Visão geral sobre a doença renal crônica em gatos e cães / Overview of chronic kidney disease in cats and dogs

A Doença Renal Crônica (DRC) é uma condição que afeta a capacidade dos rins de filtrar o sangue e eliminar substâncias tóxicas do organismo. É uma doença degenerativa e que progride para estágios avançados sem que os animais apresentem sinais claros ou visíveis inicialmente. A doença renal crônica pode afetar gatos e cães de todas as idades, porém sua prevalência aumenta com o avançar da idade.(AU)

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.

Doença policística felina tratada com homeopatia: relato de caso / Feline polycystic disease treated withhomeopathy: case report

Foi avaliado o tratamento homeopático de um felino com doença renal policística, moléstia hereditária muito comum na espécie felina. Por ser progressiva, o prognóstico depende do estágio de evolução da doença renal crônica, da resposta do felino ao tratamento inicial e do desejo do tutor em dar continuidade ao tratamento. A observação teve duração de 9 (nove) meses e a avaliação dos resultados foi realizada com o emprego de exame clínico e de exames complementares como imagens ultrassonográficas e exames laboratoriais. A terapia foi composta por medicamento homeopático constitucional Phosphorus 30CH e episódico Kresolum 6CH associado à introdução de dieta renal (ração seca adjuvante). O medicamento homeopático não provocou eventos adversos no animal. Os resultados sugerem que um animal com doença policística felina pode ser tratado pela homeopatia.(AU)

The homeopathic treatment of a feline with polycystic kidney disease was evaluated, a common hereditary disease in the feline species. Because it is progressive, the prognosis depends on the stage of evolution of the chronic kidney disease, the feline response to the initial treatment and the guardian's desire to continue the treatment. The observation lasted 9 (nine) months and the evaluation of the results was performed through clinical examination and complementary tests such as ultrasound images and laboratory tests. The therapy was composed of constitutional Phosphorus 30CH and episodic Kresolum 6CH homeopathic medication associated with the introduction of diet kidney diet (adjunct dry feed). The homeopathic medicine did not cause adverse events in the animal. The results suggest that an animal with feline polycystic disease can be treated by homeopathy.(AU)

Puerarin alleviated oxidative stress and ferroptosis during renal fibrosis induced by ischemia/reperfusion injury via TLR4/Nox4 pathway in rats

Purpose: To investigate the role of puerarin on renal fibrosis and the underlying mechanism in renal ischemia and reperfusion (I/R) model. Methods: Rats were intraperitoneally injected with puerarin (50 or 100 mg/kg) per day for one week before renal I/R. The level of renal collagen deposition and interstitial fibrosis were observed by hematoxylin and eosin and Sirius Red staining, and the expression of α-smooth muscle actin (α-SMA) was examined by immunohistochemical staining. The ferroptosis related factors and TLR4/Nox4-pathway-associated proteins were detected by Western blotting. Results: Puerarin was observed to alleviate renal collagen deposition, interstitial fibrosis and the α-SMA expression induced by I/R. Superoxide dismutase (SOD) activities and glutathione (GSH) level were decreased in I/R and hypoxia/reoxygenation (H/R), whereas malondialdehyde (MDA) and Fe2+ level increased. However, puerarin reversed SOD, MDA, GSH and Fe2+ level changes induced by I/R and H/R. Besides, Western blot indicated that puerarin inhibited the expression of ferroptosis related factors in a dose-dependent manner, which further demonstrated that puerarin had the effect to attenuate ferroptosis. Moreover, the increased expression of TLR/Nox4-pathway-associated proteins were observed in I/R and H/R group, but puerarin alleviated the elevated TLR/Nox4 expression. Conclusions: Our results suggested that puerarin inhibited oxidative stress and ferroptosis induced by I/R and, thus, delayed the progression of renal fibrosis, providing a new target for the treatment of renal fibrosis.

Experimental model of nephropathy associated with diabetes mellitus in mice

Purpose: Nontransmissible chronic diseases, such as diabetes mellitus (DM) and nephropathy, affect a significant portion of the population, often treated due to injuries that require healing and regeneration. To create an experimental model of associated comorbidities, for healing and regeneration studies, protocols for induction of nephropathy by ischemia and reperfusion (I/R) and induction of DM by injection of streptozotocin (STZ) were associated. Methods: Sixty-four mice (Mus musculus), female, adult, Swiss strain, weighing approximately 20 g, were divided into four groups: G1: control (n = 24), G2: nephropathy group (N) (n = 7), G3, DM (n = 9), and G4: N+DM (n = 24). Arteriovenous stenosis (I/R) of the left kidney was performed as the first protocol. The animals received a hyperlipidemic diet for 7 days after the injection of STZ (150 mg/kg, via i.p.) and an aqueous glucose solution (10%) for 24 h. The animals in the G3 and G4 groups were observed for 14 days before receiving the diet and STZ. The evolution of nephropathy was observed using a urine test strip and the DM, through the analysis of blood glucose with a reagent strip on a digital monitor. Results: The ischemic induction protocols of nephropathy and DM with STZ, associated, were sustainable, low-cost, and without deaths. There were alterations compatible with initial renal alterations, in the first 14 days, such as increased urinary density, pH alteration, presence of glucose, proteins and leukocytes, when compared to the control group. DM was confirmed by the presence of hyperglycemia 7 days after induction and its evolution after 14 days. The animals in the G4 group showed constant weight loss when compared to the other groups. It was possible to observe morphological alterations in the kidneys submitted to I/R, regarding coloration, during surgery and after the end of the observation period, in the volume and size of the left kidney, when compared to the contralateral kidney. Conclusion: It was possible to induce nephropathy and DM associated in the same animal, in a simple way, confirmed with rapid tests, without losses, providing a basis for future studies.

Hipertensão situacional em cães dóceis adultos / Situational hypertension in docile adult dogs

A hipertensão arterial sistêmica (HAS) é uma enfermidade silenciosa que pode afetar gatos e cães. Embora bastante descrita em felinos, a "Síndrome do Jaleco Branco", ou hipertensão situacional, é pouco relatada em cães. Assim, este trabalho tem como objetivo mostrar a importância do estresse na aferição da pressão arterial de cães adultos. O estudo foi realizado com 46 cães de ambos os sexos, dóceis, adultos, e aparentemente saudáveis. Após anamnese, exame físico, ambientação e manejo amigável dos animais, mensurou-se a pressão arterial sistólica (PAS) pelo método Doppler no membro torácico. Foram feitas várias aferições para obtenção de média aritmética. Animais com até 160mmHg de PAS, na primeira aferição, foram considerados normotensos (36 cães, correspondente a 78,26%). Para os que tiveram PAS maior ou igual a 160mmHg (dez cães, equivalente a 21,74%), realizou-se um segundo momento de aferição, após 15 a 30 minutos, com os animais em repouso. Assim, seis desses cães apresentaram PAS entre 154mmHg e 200mmHg, sendo, então, um considerado pré-hipertenso e cinco hipertensos, e outros quatro considerados normotensos. Para o animal com pré-hipertensão e para os hipertensos, realizaram-se exames complementares, pelos quais quatro cães foram diagnosticados com doença renal crônica e dois com dislipidemia familiar dos Schnauzers. Dessa forma, pode-se concluir que, dos 46 cães avaliados, 36 apresentaram-se normotensos (78,26%), um pré-hipertenso (2,17%), cinco hipertensos (10,87%) e quatro com hipertensão situacional (8,7%). Portanto, para cães em ambiente hospitalar, é importante realizar um manejo amigável e, quando necessário, mais de um momento de aferição de PAS para evitar diagnósticos errôneos de HAS.

Systemic arterial hypertension (SAH) is a silent disease that can affect cats and dogs. Although well described in felines, "white coat syndrome", or situational hypertension, is little reported in dogs. Thus, this paper aims to show the importance of stress in the measurement of blood pressure from adult dogs. The study was conducted with 46 dogs of both sexes, docile, adults, apparently healthy. After anamnesis, physical examination, ambiance, and friendly management of animals, systolic blood pressure (SBP) was measured by the doppler method in the thoracic limb. Several measurements were made to obtain an arithmetic average. Animals up to 160mmHg of SBP, in the first measurement, were considered normotensive (36 dogs, corresponding to 78.26%). For those with SBP higher than or equal to 160mmHg (10 dogs, equivalent to 21.74%), a second measurement was performed after 15 to 30 minutes, with the animals at rest. Therefore, six of these dogs presented SBP between 154mmHg and 200mmHg (one considered prehypertense and five hypertensives) and four normotensives. For the animal with prehypertension and the hypertensives, complementary examinations were performed, in which four dogs were diagnosed with chronic kidney disease and two with family dyslipidemia of the Schnauzers. Thus, it can be concluded that among the 46 dogs evaluated, there were 36 normotenses (78.26%), a one prehypertense (2.17%), five hypertensives (10.87%), and four with situational hypertension (8.7%). Therefore, regarding dogs in a hospital environment, it is important to perform friendly management and, when necessary, more than one moment of SBP measurement to avoid erroneous diagnoses of SAH.

Hypertrophic phenotypic cardiomyopathy in an ocelot (Leopardus pardalis)

Background: Hypertrophic cardiomyopathy phenotype (HCM) is the most common cardiac disease in domestic cats but is rarely described in wild species. This phenotype is characterized by concentric hypertrophy of the left ventricle and may be of familial inheritance or secondary to other diseases such as hyperthyroidism, chronic kidney disease, systemic arterial hypertension, and hyperaldosteronism. HCM can cause diastolic and systolic dysfunction and may cause congestive heart failure in affected animals. The present work aims to describe the first report of cardiomyopathy of the hypertrophic phenotype in a specimen of Leopardus pardalis, kept under human care. Case: A 11-year-old female ocelot (Leopardus pardalis) kept under human care, during a preventive care visit, had hypertrophic cardiomyopathy phenotype detected by cardiological evaluation with echocardiogram and a murmur grade III/ VI could be detected on cardiac auscultation. This preventive care occurred under chemical restraint with ketamine [6 mg/kg, i.m] associates with midazolam [0.5 mg/kg, i.m] and other evaluations have been done like complete blood count (CBC), biochemistry (alanine aminotransferase, aspartate aminotransferase, total proteins, albumin, albumin:globulin ratio, creatinine, urea, sodium, potassium, calcium, phosphorus, and globulin) and tyroid hormones [free tyroxine (T4) and thyroid-stimulating hormone (TSH)]. Medical management based on clopidogrel, and atenolol was administered for 3 months until the patient showed manifestations of congestive heart failure (CHF) 80 days later the initial evaluation. In this moment the patient presented with dyspnea, so a cardiological and laboratory evaluation was requested. On pulmonary auscultation crackling was identified, suggesting pulmonary edema and, on echocardiographic examination, some parameters had worsened. The CBC and biochemistry were all within reference ranges. Then, the beta-blocker was discontinued and replaced by pimobendan combined with furosemide as treatment of CHF, and the condition stabilized. After one year, the patient was re-evaluated and showed a slight improvement in the condition but still remained stable. Also, feline proBNP levels was tested (SNAP Feline proBNP® IDEXX) in this moment and it was increased. Discussion: The findings on echocardiography associated with the subjective evaluation associated with progressive worsening and clinical manifestation of CHF, as well as the response to treatment, even though there are no reference values for the species, reinforce the diagnosis. There is no evidence to suggest diseases that may contribute to secondary left ventricular hypertrophy. It is believed that pimobendan plays a key role in maintaining hemodynamic balance, since this has already been observed in other mammalian species. The use of beta blockers is commonly employed in domestic cats with HCM, and they have been prescribed in an attempt to promote greater ventricular relaxation, decrease left ventricular outflow obstruction, thus improving ventricular filling for maintenance of cardiac output. In view of the atrial enlargement and possible risk of thrombus formation, clopidogrel was prescribed, extrapolating what is known from domestic cats. It is reasonable to conclude that in this case, the cardiomyopathy behaved similarly to what is observed in domestic cats, both in its clinical evolution and in the means of diagnosis, and in its response to the therapy instituted.

Pyometra in a tiger (Panthera tigris)

Background: Captive tigers can live a long life, around 26 years. Among the diseases described some of non-infectious origin are quite common, such as chronic kidney disease, spondylosis, and biliary cysts or tumors. On the other hand, pyometra has been frequently reported in lions, who have a higher risk of developing the disease than tigers and leopards. Pyometra is a disease with few descriptions in tigers and it may be related to the physiological features of the species. The animal is listed as Endangered on the International Union for the Conservation of Nature Red List of Threatened. The present report aims to describe the diagnosis and treatment of pyometra in a captive tigress. Case: A 7-year-old entire female tiger (Panthera tigris) weighing 140 kg was presented with a 3-day history of anorexia and prostration. For clinical examinations, collection of laboratory and imaging tests, the patient initially underwent dissociative anesthesia to allow catheterization of the cephalic vein and intravenous general anesthesia for orotracheal intubation followed by anesthetic maintenance in isoflurane. On general physical examination, the animal had normal colored mucosa, vital parameters within normal limits, and a body condition score of 6 on a scale of 9. There was no presence of vulvar secretion. The blood count and the biochemical exams showed values within the normal range for the species. The chest X-ray in the right and left views did not demonstrate pulmonary abnormalities. Ultrasonographic examination of the abdomen showed distension of the uterine body and horns, which have intraluminal hyperechoic fluid content without flocculation. Based on the imaging exam, the diagnosis was suggestive of pyometra. Exploratory celiotomy was performed via ventral midline, confirming the condition, which was treated by ovariohysterectomy. The surgical technique was performed as described for therapeutic ovariohysterectomy in dogs and cats. Culture of uterine content identified Escherichia coli. The histological analysis identified diffuse endometritis associated with follicular cysts. The tiger had complete recovery without any complications. The patient was releasing 13 days after the surgical procedure and in the last contact four months after the surgery, it was in perfect health conditions. Discussion: Pyometra in large exotic felids has been occasionally reported, mainly in animals more than 10 years of age. Although the tigress in the report is estimated to be seven years old. The patient in question started with anorexia and prostration and as there was already a history of cystic endometrial hyperplasia, a possible pyometra was suspected, despite being uncommon in the species. There was not vaginal discharge. The definitive diagnosis was by means of ultrasound examination and ovariohysterectomy was performed. Abdominal surgery for these large felids is complex, due to the intra-abdominal volume the flank approach or by laparoscopic is suggested, however in this case a ventral midline incision was performed without intercurrences and complications in the post-operative period. The surgical technique like that used in small animals was effective for the treatment of pyometra in the tigress with the use of ovariohysterectomy. Culture of uterine content identified Escherichia coli, which has been the most commonly isolated pathogen in pyometra of large felids. It was concluded that, as in bitches with pyometra, early diagnosis and surgical treatment is ideal for the patient's recovery.

Effects of intravenous administration of allogeneic mesenchymal stromal cells, derived from adipose tissue, in five dogs with chronic kidney disease / [Efeitos da administração intravenosa de células mesenquimais alogênicas, derivadas do tecido adiposo, em cinco cães com doença renal crônica]

This study aimed to evaluate the safety of allogeneic adipose-derived mesenchymal stromal cell (aASC) treatment in dogs with chronic kidney disease (CKD) at the time of infusions and during the 120-day follow-up after the last infusion. Five dogs with CKD received three intravenous infusions of approximately 1×106?10% of aASCs per kilogram of body weight at 21-day intervals. Clinical and laboratory evaluations were performed at the time of each treatment and at 30 and 120 days after the last infusion. Adverse effects of the treatment were assessed using clinical observations, laboratory analyses, and owners' answers about their dog's behavior after infusions and during follow-up. The investigated animals did not present any adverse effects immediately after infusion or during the follow-up after the last infusion according to clinical and laboratory observations, as well as the dog owner's descriptions. One treated animal showed a reduction in creatinine, from 3.5mg/dL to 2.4mg/dL from day 0 to day 153, gained 100g of body weight, and improved disposition. The study results demonstrate that aASC therapy is safe for dogs with CKD; however, further studies are needed to investigate these promising results.

Este estudo teve como objetivo avaliar a segurança do tratamento com células estromais mesenquimais alogênicas derivadas do tecido adiposo (aASC) em cães com doença renal crônica (CKD) no momento das infusões e durante o acompanhamento de 120 dias após a última infusão. Cinco cães com CKD receberam três infusões intravenosas de aproximadamente 1×106?10% de aASC por quilograma de peso corporal em intervalos de 21 dias. Foram realizadas avaliações clínicas e laboratoriais no momento de cada tratamento e aos 30 e 120 dias após a última infusão. Os efeitos adversos do tratamento foram avaliados utilizando observações clínicas, análises laboratoriais e respostas dos proprietários sobre o comportamento de seu cão após as infusões e durante o acompanhamento. Os animais investigados não apresentaram nenhum efeito adverso imediatamente após a infusão ou durante o acompanhamento após a última infusão de acordo com as observações clínicas e laboratoriais, bem como as descrições do dono do cão. Um animal tratado apresentou uma redução na creatinina, de 3,5mg/dL para 2,4mg/dL do dia 0 ao dia 153, ganhou 100g de peso corporal, e melhorou a disposição. Os resultados do estudo demonstram que a terapia aASC é segura para cães com CKD; entretanto, são necessários mais estudos para investigar estes resultados promissores.

Pelve extrarrenal em uma gata - diagnóstico por cintilografia / Extrarenal pelvis in a cat - diagnosis by scintigraphy

Background: In people, extrarenal pelvis is a normal anatomical variant, characterized by the protusion of the pelvis out of the renal hilum, which can be associated with other anomalies, or predispose to stasis or infection. While other diagnostic imaging methods provide anatomical and morphological information about the kidney, scintigraphy allows to determine the renal function and has greater sensitivity in the detection of functional alterations. The aim of this work is to report the case of an asymptomatic cat diagnosed with extrarenal pelvis detected by scintigraphy, which presented alterations in laboratory and renal imaging tests, and absence of associated obstructive process. Case: A 7-year-old mixed-breed female cat was evaluated for a routine health assessment at the Veterinary Teaching Hospital of the Federal University of Rio Grande do Sul (HCV-UFRGS). When performing the imaging and laboratory tests, renal alterations compatible with chronic kidney disease were found in the abdominal ultrasonography examination and in serum creatinine levels. Therefore, it was decided to perform scintigraphy evaluation to better assess renal function. Dynamic renal scintigraphy with 99mTcDTPA revealed an evident concentration of the radiotracer in the left kidney with effective elimination only after the diuretic stimulus. The right kidney exhibited less concentration of the radiotracer but showed effective elimination before the diuretic stimulus. Image analysis suggested the presence of an extrarenal pelvis on the left side. The relative renal uptake was 68% for the left kidney and 32% for the right kidney. The glomerular filtration rate was 1.65 mL/min/kg. Static renal scintigraphy with 99mTcDMSA revealed irregularity in the distribution of the radiotracer in both kidneys, showing less activity in the caudal pole of the left kidney. The right kidney was apparently reduced and with less activity, especially in the medial portion. The relative renal uptake was 65% for the left kidney and 35% for right kidney, while the absolute renal uptake of the left kidney was 33% and that of the right kidney was 17%. The alteration described in the left kidney, in correlation with dynamic renal scintigraphy, suggested an aspect of lower activity in the caudal pole due to the presence of activity in the extrarenal pelvis. The left kidney was classified as presenting normal renal function and there was moderate to severe deficit of renal function on the right side. Discussion: Chronic kidney disease may be present before clinical signs and biochemical abnormalities are identified. In this report, the animal was referred for a routine evaluation and showed no clinical signs nor alterations on physical examination. However, as renal morphological alterations were seen on ultrasonography and the cat presented mild azotemia, it was decided to perform two renal scintigraphy exams. Despite the radiotracer elimination from the left kidney was seen only after the diuretic stimulus, dynamic renal scintigraphy did not show any obstructive process. This delay on elimination was probably a result of the anatomical variant called extrarenal pelvis. In the static renal scintigraphy, it was possible to evaluate morphological changes in the kidneys and suggest less activity in the caudal pole of the left kidney, due to the presence of activity in the extrarenal pelvis, apparently causing the mentioned defect. The correct diagnosis of morphological changes is essential and for this purpose the best combination of imaging tests is necessary. Renal scintigraphy was fundamental, in this case, for the diagnosis of extrarenal pelvis in one of the kidneys, an abnormality not reported in the feline species within the literature researched by the authors. In addition, renal scintigraphy helped to guide the clinical management of the patient described in this report.

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.

The antifibrotic and anti-inflammatory effects of FZHY prescription on the kidney in rats after unilateral ureteral obstruction

Purpose: To explore the potential impact of traditional Chinese herb FuZhengHuaYuJiangZhuTongLuo recipe (FZHY) on renal interstitial fibrosis (RIF) in chronic kidney disease (CKD) at cellular and molecular levels. Methods: Unilateral ureteral obstruction (UUO) rats were established as the RIF mo el in vivo. The rats were given intragastric administration with FZHY once a day for consecutive 7, 14 and 21 days, respectively. The renal function parameters and inflammation indicators in kidney tissues were measured using enzyme-linked immunosorbent assay, the CD4+/CD8+ T cells in peripheral blood was detected using flow cytometry, the renal fibrosis degree was estimated using Masson's staining, and the fibrosis-related genes' expression was detected using quantitative polymerase chain reaction, western blotting, and immunohistochemistry analyses. Results: FZHY prescription reduced the serum creatinine and blood urea nitrogen, decreased the levels of c-reactive protein, interleukin-1, interleukin-6 and tumor necrosis factor-α in kidney tissues, and increased the ratio of CD4+/CD8+ T cells in peripheral blood. FZHY prescription suppressed the renal tissue fibrosis and reduced the levels of laminin, fibronectin, collagen I and collagen III. Conclusions: FZHY prescription suppressed the renal fibrosis and improved the condition of "Healthy Qi Deficiency and Evil Qi Excess" in rats with UUO, which may provide an effective method for CKD treatment.

Fibrous osteodystrophy due to secondary renal hyperparathyroidism in a senile dog / Osteodistrofia fibrosa decorrente de hiperparatireodismo secundário renal em cão senil

Renal hyperparathyroidism stands out among the complications of kidney disease in dogs due to phosphorus retention with a predisposition to hypocalcemia, parathyroid hormone stimulation with mobilization of calcium from the bones, characterizing fibrous osteodystrophy, unusual in the elderly. The objective was to report it in 12-year-old Labrador with polyuria, polydipsia, and emesis for five months due to maxillary and mandibular volume increase, followed by loosely fixed teeth, and facial deformity. Blood tests showed anemia, thrombocytosis, azotemia, hypoalbuminemia and hyperphosphatemia and urinalysis showed low density, glycosuria, proteinuria, and moderate caudate and transitional epithelial cells. Oral x-rays showed loss of dental bone support and decreased bone radiopacity. Chest radiographs showed decreased density in the ribs and costochondral junction; on the other hand, organs of the cardiorespiratory system showed no changes. The electrocardiogram and echocardiogram did not show impairment. Abdominal ultrasound revealed kidneys with asymmetry, increased echogenicity of the cortical and poorly preserved cortico-medullary definition. Oral histopathology showed intense fibroplasia associated with bone reabsorption. Support therapy was instituted, but the patient died ten days after consultation. Thus, although uncommon in the elderly, fibrous osteodystrophy should be investigated in dogs with advanced-stage chronic kidney disease and, even with conservative therapies, the prognosis is unfavorable.

O hiperparatireoidismo renal destaca-se entre as complicações da doença renal em cães, pela retenção de fósforo com predisposição à hipocalcemia, estimulação de paratormônio com mobilização do cálcio dos ossos, caracterizando a osteodistrofia fibrosa, incomum em idosos. O objetivo foi relatá-la em Labrador de 12 anos com poliúria, polidipsia e vômitos há cinco meses, além de aumento de volume maxilar e mandibular seguido de dentes frouxamente fixados e deformidade facial. Os exames sanguíneos denotaram anemia, trombocitose, azotemia, hipoalbuminemia, hiperfosfatemia, urinálise, baixa densidade, glicosúria, proteinúria e moderadas células caudadas e epiteliais de transição. Pelos raios X orais, houve perda da sustentação óssea dentária e diminuição da radiopacidade óssea. As radiografias de tórax demonstraram diminuição da densidade óssea na região dos arcos costais e junção costocondral; em contrapartida, órgãos do sistema cardiorrespiratório se mostraram sem alterações aparentes. O eletrocardiograma e o ecocardiograma não incidiram comprometimento. O ultrassom abdominal revelou rins com assimetria, aumento da ecogenicidade cortical e definição corticomedular pouco preservada, e a histopatologia oral apontou intensa fibroplasia associada à reabsorção óssea. Foi instituída terapia suporte, mas o paciente veio a óbito 10 dias após a consulta. Assim, mesmo que incomum em idosos, a osteodistrofia fibrosa deve ser investigada em cães com doença renal crônica em estágio avançado, mesmo com as terapias conservadoras, o prognóstico é desfavorável.

Vincristine sulfate treatment influence on kidney function of female dogs with transmissible venereal tumor / Influência do tratamento com sulfato de vincristina na função renal de cadela com tumor transmissível venéreo

Chemotherapy agents have some undesirable and non-selective cytostatic effects. Considering that kidneys are vulnerable to drug-induced toxicity, this study evaluated renal injury caused by vincristine sulfate (VS) in 12 female dogs diagnosed with transmissible venereal tumor (TVT). The animals were treated with VS (0.025 mg/kg IV) every 7 days for 4 weeks. During treatment, the animals were subjected to clinical examination, blood count, serum measurement of symmetric dimethylarginine (SDMA), blood urea nitrogen (BUN), creatinine, alanine aminotransferase, and alkaline phosphatase. In addition, urinalysis and urinary gamma-glutamyl transferase (GGT) measurements were performed. All parameters were determined three times: before beginning the treatment (T0), after 14 days (T1), and after 28 days (T2). During the study period, there were no changes in serum urea or creatinine levels, urine specific gravity, or persistent proteinuria. Furthermore, urinary GGT measurement did not indicate tubular lesions, and consistent elevation of SDMA was found in only one patient above the reference range. The results showed that weekly therapy with VS as a single agent for 28 days does not induce renal injury in most cases.(AU)

Os agentes quimioterápicos possuem efeitos citostáticos indesejáveis e não seletivos. Considerando a vulnerabilidade renal à toxicidade induzida por drogas, este estudo avaliou a lesão renal causada pelo sulfato de vincristina (VS) em 12 cadelas com diagnóstico de tumor venéreo transmissível (TVT). Os animais foram tratados com VS (0,025 mg / kg IV) a cada sete dias, durante quatro semanas. No transcurso do tratamento, os animais foram submetidos a exame clínico, hemograma, dosagem sérica de dimetilarginina simétrica (SDMA), nitrogênio ureico sanguíneo (BUN), creatinina, alanina aminotransferase e fosfatase alcalina. Além disso, foram realizadas análises de urina e medições de gama-glutamil transferase (GGT) urinária. Todos os parâmetros foram mensurados em três tempos, antes do início do tratamento (T0), aos 14 dias (T1) e aos 28 dias (T2). Durante o período do estudo, não houve alterações nas concentrações de ureia ou creatinina séricas, na gravidade específica da urina ou proteinúria persistente. Além disso, a medição de GGT urinária não indicou lesões tubulares, e elevação consistente de SDMA foi encontrada em apenas um paciente acima do intervalo de referência. Os resultados mostraram que a terapia semanal com VS como agente único por 28 dias não induz lesão renal na maioria dos casos.(AU)

Cystitis in a bitch with chronic kidney disease caused by multidrug-resistant Escherichia coli

Background: In dogs with bacterial cystitis that is resistant to multiple antibiotics, resulting from repeated infections andantimicrobial administration, especially if the dog has impaired renal function and the induction of systemic side effectsby intravenous or oral administration is a concern, intravesical instillation of antibiotics might represent an alternativetreatment option. In human and veterinary medicine, a number of studies showed intravesical instillation of antibiotics iseffective for the therapy multidrug-resistant bacterial urinary tract infection (UTI). This report firstly illustrates successfulintravesical meropenem treatment of a UTI caused by multidrug-resistant Escherichia coli with no systemic side effectsin dog with chronic kidney disease (CKD).Case: A 15-year-old spayed female Maltese was presented with recurrent bacterial cystitis. The risk factors for the recurrent UTI were spinal cord injury and CKD which had been managed for 1 year. Ultrasound-guided cystocentesis wasperformed to obtain a urine sample for urinalysis, bacteriologic culture, and antibiotic susceptibility testing. Bacterialcystitis caused by multidrug-resistant Escherichia coli was diagnosed on the basis of bacterial culture, and antimicrobialsusceptibility testing. Because the dog had CKD, reducing the clearance of meropenem, intravesical instillation of antibiotics was initiated. The intravesical instillation process consisted of the emptying of the urinary bladder, infusion of adiluted meropenem solution (8.5 mg/kg diluted in 20 mL of saline solution) into the bladder through a urethral catheter,and retention of the meropenem solution in the bladder for 1 h, and its removal. The procedure was repeated every 8 h. Onday 8 of the intravesical instillation therapy, bactereologic culture yielded a growth of E. coli (50,000 CFUs/mL), whichwas less than previously obtained. the concentration of the meropenem solution...

Cystitis in a bitch with chronic kidney disease caused by multidrug-resistant Escherichia coli

Background: In dogs with bacterial cystitis that is resistant to multiple antibiotics, resulting from repeated infections andantimicrobial administration, especially if the dog has impaired renal function and the induction of systemic side effectsby intravenous or oral administration is a concern, intravesical instillation of antibiotics might represent an alternativetreatment option. In human and veterinary medicine, a number of studies showed intravesical instillation of antibiotics iseffective for the therapy multidrug-resistant bacterial urinary tract infection (UTI). This report firstly illustrates successfulintravesical meropenem treatment of a UTI caused by multidrug-resistant Escherichia coli with no systemic side effectsin dog with chronic kidney disease (CKD).Case: A 15-year-old spayed female Maltese was presented with recurrent bacterial cystitis. The risk factors for the recurrent UTI were spinal cord injury and CKD which had been managed for 1 year. Ultrasound-guided cystocentesis wasperformed to obtain a urine sample for urinalysis, bacteriologic culture, and antibiotic susceptibility testing. Bacterialcystitis caused by multidrug-resistant Escherichia coli was diagnosed on the basis of bacterial culture, and antimicrobialsusceptibility testing. Because the dog had CKD, reducing the clearance of meropenem, intravesical instillation of antibiotics was initiated. The intravesical instillation process consisted of the emptying of the urinary bladder, infusion of adiluted meropenem solution (8.5 mg/kg diluted in 20 mL of saline solution) into the bladder through a urethral catheter,and retention of the meropenem solution in the bladder for 1 h, and its removal. The procedure was repeated every 8 h. Onday 8 of the intravesical instillation therapy, bactereologic culture yielded a growth of E. coli (50,000 CFUs/mL), whichwas less than previously obtained. the concentration of the meropenem solution...(AU)

Effect of electrophysical resources on healing of neurotendinous injury in an experimental model of type I diabetes and kidney disease

Purpose: To evaluate and describe the effect of electrophysical resources laser therapy (LLLT), intravascular laser blood irradiation (ILIB), and cryotherapy on the healing process of neurotendinous injury, as well as possible systemic changes, in the experimental model of type 1 diabetes associated with kidney injury. Methods: The animals were randomized into four groups: G1) healthy control with untreated injury; G2) healthy control with injury and treatment; G3) disease control with untreated lesion; G4) disease with injury and treatment. Furthermore, the treated groups were divided into three, according to the type of treatment. All animals were induced to neurotendinous injury and treated according to the therapeutic protocols. Healing and inflammation were analyzed by semiquantitative histopathological study. Results: It was observed in sick animals treated with cryotherapy and ILIB reduction of inflammatory exudate, presence of fibroblasts and organization of collagen, when compared to the effects of LLLT. Moreover, there was reduction in glycemic levels in the group treated with ILIB. Conclusions: Cryotherapy promoted reduction in inflammatory exudate and organization of collagen fibers, in addition to the absence of signs of tissue necrosis, in the groups treated with and without the disease. ILIB therapy showed the same findings associated with significant reduction in glycemic levels in the group of diseased animals. The application of LLLT showed increased inflammatory exudate, low organization of collagen fibers and low sign of tissue degeneration and necrosis. This study in a model of associated diseases (diabetes and kidney disease) whose effects of electrophysical resources studied after neurotendinous injury allows us to verify histopathological variables suggestive of patients with the same comorbidities.

Leptospira spp. of the urinary tract of female carrier goats in semi-arid conditions

Background: Leptospirosis is an important infectious disease in goat farming, with a worldwide distribution. It is usually transmitted by rodents and the genital route, may cause reproductive losses, negatively impacting goat farming. The diagnosis lies on serological, molecular and isolation techniques. Considering the importance of this disease for small ruminants, this work aimed to evaluate the serological, molecular findings and isolation of pathogenic leptospires in the urinary tract (kidney and bladder tissues) of goats. Materials, Methods & Results: Thirty-four adult goats were used for slaughter. Renal samples (n = 34), bladder (n = 34), were collected for isolation of the agent and molecular detection of Leptospira sp. and blood samples (n = 34) for serological testing. The polymerase chain reaction (PCR) was used as a molecular test and the microscopic serum agglutination test (MAT) was used as a serological test. Samples with DNA amplification were subjected to genetic sequencing. The presence of Leptospira DNA was found in the tissues of 8 (23.4%) goats, and of these, only 2 were positive in PCR and MAT. There was a slight agreement between the PCR and MAT techniques (k = 0.150; P = 0.436). In 6 (17.6%) samples of renal tissue and 2 (5.8%) bladder samples, Leptospira DNA was detected. The genes in a kidney tissue sample were sequenced and demonstrated 99% similarity to Leptospira interrogans. Anti-Leptospira sp. were detected in 6 (17.6%) of the animals tested. Discussion: Serology identified 3 predominant serogroups: Icterohaemorrhagiae, Tarassovi and Autumnalis, serogroups that are related to the presence of rodents that coexist in rural environments. Autumnalis has been reported in small ruminants, raising the hypothesis that goats are adapted, becoming chronic carriers and possible maintenance hosts. The frequency obtained (17.6%) may be the result of the mixed breed pattern and rustic characteristics inherent to the goat species. Given the characteristics of the semi-arid region, such as low rainfall and high solar incidence, it is essential to use an adapted methodology, with a lower cut-off point (1:50), as the serological titer is an established relationship between the animal species, the level of exposure throughout its evolution and the region studied. Molecular findings and bacterial isolation reveal the agent's ability to colonize the urinary tract of goats. These data show the importance that urine has in the epidemiological chain, being able to transmit the agent through direct contact with this product or through contamination of soil and water. There was no statistical agreement between the diagnostic techniques used in this study, in this case, an association between PCR and MAT is recommended to obtain data with high sensitivity and specificity. A bladder sample was sequenced and showed 99% similarity to Leptospira interrogans. In the semiarid region, the most common form of leptospirosis spread is through the sale of animals in business fairs for breeding, rearing or slaughter, as well as sharing the same property with several breeders. The introduction of chronic and asymptomatic carriers on the properties represents a serious risk for the spread of the disease. The results show the presence of Leptospira spp. in semi-arid goat herds, having as risk factors the presence of rodents and intercropping. The association of MAT and PCR is necessary for a better diagnosis of the disease.

Prevalence, clinical and epidemiological features of feline hyperthyroidism at a veterinary teaching hospital in Brazil: a retrospective study / Prevalência, características clínicas e epidemiológicas do hipertireoidismo felino em um hospital veterinário universitário no Brasil: um estudo retrospectivo

The hyperthyroidism is the most frequently endocrinopathy in cats. The increasing number of diagnoses over time is due to the greater familiarity with the disease and the development of increasingly sensitive diagnostic tools available. This study aimed to retrospectively evaluate the prevalence, clinical characteristics and risk factors of hyperthyroidism in cats admitted at one of the largest veterinary teaching hospital in Brazil. Between 2002 and 2007, 234 cats were admitted to the veterinary teaching hospital of the University of São Paulo, Brazil. Total thyroxine (T4t) serum concentration was measured from all cats. Also analyzed the medical charts of cats. Of the 234 cats, 26 (11.1%) were considered hyperthyroid (T4t ≥3.8 µg/dL). Of hese 26 cats, only two (7.7%) were initially diagnosed as hyperthyroid. The age of cats ranged from 6 to 27 years old (13.1 ± 4.5 years). Twelve patients (46.2%) were female and 14 (53.8%) were male. Eight (30.8%) cats were Siamese, while the others were mixed breed (69.2%). Dry food was the most common food type consumed by cats. There was a high prevalence of hyperthyroid cats with concomitant chronic kidney disease (CKD). This study sheds light on the importance of routinely monitoring feline hyperthyroidism and brings epidemiological and clinical data of this endocrinopathy in cats from one of the largest veterinary teaching hospitals in the country.(AU)

O hipertireoidismo é a endocrinopatia mais frequente em gatos. O aumento do número de diagnósticos ao longo do tempo deve-se à maior familiaridade com a doença e ao desenvolvimento de ferramentas diagnósticas cada vez mais sensíveis. Este estudo teve como objetivo avaliar retrospectivamente a prevalência, características clínicas e fatores de risco do de hiperti-reoidismo em gatos atendidos em um dos maiores hospitais veterinários universitários do Brasil. Entre 2002 e 2007, 234 gatos foram admitidos no hospital veterinário universitário da Universidade de São Paulo, Brasil. A concentração sérica total de tiroxina (T4t) foi mensurada em todos os gatos. Também foram analisados os prontuários médicos dos gatos. Dos 234 gatos, 26 (11,1%) foram considerados hipertireoideos (T4t ≥3,8 µg/dL). Desses 26 gatos, apenas dois (7,7%) foram diagnosticados inicialmente com hipertireoidismo. A idade dos gatos variou de 6 a 27 anos (13,1 ± 4,5 anos). Doze pacientes (46,2%) eram do sexo feminino e 14 (53,8%) do sexo masculino. Oito (30,8%) eram siameses, enquanto os demais eram mestiços (69,2%). A ração seca foi o tipo de alimento mais consumido. Houve alta prevalência de gatos hipertireoideos com doença renal crônica (DRC) concomitante. Este estudo esclarece a importância do monitoramento rotineiro do hipertireoidismo felino e traz dados epidemiológicos e clínicos desta endocrinopatia em gatos de um dos maiores hospitais veterinários do País.(AU)

Inflammation: improving understanding to prevent or ameliorate kidney diseases

Abstract Inflammatory processes are believed to play an important role in immune response to maintain tissue homeostasis by activating cellular signaling pathways and releasing inflammatory mediators in the injured tissue. Although acute inflammation can be considered protective, an uncontrolled inflammation may evolve to tissue damage, leading to chronic inflammatory diseases. Inflammation can be considered the major factor involved in the pathological progression of acute and chronic kidney diseases. Functional characteristics of this organ increase its vulnerability to developing various forms of injuries, including acute kidney injury (AKI) and chronic kidney disease (CKD). In view of translational research, several discoveries should be considered regarding the pathogenesis of the inflammatory process, which results in the validation of biomarkers for early detection of kidney diseases. Biomarkers enable the identification of proinflammatory mediators in kidney affections, based on laboratory research applied to clinical practice. Some inflammatory molecules can be useful biomarkers for the detection and diagnosis of kidney diseases, such as neutrophil gelatinase-associated lipocalin, kidney injury molecule-1 and interleukin 18.