Nasal mucosal mineralization, ulceration and epistaxis in a dog with uremia caused by chronic renal failure / Mineralização, ulceração e epistaxe em um cão com uremia causada por insuficiência renal crônica

ABSTRACT: Soft tissue mineralization and epithelial ulceration are common findings in dogs with uremia, being commonly reported in the gastrointestinal tract, lungs and pleura. This report described a case of nasal mucosal mineralization and ulceration contributing to recurrent epistaxis in a dog with chronic renal failure and uremia. A dog with recurrent epistaxis accompanied by elevated urea and creatinine was hospitalized. Platelet count and coagulation tests were within normal limits. Chronic renal failure was diagnosed, and the dog was euthanized. On necropsy, the kidneys were small, with an irregular capsular surface. The nasal conchae were slightly reddish. Histopathology revealed chronic glomerulonephritis, with gastric mineralization and bilateral parathyroid hyperplasia. Vascular and basal lamina mineralization, epithelial ulceration and hemorrhage were seen in the nasal conchae. The observed findings indicated that nasal mineralization and ulceration were caused by uremia. The severity of histopathological findings suggested that nasal mineralization/ulceration may have caused or at least contributed to epistaxis in this dog. We hope to stimulate further investigations into possible association between uremia, nasal mucosa mineralization/ulceration and epistaxis in dogs.

RESUMO: Mineralização dos tecidos moles e ulceração epitelial são achados comuns em cães com uremia, sendo geralmente observados no trato gastrointestinal, pulmões e pleura. O objetivo desse relato é reportar um caso de mineralização e ulceração da mucosa nasal contribuindo para epistaxe recorrente em um cão com insuficiência renal crônica e uremia. Um cão com epistaxe recorrente e aumento da ureia e creatinina foi hospitalizado. A contagem plaquetária e os testes de coagulação não tinham alterações. Foi diagnosticado insuficiência renal crônica, e o cão foi submetido a eutanásia. Na necropsia, o cão tinha os rins diminuídos, com superfície irregular. As conchas nasais estavam levemente avermelhadas. Histologicamente, foi diagnosticada uma glomerulonefrite crônica com mineralização gástrica e hiperplasia das paratireoides. As conchas nasais tinham mineralização da parede de vasos e membrana basal, úlceras e hemorragia. Os achados histopatológicos indicam que a mineralização e ulceração nasal foram causadas pela uremia. A severidade das lesões histológicas sugere que a mineralização/ulceração nasal pode ter causado, ou pelo menos contribuído, para a epistaxe deste cão. Espera-se, com esse relato, estimular futuros estudos que investiguem uma possível associação entre uremia, mineralização/ulceração nasal e epistaxe em cães.

Nasal mucosal mineralization, ulceration and epistaxis in a dog with uremia caused by chronic renal failure / Mineralização, ulceração e epistaxe em um cão com uremia causada por insuficiência renal crônica

Soft tissue mineralization and epithelial ulceration are common findings in dogs with uremia, being commonly reported in the gastrointestinal tract, lungs and pleura. This report described a case of nasal mucosal mineralization and ulceration contributing to recurrent epistaxis in a dog with chronic renal failure and uremia. A dog with recurrent epistaxis accompanied by elevated urea and creatinine was hospitalized. Platelet count and coagulation tests were within normal limits. Chronic renal failure was diagnosed, and the dog was euthanized. On necropsy, the kidneys were small, with an irregular capsular surface. The nasal conchae were slightly reddish. Histopathology revealed chronic glomerulonephritis, with gastric mineralization and bilateral parathyroid hyperplasia. Vascular and basal lamina mineralization, epithelial ulceration and hemorrhage were seen in the nasal conchae. The observed findings indicated that nasal mineralization and ulceration were caused by uremia. The severity of histopathological findings suggested that nasal mineralization/ulceration may have caused or at least contributed to epistaxis in this dog. We hope to stimulate further investigations into possible association between uremia, nasal mucosa mineralization/ulceration and epistaxis in dogs.

Mineralização dos tecidos moles e ulceração epitelial são achados comuns em cães com uremia, sendo geralmente observados no trato gastrointestinal, pulmões e pleura. O objetivo desse relato é reportar um caso de mineralização e ulceração da mucosa nasal contribuindo para epistaxe recorrente em um cão com insuficiência renal crônica e uremia. Um cão com epistaxe recorrente e aumento da ureia e creatinina foi hospitalizado. A contagem plaquetária e os testes de coagulação não tinham alterações. Foi diagnosticado insuficiência renal crônica, e o cão foi submetido a eutanásia. Na necropsia, o cão tinha os rins diminuídos, com superfície irregular. As conchas nasais estavam levemente avermelhadas. Histologicamente, foi diagnosticada uma glomerulonefrite crônica com mineralização gástrica e hiperplasia das paratireoides. As conchas nasais tinham mineralização da parede de vasos e membrana basal, úlceras e hemorragia. Os achados histopatológicos indicam que a mineralização e ulceração nasal foram causadas pela uremia. A severidade das lesões histológicas sugere que a mineralização/ulceração nasal pode ter causado, ou pelo menos contribuído, para a epistaxe deste cão. Espera-se, com esse relato, estimular futuros estudos que investiguem uma possível associação entre uremia, mineralização/ulceração nasal e epistaxe em cães.

B-mode and Doppler ultrasound of bitches' kidneys with mammary neoplasia submitted to adjuvant chemotherapy / Ultrassonografia modo-B e Doppler dos rins de cadelas com neoplasias mamárias submetidas à quimioterapia adjuvante

Mammary neoplasia represents the most frequently diagnosed type of neoplasia in bitches. Although surgical removal is the procedure of choice for therapeutic management, chemotherapy protocols appear as important allies and adjuvants. Despite the great advances that have occurred in the field of cancer therapy, the systemic repercussions of these drugs still impose important limitations on their use. In this sense, the development of increasingly targeted therapeutic protocols and preventive monitoring of patients represent important strategies to avoid possible complications - among them, Acute Kidney Injury (AKI). Routinely, ultrasound evaluation is used to identify morphological or metastatic variations in abdominal cavity organs. Acting complementary to the B-mode evaluation, Doppler mapping proves to be efficient in recognizing alterations in vascular hemodynamics. Therefore, the objective of the present study was to evaluate the use of B-mode and Doppler ultrasound to identify renal morphological and hemodynamic alterations in bitches with mammary neoplasia submitted to adjuvant chemotherapy protocols that associate gemcitabine with carboplatin. Thirteen bitches were included, without distinction of breed and between seven and 13 years of age. The animals were evaluated ultrasonographically at two different times during three consecutive chemotherapy cycles: before (T0) and one and a half hours after each cycle (T1), for 42 days. No morphological changes were observed in B-mode throughout the chemotherapy protocol. However, the Doppler velocimetry indices demonstrated statistical differences before (T0) and after (T1) the administration of the drugs. It was concluded that Doppler ultrasound could be used as a complementary method for monitoring the renal response of patients exposed to nephrotoxic drugs and potentially causing renal injury.

As neoplasias mamárias representam o tipo de neoplasma mais frequentemente diagnosticado em fêmeas da espécie canina. Embora a remoção cirúrgica seja o procedimento de eleição para a conduta terapêutica, os protocolos quimioterápicos aparecem como importantes aliados e adjuvantes. Apesar dos grandes avanços ocorridos na área da terapia oncológica, as repercussões sistêmicas destes fármacos ainda impõem importantes limitações ao seu uso. Neste sentido, o desenvolvimento de protocolos terapêuticos cada vez mais direcionados e o monitoramento preventivo dos pacientes representam estratégias importantes para evitar possíveis complicações - dentre elas, a injúria renal aguda (IRA). Rotineiramente, a avaliação ultrassonográfica é utilizada para identificação de variações morfológicas ou metastáticas em órgãos da cavidade abdominal. Atuando de forma complementar à avaliação em modo-B, o mapeamento Doppler mostra-se eficiente no reconhecimento de alterações na hemodinâmica vascular. Portanto, o objetivo do presente estudo foi avaliar a utilização da ultrassonografia modo-B e Doppler como método para identificação de alterações morfológicas e hemodinâmicas renais em cadelas com neoplasias mamárias submetidas a protocolos quimioterápicos adjuvantes que associam a gencitabina à carboplatina. Foram incluídas 13 fêmeas caninas, sem distinção quanto a raça e com idades entre sete e 13 anos. Os animais foram avaliados ultrassonograficamente em dois momentos distintos durante três ciclos quimioterápicos consecutivos: antes (T0) e uma hora e meia após a realização de cada ciclo (T1), totalizando 42 dias. Não foram observadas alterações morfológicas em modo-B ao longo do protocolo quimioterápico. Entretanto, os índices dopplervelocimétricos demonstraram diferenças estatísticas antes (T0) e após (T1) a administração dos fármacos. Concluiu-se que a ultrassonografia Doppler pode ser utilizada como método complementar para o monitoramento da resposta renal de pacientes expostos a fármacos nefrotóxicos e potencialmente causadores de injúrias renais.

Cyanidin-3-O-glucoside plays a protective role against renal ischemia/ reperfusion injury via the JAK/STAT pathway

Purpose: To investigate the role of cyanidin-3-O-glucoside (C3G) in renal ischemia/reperfusion (I/R) injury and the potential mechanisms. Methods: Mouse models were established by clamping the left renal vessels, and in vitro cellular models were established by hypoxic reoxygenation. Results: Renal dysfunction and tissue structural damage were significantly higher in the I/R group. After treatment with different concentrations of C3G, the levels of renal dysfunction and tissue structural damage decreased at different levels. And its protective effect was most pronounced at 200 mg/kg. The use of C3G reduced apoptosis as well as the expression of endoplasmic reticulum stress (ERS)-related proteins. Hypoxia/reoxygenation (H/R)-induced apoptosis and ERS are dependent on oxidative stress in vitro. In addition, both AG490 and C3G inhibited the activation of JAK/STAT pathway and attenuated oxidative stress, ischemia-induced apoptosis and ERS. Conclusions: The results demonstrated that C3G blocked renal apoptosis and ERS protein expression by preventing reactive oxygen species (ROS) production after I/R via the JAK/STAT pathway, suggesting that C3G may be a potential therapeutic agent for renal I/R injury.

Evaluation of kidney injury through early markers in canine pyometra / Avaliação de lesão renal através de marcadores precoce em piometra canina

Fourteen female dogs diagnosed with pyometra were studied at three separate times: at diagnosis (T0) and 24 h (T1) and 10-15 days (T2) after ovariohysterectomy (OH). The means of the markers, symmetric dimethylarginine (SDMA) (17.71 to 26.54 µg/dL) and the urinary gamma-glutamyl transferase to creatinine ratio (uGGT/uCr) (1.06 to 2.62 U/mg), varied, showing an increase with time. Further, the elevation of gamma-glutamyl transferase (uGGT) (56.61 to 128.12 U/L) and the urinary protein to creatinine ratio (RPC) (0.26 to 1.24) was evident at T0 and T1. A reduction in the means of RPC, uGGT, and uGGT/uCr was observed 10-15 days after OH. Despite the elevation of these markers, the concentration of creatinine (1.11 to 1.40 mg/dL), urea (40.07 to 67.16 mg/dL), and urinary specific gravity (1.027 to 1.028) only presented slight variation. In canine pyometra, complications secondary to acute renal injury may be present that may be mild and transient in most treated animals. As elevation in SDMA and RPC preceded changes in creatinine levels for the evaluation of glomerular filtration, tubular markers could assist in the early identification of renal damage in canine pyometra.(AU)

Catorze cadelas com diagnóstico de piometra foram estudadas em três tempos distintos, sendo no momento do diagnóstico (T0), 24 horas (T1) e 10 a 15 dias (T2) após a ovário-histerectomia (OH). O objetivo foi avaliar o uso de diferentes biomarcadores renais em cadelas com piometra e estimar suas precocidades diante do agravo. As médias em dimetilarginina simétrica (SDMA) (17,71 a 26,54µg/dL) e relação gama-glutamil transferase e creatinina urinária (uGGT/uCr) (1,06 a 2,62U/mg) variara, apresentando aumento em todos os momentos. Já a elevação do gama-glutamil transferase (uGGT) (56,61 a 128,12 U/L) e da razão proteína e creatinina urinárias (RPC) (0,26 a 1,24) foram evidenciadas nos dois primeiros tempos. Uma redução na média do RPC, uGGT e uGGT/uCr foi observada 10-15 dias após a implantação do tratamento (OH). Apesar da elevação desses marcadores, a concentração de creatinina (1,11 a 1,40mg/dL), ureia (40,07 a 67,16mg/dL) e densidade urinária (1,027 a 1,028) sofreram poucas variações. Em piometra canina, as complicações renais agudas secundárias podem estar presentes, ainda que leve e transitória nos animais tratados. Os marcadores tubulares foram considerados precoces na injúria renal aguda. Além disso, a SDMA e o RPC antecederam as alterações de creatinina em todos os tempos analisados.(AU)

Congenital renal hypoplasia and contralateral kidney failure in a giant otter (Pteronura brasiliensis) ex situ in Southeastern Brazil

Renal hypoplasia is incomplete development of the kidneys, in which fewer than normal numbers of nephrons are present at birth. This report is the first of these conditions in mustelids. A female adult giant otter (Pteronura brasiliensis), ex situ, presented clinically an unusual behavior with prostration, anorexia, hiding in the shelter, ataxia, paraparesis, and death in a clinical course of one day. At the postmortem exam, the left kidney was markedly enlarged and pale and the right kidney was severely reduced and had mild to moderate capsular thickening. Histologically, the left kidney had mineralization, proliferation of fibrous connective tissue and a mild neutrophilic infiltrate. The right kidney presented a reduced number of glomeruli, tubular atrophy and an increase in fibrous connective tissue, which were findings compatible with congenital kidney hypoplasia. Due the clinical condition of the animal, gross and microscopic findings, the cause of death was established as kidney failure induced by renal hypoplasia.(AU)

Protective effect and mechanism of Shenkang injection on adenine-induced chronic renal failure in rats

Purpose: To investigate the protective effects of Shenkang injection (SKI) on adenine-induced chronic renal failure (CRF) in rat. Methods: Sprague Dawley rats were randomly divided into five groups: control, model, and SKI groups (5, 10, 20 mL/kg). Rats in model and SKI groups were treated with adenine i.g. at a dose of 150 mg/kg every day for 12 weeks to induce CRF. Twelve weeks later, SKI was administered to the rat i.p. for four weeks. The effects of SKI on kidney injury and fibrosis were detected. Results: SKI inhibited the elevation of the urine level of N-acetyl-b-D-glucosaminidase, kidney injury molecule-1, beta-2-microglobulin, urea protein in CRF rats. The serum levels of uric acid and serum creatinine increased and albumin decreased in the model group, which was prevented by SKI. SKI inhibited the release of inflammatory cytokines and increasing the activities of antioxidant enzymes in serum. SKI inhibited the expression of transforming growth factor-β1, vascular cell adhesion molecule 1, intercellular adhesion molecule 1, collagen I, collagen III, endothelin-1, laminin in kidney of CRF rats. Conclusions: SKI protected against adenine-induced kidney injury and fibrosis and exerted anti-inflammatory, and antioxidant effects in CRF rats.

Antioxidant extract of black rice prevents renal dysfunction and renal fibrosis caused by ethanol-induced toxicity / Extrato antioxidante de arroz-preto previne disfunção renal e fibrose renal causada pela toxicidade induzida pelo etanol

This study was conducted to evaluate the protective role of extracted natural antioxidants from black rice and their effect on kidney failure and renal cirrhosis caused by ethanol-induced toxicity. Antioxidant activity in terms of total phenol content, flavonoid compounds and anthocyanin, as well as antioxidant capacity, was determined in an extract of black rice. The findings noted that the black rice extract contained high amounts of antioxidant activity and capacity. Total phenolic compounds from black rice extract were fractionated using HPLC and the results showed that ferulic, sinapic, ascorbic, salicylic and coumaric acids were the highest in the extract. Biological experiments were performed on male albino adult rats (40 animals, 10 rats for each group), divided into four groups. After five weeks, kidney functions and protein fractions were assessed. In addition, superoxide dismutase (SOD), glutathione (GSH) and malondialdehyde (MDA) enzyme activities were determined in all groups. The results found that kidney function, total protein, albumin and globulin were affected by renal dysfunction and renal fibrosis in the positive control (PC), whereas groups 3 and 4 noted an improvement in renal function nearly or equal to the healthy rats which were fed on a basal diet. Furthermore, the PC group showed significantly decreased levels of enzymatic antioxidants, namely SOD and GSH with a concomitant elevated MDA level compared with those in the negative rats fed on a basal diet. Groups 3 and 4 also reported improvements in enzyme activity. These results were further supported by histopathological findings which revealed a curative effect in groups 3 and 4, which avoided renal dysfunction and renal fibrosis from ethanol-induced toxicity. From the results, it can be said that the black rice extract with the highest amounts of antioxidants led to improvements in all parameters, especially kidney function, total protein, albumin, and globulin, in addition to enzyme activity. Therefore, black rice can be recommended as a benefit to general health.

Este estudo foi conduzido para avaliar o papel protetor dos antioxidantes naturais extraídos do arroz-preto e seu efeito na insuficiência renal e cirrose renal causada pela toxicidade induzida pelo etanol. A atividade antioxidante em termos de teor de fenóis totais, compostos flavonoides e antocianinas, bem como a capacidade antioxidante, foi determinada em um extrato de arroz-preto. As descobertas observaram que o extrato de arroz-preto continha grandes quantidades de atividade e capacidade antioxidante. Os compostos fenólicos totais do extrato de arroz-preto foram fracionados por HPLC e os resultados mostraram que os ácidos ferúlico, sinápico, ascórbico, salicílico e cumárico foram os mais elevados no extrato. Experimentos biológicos foram realizados em ratos adultos albinos machos (40 animais, 10 ratos para cada grupo), divididos em quatro grupos. Após cinco semanas, as funções renais e frações proteicas foram avaliadas. Além disso, as atividades das enzimas superóxido dismutase (SOD), glutationa (GSH) e malondialdeído (MDA) foram determinadas em todos os grupos. Os resultados mostraram que a função renal, proteína total, albumina e globulina foram afetadas por disfunção renal e fibrose renal no controle positivo (CP), enquanto os grupos 3 e 4 observaram uma melhora na função renal quase ou igual aos ratos saudáveis ​​que foram alimentados em uma dieta básica. Além disso, o grupo PC apresentou níveis significativamente diminuídos de antioxidantes enzimáticos, ou seja, SOD e GSH com um nível concomitante de MDA elevado em comparação com aqueles nos ratos negativos alimentados com uma dieta basal. Os grupos 3 e 4 também relataram melhorias na atividade enzimática. Esses resultados foram ainda apoiados por achados histopatológicos que revelaram um efeito curativo nos grupos 3 e 4, que evitou a disfunção renal e fibrose renal por toxicidade induzida pelo etanol. A partir dos resultados, pode-se dizer que o extrato de arroz-preto com maior quantidade de antioxidantes levou a melhorias em todos os parâmetros, principalmente função renal, proteína total, albumina e globulina, além da atividade enzimática. Portanto, o arroz-preto pode ser recomendado como um benefício para a saúde geral.

Laboratory changes inherent to acute kidney injury induced by aminoglycosides in wistar rats / Alterações laboratoriais inerentes à lesão renal aguda induzida por aminoglicosídeos em ratos wistar

Acute kidney injury (AKI) is defined as an increase greater than 0.3 mg/L of serum creatinine within 48 hours and is a major cause of death in patients in intensive care units. Twenty-four Wistar rats were divided into three groups: Control (0.9% saline), Genta (gentamicin 50 mg.kg-¹ BID) and Deh+Genta (gentamicin 50 mg.kg-¹ BID + water restriction) and tested in an AKI model by aminoglycoside administration and dehydration implementation. The animals in the Deh+Genta group exhibited the lowest average weight and feed intake after the fifth day of the experiment. In this same period, water consumption by the Genta group was lower than the Control group, but in the following days of the experiment, polydipsia was noted for this group. The Deh+Genta group displayed the highest mean serum urea after the fifth day. The gentamicin-treated groups exhibited higher means than the Control group for serum creatinine, which proved to be a late renal marker for AKI. Serum GGT was higher in the Deh+Genta group, whereas urinary GGT was higher in the groups that received gentamicin, characterizing enzymuria, although severe dehydration can mask the results by indicating false negative values. The urinary GGT enzyme did not act as an early AKI biomarker. Decreased glomerular filtration rates enhanced the concentration of blood components and masked urinary and tissue components.

A lesão renal aguda (LRA) é definida como um aumento superior a 0,3 mg / L da creatinina sérica em 48 horas e é a principal causa de morte em pacientes em unidades de terapia intensiva. Vinte e quatro ratos Wistar foram divididos em três grupos: Controle (solução salina 0,9%), Genta (gentamicina 50 mg.kg-¹ BID) e Deh + Genta (gentamicina 50 mg.kg-¹ BID + restrição hídrica) e testados em um Modelo AKI por administração de aminoglicosídeos e sujeição à desidratação. Os animais do grupo Deh + Genta apresentaram o menor peso médio e o menor consumo de ração após o quinto dia de experimento. Nesse mesmo período, o consumo de água do grupo Genta foi inferior ao do grupo Controle, mas nos dias posteriores do experimento, o grupo Genta apresentou polidipsia. O grupo Deh + Genta apresentou média de uréia sérica mais elevada após o quinto dia. Os grupos tratados com gentamicina apresentaram médias superiores à do grupo Controle para a creatinina sérica, que se mostrou um marcador renal tardio de IRA. O valor de GGT sérico foi maior no grupo Deh + Genta, enquanto o valor de GGT urinário foi maior nos grupos que receberam gentamicina, caracterizando enzimúria, mas a desidratação severa pode mascarar os resultados por apresentar valores falsos negativos. A enzima GGT urinária não atuou como um biomarcador precoce de IRA. A diminuição da taxa de filtração glomerular aumentou a concentração de componentes do sangue e mascarou componentes urinários e teciduais.

Downer cow syndrome causing rhabdomyolysis and acute renal failure in a 17-month-old Guzerá heifer / Síndrome da vaca caída causando rabdomiólise e insuficiência renal aguda em uma novilha Guzerá de 17 meses

The downer cow syndrome (DCS) is characterized by an alert cow showing inability or reluctance to stand for 12 hours or more. This paper reported clinical, laboratory, and pathological findings in a Guzerá heifer with rhabdomyolysis, pigmenturia and acute renal failure following DCS. A 17-month-old Guzerá heifer was transported via a 350-km ride in a truck and showed sternal recumbency and severe difficulty in standing and walking. Neurological examination was unremarkable, and the heifer presented normal response to cranial nerves and spinal cord tests. Rectal palpation revealed a 5-month gravid uterus. No other abnormalities were noted in the pelvis or around the coxofemoral joints. Biochemical abnormalities included extremely high muscular enzyme activities (creatine phosphokinase and aspartate aminotransferase) and high creatinine levels. Urinalysis revealed blackish and cloudy urine, proteinuria, and a positive occult blood test. Spinal cord ultrasonography showed no abnormalities. This report highlighted an uncommon clinical presentation (myoglobinuria) and pathological findings in a heifer with DCS as a consequence of severe compressive muscle damage. Practitioners and producers must be aware of the risk of careless road transportation for long distances of cattle, especially obese cows, avoiding unnecessary suffering and expenses due to DCS.

A síndrome da vaca caída (SVC) é caracterizada por um bovino alerta que mostra incapacidade ou relutância em permanecer em estação por 12 horas ou mais. O objetivo deste trabalho é relatar os achados clínicos, laboratoriais e patológicos em uma novilha Guzerá com rabdomiólise, pigmentúria e insuficiência renal aguda após a SVC. Uma novilha da raça Guzerá, de 17 meses de idade, foi transportada de caminhão por 350 km e apresentou decúbito esternal, grande dificuldade para assumir estação e caminhar. O exame neurológico não demonstrou alterações, e a novilha possuía resposta normal aos testes de nervos cranianos e medula espinhal. A palpação retal revelou útero grávido de cinco meses. Nenhuma outra anormalidade foi observada na pelve ou na região das articulações coxofemorais. As anormalidades bioquímicas incluíram atividades de enzimas musculares (creatina fosfoquinase e aspartato aminotransferase) extremamente aumentadas e níveis elevados de creatinina. A urinálise revelou urina enegrecida e turva, proteinúria e teste de sangue oculto positivo. O exame ultrassonográfico da medula espinhal não apresentou anormalidades. Este relato evidencia uma apresentação clínica (mioglobinúria) e achados patológicos incomuns em uma novilha com SVC em consequência de extensa lesão muscular compressiva. Veterinários e produtores devem estar atentos aos riscos do transporte rodoviário descuidado por longas distâncias de bovinos, especialmente vacas obesas, evitando assim sofrimento e despesas desnecessárias decorrentes da SVC.

Correlation between renal ultrasonography and serum cystatin C in acute kidney disease of critically ill dogs / Correlação entre a ultrassonografia e a determinação da cistatina C sérica em cães admitidos em unidade de terapia

Acute kidney injury (AKI) is defined as the rapid decline in kidney function. Its development is related to critical clinical statuses, such as sepsis, complicated post-surgical recovery, and infectious diseases. Serum cystatin C (CysC) has the best correlation with the glomerular filtration rate. Ultrasonography stands out because it is highly accessible and can be done at the bedside. Twenty-eight dogs admitted to the intensive care unit with serum creatinine values <1.6 mg/dL and at-risk factors of AKI development were selected. CysC measurements and ultrasound assessments were performed daily for 72 hours. Using CysC dosage, 22/28 animals (78.6%) were considered to have AKI, and 17/22 had ultrasound compatible with AKI changes, demonstrating moderate agreement with CysC dosage. Increased cortical renal echogenicity is the most prevalent alteration in critically ill patients and is correlated with serum increases in CysC and is associated with renal structural damage.

A injúria renal aguda (IRA) é definida como o declínio rápido da função renal. Seu desenvolvimento está relacionado a quadros clínicos críticos, como sepse, pós-operatório complicado e doenças infecciosas. A cistatina C sérica (CisC) tem melhor correlação com taxa de filtração glomerular. A ultrassonografia se destaca por ser altamente acessível e pode ser realizada à beira do leito. Foram selecionados 28 cães, internados em unidade de terapia intensiva, com valores de creatinina sérica <1,6mg/dL e fatores de risco para o desenvolvimento de IRA. Medições de CisC e avaliações ultrassonográficas foram realizadas diariamente por 72 horas. Utilizando-se a dosagem de CisC, 22/28 animais (78,6%) foram considerados portadores de IRA e 17/22 apresentaram ultrassom compatível com alterações de IRA, demonstrando concordância moderada com a dosagem de CisC. O aumento da ecogenicidade cortical renal é a alteração mais prevalente em pacientes críticos, está correlacionado com aumentos séricos de CisC e associado a dano estrutural renal.

Uso do Bypass Ureteral Subcutâneo no manejo das obstruções ureterais em gatos: revisão de literatura / Use of Subcutaneous Ureteral Bypass in the management of ureteral obstructions in cats - literature review

A obstrução ureteral em felinos é uma afecção, potencialmente fatal e comum na clínica de pequenos animais por levar à restrição do fluxo normal de urina. As principais causas dessa obstrução são ureterólitos (cálculos) que podem ser classificados como simples, mistos ou compostos. Os sinais clínicos da obstrução ureteral não são muito evidentes até que a obstrução seja completa, bilateral ou que haja disfunção do rim contralateral. O diagnóstico da doença é firmado com base nos sinais clínicos, exames complementares como hemograma, bioquímico, radiografia, ultrassonografia abdominal, urinálise e urocultura, uretropielografia retrógrada, pielografia anterógrada, tomografia computadorizada e estudo da taxa de filtração glomerular ureteral. A obstrução ureteral é uma enfermidade que deve ser tratada com emergência, o tratamento deve ser determinado com base no tipo de cálculo presente, os casos mais severos necessitam de intervenção cirúrgica como a técnica bypass para descompressão. O presente artigo é uma revisão sobre a eficácia do emprego do bypass para o tratamento na obstrução ureteral.(AU)

Ureteral obstruction in felines is a potentially fatal and common condition in small animal clinics, as it leads to restriction of the normal flow of urine. The main causes of this obstruction are urolithiasis (renal calculi) which can be classified as: simple, mixed or compound. Clinical signs are not very evident until the obstruction is complete, bilateral, or when occurs a contralateral edge dysfunction. The diagnosis of the disease was settled with the association of clinical signs and the results of complementary tests such as blood count, biochemistry, radiography, abdominal ultrasonography, urinalysis and urine culture, retrograde urethropielography, antegrade pyelography, computed tomography and study of the ureteral glomerular filtration rate. It is an illness that must be treated with emergency, the treatment must be determined based on the type of calculus present, in the most severe cases it must be performed a of surgical intervention such as a bypass technique for decompression. This article is a review of the avaiable information about the effectiveness of bypass usage for treatment of ureteral obstruction in felines.(AU)

Comparative compositional and functional venomic profiles among venom specimens from juvenile, subadult and adult Russell's viper ( Daboia siamensis ): correlation with renal pathophysiology in experimental rabbits

Abstract Background: Eastern Russell's viper (Daboia siamensis) is one of the most medically significant snakes responsible for the development of acute renal failure. However, variation of the clinical picture and renal pathophysiology following bites by young and adult D. siamensis have not been elucidated. Methods: In this study, we analyzed the venomic profiles of D. siamensis at different maturation stages of juvenile, subadult and adult groups. The same pooled venom from each group was subjected to enzymatic, electrophoretic and proteomic analysis, including sublethal toxicity (0.1 mg/kg iv.) examined on bodily functions by comparing the venom compositional and functional profiles among venom specimens from juvenile, subadult and adult D. siamensis by correlating them with the renal pathophysiology in experimental rabbits. Results: The comparative studies revealed that juvenile venom possessed higher phospholipase A2 , metalloproteinase and serine proteinase levels, while subadult and adult venoms contained more L-amino acid oxidase, phosphodiesterase, the Kunitz-type serine protease inhibitor, disintegrin families and endothelial growth factor. An in vivo study revealed that the adult and subadult venoms caused persistent hypotension and bradycardia, while thrombocytopenia was a more characteristic effect of juvenile venom. All venom age groups showed significant reductions in renal hemodynamics and electrolyte excretions. The juvenile venom caused a higher tubulonephrosis lesion score than adult and subadult venoms. Conclusions: The D. siamensis venom shows an ontogenetic shift in its compositions and activities. Renal function alterations after envenomation depend on either the synergistic actions of different venom components or the disproportionate expression between the concentrations of enzymatic and non-enzymatic proteins in each age venom group. The high proportion of enzymatic toxin proteins in the juvenile venom results in greater nephrotoxicity.(AU)

Linfoma renal primário em cão / Primary kidney lymphoma in a dog

Background: Lymphoma is a malignant lymphoid tumor originating in the lymph nodes or other solid organs and comprises90% of all hematopoietic tumors in dogs. However, primary kidney lymphoma is rare and is associated with nonspecificclinical signs. Tumor invasion in both kidneys can cause severe clinical signs due to renal failure, complicating the patient’streatment and prognosis. The aim of this case was to report the case of a dog affected by bilateral primary kidney lymphoma. In addition, to characterize the clinical and histopathological presentation due to the intense morphological changes.Case: A 5-year-old male Poodle dog was admitted showing apathy and emesis for 5 days. On physical examination, thedog showed 10% of dehydration, reddish oral mucous membranes, poor body condition (score 1/5), uremic breath, andpain in the kidney area. Complementary tests revealed severe low white blood cells count, high BUN levels, high levels ofpotassium, calcium, and phosphorus (serum biochemistry). Abdominal ultrasound showed bilateral kidney enlargement.Fine needle aspiration of the mass (guided by ultrasound) revealed round cell tumor. Radiographs showed no alterations.The dog died due to his poor condition and necropsy was performed. On post-mortem examination, the kidneys were bothenlarged, pale, and with an irregular subcapsular surface. The histopathological diagnostic was primary renal lymphoma.Immunohistochemical staining revealed that neoplastic cells were strongly positive for anti CD20 and PAX5, while negative for CD3, supporting the diagnosis of B-cell lymphoma.Discussion: The diagnosis was based on clinical, complementary tests, fine needle aspiration, histopathological andimmunohistochemical findings. In dogs, primary kidney tumors are uncommon and usually malignant. The presence ofvomiting, uremic breath, dehydration, weight loss, and erosive and ulcerative lesions on the tongue (uremic glossitis)...

Linfoma renal primário em cão / Primary kidney lymphoma in a dog

Background: Lymphoma is a malignant lymphoid tumor originating in the lymph nodes or other solid organs and comprises90% of all hematopoietic tumors in dogs. However, primary kidney lymphoma is rare and is associated with nonspecificclinical signs. Tumor invasion in both kidneys can cause severe clinical signs due to renal failure, complicating the patientstreatment and prognosis. The aim of this case was to report the case of a dog affected by bilateral primary kidney lymphoma. In addition, to characterize the clinical and histopathological presentation due to the intense morphological changes.Case: A 5-year-old male Poodle dog was admitted showing apathy and emesis for 5 days. On physical examination, thedog showed 10% of dehydration, reddish oral mucous membranes, poor body condition (score 1/5), uremic breath, andpain in the kidney area. Complementary tests revealed severe low white blood cells count, high BUN levels, high levels ofpotassium, calcium, and phosphorus (serum biochemistry). Abdominal ultrasound showed bilateral kidney enlargement.Fine needle aspiration of the mass (guided by ultrasound) revealed round cell tumor. Radiographs showed no alterations.The dog died due to his poor condition and necropsy was performed. On post-mortem examination, the kidneys were bothenlarged, pale, and with an irregular subcapsular surface. The histopathological diagnostic was primary renal lymphoma.Immunohistochemical staining revealed that neoplastic cells were strongly positive for anti CD20 and PAX5, while negative for CD3, supporting the diagnosis of B-cell lymphoma.Discussion: The diagnosis was based on clinical, complementary tests, fine needle aspiration, histopathological andimmunohistochemical findings. In dogs, primary kidney tumors are uncommon and usually malignant. The presence ofvomiting, uremic breath, dehydration, weight loss, and erosive and ulcerative lesions on the tongue (uremic glossitis)...(AU)

Hydronephrosis in a bitch with ovarian remnant syndrome - postsurgical complications

Background: Elective ovariohysterectomy (OH) is minimally invasive, but when performed incorrectly, it can lead to postsurgical complications, such as stump pyometra, ovarian remnant syndrome and foci of adhesion generated by tissue reactions to threads and materials used in vessel hemostasis. The formation of adhesions and successive surgeries predisposes patients to other diseases, such as ureteral obstruction and hydronephrosis. Thus, we reported a case of hydronephrosis in a bitch submitted to conventional OH, followed by ovariectomy (OV) due to ovarian remnant syndrome and consequent intraperitoneal adhesions caused by successive surgical interventions. Case: A 11-year-old mixed breed medium size bitch with a history of stump pyometra and ovarian remnant syndrome (SOR) was treated at the Veterinary Hospital-HV of UFPA after 2 previous surgeries. It had been spayed using conventional OH and underwent ovariectomy OV approximately 4 years ago, as it showed signs of estrus after the first surgery, characterizing SOR. On physical examination, its abdomen was distended especially in the left hemiabdomen, with no palpable pain. Ultrasonography showed a cavity in the topographic area of the left kidney, with anechoic content, thin walls, and defined contour. There were nonvascularized tubular structures, suggesting hydroureter and severe hydronephrosis. Exploratory celiotomy was performed, showing the intense presence of abdominal adhesions, followed by an incision in the abdominal midline from the xiphoid process in a caudal direction to the pubis, thereby showing the left kidney. After vesical drainage of 900 mL of renal filtrate, atrophy of the renal parenchyma and preservation of the renal capsule was considered, resulting in its complete resection, followed by the synthesis of the abdominal wall. In the postoperative period, the patient was properly monitored and obtained a satisfactory outcome manifested by a complete recovery. After vesical drainage of 900 mL of renal filtrate, atrophy of the renal parenchyma and preservation of the renal capsule only was considered, resulting in its complete resection, followed by the synthesis of the abdominal wall. In the postoperative period, the patient was properly monitored and obtained a satisfactory outcome manifested by a complete recovery. After vesical drainage of 900 mL of renal filtrate, renal parenchymal atrophy and preservation of the renal capsule only was adopted. Discussion: The choice of the conventional OH technique, followed by the failure to perform, favored the formation of adhesions only diagnosed late. Less invasive alternatives achieved less long-term damage. Excessive intracavitary manipulation and reaction to the nylon suture thread favored the development of these adhesions, and consequently, unilateral obstruction of the left ureter, hydroureter, hypertrophy, and destruction of the renal parenchyma, led the patient to undergo a third surgery, namely, unilateral nephrectomy. In this case, no changes were observed in serum levels, leaving only a subtle abdominal enlargement with hydronephrosis installed silently. There was no possibility of carrying out initial surgical planning, as the affected kidney, making unilateral nephrectomy necessary. Currently, the patient has normal renal function in the contralateral organ, with no clinical or laboratory changes because the affected kidney was not functional, making unilateral nephrectomy necessary. Currently, the patient has normal renal function with no clinical or laboratory changes because the affected kidney was not functional, making unilateral nephrectomy necessary. Currently, the patient has normal renal function in the contralateral organ, with no clinical or laboratory changes.

Polymyositis associated with brainstem signs in a dog

Background: Polymyositis is a generalized inflammatory myopathy which can lead to rhabdomyolysis. This affection may have several origins, including degenerative, metabolic, autoimmune, infectious, inflammatory, ischemic, traumatic, by drug use, induced by toxins and also of idiopathic origin. Diagnosis is made with seric dosage, electrodiagnostic tests and muscle biopsy. Lesions in the rostral oblong medulla may affect the central vestibular system, and there may be signs such as opisthotonos, nystagmus, and strabismus. The aim of this report is to describe a case of a mixed breed dog with manifestation of polymyositis associated with brainstem signs of probable idiopathic origin. Case: A 5-year-old mixed breed male dog was attended with opisthotonos episodes for 2 days, and pelvic limbs extension and thoracic limbs flexion that lasted 10 to 20 min at intervals of approximately 1 h. The animal was anorexic and had also presented one episode of emesis. Upon neurological examination, ventromedial strabismus and Horner's syndrome was observed on the right side, besides vertical nystagmus, flaccid tetraparesis and absence of proprioception in the four limbs. Biochemical analyses revealed creatine kinase (CK) increased (2,433.9 UI/L - reference: 1.5-28.4 UI/L), and urinalysis showed dark color and presence of occult blood without, however, erythrocyturia. Electrocardiogram (ECG) showed QS wave and deviation of the electrical axis. Treatment with prednisolone (1 mg/kg, BID), phenobarbital (2 mg/kg, BID), maropitant citrate (1 mg/kg in 2 doses), and crystalloid fluid therapy (50 mL/kg/day) were prescribed. On the 4th day, the dog was more active and feeding without a tube, so it recommended keep the treatment at home. On the 10th day, the animal had proprioception present on the 4 limbs and normorexia. Biochemical analyses and urinalysis showed no alterations, but normochromic normochromic anemia with thrombocytopenia and leukocytosis by neutrophilia showed in blood count exam. PCR to Ehrlichia canis, Hepatozoon sp., and Babesia canis resulted negative. On the 15th day, blood count, biochemical analyses and urinalysis showed no alterations. Neurological examination revealed only positional vertical nystagmus. which remained as a sequel. Discussion: Polymyositis may be accompanied by rhabdomyolysis, characterized by acute muscle necrosis, increased CK and myoglobinuria. The animal had polymyositis of acute onset, with myoglobinuria and elevated CK values, whose presentation included myalgia and muscle weakness. In humans, polymyositis is accompanied by changes in electrocardiographic tracing without clinical alterations. In dogs, the first report that showed cardiac involvement was compatible with myocarditis. The changes in ECG in the present case was attributed to failure in myocardial electrical conduction. The patient also showed signs of brainstem and central vestibular system injuries. Stress myopathy, intoxication, snakebite, infectious, and metabolic diseases were discarded leading to a clinical suspicion as idiopathic origin. Similar to a published case, the patient of this report received symptomatic and supportive treatment, being discharged from the hospital 20 days after the onset of clinical signs. Thus, polymyositis may be accompanied by signs indicative of brainstem injury. Patients with rhabdomyolysis require intense monitoring due to the high risk of developing acute renal failure. Since no causative agent was identified, symptomatic treatment combined with the prevention of possible complications were fundamental for the maintenance of the animal's life.

Bothrops envenomation in dogs: local and systemic manifestations

Background: Snakebite envenoming is a condition that affects humans and domestic animals worldwide. Identification of the snake species involved in the envenomation is infrequent. Bothrops envenomation presents typical clinicopathological features. This report describes epidemiological, clinical, and pathological data of 2 cases of Bothrops envenomation in dogs, including the first case of Bothrops moojeni snake striking a domestic animal in Brazil. Cases: Case 1. A dog was witnessed to have a Bothrops moojeni snakebite on a farm. In the first 24 h, acute lameness, pain, diffuse swelling, focal bleeding at the left forelimb, and increased whole-blood clotting time were observed in the envenomed dog. Polyvalent antivenom was administered in addition to fluid therapy, analgesics, corticosteroids, and antibiotics. On the 5th day, the animal presented spontaneous bleeding at the wound site, thrombocytopenia, and increased whole-blood clotting time. An additional dose of polyvalent antivenom was administered, and local treatment at the snakebite site was initiated. After 13 days, the dog showed no clinical or laboratory changes and recovered entirely. Case 2. A mongrel dog was taken for a necropsy to determine the cause of death. Grossly, major findings included swelling in the nasal plane that extended to the neck and dissecting hemorrhage in the subcutaneous tissue and adjacent musculature. Hemorrhages were observed in the heart, parietal pleura, left forelimb, lumbar region, and perirenal tissue. Marked necrosis and disruption of small blood vessels and lymphatics within the deep dermis and subcutaneous tissue were the main microscopic findings close to the snakebite site. Additionally, degeneration and necrosis of muscle fibers and dissecting hemorrhage were observed in the head and neck tissues surrounding the snakebite site. Kidneys showed marked interstitial hemorrhage and acute tubular nephrosis. Discussion: Bothrops envenoming is characterized by local (hemorrhage, dermonecrosis, and myonecrosis) and systemic (coagulative disorders, systemic hemorrhage, and acute kidney injury) changes due to the effect of the main venom components such as phospholipase A2 and metalloproteinases. These changes are hallmarks for the bothropic envenomation, supporting the diagnosis in cases 1 and 2. In case 1, the dog developed a Bothrops moojeni snakebite envenomation, but the immediate treatment with antivenom allowed a favorable outcome. In case 2, gross and microscopic findings supported the presumptive diagnosis of fatal bothropic envenomation. A marked local reaction such as swelling, pain, bleeding, bruising, and tissue necrosis was observed in case 1. In case 2, the most significant local changes were swelling and edema at the head and neck, hemorrhage in the subcutaneous tissue, and adjacent musculature. Systemic effects were observed clinically as spontaneous bleeding, thrombocytopenia, increased whole-blood clotting time (Case 1), systemic hemorrhages, and acute tubular nephrosis (Case 2). A proper treatment probably prevented the development of acute renal failure in Case 1. Herein, we show the first case of accidental snakebite envenomation by B. moojeni in a dog in Brazil. Information is scarce on the identification of venomous snake species striking domestic animals. Fast detection of well-determined clinical and pathological findings of Bothrops envenomation is essential for a correct diagnosis, therapeutics, and a good prognosis, even in cases with an unknown history.

Predisposition to acute pancreatitis in dogs with severe acute renal failure / Predisposição à pancreatite aguda em cães com insuficiência renal aguda grave

Patients with acute renal failure often have a negative energy balance, which promotes metabolic changes predisposing to complications. The objective of this study was to evaluate laboratory parameters of 30 dogs with severe acute renal failure, to assess their relationship with the possibility of developing acute pancreatitis due to the negative energy balance, and to correlate these findings with the degree of renal failure. Serum concentrations of urea, creatinine, beta-hydroxybutyrate, triglycerides, amylase, total lipase, and canine pancreatic lipase were compared between healthy dogs and dogs with severe acute renal failure. A greater serum concentration of beta-hydroxybutyrate and greater activity of pancreatic enzymes, particularly canine pancreatic lipase, as well as a stronger correlation between the latter and serum creatinine concentrations, were related to the occurrence of acute pancreatitis in patients with severe acute renal failure. A greater degree of renal failure implied a greater predisposition to acute pancreatitis.(AU)

O portador de insuficiência renal aguda é um paciente que, muitas vezes, encontra-se sob importante condição de balanço energético negativo, gerando alterações metabólicas que predispõem a complicações. O objetivo deste estudo foi avaliar parâmetros laboratoriais de trinta cães com insuficiência renal aguda grave, quanto a possibilidade de desenvolvimento de pancreatite aguda em função do balanço energético negativo, e relacioná-los ao grau de gravidade da insuficiência renal. As concentrações séricas de ureia, creatinina, betahidroxibutirato, triglicérides, amilase, lipase total e lipase pancreática canina foram comparadas entre o grupo de cães hígidos e o de cães doentes. Observou-se maior concentração sérica de betahidroxibutirato e maior atividade das enzimas pancreáticas, especialmente da lipase pancreática canina, além de forte correlação entre esta última e a concentração sérica de creatinina, demonstrando a ocorrência de pancreatite aguda em pacientes com insuficiência renal aguda grave. Verificou-se também que quanto mais grave é a insuficiência renal, maior é a predisposição à pancreatite aguda.(AU)

Predisposition to acute pancreatitis in dogs with severe acute renal failure / Predisposição à pancreatite aguda em cães com insuficiência renal aguda grave

Patients with acute renal failure often have a negative energy balance, which promotes metabolic changes predisposing to complications. The objective of this study was to evaluate laboratory parameters of 30 dogs with severe acute renal failure, to assess their relationship with the possibility of developing acute pancreatitis due to the negative energy balance, and to correlate these findings with the degree of renal failure. Serum concentrations of urea, creatinine, beta-hydroxybutyrate, triglycerides, amylase, total lipase, and canine pancreatic lipase were compared between healthy dogs and dogs with severe acute renal failure. A greater serum concentration of beta-hydroxybutyrate and greater activity of pancreatic enzymes, particularly canine pancreatic lipase, as well as a stronger correlation between the latter and serum creatinine concentrations, were related to the occurrence of acute pancreatitis in patients with severe acute renal failure. A greater degree of renal failure implied a greater predisposition to acute pancreatitis.(AU)

O portador de insuficiência renal aguda é um paciente que, muitas vezes, encontra-se sob importante condição de balanço energético negativo, gerando alterações metabólicas que predispõem a complicações. O objetivo deste estudo foi avaliar parâmetros laboratoriais de trinta cães com insuficiência renal aguda grave, quanto a possibilidade de desenvolvimento de pancreatite aguda em função do balanço energético negativo, e relacioná-los ao grau de gravidade da insuficiência renal. As concentrações séricas de ureia, creatinina, betahidroxibutirato, triglicérides, amilase, lipase total e lipase pancreática canina foram comparadas entre o grupo de cães hígidos e o de cães doentes. Observou-se maior concentração sérica de betahidroxibutirato e maior atividade das enzimas pancreáticas, especialmente da lipase pancreática canina, além de forte correlação entre esta última e a concentração sérica de creatinina, demonstrando a ocorrência de pancreatite aguda em pacientes com insuficiência renal aguda grave. Verificou-se também que quanto mais grave é a insuficiência renal, maior é a predisposição à pancreatite aguda.(AU)