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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine patient demographics, clinicopathologic findings, and outcome associated with naturally acquired acute intrinsic renal failure (ARF) in cats.

Design—Retrospective case series.

Animals—32 cats with ARF.

Procedures—Cats were considered to have ARF if they had acute onset of clinical signs (< 7 days), serum creatinine concentration > 2.5 mg/dL (reference range, 0.8 to 2.3 mg/dL) and BUN > 35 mg/dL (reference range, 15 to 34 mg/dL) in conjunction with urine specific gravity < 1.025 or with anuria or increasing serum creatinine concentration despite fluid therapy and normal hydration status, and no signs of chronic renal disease. Cases were excluded if cats had renal calculi or renal neoplasia.

Results—Causes of ARF included nephrotoxins (n = 18 cats), ischemia (4), and other causes (10). Eighteen cats were oliguric. For each unit (mEq/L) increase in initial potassium concentration, there was a 57% decrease in chance of survival. Low serum albumin or bicarbonate concentration at initial diagnosis was a negative prognostic indicator for survival. Initial concentrations of BUN, serum creatinine, and other variables were not prognostic. Seventeen (53%) cats survived, of which 8 cats had resolution of azotemia and 9 cats were discharged from the hospital with persistent azotemia.

Conclusions and Clinical Relevance—Results suggested that survival rates of cats with ARF were similar to survival rates in dogs and that residual renal damage persisted in approximately half of cats surviving the initial hospitalization.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To describe the technique and evaluate short- and long-term outcomes in female dogs after endoscopic-guided laser ablation (ELA) of various vestibulovaginal septal remnants (VVSRs).

Design—Retrospective case series.

Animals—36 dogs.

Procedures—Medical records of dogs with VVSRs that underwent ELA were retrospectively reviewed. All patients underwent complete cystourethrovaginoscopy for diagnosis and treatment. Endoscopic-guided laser ablation (with a holmium:yttrium-aluminum-garnet or diode laser) was used to transect the vaginal membrane. Patients with intramural ectopic ureters were concurrently treated with ELA of their ectopic ureters. Endoscopy was repeated 6 to 8 weeks after ELA of vaginal remnants in some patients, and the procedure sites were reassessed.

Results—36 female dogs with persistent paramesonephric septal remnants (n = 19), vaginal septa (11), or dual vaginas (6) were included. Twenty-six dogs had urinary incontinence, 2 had recurrent UTIs, and 8 had both. Thirty of 36 (83%) dogs had concurrent ectopic ureters. Endoscopic-guided laser ablation was performed with holmium:yttrium-aluminum-garnet and diode lasers in 8 and 28 dogs, respectively. Five dogs had mild postoperative dysuria for < 24 hours. One patient developed a complication involving inadvertent laser perforation of the vaginal wall. There were no negative effects from this event, and the perforation was fully healed within 8 weeks. At the time of follow-up, all defects were fully healed with no sign of recurrence in the 18 (50%) patients reevaluated. There was a significant improvement in continence scores and a significantly decreased incidence of UTIs after ELA. The median follow-up time was 34 months (range, 8 to 57 months).

Conclusions and Clinical Relevence—The results of the present study indicated that ELA provided an effective, safe, and minimally invasive treatment option for various VVSRs in dogs, avoiding the need for more invasive surgery.

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in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the long-term outcome for small animal patients with acute kidney injury (AKI) treated with intermittent hemodialysis (IHD).

Design—Retrospective case series.

Animals—42 cats and 93 dogs treated with IHD for AKI.

Procedures—Medical records of cats and dogs treated with IHD for AKI from January 1997 to October 2010 were reviewed. Standard methods of survival analysis with Kaplan-Meier product limit curves were used. The log-rank, Mann-Whitney, and Kruskal-Wallis tests were used to determine whether outcome, number of IHD treatments, or duration of hospitalization was different when dogs and cats were classified according to specific variables.

Results—The overall survival rate at the time of hospital discharge was 50% (21/42) for cats and 53% (49/93) for dogs. The overall survival rate 30 days after hospital discharge was 48% (20/42) for cats and 42% (39/93) for dogs. The overall survival rate 365 days after hospital discharge was 38% (16/42) for cats and 33% (31/93) for dogs. For all-cause mortality, the median survival time was 7 days (95% confidence interval, 0 to 835 days) for cats and 9 days (95% confidence interval, 0 to 55 days) for dogs.

Conclusions and Clinical Relevance—Cats and dogs with AKI treated with IHD have survival rates similar to those of human patients. Although there was a high mortality rate prior to hospital discharge, those patients that survived to discharge had a high probability of long-term survival.

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in Journal of the American Veterinary Medical Association

SUMMARY

Objective

To determine usefulness of carbamylated hemoglobin (CarHb) concentration for differentiation of acute renal failure (ARF) from chronic renal failure (CRF) in dogs.

Sample Population

Samples from dogs with ARF or CRF and from nonazotemic control dogs.

Procedure

CarHb concentration was determined in heparinized blood samples by measuring the micrograms of valine hydantoin (VH) per gram of hemoglobin (Hb), using a high-performance liquid chromatography assay, in which carbamyl valine is converted to VH via acid hydrolysis.

Results

CarHb concentration was significantly higher in dogs with ARF and CRF, compared with values in control dogs (ARF vs control, P < 0.05; CRF vs control, P < 0.001). Furthermore, CarHb concentration was significantly (P < 0.001) higher in dogs with CRF, compared with that in dogs with ARF. Carbamylated hemoglobin concentration did not correlate with serum urea nitrogen or creatinine concentration. Using a cutoff value of 100 μg of VH/g of Hb, the sensitivity and specificity of CarHb concentration for differentiating ARF from CRF was 96.1 and 84.2%, respectively.

Conclusions

CarHb concentration was useful in the differentiation of ARF from CRF in the dogs of this study.

Clinical Relevance

CarHb concentration may be used to increase the accuracy of identifying ARF, so that early, aggressive management can be instituted, thereby increasing the chance of recovery. (Am J Vet Res 1997;58:1193–1196)

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in American Journal of Veterinary Research