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Compendium May 2006 (Vol 28, No 5)

Abstract Thoughts (May 2006)

by Joseph Harari, MS, DVM, DACVS

    Berent AC, Murakami T, Scroggin RD, et al: Reliability of using reagent test strips to estimate blood urea nitrogen concentration in dogs and cats. JAVMA 227(8):1253-1256, 2005.

    Abstract: In this prospective study conducted at a veterinary teaching hospital, fresh blood samples were collected from 116 dogs and 58 cats on admission for subsequent evaluation of the accuracy of blood urea nitrogen (BUN) test strips. Animals used in the study were tested before routine elective surgery, as part of a geriatric or an emergency examination, or during monitoring while being hospitalized in the intensive care unit. Estimates of the concentration (categories 1 through 4) in the test strips were compared with concentrations measured by an automated analyzer.

    Automated analysis confirmed correct test-strip categorical classification in 114 dogs and 56 cats. Data revealed that dogs and cats with category 1 and 2 test-strip results are likely nonazotemic; in category 3, dogs are likely azotemic, whereas cats are equivocal; and animals in category 4 are likely azotemic. The high specificity of the reagent strips suggested that nonazotemic animals will unlikely have a false-positive result, although one dog and two cats with azotemia had false-negative results. Based on mean automated evaluations, test strips underestimated high BUN concentrations (categories 3 and 4) in dogs and possibly in cats.

    The authors concluded that reagent test strips were reliable for rapid estimation of BUN concentrations in dogs and cats and classification of azotemic or nonazotemic states. Verification, as clinically indicated, should be done by an automated analyzer.

    Commentary: Reagent test strips are routinely used in veterinary medicine to rapidly estimate BUN concentration. Limitations of this examination relate to subjective color analysis, technical timing of the procedure, storage and quality of the strips, and lighting. Using a serum chemistry analyzer as the gold standard, the authors evaluated the accuracy of the strips in a clinical setting with normal and ill animals. The results support the use of commercial strips, although automated verification should be considered when dealing with morbid patients, especially cats. It was also interesting to note that automated values overlapped extensively in categories 1 and 2, indicating that commercial strips may not be useful for estimating low BUN concentrations.

    Canine Insulinoma: Detection Via Ultrasonography, Computed Tomography, And Single-Photon Emission Computed Tomography

    Robben JH, Pollak YW, Kirpensteijn J, et al: Comparison of ultrasonography, computed tomography, and single-photon emission computed tomography for the detection and localization of canine insulinoma. J Vet Intern Med 19:15-22, 2005.

    For best selection of surgical candidates for canine in­su­linoma, transabdominal ultrasonography, computed tomography (CT), and single-photon emission CT (SPECT: somatostatin receptor scintigraphy, with [111In-DTPA-d-Phe1]octreotide) were compared for accuracy in identifying primary tumors and lymph node and liver metastases in 13 dogs. Intraoperative inspection and palpation served as the control method.

    Twelve dogs had one pancreatic tumor; one had two tumors. CT identified 10 tumors, two of which were also found with SPECT and ultrasonography; two of which were found with ultrasonography but not SPECT; and three of which were found with SPECT but not ultrasonography. CT did not identify four primary tumors; one of these was found by SPECT and one with ultrasonography. No method identified two tumors. CT revealed two of five lymph node metastases but also produced 28 false-positive results; ultrasonography and SPECT did not find these metastases but did uncover liver metastases, as did CT. The control method found all primary tumors.

    Key Findings:

    • CT identified most primary tumors but may not be appropriate for lymph node metastases.
    • SPECT seemed as effective as ultrasonography and CT in identifying primary tumors.
    • A proposed protocol includes transabdominal ultrasonography for diagnosis and initial assessment as well as intraoperative inspection and palpation for primary tumor identification plus CT or intraoperative ultrasonography, if needed.

    Long-Term Effects Of Endoscopic Collagen Injection In Treating Urethral Sphincter Incompetence In Female Dogs

    Barth A, Reichler IM, Hubler M, et al: Evaluation of long-term effects of endoscopic injection of collagen into the urethral submucosa for treatment of urethral sphincter incompetence in female dogs: 40 cases (1993"2000). JAVMA 226:73"76, 2005.

    Long-term success of collagen injection in treating urethral sphincter incompetence, a common adverse effect of spaying, was analyzed retrospectively for 40 female dogs. Data obtained from records included history and results of physical examination and neurologic, radiographic, ultrasonographic, hematologic, and urinary studies. Three injections of collagen (from calf skin) were made via an endoscope into urethral submucosa at 2-, 6-, and 10-o'clock positions. Dogs with recurrence of incontinence had either phenylpro­pa­nol­amine or ephedrine treatment or another collagen procedure. Duration of follow-up (i.e., telephone contact with owners) was from less than 2 weeks to 36 to 48 months after surgery.

    No significant relationship between severity of incontinence, age, amount of collagen used, or course of procedure and initial or final result was found. Continence was achieved in 68% of dogs by injection alone; in another 15%, it was achieved with postprocedure use of medication. Spreading of collagen, with flattened deposits, appeared to lead to relapse. Adverse effects (in 15% of dogs) were mild and not long-lasting.

    Key Findings:

    • Collagen injection yielded satisfactory long-term (i.e., mean: 33 months) success as incontinence treatment and compared well to established surgical methods.
    • The procedure is minimally invasive, risk of adverse effects is low, and collagen has good biocompatibility (i.e., better than polytef).
    NEXT: An In-Depth Look: Disruption of the Gastric Mucosal Barrier in Dogs

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