Clinical findings and outcome following medical treatment in dogs with idiopathic renal haematuria: 41 cases (2001-2018).

OBJECTIVES: To characterise and document the progression of idiopathic renal haematuria in a large cohort of medically managed UK dogs. MATERIALS AND METHODS: Retrospective study of 41 client-owned dogs with confirmed (n=14), or suspected (n=27) idiopathic renal haematuria from 4 UK-based referral centres. Clinical findings and outcomes of dogs (2001 to 2018) were determined from the review of medical records and telephone follow-up. RESULTS: Median survival time from diagnosis was long [1482 (152 to 1825) days] irrespective of treatment and clinical response. Only 1 case was euthanased due to idiopathic renal haematuria, and anaemia or azotaemia occurred infrequently. In total, 25 dogs received angiotensin-converting enzyme-inhibitor or angiotensin receptor blocker therapy, of which 23 received benazepril [0.44 (0.19 to 0.82) mg/kg/24 hours], two received enalapril (0.40 and 0.78 mg/kg/24 hours) and one received telmisartan (1 mg/kg/24 hours). In cases with follow-up urinalyses, complete resolution of haematuria was documented in eight of 19 (42%) dogs following angiotensin-converting enzyme-inhibitor/angiotensin receptor blocker treatment, with partial improvement in five of 19 (26%) and no improvement in six of 19 (31%). Conversely, of the two untreated dogs where outcome was available, one had partial improvement and the other had no improvement. CLINICAL SIGNIFICANCE: In this study, idiopathic renal haematuria was associated with a good prognosis and low complication rate. Resolution or improvement in haematuria occurred in both angiotensin-converting enzyme-inhibitor/angiotensin receptor blocker-treated and untreated dogs, indicating that further studies are required to evaluate the effectiveness and safety of these interventions.

Measurement of serum 7α-hydroxy-4-cholesten-3-one as a marker of bile acid malabsorption in dogs with chronic diarrhoea: a pilot study.

Bile acid malabsorption is a common cause of chronic diarrhoea in people, however it has never previously been investigated in dogs, despite clinical suspicion of its existence. The goal of this study was to assess the feasibility of measuring serum 7α-hydroxy-4-cholesten-3-one (C4) in dogs, as a potential marker of bile acid malabsorption, and to see whether this is related to clinical disease severity or the presence of hypocobalaminaemia. Serum C4 concentration was measured in 20 clinically healthy control dogs and 17 dogs with chronic diarrhoea. Three of the 17 affected dogs (17.6 per cent) had a C4 concentration significantly above the range of clinically healthy dogs; these dogs were all poorly responsive to conventional therapy. These results suggest that bile acid malabsorption may be a clinically relevant disorder in dogs with chronic diarrhoea and serum C4 may be a useful tool to investigate this further.

Prevalence of pancreatic, hepatic and renal microscopic lesions in post-mortem samples from Cavalier King Charles spaniels.

OBJECTIVES: The objective of this study was to describe the prevalence of microscopic pancreatic, hepatic and renal lesions in post-mortem samples from Cavalier King Charles spaniels. METHODS: The prevalence of microscopic lesions was determined by routine histopathology and compared to ante-mortem clinical signs. RESULTS: There was evidence of chronic pancreatitis in 51·9% of the cases, and age correlated with severity. Renal lesions were diagnosed in 52·2% of cases, most of which were inflammatory. Ante-mortem diagnosis of pancreatic and renal disease was 25 and 16·7%, respectively. Primary hepatic lesions were diagnosed in 11·1% of cases; secondary hepatic lesions were diagnosed in 64·8%. CLINICAL SIGNIFICANCE: Pancreatic and renal lesions are common in Cavalier King Charles spaniels, but they have similar rates of hepatic disease as the general population. The increasing prevalence of pancreatic lesions with age suggests that it might be a progressive condition.

A systematic review of cerebral oxygenation-monitoring devices in cardiac surgery.

OBJECTIVE: Cerebral oxygenation monitoring via near-infrared spectroscopy (NIRS) during cardiopulmonary bypass (CPB) is increasingly becoming an accepted and valued component of intraoperative monitoring. In recent years, new devices have become available which all make different claims. The purpose of this study is to examine the research on these individual devices to establish the levels of evidence for each and formulate a research path for further evaluation of this technology in cardiac surgery. METHODS: This study is a systematic review of published research on cerebral oximetry. We searched PubMed, CINAHL and Scopus for full-length, peer-reviewed articles containing original data resulting from the study of patient neurologic outcomes based on the use of FDA-approved near-infrared spectroscopy devices. The studies were then grouped and classified based on the device used and the levels of evidence each study provided. RESULTS: Only a very limited number of high-level clinical evidence research papers are currently available, with nearly all of those papers based on the INVOS system. This is likely due to the different lengths of time each device has been on the market and its availability for use in clinical trials. Challenges to testing include the expense of testing various devices, the lack of a globally accepted gold standard for cerebral oxygenation saturation, the limited availability of patient frontal surface area and the gradual adoption of this technology. Despite these limitations, significant results have been identified in relation to patient outcomes. CONCLUSION: At this time, there is limited high-level evidence available for all of the NIRS devices on the market despite significant outcomes found in these studies. Additional prospective randomized studies should be conducted in order to establish the potential role NIRS may play in patient monitoring as well as assessing the efficacy of the multiple devices on the market.