renal

Question 1

Acute on chronic kidney disease in dogs: Etiology, clinical and clinicopathologic findings, prognostic markers, and survival Dunaevich JVIM 2020

Answer 1

Short-term outcome of dogs with ACKD is comparable to those with AKI but long-term prognosis is guarded. The IRIS AKI grade at presentation is a prognostic indicator of short-term outcome.

Question 2

Cystatin C and Iris: Advances in the Evaluation of Kidney Function in Critically Ill Dog Paes-leme FRontiers 2021

Answer 2

the measurement of serum cystatin C immediately on admission to the ICU was superior in the early identification of patients with AKI when compared to the IRIS classification and serum creatinine in critically ill dogs.

Question 3

Evaluation of Symmetric Dimethylarginine (SDMA) in Dogs with Acute Pancreatitis GOri Vet Sci 2020

Answer 3

SDMA was not significantly different between survivors and non-survivors. Although further studies are warranted, SDMA may be a useful tool in canine AP, as a high SDMA may be related to subclinical kidney impairment.

Question 4

Urine neutrophil gelatinase-associated lipocalin to diagnose and characterize acute kidney injury in dogs Monari JVIM 2020

Answer 4

Urinary NGAL is a sensitive marker for AKI in dogs, but its specificity is affected by systemic inflammation. Increased urinary NGAL in both I-AKI and VR-AKI also suggests the presence of tubular damage in transient AKI. Combining urine chemistry data with IRIS criteria could facilitate AKI characterization in dogs.

Question 5

Clinicopathological features of cutaneous and renal glomerular vasculopathy in 178 dogs Walker vet rec 2021

Answer 5

The time frame over which AKI may develop is longer than previously reported, neurological signs can be identified at presentation or during hospitalisation, and thrombocytopenia is even more common than previously reported.

Question 6

Hypertension, retinopathy, and acute kidney injury in dogs: A prospective study Cole 2020 JVIM

Answer 6

Systemic hypertension is common in dogs with AKI. Systemic hypertension might be associated with Fluid overload which itself is associated with nonsurvival. Monitoring for Systemic Hypertension and fluid overload is therefore warranted in dogs with AKI.

Question 7

Prospective evaluation of 5 urinary biomarkers as predictors of acute kidney injury in nonazotemic, hospitalized dogs Nivy JVIM 2021

hypothesis: Urinary (u) activity of γ-glutamyl transpeptidase (GGT) and alkaline phosphatase (ALP), and concentrations of heat-shock protein 70 (HSP70) and interleukins (ILs) -6 and -18, are predictive biomarkers for AKI and survival.

Answer 7

The predictive value of individual urinary biomarkers was reduced by moderate sensitivities and specificities. SDMA showed moderate discriminatory utility for AKI prediction, and often displayed discordant results with sCr.

Question 8

Retrospective evaluation of acute kidney injury in dogs with pit viper envenomation (2008-2017): 56 cases Martinez JVECC 2020

Answer 8

Development of AKI in dogs following pit viper envenomation carries an increased risk of mortality that is associated with severity of shock at presentation and increased doses of antivenom administration.

Question 9

Retrospective evaluation of Vitis vinifera (grapes) ingestion in dogs presented to emergency clinics in the UK (2012-2016): 606 Cases Croft JVECC 2021

Answer 9

All dogs survived to discharge. One out of 33 cases with repeated creatinine concentration developed IRIS AKI grade I within 24 hours following ingestion, when current emergency treatment guidelines were followed in whole or part.

Question 10

Association of markers of endothelial activation and dysfunction with occurrence and outcome of pulmonary hemorrhage in dogs with leptospirosis Sonderegger 2021 JVIM

Answer 10

Soluble intercellular adhesion molecule 1, VEGF, and Ang-2 do not discriminate leptospirosis from AKI-nL. In dogs with leptospirosis, sICAM-1 and VEGF predict outcome and sICAM-1 might identify dogs at risk for pulm haemorrhage.

soluble intercellular adhesion molecule 1 (sICAM‐1), vascular endothelial growth factor (VEGF), and angiopoietin‐2 (Ang‐2)

Question 11

Retrospective evaluation of the clinical course and outcome following grape or raisin ingestion in dogs (2005-2014): 139 cases JVECC 2020 Reich

Answer 11

The prevalence of AKI and mortality was low in dogs with confirmed grape or raisin ingestion. Due to the retrospective nature of the study, conclusions about the utility of gastrointestinal decontamination and other therapies cannot be made.

Question 12

Comparison of clinicopathological patterns of renal tubular damage in dogs with acute kidney injury caused by leptospirosis and other etiologies Zamagni vet J 2020

Answer 12

when compared to other aetiologies of intrinsic AKI, canine leptospirosis was characterised by increased glucosuria and kaliuresis.

Question 13

Prospective randomized controlled blinded clinical trial evaluating biomarkers of acute kidney injury following 6% hydroxyethyl starch 130/0.4 or Hartmann’s solution in dogs Boyd 2021 JVECC

Answer 13

There were no differences in change over time of urine AKI biomarkers in dogs treated with 10 - 40 mL/kg HES or CRYST over 24 hours. Larger clinical trials with patient-centered outcomes are required to investigate the safety of HES in dogs.

Question 14

Toxicosis with grapes or raisins causing acute kidney injury and neurological signs in dogs Jvim 2020

Answer 14

15 grape/raisin ingestion
Toxicosis with grapes or raisins causing acute kidney injury and neurological signs in dogs 73% had severe forebrain, cerebellar, or vestibular signs may be an important feature of Grape/raisin toxicity and dominate the early clinical picture.The described features suggest a reversible functional brain injury specific to GRT and unrelated to uremia.

Question 15

Evaluation of changes in the epidemiology of leptospirosis in dogs after introduction of a quadrivalent antileptospiral vaccine in a highly endemic areaJVIM 2020 FRancey

Answer 15

Use of the L4 vaccine was associated with significantly decreased odds of disease.

Question 16

Hyperammonemia in azotemic cats JFMS 2021 Carvalho

Answer 16

A correlation exists between blood ammonia and BUN, Cr and phosphorus in cats with renal azotemia
Hyperammonemia was documented in 4/18 (22%) cats, with a median of 95 µmol/dl (range 85-98 µmol/dl)

Question 17

Obesity and recovery from acute kidney injury (Ob AKI): a prospective cohort feasibility study BMJ open 2019 Maclaughlin

Answer 17

Feasibility to conduct a long-term observational study addressing AKI outcomes associated with obesity was demonstrated. A fully powered prospective cohort study to examine the relationships between obesity and outcomes of AKI is warranted.

Question 18

Survival and complications in cats treated with subcutaneous ureteral bypass JSAP 2021 Kulendra

Answer 18

subcutaneous ureteral bypass placement was associated with an approximately 10% in-hospital mortality and a high complication rate (48%)
overall median survival time of over 2 years (a significant association between long-term survival and creatinine at presentation was identified)

Question 19

Ultrasonographic findings in cats with acute kidney injury: a retrospective study JFMS 2019 Cole

Answer 19

The increasing number of renal ultrasonographic abnormalities and the presence of retroperitoneal fluid alone are associated with oligouria/anuria and a higher ultrasound score may suggest a poorer long-term prognosis.

ephromegaly, pyelectasia and increased renal echogenicity.

Question 20

Effect of prazosin on feline recurrent urethral obstruction JFMS 2021 Hanson

Answer 20

Prazosin administered at 0.5 mg PO q12h did not decrease the rate of urethral obstruction this population of obstructed male cats vs placebo. These results further support evidence suggesting that prazosin may not be beneficial in the prevention of feline rUO.

Question 21

Postmortem urinary tract changes in cats with urethral obstruction JVECC 2020

Answer 21

Hyperkalemia paralleled the severity of bladder and renal lesions.

Question 22

Multicenter evaluation of decompressive cystocentesis in the treatment of cats with urethral obstruction JAVMA 2021 Reineke

Answer 22

Decompressive cystocentesis did not improve time to place the urinary catheter or ease of Urethral catheter in cats with urethral obstruction

Question 23

Retrospective evaluation of urinary indwelling catheter type in cats with urethral obstruction (January 2014 to December 2014): 91 cases JVECC 2020 Davidow

Answer 23

No difference in recurren of Urethral obstruction was found in cats treated for urethral obstruction with a 3.5-Fr Argyle (semi rigid) or red rubber catheter,
11% of recurrent urethral obstruction

Question 24

Association of abdominal effusion with a single decompressive cystocentesis prior to catheterization in male cats with urethral obstruction
JVECC 2020 Gerken

Answer 24

Abdominal effusion may be found at presentation in cats with urethral obstruction.

A single decompressive cystocentesis prior to catheterization did not lead to development of clinically significant abdominal effusion or other discernable complications and appears to be a safe procedure in this population of patients.

Question 25

Associations between increased body condition score, bodyweight, age and breed with urethral obstruction in male castrated cats VEt J 2019 Jukes

Answer 25

Incidence rate ratios increased with age to 2 to 4years
The incidence rate of urethral obstruction did increased with BCS

Question 26

Radiographic diagnoses in 80 cats before and 73 cats after unobstructing the urethra JSAP 2021 Young

Answer 26

Radiographs obtained before unobstructing the urethra provided a diagnostic advantage for detecting a cause for urethral obstruction compared to radiographs obtained after unobstructing the urethra. Urethral plugs were the most common diagnosis.

Question 27

Incidence of bacteriuria at presentation and resulting from urinary catheterization in feline urethral obstruction 2019 JVECC Cooper

Answer 27

No urine cultures yielded growth at presentation (0/34).
The overall incidence of acquired bacteriuria was found to be 13% and could represent a transient bacterial population or true bacterial urinary tract infection.

Question 28

A prospective randomized, double-blinded clinical study evaluating the efficacy and safety of bupivacaine versus morphine-bupivacaine in caudal epidurals in cats with urethral obstruction JVECC 2020

Answer 28

Caudal epidural appears to be safe, may reduce the amount of IV anesthesia needed to facilitate urinary catheterization, and can be used to provide long-term analgesia in the hospital.

Question 29

Clinical outcomes of 28 cats 12-24 months after urethrostomy Sousa-Filho JFMS 2020

Answer 29

A proportion of cats that underwent urethrostomy showed bacteriuria, recurrent UTIs and increased levels of SDMA.
prepubic urethrostomy - potential for recurrent complications and lower owner satisfaction.

Question 30

Effect of urinary bladder lavage on in-hospital recurrence of urethral obstruction and durations of urinary catheter retention and hospitalization for male cats Dorsey JAVMA 2019

Answer 30

urinary bladder lavage at the time of urethral catheterization had no significant effect on in-hospital recurrence rate of the condition, duration of urinary catheter retention, or duration of hospitalization;

Question 31

Welfare of cats 5-29 months after perineal urethrostomy: 74 cases (2015-2017) Slater 2020 JFMS

Answer 31

QOL after PU surgery was reported to be very good.

Question 32

Comparison of surgical indications and short- and long-term complications in 56 cats undergoing perineal, transpelvic or prepubic urethrostomy Seneviratne JFMS 2021

Answer 32

PU was the most common feline urethrostomy technique indicated.
Short-term urethrostomy complications are common, irrespective of the urethrostomy technique. Long-term complications are less frequent but more common with PPU (short-term dermatitis and long-term incontinence)
good QOL after surgeries.

Question 33

A specific immunoassay for detection of feline kidney injury molecule 1
Bland 2019 JFMS

Answer 33

reliminary results show marked though transient increases in cats with sepsis and urethral obstruction-associated AKI, and expression in injured tubules.

Question 34

Retrospective analysis of diagnoses and outcomes of 45 cats with micturition disorders presenting as urinary incontinence JVIM 2020 Lonc

Answer 34

Incontinent cats with spinal cord disorders were common and warrant a more guarded prognosis than do cats with bladder or urethral disorders

Question 35

Kidney injury molecule-1 and urinary gamma-glutamyl transferase as biomarkers of acute kidney injury in cats JSAP 2022 Junior

Answer 35

Cats with post-renal obstruction and potential intrinsic renal damage had higher urinary gamma-glutamyl transferase index than healthy cats at the time of presentation and showed increase in kidney injury molecule-1/urinary creatinine ratio over time.

Question 36

Treatment and outcomes of ureter injuries due to ovariohysterectomy complications in cats and dogs JSAP 2020 Plater

Answer 36

A key indicator of a ureteric injury is an animal failing to recover normally or becoming unwell shortly after ovariohysterectomy. Anuria is likely in animals with bilateral ureter injury. Excellent outcomes are possible following surgical treatment.

Question 37

Evaluation of preoperative ultrasonographic parameters to predict renal recovery in long-term survivors after treatment of feline ureteral obstructions: 2012-2019
JFMS 2022 Mc Entee

Answer 37

In this study, long-term renal function based on preoperative ultrasound imaging findings could not be predicted in cats with unilateral ureteral obstruction, regardless of the severity of the biochemical parameters, renal pelvic dilation (large or small pelvis), kidney size or thickness of renal parenchyma assessed.

Question 38

Urolithiasis in dogs: Evaluation of trends in urolith composition and risk factors (2006-2018) JVIM 2021 Kopecny

Answer 38

Although calcium oxalate- and struvite-containing uroliths continue to be the most common uroliths submitted from dogs, a decrease in the proportion of CaOx-containing uroliths and an increase in the proportion of cystine-containing uroliths occurred during the time period evaluated.
Age, breed, and sex predispositions for uroliths were similar to those previously identified.

Question 39

Risk factors for urinary bacterial growth in dogs with congenital portosystemic shunts: 66 cases (1997-2019) JSAP 2021 TInoco-NAjera

Answer 39

Clinical and subclinical bacteriuria can occur in dogs with congenital portosystemic shunts. In this group of dogs, bacteriuria was a risk factor for urinary bacterial growth

Question 40

Association between hyperlipidemia and calcium oxalate lower urinary tract uroliths in dogs JVIM 2022 Paulin

Answer 40

Serum lipid screening in dogs diagnosed with CaOx uroliths might be recommended to improve their medical staging and management.

Question 41

Hepatic leptospiral infections in dogs without obvious renal involvement McCallum 2019 JVIM

Answer 41

The presence of hepatic leptospiral organisms may be associated with chronic granulomatous hepatitis without clinical evidence of renal involvement

Question 42

Effect of telmisartan, angiotensin-converting enzyme inhibition, or both, on proteinuria and blood pressure in dogs

Answer 42

In comparison to group ACEi alone, combination treatment of an ACEi with TEL significantly reduced systolic blood pressure by 13 mm Hg.
Angiotensin-converting enzyme inhibitor + TEL in comparison to ACEi alone showed significant reduction in UPC of 2.5.
The UPC of group ACEi + TEL was significantly lower in comparison to TEL alone by 3.8.