EFFECTS OF MEASUREMENT OF PLASMA ACTIVITY INPUT ON NORMALIZATION OF GLOMERULAR FILTRATION RATE TO PLASMA VOLUME IN DOGS

Glomerular filtration rate (GFR) normalized to body fluid volumes to adjust for differing body size and conformation is more physiologically correct than a relationship with body weight (BW). GFR can be normalized to plasma volume by a renographic method that uses the Rutland-Patlak plot with plasma activity and kidney activity inputs. A plasma time-activity curve is obtained from a region of interest (ROI) of the left ventricle (LV), the size of which is in theory not critical. The aims of the study were to evaluate the effect of different LV ROI sizes, the effect of extravascular activity in the thorax over the LV ROI, and different time intervals for the semilogarithmic LV plot. Seventy-two scintigrams were used, with three different-sized automatic and a manual LV ROI, all with and without subtracting extravascular activity, and with LV curve time intervals of 30-120 s and 60-240 s. GFR/plasma volume was not affected by LV ROI sizes but significantly affected by extravascular activity subtraction and different time intervals. Subtracting extravascular activity from the LV ROI did not improve precision, but increased variability caused by different LV ROI sizes and time intervals chosen for the LV plot. The ROI for measuring extravascular activity apparently contained a considerable and variable intravascular component, which when subtracted, created noisy and unreliable LV curves. Manual LV ROI, without extravascular subtraction, and a time interval for LV input between 1 and 4 min are recommended as they gave the least variability determined by statistical analysis. With these methods, normal individual GFR/plasma volume in normal beagle dogs was 29.2 +/- 6.5 ml/min/l.     

THE EFFECT OF A COMBINATION OF MEDETOMIDINE-BUTORPHANOL AND MEDETOMIDINE, BUTORPHANOL, ATROPINE ON GLOMERULAR FILTRATION RATE IN DOGS

The effects of intramuscularly administered medetomidine and butorphanol (MB), and medetomidine, butorphanol, atropine (MBA) on glomerular filtration rate (GFR) were determined in six dogs as measured by 99m-Tc-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA) nuclear scintigraphy. Direct systolic, diastolic, and mean arterial blood pressures and heart rate were measured at regular time intervals before, during, and after GFR calculations. The mean GFR measurement following MB was significantly greater (4.44 ml/min/kg) than following MBA (3.82 ml/min/kg) or saline treatment (3.41 ml/min/kg). There was no significant difference between the mean GFR measurements following MBA injection and following saline injection. Diastolic and mean arterial pressures following MBA injection were significantly higher than the values recorded after either MB or saline alone. Heart rate following MB administration was significantly lower than that recorded for dogs receiving MBA or saline alone. The results of this study indicate that the administration of medetomidine in combination with butorphanol significantly increases total GFR in healthy dogs, while the administration of the combination of medetomidine, butorphanol, and atropine does not.     

EFFECT OF REGION OF INTEREST SELECTION AND UPTAKE MEASUREMENT ON GLOMERULAR FILTRATION RATE MEASURED BY 99mTc-DTPA SCINTIGRAPHY IN DOGS

Determinations of different methods of measurement of uptake of 99mTc-DTPA using scintigraphy of glomerular filtration rate (GFR) were made from 29 studies on 10 healthy beagle dogs. GFR was measured by calculating the percentage dose uptake (integral method) and rate of uptake (slope method) of 99mTc-DTPA using manual kidney regions of interest (ROI) and automatic kidney and background ROIs at different time periods of the uptake phase. These results were compared using linear regression analysis to the GFR obtained from 99mTc-DTPA plasma clearance using multiple blood samples. The best correlation coefficient between percentage DTPA uptake and GFR by DTPA clearance (r = 0.84, P < 0.001) was derived from time intervals between 30s-120s with a perirenal background ROI at 1 or 2 pixels out from the kidney ROI using automatic kidney ROI at 20% threshold. With the slope method, the best correlation coefficient (r = 0.85, P < 0.001) was obtained from time intervals between 30s-peak with the background ROI at 2 pixels out from the kidney ROI using automatic ROI at 35% threshold. The offset was higher, and the correlation varied more with different ROIs and the method was unreliable at time intervals extending beyond the peak radioactivity. Manual kidney ROIs with automatic background ROIs had slightly lower correlations. With DTPA renography both integral and slope uptake method with automatic kidney and background ROIs are accurate methods to estimate the GFR, but that the integral method is much more stable to variations in ROI size and the duration of the uptake phase of the renogram.     

EVALUATION OF 99MTC-DIETHYLENETRIAMINEPENTAACETIC ACID RENAL SCINTIGRAM CURVES IN NORMAL DOGS AFTER INDUCTION OF DIURESIS

The normal 99mTc-diethylenetriaminepentaacetic acid (DTPA) renal scintigram curve has 3 distinct phases; an arterial phase followed by progressive uptake and subsequent excretion from the kidney. In dogs with X-linked hereditary nephritis, a distinct flattening of the renal scintigram curve has been observed prior to any decline in glomerular filtration rate (GFR). The cause of this shape change is not known, however, it coincided with decreased urine-specific gravity and thus might be related to polyuria. To further evaluate this possibility, we assessed whether diuresis without concurrent renal disease could flatten the 99mTc-DTPA renal scintigram curve. GFR scintigraphy was performed in six healthy dogs once as a baseline, and again after induction of diuresis by each of four different methods. Scintigram curves were evaluated subjectively as well as quantitatively by calculation of GFR estimates, mean renal transit times, time to peak activity and half-time clearance. Complete flattening of the renal scintigram curve did not occur with diuresis alone, and therefore, flattening of the scintigram curve may serve as an early indicator of renal dysfunction. However, during diuresis after intravenous saline administration, alterations in time to peak activity and mean renal transit time may create inaccuracies in GFR estimates based on the conventional regression formula that cause a false lowering of the resultant global GFR value.     

DIURETIC RENAL SCINTIGRAPHY IN NORMAL DOGS

Diuretic renal scintigraphy is commonly used in human medicine to differentiate obstructive from nonobstructive pyelectasia. In order to determine normal parameters, 99mTc-DTPA renal scintigraphy was performed twice in 20 healthy adult Mongrel dogs. Each dog was injected with either 3.0 mg/kg furosemide or an equivalent volume of saline 4.5 min following injection of the radiopharmaceutical. The following parameters were evaluated: (1) global and individual glomerular filtration rate (GFR); (2) time of peak (TOP) of the time-activity curve (TAC); (3) shape of the TAC; (4) individual kidney excretion half-time (T1/2); (5) proportion of maximum activity measured at end of study (8 min); (6) time of onset; and (7) duration of the effect of the diuretic. Most TAC in the diuretic renography group showed a steep drop in the curve following administration of the diuretic compared with a gradual slope in the saline control group. There was a statistically significant difference in T1/2 between the control renograms (median 10.25 min, range 4.41-18.07 min) and the diuretic renograms (median 4.16 min, range 3.62-5.90 min). There was a statistically significant difference in percentage maximum activity between the control renograms (median 65.25%, range 48.27-93.68%) and the diuretic renograms (median 48.54%, range 35.64-58.76%). Median time of onset of the diuretic effect was 1.10 min (0.20-2.40 min), and median duration was 0.83 min (0.30-2.35 min).     

QUANTITATIVE AND QUALITATIVE SCINTIGRAPHIC MEASUREMENT OF RENAL FUNCTION IN DOGS EXPOSED TO TOXIC DOSES OF GENTAMICIN

Five, 3-month-old mongrel dogs weighing between 4.5 to 5.5 kg were studied to evaluate and compare the efficiency of 99mTc-DTPA, 99mTc-MAG3, and 99mTc-DMSA in detecting gentamicin-induced renal tubular injury. After baseline renograms using all three methods, all dogs received daily intramuscular injections of gentamicin at a dose of 30-45 mg/kg. Additional studies were obtained after a cumulative dose of 450, 1,575, and 2,250 mg of gentamicin was reached. Glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and percentage of total renal uptake measurements were calculated. Baseline and post-gentamicin injection blood urea nitrogen (BUN) and serum creatinine values were determined. A Duncan test revealed significant renal function impairment at 450 mgs of cumulated gentamicin with 99mTc-DMSA and at 1,575 mgs of cumulated gentamicin for 99mTc-DTPA and 99mTc-MAG3. There was no correlation between BUN and serum creatinine values when compared to gentamicin (p > 0.05). The images obtained with 99mTc-MAG3 were of better quality than those obtained with 99mTc-DTPA even under severe renal dysfunction. Percentage of 99mTc-DMSA uptake indicated renal damage, before than GFR and ERPF. BUN and serum creatinine measurements were poor indicators of gentamicin-induced renal failure.     

DETERMINATION OF GLOMERULAR FILTRATION RATE IN DOGS USING CONTRAST-ENHANCED COMPUTED TOMOGRAPHY

The purpose of this project was to establish a procedure and reference values for glomerular filtration rate (GFR) using contrast-enhanced computed tomography (CT) in eight healthy dogs. A single section of the kidney was scanned sequentially after bolus injection (3 ml/s) of iohexol (300 mg/kg). Time-attenuation curves were constructed and the GFR per volume of kidney was calculated using Patlak graphical analysis software. The GFR was then converted from contrast clearance per unit volume (ml/min/ml) to contrast clearance per body weight (ml/min/kg). Individual kidney and global GFR were calculated using both CT and nuclear scintigraphy. Global GFR for each dog was also determined by plasma iohexol clearance. Contrast-enhanced CT underestimated the global GFR compared with the other two methods. The average global GFR was 2.57 +/- 0.33 ml/ min/kg using functional CT and 4.06 +/- 0.37 ml/min/kg using plasma iohexol clearance. There was significant (P < 0.05) interobserver variability of CT GFR of the right kidney and total GFR. There was decreased interobserver variability for the left kidney. There was no difference in the intraobserver variability for CT-determined individual kidney and global GFR. There was no difference between the motion corrected and nonmotion corrected values for individual and global CT GFR. Nuclear scintigraphy produced a slightly higher coefficient of variation than contrast-enhanced CT, 2.9% and 1.0%, respectively. It is hypothesized that altered renal blood flow, hematocrit of the small vessels, and nephrotoxicity play a role in the underestimation of GFR by contrast-enhanced CT.     

EFFECTS OF HYDRATION ON SCINTIGRAPHIC GLOMERULAR FILTRATION RATE MEASURED USING INTEGRAL AND PLASMA VOLUME METHODS IN DOGS WITH SUSPECTED RENAL DISEASE

The current standard scintigraphic method for estimating glomerular filtration rate (GFR) in dogs is the integral method, which normalizes renal GFR to body weight. The plasma volume method, that is normalizing GFR to plasma volume, has been reported to be more physiologically correct. The aim of this prospective study was to test the effect of hydration status on GFR measured by these two methods in a group of dogs with suspected renal disease. Eleven dogs were recruited. All dogs underwent standardized scintigraphic examinations before and after 15 ml/kg of fluid was administered intravenously at 5–7 ml/kg/min. Individual kidney GFR estimates (n = 22) were calculated using both methods and a consensus of two observers who were unaware of clinical findings. Individual kidney GFR increased significantly (P = 0.0008) after fluid administration using the integral method and individual kidney GFR using the plasma volume method remained constant. Percentage differences for individual kidney GFR before and after fluid administration were 31.4 ± 58.1% (change ± 95% CI) for the integral method and 0.1 ± 70% (change ± 95% CI) for the plasma volume method. Intravenously administered fluid increased individual kidney GFR from low to normal in 10 of 22 kidneys using the integral method and in 1 of 22 kidneys using the plasma volume method. Findings supported the use of the plasma volume method for scintigraphic calculation of GFR in dogs with suspected renal disease and indicated that errors of kidney status classification may more likely occur when the integral method is used.     

DIURETIC RENAL SCINTIGRAPHY IN NORMAL CATS

The purpose of this study was to develop a protocol for diuretic renal scintigraphy (renography) in cats and describe normal findings. ^99mTc‐DTPA renal scintigraphy was performed twice in 10 healthy cats. Furosemide or saline were injected 4.5 min after radiopharmaceutical administration for the diuretic or control scan, respectively. A dynamic acquisition was performed for 8 min. The following parameters were evaluated: (1) global and individual glomerular filtration rate (GFR); (2) shape of the time–activity curve (TAC); (3) time of peak (TOP); (4) individual kidney excretion half‐time (T_1/2) of the radiopharmaceutical; (5) percentage of maximum activity measured at the end of the study. Global GFR in the control studies (2.79±0.83 ml/min/kg, mean±SD) did not differ significantly from the diuretic scans (2.34±0.51 ml/min/kg). The shape of most (16/20) TAC of diuretic renograms was similar to those of control renograms. The TOP of the diuretic renogram curves was 3.06±0.58 min, and did not differ from that of the control scans (3.01±0.61 min). T_1/2 of the diuretic renograms was significantly shorter (5.15±0.83 min) than that of the control renograms (6.31±1.50 min). A significantly lower percentage of maximum activity was present at the end of the study in diuretic renograms (median: 47.25%; range: 33.60–59.60%) compared with control renograms (63.40%; 30.00–69.40%). Diuretic renal scintigraphy is a noninvasive and fast procedure to perform in cats. The applicability of this technique needs to be investigated in patients with significantly impaired renal function and obstructive uropathies.     

COMPARISON BETWEEN THE SCINTIGRAPHIC UPTAKE AND PLASMA CLEARANCE OF 99mTc-DIETHYLENETRIAMINEPENTACETIC ACID (DTPA) FOR THE EVALUATION OF THE GLOMERULAR FILTRATION RATE IN DOGS

The scintigraphically measured percentage dose uptake of ^99mTc-DTPA by the kidneys and the plasma clearance of ^99mTc-DTPA have been reported to correlate well with inulin clearance. These two parameters were evaluated in seven dogs with known or suspected naturally occurring renal disease and compared to simultaneously measured renal inulin clearance. Correlation between inulin clearance and the ^99mTc-DTPA plasma clearance was better ( p =.0016) than the correlation between the percentage DTPA uptake by the kidney. It was concluded that measurement of ^99mTc-DTPA plasma clearance is a more accurate method to estimate global glomerular filtration rate (GFR) than the percentage kidney uptake.     

EVALUATION OF RENAL HEMODYNAMICS IN AWAKE AND ISOFLURANE-ANESTHETIZED CATS WITH PULSED-WAVE DOPPLER AND QUANTITATIVE RENAL SCINTIGRAPHY

The feasibility and reproducibility of obtaining the pulsed-wave Doppler measurements of resistive index (RI) and pulsatility index (PI) were investigated in intrarenal arteries of normal, nonsedated cats, and cats anesthetized with isoflurane. In addition, relative renal function and relative renal blood flow were evaluated using quantitative renal scintigraphy. The percentage of injected dose uptake, time to peak activity, and two indices of renal blood flow (K/A ratio and flow index) obtained during the first pass of ^99mTc-MAG₃, were determined for both awake and anesthetized cats. Results indicate that measuring RI and PI in nonsedated cats is readily accomplished and that the results are reproducible within an animal. Mean RI and PI values in the awake cats were 0.55 and 0.8, respectively. Significant differences between the awake and anesthetized cats were found for all pulsed-wave Doppler and quantitative renal scintigraphic measurements evaluated.     

CLINICAL SIGNIFICANCE OF RENAL PELVIC DILATATION ON ULTRASOUND IN DOGS AND CATS

Renal pelvic dilatation is often recognized sonographically in dogs and cats, but ranges of measurements expected with different urologic conditions remain unknown. Ultrasound images of 81 dogs and 66 cats with renal pelvic dilatation were reviewed, and six groups were formed based on medical records: (I) clinically normal renal function, and (II) clinically normal renal function with diuresis; (III) pyelonephritis; (IV) noninfectious renal insufficiency; (V) outflow obstruction; (VI) miscellaneous nonobstructive anomalies. Medians for maximal pelvic width (range) for group I was 2.0 mm (1.0–3.8) in 11 dogs, and 1.6 mm (0.8–3.2) in 10 cats; for group II, 2.5 mm (1.3–3.6) in 15 dogs, and 2.3 mm (1.1–3.4) in 16 cats; for group III, 3.6 mm (1.9–12.0) in nine dogs, and 4.0 mm (1.7–12.4) in seven cats; for group IV, 3.1 mm (0.5–10.8) in 33 dogs, and 2.8 mm (1.2–7.3) in 13 cats; for group V, 15.1 mm (5.1–76.2) in six dogs, and 6.8 mm (1.2–39.1) in 17 cats; and for group VI, 3.8 mm (1.2–7.6) in seven dogs, and 3.0 mm (1.3–7.5) in three cats. Pelvic width in group I was lower than in groups III–V (P=0.0001), but did not significantly differ from group II. Pelvic width ≥13 mm always indicated obstruction. While the proportion of bilateral pelvic dilatation was not different among groups, the difference in pelvic width (maximal–minimal) was greater in group V vs. groups I, II, and IV (P=0.0009). These results confirm that renal pelvic dilatation can be detected sonographically in dogs and cats with clinically normal renal function, and that it increases with renal insufficiency, pyelonephritis, or outflow obstruction. Nevertheless, renal pelvic width varies substantially within groups and should be interpreted with caution.     

THE EFFECTS OF A UNILATERAL ULTRASOUND-GUIDED RENAL BIOPSY ON RENAL FUNCTION IN HEALTHY SEDATED CATS

Complications of renal biopsies are well documented except for the change in renal function after a biopsy. Eighteen healthy, adult cats were divided into two groups (n = 9 cats/group). For the measurement of global and split renal function, Group 1 used the renal uptake of 99mTc-DTPA and Group 2 used the renal uptake of 99mTc-MAG3. Scintigraphic data were collected on days (-4), (-3), 0, 1, 2, and 4 post renal biopsy. Using ultrasound guidance, biopsies were taken from the right renal cortex on dO, before acquiring scintigraphic images. P - values less than 0.10 were considered significant due to the limited number of observations. The only statistically significant change (p = 0.08) in global renal function detected was by day following a unilateral renal biopsy. Cats imaged using 99mTc-MAG3 had discernible liver activity. A unilateral, ultrasound guided renal biopsy has minimal effect on renal function in normal, healthy sedated cats.     

PRELIMINARY EVALUATION OF 99mTECHNETIUM DIETHYLENETRIAMINE PENTAACETIC ACID, 99mTECHNETIUM DIMERCAPTOSUCCINIC ACID, AND 99mTECHNETIUM MERCAPTOACETYLTRIGLYCINE FOR RENAL SCINTIGRAPHY IN CORN SNAKES (ELAPHE GUTTATA GUTTATA)

The efficacy of three radiopharmaceuticals, 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA), 99mTc-dimercaptosuccinic acid (99mTc-DMSA), and 99mTc-mercaptoacetyltriglycine (99mTc-MAG3), for renal imaging was examined in 16 corn snakes (Elaphe guttata guttata). All snakes received the radiopharmaceutical via an intracardiac injection. The kidneys could not be visualized in the three snakes that received 99mTc-DTPA or in the three snakes that received 99mTc-DMSA, but were well delineated in all 10 snakes receiving 99mTc-MAG3. These snakes were anesthetized and a dynamic frame mode acquisition was obtained for 30 min immediately following injection. A 60 s single static frame mode image was then obtained with the snake in a curled position. Two of the 10 snakes that received 99mTc-MAG3 were removed from further analysis because of suspected pericardial injections. Of the remaining eight snakes, the mean (+/- SD) renal uptake was 25 +/- 9.8% or 24 +/- 9.7%, with or without correction for residual injection site activity, respectively. Correction for remaining radioactivity in the heart does not appear to be necessary if it is less than 10% of the total dose. 99mTc-MAG3 provided consistently high quality images of the kidneys and further studies are warranted to evaluate its sensitivity for detecting decreased function in snakes with renal disease.     

RENAL NUCLEAR MEDICINE: A REVIEW

Renal nuclear medicine is used to evaluate renal function and morphology. Renal scintigraphy is the best imaging modality for evaluation of functional parameters such as glomerular filtration rate and effective renal plasma flow. The commonly used renal radiopharmaceuticals are reviewed. Both imaging and non-imaging techniques are presented. Specific applications of renal nuclear medicine are discussed.     

DETERMINATION OF TIME OF ONSET AND LOCATION OF EARLY SKELETAL LESIONS IN YOUNG DOGS EXPERIMENTALLY INFECTED WITH HEPATOZOON AMERICANUM USING BONE SCINTIGRAPHY

Canine hepatozoonosis caused by Hepatozoon americanum has periosteal proliferation on long bones, pelvis, vertebrae, and skull. The pathogenesis of the periosteal proliferation is unknown but may be similar to hypertrophic osteopathy. Objectives were to determine the time frame for onset of bone lesions, to characterize spatial distribution of early bone lesions, and to describe the scintigraphic appearance of bone lesions in six immature dogs infected with 400 H. americanum oocysts on day 0. 99mTc-MDP bone scintigraphy was performed before and after infection. The onset bone lesions noted using scintigraphy was before day 35/36 in three dogs, day 46 in one dog, day 53 in one dog, and between days 46 and 67 in one dog. Early bone lesions primarily occur proximal to the carpus/tarsus and on the axial skeleton. Bone lesions were diffuse, bilaterally symmetric, homogenous, high intensity regions of radiopharmaceutical uptake.     

EFFECT OF ANISOTROPY AND SPATIAL COMPOUND IMAGING ON RENAL CORTICAL ECHOGENICITY IN DOGS

The echogenicity of the renal cortex is an important parameter to consider in dogs that are suspected to have renal dysfunction. Focal increases in echogenicity have been attributed to neoplasia, infection, calcification, fibrosis, gas, and infarction. Anisotropic backscatter has been described as a source of focally increased renal cortical echogenicity in several species. The source of anisotropy appears to be the medullary rays, which are oriented perpendicular to the renal capsule. Spatial compound imaging (SCI) is an ultrasound setting that uses beam steering to acquire and average several overlapping scans of an object from different view angles, creating a compound image that is updated in real time. The impact of insonation angle and SCI on renal cortical echogenicity was evaluated ex vivo in eight kidneys from four dogs. Significant angle‐dependent differences in cortical echogenicity were detected with both microconvex and linear transducers (P < 0.0001). Furthermore, the angle‐dependent echogenicity differences persisted when SCI mode was used. Our finding that echogenicity was increased using a perpendicular insonation angle (90°) relative to the tubules, compared to a parallel insonation angle (0°) should assist in the interpretation of ultrasonographic images of the dog kidney.     

VALIDATION OF DECONVOLUTIONAL ANALYSIS FOR THE MEASUREMENT OF HEPATIC FUNCTION IN DOGS WITH TOXIC-INDUCED LIVER DISEASE

The extraction of the hepatobiliary radiopharmaceutical ^99mTc-mebrofenin ( Choletec ) by the liver can be used to evaluate the severity of hepatocellular disease. The hepatic parenchymal cells extract mebrofenin from the blood by the same active transport mechanism as bilirubin. The ability of the liver to extract ^99mTc-membrofenin is a measure of hepatic parenchymal cell function. In this study, we induced hepatocellular disease by administration of a hepatotoxic drug and compared a direct method of determining the hepatic extraction of ^99mTc-membrofenin to hepatic extraction fraction derived from deconvolutional analysis. We also compared both methods of calculating the hepatic extraction of ^99mTc-membrofenin to liver histopathology. Hepatic extraction fraction derived from deconvolutional analysis correlated very well to the direct measurement technique (R=0.922, p<0.001). Both methods of determining hepatic extraction correlated well to quantitative histopathology, having the same correlation coefficient and p values. (R=-0.833, p=0.003). As the hepatic extraction ^99mTc-membrofenin decreased, the severity of the histopathologic lesions of the liver increased in a linear fashion. There was a significant correlation of the hepatic excretion T_1/2 to quantititative histopathology (R=0.949, p<0.001). The hepatic excretion T_1/2 increased as the severity of the histopathologic lesions of the liver increased. Hepatic extraction (HEF) and excretion of ^99mTc-membrofenin are good predictors of the severity of hepatocellular damage in toxic induced liver disease. This study helps validate the premise that HEF derived from deconvolutional analysis ois a good predictor of the actual first pass hepatic extraction of ^99mTc-membrofenin.     

CHANGES IN RENAL FNCTION IN CATS FOLLOWING TREAMENT OF HYPERTHYROIDISM USING131I

Changes in renal fnction of twenty-two cats treated for hyperthyrodism using radioiodine were evaluated. Serum thyroxine (T₄), serum creatinine, blood urea nitrogen (BUN) and urine specificgravity were measured before treatment and 6 and 30 days after treatment. Twenty-two cats had pretreatment and 21 cats had 6 day posttreatment measurement of glomercular filtration rate (GFR) using nuclear medicine imaging techniques. there were significant declines in serum T₄ at 6 days following treatment, but the changes in GFR, serum creatinine and BUN were not significant. At 30 days following treatment, there were significant increases in BUN and serum creatinine and further significant declines in serum T₄. Nine cats were in renal failure prior to treatment and 13 cats were in renal failure 30 days following treatment. Renal failure was defined as BUN greater than 30 mg/dl and/or serum creatinine greater than 1.8 mg/dl with concurrent urine specific gravity less than 1.035. these 13 cats included eight of 9 cats in renal failure prior to treatment on 9 of these 13 cats indicated that all remained in renal failure. Based on receiver operating curve analysis of pretreatment glomerular filtration rate (GFR) in predicting posttreatment renal failure, a value of 2.25 ml/kg/min as a point of maximum sensitivity (100%) and spefificity (78%) was derived, Fifteen of 22 cats had pretratmentGFR measurements of less than 2.25 ml/kg/min. these 15 cats included all 9 cats in renal failure and 65 cats with normal renal clinicopathologic values prior to treatment. at 30 days following treatment, 13 of these 15 cats were in renal failure. The 2 cats not in renal failure had persistently increased serum T₄ values. seven of 22 cats had pretreatment GFR measurements greater than 225 ml/kg/min. None of these 7 cats was in renal failure at 30 days following treatment, all cats having normal BUN, serum creatinine, and urine specific gravity values. It was concluded that significant declines in renal function occur after treatment of hyperthyroidism and this decline is clinically important in cats with renal disease. Pretreatment measurement of GFR is valuable in detecting subclinical renal disease and in predicting which cats may have clinically important declines in renal function following treatment.     

THE EFFECT OF INTRAVENOUS DIAZEPAM ON SOLID PHASE GASTRIC EMPTYING IN NORMAL CATS

Intravenous diazepam has been advocated as an appetite stimulant in anorexic cats. Diazepam has also been used to stimulate the intake of radiographic contrast medium-food mixture to determine the gastric emptying time of a solid meal. Diazepam has been suspected to delay gastric emptying in cats. One study found diazepam combined with Valium to have little effect on gastric transit times in cats while diazepam alone accelerates gastric emptying in humans. The purpose of this study was to determine if diazepam influences gastric emptying times in normal cats. The gastric emptying half-time of solid food in normal, non-diazepam treated cats has been previously determined using a scintigraphic technique using ^99mTc-sulfur colloid to radiolabel solid dry food. The median gastric emptying half-time was 2.3 hours and the mean meal size was 16.1 grams. Gastric emptying half-times were determined in this study using diazepam as an appetite stimulant. The median gastric emptying half-times of diazepam tratment groups given both a 16.1 gram meal and a large meal were both significantly longer than the normal non-treated group (P c 0.05). Solid phase gastric emptying is therefore significantly delayed when diazepam is used as an appetite stimulant, irrespective of the volume of the meal.