Endotoxic kidney injury in Beagle dogs assessed by serum creatinine and symmetric dimethylarginine, and urinary neutrophil gelatinase-associated lipocalin and clusterin.

Sepsis of Gram negative bacterial origin results in lipopolysaccharide-induced endotoxemia. This often leads to acute kidney injury (AKI) and its recognition remains a challenge and delays treatment. As renal damage occurs before a rise in serum creatinine is detected, new early biomarkers of kidney injury need to be explored. The aim of this study was to determine changes in serum parameters of renal function and urine biomarkers of renal injury. This was a descriptive study. Endotoxemia was induced intravenously in six anaesthetized Beagles (T1). To achieve normotension, dogs received fluids (T2), followed by a continuous infusion of noradrenaline and dexmedetomidine or 0.9% NaCl (T3). Ten minutes later, the dogs received fluids (T4) and noradrenaline and dexmedetomidine or 0.9% NaCl in a crossover manner (T5). At each timepoint, blood and urine were collected for serum creatinine, urea, symmetric dimethylarginine, urine protein/creatinine (UPC) ratio, urine neutrophil-gelatinase-associated lipocalin (U-NGAL), U-NGAL/creatinine ratio, urine clusterin (U-clusterin) and U-clusterin/creatinine ratio. Data were analyzed using a mixed-effect model taking into account time and stage of veterinary AKI (VAKI). Three of six dogs had a VAKI stage ≥1; one with anuria and elevated creatinine. Serum creatinine (P < 0.001), U-NGAL/creatinine ratio (P = 0.01) and U-clusterin/creatinine ratio increased over time (P < 0.01). The UPC ratio (mean (range) 0.68 (0.35-2.3) versus 0.39 (0.15-0.71) P < 0.01) and U-NGAL (3164 pg/mL (100-147,555) versus 100 (100-14,524), P = 0.01) were higher in VAKI stage ≥1 versus stage 0, respectively. Endotoxemia induced VAKI stage ≥1 in half of the dogs. Repeated measurement of selected parameters could detect AKI early.

[Diagnostic utility of creatine kinase elevation in the routine biochemical profile in cats]. / Diagnostischer Nutzen einer Kreatin­kinase Erhöhung im Routine­chemogramm bei Katzen.

INTRODUCTION: Creatine kinase (CK) is a muscle enzyme that is very sensitive to muscle damage. Therefore, serum CK is measured particularly to confirm suspected myopathy. Since 2013, this enzyme has been included in the routine chemistry profile in our hospital. Soon thereafter, the subjective impression developed that its elevation did not correlate to and was not explainable with the actual clinical problem. Therefore, the aim of this retrospective study was to investigate in which clinical cases the CK elevation was adequate and in which cases without clinical evidence of muscle damage the CK was so markedly elevated that it implied a clinically relevant muscle damage. For this purpose, we evaluated the CK values of 1641 cats presented in the years 2013/2014 at our university animal hospital. The CK was comprehensibly elevated in cats with trauma and various diseases with obvious and traceable muscle damage like thrombo-embolic damage or seizures. In addition, the CK was elevated in diseases where concomitant muscle damage is perceivable like in cats with hypertrophic cardiomyopathy. However, the CK also was commonly and sometimes dramatically elevated in cats of essentially any disease group without any comprehensible skeletal muscular lesion. These results confirm the hypothesis that the diagnostic value of this parameter is most questionable. A CK elevation does not allow any conclusion regarding its original diagnostic purpose, i.e. to confirm the presence of a clinically relevant myopathy.

INTRODUCTION: La créatine kinase (CK) est une enzyme musculaire très sensible lors de dommages musculaires. Par conséquent, la CK sérique est mesurée en particulier pour confirmer une myopathie suspectée. Depuis 2013, cette enzyme fait partie du chimiogramme de routine de notre hôpital. Après peu de temps, l'impression subjective s'est développée que son élévation n'était pas corrélée ni explicable avec le problème clinique réel. Par conséquent, le but de cette étude rétrospective était d'étudier dans quels cas cliniques l'élévation de la CK était adéquate et dans quels cas sans signe clinique de lésion musculaire, la CK était si nettement élevée qu'elle impliquait une lésion musculaire cliniquement pertinente. À cette fin, nous avons évalué les valeurs CK de 1641 chats présentés dans les années 2013/2014 à notre hôpital universitaire pour animaux. La CK était sensiblement élevée chez les chats souffrant de traumatismes et de diverses affections avec des lésions musculaires évidentes et traçables comme des dommages thrombo-emboliques ou des convulsions. De plus, la CK était élevée dans les maladies où des lésions musculaires concomitantes étaient décelables comme chez les chats atteints de cardiomyopathie hypertrophique. Cependant la CK était également couramment et parfois considérablement élevée chez les chats de pratiquement n'importe quel groupe de pathologies sans aucune lésion musculaire squelettique explicable. Ces résultats confirment l'hypothèse que la valeur diagnostique de ce paramètre est très discutable. Une élévation de la CK ne permet aucune conclusion concernant son objectif diagnostique d'origine, c'est-à-dire de confirmer la présence d'une myopathie cliniquement significative.

Investigation of the Status Quo of Veterinary Point-of-Care Laboratories in Switzerland: Availability, Application, and Quality Management.

INTRODUCTION: The extent to which Swiss veterinary practitioners follow the guidelines for quality assurance of the American Society for Veterinary Clinical Pathology (ASVCP) for point-of-care (POC) testing is unknown. Thus, the aim of this study was to assess the availability, application, and quality management of POC analyzers in Swiss veterinary practices/clinics. For this purpose, we created an online questionnaire on laboratory equipment, quality management, and biosafety, which all members of the Society of Swiss Veterinarians (GST) were invited to complete. In total, 192 clinics/practices participated, of which 69% had automated POC analyzers, mainly for clinical chemistry (99%) and/or hematology (86%). Sample analyses and equipment maintenance were mostly performed by veterinary technicians (81% and 68%, respectively). Reference intervals were adopted from manufacturers (80%) or literature (17%). The results showed that most participants perform basic internal quality control (chemistry: 75%; hematology: 86%), and many use at least two levels of quality control material (47%-48%). Controls are mostly run once a month (chemistry: 36%; hematology: 35%) or ≤4 times/year (36% and 25%). Only three clinics/practices reported participation in an external quality assessment program; comparative testing was more common (chemistry: 42%; hematology: 52%). Only one-quarter of the participants stated that they make use of the data generated through internal and external quality control measures. In conclusion, POC analyzers are widely available in Swiss veterinary clinics/practices, and internal quality control is performed to some extent. However, quality assessment and management and biosafety awareness and measures need to be improved, ideally with the support of clinical pathologists.

INTRODUCTION: On ignore dans quelle mesure les vétérinaires suisses respectent les directives d'assurance qualité de l'American Society for Veterinary Clinical Pathology (ASVCP) pour les tests au point de service (Point of Care, POC). Ainsi, l'objectif de cette étude était d'évaluer la disponibilité, l'application et la gestion de la qualité des analyseurs POC dans les cabinets/cliniques vétérinaires suisses. À cette fin, nous avons créé un questionnaire en ligne sur les équipements de laboratoire, la gestion de la qualité et la biosécurité que tous les membres de la Société suisse des vétérinaires (GST) ont été invités à remplir. Au total, 192 cliniques/cabinets ont participé, dont 69% avaient des analyseurs POC automatisés, principalement pour la chimie clinique (99%) et/ou l'hématologie (86%). Les analyses des échantillons et la maintenance de l>équipement ont été principalement effectuées par des assistant(e)s en médecine vétérinaires (81% et 68%, respectivement). Les intervalles de référence ont été fixés sur la base des indications des fabricants (80%) ou de la littérature (17%). Les résultats ont montré que la plupart des participants effectuent un contrôle de qualité interne de base (chimie: 75%; hématologie: 86%) et que beaucoup utilisent au moins deux niveaux de matériel de contrôle de la qualité (47% ­48%). Les contrôles sont principalement effectués une fois par mois (chimie: 36%; hématologie: 35%) ou ≤4 fois / an (36% et 25%). Seules trois cliniques/cabinets ont déclaré avoir participé à un programme externe d'évaluation de la qualité. Les tests comparatifs étaient plus courants (chimie: 42%; hématologie: 52%). Un quart seulement des participants ont déclaré utiliser les données générées par des mesures de contrôle de qualité internes et externes. En conclusion, les analyseurs POC sont largement disponibles dans les cliniques/cabinets vétérinaires suisses et le contrôle qualité interne est effectué dans une certaine mesure. Cependant, l'évaluation et la gestion de la qualité ainsi que la sensibilisation et les mesures en matière de biosécurité doivent être améliorées, idéalement avec le soutien de pathologistes cliniciens.

Plasma homocysteine concentrations in healthy horses and horses with atrial fibrillation.

INTRODUCTION: Homocysteine (HCY) is an amino acid produced from methionine metabolism. Plasma homocysteine concentrations ([HCY]p) are elevated (>13 µmol/L) in people with atrial fibrillation (AF) and can predict the recurrence of AF after cardioversion. This study aimed to validate a commercially available human HCY assay for use in horses to develop reference intervals for [HCY]p and compare [HCY]p in healthy horses and horses with AF. ANIMALS: Healthy horses (n = 27) and horses with AF (n = 55, 34 of which were cardioverted using transvenous electrical cardioversion). MATERIALS AND METHODS: Blood samples were analysed for HCY using an automated enzyme-cycling assay (Homocysteine Cobas C, Integra, Roche) and creatinine (compensated Jaffe method). Assay linearity and precision were assessed, reference intervals calculated and [HCY]p and creatinine compared between groups. RESULTS: The assay was precise (coefficient of variation 1.6-4.3%, n = 10 repetitions) and provided linear results (r = 0.99 for spiked and natural samples) for a range of [HCY]p. The reference interval for [HCY]p was 1.5-7.8 µmol/L. The plasma concentration of homocysteine was 4.65 ± 1.5 µmol/L (mean ± standard deviation) in healthy horses and 4.65 ± 1.72 µmol/L in horses with AF (p=0.99); [HCY]p was not associated with recurrence of AF (n = 18, p=0.97). A weak, positive correlation between plasma creatinine and [HCY]p was detected (r = 0.295, p=0.008, r2 = 0.11). CONCLUSIONS: This assay allows precise measurement of [HCY]p in horses. Unlike in people, [HCY]p is not increased in horses with AF and cannot predict AF recurrence. This might be due to differences in the underlying pathological mechanisms of AF development in people and horses.

Altered Serum Thyrotropin Concentrations in Dogs with Primary Hypoadrenocorticism before and during Treatment.

BACKGROUND: Thyrotropin (TSH) can be increased in humans with primary hypoadrenocorticism (HA) before glucocorticoid treatment. Increase in TSH is a typical finding of primary hypothyroidism and both diseases can occur concurrently (Schmidt's syndrome); therefore, care must be taken in assessing thyroid function in untreated human patients with HA. OBJECTIVE: Evaluate whether alterations in cTSH can be observed in dogs with HA in absence of primary hypothyroidism. ANIMALS: Thirty dogs with newly diagnosed HA, and 30 dogs in which HA was suspected but excluded based on a normal ACTH stimulation test (controls) were prospectively enrolled. METHODS: cTSH and T4 concentrations were determined in all dogs and at selected time points during treatment (prednisolone, fludrocortisone, or DOCP) in dogs with HA. RESULTS: cTSH concentrations ranged from 0.01 to 2.6 ng/mL (median 0.29) and were increased in 11/30 dogs with HA; values in controls were all within the reference interval (range: 0.01-0.2 ng/dL; median 0.06). There was no difference in T4 between dogs with increased cTSH (T4 range 1.0-2.1; median 1.3 µg/dL) compared to those with normal cTSH (T4 range 0.5-3.4, median 1.4 µg/dL; P=0.69) and controls (T4 range 0.3-3.8, median 1.8 µg/dL; P=0.35). After starting treatment, cTSH normalized after 2-4 weeks in 9 dogs and after 3 and 4 months in 2 without thyroxine supplementation. CONCLUSIONS AND CLINICAL RELEVANCE: Evaluation of thyroid function in untreated dogs with HA can lead to misdiagnosis of hypothyroidism; treatment with glucocorticoids for up to 4 months can be necessary to normalize cTSH.

[Enzyme arrangement of various tissues in swine. 3. Studies of pre- and postnatal activities of various enzymes (ATPase, GOT, GPT, leucine aminopeptidase, acid and alkaline phosphatases, aldose reductase, glucuronate reductase, sorbitol dehydrogenase) in various tissues]. / Untersuchungen über die Enzymausrüstung verschiedener Gewebe beim Schwein. 3. Mitteilung: Untersuchungen über die prä- und postnatale Aktivität verschiedener Enzyme (ATPase, GOT, GPT, Leuzinaminopeptidase, saure und alkalische Phosphatase, Aldolreduktase, Glukuronatreduktase, Sorbitdehydrogenase) in einigen Geweben.

The crude protein levels as well as the activities of various enzymes were studied in certain tissues of fetuses (80th through 114th days of development), piglets of different age groups, and pigs for slaughter. In most of the tissues tested the postnatal activities of Na-K-ATPase were beyond those recorded from fetuses. The highest GOT activities were recorded from the liver, myocardium, and kidneys. Activities were found to rise sizeably in some tissues after birth. The activity of GPT, too, exhibited age-dependent variations. The activity of leucine-aminopeptidase increased strongly after birth in liver and kidneys. Acid phosphatase activity was less markedly influenced by development phases. Those enzymes which are involved in the formation of fructose and glucose (aldolreductase, glucuronate-reductase, and sorbite-dehydrogenase) had their highest activities, all age-dependent, in liver and kidneys.