Objective—To compare results of a CBC performed on blood samples obtained from healthy dogs and cats by use of standard and microsample collection tubes.
Animals—29 healthy client-owned animals (14 dogs and 15 cats).
Procedures—A blood sample (3 mL) was collected from each animal; 2.5 mL was transferred into a vacuum tube that contained sodium EDTA, and 0.5 mL was transferred into a microsample tube that contained sodium EDTA. Variables evaluated were total numbers of RBCs and WBCs, hemoglobin concentration, Hct, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration (MCHC), mean platelet volume, and plasma total protein concentration as well as neutrophil, lymphocyte, monocyte, eosinophil, basophil, and platelet counts. Results for the 2 types of tube in each species were compared by use of Pearson correlation coefficients, Passing-Bablok regression analysis, and Bland-Altman analysis.
Results—The Pearson correlation coefficient was low for basophil count in cats and moderate, high, or very high for all other variables. Constant and proportional biases were identified for MCHC in dogs by use of Passing-Bablok regression analysis, although the mean difference between types of blood collection tubes was small. No evidence of constant or proportional bias for any other variable was revealed by regression analysis or Bland-Altman analysis.
Conclusions and Clinical Relevance—Samples obtained from healthy dogs and cats by use of microsample blood collection tubes provided clinically equivalent CBC results, compared with results for samples obtained by use of standard blood collection tubes, and minimized the total sample volume collected for diagnostic testing.
Objective—To compare results of biochemical analyses performed on plasma samples obtained from healthy dogs and cats by use of standard and microsample blood collection tubes.
Animals—29 healthy client-owned animals (14 dogs and 15 cats).
Procedures—A blood sample (3 mL) was collected from each animal; 2.5 mL was transferred into a vacuum tube that contained lithium heparin, and 0.5 mL was transferred into a microsample tube that contained lithium heparin. Variables evaluated were albumin, bicarbonate, BUN, calcium, chloride, cholesterol, creatinine, glucose, phosphorus, potassium, sodium, total bilirubin, and total protein concentrations and alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, and creatine kinase activities. Results for the 2 types of tubes in each species were compared by use of Pearson correlation coefficients, Passing-Bablok regression analysis, and Bland-Altman analysis.
Results—Data were normally distributed, except for creatine kinase activity of cats. The Pearson correlation coefficient was minimal for total bilirubin concentration in cats and moderate, high, or very high for all other variables. Constant bias for cholesterol and glucose concentration in dogs was identified during Bland-Altman analysis, although the mean difference between types of blood collection tubes was small. No constant or proportional bias for any other variable was revealed by regression analysis or Bland-Altman analysis.
Conclusions and Clinical Relevance—Samples obtained from healthy dogs and cats by use of microsample blood collection tubes that contained lithium heparin provided clinically equivalent biochemical results, compared with results for samples obtained by use of standard blood collection tubes, and minimized the total sample volume collected for diagnostic testing.
Case Description—An 8-year-old spayed female Yorkshire Terrier and 5-year-old castrated male West Highland White Terrier were evaluated because of cyclophosphamide intoxication subsequent to pharmacy error. Both dogs received cumulative doses of approximately 1,080 mg of cyclophosphamide/m2 after cyclophosphamide was erroneously dispensed instead of cyclosporine by different pharmacies.
Clinical Findings—Both dogs became lethargic, and 1 dog also had anorexia, vomiting, and diarrhea within 2 days after initiation of cyclophosphamide administration. The other dog developed anorexia on the seventh day after initiation of cyclophosphamide administration. The dogs were evaluated by their primary-care veterinarians 9 and 11 days after administration of the first dose of cyclophosphamide, and both had severe leukopenia and thrombocytopenia.
Treatment and Outcome—One dog was treated on an outpatient basis with broad-spectrum antimicrobials, granulocyte colony-stimulating factor, and an appetite stimulant. The other dog was more severely affected and was hospitalized for 7 days, during which it was treated with broad-spectrum antimicrobials, gastroprotectants, granulocyte colony-stimulating factor, and cryopreserved platelet and packed RBC transfusions. Both dogs fully recovered after treatment.
Clinical Relevance—This was the first report of survival for dogs with inadvertent prolonged cyclophosphamide intoxication subsequent to pharmacy error. Although the 2 dogs had similar clinical signs and clinicopathologic findings, the severity of disease and treatment required differed for each dog. Dogs can recover from prolonged cyclophosphamide intoxication provided appropriate supportive care is administered.
CASE DESCRIPTION A 6-year-old spayed female Great Pyrenees (dog 1) and a 2-year-old spayed female German Shepherd Dog (dog 2) were evaluated because of gross hematuria of 5 and 2 months' duration, respectively.
CLINICAL FINDINGS In both dogs, coagulation times were within reference limits, results of aerobic bacterial culture of urine samples were negative, echogenic debris could be seen within the urinary bladder ultrasonographically, and hematuric urine could be seen exiting the right ureterovesicular junction, with grossly normal urine exiting the left ureterovesicular junction, during cystoscopy. A diagnosis of idiopathic renal hematuria was made in both dogs.
TREATMENT AND OUTCOME Both dogs underwent retrograde ureteropyelography, unilateral povidone iodine sclerotherapy, and ureteral stent placement. The right ureter was occluded with a ureteropelvic junction balloon catheter, and a 5% povidone iodine solution was infused into the renal pelvis 3 times. A double-pigtail ureteral stent was then placed. Both dogs recovered without complications, with cessation of gross hematuria within 12 hours. Cystoscopic removal of the ureteral stent was performed in dog 1 after 4 months; at that time, the urine sediment contained 5 to 10 RBCs/hpf. In dog 2, urine sediment contained 50 to 75 RBCs/hpf 2 weeks after sclerotherapy, with continued resolution of gross hematuria 8 weeks after sclerotherapy. The owners declined removal of the stent in dog 2.
CLINICAL RELEVANCE Findings suggested that povidone iodine sclerotherapy may be an effective renal-sparing treatment for idiopathic renal hematuria in dogs. Further evaluation with longer follow-up times is warranted.
OBJECTIVE To assess the effects of age, body condition score (BCS), and muscle condition score (MCS) on radial and coccygeal systolic arterial blood pressure (SAP) in cats.
DESIGN Prospective randomized trial.
ANIMALS 66 privately owned cats enrolled between May and December 2010.
PROCEDURES BCS and MCS of cats were assessed by 2 investigators; SAP was measured via Doppler ultrasonic flow detector, with cats positioned in right lateral or sternal recumbency for measurements at the radial or coccygeal artery, respectively, with order of site randomized. Associations among variables were assessed through correlation coefficients, partial correlation coefficients, and ANCOVA.
RESULTS Interrater reliability for BCS and MCS assessment was high (correlation coefficients, 0.95 and 0.83, respectively). No significant effect was identified for order of SAP measurement sites. Coccygeal and radial SAP were positively correlated (ρ = 0.45). The median difference in coccygeal versus radial SAP was 19 mm Hg, but differences were not consistently positive or negative. Radial SAP was positively correlated with age (ρ = 0.48) and negatively correlated with MCS (ρ = −0.30). On the basis of the correlation analysis, the association between radial SAP and MCS reflected the confounding influence of age. Coccygeal SAP was not significantly correlated with age, BCS, or MCS.
CONCLUSIONS AND CLINICAL RELEVANCE Use of the coccygeal artery is recommended to reduce the confounding effects of age and sarcopenia on Doppler ultrasonographic SAP measurements in cats. Additionally, monitoring for changes in MCS is recommended for cats undergoing serial SAP measurement.
OBJECTIVE To compare absorption characteristics of orally administered compounded itraconazole capsules and suspension with those of reference (brand-name) formulations in healthy cats.
DESIGN Randomized crossover study.
ANIMALS 8 healthy adult cats.
PROCEDURES After 12 hours of food withholding, cats received 50 mg of itraconazole (reference capsule, reference solution, compounded capsule, and compounded suspension) in a randomized crossover design, with a 21-day washout period. Capsules were administered with a small meal. Blood samples were collected at predetermined intervals for high-pressure liquid chromatography analysis of plasma itraconazole concentrations. Area under the concentration-time curve, maximum concentration, and terminal half-life of itraconazole were determined and compared among formulations.
RESULTS 7 cats completed the study. Mean half-life of itraconazole in reference formulations was 18 to 26 hours. Absorption of the reference solution was 3 times that of the reference capsule. Compounded formulations were absorbed poorly and inconsistently. Complete pharmacokinetic results for the compounded capsule were obtained for only 3 of 6 cats and for the compounded suspension for only 1 of 5 cats, precluding bioequivalence analysis. Relative absorption of compounded formulations was only 2% to 8% of reference formulation values.
CONCLUSIONS AND CLINICAL RELEVANCE Compounded oral formulations of itraconazole should not be used for cats because of poor absorption. The differences in absorption between the 2 reference formulations suggested that doses required to meet human target serum concentrations in cats are markedly different (capsules, 12.5 mg/kg [5.7 mg/lb], q 24 h, with food; solution, 4 mg/kg [1.8 mg/lb], q 24 h, without food).
Objective—To determine the diagnostic usefulness of semiquantitative and quantitative microalbuminuria assays and urine albumin-to-creatinine (UAC) ratio for detecting disease in cats.
Animals—441 cats evaluated at a veterinary teaching hospital.
Procedures—Urine samples from cats for which a complete medical record was available were included. Urine dipstick results, urine protein-to-creatinine ratios (cutoffs, 0.1 and 0.4), semiquantitative and quantitative microalbuminuria assay results (cutoff, 1 mg/dL), and UAC ratio values (cutoffs, 100 and 200 mg/g) were determined. Clinical diagnoses determined within 3 months of enrollment were recorded. Sensitivity and specificity were determined with disease status used as the standard. The influences of clinical diagnosis, sex, age, serum urea nitrogen and creatinine concentrations, blood pressure, bacterial urine culture results, rectal temperature, pyuria, hematuria, and bacteriuria were evaluated by means of logistic regression.
Results—Of 441 cats that were eligible for inclusion, 40 were healthy and 401 had ≥ 1 disease. Results of logistic regression indicated that significant associations existed for age, presence of disease, presence of urinary tract disease, azotemia, hematuria, and pyuria and results of 1 or both of the microalbuminuria assays.
Conclusions and Clinical Relevance—Microalbuminuria was associated with underlying disease. Sensitivity and specificity of the microalbuminuria assays for detection of systemic disease were superior to those of other tests. Microalbuminuria testing in conjunction with other screening procedures may increase identification of occult disease. A prospective study evaluating the predictive values of screening tests with and without microalbuminuria determination is needed to validate this recommendation.
Objective—To evaluate semiquantitative and quantitative assays for microalbuminuria and determination of the urine albumin-creatinine (UAC) ratio in detection of systemic disease in dogs without overt proteinuria.
Procedures—Urine samples that had been obtained from dogs for which a complete medical record was available and in which results of a dipstick test for urine protein were negative were evaluated. Urine protein-creatinine ratios (cutoff values, 0.5 and 0.1), semiquantitative and quantitative microalbuminuria values (cutoff value, 1 mg/dL), and UAC ratios (cutoff values, 100 and 200 mg/g) were determined. Clinical diagnoses rendered within 3 months of enrollment in the study were recorded. Sensitivity and specificity were determined with disease status serving as the standard. Associations with clinical diagnosis, sex, age, BUN and serum creatinine concentrations, blood pressure, results of bacterial culture of urine, temperature, pyuria, hematuria, and bacteriuria were evaluated by use of logistic regression analysis.
Results—48 dogs were healthy, and 360 had at least 1 disease. Significant associations were detected between age, presence of disease, presence of neoplastic disease, BUN and serum creatinine concentrations, and hematuria and results of 1 or both of the microalbuminuria assays.
Conclusions and Clinical Relevance—Microalbuminuria was associated with underlying disease. The sensitivity and specificity of the semiquantitative microalbuminuria test for detection of systemic disease were superior to those of other tests. Microalbuminuria testing in conjunction with other screening procedures may increase diagnosis of subclinical disease, but a prospective study in which the predictive values of screening tests are evaluated, with and without microalbuminuria determination, is needed.