Journal of Veterinary Internal Medicine最新文献

{"title":"Weekly Biological Variation of Urine Protein Creatinine Ratio and Urine Specific Gravity in Healthy Dogs","authors":"Yanick Couture,&nbsp;Deborah Keys,&nbsp;Stacie Summers","doi":"10.1111/jvim.70052","DOIUrl":"https://doi.org/10.1111/jvim.70052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Urine protein-creatinine ratio (UPC) and urine specific gravity (USG) are important measurements in the determination of renal proteinuria and chronic kidney disease. Biological and analytical variation estimates of these analytes to calculate the index of individuality (IoI) and a reference change value (RCV) are important to determine whether a population-based reference interval can be used to detect clinically meaningful changes and facilitate the interpretation of serial measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Determine the biological variation of UPC and USG using calculations of RCV and IoI in healthy dogs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Eleven healthy client-owned young adult dogs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective observational study. First-morning urine samples were collected by voiding once weekly for 6 consecutive weeks for batch analysis. Twenty random samples were run in duplicate. Urine protein concentration, urine creatinine concentration, and USG were measured using a colorimetric pyrogallol red molybdate complex, enzymatic Jaffe method, and manual refractometer, respectively. Restricted maximum likelihood estimations were used to determine within-individual, between-individual, and analytical coefficients of variation and calculation of RCV and IoI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All dogs were non-proteinuric at enrollment (UPC &lt; 0.2) and remained non-proteinuric on subsequent measurements. Urine protein concentration, urine creatinine concentration, UPC, and USG had intermediate individuality. The RCV was 73% for urine protein concentration, 68% for urine creatinine concentration, 31% for UPC, and 3% for USG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Population-based reference intervals for UPC and USG should be interpreted cautiously for single measurements and calculated RCVs should be applied to serial measurements to identify clinically meaningful changes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of the Freestyle Libre 3 Continuous Glucose Monitoring System in Hypo- and Euglycemic Cats","authors":"Antonio M. Tardo,&nbsp;Chiquitha Crews,&nbsp;Jocelyn Mott,&nbsp;Lauren T. Porter,&nbsp;Christopher Adin,&nbsp;Chen Gilor","doi":"10.1111/jvim.70048","DOIUrl":"https://doi.org/10.1111/jvim.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The FreeStyle Libre 3 (FSL3) has several improvements compared to previous FreeStyle Libre systems, but its accuracy has not yet been determined in cats. In diabetic people, FSL3 offers increased accuracy, and its smaller size could be advantageous for use in veterinary patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Assess the accuracy of FSL3 in cats with experimentally induced hypoglycemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Seven healthy, purpose-bred cats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Hyperinsulinemic-hypoglycemic clamps were performed. Interstitial glucose concentration (IG), measured by FSL3, was compared to blood glucose concentration (BG) measured by AlphaTrak2. Data were analyzed for all paired measurements (<i>n</i> = 474) and during stable BG (≤ 1 mg/dL/min change over 10 min). Pearson's r test, Bland–Altman test, and Parkes Error Grid analysis (EGA) respectively used to determine correlation, bias, and clinical accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Blood glucose concentration and IG correlated strongly (<i>r</i> = 0.86, <i>p</i> &lt; 0.0001) in stable glycemia and moderately at all rates of change (<i>r</i> = 0.73, <i>p</i> &lt; 0.0001). Analytical accuracy was not achieved, whereas clinical accuracy was demonstrated with 99%–100% of the results in zones A + B of the Parkes EGA. Interstitial glucose concentration underestimated BG in euglycemia and mild hypoglycemia (mean −11.7 ± 11.2, −5.5 ± 9.1, −1.5 ± 6.0 mg/dL in the ranges 91–120, 66–90, and 56–65 mg/dL, respectively), but overestimated BG in marked hypoglycemia (mean 6.3 ± 5.7, 15.7 ± 5.6 mg/dL in the ranges 46–55 and &lt; 45 mg/dL, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The FSL3 underestimates BG across most of the hypo-euglycemic range but overestimates BG in marked hypoglycemia (&lt; 55 mg/dL). Recognizing the proportional, glycemic-dependent bias of FSL3 improves the safety of its clinical application in cats.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facial Myokymia With or Without Concurrent Neurological Deficits in Seven Dogs and Two Cats","authors":"Tomás Elvira,&nbsp;Claudia Mallol,&nbsp;Abbe Crawford,&nbsp;Edward Ives,&nbsp;Anne R. Fraser,&nbsp;Lorenzo Mari,&nbsp;Anna Tauro,&nbsp;Patricia Alvarez,&nbsp;Victoria Indzhova,&nbsp;Giulia Corsini,&nbsp;Bruno Lopes,&nbsp;Josep Brocal","doi":"10.1111/jvim.70041","DOIUrl":"https://doi.org/10.1111/jvim.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Myokymia is a form of peripheral nerve hyperexcitability that can be focal or generalized. Information regarding focal myokymia in veterinary medicine is currently limited, resulting in a need for a better understanding of this clinical sign.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Hypothesis/Objectives</h3>\u0000 \u0000 <p>Describe the clinical presentation, diagnostic findings, treatment, and outcomes in dogs and cats with facial myokymia (FM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Seven dogs and two cats with clinically confirmed FM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective study. Clinical records from six referral institutions were reviewed to identify cases with FM. Signalment, clinical presentation, diagnostic test results, treatment, and outcome were recorded and evaluated for each patient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Facial myokymia was detected before referral in 6/9 cases. Concurrent vestibular signs were present in 7/9 cases, whereas signs of facial nerve dysfunction other than FM were present in three cases. The diagnoses in the seven dogs were facial and vestibular neuropathy of unknown etiology (<i>n</i> = 2), extra-axial neoplasia (<i>n</i> = 1), otitis media-interna with intracranial extension (<i>n</i> = 1), otitis interna with associated facial and vestibulocochlear neuropathy (<i>n</i> = 1), meningoencephalitis of unknown origin (<i>n</i> = 1) and neoplasia or hypertrophic neuritis (<i>n</i> = 1). The two cats were diagnosed with retrobulbar adenosquamous carcinoma with intracranial extension and traumatic orofacial injury. When prednisolone was used (6/9 cases) FM improved or resolved, although relapses were common.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Clinical Importance</h3>\u0000 \u0000 <p>Facial myokymia is an uncommon and nonspecific clinical sign in dogs and cats, associated with a range of structural disorders affecting the facial motor nucleus, nerve, or both. Control of FM is variable, and treatment and outcome depend on the underlying cause.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apoptosis Inhibitor of Macrophage (CD5-Like Antigen) in Healthy Dogs and Dogs With Acute Kidney Injury","authors":"William H. Whitehouse,&nbsp;Rodrigo Mohallem,&nbsp;Uma K. Aryal","doi":"10.1111/jvim.70053","DOIUrl":"https://doi.org/10.1111/jvim.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Apoptosis inhibitor of macrophage (AIM) is a fundamental mediator of recovery from acute kidney injury (AKI) in mice, but its role in AKI in dogs is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Hypothesis/Objectives</h3>\u0000 \u0000 <p>To detect and quantify AIM in serum and urine from both healthy dogs and dogs with AKI, and to determine if AIM is higher in dogs with AKI compared to healthy controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Eight dogs with International Renal Interest Society (IRIS) Grade II–V AKI and 10 healthy adult dogs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective case–control study. Liquid chromatography-mass spectrometry (LC–MS) based targeted proteomics was used to quantify AIM. AIM peak areas were compared between the AKI and healthy cohorts and correlated with selected markers of renal function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AIM was able to be quantified in the urine of 5/8 dogs with AKI and 1/10 healthy dogs. AIM was quantified in the serum of all dogs, and there was no difference in peak area between the two groups (AKI: median, 67 840 (range, 9797-98 725); control: median, 79 072 (range, 46 400-160 330); <i>p</i> = 0.274). In dogs with AKI, AIM was not correlated with serum creatinine, blood urea nitrogen, phosphorus, or potassium concentrations, urine specific gravity, or IRIS AKI grade.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Clinical Importance</h3>\u0000 \u0000 <p>AIM was predominantly detected in the urine of dogs with AKI and not in the urine of healthy dogs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Familial Narcolepsy in Dogo Argentino Dogs Is Caused by a Tandem Duplication Mutation in HCRTR2","authors":"Alejandra Mondino,&nbsp;Michael W. Vandewege,&nbsp;Rody Artigas,&nbsp;Luis Delucchi,&nbsp;Karen M. Hermida,&nbsp;Camila E. Yanez,&nbsp;Jonah N. Cullen,&nbsp;Steven G. Friedenberg,&nbsp;Kathryn M. Meurs,&nbsp;Joshua A. Stern,&nbsp;Natasha J. Olby","doi":"10.1111/jvim.70056","DOIUrl":"https://doi.org/10.1111/jvim.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Familial narcolepsy in dogs has been associated with mutations in the <i>HCRTR2</i> gene in Labrador retrievers, dachshunds, and Doberman pinschers, with the causal mutation differing between breeds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To characterize the genetic mutation responsible for familial narcolepsy in Dogo Argentino dogs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Ten Dogo Argentino dogs, three narcoleptic and seven clinically normal, of which four were related and three were unrelated to the narcoleptic dogs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Case control prospective study. DNA was extracted from blood samples of all dogs. Whole-genome sequencing was performed on two affected dogs, and variants were identified using bioinformatic pipelines, with comparisons made to a database of 2766 dogs. Structural variants were validated through PCR and Sanger sequencing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A novel tandem duplication in the <i>HCRTR2</i> gene was identified. All three affected dogs and the clinically normal parents of one affected dog had this duplication, suggesting an autosomal recessive pattern of inheritance. This duplication was absent in the 2766 dogs in the database, emphasizing its potential relevance in the Dogo Argentino breed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Clinical Importance</h3>\u0000 \u0000 <p>This discovery emphasizes the critical role of the <i>HCRTR2</i> gene in narcolepsy in dogs, and the diversity of mutations that can lead to this condition. Further genetic testing in this breed is warranted to identify carriers and prevent the further spread of this condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn Foals","authors":"Pamela A. Wilkins,&nbsp;David Wong,&nbsp;Nathan M. Slovis,&nbsp;Niamh Collins,&nbsp;Bonnie S. Barr,&nbsp;Catriona MacKenzie,&nbsp;Cristobal Navas De Solis,&nbsp;Carolina Castagnetti,&nbsp;Jole Mariella,&nbsp;Teresa Burns,&nbsp;Gillian Perkins,&nbsp;Barbara Delvescovo,&nbsp;L. Chris Sanchez,&nbsp;Ann M. Kemper,&nbsp;K. Gary Magdesian,&nbsp;Daniela Bedenice,&nbsp;Sandra D. Taylor,&nbsp;Jenifer Gold,&nbsp;Bettina Dunkel,&nbsp;Gene Pranzo,&nbsp;Peter D. Constable","doi":"10.1111/jvim.70004","DOIUrl":"https://doi.org/10.1111/jvim.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sepsis has been defined in humans as the concurrent proven or suspected presence of microbial infection and the systemic inflammatory response syndrome (SIRS). Sepsis is the leading cause of morbidity and mortality in neonatal foals. The clinical utility of using SIRS or its individual components to predict infection and mortality in critically ill foals is currently unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Assess the ability of history and signalment, clinical findings, laboratory results, and SIRS-related indices to predict infection and mortality in critically ill foals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Retrospective, multi-center, cross-sectional study using a convenience sample of 1068 critically ill foals &lt; 3 days of age admitted to 16 veterinary referral hospitals in 4 countries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were retrieved from medical records. Infection was defined as the presence of bacteremia (positive blood culture) or clinical identification of an infected focus on admission. Univariate non-parametric and categorical methods, multivariate logistic regression, and classification tree methods were used for statistical analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Foal age at admission and presence of toxic neutrophils were independent predictors of infection, whereas SIRS-related indices were not predictive of infection. In-hospital mortality was 24%. Independent predictors for mortality were hypokinetic pulses, cold extremities, presence of seizures, blood L-lactate concentration &gt; 6.0 mmol/L, and increased serum potassium and total bilirubin concentrations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Clinical Importance</h3>\u0000 \u0000 <p>The presence of infection in critically ill newborn foals was not predicted by SIRS indices. Cardiovascular dysfunction was strongly associated with mortality, suggesting that maintaining adequate perfusion and pulse pressure should be important treatment goals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Response to Letter Regarding “An Artificial Neural Network-Based Model to Predict Chronic Kidney Disease in Aged Cats”","authors":"Matthew K. Wun","doi":"10.1111/jvim.70033","DOIUrl":"https://doi.org/10.1111/jvim.70033","url":null,"abstract":"&lt;p&gt;I thank Biourge et al. for their response to my letter and for highlighting the importance of early chronic kidney disease (CKD) diagnosis in cats. However, I am disappointed that the authors have elected not to disclose the number of cats with a baseline serum creatinine concentration between 1.6 and 1.9 mg/dL included in the testing dataset, on the basis that all cats “were healthy based on history and physical examination and had serum creatinine concentrations below the diagnostic threshold for CKD according to the reference interval of the laboratory used, and thus did not have a diagnosis of CKD at the time of screening.” The authors cite a 2019 International Renal Interest Society (IRIS) article, which states that cats with a serum creatinine concentration reaching the threshold for stage 2 CKD but within the laboratory reference interval must also have other independent evidence of CKD before a diagnosis can be made, to minimize the potential for false positive diagnoses [&lt;span&gt;1&lt;/span&gt;]. Since this article was written, it has been shown that a serum creatinine concentration &gt; 1.76 mg/dL has a 92.9% and 90.9% specificity for borderline-low and low glomerular filtration rate (GFR) in cats, respectively [&lt;span&gt;2&lt;/span&gt;]. Although the specificity of a &gt; 1.5 mg/dL creatinine cutoff was not provided in this study, an older article reports a specificity of 73% for the detection of a GFR ≤ 70% of normal [&lt;span&gt;3&lt;/span&gt;]. Furthermore, current IRIS guidelines state that CKD may be diagnosed based on the sole finding of a serum SDMA persistently &gt; 14 μg/dL [&lt;span&gt;4&lt;/span&gt;], which has a 75.0% and 75.7% specificity for a borderline-low and low GFR in cats, respectively [&lt;span&gt;2&lt;/span&gt;]. If this level of specificity is considered acceptable, it stands to reason that a serum creatinine concentration &gt; 1.5 mg/dL (although ideally &gt; 1.76 mg/dL) should also be sufficient.&lt;/p&gt;&lt;p&gt;Accordingly, Biourge et al.'s suggestion that diagnosing a cat with CKD based on a sustained serum creatinine concentration between 1.6 and 1.9 mg/dL (especially with a urine specific gravity ≤ 1.035) represents “a common misconception about the IRIS staging system,” and their following statement that these cats “are at a stage where plasma creatinine concentration is still within the laboratory reference interval and would thus be considered as normal in a regular senior screening” appears misguided. I am also not sure that their opinion is widely shared, with various key opinion leaders stating that CKD or renal azotemia in cats be considered with a serum creatinine concentration ≥ 1.6 mg/dL [&lt;span&gt;5-7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;I again urge Biourge et al. to share the aforementioned data from their study. If cats with a baseline serum creatinine concentration between 1.6 and 1.9 mg/dL were considered “healthy,” their model might simply be predicting the likelihood that cats with early IRIS stage 2 CKD progress to a serum creatinine concentration ≥ 2.0 mg/dL within the subs","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal Treatment of a Peripheral Primitive Neuroectodermal Tumor Originating From the Thoracic Cavity in a Dog","authors":"Leah H. Ackerman,&nbsp;Madison Toonder,&nbsp;Sarah Bosch,&nbsp;Varvara B. Semenova,&nbsp;Timothy P. Spicer,&nbsp;Oscar Alas,&nbsp;Lily S. Thorsen,&nbsp;Aitor Gallestegui Menoyo,&nbsp;Valentina B. Stevenson,&nbsp;Jishnu Rao Gutti,&nbsp;Paulo Vilar Saavedra,&nbsp;Rebecca Nance,&nbsp;Bakash Sahay,&nbsp;Gabriela P. Hery,&nbsp;Ann M. Chan,&nbsp;Marc E. Salute,&nbsp;Nesrine Bensilmane,&nbsp;Virneliz Fernandez Vega,&nbsp;Rowan J. Milner","doi":"10.1111/jvim.70050","DOIUrl":"https://doi.org/10.1111/jvim.70050","url":null,"abstract":"<p>Peripheral primitive neuroectodermal tumor (pPNET) is a very rare, highly malignant tumor encountered in young dogs, with only four necropsy cases in the veterinary literature. A 1.5-year-old male intact French Bulldog presented for evaluation of progressive left forelimb lameness and ipsilateral Horner's syndrome. Whole body computed tomography identified a 12 cm mediastinal mass with extension into the vertebral canal and multifocal metastatic lesions. Histological and immunohistochemical results were consistent with a pPNET. Chemotherapy, radiation therapy, immunotherapy, and targeted therapy were administered. Precision-based tumor testing, including DNA sequencing and chemosensitivity assays, were performed to guide systemic treatment recommendations. A partial remission was observed 3.5 months from presentation based on imaging and improved clinical status. After 7 months of treatment, diffuse metastatic disease, including intracranial spread, was observed and the dog was euthanized.</p>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Second Letter on Response Letter Regarding “An Artificial Neural Network-Based Model to Predict Chronic Kidney Disease in Aged Cats”","authors":"Vincent Biourge,&nbsp;Sebastien Delmotte,&nbsp;Alexandre Feugier,&nbsp;Richard Bradley,&nbsp;Molly McAllister,&nbsp;Jonathan Elliott","doi":"10.1111/jvim.70032","DOIUrl":"https://doi.org/10.1111/jvim.70032","url":null,"abstract":"&lt;p&gt;We are sorry to have disappointed Dr. Wun in not providing him with the numerical information he requested. Our answer did focus on the rationale of our model, which was intended to predict as accurately as possible which cats would progress to azotemic CKD within 12 months of the initial screening in field conditions. We have expanded upon our previous reply in this letter.&lt;/p&gt;&lt;p&gt;Defining what constitutes early kidney disease is not straightforward, and key opinion leaders from the IRIS group offer a number of possible definitions, no doubt because none of these on their own is perfect. In our study, we took the approach of using a subsequent conventional diagnosis of azotemic CKD (based on our laboratory's reference interval for serum creatinine concentration together with USG &lt; 1.035) within 12 months of a single screening event to indicate that, at the screening event, the cat had subclinical early CKD. In our opinion, this is an unambiguous definition of early CKD, whereas most other ways of defining early CKD, without subsequent follow-up confirming a conventional diagnosis of CKD, carry a degree of uncertainty about whether these cats will continue to lose kidney function over time.&lt;/p&gt;&lt;p&gt;Dr. Wun cites Brans et al. (2021) as evidence that a serum creatinine concentration of 1.76 mg/dL has a 92.9% specificity for borderline low GFR (&lt; 1.7 mL/kg/min). This study, which focused on comparing the ability of serum SDMA and creatinine concentrations to identify cats with “borderline low GFR,” included 17 clinically healthy cats with no mention of how their kidney function progressed over time. The “borderline low GFR” definition was based on a previously published study from the same group, which involved 16 healthy clinically normal cats. Such small numbers would not be sufficient to establish a robust reference interval, and using this data to define a cutoff value of serum creatinine concentration with a given sensitivity and specificity to diagnose CKD early seems flawed to us.&lt;/p&gt;&lt;p&gt;Measurement of GFR in clinical practice is laborious and, despite a number of published studies, what constitutes a normal GFR and the variations that occur in a large population of healthy cats are not well defined. If it were, the IRIS group would have adopted GFR to define the stages of CKD and thus better define the non-azotemic stages. Importantly, the variation in GFR within the same cat when measured multiple times remains to be clearly defined. This variation needs to be understood before serial GFR measurements could be used to document deteriorating kidney function over time in early-stage CKD.&lt;/p&gt;&lt;p&gt;Our study was designed to help veterinarians in primary care practice make better use of health screening data to identify cats with a high likelihood of developing azotemic CKD within 12 months of a single visit. Data from 218 healthy cats screened and followed prospectively were analyzed by an artificial neural network to build models that identi","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Adrenocorticotropic Hormone Concentration and Clinical Signs of Pituitary Pars Intermedia Dysfunction in Swiss and Austrian Equids","authors":"Nathalie Fouché,&nbsp;Camille Doras,&nbsp;Gertraud Schüpbach-Regula,&nbsp;Alexandre Scherer,&nbsp;Barbara Freudenschuss,&nbsp;Vinzenz Gerber","doi":"10.1111/jvim.70008","DOIUrl":"https://doi.org/10.1111/jvim.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There remains a scarcity of data concerning the relationship between the clinical signs associated with PPID and plasma ACTH concentrations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Report the frequency of clinical signs in the study cohort and identify individual clinical signs or combinations of clinical signs associated with high ACTH concentrations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Two hundred eighty equids were examined by private veterinarians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study of animals with clinical suspicion of PPID was conducted between August and November. Private practitioners completed an online questionnaire reporting detailed information, including signalment, owner-reported history, and clinical observations during the examination. Plasma ACTH concentrations of each animal were measured. Associations between clinical signs and ACTH concentrations were examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Age, month, and specific clinical signs (hair coat abnormalities, laminitis, and supraorbital fat) were univariably associated with high ACTH concentrations. The first three dimensions of the multiple correspondence analysis (MCA) described the aggregation of clinical signs according to a known semiological typicity. Dimensions 1, 2, and 3 corresponded to features indicative of equine metabolic syndrome, early-stage PPID, and advanced PPID, respectively. Further regression analysis showed that Dimensions 1 and 3, as well as age, were significant predictors of high ACTH levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Clinical Importance</h3>\u0000 \u0000 <p>The results indicate that particular clinical signs commonly associated with advanced stages of PPID are associated with high ACTH levels. Furthermore, in this data set, a phenotype compatible with metabolic syndrome was also linked to higher ACTH concentrations. These findings underscore the importance of seeking more sensitive biomarkers for the diagnosis of early PPID.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}