Comparison of signalment, clinicopathologic findings, histologic diagnosis, and prognosis in dogs with glomerular disease with or without nephrotic syndrome.

BACKGROUND: Nephrotic syndrome (NS) develops most commonly in people with glomerular diseases associated with marked albuminuria. Hypernatremia, hypertension, and progressive renal failure are more prevalent in nephrotic than nonnephrotic human patients. HYPOTHESIS/OBJECTIVES: Dogs with NS have higher serum cholesterol, triglyceride, and sodium concentrations, higher urine protein:creatinine ratios (UPC) and systolic blood pressure, and lower serum albumin concentrations than dogs with nonnephrotic glomerular disease (NNGD). NS is associated with membranous glomerulopathy and amyloidosis. Affected dogs are more likely to be azotemic and have shorter survival times. ANIMALS: Two hundred and thirty-four pet dogs (78 NS dogs, 156 NNGD dogs). METHODS: Multicenter retrospective case-control study comparing time-matched NS and NNGD dogs. NS was defined as the concurrent presence of hypoalbuminemia, hypercholesterolemia, proteinuria, and extravascular fluid accumulation. Signalment, clinicopathologic variables, histopathologic diagnoses, and survival time were compared between groups. RESULTS: Age, serum albumin, chloride, calcium, phosphate, creatinine, and cholesterol concentrations, and UPC differed significantly between NS and NNGD dogs. Both groups were equally likely to be azotemic at time of diagnosis, and NS was not associated with histologic diagnosis. Median survival was significantly shorter for NS (12.5 days) versus NNGD dogs (104.5 days). When subgrouped based on serum creatinine (< or ≥1.5 mg/dL), survival of NS versus NNGD dogs was only significantly different in nonazotemic dogs (51 versus 605 days, respectively). CONCLUSIONS AND CLINICAL IMPORTANCE: Presence of NS is associated with poorer prognosis in dogs with nonazotemic glomerular disease. Preventing development of NS is warranted; however, specific interventions were not evaluated in this study.

Approaches to veterinary education--tracking versus a final year broad clinical experience. Part one: effects on career outcome.

This is the first of two papers that provide extensive data and analysis on the two major approaches to clinical veterinary education, which either provide students with experience of a broad range of species (often defined as omni/general clinical competence), or just a few species (sometimes just one), usually termed 'tracking'. Together the two papers provide a detailed analysis of these two approaches for the first time. The responsibilities of veterinary medicine and veterinary education are rapidly increasing throughoutthe globe. It is critical for all in veterinary education to reassess the approaches that have been used, and evaluate on a school-by-school basis which may best meet its expanding and ever-deepening responsibilities.

Approaches to veterinary education--tracking versus a final year broad clinical experience. Part two: instilled values.

This is the second of two papers that the authors have written on this subject, and together they describe the results of the first major study of the outcomes of the two general approaches to the clinical training of veterinary students. One approach provides students with a broad experience with multiple species and the other provides them with an in-depth experience with just the species that they intend to work with in practice upon graduation (the latter is termed 'tracking', i.e. students follow a course of study along a particular specialised 'track'). This study obtained extensive feedback from the graduates of two schools, each of which was representative of one of the two approaches to clinical education. A total of 1,714 students took part in a survey in which they were asked to provide information about their career paths, their professional satisfaction, and their assessment of their training, especially in comparative veterinary medicine. They were also asked to say whether or not they would have preferred a different kind of training and who they would be most likely to hire as an associate: a tracking graduate or one who had received a broad-based education. The studies show that the several concerns that have been verbalised about tracking appear to be invalid. Upon graduation more than 90% of veterinary practitioners practice in quite a narrow area of veterinary medicine. We must, therefore, consider what benefits are gained from providing the typical very general preclinical education and offering students clinical training in animals with which they do not intend to practice upon graduation.