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WSV18-0060
WSAVA GLOBAL NUTRITION
EVERYBODY EATS: DON’T FORGET TO FEED YOUR HOSPITALIZED PATIENTS
L. Weeth1, F. Gaschen2
1Weeth Nutrition Services, Clinical Nutrition, Los Angeles, USA
2Louisiana State University, Internal Medicice, Baton Rouge, USA
Chronic intestinal protein loss is a sign of failure of digestive function that may result from severe acute or chronic inflammatory lesions or from a disruption of chyle absorption and intestinal lymph flow. While the exact mechanisms leading to intestinal protein loss have not been elucidated in the dog, the three basic mechanisms defined for humans with protein-losing enteropathy
(PLE) likely also apply to canine PLE. It is frequently associated with severe chronic idiopathic inflammatory enteropathies such as inflammatory bowel disease
(IBD) or with idiopathic intestinal lymphangiectasia in specific breeds. Protein loss may result from: 1) erosive or ulcerative mucosal lesions causing secondary exudation of proteins; 2) lymphatic dysfunction causing leakage of protein-rich lymph into the intestinal lumen; 3) mucosal changes disturbing the mucosal barrier, causing abnormal permeability and protein leakage into the lumen; or 4) a combination of all three of the previously listed conditions. This presentation will focus on chronic intestinal disorders associated with intestinal protein loss in dogs and the dietary and medical treatments for this condition.
Your Singapore, the Tropical Garden City
WSV18-0102
NEPHROLOGY
SERUM CREATININE CONCENTRATION: USEFUL TIPS FOR CORRECT INTERPRETATION
G. Segev1
1Koret School of Veterinary Medicine, Israel Introduction
Acute kidney injury (AKI) and chronic kidney disease (CKD) are common in dogs and cats and are associated with substantial morbidity and mortality. Serum creatinine is the most commonly utilized marker for renal function, but is neither sensitive nor specific for early detection of kidney injury.
Limitations of serum creatinine concentration
Despite the diagnostic advancements made in other medical fields (e.g., the use of biomarkers in cardiology), serum creatinine is still being used as the marker for kidney function despite its multiple shortcomings.
The main limitation of serum creatinine include the following:
1. Serum creatinine is affected by extra-renal factors, like hydration status and muscle mass, therefore it lacks specificity. Creatinine may
be increased in dehydrated animals in face of normal kidney function. In cachectic animals (common in animals with advanced CKD) creatinine concentration will overestimate kidney function.
2. Creatinine is influenced by muscle mass there- fore its baseline concentration varies among dog breeds. The attempt to include all dogs under one reference range results in a very wide reference range, which decreases its sensitivity.
3. The nonlinear relationship between glomerular filtration rate (GFR) and creatinine (Fig. 1) also de- creases its sensitivity since substantial changes in GFR at the early stages of the disease, are associated with only small changes in serum creatinine concentration, thus creatinine will not increase above its reference range until sub- stantial loss in GFR has already occurred. This phenomenon is more pronounced in dogs with low baseline creatinine concentration (dogs with low muscle mass). In most dog breeds creati- nine is not expected to rise above the reference range until ~75% of nephrons become non-func- tional.
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