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Postmortem evaluation of renal tubular vacuolization in critically ill dogs.

Abstract

OBJECTIVE

To describe the frequency of renal tubular vacuolization (RTV) as a surrogate of osmotic nephrosis and assess hyperosmolar agents as predictors of RTV severity.

DESIGN

Retrospective study (February 2004-October 2014).

SETTING

Veterinary teaching hospital.

ANIMALS

Fifty-three client-owned, critically ill dogs that had a postmortem examination.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The frequency, severity, and location of RTV were determined in small group of critically ill dogs postmortem. Logistic regression was performed to assess cumulative 6% HES (670/0.75) and mannitol dose as predictors for RTV severity with presenting serum creatinine concentration, cumulative furosemide dose, and duration of hospitalization as covariates. RTV was noted in 45 (85%) of 53 critically ill dogs and was most commonly located to the medullary rays (68%). Cumulative 6% HES (670/0.75) dose (P = 0.009) and presenting serum creatinine concentration (P = 0.027) were significant predictors of RTV severity. For every 1 mL/kg increase in 6% HES (670/0.75) dose that a dog received, there was 1.6% increased chance of having more severe RTV (OR 1.016; 95% CI 1.004-1.029). In addition, for every 88.4 μmol/L (1 mg/dL) increase in presenting serum creatinine, there was a 22.7% increased chance of having more severe RTV (OR 1.227; 95% CI 1.023-1.472). Cumulative mannitol (P = 0.548) and furosemide (P = 0.136) doses were not significant predictors of RTV severity.

CONCLUSION

In a small group of critically ill dogs, there was a high frequency of RTV identified on postmortem examination. Administration of 6% HES (670/0.75) and presenting serum creatinine concentration were significant predictors of RTV severity. Larger prospective studies are needed to determine the etiology and significance of RTV in dogs.

Authors+Show Affiliations

Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN.Department of Veterinary Biosciences, The Ohio State University College of Veterinary Medicine, Columbus, OH.Department of Clinical Studies-Philadelphia, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA.Department of Pathobiology-Philadelphia, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA.Office of Information Technology, University of Tennessee, Knoxville, TN.Department of Clinical Studies-Philadelphia, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30983126

Citation

Schmid, Sarah M., et al. "Postmortem Evaluation of Renal Tubular Vacuolization in Critically Ill Dogs." Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001), vol. 29, no. 3, 2019, pp. 279-287.
Schmid SM, Cianciolo RE, Drobatz KJ, et al. Postmortem evaluation of renal tubular vacuolization in critically ill dogs. J Vet Emerg Crit Care (San Antonio). 2019;29(3):279-287.
Schmid, S. M., Cianciolo, R. E., Drobatz, K. J., Sanchez, M., Price, J. M., & King, L. G. (2019). Postmortem evaluation of renal tubular vacuolization in critically ill dogs. Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001), 29(3), pp. 279-287. doi:10.1111/vec.12837.
Schmid SM, et al. Postmortem Evaluation of Renal Tubular Vacuolization in Critically Ill Dogs. J Vet Emerg Crit Care (San Antonio). 2019;29(3):279-287. PubMed PMID: 30983126.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postmortem evaluation of renal tubular vacuolization in critically ill dogs. AU - Schmid,Sarah M, AU - Cianciolo,Rachel E, AU - Drobatz,Kenneth J, AU - Sanchez,Melissa, AU - Price,Josh M, AU - King,Lesley G, Y1 - 2019/04/14/ PY - 2017/02/15/received PY - 2017/12/21/revised PY - 2018/01/11/accepted PY - 2019/4/16/pubmed PY - 2019/7/16/medline PY - 2019/4/16/entrez KW - canine KW - hydroxyethyl starch KW - osmotic nephrosis KW - vacuolization SP - 279 EP - 287 JF - Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) JO - J Vet Emerg Crit Care (San Antonio) VL - 29 IS - 3 N2 - OBJECTIVE: To describe the frequency of renal tubular vacuolization (RTV) as a surrogate of osmotic nephrosis and assess hyperosmolar agents as predictors of RTV severity. DESIGN: Retrospective study (February 2004-October 2014). SETTING: Veterinary teaching hospital. ANIMALS: Fifty-three client-owned, critically ill dogs that had a postmortem examination. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The frequency, severity, and location of RTV were determined in small group of critically ill dogs postmortem. Logistic regression was performed to assess cumulative 6% HES (670/0.75) and mannitol dose as predictors for RTV severity with presenting serum creatinine concentration, cumulative furosemide dose, and duration of hospitalization as covariates. RTV was noted in 45 (85%) of 53 critically ill dogs and was most commonly located to the medullary rays (68%). Cumulative 6% HES (670/0.75) dose (P = 0.009) and presenting serum creatinine concentration (P = 0.027) were significant predictors of RTV severity. For every 1 mL/kg increase in 6% HES (670/0.75) dose that a dog received, there was 1.6% increased chance of having more severe RTV (OR 1.016; 95% CI 1.004-1.029). In addition, for every 88.4 μmol/L (1 mg/dL) increase in presenting serum creatinine, there was a 22.7% increased chance of having more severe RTV (OR 1.227; 95% CI 1.023-1.472). Cumulative mannitol (P = 0.548) and furosemide (P = 0.136) doses were not significant predictors of RTV severity. CONCLUSION: In a small group of critically ill dogs, there was a high frequency of RTV identified on postmortem examination. Administration of 6% HES (670/0.75) and presenting serum creatinine concentration were significant predictors of RTV severity. Larger prospective studies are needed to determine the etiology and significance of RTV in dogs. SN - 1476-4431 UR - https://www.unboundmedicine.com/medline/citation/30983126/Postmortem_evaluation_of_renal_tubular_vacuolization_in_critically_ill_dogs L2 - https://doi.org/10.1111/vec.12837 DB - PRIME DP - Unbound Medicine ER -