Does blood contamination of urine compromise interpretation of the urine protein to creatinine ratio in dogs?

AIMS: To determine the effect of contamination of urine with 0–5% blood, varying in haematocrit and protein concentrations, on the urine protein to creatinine ratio (UPC) in dogs, and to determine whether the colour of urine can be used to aid interpretation of UPC results.

METHODS: Urine samples were collected by free catch from 18 dogs, all of which had UPC?<0.2. Venous blood samples were also collected from each dog, and the blood from each dog was added to its own urine to produce serial concentrations of 0.125–5% blood. The colour of each urine sample was recorded by two observers scoring them as either yellow, peach, orange, orange/red or red. Protein and creatinine concentrations were determined, and dipstick analysis and sediment examination was carried out on each sample. Based on colour and dipstick analysis, samples were categorised as either having microscopic, macroscopic or gross haematuria. A linear mixed model was used to examine the effect of blood contamination on UPC.

RESULTS: The uncontaminated urine of all 18 dogs had a UPC?<0.2. Adding blood to the urine samples resulted in an increase in UPC at all contamination concentrations compared to the non-contaminated urine (p<0.001). None of the 54 samples with microscopic haematuria had UPC?>0.5. For 108 samples with macroscopic haematuria the UPC was >0.5 in 21 samples (19.4 (95% CI=13.1–27.9)%), and for 54 samples with gross haematuria 39 (72 (CI=59.1–82.4)%) had a UPC?>0.5. No samples had a UPC?>2.0 unless the blood contamination was 5% and only 3/18 (17%) samples at this blood contamination concentration had a UPC?>2.0.

CONCLUSIONS AND CLINICAL RELEVANCE: This study showed that while blood contamination of ≥0.125% does increase the UPC, if the urine remains yellow (microscopic haematuria), then there is negligible chance that a UPC?>0.5 will be solely due to the added blood. In that scenario, attributing the proteinuria present to the haematuria in the sample would be inappropriate. However blood contamination that results in discolouration of the urine sample from yellow (indicating macroscopic or gross haematuria) could increase the UPC above the abnormal range and would need to be considered as a differential for the proteinuria. Thus knowledge of urine colour, even if limited to simple colour scores (yellow, discoloured, red) could be utilised to aid interpretation of the UPC in samples with haematuria.     

Can malignant and inflammatory pleural effusions in dogs be distinguished using computed tomography?

Computed tomography (CT) is the primary imaging modality used to investigate human patients with suspected malignant or inflammatory pleural effusion, but there is a lack of information about the clinical use of this test in dogs. To identify CT signs that could be used to distinguish pleural malignant neoplasia from pleuritis, a retrospective case‐control study was done based on dogs that had pleural effusion, pre‐ and postcontrast thoracic CT images, and cytological or histopathological diagnosis of malignant or inflammatory pleural effusion. There were 20 dogs with malignant pleural effusion (13 mesothelioma, 6 carcinoma; 1 lymphoma), and 32 dogs with pleuritis (18 pyothorax; 14 chylothorax). Compared to dogs with pleuritis, dogs with malignant pleural effusions were significantly older (median 8.5 years vs. 4.9 years, P = 0.001), more frequently had CT signs of pleural thickening (65% vs.34%, P = 0.05), tended to have thickening of the parietal pleura only (45% vs. 3%, P = 0.002) and had more marked pleural thickening (median 3 mm vs. 0 mm, P = 0.03). Computed tomography signs of thoracic wall invasion were observed only in dogs with malignant pleural effusions (P = 0.05). There were no significant differences in pleural fluid volume, distribution or attenuation, degree of pleural contrast accumulation, amount of pannus, or prevalence of mediastinal adenopathy. Although there was considerable overlap in findings in dogs with malignant pleural effusion and pleuritis, marked thickening affecting the parietal pleural alone and signs of thoracic wall invasion on CT support diagnosis of pleural malignant neoplasia, and may help prioritize further diagnostic testing.     

How often do veterinarians assess the bodyweight and body condition of dogs?

Measurements of bodyweight and body condition are useful for monitoring the state of health of companion animals, but the frequency with which they are used by veterinarians in general practice is not known. Information derived from 148 dogs was analysed to determine how often their bodyweight and body condition had been assessed. Bodyweight had been measured at least once in 103 (70 per cent) of the dogs. The median time between the measurements was 114 days (range five days to 6.8 years), and the median number of consultations per measurement was four (range one to 44). Body composition had been assessed subjectively in 43 (29 per cent) of the dogs. The median time between the assessments was 216 days (21 days to 6.26 years) and the median number of consultations per assessment was seven (two to 43). A recognised body condition score had been assessed in only one dog on one occasion.     

Does the tumour microenvironment alter tumorigenesis and clinical response in transmissible venereal tumour in dogs?

The canine transmissible venereal tumour (CTVT) is a transmissible cancer that is spread naturally between dogs, with the ability to develop and evade the immune system, despite strict immune surveillance of the host. Furthermore, molecular signalling between cells of the immune system and the tumour microenvironment appear to influence the behaviour and development of the tumour. Thus, this study aimed to quantify the expression of genes related to the immune system such as IL‐6, IFN‐γ, and TGF‐β, as well as angiogenic factors (VEGF, CXCR4), in CTVT cells in vivo and in vitro (primary culture), correlating with the clinical response of the animals treated with vincristine. As expected, the most prevalent subtype was plasmacytoid cells, although lymphocytic cells were also found, indicating the possibility of polyclonality. When we compared the gene expressions of IFN‐γ and IL‐6, we mostly found low expression, concluding that MHC expression was probably not occurring in tumour cells, and no activation of immune cells to eliminate the tumour. The TGF‐β gene was normal in the majority of animals but demonstrated decreased expression in vincristine resistant animals, leading to the hypothesis that the concentration of tumour‐derived TGF‐β was affecting and even suppressing the real TGF‐β expression, favouring tumour proliferation and progression in these cases. VEGF expression was extremely high, demonstrating its angiogenic role in tumour growth, while CXCR4 was decreased, possibly because of CTVT’s low metastatic potential. Thus, we concluded that the tumour microenvironment, together with the immune system of the host, influences CTVT, presumably altering its tumorigenesis and the animal’s clinical response to treatment.     

Is there a link between bacteriuria and a reversible encephalopathy in dogs and cats?

Bacteriuria has been associated with abnormal neurological status in humans, especially geriatric patients. In this report, we review 11 cases (seven dogs and four cats) that suggest an association between bacteriuria and abnormal neurological status in veterinary medicine. These cases showed diffuse forebrain signs with or without brainstem signs, but primary brain disease was excluded by MRI and cerebrospinal fluid analysis. Bacteriological culture of urine was positive in each animal and neurological deficits improved or resolved with initiation of antibiosis ± fluid therapy and levetiracetam. While further studies are needed to definitively confirm or refute the link between bacteriuria and a reversible encephalopathy, urine bacteriological culture should be considered in veterinary patients presented with acute onset forebrain neuro-anatomical localisation, even in the absence of clinical signs of lower urinary tract inflammation.     

Does the A-line ARX-lndex provide a reasonable assessment of anaesthetic depth in dogs undergoing routine surgery?

The monitoring of anaesthetic depth is usually based on the subjective assessment of the patient. An objective assessment of anaesthesia has only recently become possible. The auditory-evoked response has predictable changes in response to increasing doses of anaesthetic agents. Recent advances have brought about a regression model with exogenous input of the auditory-evoked response, the A-line ARX-Index (AAI Index). The AAI Index is a dimensionless number between 0 and 100. This technology has been incorporated into the AEP (auditory-evoked potential) monitor that is utilised to assess anaesthetic depth in humans. This study was undertaken to determine if the AEP monitor was useful in dogs. Ten dogs were enrolled in the study. After a full clinical and otoscopic examination, dogs were premedicated with acetylpromazine and morphine. Anaesthesia was induced with thiopentone and maintained with halothane. End-tidal carbon dioxide, temperature, pulse oximetry, blood pressure and the electrocardiogram were monitored and recorded every 5 minutes. Anaesthetic depth was assessed as either being adequate or inadequate by the anaesthetist during surgery. An AEP monitor was attached to the patient and automatically collected AAI Index data. The anaesthetist was blinded to the AEP monitor. Following the completion of the surgical procedure, the patient was allowed to wake up with the AEP monitor attached. The AAI Index was analysed to compare adequate with inadequate anaesthesia during the period of surgery and awake with sleep data during recovery. All AAI Index values associated with inadequate anaesthesia were greater than 31 while adequate values were less than 35. The difference between the groups was statistically significant and the power was 0.97. Statistically, the awake and sleep values were significantly different with a power of 0.99. From this study it can be concluded that the AAI Index shows good prospect for the evaluation of anaesthetic depth in dogs undergoing surgery. A larger study is needed to confirm these results.     

What is the definition of intraoperative hypotension in dogs? Results from a survey of diplomates of the ACVAA and ECVAA

ObjectiveDetermine arterial blood pressure range that diplomates of the American College of Veterinary Anesthesia and Analgesia (ACVAA) and European College of Veterinary Anaesthesia and Analgesia (ECVAA) use to define intraoperative hypotension in dogs and identify the threshold values used for intervention.Study designSurvey of veterinary anesthesia specialists.PopulationDiplomates of the ACVAA and ECVAA.MethodsACVAA and ECVAA diplomates (n=313) were invited to participate in an Internet-based survey regarding anesthetized healthy dogs undergoing two types of procedures (diagnostic or surgical).ResultsThere were 151 respondents to the survey; 70.2% were ACVAA diplomates and 29.8% were ECVAA diplomates. The majority of the respondents (70.9%) worked in academia while the others were in private practice (19.2%), or research, diagnostic or pharmaceutical fields (9.9%). Hypotension was defined (mean ± SD) by the respondents as systolic arterial blood pressure (SAP) <87 ± 8 mmHg for surgical cases and <87 ± 6 mmHg for diagnostic cases, or mean arterial pressure (MAP) <62 ± 4 mmHg for both types of cases. Arterial pressures reported to prompt treatment were SAP 85 ± 13 mmHg or MAP 61 ± 4 mmHg in surgical cases, and SAP 84 ± 11 mmHg or MAP 63 ± 8 mmHg in diagnostic cases.Conclusions and clinical relevanceThere was agreement between ACVAA and ECVAA diplomates on the definition of intraoperative hypotension in dogs during anesthesia. The blood pressures used to define hypotension were similar to the pressures that would prompt diplomates to start treatment. Readers could infer that diplomates define hypotension as a clinical condition that requires treatment at the time of diagnosis.     

Relationship between latency of brainstem auditory‐evoked potentials and head size in dogs

Summary

Cranium and brainstem dimensions were measured in 32 postmortem dog heads. Positive correlations were found between cranium length (CL) and brainstem length (BL) (r=0.87), between cranium width (CW) and brainstem width (BW) (r=0.83), and between cranium distance (CD = CL CW/2) and brainstem distance (BD = BL+BW/2) (r=0.91). Positive correlation coefficients were also found between CL and CW (r=0.90), and between BL and BW (r=0.85). It was concluded that head size accurately reflected brainstem size. A least squares estimation of the brainstem distance (BD) from CL and CW values was BD = 10.9 + 0.16 (CL CW/2) (BD, CL and CW in mm).

Brainstem auditory evoked potentials (BAEPs) and cranium dimensions were measured in 43 dogs (86 ears) with different head size, body size, sex and age. Wave form, absolute and interpeak latencies and correlation coefficients, relating latencies to cranium dimensions and body weight, were analysed CL, CW, and CD were positively correlated with body weight (r=0.93, 0.70 and 0.93, respectively), and CL, CW, and CD were correlated with age (r=0.33, 0.52 and 0.40, respectively). BAEPs consisted of five distinct positive peaks (I to V). Secondary positive peaks following peaks I and II were seen in 60% (I') and 90% (II') of the recordings. Late waves were recorded in 90% (VI), 50% (VII), and 25% (VIII) of the recordings. Latencies increased with decreasing stimulus intensity level (from 90 dB to 10 dB hearing level, HL),especially for peaks I, II, V, and the I‐V interpeak interval Absolute and interpeak latencies were positively correlated with cranium distance and body weight. Correlation coefficients increased as wave latencies increased At 90 dB HL, the highest correlation coefficients, relating cranium distance to peak V and the I‐V interpeak latency, were 0.55 and 0.53 (P < 0.00001), respectively. Regression analysis showed that each 1 cm increase in cranium distance was accompanied by an increase of 0.006 ms in the latency of wave I, 0.03 ms for wave III, 0.05 ms for wave V, and 0.05 ms for the I‐V interpeak interval Regression analysis showed that an increase of 1 kg in body weight was accompanied by an increase of 0.001 ms in the latency of wave I, 0.005 ms for wave III, 0.011 ms for wave V, and 0.01 ms for the I‐V interpeak interval. It is concluded that head size, which accurately reflects brain size, is a relevant source (25%) of intersubject variance of BAEP latencies in the dog.     

Toxocara eggs shed by dogs and cats and their molecular and morphometric species-specific identification: is the finding of T. cati eggs shed by dogs of epidemiological relevance?

Intestinal infections with Toxocara cati and Toxocara canis in their definitive host (felids and canids, respectively) are diagnosed by egg identification in faeces using coproscopical techniques. The Toxocara species is assumed to comply with the species from which the examined faeces were obtained, i.e. T. cati in cats and T. canis in dogs. We isolated and measured Toxocara eggs from faecal samples of 36 cats and 35 dogs from Switzerland and identified the Toxocara species by PCR. Amongst the isolates originating from dogs, 24 (68.5%) were determined as T. canis and 11 (31.5%) as T. cati. In all samples originating from cats, only T. cati was identified. Based on PCR identification, eggs of T. canis (n=241) and T. cati (n=442) were measured, revealing statistically significant different (p<0.001) mean sizes of 62.3 by 72.7 μm for T. cati and 74.8 by 86.0 μm for T. canis eggs. Considering that coprophagy is not unusual for dogs, a considerable percentage of Toxocara infections coproscopically diagnosed in dogs, as well as assumptions on anthelminthic resistance in regularly treated dogs, might in fact relate to intestinal passages of eggs following the uptake of other animals' faeces.