Background: Serum symmetric dimethylarginine (SDMA) concentrations are considered a biomarker for renal dysfunction in dogs and humans with acute kidney injury (AKI). No studies have assessed SDMA in cats with AKI.Hypothesis/Objectives: SDMA correctly identifies cats with azotemic AKI.Animals: Fifteen control cats, 22 with novel AKI, 13 with acute on chronic-AKI (AoC) and 19 with chronic kidney disease (CKD). Methods: Retrospective study. Cats with azotemia (serum creatinine concentrations >1.7 mg/dL) were defined as having AKI or CKD based on history, clinical signs, clinicopathological findings and diagnostic imaging, and classified using the International Renal Interest Society (IRIS) grading/staging systems. Serum SDMA concentrations were compared between groups with nonparametric methods, and correlations assessed using Spearman's correlation coefficient. Data are presented as median [range].Results: SDMA concentrations were 11 (8-21) μg/dL, 36 (9-170)μg/dL, 33 (22-75) μg/dL and 25 (12-69) μg/dL in control, novel AKI, AoC and CKD cats. SDMA concentrations were significantly higher in cats with novel AKI (P < .001), AoC (P < .001) and CKD (P < .01) compared to controls. SDMA concentrations were significantly higher in cats with more advanced AKI (IRIS grade IV-V) compared to less severe AKI (IRIS grade II).Serum creatinine and SDMA concentrations had a significant correlation in cats with novel AKI (r s = 0.826, n = 22; P < .001) and a significant correlation when all cats across all 4 groups were considered together (r s = 0.837, n = 69; P < .001).Conclusions and Clinical Importance: Serum SDMA concentrations are elevated in cats with established AKI (novel and AoC) and CKD, providing evidence for use of SDMA as a biomarker for AKI in cats.
An 11 year old female-neutered Labrador presented for facial swelling. Clinicopathological abnormalities included hyperglobulinemia, azotemia, hypercalcemia, nonregenerative anemia, thrombocytopenia, and spurious hypoglycemia. Normoglycemia was subsequently confirmed using a cage-side analyzer (AlphaTRAK, Zoetis, UK). Serum and urine protein electrophoresis documented monoclonal (immunoglobulin M) gammopathy with Bence-Jones proteinuria. Computed tomography imaging revealed a monostotic osteolytic bone-lesion, and bone marrow cytology and histopathology documented plasmacytosis with multiple myeloma oncogene 1 / interferon regulatory factor 4 positivity, consistent with multiple myeloma. Infectious disease testing initially indicated seropositivity for Leishmania, Borrelia, and Anaplasma spp.; however, Leishmania PCR (splenic and bone marrow aspirates), and paired serological titers for Borrelia and Anaplasma were negative. Consequently, initial serological results were considered to be false positive because of paraproteinemia-associated assay interference. Chemotherapy (prednisolone and melphalan combination therapy) was initiated, but the dog was euthanased 30 days later because of the development of pericardial effusion. This is a report of spurious serological (and other laboratory) results occurring secondary to monoclonal gammopathy in a dog.
A 5-year-old, male, neutered lurcher dog was presented for investigation of a cranial abdominal mass and suspected acute pancreatitis. Advanced diagnostic imaging revealed the presence of a cavitated mass, multiple splenic nodules and coeliac lymphadenopathy. Fluid analysis from ultrasound-guided mass-lesion aspiration was suggestive of a pancreatic origin. After medical stabilisation, the dog underwent celiotomy where partial left limb pancreatectomy, splenectomy and coeliac lymphadenectomy were performed. Histopathological examination was consistent with a chronic pancreatic haematoma, splenic nodular hyperplasia with sinus histiocytosis and sinus erythrocytosis of the coeliac lymph node. Post-operatively, the dog recovered rapidly with supportive care. Re-examination 3 months later showed that it remained clinically normal with no symptoms of pancreatitis, and no evidence of recurrence of the haematoma or metastatic disease. This report describes the presentation of a large pancreatic lesion, compatible with a haematoma, and its successful surgical treatment in a dog.
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