Continuous positive airway pressure (CPAP) provision with a pediatric helmet for treatment of hypoxemic acute respiratory failure in dogs.

OBJECTIVE: To evaluate arterial blood gas parameters and pulmonary radiography, before and after provision of continuous positive airway pressure (CPAP) via a pediatric helmet in dogs with acute hypoxemic respiratory failure. DESIGN: Single-center, observational study conducted from 2016 to 2017. SETTING: University teaching hospital. ANIMALS: Seventeen dogs presenting with clinical signs compatible with respiratory failure, confirmed by arterial blood gas analyses. INTERVENTIONS: For each animal arterial blood samples and thoracic radiographs were performed at arrival (T0 ). Hypoxemic dogs (PaO2  <80 mm Hg), without evidence of pneumothorax or pleural effusion, received CPAP ventilation via a pediatric Helmet for at least 1 hour. At the end of CPAP ventilation, a second arterial blood gas analysis was performed at room air (T1 ). The F-shunt was also calculated. MEASUREMENT AND MAIN RESULTS: Respiratory rate, heart rate and rhythm, mean blood pressure, mucosal membrane color, and rectal temperature were recorded. Tolerance to the helmet was evaluated using a predetermined scoring system. Two dogs were excluded from the study for low tolerance to the helmet. In 15 of 17 dogs, a significant difference between T0 and T1 was noted for PaO2 (60.84 ± 3 mm Hg vs 80.2 ± 5.5 mm Hg), P(A-a)O2 (52.4 ± 4.4 mm Hg vs 35.2 ± 6 mm Hg), PaO2 /FiO2 (289.7 ± 14.3 vs 371 ± 21), and %SO2 (91.3 vs 98.8). In 15 of 17 dogs, the helmet was well tolerated. F-shunt significantly decreased following provision of CPAP (37%; range, 8.4-68% vs 6%; range, -5.6-64.3%). CONCLUSION: The use of a pediatric helmet appears to be a suitable device for delivery of CPAP in dogs with hypoxemic acute respiratory failure. The device appears to be reasonably tolerated and improved oxygenation in most dogs.

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 glomerular filtration rate estimation by means of plasma clearance of iohexol in domestic rabbits (Oryctolagus cuniculus).

OBJECTIVE: To evaluate glomerular filtration rate (GFR) estimation by means of plasma clearance of iohexol (IOX) in domestic rabbits and to assess accuracy of limited-sampling models for GFR estimation. ANIMALS: 6 healthy domestic rabbits (Oryctolagus cuniculus). PROCEDURES: Each rabbit received IOX (64.7 mg/kg [0.1 mL/kg], IV), and blood samples were collected at predetermined times before and after administration. Plasma IOX concentration was determined by high-performance liquid chromatography. The pharmacokinetics of IOX was determined by a noncompartmental method. For each rabbit, plasma clearance of IOX was determined by dividing the total IOX dose administered by the area under the concentration-time curve indexed to the subject's body weight. The GFR estimated from the plasma IOX concentration at 6 sampling times (referent model) was compared with that estimated from the plasma IOX concentration at 5 (model A), 4 (model B), and 3 (models C, D, and E) sampling times (limited-sampling models). RESULTS: Mean ± SD GFR was 4.41 ± 1.10 mL/min/kg for the referent model and did not differ significantly from the GFR estimated by any of the limited-sampling models. The GFR bias magnitude relative to the referent model was smallest for model D in which GFR was estimated from plasma IOX concentrations at 5, 15, and 90 minutes after IOX administration. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that plasma clearance of IOX was a safe, reliable, accurate, and clinically feasible method to estimate GFR in domestic rabbits. Further research is necessary to refine the method.

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.

Double filtration plasmapheresis in the treatment of hyperproteinemia in dogs affected by Leishmania infantum.

Three dogs were evaluated for severe hyperproteinemia and hyperglobulinemia secondary to Leishmania infantum. Double filtration plasmapheresis (DFPP) was performed in two dogs at days 1, 2, and 6 after presentation. The third dog received DFPP at days 1 and 3 after presentation and eleven hemodialysis treatments. Significant reduction in serum total protein (p ＜ 0.0001), alpha-1 (p = 0.023), alpha-2 (p = 0.018), gamma globulins (p = 0.0105), and a significant increase in albumin/globulin ratio (p = 0.0018) were found. DFPP may be a promising therapeutic technique for rapid resolution of signs of hyperproteinemia in dogs affected by L. infantum.

Effects of probiotic VSL#3 on glomerular filtration rate in dogs affected by chronic kidney disease: A pilot study.

The aim of this study was to evaluate the effects of probiotic VSL#3 on glomerular filtration rate (GFR) in dogs affected by chronic kidney disease (CKD). The treatment group (n = 30) received prescription renal diet and probiotic VSL#3 (112 to 225 × 109 lyophilized bacteria per 10 kg body weight, PO, q24h for 2 months); the control group (n = 30) received prescription renal diet and standard therapy. All dogs underwent GFR measurement at the beginning of the study (T0) and were re-evaluated by GFR measurement after 2 months (T1). The GFR was significantly higher (P = 0.0001) in the treatment group compared to the control group at T1. In the treatment group, the GFR was significantly higher (P = 0.0008) at T1 compared to T0. In the control group, the GFR was significantly lower (P = 0.001) at T1 compared to T0. VSL#3 supplementation seemed to be efficient in reducing deterioration of GFR over time in dogs affected by CKD.

Effets du probiotique VSL no3 sur le taux de filtration glomérulaire chez les chiens affectés par la maladie rénale chronique : étude pilote. Le but de la présente étude consistait à évaluer les effets du probiotique VSL no 3 sur le taux de filtration glomérulaire (TFG) chez des chiens affectés de maladie rénale chronique (MRC). Le groupe de traitement (n = 30) a reçu une diète de prescription rénale et le probiotique VSL no 3 (112 à 225 × 109 de bactéries lyophilisées par 10 kg de poids corporel), PO, q24h pendant 2 mois; le groupe témoin (n = 30) a reçu une diète de prescription rénale et une thérapie standard. Tous les chiens ont subi une mesure du TFG au début de l'étude (T0) et ont été réévalués par la mesure du TFG après 2 mois (T1). Le TFG était significativement supérieur (P = 0,0001) dans le groupe de traitement comparativement au groupe témoin à T1. Dans le groupe de traitement, le TFG était significativement supérieur (P = 0,0008) à T1 comparativement à T0. Dans le groupe témoin, le TFG était significativement inférieur (P = 0,001) à T1 comparativement à T0. La supplémentation au VSL no 3 semblait être efficace pour la réduction de la détérioration du TFG au fil du temps chez les chiens atteints de MRC.(Traduit par Isabelle Vallières).

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 vs. 0.144 ng/ml). No significant correlation was observed between OTA levels and creatinine values in CKD dogs. This is the 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.

Prognostic role of the product of serum calcium and phosphorus concentrations in dogs with chronic kidney disease: 31 cases (2008-2010).

OBJECTIVE: To investigate serum calcium-phosphorus concentration product (sCaPP) as a predictor of mortality rate in dogs with chronic kidney disease (CKD). DESIGN: Retrospective case-control study. ANIMALS: 31 dogs with definitive CKD and 35 apparently healthy dogs. PROCEDURES: All dogs had been referred for nephrological consultation between December 2008 and December 2010. Dogs with CKD had stable disease for ≥ 3 months. On the basis of glomerular filtration rate < 60 mL/min/m(2), 13 of the 35 apparently healthy dogs were subsequently classified as having early CKD. Disease stage among dogs was determined on the basis of plasma creatinine concentration as follows: stage 1, < 123.7 µmol/L (n = 13), stage 2, 123.7 to 176.8 µmol/L (7); stage 3, 185.6 to 442 µmol/L (13); or stage 4, > 442 µmol/L (11). For each dog, serum concentrations of ionized and total calcium and phosphorus were evaluated once; the latter 2 variables were used to determine sCaPP. RESULTS: The sCaPP differed significantly between the 22 healthy dogs and dogs with stage 3 or stage 4 CKD. The proportion of dogs with sCaPP > 70 mg(2)/dL(2) increased with stage of disease. Mortality rate among the 24 dogs with sCaPP > 70 mg(2)/dL(2) was higher than that among the 42 dogs with sCaPP ≤ 70 mg(2)/dL(2). Dogs with sCaPP > 70 mg(2)/dL(2) had a comparatively lower survival rate, and risk of death was 4.2 times as high as risk for dogs with sCaPP ≤ 70 mg(2)/dL(2). CONCLUSIONS AND CLINICAL RELEVANCE: For dogs with CKD, sCaPP > 70 mg(2)/dL(2) appeared to be a negative prognostic indicator, which was not influenced by the concomitant serum concentrations of phosphorus and total or ionized calcium.

Renal alterations in feline immunodeficiency virus (FIV)-infected cats: a natural model of lentivirus-induced renal disease changes.

Human immunodeficiency virus (HIV) is associated with several renal syndromes including acute and chronic renal failures, but the underlying pathogenic mechanisms are unclear. HIV and feline immunodeficiency virus (FIV) share numerous biological and pathological features, including renal alterations. We investigated and compared the morphological changes of renal tissue of 51 experimentally and 21 naturally infected cats. Compared to the latter, the experimentally infected cats exhibited some mesangial widening and glomerulonephritis, milder proteinuria, and lower tubular and interstitial alterations. The numbers of giant protein tubular casts and tubular microcysts were also lower. In contrast, diffuse interstitial infiltrates and glomerular and interstitial amyloidosis were detected only in naturally infected cats. Similar alterations are found in HIV infected patients, thus supporting the idea of a causative role of FIV infection in renal disease, and underlining the relevance of the FIV and its natural host as an animal model for investigating lentivirus-associated nephropathy.

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.