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Journal of Veterinary Internal Medicine 2023Hyperthyroid cats often have urine specific gravity (USG) values <1.035. It remains unclear how USG changes after treatment, if USG can be used to predict azotemia after...
BACKGROUND
Hyperthyroid cats often have urine specific gravity (USG) values <1.035. It remains unclear how USG changes after treatment, if USG can be used to predict azotemia after treatment, or how iatrogenic hypothyroidism influences USG values.
OBJECTIVES
To determine the proportion of hyperthyroid cats with USG <1.035 vs ≥1.035; if USG changes after treatment; and whether USG <1.035 correlated with unmasking of azotemia or hypothyroidism.
ANIMALS
Six hundred fifty-five hyperthyroid cats treated with radioiodine; 190 clinically normal cats.
METHODS
Prospective, before-and-after study. Hyperthyroid cats had serum thyroxine, thyroid-stimulating hormone, and creatinine concentrations, and USG measured before and 6 months after successful treatment with radioiodine.
RESULTS
Of untreated hyperthyroid cats, USG was ≥1.035 in 346 (52.8%) and <1.035 in 309 (47.2%). After treatment, 279/346 (80.6%) maintained USG ≥1.035, whereas 67/346 (19.4%) became <1.035; 272/309 (88%) maintained USG <1.035, whereas 37/309 (12%) became ≥1.035. Only 22/346 (6.4%) with USG ≥1.035 developed azotemia after treatment, compared with 136/309 (44%) with <1.035 (P < .001). Of cats remaining nonazotemic, 38% had USG <1.035, compared with 20% of normal cats (P < .001). The 137 cats with iatrogenic hypothyroidism had lower USG after treatment than did 508 euthyroid cats (1.024 vs 1.035), but USGs did not change after levothyroxine supplementation. USG <1.035 had high sensitivity (86.1%) but moderate specificity (65.2%) in predicting azotemia after treatment.
CONCLUSIONS AND CLINICAL IMPORTANCE
Hyperthyroidism appears not to affect USG in cats. However, cats with evidence of sub-optimal concentrating ability before radioiodine treatment (USG < 1.035) are more likely to develop azotemia and unmask previously occult chronic kidney disease. Iatrogenic hypothyroidism itself did not appear to affect USG values.
Topics: Cats; Animals; Iodine Radioisotopes; Azotemia; Prospective Studies; Hypothyroidism; Hyperthyroidism; Kidney Concentrating Ability; Iatrogenic Disease; Cat Diseases
PubMed: 37668163
DOI: 10.1111/jvim.16849 -
Journal of Veterinary Science Sep 2023This case report describes the hematological and radiological examination of urinary bladder rupture and complete urethral obstruction. associated with urolithiasis in...
This case report describes the hematological and radiological examination of urinary bladder rupture and complete urethral obstruction. associated with urolithiasis in Hanwoo. Hyponatremia, hypochloremia, azotemia, and hyperglycemia were observed in both urethral obstruction and urinary bladder rupture. However, cattle with urethral obstruction showed hyperkalemia and mild hyperglycemia, whereas cattle with bladder rupture showed marked hyperglycemia and normal potassium levels. In ultrasonography, the urethral obstruction showed a dilated bladder with a thick bladder wall. In contrast to previous literature, in this study, severe electrolyte changes such as severe hyponatremia, hypochloremia, and hyperkalemia occurred in a case of complete urethral obstruction.
Topics: Cattle; Animals; Urinary Bladder; Hyperkalemia; Hyponatremia; Urethral Obstruction; Urolithiasis; Hyperglycemia; Republic of Korea; Cattle Diseases
PubMed: 37638710
DOI: 10.4142/jvs.23010 -
Comparative Immunology, Microbiology... Oct 2023This retrospective study evaluated factors responsible for mortality of dogs hospitalized for Canine Leishmaniosis. Medical records of 31 dogs with leishmaniosis from a...
This retrospective study evaluated factors responsible for mortality of dogs hospitalized for Canine Leishmaniosis. Medical records of 31 dogs with leishmaniosis from a Portuguese Veterinary Teaching Hospital were examined between August 2018 and January 2022. Females (n = 18) and pure breed dogs (n = 27) were overrepresented, with higher frequency of Labrador Retriever (n = 4). Median age was 7 years (interquartile range=7). Most had historical findings of lethargy (n = 26) and the commonest clinicopathological abnormality was hypoalbuminemia (n = 26). Eleven dogs were classified as LeishVet stage II, 10 stage III and 10 stage IV. Fourteen dogs (45.2%) died or were euthanized, with azotemia, leukocytosis, stage IV, absence of diagnosis before hospitalization and lack of leishmaniosis specific treatment during hospitalization contributing to mortality. Absence of hypoalbuminemia and stages II/III increased survival. Mean hospitalization length prior to discharge was 5.41days ( ± 1.84) and diarrhea prolonged hospital stay.
Topics: Female; Dogs; Animals; Retrospective Studies; Hospitals, Animal; Hypoalbuminemia; Prognosis; Dog Diseases; Leishmania infantum; Hospitals, Teaching; Leishmaniasis; Leishmaniasis, Visceral
PubMed: 37634471
DOI: 10.1016/j.cimid.2023.102041 -
Toxics Aug 2023Analysis of vitreous urea nitrogen (VUN) and creatinine (CREA) has been shown to be a useful indicator of azotemia in human postmortem examinations. Previous studies in...
Analysis of vitreous urea nitrogen (VUN) and creatinine (CREA) has been shown to be a useful indicator of azotemia in human postmortem examinations. Previous studies in cats, dogs, horses, and cattle have shown a good correlation between serum and postmortem ocular fluid for urea and creatinine. The aim of this study was to evaluate differences in VUN, CREA, and magnesium (MG) concentrations in vitreous humor collected postmortem from cats that presented with renal or post-renal disease and cats without renal or post-renal disease. Nine cats with renal or post-renal disease and twenty cats without renal or post-renal disease that underwent autopsy were used in this study. Collection of postmortem vitreous humor was performed, and vitreous samples were frozen at -80 °C for a minimum of 24 h prior to analysis using an in-clinic dry chemistry analyzer. Overall, there were statistically significant differences for VUN, CREA, and MG between cats with renal or post-renal disease and cats without renal or post-renal disease. Analysis of vitreous humor from cats suspected to have renal or post-renal disease can provide useful diagnostic information pertaining to renal function and issues in the urethra and urinary bladder. Future studies exploring postmortem vitreous chemistry in cats are warranted.
PubMed: 37624190
DOI: 10.3390/toxics11080685 -
BMC Veterinary Research Aug 2023Chronic kidney disease (CKD) is a common cause of morbidity and mortality in captive wildlife species. However, CKD has been rarely documented in giant pandas.
BACKGROUND
Chronic kidney disease (CKD) is a common cause of morbidity and mortality in captive wildlife species. However, CKD has been rarely documented in giant pandas.
CASE PRESENTATION
The following report describes a case of an eight-year-old female giant panda showing clinical signs of epistaxis, bloody diarrhea, polyuria, azotemia and anemia. The animal died despite of supportive treatments. Necropsy was performed. Grossly, both kidneys were shrunken and scarred with pallor. Subcutis edema and petechia on the epicardium of the heart were observed. The tissue samples were made into paraffin sections and stained by H.E and special staining including Periodic Acid-Schiff (PAS), von Kossa, Masson's trichrome, Phosphotungstic acid-hematoxylin (PTAH), and Congo red. Histopathology examination revealed severe chronic tubulointerstitial nephritis with marked interstitial fibrosis, glomerulosclerosis, tubular atrophy and calcification in kidneys, and acute necrotizing hemorrhagic myocarditis with calcification in heart. Other lesions included intestinal hemorrhage, hepatic fatty degeneration and necrosis with hemosiderin, and splenic hemosiderin.
CONCLUSIONS
In summary, chronic kidney disease was finally diagnosed based on the association of clinical, gross, and histopathological findings. Heart failure secondary to CKD is the leading cause of death in this giant panda. The potential cause of CKD in this animal is possibly due to long term and uncontrolled hypertension. Blood pressure monitoring is essential in establishing the diagnosis and management of hypertension in giant panda.
Topics: Animals; Female; Ursidae; Hemosiderin; Renal Insufficiency, Chronic; Kidney; Hypertension
PubMed: 37612662
DOI: 10.1186/s12917-023-03663-8 -
Cureus Jul 2023Rickettsial infection, known as Rocky Mountain spotted fever, is a challenging diagnosis as early clinical manifestations are difficult to distinguish from viral...
Rickettsial infection, known as Rocky Mountain spotted fever, is a challenging diagnosis as early clinical manifestations are difficult to distinguish from viral illnesses. Symptoms at presentation depend on the organs involved, ranging from a skin rash as evidence of vascular damage to prerenal azotemia, respiratory failure, hepatic injury, or encephalitis. We report an unusual case of an otherwise healthy 83-year-old female whose serologies tested positive for , which led to cardiac dysrhythmia, i.e., the new onset of atrial fibrillation associated with conversion pauses. The patient was treated with antibiotics and ultimately underwent permanent pacemaker placement with resolution. This case highlights cardiac dysrhythmia as a late and severe manifestation in patients diagnosed with rickettsial illness.
PubMed: 37609088
DOI: 10.7759/cureus.42288 -
Journal of Clinical Medicine Jul 2023The aims of this study were to analyze prevalence and severity of vascular risk factors in older patients referred to our clinic due to onset of Very Late-Onset...
BACKGROUND
The aims of this study were to analyze prevalence and severity of vascular risk factors in older patients referred to our clinic due to onset of Very Late-Onset Schizophrenia-Like Psychosis (VLOSLP) and to create a specific phenotype based on pathophysiological insight rather than age of onset.
METHODS
In a longitudinal study, 103 (M = 39, F = 64; mean age of 80.32 ± 7.65 years) patients were evaluated with cognitive, neuropsychiatric, and functional assessment scales. Blood concentration of hemoglobin (Hb), mean corpuscular volume (MCV), platelets, total protein test (TPT), creatinine, azotemia, glycemia, total cholesterol (TC), triglycerides (TG), uric acid (UA), sodium (Na), potassium (K), chlorine (Cl), calcium (Ca), folate, vitamin B12 (Vit-B12), and homocysteine were measured. Presence/absence of tobacco use, alcohol consumption, psychoactive substance use, hypertension, hyperlipidemia, diabetes mellitus, and history of vascular disease were collected.
RESULTS
Females were more apathetic than males (NPI-Apathy: = 0.040). Males had a significantly higher level of Hb ( = 0.019) and UA ( = 0.001), and a lower level of platelets ( = 0.004) and Ca ( = 0.003), and used more tobacco ( = 0.046) and alcohol ( = 0.024) than females. Comparing patients < 80 and ≥80 years, we found differences in frequency of vascular risk factors among men ( = 0.027). In total, 102 patients were treated for psychosis (59.16% of them were using atypical antipsychotics).
CONCLUSIONS
The results of this study could be useful for a progressive demonstration of the causal relationship between cardiac and cerebral vascular events and VLOSLP.
PubMed: 37510946
DOI: 10.3390/jcm12144831 -
Diagnostics (Basel, Switzerland) Jul 2023Acute kidney injury (AKI) is common in cirrhotic patients affecting almost 20% of these patients. While multiple etiologies can lead to AKI, pre-renal azotemia seems to... (Review)
Review
Acute kidney injury (AKI) is common in cirrhotic patients affecting almost 20% of these patients. While multiple etiologies can lead to AKI, pre-renal azotemia seems to be the most common cause of AKI. Irrespective of the cause, AKI is associated with worse survival with the poorest outcomes observed in those with hepatorenal syndrome (HRS) and acute tubular necrosis (ATN). In recent years, new definitions, and classifications of AKI in cirrhosis have emerged. More knowledge has also become available regarding the benefits and drawbacks of albumin and terlipressin use in these patients. Diagnostic tools such as urinary biomarkers and point-of-care ultrasound (POCUS) became available and they will be used in the near future to differentiate between different causes of AKI and direct management of AKI in these patients. In this update, we will review these new classifications, treatment recommendations, and diagnostic tools for AKI in cirrhotic patients.
PubMed: 37510105
DOI: 10.3390/diagnostics13142361 -
BMC Nephrology Jul 2023Elevated creatinine concentrations often indicate acute renal injury and renal biopsies are considered in this situation. However,pseudohypercreatininemia is potential...
BACKGROUND
Elevated creatinine concentrations often indicate acute renal injury and renal biopsies are considered in this situation. However,pseudohypercreatininemia is potential cause of elevated creatinine concentrations, and invasive interventions should be avoided.
CASE PRESENTATION
A 54-year-old woman underwent surgery for descending aortic dissection.Nine days postoperatively, her creatinine concentration increased from 1 mg/dl to 5.78 mg/dl (normal range, 0.47-0.7 mg/dl). Azotemia and hyperkalemia were absent and physical examination findings were unremarkable. Cystatin C concentration was 1.56 mg/l (normal range, 0.56-0.8 mg/l) and pseudohypercreatininemia was suspected. Testing with different reagents showed a creatinine concentration of 0.84 mg/dl. Immunoglobulin (Ig)G was markedly elevated, and creatinine and IgG fluctuated in parallel, suggesting the cause of the pseudohypercreatininemia. IgG4 was also elevated at 844 mg/dl. Immunosuppressive steroid therapy effectively decreased the IgG concentration and resolved the pseudohypercreatininemia.
CONCLUSIONS
In cases of elevated creatinine concentration with the presence of abnormal proteins, pseudohypercreatininemia should be considered. We report a rare case of pseudohypercreatininemia caused by polyclonal IgG.
Topics: Female; Humans; Middle Aged; Acute Kidney Injury; Aortic Dissection; Biomarkers; Creatinine; Cystatin C; Immunoglobulin G; Immunosuppressive Agents; Postoperative Complications; Steroids
PubMed: 37491221
DOI: 10.1186/s12882-023-03275-2 -
Paediatrics & Child Health Aug 2023Acetaminophen has gained interest in the neonatal community for its use in the management of hemodynamically significant patent ductus arteriosus (HsPDA) in preterm...
OBJECTIVES
Acetaminophen has gained interest in the neonatal community for its use in the management of hemodynamically significant patent ductus arteriosus (HsPDA) in preterm infants. We conducted a systematic review of randomized controlled trials (RCTs) comparing the efficacy and safety of acetaminophen with indomethacin for the management of HsPDA in preterm infants.
METHODS
We searched PROSPERO, OVID Medline, OVID EMBASE, Wiley Cochrane Library (CDSR and Central), EBSCO CINAHL, and SCOPUS from inception to June 15, 2021. Bibliographies of identified studies were searched for additional references. Data were analyzed with Review Manager (RevMan) Version 5.3.
RESULTS
Four RCTs were identified, enrolling a total of 380 subjects. There was no difference between the interventions for the outcome of PDA closure after one course (RR 1.04 [95% CIs: 0.84, 1.29], -value 0.70) or after two courses of treatment (RR 1.01 [95% CIs: 0.92, 1.12], -value 0.77); and for the outcome of PDA ligation (RR 1.56 [95% CIs: 0.48, 5.12], -value 0.46). However, patients who received acetaminophen had lower rates of necrotizing enterocolitis (RR 0.37 [95% CIs: 0.14, 0.95], -value 0.04). There were no significant differences noted in the other clinical outcomes, that is, intraventricular hemorrhage, bronchopulmonary dysplasia, retinopathy of prematurity requiring treatment, and death. Two studies noted significant post-treatment elevation of serum creatinine and blood urea with indomethacin, as compared to none with acetaminophen use.
CONCLUSIONS
Acetaminophen has comparable efficacy to indomethacin for the outcome of HsPDA closure, with a better safety profile, that is, lesser rates of necrotizing enterocolitis and post-treatment azotemia noted with its use.
PubMed: 37484043
DOI: 10.1093/pch/pxac130