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- Author or Editor: Larry G. Adams x
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SUMMARY
The influence of induced chronic renal failure on 24- hour urinary excretion and fractional excretion of sodium and potassium was studied in cats. Induction of chronic renal failure significantly increased fractional excretion of potassium (P < 0.0001) and sodium (P < 0.05); however, 24-hour urinary excretion of sodium and potassium decreased slightly following induction of chronic renal failure.
Fractional excretion and 24-hour urinary excretion of sodium and potassium were compared by linear regression in clinically normal cats, cats with chronic renal failure, and clinically normal and affected cats combined. In clinically normal cats, linear regression revealed only moderate correlation between fractional excretion and 24- hour urinary excretion for sodium and potassium. Linear regression of these same relationships in cats with chronic renal failure, and in clinically normal cats and cats with chronic renal failure combined, indicated low correlation.
Fractional excretions of sodium and potassium were not reliable indicators of 24-hour urinary excretion of these electrolytes in cats with chronic renal failure or unknown glomerular filtration rate. Fractional excretion of potassium and sodium correlated only moderately with 24-hour urinary excretion in clinically normal cats.
Summary
To determine the effects of long-term dietary protein restriction in cats with chronic renal failure (crf), 4 healthy adult cats and 7 cats with surgically induced crf were fed a high-protein (hp, 51.7% protein) diet and 4 healthy adult cats and 7 cats with surgically induced crf were fed a low-protein (lp, 27.6% protein) diet for 1 year.
Cats with induced crf that were fed the lp diet had reduced serum urea nitrogen concentrations, despite lower glomerular filtration rates, compared with cats with crf fed the hp diet. Despite five-sixths reduction in renal mass, reduced glomerular filtration rate, and azotemia, 13 of the 14 cats with induced crf retained the ability to concentrate urine and produced urine with a specific gravity > 1.035.
Cats fed the hp diet consumed significantly more calories than did cats fed the lp diet, presumably because the hp diet was more palatable. As a result of the lower caloric intake in cats fed the lp diet, these cats were protein and calorie restricted, compared with cats fed the hp diet. Cats fed the hp diet weighed significantly more than did cats fed the lp diet. Mean hematocrit and mean serum albumin concentration were significantly lower in control cats and in cats with crf fed the lp diet, compared with control cats and cats with crf fed the hp diet.
Hypokalemia developed in 4 of 7 cats with crf fed the hp diet (containing 0.3% potassium); hypokalemia did not develop in control cats fed the same diet or in cats with crf fed the lp diet containing 0.4% potassium. Excessive kaliuresis, hypomagnesemia, and metabolic acidosis did not appear to contribute to the hypokalemia. Subsequent supplementation of the hp diet with potassium gluconate prevented hypokalemia in cats with crf.
Abstract
Objective—To test the hypothesis that feline calcium oxalate uroliths are intrinsically more resistant to comminution via shock wave lithotripsy (SWL) than canine calcium oxalate uroliths through comparison of the fragility of canine and feline uroliths in a quantitative in vitro test system.
Sample Population—Calcium oxalate uroliths (previously obtained from dogs and cats) were matched by size and mineral composition to create 7 pairs of uroliths (1 canine and 1 feline urolith/pair).
Procedure—Uroliths were treated in vitro with 100 shock waves (20 kV; 1 Hz) by use of an electrohydraulic lithotripter. Urolith fragmentation was quantitatively assessed via determination of the percentage increase in projected area (calculated from the digital image area of each urolith before and after SWL).
Results—After SWL, canine uroliths (n = 7) fragmented to produce a mean ± SD increase in image area of 238 ± 104%, whereas feline uroliths (7) underwent significantly less fragmentation (mean image area increase of 78 ± 97%). The post-SWL increase in fragment image area in 4 of 7 feline uroliths was < 50%, whereas it was > 150% in 6 of 7 canine uroliths.
Conclusions and Clinical Relevance—Results indicate that feline calcium oxalate uroliths are less susceptible to fragmentation via SWL than canine calcium oxalate uroliths. In some cats, SWL may not be efficacious for fragmentation of calcium oxalate nephroliths or ureteroliths because the high numbers of shock waves required to adequately fragment the uroliths may cause renal injury. (Am J Vet Res 2005;66:1651–1654)
Abstract
OBJECTIVE
To investigate the effect of iohexol on standardized quantitative urine culture results in dogs. The authors hypothesized that the presence of iohexol in inoculated urine samples would result in lower bacterial concentrations (CFU/mL) and, therefore, decrease culture sensitivity.
SAMPLE
Urine samples were aseptically collected during cystoscopy from a single client-owned dog untreated with antimicrobials.
PROCEDURES
An experimental controlled study. The urine sample was divided into 38 aliquots (0.5 mL each) that were used as negative controls or inoculated with an equal amount of Escherichia coli (105 CFU/mL). Different volumes (0.1 and 0.5 mL) of contrast or saline were added to the aliquots and quantitative culture results were compared. Two different incubation times between the preparation of aliquots and culture were evaluated (15 minutes and 24 hours).
RESULTS
All aliquots from samples inoculated with E. coli (positive controls and iohexol-group) had the same reported quantitative result (104 CFU/mL). No growth was reported for the negative controls. Iohexol did not show any anti-E. coli properties in canine urine cultures for dilutions up to 1:2 contrast:urine and concentrations up to 120 mgI/mL. No difference was reported when iohexol was incubated with inoculated urine for 15 minutes or 24 hours.
CLINICAL RELEVANCE
Based on the experimental in vitro conditions described, administration of iohexol before the collection of urine during urologic procedures does not negatively impact the isolation and growth of E. coli.
Abstract
Objective
To determine whether administration of amphotericin B in a fat emulsion solution would reduce the nephrotoxicity of amphotericin B, compared with that associated with administration of amphotericin B in 5% dextrose solution.
Design
Prospective controlled study.
Animals
2 groups of 5 adult male Beagles.
Procedure
Dogs received amphotericin B (1 mg/kg of body weight/d) prepared in 5% dextrose solution or in 20% fat emulsion daily for 6 doses. Serum biochemical analysis, CBC, urinalysis, and endogenous creatinine clearance were performed on days 0 and 8, 2 days after the last dose of amphotericin B. On day 8, dogs were euthanatized and gross necropsies were performed. Unbiased semiquantitative scoring of the kidneys for the degree of injury was performed by use of light microscopy.
Results
There were no significant differences in serum creatinine, urea nitrogen, or potassium concentrations, urine specific gravity, endogenous creatinine clearance, or degree of tubulo-interstitial injury between the 2 groups.
Conclusion
In this model, the degree of nephrotoxicity of amphotericin B was not significantly different for dogs receiving the drug in a fat emulsion versus its administration in 5% dextrose. (Am J Vet Res 1996;57:1054–1058)
Abstract
Objective—To describe the use of sclerotherapy for the renal-sparing treatment of idiopathic renal hematuria (IRH) in dogs and report clinical outcomes.
Design—Retrospective case series.
Animals—6 dogs (8 renal pelvises) with IRH.
Procedures—Medical records of dogs that underwent sclerotherapy were reviewed. Each ureterovesicular junction was identified cystoscopically to determine the side of bleeding, and a retrograde ureteropyelogram was performed with endoscopic and fluoroscopic guidance. A ureteropelvic junction balloon was used for ureteral occlusion, and pelvis filling volumes were recorded. A povidone iodine mixture, followed by a sterile silver nitrate solution, was infused into the renal pelvis. A double-pigtail ureteral stent was placed after the procedure. Information on preprocedure and postprocedure biochemical changes, imaging parameters, and clinical outcomes was obtained.
Results—6 dogs (5 males and 1 female) had sclerotherapy for unilateral (4) or bilateral (2) bleeding. Five were right-sided and 3 were left-sided. The median age and weight of dogs were 3 years and 42.4 kg (93.28 lb), respectively. Median procedure time was 150 minutes. One dog that did not have a ureteral stent placed following the procedure developed short-term signs of renal pain and pyelectasis. Cessation of macroscopic hematuria occurred in 4 of 6 dogs (median, 6 hours). Two additional dogs improved moderately. Median follow-up time was 8 months (range, 3.5 to 20.5 months).
Conclusions and Clinical Relevance—Topical sclerotherapy for IRH was safe and effective. Local sclerotherapy for IRH in dogs could be considered a valuable and minimally invasive renal-sparing treatment over ureteronephrectomy.
Abstract
Objective—To determine the outcome in dogs undergoing urethral stent placement for management of urethral obstruction secondary to transitional cell carcinoma (TCC).
Design—Retrospective case series.
Animals—19 dogs with histopathologically confirmed TCC.
Procedures—Information regarding urethral stent placement and follow-up treatment was obtained from review of medical records. Quality of life assessment was performed with an owner questionnaire.
Results—Self-expanding nitinol stents were successfully placed in 17 of 19 dogs; stent placement was not possible in one dog, and another dog was euthanatized 2 days after stent placement, but before discharge from the hospital. Median survival time in 17 dogs following successful long-term stent placement was 78 days (range, 2 to 366 days). Complications following stent placement in 18 dogs included incontinence (n = 7), reobstruction from continued growth of urethral TCC (3), acute reobstruction shortly after the procedure (1), and stent migration (2). Of the 17 owners surveyed, 16 were satisfied with the outcome and would recommend urethral stent placement.
Conclusions and Clinical Relevance—The placement of self-expanding nitinol urethral stents was successful in alleviating TCC-induced urethral obstruction and providing good quality of life for most dogs.
Abstract
Objective—To assess the diagnostic utility of transurethral cystoscopic biopsy in dogs with histologically confirmed transitional cell carcinoma (TCC) of the urinary bladder and urethra.
Design—Retrospective case series.
Animals—92 dogs with histologically confirmed TCC.
Procedures—Information on sex, breed, neuter status, body weight, tumor location, biopsy method, number of biopsy procedures, experience level of clinician performing biopsy, and quality of biopsy sample was obtained from medical records. The association of variables with likelihood of achieving a diagnostic-quality biopsy sample was evaluated by use of logistic regression.
Results—If used as the initial biopsy method, cystoscopic biopsy samples were of diagnostic quality in 65% of male dogs and 96% of female dogs with histologically confirmed TCC. Cystoscopic biopsy samples were significantly more likely to be of diagnostic quality in female dogs than in male dogs.
Conclusions and Clinical Relevance—Cystoscopic biopsy is an effective method to obtain biopsy samples in dogs with TCC of the bladder and urethra. Cystoscopy is more likely to produce a diagnostic-quality biopsy sample in female dogs with TCC than in male dogs with TCC. Cystoscopy should be considered as a primary means of biopsy in male and female dogs with masses of the urinary bladder or urethra.
Abstract
Case Description—2 dogs and 5 cats were evaluated for treatment of ureteroliths.
Clinical Findings—Spontaneous retrograde movement of 1 or more ureteroliths was detected by radiography, ultrasonography, fluoroscopy, and a combination of fluoroscopy and ultrasonography. The ureteroliths moved retrograde up to 4 centimeters. Retrograde movement of ureteroliths into the renal pelvis resulted in improved renal function in some patients but made complete surgical removal of all uroliths more difficult.
Treatment and Outcome—Medical management was not successful, and ureteroliths were surgically removed. Surgical management of ureteroliths was complicated by retrograde movement of ureteroliths in the perioperative period.
Clinical Relevance—Ureteroliths can move retrograde within the ureter and even back into the renal pelvis. Retrograde movement of ureteroliths may make surgical planning more difficult.