A 10-year-old 26-kg (57-lb) spayed female Boxer was referred to the Veterinary Teaching Hospital of the University of Pisa because of 2 episodes of syncope and progressive lethargy. When the dog was 1 year old, a systolic murmur was detected but was not further investigated by echocardiography. At the initial physical examination, the dog was cachectic (body condition score, 2/9) and had a dull mental status. It was unable to maintain a standing position. Rectal temperature was 39.6°C (103.28°F), mucous membranes were pale pink, and capillary refill time was 2 seconds. Respiratory rate was 36 breaths/min with normal auscultatory findings.
Objective—To investigate serum calcium-phosphorus concentration product (sCaPP) as a predictor of mortality rate in dogs with chronic kidney disease (CKD).
Design—Retrospective case-control study.
Animals—31 dogs with definitive CKD and 35 apparently healthy dogs.
Procedures—All dogs had been referred for nephrological consultation between December 2008 and December 2010. Dogs with CKD had stable disease for ≥ 3 months. On the basis of glomerular filtration rate < 60 mL/min/m2, 13 of the 35 apparently healthy dogs were subsequently classified as having early CKD. Disease stage among dogs was determined on the basis of plasma creatinine concentration as follows: stage 1, < 123.7 μmol/L (n = 13), stage 2, 123.7 to 176.8 μmol/L (7); stage 3, 185.6 to 442 μmol/L (13); or stage 4, > 442 μmol/L (11). For each dog, serum concentrations of ionized and total calcium and phosphorus were evaluated once; the latter 2 variables were used to determine sCaPP.
Results—The sCaPP differed significantly between the 22 healthy dogs and dogs with stage 3 or stage 4 CKD. The proportion of dogs with sCaPP > 70 mg2/dL2 increased with stage of disease. Mortality rate among the 24 dogs with sCaPP > 70 mg2/dL2 was higher than that among the 42 dogs with sCaPP ≤ 70 mg2/dL2. Dogs with sCaPP > 70 mg2/dL2 had a comparatively lower survival rate, and risk of death was 4.2 times as high as risk for dogs with sCaPP ≤ 70 mg2/dL2.
Conclusions and Clinical Relevance—For dogs with CKD, sCaPP > 70 mg2/dL2 appeared to be a negative prognostic indicator, which was not influenced by the concomitant serum concentrations of phosphorus and total or ionized calcium.
A14-year-old 18-kg (39.6-lb) sexually intact male German Shorthaired Pointer was evaluated because of severe weakness and inability to maintain a standing position. The owner had found the dog outdoors in lateral recumbency, after it had been outside for several hours during the winter season. It had been recently determined that the dog had vestibular syndrome.
On physical examination, the dog was in lateral recumbency and had dull mentation. The dog's rectal temperature was 33.8°C (92.84°F); oral mucous membranes were pale pink, and capillary refill time was 2 seconds. The femoral pulses were weak and irregular, and the heart rate was
A 13-year-old 4.2-kg (9.2-lb) spayed female Maine Coon cat was referred to the Veterinary Teaching Hospital of the University of Pisa for cardiovascular evaluation after an acute episode of dyspnea associated with suspected cardiogenic pulmonary edema. The cat was initially treated with furosemide by the referring veterinarian. On physical examination, the cat had dull mentation and was paraparetic. The respiratory rate was 36 breaths/min, and the heart rate was 180 beats/min. Femoral pulse quality was weak bilaterally. Cardiac auscultation revealed no murmur or gallop sounds. Lung auscultation revealed no detectable abnormalities. The cat's rectal temperature was 37.1°C (98.8°F).