Objective—To determine whether a glomerular filtration rate (GFR) assay based on serum iohexol clearance can be used to predict carboplatin clearance in cats.
Animals—10 cats with tumors.
Procedures—GFR was measured concurrently by use of plasma clearance of technetium Tc 99m–labeled diethylenetriaminepentaacetic acid (99mTc-DTPA) to yield GFR99mTc-DTPA and serum clearance of iohexol to yield GFRIohexol. A single dose of carboplatin was administered IV as a bolus. Dose was calculated by use of a target value for the area under the plasma platinum concentration-versus-time curve (AUCTarget) and estimation of platinum clearance (CLPT) derived from GFR99mTc-DTPA as follows: dose = AUCTarget × 2.6 × GFR99mTc-DTPA × body weight, where AUCTarget is 2.75 min·mg·mL−1. Plasma platinum concentrations were measured via atomic absorption spectrophotometry. Values for GFR99mTc-DTPA and GFRIohexol were compared by use of least-squares regression and Bland-Altman analysis. Least-squares regression was used to determine whether CLPT could be predicted from GFR99mTc-DTPA or GFRIohexol (or both).
Results—GFR99mTc-DTPA and GFRIohexol were strongly correlated (r = 0.90), but GFRIohexol values were significantly larger by a factor of approximately 1.4. Platinum clearance had a significant linear relationship to GFR99mTc-DTPA (CLPT = 2.5 × GFR99mTc-DTPA) and to GFRIohexol (CLPT = [1.3 × GFRIohexol] + 1.4).
Conclusions and Clinical Relevance—In cats, serum iohexol clearance was an accurate predictor of CLPT and can be used to calculate the carboplatin dose as follows: dose = AUCTarget × ([1.3 × GFRIohexol] + 1.4) × body weight.
Objective—To determine whether a carboplatin dose calculation that is based on a targeted area under the concentration-versus-time curve (AUCTarget) and individual glomerular filtration rate (GFR) accurately predicts carboplatin-associated myelotoxicoses in tumor-bearing cats, and to determine the maximum tolerated AUCTarget.
Animals—32 cats with tumors.
Procedures—In each cat, plasma clearance of technetium Tc 99m-labeled diethylenetriaminepentaacetic acid was measured to assess GFR. Carboplatin was administered IV. The dose was calculated by use of an equation as follows: Dose = AUCTarget × 2.6 × GFR × body weight. Initial AUCTarget was 2.0 min·mg·mL−1 and was increased in increments of 0.50 min·mg·mL−1 in cohorts of 3 cats. To assess myelotoxic effects, CBCs were performed weekly for ≥ 4 weeks. Following identification of the maximum tolerated AUCTarget, additional cats were treated at that AUCTarget and plasma platinum concentrations were measured in 6 cats.
Results—The AUCTarget values ranged from 2.0 to 3.0 min·mg·mL−1. Neutropenia was the dose-limiting toxicosis, and the maximum tolerated AUCTarget was 2.75 min·mg·mL−1. Nineteen cats received this dose of carboplatin; 13 became neutropenic, but only 1 developed severe neutropenia (< 500 neutrophils/μL), and none had neutropenia-associated clinical signs. In the cats that had plasma platinum concentration determined, the difference between AUCTarget and the measured value ranged from −0.23 to 0.31 min·mg·mL−1 (median, 0.20 min·mg·mL−1).
Conclusions and Clinical Relevance—In cats, carboplatin-associated myelotoxicoses were accurately and uniformly predicted by use of the proposed dosing strategy. The maximum tolerated AUCTarget for a single dose of carboplatin was 2.75 min·mg·mL−1.
Objective—To determine whether sensitivity of
detecting an anomalous portosystemic blood vessel
during operative mesenteric portography varied with
Animals—34 dogs with a portosystemic shunt diagnosed
via scintigraphy or surgery.
Procedure—Portograms were evaluated for a portosystemic
blood vessel. Sensitivity was calculated
from results obtained with dogs in left lateral, right lateral,
and dorsal recumbency and from results
obtained with dogs in 2 or 3 positions. Differences in
sensitivity among positions and between 2 examiners
Results—Sensitivity was 85, 91, and 100% in dorsal,
right lateral, and left lateral recumbency, respectively.
Sensitivity was lower in dorsal recumbency than in left
lateral recumbency, although differences were not significant.
There was no significant difference between
sensitivity of results obtained in dorsal and right lateral
recumbency or right lateral and left lateral recumbency.
Sensitivity for combined right lateral and dorsal
positions was 97%, which was better than that in dorsal
recumbency alone, although the difference was
not significant. Because sensitivity in left lateral
recumbency was 100%, there was no need to evaluate
the improvement obtained by combining the result
of this position with the results of other positions.
Conclusion and Clinical Relevance—Results of
mesenteric portography varied with patient positioning.
The optimal position varied among patients but
left lateral recumbency may be better and dorsal
recumbency worse. Sensitivity may be improved by
performing the test with the patient in orthogonal
recumbent positions. (J Am Vet Med Assoc 2001;
Objective—To compare estimation of glomerular filtration rate determined via conventional methods (ie, scintigraphy and plasma clearance of technetium Tc 99m pentetate) and dynamic single-slice computed tomography (CT).
Animals—8 healthy adult cats.
Procedures—Scintigraphy, plasma clearance testing, and dynamic CT were performed on each cat on the same day; order of examinations was randomized. Separate observers performed GFR calculations for scintigraphy, plasma clearance testing, or dynamic CT. Methods were compared via Bland-Altman plots and considered interchangeable and acceptable when the 95% limits of agreement (mean difference between methods ± 1.96 SD of the differences) were ≤ 0.7 mL/min/kg.
Results—Global GFR differed < 0.7 mL/min/kg in 5 of 8 cats when comparing plasma clearance testing and dynamic CT; the limits of agreement were 1.4 and −1.7 mL/min/kg. The mean ± SD difference was −0.2 ± 0.8 mL/min/kg, and the maximum difference was 1.6 mL/min/kg. The mean ± SD difference (absolute value) for percentage filtration by individual kidneys was 2.4 ± 10.5% when comparing scintigraphy and dynamic CT; the maximum difference was 20%, and the limits of agreement were 18% and 23% (absolute value).
Conclusions and Clinical Relevance—GFR estimation via dynamic CT exceeded the definition for acceptable clinical use, compared with results for conventional methods, which was likely attributable to sample size and preventable technical complications. Because 5 of 8 cats had comparable values between methods, further investigation of dynamic CT in a larger sample population with a wide range of GFR values should be performed.
Objective—To assess agreement between a commercially available Geiger-Meuller (GM) survey meter and millirem tissue-equivalent (TE) meter for measuring radioactivity in cats treated with sodium iodine I 131 (131I).
Animals—15 cats with hyperthyroidism and undergoing 131I treatment.
Procedures—Duplicate measurements were obtained at a distance of 30 cm from the thyroid region of each cat's neck by 2 observers who used both meters on day 3 or 5 after131I administration. Comparisons of measurements between meters and observers were made, with limits of agreement defined as the mean difference ± 2 SDs of the differences.
Results—For observer 1, the mean of the differences in the 2 meters' measurements in all cats was 0.012 mSv/h (SD, 0.011 mSv/h). For observer 2, the mean of the differences in measurements was 0.012 mSv/h (SD, 0.010 mSv/h). For the GM meter, the mean of the differences of the 2 observers for all cats was 0.003 mSv/h (SD, 0.011 mSv/h). For the TE meter, the mean of the differences of the 2 observers for all cats was 0.003 mSv/h (SD, 0.007 mSv/h).
Conclusions and Clinical Relevance—Results indicate that there was considerable agreement between meters and observers in measurements of radioactivity in cats treated with 131I. Measurements obtained by use of the GM meter may be approximately 0.01 mSv/h less than or 0.03 mSv/h higher than those obtained with the TE meter. If this range is acceptable for an institution's release criteria, the 2 meters should be considered interchangeable and acceptable for clinical use.
Objective—To characterize the pharmacokinetic disposition
of carboplatin and determine whether
glomerular filtration rate (GFR) could be used to predict
carboplatin clearance and myelotoxic effects in
cats with tumors.
Animals—10 cats with tumors.
Procedure—Glomerular filtration rate was assessed
in each cat by monitoring plasma clearance of technetium
Tc 99m-labeled diethylenetriaminepentaacetic
acid (99mTc-DTPA). Each cat received carboplatin (200
mg/m2 of body surface area) administered as an IV
bolus. Plasma platinum concentrations were measured
via atomic absorption spectrophotometry, and
pharmacokinetic analysis was performed. A CBC was
performed weekly for each cat, and the correlation
between the area under the concentration-versus-time
curve (AUC) and the severity of myelosuppression
was calculated. Least squares regression analysis
was performed to determine whether GFR could
be used to predict plasma platinum clearance (ClPt).
Results—For all cats, AUC measurements ranged
from 0.99 to 4.30 min·mg·mL–1. Neutrophil concentration
nadirs were detected 1 to 3 weeks after
treatment and ranged from 200 to 8,000 cells/µL.
The absolute neutrophil concentration at the nadir
was inversely correlated with AUC. The ClPt was predicted
by use of GFR measurements (ClPt = 2.60 ×
GFR). A carboplatin dose prescription model was
derived involving AUC, estimated ClPt, and body
weight in kilograms (BWkg), in which dose = AUC ×
2.60(GFR) × BWkg.
Conclusions and Clinical Relevance—In cats, an
individualized prescription strategy for carboplatin
administration based on a targeted AUC and determination
of GFR might more uniformly predict myelosuppression
than that predicted by conventional dosing
based on body surface area. (Am J Vet Res 2004;65:1502–1507)
Objective—To determine whether dorsolateral subluxation
(DLS) scores in young dogs could be used to
reliably predict which dogs would develop evidence of
hip osteoarthritis and whether DLS scores measured
at various ages correlated with each other.
Animals—129 Labrador Retrievers, Greyhounds, and
Labrador Retriever-Greyhound crossbreds.
Procedures—DLS scores were measured on radiographs
taken at 4, 8, and 12 months of age and at
necropsy (8 to 36 months of age). At necropsy, the
hip joints were examined macroscopically and a score
assigned for degree of cartilage degeneration.
Results—DLS scores at 4 (n = 35, rs = –0.62), 8 (n =
106, rs = –0.54), and 12 (n = 15, rs = –0.87) months of
age were significantly correlated with cartilage degeneration
scores, and DLS scores at 8 months of age
were significantly correlated with scores obtained at
the time of necropsy (n = 39, rs = 0.87). The DLS
scores at 4 months of age were significantly different
from scores at 8 months of age, but scores did not differ
significantly thereafter. Likelihood ratios for cartilage
lesions for low (< 45%), intermediate (≥ 45 but ≤
55%), and high (> 55%) DLS scores at 8 months of
age were 8.0, 2.6, and 0.2, respectively.
Conclusions and Clinical Relevance—Results suggest
that DLS score at 8 months of age was a reasonable,
albeit imperfect, predictor of the condition of the
hip joint cartilage at necropsy. Thus, the DLS method
might be useful for early identification of dogs with hip
dysplasia. (Am J Vet Res 2001;62:1711–1715)
Objective—To compare the accuracy of the extended-
hip radiographic (EHR) score, the distraction index
(DI), and the dorsolateral subluxation (DLS) score for
identifying hip dysplasia in dogs at 8 months of age.
Animals—129 Labrador Retrievers, Greyhounds, and
Labrador Retriever-Greyhound crossbreds.
Procedure—Radiography was performed when dogs
were 8 months of age. Dogs were euthanatized at 8
to 36 months of age; hip dysplasia was diagnosed at
the time of necropsy on the basis of results of a gross
examination of the articular cartilage of the hip joints
for signs of osteoarthritis.
Results—The EHR score, DI, and DLS score at 8
months of age were all significantly correlated with
degree of cartilage degeneration at necropsy.
Sensitivity and specificity of using EHR score at 8
months of age to diagnose hip dysplasia (scores > 3
were considered abnormal) were 38 and 96%, respectively;
sensitivity and specificity of using DI (values >
0.7 were considered abnormal) were 50 and 89%; and
sensitivity and specificity of using DLS score (scores ≤
55% were considered abnormal) were 83 and 84%.
Conclusions and Clinical Relevance—Results suggested
that specificities of the 3 methods for diagnosing
hip dysplasia in dogs at 8 months of age were
similar. However, the DLS score had higher sensitivity,
indicating that there were fewer false-negative
results. (J Am Vet Med Assoc 2001;219:1242–1246)