Association of Renal Resistive Index, Renal Pulsatility Index, Systemic Hypertension, and Albuminuria with Survival in Dogs with Pituitary-Dependent Hyperadrenocorticism.

An increased renal resistive index (RI) and albuminuria are markers of target organ damage secondary to systemic hypertension. This study evaluated associations between systemic blood pressure (SBP), renal RI, pulsatility index (PI), and albuminuria in dogs with pituitary-dependent hyperadrenocorticism (PDH). Predictors of overall mortality were investigated. Twenty client-owned dogs with PDH and 20 clinically healthy client-owned dogs as matched controls were included. Incidence rates of systemic hypertension (SBP ≥ 160 mmHg), albuminuria, and increased renal RI (≥ 0.70) and PI (≥ 1.45) in the control group were 5%, 0%, 5%, and 0%, respectively, compared to 35%, 40%, 50%, and 35%, respectively, in the PDH group (P = 0.001, P < 0.001, P < 0.001, and P = 0.001, resp.). No association between systemic hypertension, renal RI, renal PI, and albuminuria was observed. PDH was the only predictor of albuminuria and increased renal RI. Survival was not affected by increased renal PI, systemic hypertension, or albuminuria. Increased renal RI (≥ 0.70) was the only predictor of overall mortality in dogs with PDH.

Assessment of left ventricular function by two-dimensional speckle-tracking echocardiography in small breed dogs with hyperadrenocorticism.

BACKGROUND: Hyperadrenocorticism (HAC) is associated with an increased prevalence of hypertension. This study investigated the left ventricular function using two-dimensional speckle-tracking echocardiography (2D-STE) in small breed dogs affected with spontaneous HAC. Age-matched healthy controls (n = 9), dogs with pituitary-dependent hyperadrenocorticism (PDH, n = 10), and dogs with adrenal-dependent hyperadrenocorticism (ADH, n = 9) were included in this study. Conventional echocardiography, global longitudinal and circumferential strain, and strain rate were assessed. RESULTS: On group-wise comparison, left ventricular free wall (LVFWd) and interventricular septal thickness in diastole (IVSd) were thickest in the ADH group, followed by the PDH and controls (P = 0.014 and P = 0.001, respectively). Neither LVFWd nor IVSd was correlated with systemic blood pressure (P = 0.238 and P = 0.113, respectively). The values of all variables derived from the global strain and strain rate in longitudinal and circumferential directions followed the same pattern: highest in the controls, followed by PDH and then ADH (all P < 0.05, respectively). On multiple regression analyses, global longitudinal strain, global longitudinal strain rate in systole and early diastole, and global circumferential strain all decreased linearly with increased IVSd (all P < 0.05). CONCLUSIONS: Left ventricular hypertrophy (LVH) was more prevalent in the HAC group compared to the control group. Association between hypertension and development of LVH was not identified. Decreased global longitudinal and circumferential strains were associated with increased IVSd. 2D-STE revealed significant decreases in systolic functions that were undetected using conventional echocardiography in the ADH and PDH groups.

Feline sarcoptic mange in Taiwan: a case series of five cats.

BACKGROUND: Sarcoptes scabiei infestation is rare in cats. OBJECTIVE: To report the clinical presentations and treatments of cats infested with S. scabiei. ANIMALS: Five cats that presented with progressive and nonresponsive crusting lesions on the concave and convex aspects of the pinnae are included in this series. Other dermatological manifestations recorded were crusts on the bridge of the nose (five of five), crusty pododermatitis (three of five), crusty lesions on the tail (one of five) and pruritic erythematous papules on the arms and/or thighs of the owners (five of five). None of the cats was living in a household with a dog. METHODS: Sarcoptic (S. scabiei) mange was diagnosed based on the identification of S. scabiei in deep skin scrapings. A spot-on application of 1.0% moxidectin and 10% imidacloprid (0.1 mL/kg) was administered every 2 weeks for three applications. All cats were re-evaluated at the time of treatment. RESULTS: All five cats and their owners improved after the first application and reached clinical remission after the third application. Deep skin scrapings from all cats were negative for S. scabiei after the first application. No clinical adverse effects or abnormalities on routine blood tests were noted during the study period. No reinfestation was reported during the follow-up period of 6 months after treatment. CONCLUSION: Although sarcoptic mange is rare in cats, it should be considered as a differential diagnosis for cats presenting with crusting lesions on the pinnae and nose and crusty pododermatitis. A spot-on preparation of moxidectin and imidacloprid was used successfully to treat cats with S. scabiei infestation.

Treatment of canine generalized demodicosis associated with hyperadrenocorticism with spot-on moxidectin and imidacloprid.

BACKGROUND: Canine generalized demodicosis associated with hyperadrenocorticism is often problematic and might be intractable. The aim of this study was to report the efficacy of a weekly application of spot-on moxidectin/imidacloprid in dogs with hyperadrenocorticism and secondary generalized demodicosis. METHODS: Dogs with hyperadrenocorticism and secondary generalized demodicosis were included. The condition of hyperadrenocorticism was treated and stabilized with trilostane before and throughout the study period in all dogs. RESULTS: Average total live adult mite counts before treatment and after four, eight and 12 weeks of spot-on moxidectin/imidacloprid (2.5/10 mg/kg) applications were 20.1±6.3 (range, 13-33), 0.5±0.7 (range, 0-2; 6/11 were negative), 0.2±0.4 (range, 0-1; 9/11 were negative), 0.2±0.4 (range, 0-1; 9/11 were negative) and 0.1±0.3 (range, 0-1; 10/11 were negative) respectively; this difference was significant (P<0.001). Ten of 11 dogs (90.1%) achieved clinical remission, as demonstrated by the absence of demodectic mites at any life stage at monthly scrapings for eight consecutive weeks, and maintained remission throughout the 12-month follow-up period. CONCLUSION: The weekly application of spot-on moxidectin/imidacloprid appeared to be effective and safe against generalized adult onset canine demodicosis associated with hyperadrenocorticism.

Associations among systemic blood pressure, microalbuminuria and albuminuria in dogs affected with pituitary- and adrenal-dependent hyperadrenocorticism.

BACKGROUND: Hypertension and proteinuria are medical complications associated with the multisystemic effects of long-term hypercortisolism in dogs with hyperadrenocorticism (HAC). METHODS: This study investigated the relationships among adrenocorticotropic hormone (ACTH)-stimulation test results, systemic blood pressure, and microalbuminuria in clinically-healthy dogs (n = 100), in dogs affected with naturally occurring pituitary-dependent (PDH; n = 40), or adrenal-dependent hyperadrenocorticism (ADH; n = 30). RESULTS: Mean systemic blood pressure was similar between clinically healthy dogs and dogs with HAC (p = 0.803). However the incidence of hypertension was highest in dogs with ADH (p = 0.017), followed by dogs with PDH, with the lowest levels in clinically healthy dogs (p = 0.019). Presence of microalbuminuria and albuminuria in clinically healthy dogs and dogs affected with HAC was significantly different (p < 0.001); incidences of albuminuria followed the same pattern of hypertension; highest incidence in dogs with ADH, and lowest level in clinically healthy dogs; but microalbuminuria showed a different pattern: clinically healthy dogs had highest incidences and dogs with ADH had lowest incidence. The presence of albuminuria was not associated with blood pressure values, regardless of whether dogs were clinically healthy or affected with ADH or PDH (p = 0.306). CONCLUSIONS: Higher incidence of hypertension and albuminuria, not microalbuminuria was seen in dogs affected with HAC compared to clinically healthy dogs; incidence of hypertension and albuminuria was significantly higher in dogs affected with ADH compared to PDH. However, presence of albuminuria was not correlated with systemic blood pressure.

Use of ketoconazole to treat dogs with pituitary-dependent hyperadrenocorticism: 48 cases (1994-2007).

OBJECTIVE: To evaluate the effectiveness of ketoconazole as a treatment for dogs with pituitary-dependent hyperadrenocorticism (PDH). DESIGN: Retrospective case series. ANIMALS: 48 client-owned dogs in which PDH was diagnosed. PROCEDURES: Medical records of dogs with PDH that were treated with ketoconazole were examined. Data collected from each record included signalment, clinical signs, results of ACTH stimulation tests before and after treatment with ketoconazole, serum alkaline phosphatase (ALP) and alanine aminotransferase (ALT) activities, dosage of ketoconazole, clinical response, and survival time. RESULTS: 43 of 48 (90%) dogs had evidence of clinical improvement during the treatment period. In all dogs, treatment with ketoconazole resulted in significantly lower serum cortisol concentrations as measured before and after ACTH stimulation testing; 69% (33/48) of serum cortisol concentrations measured after ACTH stimulation were within the reference range. Serum ALP and ALT activities significantly decreased after treatment with ketoconazole. Survival time after diagnosis of PDH ranged from 2 to 61 months (mean, 26.9 months; median, 25 months). CONCLUSIONS AND CLINICAL RELEVANCE: Ketoconazole was a safe and effective option for treating dogs with PDH. Additional research is needed to evaluate the effects of long-term treatment with ketoconazole on adrenal glands.

Indirect measurement of systemic blood pressure in conscious dogs in a clinical setting.

The present study compared 2 indirect methods, Doppler sphygmomanometry and oscillometry, for measurement of the systemic blood pressure level in 100 conscious, client-owned dogs in a clinical setting on 2 separate occasions. The mean systemic blood pressure values, measured by Doppler sphygmomanometry on 2 separate occasions, were 156 +/- 38.2 mmHg and 150 +/- 34.1 mmHg, respectively. Using oscillometry, the mean systolic blood pressure values were 138 +/- 36.9 mm Hg and 133 +/- 33.5 mm Hg on 2 separate occasions. There were significant differences between the systemic blood pressure readings for both methods on the same occasion (P<0.001). The coefficients of variance from 5 consecutive measurements in the same dog obtained by Doppler sphygmomanometry on the 2 separate occasions were 4.1 +/- 3.2% and 3.1 +/- 1.7%; that of the oscillometric method on the 2 separate occasions were 18.7 +/- 11.3% and 17.2 +/- 12.5%. The coefficients of variance of these 2 methods were statistically different on each occasion (P<0.001). Five consecutive systemic blood pressure readings were obtained for each dog within 6 min on both occasions using Doppler sphygmomanometry. More than 15 min was required to complete 5 consecutive systemic blood pressure readings by oscillometric sphygmomanometry for all dogs on each occasion. The results of this study indicate that Doppler sphygmomanometry provides more efficient and precise measurements of the systemic blood pressure level than oscillometric testing in conscious dogs in a clinical setting.

Iatrogenic hyperadrenocorticism in 12 cats.

Iatrogenic hyperadrenocorticism is an extremely rare condition in cats. Twelve cats with a medical history of progressive skin lesions and long-term treatment with corticosteroids were retrospectively studied. Noncutaneous signs in the cats were variable and included anorexia, lethargy, polydipsia, polyuria, and atrophy of the thigh muscles. Laboratory abnormalities included leukocytosis, elevated alanine aminotransferase levels, and hyperglycemia. Transient diabetes mellitus was a secondary complication in four cats, and transient hypothyroidism was suspected in four cats. The mean time for regression of signs was 4.9 months after corticosteroid withdrawal.

Systolic blood pressure of clinically normal and conscious cats determined by an indirect Doppler method in a clinical setting.

The purposes of the present study were to determine the systolic blood pressure (SBP) of clinically normal and conscious cats, and to set up reference values of feline SBP for subsequent clinical application. SBPs were measured in 53 healthy cats using an ultrasonic Doppler device. The mean SBP was 133.6 +/- 16.0 mmHg (range, 110.0-180.0 mmHg). The distribution of SBP values was not significantly affected by factors such as breed, body condition score, or age (P>0.05), but SBP values of female cats were significantly lower and more variable than those of males (t test, P=0.004; F test, P<0.001). Feline SBP between 114.3 mmHg and 149.5 mmHg was considered indicative of normotension. SBP values higher than 159.3 mmHg were defined as hypertension, and those less than 104.5 mmHg were determined as hypotension.