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Assisted feeding through an oesophagostomy tube in patients with chronic kidney disease and uraemic syndrome: impact on body condition score, renal function and survival
Full text linkLa dietoterapia rappresenta il primo strumento terapeutico nel paziente in
presenza di danno renale acuto e malattia renale cronica. Tuttavia la maggior
parte di tali pazienti non è in grado di alimentarsi volontariamente e nel
quantitativo adeguato ai propri fabbisogni. Obiettivo del presente studio è
di valutare BCS, parametri di funzionalità renale e sopravvivenza in pazienti
in crisi uremica sottoposti o meno ad alimentazione assistita.
Lo studio è stato condotto su quattordici cani con pregressa CKD e in fase
di riacutizzazione o scompenso. Sette pazienti sono stati gestiti mediante
impiego di feeding tube (FT), 7 mediante terapia medica tradizionale (GC).
Per ciascuno dei due gruppi, BCS, creatinina, urea, e fosforo sierici e sopravvivenza,
sono stati valutati a T0 e ad uno (T1) e due mesi (T2). I dati sono
stati elaborati statisticamente.
Il GC presentava una differenza significativa di BCS (p=0,04), creatinina
(p=0,001), urea (p=0,005) e fosforo (p=0,04) a diversi controlli. Il FT presentava
una differenza significativa di BCS (p=0,03), valori sierici di creatinina
(p=0,006), urea (p=0,0001) e fosforo (p=0,02) ai diversi controlli. Il FT mostrava
una sopravvivenza alla crisi uremica maggiore (p=0,01) del GC.
Le evidenze del presente studio riportano un significativo miglioramento di
BCS, parametri di funzionalità renale e sopravvivenza nei pazienti gestiti con
feeding rispetto agli altri. Il feeding tube sembra rappresentare un ausilio terapeutico
estremamente utile nella gestione medica del paziente in crisi uremica.Introduction – A renal diet is a fundamental part of the medical management
of patients with acute and chronic kidney disease. Unfortunately, most patients
are not able to eat a sufficient amount of a renal diet to achieve an adequate
calorie intake. The aim of this study was to evaluate the Body Condition Score
(BCS), renal function and survival rate in a group of uraemic patients managed
with a feeding tube and compare the findings with those in a comparable group
managed without a feeding tube.
Materials and Methods – Fourteen dogs with acute-on-chronic kidney disease
formed the study population. Seven dogs were managed with the use of a feeding
tube (FT group) and seven were managed without a feeding tube (control
group). BCS, serum creatinine, urea and phosphate concentrations and survival
rate were evaluated in both groups at time 0 (T0), after 1 month (T1) and after
2 months (T2). Data were analysed statistically.
Results – There were significant differences in BCS (p=0.04), creatinine
(p=0.001), urea (p=0,005) phosphate (p=0.04) at the different time points in the
control group. The FT group also had significant difference in BCS (p=0.03), creatinine
(p=0.006), urea (p=0.0001) and phosphate (p=0.02) at the different time
points. The survival rate was higher in the FT group than in the control group
(p=0.01).
Discussion – The results of the present study show significant improvements
in BCS, renal function and survival in patients managed with a feeding tube, compared
to those in which a feeding tube was not used. A feeding tube seems to
be a very useful therapeutic instrument for the management of patients with
uraemic syndrome
Glomerular filtration rate evaluation in the dog throughout the plasmatic clearance of iohexol: Simplified methods
No full textGFR (glomerular filtration rate - GFR) shows the rate of glomerular filtration through renal glomeruli and, despite of the most used paramethers for the evaluation of renal disfunction (plasmatic creatinine, urea and urinary specific gravity), allows an early diagnosis of renal failure. Iohexol, a non-ionic low osmolarity contrast medium, has renal clearance only and can be used as a reliable GFR marker in humans and animals. The pourpose of the present study was to establish simplified methods of GFR determination in dogs through the plasmatic clearance of iohexol and to evaluate the accuracy of Cockroft-Gault equations GFR prediction.
In the 35 dogs of our study the plasmatic concentration of iohexol was directly evaluated by using an HPLC method. A linear regression analysis among the reference 11-point method (5, 15', 30', 45" 60', 90" 180', 240', 300', 420'e 24 hours) and the four simplified five-sample models was performed.
The best time for sampling in the 5-sample method was 5, 15, 60, 90 and 180 minutes. The linear regression analysis among the reference 11-point method and the equations for the prediction of GFR in the dog showed no significant correlation. GFR determination can be considered the only reliable method to assess renal function in dogs. Plasma clearance of iohexol can be estimated in dogs from 5 blood samples with a reasonable margin of error and used as a good routine method of GFR evaluation in early diagnosis of nephropaties
CANINE CHRONIC KIDNEY DISEASE: RETROSPECTIVE STUDY OF A TEN YEAR PERIOD OF CLINICAL ACTIVITY
No full textChronic kidney disease (CKD) is a progressive, pathological disease with a higher prevalence in geriatric patients. The aim of the present study was to estimate the prevalence of dogs affected by CKD at the Department of Veterinary Clinics over a 10-year period of clinical activity, according to gender, age, breed, and IRIS stage. Males showed a prevalence of 60.17%, while females showed a prevalence of 39.82%; 28.40% of dogs were younger than 6 years, 42.12% were between 6 and 10 years, and 29.46% were older than 10 years. Mixed breed patients showed a prevalence of 31.38%, followed by Boxer (9.36%), German Shepherd (7.76%), and Setter (5.42%). The prevalence of CKD was 24.25% in IRIS 2, 52.97% in IRIS 3, and 22.76 in IRIS 4. The results showed that CKD represents a more frequent reason for consultation in canine patients than in the past. It is not clear whether the high prevalence of CKD is due to an actual increase in the disease or an increased frequency of early diagnosis
Pet's diseases and owner's anxiety: is the leash an umbilical cord?
No full textNowadays domestic animals take part to the family system and represent a fundamental element of its equilibrium.
Therefore, pet’s symptoms or diseases may become stressors for owners. The aims of the present study were to
evaluate if the management of a pet affected by a disease may influence the anxiety of the owner and if some pathologies
or symptoms may affect owner’s anxiety more deeply. Eighty five owners of dogs and cats presented to the Veterinary
Teaching Hospital “Mario Modenato” of the University of Pisa for dermatologic, gastro enteric and nephrological disorders
were enrolled in the study through the administration of the State-Trait Anxiety Inventory Test (STAI). The questionnaire
was anonymous and in accordance with privacy laws. Data were statistically analysed through the t-test and
ANOVA test. Both men and women showed significantly higher values of trait anxiety (47.68±12.97 vs 43.07±8.05;
p=0.04), compared to state anxiety (45.68±12.71 vs 38.9±9.89; p=0.03) but men presented significantly higher scores than
women. No significant differences were found among owners concerning age and educational level. Cat’s owners showed
significantly lower levels of anxiety than dogs ones and owners of nephropatic patients were less anxious than owners of
gastroenteric and dermatologic subjects. The present data seemed to show that owner’s anxiety may be affected more or
less deeply by pet’s disease, according to kind of disease, seriousness of symptoms and owner’s gender
RETROSPECTIVE OBSERVATION OF 64 DOGS WITH RENAL FAILURE MANAGED BY HEMODIALYSIS
No full textAcute Kidney Injury (AKI) is a severe disease associated with a sudden onset of renal
parenchymal injury most typically characterized by generalized failure. AKI may to be
severe and culminated with the requirement for renal replacement therapy (RRT) or
death. The aim of this study was to evaluate potential prognostic factors (clinical and
laboratory parameters), intra/inter dialysis complications and mortality rate in a cohort
of dogs with AKI and AKI/CKD managed by hemodialysis (HD) at Department of
Veterinary Science of University of Pisa between 2012 and 2015. We included 64 dogs
with anamnestic, clinical, imaging and laboratory findings of AKI or acute on chronic
kidney disease (AKI/CKD) managed by hemodialysis. All Dogs were also divided into two
groups: survivors and non-survivors. Survivors were defined as patients remaining not
dependent by dialysis for at least 30 days after discharge from the hospital. Data were
statistically analyzed with GraphPad Prism® for Mac. In our cohort 43/64 were males
and 21/64 were females. Mean age and body weight were 5.5 ± SD 3.3 years and 26.7
kg±1SD 1.6 kg respectively. At presentation 26/64 dogs were anuric (<0.5 ml/kg/h),
15/64 were oliguric (1ml/kg/h). 29/64 dogs
were in AKI stage 5 (SrCr>10mg/dl), 29/64 were in AKI 4 (SrCr 5-10 mg/dL), 2/64 were
in AKI 3 (SrCr 2.6-5mg/dL), 1/64 were in AKI 2 (SrCr 1.6-2.5) and 3/64 were in AKI 1
(SrCr<1.6mg/dL). Most of etiology of AKI in this dogs were: Leptospira infection (14/64),
Leishmania infection (5/64), toxicity (8/64), ethylene glycol (3/64), pancreatitis (4/64),
heart stroke (2/64), snake bite (2/64), uretheral obstruction (2/64), pyometra (3/64),
unknown (17/64) and other causes (4/64). Non-survivors dogs were 37/6, while
survivors were 27/64. T-Test unpaired showed significant difference at presentation in
serum creatinine (p=0.047), phosphorus (p=0.0468), and ionic calcium (p=0.042)
between survivors and non-survivors. No significant difference was found in serum urea,
albumin, C-reactive protein (CRP) and potassium between survivors and non-survivors.
In our cohort the overall survival rate was 42.2% and it showed similar to previously data reported. Serum creatinine, phosphorous and ionized calcium seemed to have a
significant prognostic relevance, while serum urea, CRP and potassium did not seem to
affect prognosis significantly
Canine chronic kidney disease: Retrospective study of a 10-year period of clinical activity
No full textChronic kidney disease (CKD) is a progressive, pathological disease with a higher prevalence in geriatric patients. The aim of the present study was to estimate the prevalence of dogs affected by CKD at the Department of Veterinary Clinics over a 10-year period of clinical activity, according to gender, age, breed, and IRIS stage. Males showed a prevalence of 60.17%, while females showed a prevalence of 39.82%; 28.40% of dogs were younger than 6 years, 42.12% were between 6 and 10 years, and 29.46% were older than 10 years. Mixed breed patients showed a prevalence of 31.38%, followed by Boxer (9.36%), German shepherd (7.76%), and setter (5.42%). The prevalence of CKD was 24.25% in IRIS 2, 52.97% in IRIS 3, and 22.76 in IRIS 4. The results showed that CKD represents a more frequent reason for consultation in canine patients than in the past. It is not clear whether the high prevalence of CKD is due to an actual increase in the disease or an increased frequency of early diagnosis
INSUFFICIENZA RENALE CRONICA DEL CANE E DEL GATTO: STUDIO RETROSPETTIVO SU 10 ANNI D’ ATTIVITA’
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