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Within clinical small animal practice, diagnosis of both chronic kidney disease and acute kidney injury is common. To assess renal function, measurement of glomerular filtration rate is considered the gold standard. Currently, routine tests of kidney function include surrogate markers of glomerular filtration rate such as serum creatinine, and urea, each with their own limitations, whilst urine protein to creatinine ratio gives an indication of glomerular and tubular handling of protein, and urine specific gravity information about urine concentrating ability by the kidney. These parameters are used together with historical and physical examination data to give a diagnosis of kidney disease following which creatinine, proteinuria and blood pressure are used to stage chronic kidney disease and, together with urine output, grade acute kidney injury according to the International Renal Interest Society. However, there has been much concern that creatinine is insensitive when used to indicate early decline in renal function and this has highlighted the need for additional methods of diagnosing and monitoring these patients, with the potential to allow earlier therapeutic intervention. Symmetric dimethylarginine is a novel biomarker, which has been shown to perform as a surrogate marker of glomerular filtration rate in small animals. This article will review current research on symmetric dimethylarginine and the ways in which it may be utilised in small animal practice; current research supports the use of symmetric dimethylarginine as a screening test for detection of early chronic kidney disease according to International Renal Interest Society guidelines, but further research is required in to the usefulness of symmetric dimethylarginine as a tool for monitoring disease and the effect of non-renal influences.

Objectives To determine the proportion of dogs diagnosed with immune-complex glomerulonephritis in a large cohort of UK dogs with clinical suspicion of glomerular disease in which renal histopathology, including routine light microscopy, transmission electron microscopy and immunofluorescence, had been performed. The second objective was to describe treatment and long-term clinical outcome of dogs diagnosed with immune-complex glomerulonephritis. Materials and methods Sixty-two UK dogs that underwent renal biopsies for investigation of suspected glomerulopathy (urine protein-to-creatinine ratio persistently >0.5) were included in this retrospective multicentre study. Signalment, clinico-pathological abnormalities, histopathological diagnosis, treatment following diagnosis and survival were recorded. Results Seventeen (27%) of the dogs with suspected glomerular disease were diagnosed with immune-complex glomerulonephritis and nine (53%) of these were still alive at the study end point, with a median follow-up of 366 days (range 52 to 1299). Six dogs diagnosed with immune-complex glomerulonephritis were treated with mycophenolate. Four received mycophenolate alone for immunosuppression and two received mycophenolate and chlorambucil; all these six dogs were alive at data collection [median follow-up time 712.5 days (range 73 to 1299)]. Seven dogs diagnosed with immune-complex glomerulonephritis did not receive immunosuppressive treatment; only one of these dogs was alive at study end point [median survival time 302 days (range 52 to 723)]. Clinical significance Immune-complex glomerulonephritis may be less common in the UK than previously reported in North America and mainland Europe, reducing the likelihood of treatment modification following renal biopsy. Mycophenolate was the most commonly used immunosuppressant for cases of immune-complex glomerulonephritis.

Background Measurement of serum ionized calcium is not always available in practice. Total calcium (tCa) might not be reliable for determination of calcium status in cats. Objectives To predict serum ionized calcium concentration from signalment, biochemistry profile and T4, and compare predicted ionized calcium (piCa) to tCa. Animals A total of 1701 cats from two hospitals. Methods Cross-sectional study. Cats with serum ionized calcium, biochemistry profile and T4 available were screened over 6 years and included in the training set (569 cats) to create a multivariate adaptive regression splines model to calculate piCa. Diagnostic performances of tCa and piCa and its prediction interval (PI) were compared in 652 cats from the same institution (test set) and 480 cats from a different hospital (external set). Results The final model included tCa, chloride, albumin, cholesterol, creatinine, BUN, body condition score, GGT, age, and potassium. For hypercalcemia, piCa was highly specific (test set: 99.8%; confidence interval [CI]: 99.5-100; external set: 97%; CI: 95.3-98.7) but poorly sensitive (test set: 30.4%; CI: 18.3-42.4; external set: 42.5%; CI: 31.7-53.3). For hypocalcemia, piCa was also highly specific (test set: 81.6%; CI: 78-85; external set: 99.6%; CI: 99-100) but poorly sensitive (test set: 57.6%; CI: 50.6-64.6; external set: 0%). These diagnostic performances were comparable to those of tCa. The upper and lower limits of piCa PI had high sensitivity for detecting ionized hypercalcemia and hypocalcemia, respectively. Conclusions and clinical importance Predicted ionized calcium is useful to confirm suspected hypercalcemia in cats and screen for hypercalcemia and hypocalcemia.

Background Bleeding tendencies can occur with uremia. Objectives To characterize primary hemostatic function in dogs with acute kidney injury (AKI). Animals Ten dogs with International Renal Interest Society AKI grade III or above and 10 healthy controls. Methods Prospective study comparing PCV, platelet count, platelet aggregometry (Multiplate), and von Willebrand factor antigen to collagen binding activity ratio (vWF:Ag:vWF:CBA) in 2 groups of dogs (AKI group versus controls). Buccal mucosal bleeding time was measured in the AKI group only. Data are presented as median [25th, 75th percentile] unless otherwise stated. Significance was set at P

Background Glomerular filtration rate (GFR) estimation is the gold standard for assessment of renal function, although the clinical utility of this test is unclear. Objectives To describe the clinical utility of GFR estimation in dogs. Animals Medical records of 132 dogs that had serum iohexol clearance measured between 2012 and 2017. Methods Iohexol clearance and clinical records were reviewed and submitting practices contacted to obtain outcome data. Dogs were classified into 4 groups based on the reason for performing GFR estimation: A1 (screening for pre‐azotemic chronic kidney disease [CKD], n = 105), A2 (confirmation of azotemic CKD, n = 3), B (screening for pre‐azotemic acute kidney injury, n = 19), and C (miscellaneous causes, n = 5). Descriptive review of the clinical utility of GFR estimation is provided. Results For dogs in Group A1, renal disease was diagnosed in 9/9 dogs with a GFR ≥40% decreased below the mean GFR of their body weight category, in 5/6 dogs with a ≥30% but

Copyright © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Retrospective study of cats presenting to the Queen Mother Hospital for Animals, Royal Veterinary College with acute kidney injury between 2007 and 2015. Systolic blood pressure was measured using Doppler sphygmomanometry and systemic hypertension was defined pressures e150 mmHg. Median systolic blood pressure measurement, grade of acute kidney injury (as defined by the International Renal Interest Society), serum creatinine on admission, anuria or oliguria, length of hospitalisation, survival to discharge and six‐month survival were all recorded.

A two-year-old, female neutered, cross-breed dog imported from Romania was diagnosed with nasal infestation of Linguatula serrata after she sneezed out an adult female. The dog was presented with mucopurulent/sanguinous nasal discharge, marked left-sided exophthalmia, conjunctival hyperaemia and chemosis. Computed tomography and left frontal sinusotomy revealed no further evidence of adult parasites. In addition, there was no evidence of egg shedding in the nasal secretions or faeces. Clinical signs resolved within 48 hours of sinusotomy, and with systemic broad-spectrum antibiotics and non-steroidal anti-inflammatory drugs. Recommendations are given in this report regarding the management and follow-up of this important zoonotic disease.

Objectives In humans, genome-wide association studies have identified variants in the uromodulin gene (UMOD) associated with blood pressure and renal function. This study aimed to evaluate the association of single nucleotide polymorphisms at the UMOD locus with renal function and blood pressure in cats. Methods We retrospectively identified cats aged 14 years that had participated in a geriatric monitoring program, and from which stored DNA samples were available, from a computerised database. We then measured the association of specific single nucleotide polymorphisms in the feline UMOD gene with renal function and systolic blood pressure as continuous variables and, also, the dichotomous outcome of azotaemic chronic kidney disease and systemic hypertension. Results Eight intronic single nucleotide polymorphisms, one 1372 base pairs upstream from UMOD and two exonic single nucleotide polymorphisms were evaluated in 227 cats with renal and blood pressure data. An analysis of 188 cats found four single nucleotide polymorphisms to be significantly associated (P

Background Numerous validated psychometric tools are available to assess impact of disease on a human's quality of life (QoL). To date, no psychometrically validated general health-related QoL tool exists for cats. Hypothesis/Objectives To develop and validate a tool for assessment of owner-perceived QoL in cats (CatQoL) and to use this tool to compare QoL between healthy cats and those with chronic kidney disease (CKD). Animals/Subjects Total of 204 owners of young healthy cats (YH, n = 99; 0.3). Young healthy cats had significantly higher AWIS (median [IQR], 1.25 [0.63, 1.88]) than OH (0.56 [−0.06, 1.00]) and CKD cats (−0.06 [−0.81, 0.88]), P < .001). CKD cats had significantly lower AWIS for eating domain (YH: 2.00 [1.00, 3.00]; OH: 2.00 [0.67, 3.00]; CKD : 1.00 [0.00, 2.67]) when compared with the YH group and OH group, and all groups differed significantly in their management domain (YH: −0.50 [−1.00, 0.00]; OH: −1.00 [−1.88, −0.50]; CKD : −1.50 [−2.50, −1.00], P < .001). Conclusions and Clinical Importance The CatQoL was validated for use in cats, and can be used as additional assessment parameter in clinical and research settings.

Background Dysautonomia is a disease characterised by degeneration of autonomic neurons. Methods The aim of this study was to perform a retrospective multicentre review of clinical data relating to cats and dogs diagnosed with dysautonomia and to evaluate their outcome. Results Cats (n=34) and dogs (n=19) with clinical signs consistent with dysautonomia were considered for this retrospective study. Reported clinical findings included oesophageal and gastrointestinal dysmotility and distension, urinary retention, reduced or absent tear production, third eyelid protrusion and inappropriate mydriasis. Treatment was supportive and included gastrointestinal prokinetics, feeding tube placement (oesophageal and percutaneous endoscopic gastrostomy tubes) and medications to treat urinary retention. The survival to discharge was 29 per cent in cats and 47 per cent in dogs. The overall survival in cats was 21 per cent and that in dogs was 32 per cent. Survival of greater than 2 years was seen in six cats and in three dogs. Conclusion This paper illustrates that some animals are able to survive this disease and can have a good long-term prognosis, which is an infrequently reported finding for this disease.

Background Role of renin-angiotensin aldosterone system (RAAS) in feline systemic hypertension is poorly understood. Objectives Examine plasma renin activity (PRA) and plasma aldosterone concentrations (PAC) in normotensive and hypertensive cats with variable renal function and in response to antihypertensive therapy. Animals One hundred and ninety-six cats >9 years from first opinion practice. Methods PRA, PAC, and aldosterone-to-renin ratio (ARR) were evaluated in cats recruited prospectively and grouped according to systolic blood pressure (SBP) and renal function (nonazotemic normotensive [Non-Azo-NT], nonazotemic hypertensive [Non-Azo-HT], azotemic normotensive [Azo-NT], azotemic hypertensive [Azo-HT]). Changes in PRA and PAC were evaluated with antihypertensive therapy (amlodipine besylate). Results Plasma renin activity (ng/mL/h; P = .0013), PAC (pg/mL; P

Three UK bred Border collie puppies were presented for investigation of pyrexia and severe lameness with associated joint swelling. Investigations revealed neutropenia, radiographic findings suggesting metaphyseal osteopathy, and polyarthritis and all dogs were subsequently confirmed with trapped neutrophil syndrome. Clinical improvement was seen after treatment with prednisolone and antibiotics and the dogs all survived to adulthood with a good short- to medium-term outcome. Trapped neutrophil syndrome is an important differential diagnosis for young Border collie dogs in the UK presenting with pyrexia, neutropenia and musculoskeletal signs.

Three new genera and four new species of the extinct mantidfly subfamily Mesomantispinae (Insecta: Neu- roptera: Mantispidae) are described from the Lower Creta- ceous Yixian Formation of Liaoning and the Middle Jurassic Jiulongshan Formation of Inner Mongolia: Archaeodrepanicus nuddsi gen. et sp. nov., A. acutus gen. et sp. nov., Sinomeso- mantispa microdentata gen. et sp. nov., (Yixian Formation) and Clavifemora rotundata gen. et sp. nov. (Jiulongshan For- mation). The specimens described herein represent the first Mesozoic mantidfly compression fossils to have body parts preserved, including the specialized raptorial forelegs articu- lated to the prothorax anteriorly, an autapomorphy of the family. These new taxa further confirm the placement of the subfamily Mesomantispinae within the family Mantispidae; however, the monophyly of Mesomantispinae has not been confirmed, and it is likely that it will prove to be para- phyletic.

Several new taxa of snakeflies (Raphidioptera) are described from the Lower Cretaceous deposits of the Wealden, UK (Barremian), Montsec, Spain (Barremian) and the Crato Formation, Brazil (Aptian). Mesoraphidia ednae sp. nov. and M. hilli sp. nov. are described from the Wealden; Nanoraphi- dia lithographica sp. nov. and Iberoraphidia dividua gen. et sp. nov. are described from Montsec, and Baissoptera lisae sp. nov. is described from the Crato Formation. The geographical range of Nanoraphidia has potentially been extended.

Seasonal outbreaks of cutaneous and renal glomerular vasculopathy (CRGV) have been reported annually in UK dogs since 2012, yet the aetiology of the disease remains unknown. The objectives of this study were to explore whether any breeds had an increased or decreased risk of being diagnosed with CRGV, and to report on age and sex distributions of CRGV cases occurring in the UK. Multivariable logistic regression was used to compare 101 dogs diagnosed with CRGV between November 2012 and May 2017 with a denominator population of 446,453 dogs from the VetCompass database. Two Kennel Club breed groups—hounds (odds ratio (OR) 10.68) and gun dogs (OR 9.69)—had the highest risk of being diagnosed with CRGV compared with terriers, while toy dogs were absent from among CRGV cases. Females were more likely to be diagnosed with CRGV (OR 1.51) as were neutered dogs (OR 3.36). As well as helping veterinarians develop an index of suspicion for the disease, better understanding of the signalment risk factors may assist in the development of causal models for CRGV and help identify the aetiology of the disease.

The annual outbreaks of cutaneous and renal glomerular vasculopathy (CRGV) reported in UK dogs display a distinct seasonal pattern (November to May) suggesting possible climatic drivers of the disease. The objectives of this study were to explore disease clustering and identify associations between agroecological factors and CRGV occurrence. Kernel-smoothed maps were generated to show the annual reporting distribution of CRGV, Kuldorff's space-time permutation statistic used to identify significant spatiotemporal case clusters and a boosted regression tree model developed to quantify associations between CRGV case locations and a range of agroecological factors. The majority of diagnoses (92 per cent) were reported between November and May while the number of regions reporting the disease increased between 2012 and 2017. Two significant spatiotemporal clusters were identified-one in the New Forest during February and March 2013, and one adjacent to it (April 2015 to May 2017)-showing significantly higher and lower proportions of cases than the rest of the UK, respectively, for the indicated time periods. A moderately significant high-risk cluster (P=0.087) was also identified in the Manchester area of northern England between February and April 2014. Habitat was the predictor with the highest relative contribution to CRGV distribution (20.3 per cent). Cases were generally associated with woodlands, increasing mean maximum temperatures in winter, spring and autumn, increasing mean rainfall in winter and spring and decreasing cattle and sheep density. Understanding of such factors may help develop causal models for CRGV occurrence.

Background:Systemic hypertension is a common clinical problem, often occurring in association with renal disease in cats. Limited information is available to assess the effect of blood pressure and the treatment of hypertension on survival. Hypothesis:That adequacy of blood pressure control is associated with the duration of survival in cats with systolic hypertension. Animals:One hundred and forty-one client-owned cats with systolic hypertension. Methods:Hypertensive cats were treated with amlodipine besylate and were followed until death or the study end point. Time-averaged systolic blood pressure (SBPOT) after implementation of antihypertensive medication and stabilization of systolic blood pressure (SBP) was calculated by using the equation (area under the curve/survival [days]). Cats were divided into quartiles based on their SBPOT, representing varying levels of blood pressure control (median [25th, 75th percentile]: Q1 = 137 [132, 141] mm Hg, Q2 = 148 [145, 151] mm Hg, Q3 = 157 [155, 158] mm Hg, Q4 = 170 [164, 175] mm Hg). Survival and clinical variables were compared between the quartiles. Cox proportional hazard regression analysis was used to determine the association of age, renal function, proteinuria, SBPOT, and the presence of hyperthyroidism on survival. Urine protein to creatinine ratio (UP: C) was compared at diagnosis of hypertension and after initiating treatment. Results:Only UP: C and SBP at diagnosis differed significantly between SBPOT quartiles. Proteinuria was the only variable significantly related to survival in hypertensive cats. A significant decline in UP: C was found in cats treated with amlodipine besylate. Conclusions and Clinical Importance: Proteinuria before and after treatment of hypertension is strongly associated with survival in cats with systolic hypertension. Treatment with amlodipine besylate can result in a significant reduction in UP: C.

CUTANEOUS and renal glomerular vasculopathy (CRGV or ‘Alabama rot’) was first identified in the USA in the 1980s. Over the past three years, more than 30 confirmed cases have been identified across the UK in various dog breeds (Holm …

Calcium isotopes were enriched in chromatography columns containing 18-crown-6 bound to a solid support. The solid support consisted of polystyrene divinylbenzene to which the crown was bound with a short tether of the structure -CH,OCH,-. Separation coefficients for the chemical exchange reaction ranged from 0.0021 to 0.0034 for the 44Ca-"Ca isotope pair. The presence of dimethylsulfoxide (DMSO) in the fluid phase was found to increase the separation coefficient. This increase was accompanied by additional mass transfer resistance. Higher calcium concentrations in the fluid phase also led to increased separation coefficients. Increases in calcium concentrations in the fluid phase resulted in substantial increases in separative power and reductions in theoretical stage heights and stage residence times. The calcium capacity of the column was decreased by the presence of DMSO and increased by increases in the fluid phase concentration.

To describe the signalment, clinicopathological findings and outcome in dogs presenting with acute kidney injury (AKI) and skin lesions between November 2012 and March 2014, in whom cutaneous and renal glomerular vasculopathy (CRGV) was suspected and renal thrombotic microangiopathy (TMA) was histopathologically confirmed. The medical records of dogs with skin lesions and AKI, with histopathologically confirmed renal TMA, were retrospectively reviewed. Thirty dogs from across the UK were identified with clinicopathological findings compatible with CRGV. These findings included the following: skin lesions, predominantly affecting the distal extremities; AKI; and variably, anaemia, thrombocytopaenia and hyperbilirubinaemia. Known causes of AKI were excluded. The major renal histopathological finding was TMA. All thirty dogs died or were euthanised. Shiga toxin was not identified in the kidneys of affected dogs. Escherichia coli genes encoding shiga toxin were not identified in faeces from affected dogs. CRGV has previously been reported in greyhounds in the USA, a greyhound in the UK, without renal involvement, and a Great Dane in Germany. This is the first report of a series of non-greyhound dogs with CRGV and AKI in the UK. CRGV is a disease of unknown aetiology carrying a poor prognosis when azotaemia develops.

Practical Veterinary Urinalysis Carolyn A. Sink, and Nicole M. Weinstein 180 pages, spiral-bound paperback, £37.50. Wiley-Blackwell. 2012. ISBN 978 0 470 95824 7 EVALUATION of urine is an often neglected diagnostic test in veterinary medicine. This should no longer be the case with a copy of ‘Practical Veterinary Urinalysis’ on your bookshelf, or perhaps, more appropriately, next to your microscope, dipsticks and refractometer in the lab. The preface of this text outlines that the main goals of the book are to provide ‘a comprehensive study of all aspects of routine urinalysis, including chemical analysis and microscopy’ and ‘a concise, systematic overview of renal physiology and urine production’.⇓ Renal physiology is …