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D J Polzin

Publications and source records attributed to D J Polzin.

65 records · Page 4Linked to original sources

Effects of diet and aging on renal measurements in uninephrectomized geriatric bitches.

Under controlled, but varied dietary conditions among geriatric, uninephrectomized Beagle bitches (dogs) observed for 4 years, renal size increase as assessed radiographically and ultrasonographically occurred at variable rates, but on a seemingly continuous basis. The maximum observed mean renal linear parameter increase found was approximately 15%. However, a 10 and 15% increase is a more representative expectation among the 4 parameters (sonographic length, radiographic length, sonographic width, radiographic width) under consideration. The rate of renal size increase was rapid during the first 2 to 3 months following uninephrectomy. Thereafter, the rate of increase was slow, but occurred to varying degrees in both the length and width as assessed radiographically or ultrasonographically. The mechanism creating the size change was hypertrophy, not hyperplasia. Within limits of the 3 diets used in the study, no significant diet effect was found on the rate or degree of long term compensatory hypertrophy. Radiographically and ultrasonographically measured renal length had the greatest correlation with each other as well as with post mortem measurements and are, therefore, the recommended parameter for imaging assessment of compensatory hypertrophy. When the prenephrectomy, radiographic renal lengths and widths were normalized as a ratio of the second lumbar vertebral body length (L2) measured from ventrodorsal radiographs, the diet group means across dogs (approximately three L2 lengths for renal length; two L2 lengths for renal width) were in the middle of the respective previously published normal radiographic ranges for mature dogs (e.g. 2.5 L2 < or = length < or = 3.5 L2; 1.58 L2 < or = width < or = 2.38 L2 lengths). Even after the hypertrophic changes occurred, the radiographic group mean lengths and widths across dogs were still within the specified normal ranges, although toward the upper end of the respective range. This information provides background for clinical interpretation of potential compensatory hypertrophy that may be encountered following uninephrectomy for spontaneous disease in aged dogs. In addition, it appears that available radiographic renal linear ranges for normal mature dogs are applicable to geriatric dogs as well.

Adaptation, Physiological↗

Age and diet effects on relative renal echogenicity in geriatric bitches.

Under controlled, but varied dietary conditions 35 geriatric, uninephrectomized, spayed Beagle bitches (dogs) observed for 4 years, renal cortical and renal medullary echogenicity was measured relative to hepatic and splenic echogenicity. Regardless of the diet fed, 60-75% of these aged dogs had renal cortical echogenicity less than that of either the liver or spleen across time; 25-35% of these dogs had renal cortical echogenicity equal to that of the liver, but less than that of the spleen across time. Less than 3% of these dogs had renal cortical echogenicity greater than that of the liver, but less than that of the spleen. Only 1 (one) of these dogs had renal cortical echogenicity equal to that of the spleen and that occurred at only one of the 14 chronologic assessments. Therefore, in either mature or aged dogs imaged with 4.0 to 5.0 MHz equipment, the renal cortical echogenicity should be considered normal if it is less than or equal to that of the liver and less than that of the spleen. In 29 dogs imaged with the 4.0/5.0 MHz equipment and 6 dogs imaged with 7.5 MHz equipment, there was no significant diet or individual dog effect. The 7.5 MHz (6 dog) group had significantly higher average cortical echogenicity scores than the 4.0/5.0 MHz (29 dog) group. However, the occurrence of renal cortical echogenicity greater than liver echogenicity was seen in only 5 of 83 samples (approximately 6.0%) made on 6 dogs imaged with 7.5 MHz equipment and only 1 of 375 samples (approximately 0.27%) made on 29 dogs with 4.0/5.0 MHz equipment. With the exception of one occurrence, all dogs had renal medullary echogenicity less than that of the liver or spleen regardless of imaging equipment frequency. The renal medulla was always hypoechoic compared to the cortex.

Aging↗

The importance of egg protein in reduced protein diets designed for dogs with renal failure.

The effects of two reduced-protein diets and a canine maintenance diet on renal function, nutrition, serum and urine acid-base and electrolyte values, and divalent ion metabolism were compared in Beagle dogs with induced chronic renal failure. Two reduced-protein (18%) diets differed in their protein sources. One 18% protein diet was formulated using egg protein as the only protein source. The other 18% protein diet was formulated using a mixture of animal and vegetable proteins. The 42% protein diet contained a mixture of animal and vegetable protein sources. Results of this study indicate that the egg-based and mixed protein-based diets had similar effects on most clinical and laboratory evaluations in dogs with chronic renal failure. However, the egg protein diet appeared to promote hyperchloremic metabolic acidosis. Both reduced-protein diets were beneficial in reducing azotemia, polyuria, hypermagnesemia, and fractional excretion of phosphorus compared with the 42% protein diet.

Acid-Base Equilibrium↗

Correlation of urine protein/creatinine ratio and twenty-four-hour urinary protein excretion in normal cats and cats with surgically induced chronic renal failure.

Urine protein/creatinine (UP/C) ratios and 24-hour urinary protein excretion were compared in clinically normal cats and cats with surgically induced chronic renal failure (CRF). Mean 24-hour urinary protein excretion in 30 clinically normal cats fed a 28% protein diet (dry weight basis) was 4.93 mg/kg/24-hour (SD = 1.34) with a range of 2.99 to 8.88. Mean UP/C ratio in these cats was 0.134 (SD = 0.037) with a range of 0.073 to 0.239. Mean 24-hour urinary protein excretion in CRF cats was 10.49 mg/kg/24-hour (SD = 11.28) with a range of 2.16 to 62.93. Mean UP/C ratio in the CRF cats was 0.359 (SD = 0.374) with a range of 0.061 to 1.916. Linear regression showed high correlation (R2 = 0.973, P less than 0.001) between 24-hour urinary protein excretion and UP/C ratio in clinically normal cats and cats with surgically induced chronic renal failure. The regression equation for 24-hour urinary protein excretion versus UP/C ratio was: 24-hour urinary protein excretion = 29.39 (UP/C) + 0.18. Results of this study indicate that UP/C ratios are a valid estimate of 24-hour urinary protein excretion in clinically normal and CRF cats. Dietary protein intake significantly affected UP/C ratios in clinically normal cats and cats with surgically induced CRF. Therefore, the influence of dietary protein should be considered when interpreting UP/C ratios.

Animals↗

The effects of cyclosporine versus standard care in dogs with naturally occurring glomerulonephritis.

Glomerulonephritis (GN) is a leading cause of chronic renal failure in dogs. However, little is known about the efficacy of available treatment options for GN in this species. The purpose of this study was to determine the effects of cyclosporine (Cy) administration on the outcome of naturally occurring GN in dogs. Thirteen dogs from 4 institutions were included in the study. Randomization of dogs into placebo-versus Cy-treated groups was stratified according to initial morphological diagnosis and contributing institution. Seven and 6 dogs were assigned to be given placebo or Cy, respectively. The initial Cy dose of 10 mg/kg every 24 hours was adjusted to maintain 24-hour trough, whole blood Cy concentrations between 250 and 400 ng/mL. There were no statistically significant differences between placebo- and Cy-treated groups with respect to serum total protein, albumin, urea nitrogen and creatinine, and plasma protein concentrations; platelet count; urine protein-creatinine ratio; endogenous creatinine clearance; 24-hour urine protein concentrations; or 24-hour urine protein-endogenous creatinine clearance ratio. However, PCV was significantly lower in the Cy-treated group. Decreased appetite, diarrhea, vomiting, weight loss, involuntary shaking, and thrombocytopenia were noted in both treatment groups; however, clinical signs in Cy-treated dogs subjectively were more severe. One Cy-treated dog developed gingival hyperplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Duplex Doppler estimation of Pourcelot resistive index in arcuate arteries of sedated normal cats.

Renal failure is an important cause of morbidity and mortality in feline patients. In human patients, intrarenal blood flow values obtained with duplex Doppler ultrasonography have been used to aid in the diagnosis and prognosis of renal failure. The purpose of this report is to present values for resistance to intrarenal blood flow in normal cats, derived by duplex Doppler ultrasonography. Ten mature clinically healthy conditioned domestic shorthaired cats were screened for normal renal anatomy and function by CBC, serum biochemical profile, urinalysis, urine protein/creatinine ratio, endogenous creatinine clearance, and renal B-mode ultrasonography; and for normal systemic blood pressure with Doppler pressure cuff measurement. Subsequently, the cats were sedated with ketamine hydrochloride, and values for mean intrarenal (arcuate artery) resistance to blood flow were determined by duplex Doppler ultrasonography, and expressed as the Pourcelot resistive index, a ratio of systolic to diastolic flow commonly used in duplex Doppler sonography in human patients. After duplex Doppler sonographic examination, histological normalcy of the kidneys was verified by evaluation of ultrasound-guided percutaneous renal biopsy. Based on the obtained resistive indices, 95% confidence intervals for normal values were calculated as follows: left kidney, 0.52 to 0.60; right kidney, 0.55 to 0.63. No statistically significant difference was noted between the values obtained for the right versus the left kidney.

Animals↗

Duplex doppler estimation of intrarenal pourcelot resistive index in dogs and cats with renal disease.

In human beings, intrarenal blood flow impedance, expressed as the resistive index (RI) and obtained by duplex Doppler ultrasonography, has been used to aid in diagnosis and prognosis of renal failure. Higher than normal values for RI were obtained in 3 of 4 dogs with acute tubular necrosis (ATN) and in 5 of 10 dogs with glomerulonephrosis (GN). Normalization of RI was observed in 2 dogs with ATN evaluated serially during treatment. Increased RI values were obtained in 9 of 10 cats with nonobstructive renal disease and in 2 of 5 cats with obstructive renal disease. Normalization of RI was observed in 3 cats with renal failure in which treatment was effective (1 with obstruction; 2 with nonobstructive disease). The magnitude of increase in RI did not correlate with the magnitude of concurrent renal dysfunction. These results suggest that duplex Doppler evaluation of intrarenal RI is more useful as an ancillary diagnostic technique in azotemic dogs with ATN than in those with GN and in azotemic dogs with nonobstructive than in those with obstructive disease.

Animals↗

Effects of enalapril versus placebo as a treatment for canine idiopathic glomerulonephritis.

A blinded, multicenter, prospective clinical trial assessed the effects of enalapril (EN) versus standard care in dogs with naturally occurring, idiopathic glomerulonephritis (GN). Twenty-nine adult dogs with membranous (n = 16) and membranoproliferative (n = 13) GN were studied. Dogs were randomly assigned to receive either EN (0.5 mg/kg PO q12-24h; n = 16) or placebo (n = 14) for 6 months (1 dog was treated first with the placebo and then with EN). All dogs were treated with low-dose aspirin (0.5-5 mg/kg PO q12-24h) and fed a commercial diet. At baseline, serum creatinine (SrCr), systolic blood pressure (SBP), and glomerular histologic grade were not different between groups, but the urine protein/creatinine ratio (UP/C) was greater in the EN group compared with the placebo group (8.7 +/- 4.4 versus 4.7 +/- 2.3). After 6 months of treatment, the change in UP/C from baseline was significantly different between groups (EN = -4.2 +/- 1.4 versus 1.9 +/- 0.9 in the placebo group). When data were adjusted for changes in SrCr (SrCr X UP/C) a similar significant reduction was noted ( 2.2 +/- 15.2 versus 8.4 +/- 10.1). The change in SBP after 6 months of treatment also was significantly different between groups (EN = -12.8 +/- 27.3 versus 5.9 +/- 21.5 mm Hg in the placebo group). Response to treatment was categorized as improvement (assigned a value of 2), no progression (assigned a value of 1), and progression (assigned a value of 0). Response was significantly better in the EN group (1.4 +/- 0.8) compared with the placebo group (0.3 +/- 0.5). These results suggest that EN treatment is beneficial in dogs with naturally occurring idiopathic GN.

Angiotensin-Converting Enzyme Inhibitors↗

Evaluation of urine gamma-glutamyl transpeptidase-to-creatinine ratio as a diagnostic tool in an experimental model of aminoglycoside-induced acute renal failure in the dog.

The potential diagnostic utility of the urine gamma-glutamyl transpeptidase (GGT)-to-creatinine ratio was evaluated in an experimental canine model of aminoglycoside-induced nephrotoxicity. A therapeutic dosage of gentamicin resulted in a twofold increase in the mean urine GGT-to-creatinine ratio that was not associated with clinically significant nephrotoxicity. In dogs each given a nephrotoxic dosage of gentamicin, an increase in mean urine GGT-to-creatinine ratios approximately three times baseline values preceded clinically significant abnormalities in serum creatinine, urine specific gravity, and urine protein-to-creatinine ratio. The urine GGT-to-creatinine ratio appears superior as an early indicator of aminoglycoside-induced nephrotoxicity. Further studies in canine clinical cases are warranted.

Acute Kidney Injury↗

Ultrasonographic-guided, percutaneous antegrade pyelography: technique and clinical application in the dog and cat.

Fluoroscopically guided, percutaneous antegrade pyelography in canine patients has been described previously in the veterinary literature. This report describes the technique with ultrasonographic guidance and its clinical application in the diagnosis of four cases (two dogs, two cats) of obstructive uropathy. The technique provided successful diagnosis of ureteral obstruction in all four cases. No complications were observed in three cases. In one feline case, ureteral obstruction with a blood clot occurred following the procedure; however, it could not be ascertained whether this event represented a complication of the technique.

Animals↗

Duplex Doppler estimation of resistive index in arcuate arteries of sedated, normal female dogs: implications for use in the diagnosis of renal failure.

The resistive index (RI), an ultrasonographic method of evaluating intrarenal resistance to blood flow, may be used to aid in diagnosis of renal failure. Values for arcuate artery RI, expressed as mean +/- two standard deviations, were obtained in clinically normal female dogs sedated with atropine, acepromazine maleate, diazepam, and ketamine hydrochloride. No statistically significant differences were noted between the values for the right kidney (0.33 to 0.57) versus the left kidney (0.32 to 0.56); however, the values were statistically significantly lower than values reported for nonsedated, normal dogs.

Acute Kidney Injury↗