Symmetric dimethylarginine correlates with the urea, creatinine, potassium, and clinical scores in feline urethral obstructions.

BACKGROUND: A urethral obstruction (UO) is an emergency commonly observed in male cats, which can result in significant clinical and laboratory alterations, leading to complications and death. OBJECTIVES: This study aimed to correlate symmetric dimethylarginine (SDMA) with the urea, creatinine, potassium, and bicarbonate levels in cats with UO. In addition, the correlation between clinical score and time of obstruction was evaluated. METHODS: Thirty male cats were selected and allocated into a control group (CG, n = 13) and an obstruction group (OG, n = 17). The laboratory analyses were conducted before treatment (M0) and at different times after treatment (12 h [M12], 24 h [M24], and 48 h [M48]). Correlations were established between SDMA and creatinine, urea, bicarbonate, potassium, time of obstruction, and the clinical score. RESULTS: A strong correlation (r > 0.6) was observed between SDMA and creatinine, urea, and potassium in the OG. Furthermore, there was substantial agreement (kappa value) between SDMA and creatinine at M24. A higher clinical score was associated with a longer time of obstruction. In the OG, at M48, the SDMA and creatinine levels were 50% and 41.2% higher, respectively. CONCLUSIONS: A correlation was observed between SDMA and creatinine in obstructed cats, and significant agreement between these values was observed 24 h after the unblocking treatment. A correlation among SDMA, urea, and potassium was observed. Approximately 9% more cats continued to have elevated SDMA levels after 48 h of treatment compared to creatinine. This suggests a slightly lower sensitivity of the latter biomarker but does not exclude the possibility of congruent and normalized values after a longer evaluation period.

The Effect of Intermittent Hemodialysis on the Hematological and Serum Biochemistry Profile in Dogs With Chronic Kidney Disease.

Intermittent hemodialysis (IHD) is a type of kidney replacement therapy commonly prescribed in veterinary medicine for cases of drug removal, fluid, acid-base, and electrolyte disorders, acute kidney injury, and cases of chronic kidney disease (CKD) in uremic crisis. This study aimed to evaluate the effects of intermittent hemodialysis in dogs with IRIS stage 4 CKD in contrast to dogs treated only with standard medical management, without dialysis, to improve their quality of life. Twenty-five dogs previously diagnosed with IRIS stage 4 CKD were selected for the study according to the inclusion criteria. Dogs were randomized to 2 distinct groups: the control group (n = 11), which underwent a conventional clinical treatment for CKD; and the hemodialysis group (n = 14), which underwent intermittent hemodialysis in addition to the clinical treatment. Both groups had a period of 15 days of clinical and laboratory evaluation. Laboratory analysis consisted of chemistry and hematological evaluation before and after both treatments at a minimum interval of 48 hours. Clinical parameters and eventual complications were assessed every 30 minutes during the IHD. When compared with conventional treatment, IHD was highly efficient in removing urea, creatinine, and phosphorus, but presented a hematological risk to the patient, requiring constant monitoring of hematological and biochemical profiles in order to correct alterations. Therefore, IHD is a highly recommended treatment if adequately monitored by trained professionals.

Symmetric dimethylarginine concentrations in dogs with International Renal Interest Society stage 4 chronic kidney disease undergoing intermittent hemodialysis.

BACKGROUND: Symmetric dimethylarginine (SDMA) is a methylated arginine derived from intranuclear methylation of l-arginine by protein-arginine methyltransferase and released into circulation after proteolysis. It is primarily eliminated by renal excretion, and its concentration is highly correlated with glomerular filtration rate (GFR) in animals and humans and is an earlier indicator of kidney dysfunction than serum creatinine concentration (sCr). OBJECTIVES: To evaluate and quantify the effects of IV fluid therapy (IF) or intermittent hemodialysis (IH) on renal function in a randomized group of dogs previously diagnosed with International Renal Interest Society (IRIS) stage 4 chronic kidney disease (CKD). ANIMALS: Twenty-four client-owned dogs with naturally occurring CKD. METHODS: Serum from 14 dogs treated by IH and 10 dogs treated with IF was submitted for measurement of sCr and SDMA. Dogs in each treatment group received up to 5 treatment sessions, administered 48 hours apart. RESULTS: Significant differences (P ≤ .05) were seen between treatment groups, but dogs from the IH group were the most affected based on SDMA (P < .001), sCr (P < .001), and blood urea (P < .001) concentrations. Furthermore, for each 10% increase in urea reduction ratio, there was a 6.2 µg/dL decrease in SDMA (P = .002). CONCLUSIONS AND CLINICAL IMPORTANCE: Although SDMA is dialyzable biomarker and despite its removal by IH, SDMA correlates better with renal function than does sCr in dogs with CKD undergoing IF and IH.

Use of Nandrolone Decanoate in Treatment of Pure Red Cell Aplasia Secondary to Diclofenac Administration: A Case Report.

Pure red cell aplasia (PRCA) is a disorder that leads to a nonregenerative anemia that results from erythroid precursors failing to reach maturity in the bone marrow, whereas the numbers of mature myeloid and megakaryocytic cells remain normal. PRCA can be induced by autoimmune processes, infections, drugs, toxins, and radiation, and is diagnosed by a bone marrow cytology examination after excluding the most common causes of nonregenerative anemia. Immunosuppressive therapies are used to treat PRCA, and usually involve the use of glucocorticoids, cyclosporin, or azathioprine. Alternatively, although little studied in veterinary medicine, drugs which stimulate bone marrow (e.g., nandrolone decanoate) have been mentioned as possible therapeutic agents. A case of PRCA that presented at the Veterinary Teaching Hospital of the Faculty of Veterinary Medicine and Animal Science (UNESP)-Botucatu, Brazil showed a good therapeutic response to weekly administration of nandrolone decanoate. Therefore, it was concluded that bone marrow stimulants might improve the quality of life of PRCA patients, provided they are used with caution and under close clinical supervision.

Intermittent hemodialysis in dogs with chronic kidney disease stage III / Hemodiálise intermitente em cães com doença renal crônica III

ABSTRACT: Intermittent hemodialysis (IHD) is a form of renal replacement that is used in veterinary medicine for cases involving drug removal, electrolyte imbalance, acute kidney injury, and chronic kidney disease (CKD). The aim of the present study was to verify the efficacy of IHD in dogs with CKD staged at grade III and to evaluate the effect of IHD on quality of life. Twelve dogs with CKD at stage III met the inclusion criteria and were divided equally into two groups. The control group (n=6) received only clinical treatment and intravenous fluid therapy, and the hemodialysis group (n=6) received clinical and IHD treatments. Blood samples were collected before and after treatments in both groups. We evaluated complications and clinical parameters of IHD every 30 minutes. Hemodialysis decreased serum urea, creatinine, and phosphorus. Despite the evident removal of nitrogen compounds, dialysis treatment did not increase survival time in these patients. The results of this study do not support the early use of dialysis in dogs with chronic kidney disease stage III.

RESUMO: A Hemodiálise Intermitente (HDI) é uma modalidade de substituição renal, utilizada na veterinária nos casos de remoção de drogas, distúrbios hidroeletrolítico, lesão renal aguda e doença renal crônica (DRC). O objetivo do presente estudo foi estudar o efeito da hemodiálise intermitente em cães com DRC estadeados no grau III, visando avaliar a qualidade de vida. Foram selecionados 12 cães com DRC no estádio III pelos critérios de inclusão, após foram divididos em Grupo Controle (n=6), onde foi preconizado apenas tratamento clínico e fluidoterapia, e Grupo hemodiálise (n=6), que além do tratamento clínico, utilizou-se a hemodiálise intermitente. A colheita de sangue para avaliação laboratorial foi realizada antes e após a fluidoterapia de ambos os grupos. Foram avaliados as intercorrências e os parâmetros clínicos durante a HDI a cada 30 minutos. A instituição do tratamento dialítico promoveu uma eficaz diminuição das concentrações séricas de ureia, creatinina e fósforo de modo mais precoce. Apesar da evidente remoção dos compostos nitrogenados, o tratamento dialítico não aumentou a sobrevida destes pacientes, não justificando o emprego desta técnica de forma precoce em cães com doença renal crônica no estádio III.