Denise Maria Nunes Simões

Evaluation of albuminuria and its relationship with blood pressure in dogs with chronic kidney disease

BACKGROUND Microalbuminuria and hypertension have long been associated with a guarded prognosis in human patients with a variety of diseases. In veterinary medicine, tests for microalbuminuria have been used for detecting early kidney damage, but there is little information regarding its association with high blood pressure in dogs with chronic kidney disease (CKD). OBJECTIVE The objective of this study was to evaluate albuminuria and its association with arterial hypertension in dogs with CKD. METHODS Urinary albumin:creatinine (UAC) ratio, urinary protein:creatinine (UPC) ratio, and systolic blood pressure were determined in 39 clinically healthy dogs and 40 dogs with CKD. RESULTS UAC in dogs with CKD (range, 0.002-7.99; median, 0.38) was statistically different from that of control dogs (range, 0.0005-0.01; median, 0.002). Microalbuminuria (UAC 0.03-0.3) and macroalbuminuria (UAC>0.3) were detected in 32.5% and 50% of dogs with CKD, respectively. Sixty percent (24/40) of dogs with CKD had systolic pressure > or =180 mmHg; in these dogs, UAC ratio (range, 0.006-7.99; median, 1.72) was significantly higher than in dogs with CKD and systolic pressure<180 mmHg (range, 0.002-4.83; median, 0.10). Of hypertensive dogs with CKD, those with UPC>1.0 usually had macroalbuminuria, those with UPC 0.5-1.0 usually had microalbuminuria, and those with UPC<0.5 usually lacked albuminuria. CONCLUSIONS UAC ratio was higher in hypertensive than in normotensive dogs with CKD. Tests designed to detect microalbuminuria may be useful for hypertensive dogs with CKD and a UPC < or = 1.0 to detect the onset and magnitude of albuminuria. Once macroalbuminuria is overt, the UPC ratio itself can be used for the same purpose.

Avaliação de dois sensores portáteis para mensuração da glicemia em cães

The clinical and analytical accuracy of two portable meters for glucose measurement in dogs was evaluated. Blood glucose values obtained by the use of portable meters were compared to those obtained using the glucose oxidase reference method, by means of correlation and error analysis. Results obtained with the blood glucose meters were not different from those obtained with the reference method. Both apparatus evaluated are adequate for use in dogs.

Hypervitaminosis A-induced hepatic fibrosis in a cat

Rationale: The excessive intake of vitamin A in the form of vitamin concentrate, supplement or vitamin-rich liver can result in hypervitaminosis A in man and animals. Although osteopathologies resulting from chronic vitamin A intoxication in cats are well characterized, no information is available concerning feline hypervitaminosis A-induced liver disease. Clinical summary: We report the first case of hepatic stellate cell lipidosis and hepatic fibrosis in a domestic cat that had been fed a diet based on raw beef liver. Radiographic examination revealed exostoses and ankylosis between vertebrae C1 and T7, compatible with deforming cervical spondylosis. Necropsy showed a slightly enlarged and light yellow to bronze liver. Microscopic and ultrastructural analyses of liver tissues revealed diffuse and severe liver fibrosis associated with hepatic stellate cell hyperplasia and hypertrophy. These cells showed immunopositive staining for α-smooth muscle actin and desmin markers. The necropsy findings of chronic liver disease coupled with osteopathology supported the diagnosis of hypervitaminosis A. Practical relevance: As in human hepatology, if there is dietary evidence to support increased intake of vitamin A, then hypervitaminosis A should be considered in the differential diagnosis of chronic liver disease in cats.

Determinação das concentrações séricas de glicose e insulina de cães em choque endotóxico

Progressive hypoglycemia is one of the main causes that could lead dogs to death with septic shock. The ancillary therapy suggested by many authors includes glucose and insulin replacement to improve tissue glucose utilization; however, there are some contradictions about insulin serum concentration values in patients with septic shock, making questionable the need for insulin replacement. This study evaluated glucose serum concentration changes in dogs with septic shock and insulin serum concentrations (absolute and relative ratios) in the hypoglycemic group obtaining information that may help the therapy of hypodinamic shock. Twenty-five dogs seen in the emergency room of the Veterinary Teaching Hospital of Universidade de Sao Paulo showing signs of endotoxic shock due to a hemorragic gastroenteritis (presumptive diagnosis of parvovirus infection) were evaluated in this study. There were 52% hypoglycemic animals, 36% normoglycemic and 12% were hyperglycemic. Out of 13 hypoglycemic dogs, 3 had absolute and relative hyperinsulinemia and only relative hyperinsulinemia in 6 dogs. Absolute hypoinsulinemia was observed in 2 animals. The finding that more than a half of the animals in the hypodinamic state of shock presented absolute or relative hyperinsulinemia, denoted the demand of carefull laboratorial evaluation of the patient prior to insulin administration. The administration should be reserved for animals with periferic resistance or decrease in insulin serum concentration.

Avaliação da albuminúria e da eletroforese de proteínas urinárias de cães com hiperadrenocorticismo e a relação com a pressão arterial sistêmica

Hyperadrenocorticism is one of the commonest endocrinopathies in dogs, and it is characterized by the excessive exposure of glucocorticoids excreted by adrenals. Chronic hypercortisolemia may promote several complications, including systemic hypertension and glomerulonephritis. Glomerulonephritis may initiate several variable degrees of proteinuria and leading to the development of chronic kidney disease. The loss of proteins through urine, mainly predominant albumin, is a characteristic of glomerular diseases and the determination of laboratorial variables, such as the urinary protein-to- creatinine ratio (UPC), urinary albumin-to-creatinine ratio (UAC; ELISA test) and electrophoresis of urinary proteins are recommended to elucidate the diagnosis. Therefore, the goal of this study is to evaluate the relationship between proteinuria and systemic arterial hypertension in dogs with hyperadrenocorticism and to determine through evaluation of albuminuria and molecular weight of urinary proteins, the segment of the nephron that could be damaged. Thirty dogs with hyperadrenocorticism were evaluated and subdivided into groups; 13 dogs with systemic arterial hypertension (group I) and 17 normotensive (group II). The UPC was determined, as well as UAC and the urine protein electrophoresis by polyacrylamide gel technique, containing dodecyl sodium sulphate (SDS-PAGE). The results were compared with data obtained from 30 clinically healthy dogs. No association between systemic arterial hypertension and albuminuria was detected in dogs with hyperadrenocorticism as well as no alterations of proteins patterns or molecular weights bands of low ( 60 kDa) was found. However, dogs with hyperadrenocorticism may develop glomerular and tubular injuries that were characterized by the presence of albuminuria and proteins of low and high molecular weights, independently of systemic arterial hypertension. In conclusion, the quantitative (UPC and UAC) and qualitative (SDS-PAGE) evaluation of urinary proteins could add information to indicate the possible segments of the nephrons that caused the loss of those proteins.

Serum intact parathyroid hormone levels in cats with chronic kidney disease

Chronic kidney disease (CKD) is frequently observed in cats and it is characterized as a multisystemic illness, caused by several underlying metabolic changes, and secondary renal hyperparathyroidism (SRHPT) is relatively common; usually it is associated with the progression of renal disease and poor prognosis. This study aimed at determining the frequency of SRHPT, and discussing possible mechanisms that could contribute to the development of SRHPT in cats at different stages of CKD through the evaluation of calcium and phosphorus metabolism, as well as acid-base status. Forty owned cats with CKD were included and divided into three groups, according to the stages of the disease, classified according to the International Renal Interest Society (IRIS) as Stage II (n=12), Stage III (n=22) and Stage IV (n=6). Control group was composed of 21 clinically healthy cats. Increased serum intact parathyroid hormone (iPTH) concentrations were observed in most CKD cats in all stages, and mainly in Stage IV, which hyperphosphatemia and ionized hypocalcemia were detected and associated to the cause for the development of SRHPT. In Stages II and III, however, ionized hypercalcemia was noticed suggesting that the development of SRHPT might be associated with other factors, and metabolic acidosis could be involved to the increase of serum ionized calcium. Therefore, causes for the development of SRHPT seem to be multifactorial and they must be further investigated, mainly in the early stages of CKD in cats, as hyperphosphatemia and ionized hypocalcemia could not be the only factors involved.