Comparison of Efficacy of Long‐term Oral Treatment with Telmisartan and Benazepril in Cats with Chronic Kidney Disease

Background

The efficacy and benefits of telmisartan in cats with chronic kidney disease (CKD) have not previously been reported.

Hypothesis

Long‐term treatment of cats with CKD using telmisartan decreases urine protein‐to‐creatinine ratio (UP/C) similar to benazepril.

Animals

Two‐hundred and twenty‐four client‐owned adult cats with CKD.

Methods

Prospective, multicenter, controlled, randomized, parallel group, blinded clinical trial with noninferiority design. Cats were allocated in a 1 : 1 ratio to either telmisartan (1 mg/kg; n = 112) or benazepril (0.5–1.0 mg/kg; n = 112) PO q24 h. The primary endpoint was prospectively defined as the change in proteinuria (benazepril:telmisartan) based on a log transformed weighted average of UP/C change from baseline (AUC 0→t/t) as a percentage compared using a confidence interval (CI) approach. Changes of UP/C from baseline were assessed on all study days and corrected for multiple comparisons.

Results

Telmisartan proved noninferior to benazepril in controlling proteinuria (CI, −0.035 to 0.268). At Day 180, UP/C compared to baseline in the telmisartan group was significantly lower (−0.05 ± 0.31; P = .016), whereas in the benazepril group the change (−0.02 ± 0.48) was not statistically significant (P = .136). Similar results were obtained at all assessment points with significant decrease in UP/C occurring with telmisartan but not benazepril.

Conclusion and Clinical Importance

Both telmisartan and benazepril were well tolerated and safe. Telmisartan proved to be noninferior to benazepril and significantly decreased proteinuria relative to baseline at all assessment points whereas benazepril did not.     

Survival and the Development of Azotemia after Treatment of Hyperthyroid Cats

Background: Hyperthyroidism complicates the diagnosis of chronic kidney disease (CKD) as it increases glomerular filtration rate. No practical and reliable means for identifying those cats that will develop azotemia after treatment for hyperthyroidism has been identified. Hyperthyroidism is associated with proteinuria. Proteinuria has been correlated with decreased survival of cats with CKD and with progression of CKD. Hypothesis: Proteinuria and other clinical parameters measured at diagnosis of hyperthyroidism will be associated with the development of azotemia and survival time. Animals: Three hundred client owned hyperthyroid cats treated in first opinion practice. Methods: Retrospective, cohort study relating clinical parameters in hyperthyroid cats at diagnosis to the development of azotemia within 240 days of diagnosis and survival time (all cause mortality). Multivariable logistic regression analysis was used to identify factors that were predictive of the development of azotemia. Multivariable Cox regression analysis was used to identify factors associated with survival. Results: Three hundred cats were eligible for survival analysis and 216 cats for analysis of factors associated with the development of azotemia. The median survival time was 417 days, and 15.3% (41/268) cats developed azotemia within 240 days of diagnosis of hyperthyroidism. Plasma concentrations of urea and creatinine were positively correlated with the development of azotemia. Plasma globulin concentration was negatively correlated with the development of azotemia. Age, urine protein : creatinine ratio, and the presence of hypertension were significantly correlated with decreased survival time. Urine specific gravity and PCV were significantly correlated with increased survival time. Conclusions and Clinical Importance: The proteinuria associated with hyperthyroidism is not a mediator of progression of CKD; however, it does correlate with all cause mortality.     

Supplementation with Calcium Salts of Linoleic and trans-Octadecenoic Acids Improves Fertility of Lactating Dairy Cows

Objectives were to evaluate effects of feeding a calcium salt rich in linoleic and trans -octadecenoic acids (LTFA) on synthesis of prostaglandin F_2α based on its metabolite (PGFM), uterine involution and pregnancy rates in lactating dairy cows. Five hundred and eleven Holstein cows were blocked according to parity, body condition score and milk yield in the previous lactation. Primiparous and multiparous cows were randomly assigned to one of the two treatments consisting of calcium salt (2% diet dry matter) of either palm oil (PO) or LTFA from 25 days prepartum to 80 days of lactation. Cows were time-inseminated at 70 ± 3 days postpartum. Feeding LTFA tended (p = 0.08) to decrease the incidence of puerperal metritis (15.1% vs 8.8%). Primiparous cows supplemented with LTFA showed larger increase in plasma PGFM concentration at day 1 postpartum (17018 vs 6897 p m ). Pregnancy rate after first insemination tended (p = 0.07) to be greater at 27 days after insemination (37.9% vs 28.6%), and was greater (p = 0.05) at 41 days after insemination (35.5% vs 25.8%) for cows fed LTFA compared with PO. These results indicate that unsaturated fatty acids fed in a rumen inert form have the potential to modulate reproductive events and improve pregnancy rates in lactating dairy cows.     

Duodenal Brunner's gland adenoma causing chronic small intestinal obstruction in a dog

An eight-year-old, neutered, female English springer spaniel was presented with a 14-month history of vomiting, marked weight loss and lethargy, all of which were non-responsive to medical therapy. Abdominal radiographs and ultrasonography showed an intraluminal soft tissue mass extending from the pyloric antrum to the proximal duodenum. Two spherical masses both approximately 8 cm in diameter were removed via a duodenotomy. Histopathological examination showed the first mass to be a trichobezoar and the aboral mass to be a Brunner's gland adenoma. Surgery resulted in a complete resolution of the clinical signs.     

Association of urinary cadmium excretion with feline hypertension

Fifty client-owned senior cats (32 normotensive and 18 hypertensive) with renal function ranging from normal to moderately reduced were recruited into a prospective cross-sectional study exploring the association of urinary cadmium excretion and hypertension in cats. Heparinised plasma samples were collected and analysed for routine biochemical parameters. Urine samples were collected via cystocentesis and were analysed for cadmium concentrations using inductively coupled plasma mass spectrometry (ICP-MS). Blood pressure was measured using the Doppler method. Urinary cadmium concentrations were indexed to urinary creatinineconcentration. Comparison of urinary cadmium excretion was made between hypertensive and normotensive cats.The median (range) urinary cadmium concentration standardised to urinary creatinine concentration (UCdCr) in the normotensive and hypertensive cats was 0.08 (0.02 to 0.37) and 0.12 (0.02 to 1.38) nmol/mmol creatinine. The UCdCr was significantly higher in hypertensive compared with normotensive cats (P=0.016). UCdCr and plasma creatinine concentration remained independent predictors of hypertensive status in a logistic regression model. UCdCr and plasma creatinine concentration were not correlated (r=-0.01, P=0.956). These data suggest cadmium exposure and accumulation in cats may play a role in the development of feline hypertension.     

Chlamydiaceae in riverine buffalo (Bubalus bubalis) and cows (Bos taurus) in Egypt with and without signs of reproductive disease

Abstract

AIMS: To obtain information and compare the prevalence of Chlamydiaceae in riverine buffalo (Bubalus bubalis) and cows (Bos taurus) in Egypt with and without clinical signs of reproductive disease.

METHODS: Vaginal swabs and blood samples were collected from animals attending Governmental Veterinary Clinics without (buffalo n=39, cows n=20) and with (buffalo n=63, cows n=53) signs of reproductive disease. Serum samples were tested for antibodies to Chlamydiaceae using complement fixation testing (CFT). Vaginal swabs were tested for Chlamydiaceae following inoculation into Vero cells and 6-day-old embryonated chicken eggs, using modified Giménez and immunoperoxidase staining, PCR analyses targeting the omp2 gene, and Restriction Fragment Length Polymorphism PCR (RFLP-PCR) for species identification.

RESULTS: Antibodies to Chlamydiaceae were detected in 30/39 (77%) and 50/63 (79%) buffalo without and with signs of reproductive disease, respectively, and 10/20 (50%) and 39/53 (74%) of cows with and without signs of reproductive disease, respectively. Positive samples from PCR analysis were identified in 31/39 (79%) and 37/63 (59%) buffalo without and with signs of reproductive disease, respectively, and 12/20 (60%) and 46/53 (89%) of cows without and with signs of reproductive disease, respectively. Using RFLP-PCR, 57/68 (84%) of samples from buffalo, and 47/58 (81%) from cows, were identified as Chlamydophila psittaci and the reminder as Cp. abortus. From the CFT and PCR results there was no significant difference in the prevalence of positive samples between species, or between animals without or with signs of reproductive disease.

CONCLUSION: The presence of anti-Chlamydiaceae antibodies in 77% of the animals with signs of reproductive disease and the detection of Chlamydiaceae in 72% of vaginal swabs of the animals suggest a pathogenic role by Chlamydiaceae in riverine buffalo and cows. The main Chlamydiaceae found in the genital tract of cattle in Egypt were Cp. psittaci and Cp. abortus.

CLINICAL RELEVANCE: Chlamydophila spp. should be included in diagnostic algorithms for reproductive disorders, in order to assess the real burden of Chlamydophila associated disease in buffalo and cattle and to evaluate the potential value of vaccines.