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1.
Renal allograft transplantation was performed as treatment for terminal renal failure in six veterinary patients. Three patients failed to survive the postsurgical period, one patient died due to acute allograft rejection, one patient died subsequent to complications of previous parenteral hyperalimentation and infection, and one patient was euthanatized due to the inability of the clients to maintain the effort necessary to manage a transplant recipient. Further clinical studies are necessary to determine if renal transplantation with cyclosporine (cyclosporin A)/prednisolone immunosuppression has the potential to provide practical treatment of terminal renal disease in clinical veterinary medicine. Pharmacologic and immunologic monitoring of transplant recipients with individualized immunosuppression is imperative. Careful surveillance is necessary to identify and eliminate nosocomial sources of infection. Candidates for transplantation cannot be critically ill or malnourished prior to surgery, and pet owners must be prepared for the financial and time commitments associated with caring for a renal allograft recipient.  相似文献   

2.
Four cats developed fibrosis within the retroperitoneal space following renal transplantation. In human transplant patients, retroperitoneal fibrosis is an uncommon complication following surgery and may be secondary to operative trauma, infection, deposition of foreign material in the operative field, urinary extravasation, and perirenal hemorrhage caused by trauma to the allograft. Possible causes of fibrosis in the cats of this report include abdominal inflammation associated with allograft rejection, pyelonephritis, and septic peritoneal effusion. All of the cats of this report were readmitted to the veterinary teaching hospital following renal transplantation because of recurrence of azotemia 1 to 5 months after transplantation. Abdominal ultrasonography revealed a 2- to 4-mm-thick capsule surrounding the allograft in 2 of 4 cats, hydronephrosis in 4 cats, and hydroureter proximally in 2 cats. An exploratory laparotomy was performed in all cats to remove the fibrotic tissue causing the ureteral obstruction. Normal renal function was restored in all cats following surgery. Histologic evaluation of biopsy specimens revealed smooth muscle (3 cats) and fibrous connective tissue (4). All 4 cats, regardless of the cause, responded well to surgical resection of the scar tissue that was causing a ureteral obstruction. None of the cats had recurrence of obstruction following surgery.  相似文献   

3.
Hypertension: A review of the mechanisms, manifestations and management   总被引：1，自引：0，他引：1  
Hypertension is a common disease of man although it is rarely diagnosed in veterinary medicine. This partly reflects a failure of recognition of the incidence and importance of hypertension in animals. Recognition of hypertension is usually late in the course following acute ocular, cardiac, renal or neurological presentation. Early screening and identification of hypertension is important as it is an organ destructive and self-perpetuating process. The physiological control and measurement of blood pressure and the pathogenesis and management of hypertension in small animals is reviewed.  相似文献   

4.
In both human and veterinary medicine, diagnosing and staging renal disease can be difficult. Measurement of glomerular filtration rate is considered the gold standard for assessing renal function but methods for its assessment can be technically challenging and impractical. The main parameters used to diagnose acute and chronic kidney disease include circulating creatinine and urea concentrations, and urine‐specific gravity. However, these parameters can be insensitive. Therefore, there is a need for better methods to diagnose and monitor patients with renal disease. The use of renal biomarkers is increasing in human and veterinary medicine for the diagnosis and monitoring of acute and chronic kidney diseases. An ideal biomarker would identify site and severity of injury, and correlate with renal function, among other qualities. This article will review the advantages and limitations of renal biomarkers that have been used in dogs and cats, as well as some markers used in humans that may be adapted for veterinary use. In the future, measuring a combination of biomarkers will likely be a useful approach in the diagnosis of kidney disorders.  相似文献   

5.
Ultrasonographic examination is a commonly employed technique for postoperative renal allograft evaluation after transplantation. Allograft size and resistive index (RI) are two objective ultrasonographic measures that may help establish a diagnosis and direct postoperative management for grafts with suboptimal function but their diagnostic efficacy has not been evaluated in clinical veterinary patients. Results of 69 feline renal transplant ultrasonographic examinations and RI determinations were studied. Based on clinical parameters at the time of the ultrasonographic examination, patients were grouped into six clinical/functional categories including evaluations of clinically normal grafts, delayed graft function, ureteral obstruction, uroabdomen, graft thrombosis, and rejection. RI, graft size (length, cross-sectional area, and volume), cyclosporine A whole blood trough concentration, Doppler blood pressure, creatinine concentration, and days from transplantation were compared between these categories and associations with each other were examined. RI was of little value in differentiating among the clinical categories with the exception of graft thrombosis. Graft volume and time from transplantation were significantly greater in grafts with signs of rejection and ureteral obstruction compared to clinically normal ultrasound examinations. Graft volume, cross-sectional area and length were generally associated. Cyclosporine A blood concentrations was associated with RI in both the pooled data and in the delayed graft function category. These results indicate RI should be used only as part of a larger clinical picture and in light of other factors including cyclosporine A concentration and the timing of the study relative to the implantation surgery for the diagnosis of postoperative transplantation complications. Graft volume may provide a more sensitive, albeit, nonspecific, indicator of allograft dysfunction.  相似文献   

6.
Feline renal transplantation can offer long-term survival with a normal quality of life for cats with renal failure. However, it is important to remember that renal transplantation is a treatment option and not a cure. Renal transplantation is never performed on an emergency basis or prophylactically. Feline renal transplantation requires special microvascular instruments and an operating microscope. Careful patient selection and perioperative monitoring have improved the success rate. The new microemulsified form of cyclosporine is recommended for immunosuppression. As survival times have steadily improved, long-term complications, such as diabetes and neoplasia, are now being recognized.  相似文献   

7.
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8.
Amniotic membrane transplantation (AMT) is an effective clinical therapy for reconstruction of the ocular surface in human and veterinary patients. Amnion is avascular and strong, contains antiangiogenic and antiinflammatory properties and growth factors, and has properties that prevent or decrease fibrosis in healing tissue. Indications for its use are steadily growing and include grafting to replace diseased, missing or excised tissue, patching to support diseased tissue during the healing process and as a substrate for the expansion of epithelial cells for transplantation to the cornea. AMT through a combination of mechanical and biologic factors can preserve the integrity of the globe, optimize the visual outcome, and minimize scarring in severely diseased corneas.  相似文献   

9.
Our objective was to evaluate the association between grading of hip status as assessed by radiographic examination (hip screening) and subsequent incidence of veterinary care and mortality related to hip dysplasia (HD) in five breeds of insured dogs in Sweden. Screening results for hip status from the Swedish Kennel Club and data on veterinary care and mortality from the insurance company Agria were merged based on the registration number of the dog. Dogs of five breeds (Bernese Mountain Dogs, German Shepherds, Golden Retrievers, Labrador Retrievers, and Rottweilers) screened during 1995–2004 and covered by an insurance plan for veterinary care or life at the time of screening were included. The study populations included between 1667 and 10,663 dogs per breed. Breed-specific multivariable Cox proportional-hazards analyses were performed to evaluate the impact of radiographic hip status on time from hip screening to first HD-related veterinary and life claim, respectively. The effects of gender, birth season, and a time-varying covariate of year were also studied. Additional analyses, on the five breeds combined, were performed to investigate the effects of hip status, breed, and the interaction between hip status and breed. The effect of hip status was highly significant (P < 0.001) for both life and veterinary claims related to HD in all five breeds with increased hazard ratio (HR) for deteriorating hip status. Dogs with moderate or severe hip status at screening had a markedly increased hazard of HD-related veterinary care and mortality compared with dogs assessed as free or mild. The time-varying covariate of year showed a significantly higher HR in the last time period for German Shepherds and Labrador Retrievers in the analyses of veterinary claims. In the analyses on all five breeds, German Shepherds had the highest HR for both veterinary care and mortality related to HD, followed by Bernese Mountain Dogs. Golden and Labrador Retrievers had the lowest HR. The effect of hip status on the hazard was the same irrespective of breed. However, as a consequence of differences between breeds in overall risk, the predictive ability of screening results for subsequent incidence of HD-related problems for individual dogs was breed-dependent. Based on the strong association between radiographic hip status and incidence of HD-related veterinary care and mortality, and the previously reported moderate heritability of hip status, we conclude that selection based on screening results for hip status can be expected to reduce the risk of HD-related clinical problems.  相似文献   

10.
Objective: To review phosphorus and phosphate metabolism and the importance of phosphate abnormalities in veterinary patients. Data sources: A review of recent human and veterinary medical literature. Human data synthesis: There is a significant amount of original research on human patients with phosphate abnormalities. Hypophosphatemia has been studied in patients with diabetic ketoacidosis (DKA), head trauma, refeeding syndrome, hypothermia and in ventilator patients that fail to wean. Hyperphosphatemia has been studied in patients with renal failure and malignancy. Phosphate levels have also been evaluated for prognostic value in sepsis and acute liver failure. Veterinary data synthesis: Although animal models were used in early experimental research, fewer studies have been published on the effects of phosphate abnormalities in veterinary patients. Hypophosphatemia has been studied in animals with DKA, with refeeding syndrome and with hyperparathyroidism. Hyperphosphatemia has been studied in animals with renal failure and with secondary hypoparathyroidism. Conclusion: Phosphorus and phosphate are important in many biological functions. This paper is a review of their role in normal metabolism and the clinical importance of phosphate imbalances for our emergency and critical care patients.  相似文献   

11.
Fifty cats with naturally occurring stable chronic renal failure (CRF) were entered into a prospective study on the effect of feeding a veterinary diet restricted in phosphorus and protein with or without an intestinal phosphate binding agent on their survival from initial diagnosis. Twenty-nine cats accepted the veterinary diet, whereas compliance (due to limited intake by the cats or owner resistance to diet change) was not achieved in the remaining 21. At diagnosis, both groups of cats were matched in terms of age, bodyweight, plasma creatinine, phosphate, potassium and parathyroid hormone (PTH) concentrations, packed cell volume and urine specific gravity. Feeding the veterinary diet was associated with a reduction in plasma phosphate and urea concentrations and prevented the increase in plasma PTH concentrations seen in cats not receiving the diet. Cats fed the veterinary diet survived for longer when compared with those that were not (median survival times of 633 versus 264 days). These data suggest that feeding a diet specifically formulated to meet the needs of cats with CRF, together with phosphate binding drugs if required, controls hyperphosphataemia and secondary renal hyperparathyroidism, and is associated with an increased survival time.  相似文献   

12.
The present paper analyzes the admission test administered to candidates to the veterinary medicine program in Italy for the academic years 2007-2008, 2008-2009, and 2009-2010 nationwide as well as the University of Pisa student intake from 2001-2002 through 2009-2010, comparing the relationship between the admission test and students' academic careers at Pisa. This paper finds that the Italian system of a locally enforced fixed intake number does not select the best possible candidates for admission because (1) there are significant variations in the candidates' preparation among the different locations where the test is held, (2) the subjects tested are not equally selective in identifying the best candidates, and (3) there is a very strong relationship between candidates' performance on the admission test and the subsequent academic career of the admitted candidates. In its findings, this study in part contradicts what is commonly believed by the Italian veterinary medicine community, and, as a result, it is extremely important that care is taken in the decision-making process-in the process, that is, of identifying a fixed intake number and of selecting the subjects to be tested on the admission test.  相似文献   

13.
Seizures or convulsions that occur during anaesthesia in veterinary patients are infrequently reported in the literature. Consequently, the incidence of such events is unknown. Several drugs commonly used in clinical veterinary anaesthesia have been shown to induce epileptiform activity in both human clinical patients and experimental candidates. The present case report describes convulsions in a four-year old male Bernese mountain dog during maintenance of anaesthesia with isoflurane after premedication with acepromazine and methadone followed by co-induction with propofol and ketamine. The dog had no history of previous convulsions. The use of several sedative and anaesthetic drugs makes it difficult to find one single causative pharmaceutical.  相似文献   

14.
Peritoneal dialysis in emergency and critical care medicine   总被引：2，自引：0，他引：2  
Peritoneal dialysis is a technique that has been used to treat acute renal failure in humans since 1923. Peritoneal dialysis is used in people to manage acute and chronic renal failure, as well as to remove dialyzable toxins (ethylene glycol, barbiturates, and ethanol), reduce severe metabolic disturbances, and for the treatment of peritonitis, pancreatitis, uroabdomen, hypothermia, and fluid overload. In veterinary medicine, acute renal failure is the prevailing indication for dialysis. This report will discuss the pathophysiology of peritoneal dialysis, indications, and contraindications. Catheter selection and placement will be reviewed. Types of dialysate solution will be discussed and the protocol established for instituting peritoneal dialysis. The report will conclude with a discussion of potential complications and methods to minimize them.  相似文献   

15.
兽药在畜禽养殖中发挥重要作用,但由于养殖户盲目用药,药物选择和使用不规范,随意搭配药物,造成兽药使用量超出安全剂量规定,不仅严重威胁畜禽和人类健康,还污染土壤、水源和大气环境,因此必须对畜禽养殖中的兽药使用进行科学引导和严格规范。该文对我国目前畜禽养殖业兽药使用的现状进行分析,从兽药生产企业准入门槛和销售流通环节入手,结合兽药法律法规、兽药使用规范、兽药监管体系、兽药检测制度提出改善对策。  相似文献   

16.
NSAIDs are the most widely used analgesics in veterinary medicine, and all have some toxic potential. The most common adverse class effects are gastrointestinal, renal, hepatic, and coagulation disorders. When treating chronic pain associated with osteoarthritis, the effectiveness of NSAIDs can be enhanced by physical therapy, use of chondroprotective agents, certain adjunctive drugs, and diet and exercise to control weight. To treat acute perioperative pain, NSAIDs are more effective when used preemptively, in the context of balanced (multimodal) analgesia, and in well-hydrated patients with normal blood pressure and renal function. Screening and monitoring to identify high-risk candidates for NSAID treatment should include a physical examination and patient history, identification of preexisting diseases or conditions, obtaining baseline and periodic hematologic and clinical chemistry values, and ensuring that other NSAIDs or contraindicated drugs are not used concurrently. When switching a patient from one NSAID to another (when no side effects have been seen), a washout period of 5 to 7 days minimizes chances for adverse drug interactions. Informing clients of the potential adverse effects of NSAID therapy and signs of NSAID toxicity greatly increases the likelihood of safe use of this class of drugs.  相似文献   

17.
Obtaining a biowaiver for topical drugs used in veterinary species faces many of the same challenges associated with human topicals. However, the skin of domestic animals varies anatomically and biochemically and experimental approaches to assess bioequivalence (BE) in veterinary species have challenges that are not often encountered with human skin. This is especially the situation with locally acting drugs. The focus of this paper is to address several of the challenges associated with (i) determining the BE of these locally acting drugs and (ii) critically examine the current technological advances that can act as a surrogate for clinical trials.  相似文献   

18.
The value of next-generation sequencing (NGS)-based applications for testing purposes in human medicine is widely recognized. Although NGS-based metagenomic screening may be of interest in veterinary medicine, in particular for intensively farmed livestock species such as pigs, there is a lack of protocols tailored to veterinary requirements, likely because of the high diversity of species and samples. Therefore, we developed an NGS-based protocol for use in veterinary virology and present here different applications in porcine medicine. To develop the protocol, each step of sample preparation was optimized using porcine samples spiked with various RNA and DNA viruses. The resulting protocol was tested with clinical samples previously confirmed to be positive for specific viruses by a diagnostic laboratory. Additionally, we validated the protocol in an NGS viral metagenomics ring trial and tested the protocol on viral multiplex reference material (NIBSC, U.K.). We applied our ViroScreen protocol successfully for 1) virus identification, 2) virus characterization, and 3) herd screening. We identified torque teno sus virus and atypical porcine pestivirus in a neurologic case, determined the full-length genome sequence of swine influenza A virus in field samples, and screened pigs using pen floor fecal samples and chewing rope liquid.  相似文献   

19.
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20.
The purpose of this study was to describe clients' level of compliance with reminders that are computer generated and to identify factors associated with owner response to a recall. Client response to a recall notice revealed that clients responded to reminders for vaccination about 3 times less often than for the other recall codes combined (dental procedures, laboratory tests, medical progress examinations, and neutering). These results suggest that veterinarians need to move away from annual vaccination reminders and toward the promotion of preventive veterinary services, such as annual wellness examinations, screening laboratory testing, and routine dental procedures. Once a practice has committed to and set up the required computer systems to promote preventive veterinary care, the stage is set for the implementation and monitoring of recommendations and reminders. This type of practice philosophy and marketing coincides perfectly with an approach to maximizing compliance in all aspects of veterinary medicine.  相似文献   

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