markers and creatinine in dogs with leishmaniosis and chronic kidney disease.

BACKGROUND: Immunotherapeutic drugs, such as domperidone, have been shown to be promising treatments against canine leishmaniosis (CanL), but limited data are available. The aim of this pilot study (therapeutic, prospective and non-controlled) was to evaluate the effect of domperidone on serum antibody titers of Leishmania infantum, globulins, gamma globulins, acute-phase proteins (e.g. C-reactive protein [CRP]), big endothelin-1 (big ET-1), serum creatinine (SC) and proteinuria in dogs with leishmaniosis affected by chronic kidney disease (CKD). METHODS: Dogs were recruited if "exposed" to or "infected" with L. infantum and affected by CKD (IRIS stage 1 [proteinuric] or IRIS stage 2-3a [SC < 3.5 mg/dl; proteinuric or non-proteinuric]). After inclusion, an oral suspension of domperidone was administered, and the dogs were followed up for 180 days, with checks at 30, 60, 90 and 180 days after initial treatment. RESULTS: Of the 14 recruited dogs, nine showed a statistically significant reduction in SC (χ2 = 9.1, df = 3, P = 0.028), but not in the urine protein/creatinine ratio (χ2 = 6.43, df = 3, P = 0.092). All dogs showed a significant reduction in antibody titers for L. infantum (χ2 = 9.56, df = 2, P = 0.008), globulins (χ2 = 11.08, df = 3, P = 0.011) and gamma globulins (χ2 = 12.38, df = 3, P = 0.006) during the study period. There was also a statistically significant reduction in CRP (χ2 = 16.7, df = 3, P = 0.001), but not in big ET-1 (χ2 = 2.04, df = 3, P = 0.563). CONCLUSIONS: This study provides preliminary results on the ability of domperidone to improve SC and reduce anti-L. infantum antibody titers, globulins, gamma globulins and CRP in dogs with leishmaniosis and CKD.

Clinical and Histopathological Features of Renal Maldevelopment in Boxer Dogs: A Retrospective Case Series (1999-2018).

Renal maldevelopment (RM) has been proposed to replace the old and sometimes misused term "renal dysplasia" in dogs. Although renal dysplasia has been described in Boxers, hereditary transmission has only been hypothesized. This study reports clinical and renal histological findings in Boxer dogs with RM, proposing a possible mode of inheritance. Medical records of 9 female Boxer dogs, older than 5 months and with a clinical diagnosis of chronic kidney disease prior to one year of age, were retrospectively reviewed. Polyuria and polydipsia (PU/PD), decreased appetite, weight loss, lethargy and weakness were described in all affected dogs. Common laboratory findings were proteinuria, diluted urine, non-regenerative anemia, azotemia, hyperphosphatemia, hypoalbuminemia and hypercholesterolemia. Histopathology of the kidneys revealed the presence of immature glomeruli in all dogs, which is consistent with RM. In 7 related dogs, the pedigree analysis showed that a simple autosomal recessive trait may be a possible mode of inheritance. Renal maldevelopment should be suspected in young Boxer dogs with a history of PU/PD, decreased appetite, weight loss, lethargy, weakness and proteinuria. Due to its possible inheritance, an early diagnosis of RM may allow clinicians to promptly identify other potentially affected dogs among the relatives of the diagnosed case.

Short-term effects of dietary supplementation with amino acids in dogs with proteinuric chronic kidney disease.

This retrospective study investigated the impact of amino acid supplementation on body weight, serum albumin, creatinine and urea concentrations, and urine protein-to-creatinine (UPC) ratio in proteinuric dogs with chronic kidney disease (CKD). Forty-six client-owned azotemic dogs with spontaneous proteinuric CKD already on a renal diet and in therapy with enalapril were included. After approximately 1 month of treatment (baseline), 29 dogs received oral amino acid supplementation daily (group A) and 17 dogs did not (group B). The parameters under investigation were determined at baseline and after 4 to 8 weeks in both groups. Compared to baseline, body weight and serum albumin increased (P < 0.01, P < 0.05, respectively) at follow-up in group A, but did not change in group B. Serum creatinine concentration did not change in both groups; urea concentration (P < 0.05) and UPC ratio (P < 0.01) decreased in group B, but not in group A. Supplementation with amino acids increased body weight and serum albumin concentration in these dogs but it might have prevented a decrease in proteinuria and urea concentration.

Effets à court terme de la supplémentation alimentaire avec des acides aminés chez les chiens atteints de la maladie rénale chronique protéinurique. Cette étude rétrospective a étudié l'impact de la supplémentation avec des acides aminés sur le poids corporel, l'albumine sérique, les concentrations de créatinine et d'urée et le rapport protéines/créatinine urinaire (UPC) chez les chiens albuminuriques atteints de maladie rénale chronique (MRC). Quarante-six chiens azotémiques, appartenant à des clients, atteints de MRC albuminurique spontanée consommant déjà une diète rénale et un traitement d'énalapril ont été inclus. Environ 1 mois après le traitement (données de référence), 29 chiens ont reçu une supplémentation quotidienne aux acides aminés (groupe A) et 17 ne l'ont pas reçu (groupe B). Les paramètres à l'étude étaient déterminés aux données de référence et après 4 à 8 semaines dans les deux groupes. Comparativement aux données de référence, le poids corporel et l'albumine sérique ont augmenté (P < 0,01, P < 0,05, respectivement) au suivi dans le groupe A, mais n'ont pas changé dans le groupe B. La concentration de créatinine sérique n'a pas changé dans les deux groupes; la concentration d'urée (P < 0,05) et le rapport d'UPC (P < 0,01) ont baissé dans le groupe B, mais non dans le groupe A. La supplémentation avec des acides aminés a augmenté le poids corporel et la concentration d'albumine sérique chez ces chiens mais elle peut avoir empêché une baisse de la concentration de protéinurie et d'urée.(Traduit par Isabelle Vallières).

Effect of dietary supplements in reducing probability of death for uremic crises in dogs affected by chronic kidney disease (masked RCCT).

Chitosan and alkalinizing agents can decrease morbidity and mortality in humans with chronic kidney disease (CKD). Whether this holds true in dog is not known. Objective of the study was to determine whether a commercial dietary supplement containing chitosan, phosphate binders, and alkalinizing agents (Renal), compared to placebo, reduces mortality rate due to uremic crises in dogs with spontaneous CKD, fed a renal diet (RD). A masked RCCT was performed including 31 azotemic dogs with spontaneous CKD. Dogs enrolled in the study were randomly allocated to receive RD plus placebo (group A; 15 dogs) or RD plus Renal (group B; 16 dogs). During a first 4-week period, all dogs were fed an RD and then randomized and clinically evaluated up to 44 weeks. The effects of dietary supplements on mortality rate due to uremic crises were assessed. At 44 weeks, compared to group A, dogs in group B had approximately 50% lower mortality rate due to uremic crises (P = 0.015). Dietary supplementation with chitosan, phosphate binders, and alkalinizing agents, along with an RD, is beneficial in reducing mortality rate in dogs with spontaneous CKD.

Comparison of urine protein-to-creatinine ratio in urine samples collected by cystocentesis versus free catch in dogs.

OBJECTIVE: To assess whether urine protein-to-creatinine (UPC) ratios determined in urine samples collected by cystocentesis versus those collected by free catch provide similar diagnostic information for dogs. DESIGN: Evaluation study. ANIMALS: 115 client-owned dogs evaluated because of various health problems requiring urinalysis or to screen for proteinuria in an area endemic for leishmaniasis. PROCEDURES: 230 paired urine samples, 1 collected by cystocentesis and 1 by free catch, were collected from the 115 dogs. The UPC ratio was determined in paired urine samples (n = 162) from 81 dogs with no indication of active inflammation according to urine sediment analysis. On the basis of the UPC ratio of urine sample collected by cystocentesis, dogs were classified as nonproteinuric (UPC ratio < 0.2), borderline proteinuric (UPC ratio of 0.2 to 0.5), or proteinuric (UPC ratio > 0.5), according to the International Renal Interest Society (IRIS). RESULTS: The correlation between UPC ratio in urine samples collected by cystocentesis and by free catch was strong (r(2) = 0.90); 75 of 81 (92.6%) dogs had UPC ratios from both urine samples that resulted in classification in the same IRIS substage with a kappa coefficient of 0.83. CONCLUSIONS AND CLINICAL RELEVANCE: The UPC ratio in dogs was minimally affected in urine samples collected by free catch, thus allowing correct grading of proteinuria with this method. The high reliability of the UPC ratio in free-catch urine samples coupled with the ease of collection should increase the use of this value for assessment of proteinuria.

Ultrasound-assisted drainage and alcoholization of hepatic and renal cysts: 22 cases.

Twenty-two dogs and cats with symptomatic renal or hepatic cysts that had undergone ultrasound-assisted drainage and alcoholization were retrospectively evaluated. Common presenting complaints were anorexia, reluctance to move, and vomiting. Abdominal pain was observed in all cases. Systemic hypertension was identified in four dogs and four cats with renal cysts. Cyst drainage and alcoholization were achieved without complications in 19 animals, and all clinical signs resolved after the procedure. In three cases, transient bleeding was observed during alcoholization, and the procedure was interrupted. Blood pressure normalized in the four dogs with renal cysts, but it remained elevated in the four cats.

Proximal ureteral ectopia causing hydronephrosis in a kitten.

A 2-month-old, female cat was presented for abdomen dilation. The patient was undernourished, and severe left hydronephrosis was diagnosed after clinical, ultrasonographical and radiographical examination. Although pyelography was performed in order to visualise the ureteral course, surgery was necessary to reach a final aetiological diagnosis and treatment. At gross examination, the left ureter crossed the renal capsula at the level of the caudal renal pole, and the subcapsular ureteral segment was markedly dilated. Distal to the renal capsula, the left ureter was very thin when compared to the right. The parenchyma of the left kidney, as suggested by ultrasonographical evaluation, was extremely reduced in thickness. An ureteronephrectomy was performed. Histopathological evaluation revealed glomerular sclerosis and diffuse parenchymal fibrosis. Severe hydronephrosis derived from an altered renal pelvic anatomy and abnormal ureteral course determining functional stenosis. Diagnosis of congenital anomaly before development of complications such as hydronephrosis could have allowed a surgical renal capsulectomy and obstruction relief. To the author's knowledge, this is the first report of severe hydronephrosis associated to altered renal pelvic anatomy and proximal ureteral ectopia in cat.

Comparison of glomerular number and specimen length obtained from 100 dogs via percutaneous echo-assisted renal biopsy using two different needles.

Our objective was to evaluate possible differences in the number of glomeruli and length of renal biopsies collected in canine subjects by two different types of biopsy needles: a semiautomatic 18-gauge Trucut and an automated 18-gauge Jamshidi modified (Biopince). One hundred biopsy samples obtained from dogs of different ages and gender affected by different nephropathies were evaluated retrospectively. All animals were biopsied using one of the two different needles. Biopsies were performed under ultrasound guidance and evaluated by a single pathologist. Statistical analysis was performed to evaluate possible differences in the number of glomeruli and length of renal biopsies collected comparisons were determined between subgroups of dogs with or without the identification of renal interstitial infiltrates and/or fibrosis. Neither the mean difference of the number of glomeruli nor the length of tissue sample collected with the different needles was significantly different. Likewise, the average biopsy length did not differ in dogs with or without renal interstitial infiltrate in animals biopsied with either biopsy needle. Both the Biopince and the Trucut devices provide diagnostically adequate biopsy renal specimens using ultrasound-guidance.

Percutaneous drainage and alcoholization of hepatic abscesses in five dogs and a cat.

Hepatic abscesses are rare and difficult to diagnose in dogs and cats. Ultrasonographic examination is essential to thoroughly examine hepatic abnormalities, and it may also help in the localization of hepatic abscesses. In this retrospective study, five dogs and one cat with focal hepatic lesions compatible with a hepatic abscess were treated with percutaneous ultrasound-assisted drainage and alcoholization using 95% ethanol. The procedure was performed rapidly under injectable anesthesia and provided excellent results in all animals. No complications or relapses were noted for 120 days following the procedure. The technique of percutaneous ultrasound-assisted drainage and alcoholization of hepatic abscesses in the dog and cat is also described.