The present study describes a rare and extreme case of prolonged survival in domestic sheep (Ovis aries) under severe natural conditions, designated as the "Monyak" case (March 2026, Eastern Rhodope Mountains, Bulgaria). A 90-day period of complete isolation involving two adult ewes and a subsequently born lamb on an inaccessible rocky ledge, with very limited access to sources of food or water, was documented. Clinical assessment performed immediately following rescue revealed profound dehydration and cachexia accompanied by multisystemic abnormalities suggestive of a prolonged catabolic state. Biochemical analysis demonstrated marked azotemia, characterized by elevated serum urea and creatinine concentrations, which may indicate reduced renal perfusion and intensified protein catabolism. Electrolyte disturbances, including hypernatremia and hyperchloremia, were compatible with severe dehydration and substantial disruption of water-electrolyte homeostasis. Furthermore, increased total serum protein concentration and hematocrit values were observed, consistent with pronounced hemoconcentration. The metabolic profile demonstrated alterations in glucose homeostasis together with enhanced ketogenesis, findings compatible with an adaptive metabolic response to sustained energy deprivation. Elevated serum activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), accompanied by increased cortisol concentrations, may reflect hepatocellular stress and activation of the hypothalamic-pituitary-adrenal (HPA) axis associated with chronic physiological stress. Hematological evaluation revealed neutrophilia and lymphopenia, constituting a leukocyte pattern compatible with a stress leukogram and suggestive of endogenous glucocorticoid stimulation. Morphological examination of peripheral blood smears demonstrated pronounced echinocytosis and increased relative cellular density secondary to plasma volume depletion associated with dehydration. Additionally, neutrophilic hypersegmentation was observed, consistent with chronic physiological stress and cellular exhaustion. Ethological assessment suggests that maternal behavior and instinctive maternal care played a pivotal role in ensuring neonatal survival under conditions of extreme resource scarcity and sustained environmental stress. In conclusion, the "Monyak" case provides a unique natural model for investigating the physiological, metabolic, and behavioral adaptive mechanisms of ruminants subjected to prolonged starvation, dehydration, and chronic stress. The findings contribute valuable insights to veterinary physiology, clinical pathophysiology, and ethology, with potential implications for understanding the limits of adaptive capacity and survival under extreme environmental conditions.

The endocannabinoid system is a complex regulatory network whose functioning is associated with maintaining homeostasis and regulating immune response. The aim of this study was to evaluate the relationship between endocannabinoid system activity, inflammation, and the progression of chronic kidney disease (CKD) in patients with autosomal dominant polycystic kidney disease (ADPKD). The study included 105 participants: 60 individuals with ADPKD and 45 healthy volunteers. From a single venous blood draw, concentrations of anandamide (AEA), 2-arachidonoylglycerol (2-AG), tumor necrosis factor α (TNF-α), and interleukin 6 (IL-6) were measured in EDTA plasma. Basic laboratory parameters were also assessed, including complete blood count, iron metabolism indices, electrolyte panel, and azotemia parameters. There were statistically significant differences in the concentrations of both endocannabinoids, with higher mean values observed in the control group (p < 0.001). IL-6 concentrations were significantly higher in the ADPKD group compared with controls (p < 0.001). Although TNF-α concentrations were higher in the ADPKD group than in the control group, these differences did not reach statistical significance. Statistically significant correlations were also identified between inflammatory markers, endocannabinoid concentrations, and indices of renal function. Patients with ADPKD exhibit an altered endocannabinoid profile characterized by reduced AEA and 2-AG concentrations, which correlates with disease progression and poorer kidney function. The endocannabinoid system may modulate inflammation in ADPKD.

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have established cardiorenal benefits in human medicine; however, clinical reports describing their use as a decongestive strategy in cats with congestive heart failure (CHF) complicated by advanced chronic kidney disease (CKD) remain limited. This case describes an 11-year-old neutered male British Shorthair cat with advanced CKD (IRIS stage 3-4) that developed CHF manifested by pleural and pericardial effusion. Thoracic radiographs confirmed pleural effusion, and echocardiography identified pericardial effusion with a hypertrophic cardiomyopathy (HCM) phenotype and left atrial enlargement, accompanied by severe azotemia on laboratory testing. Pleural effusion was managed initially with thoracocentesis for respiratory palliation, achieving partial drainage. Because escalation of loop-diuretic therapy was considered undesirable due to concern for worsening renal function, bexagliflozin (5 mg/cat PO q24h) was initiated with pimobendan as an adjunct/bridge strategy, and subcutaneous fluids were temporarily withheld given concern for fluid overload. During follow-up, serial thoracic radiographs and echocardiography documented progressive improvement culminating in complete resolution of pleural and pericardial effusions; subcutaneous fluid therapy was reintroduced thereafter without recurrence, and the cat has remained clinically stable. Renal indices fluctuated early but subsequently showed a tendency toward stabilization rather than a progressive worsening trajectory. Structured safety monitoring-including serial assessment of urinary glucose, blood glucose, and ketones-did not reveal clinically significant adverse events. This case suggests that, in carefully selected cats with CHF and advanced CKD in which conventional diuretic escalation is high risk, SGLT2i may be considered as an adjunct/bridge option for decongestion, with particular emphasis on proactive monitoring for ketone abnormalities and euglycemic ketoacidosis.

Rhabdomyolysis is a condition resulting from muscle breakdown due to trauma, extreme exertion, or seizures, causing the release of intracellular contents including potassium and phosphate (Pi). Abnormalities in serum calcium (Ca) levels have also been reported in rhabdomyolysis, although its exact mechanism remains controversial. A 57-year-old male was admitted due to tonic-clonic seizures caused by epilepsy. On the second day of hospitalization, he exhibited high creatine phosphokinase (CPK) levels (39,253 U/L) and elevated serum creatinine (Cr) levels (2.31 mg/dL), indicating rhabdomyolysis and acute kidney injury (AKI). Because of anuria and azotemia, he started hemodialysis from the third day. Subsequently, renal function gradually improved, and he was weaned off hemodialysis. However, around the 20th day of hospitalization, serum Ca levels began to rise, reaching a peak of 13.3 mg/dL. A computed tomography (CT) scan showed calcification in the left-side muscles including the pectoralis major and upper arm, and bone scintigraphy also demonstrated a high accumulation of technetium-99m hydroxymethylene diphosphonate ([99m]Tc-HMDP) in the same areas. Treatment with denosumab was administered for hypercalcemia, and serum Ca levels returned to normal. On the 45th day, a follow-up CT scan showed the disappearance of the calcific deposits, and no accumulation was seen in the bone scintigraphy.

Lymphoma represents up to 30% of neoplasms diagnosed in cats. Diagnosis of lymphoma in the urinary system by examination of urine sediment has been described in a dog, but apparently not previously in cats. Concurrent samples of serum, EDTA whole blood, and urine were submitted from a 15-year-old spayed female domestic shorthair cat exhibiting weight loss, polyuria, and polydipsia. Hematology and biochemical abnormalities included a mild normocytic, normochromic, non-regenerative anemia; an inflammatory leukogram; and azotemia. Urinalysis evaluation revealed inadequate urine concentration and marked proteinuria. Wet-mount urine sediment examination revealed moderate numbers of leukocytes and erythrocytes. A uniform population of intermediate-to-large lymphocytes was observed on a fresh, Wright-Giemsa-stained preparation from cytocentrifuged urine. The cat was euthanized and necropsy was completed. Bilateral renomegaly was identified and characterized by multifocal, pale-yellow, coalescing, poorly defined, homogenous nodules. Microscopically, these nodules were composed of dense sheets of CD3-positive round cells, consistent with T-cell renal lymphoma. Key clinical message: Lymphoma is a common neoplasm in cats that can affect many organ systems, including the upper urinary tract. This case represents an uncommon method of identifying neoplastic lymphocytes via evaluation of cytocentrifuged urine, and emphasizes the benefits of examining Romanowsky-stained urine sediment in animals.

Full medical histories from captive Alaotran gentle lemurs or Bandro (Hapalemur alaotrensis) > 1 yr old that died between 1990 and 2016 were requested from holding institutions. Eighty-six individuals died during the period analyzed. Full postmortem reports were received from 40 (46.5%) animals from 16 different institutions across Europe (15) and North America (1). Eighteen animals (45%) showed azotemia within three months of death, with accompanying histological renal lesions. Another 17 (42.5%) showed histological renal lesions, but no renal function assessment was carried out antemortem, or results were within normal limits. Only five animals (12.5%) showed no renal lesions. Of the 35 (87.5%) animals with histological renal lesions, 18 were females, and 17 were males, 11 were wild caught, and 24 were captive born. Twenty-seven animals were euthanized, seven were found dead, and in one case, no details were provided. Sixty-four blood samples from 22 animals were available. Azotemia was observed on average 407 d antemortem, with a case observed as early as 2,318 d antemortem. Twenty-nine urinalyses from 12 animals were carried out antemortem. All animals showed hematuria or proteinuria in at least one antemortem sample. A pH decrease from 8.5 to 5.0 was observed in two animals antemortem. Gross renal lesions most frequently reported were irregular surface (n = 14), abnormal shape (n = 12), and/or presence of cysts (n = 9). The most common histological lesions were interstitial nephritis (n = 25), interstitial fibrosis (n = 26), tubule dilation (n = 16), and glomerulosclerosis (n = 12). Development of additional diagnostic tools, standardization of ante- and postmortem diagnostic protocols, and further investigation into potential etiologies, such as diets offered in captivity and genetic factors, should be considered as the next steps for the veterinary management of this species in captivity.