Companion May 2012 - BSAVA

More documents

Recommendations

Info

Chronic kidney disease in dogs 26 | companion Dr Joy Archer of the University of Cambridge describes how PetSavers funding has helped carry out research into chronic kidney disease in dogs Research into chronic kidney disease in dogs was motivated by awareness from our routine diagnostic work that increasing numbers of older dogs and cats were being referred for CKD. With current laboratory tests CKD is not always diagnosed at the early stages where intervention and treatment would be most effective. This is partly due to the problems of not having widely available sensitive tests and not knowing which animals with changed tests values will progress to chronic disease. Before there are increases in the blood levels of urea, creatinine and phosphorus there is usually a marked loss of kidney function. Testing and monitoring Urine tests are more sensitive but many are affected by conditions other than CKD and also by sample handling. Urine specific gravity is a sensitive test of loss of urine concentrating ability but is dependent on many variables, including the hydration status of the patient and other constituents in the urine (e.g. blood). A more widely used moderately sensitive urine test is the measurement of the urine protein:creatinine ratio. If this is > 0.4 in dogs and > 0.2 in cats there is a strong suggestion that the animal may be developing CKD. Likewise animals with persistent albuminuria should also be monitored for progression to CKD. There is an automated method for measuring albumin in urine but it is not widely used and the available dipsticks for canine and feline microalbumin are expensive and no longer widely used in practice. The most sensitive and specific method available is the measurement of changes in GFR (glomerular filtration rate) by clearance of endogenous or exogenous creatinine or iohexol. However, these are expensive, time-consuming methods which involve numerous timed blood and urine sample collections. In human medicine, measurement of endogenous cystatin C in plasma (Left) Cambridge Resident Paola Monti who worked on the PetSavers and RCVS Trust funded project and (right) Dr Joy Arthur
and/or urine is a preferred method. Measurement of cystatin C in the plasma of dogs has been validated by several veterinary laboratories but is not currently widely used. Measurement of urinary cystatin C has recently been validated in our laboratory, and cystatin C:creatinine ratios generated. These have been shown to distinguish between dogs with no kidney disease and dogs with CKD. Funding and the future This work was carried out with the help of a PetSavers research grant and a residency scholarship from RCVS trust to Paola Monti. This work was presented at ECVIM–CA in 2011, and will be published in the Journal of Small Animal Practice*. Work is now continuing on measuring microalbumin and cystatin C in urine from dogs with CKD, dogs with no obvious disease and dogs with other (non-kidney) diseases. When this stage of the work is completed we would like to set up a prospective trial and follow the progression of CKD, and the effects of treatments in a group of dogs over a longer period. We are also setting up similar studies with cats, and have been able to confirm that special non-absorbent litter which can be used for urine collection from cats does not interfere with these tests. In this way it is hoped to provide non invasive urine tests for both dogs and cats with early CKD. We are also investigating other biomarkers for glomerular and tubular injury by the use of ELISA methods. Unfortunately many available test kits were developed for human samples using monoclonal antibodies, and this causes many technical difficulties when they are used for cats and dogs. Many of the biomarker peptides are also unstable in urine so we are evaluating best methods for collection and storage of samples. The next step will be a longitudinal study. We hope to recruit dogs and cats with CKD that can donate urine at regular intervals over a 1–2 year period. ■ Please visit www.petsavers.org.uk for more information on PetSavers grants and how you can help support studies such as Joy’s. *Editor’s note: Readers are directed to this paper which has just been published online by the JSAP. BSAVA ON CKD The Manual of Canine and Feline Nephrology and Urology has a chapter on the management of chronic kidney disease by Scott A. Brown. For details or to order the manual visit www.bsava.com or call 01452 726700. A fruitful Congress PetSavers owes a huge thanks to Congress delegates and exhibitors who helped raise funds for the charity during the event As the gateway stand to the BSAVA Balcony, PetSavers gets to meet delegates from all areas of the profession. Which is perfect for this ambitious charity, which knows that the support of vets, VNs and practice managers is vital if it wants to continue to achieve its aims. PetSavers’ relationship with the profession is very much two-way. On the one hand, appealing for donations and financial support – and on the other, the Charity provides funding for vital veterinary research – as well as offering a range of products and resources for use in the Practice. So there was plenty to talk about with the 7000+ crowd at Congress. There was a lot going on off the stand too – with two gala events offering more fundraising opportunities. On Thursday night the popular Petplan awards took place, where guests generously donated more than £1200 to PetSavers. The winners of the awards were Zaila Dunbar, Queens Park Veterinary Clinic (Vet of the Year), Lucy Kells, Wildlife Aid Foundation (Vet Nurse of the Year) and Eastcott Veterinary Hospital (Vet Practice of the Year). The PetSavers Achievement Award was presented to Barnfield Vets. Then on Friday the guests at the Banquet had the opportunity to support PetSavers and win a piece of art. The Banquet raffle has raised many thousands over the years, thanks to the continued support of Castle Fine Art Gallery in the ICC who donate a picture. This year it raised nearly £4000, and the winner of the artwork was BEVA President, Ben Mayes. PetSavers would like to thank all those who took the time to visit the stand at Congress and for all the generous donations it received. ■ companion | 27
Page 1 and 2: Celebrating Congress In pictures P4
Page 3 and 4: Surveillance - now is the time With
Page 5 and 6: FounDIng FAtHer. BSAVA welcomed the
Page 7 and 8: Party Night pArtY nIgHt. packed out
Page 9 and 10: Disease Requirements for humans Req
Page 11 and 12: Up to 8% of Daubenton’s bats carr
Page 13 and 14: What initial investigations would y
Page 15 and 16: Evaluate the CT (Figure 3). Are the
Page 17 and 18: donor can be difficult. Practically
Page 19 and 20: made aware that despite testing for
Page 21 and 22: Scottish Congress · 31 AUGUST - 2
Page 23 and 24: Figure 2: Positioning for a dorsopr
Page 25: ance, Nurse’, after passing a sui
Page 29 and 30: A busy World Congress During WSAVA/
Page 31 and 32: lungworm in donkeys and my continui
Page 33 and 34: Focus on... BSAVA East Anglia Regio
Page 35 and 36: evening Meeting - South WeSt region

Companion May 2012 - BSAVA

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?