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Biomedical subjects

J W Bartges

Publications and source records attributed to J W Bartges.

At least 19 recordsLinked to original sources

Methods for evaluating treatment of uroliths.

Formation of uroliths is not a disease but rather a complication of several disorders. Some disorders can be identified and corrected (e.g., infection-induced struvite urolith formation), and some can be identified but not corrected (e.g., hyperuricosuria occurring in Dalmatians that form ammonium urate uroliths), although for others, the underlying etiopathogenesis is not known (e.g., calcium oxalate urolith formation in Miniature Schnauzers). A common denominator of these disorders is that from time to time, they can create oversaturation of urine with one or more crystal precursors, resulting in formation of crystals. To develop rational and effective approaches to treatment, abnormalities that promote urolith formation must be identified with the goal of eliminating or modifying them. It is therefore important to understand several basic concepts associated with urolithiasis.

Animals↗

Medical dissolution and prevention of canine struvite urolithiasis. Twenty years of experience.

Two types of canine struvite uroliths have been recognized: infection-induced struvite is the most common type; sterile struvite is uncommonly recognized. Infection-induced struvite is most commonly associated with urease-producing staphylococcal UTI. For dogs that qualify, medical dissolution is an effective method of treatment. Medical dissolution protocols encompass: (1) eradication or control of UTI; (2) use of calculolytic diets; and (3) administration of urease inhibitors to patients with persistent UTI caused by urease-producing microbes.

Animals↗

Canine urate urolithiasis. Etiopathogenesis, diagnosis, and management.

Etiopathologic factors predisposing to urate lithogenesis in Dalmatian and non-Dalmatian dogs represent diverse pathologic and/or physiologic processes involving purine nucleotide and ammonia synthesis, biodegradation, and excretion. Predisposing factors for urate urolith formation include hyperuricemia, hyperammonemia, hyperuricosuria, hyperammonuria, aciduria, and genetic predisposition. Medical therapy of dogs forming urate uroliths should be directed at modifying these predisposing factors through dietary modification, administration of allopurinol, and/or surgical correction of portovascular anomalies if present. The precise mechanisms resulting in urate urolith formation in dogs have not been determined.

Animals↗

Canine cystine urolithiasis. Cause, detection, treatment, and prevention.

Cystine uroliths are a sequela to cystinuria, an inherited renal tubular defect in reabsorption of cystine and some other amino acids. At the Minnesota Urolith Center, 67 breeds of dogs were identified, including English Bulldogs, Dachshunds, Mastiffs, and Newfoundlands. In some dogs, the severity of cystinuria may decline with advancing age. Current recommendations for dissolution of cystine uroliths include various combinations of diet modification, diuresis administration of 2-MPG, and alkalinization of urine.

Animals↗

Drug-induced urolithiasis.

Diagnostic and therapeutic drugs may enhance urolithiasis in one or a combination of ways, including: (1) alteration of urine pH in such fashion as to create an environment that increases the solubility of some lithogenic substances, (2) alteration of glomerular filtration rate, tubular reabsorption, and tubular secretion of drugs of endogenous substances so as to enhance promoters or impair inhibitors of urolithiasis, and (3) precipitation (e.g., drugs or their metabolites) to form a portion or all of a urolith.

Allopurinol↗

Interventional nutrition for renal disease.

Interventional nutrition plays a central role in the management of renal diseases in veterinary medicine. Most of the clinically observable abnormalities produced by the disruption of renal function are influenced by dietary intake of calories, phosphorus, sodium, potassium, protein, or acid load. Further, the kidney is susceptible to self-perpetuating injury, an inherent property of this organ, and the extent of this injury can be modified by adjustments in dietary intake of phosphorus and polyunsaturated fatty acids. The response of each animal with renal insufficiency to the disease and to nutritional intervention varies dramatically, and individualized therapy is required; the only constant nutritional characteristic of renal insufficiency is inappetance and loss of body weight. Successful interventional nutrition must take all of these principles into account.

Acid-Base Equilibrium↗

Complications with non-endoscopic percutaneous gastrostomy in 31 cats and 10 dogs: a retrospective study.

Percutaneous gastrostomy tubes were placed non-endoscopically in 31 cats and 10 dogs using either a rigid insertion tube (n = 13) or an Eld gastrostomy tube applicator (n = 28). Tubes were placed successfully in 38 of the 41 animals and the consequent feeding was of therapeutic benefit to 31 of the animals. Six of 41 died or were euthanased for reasons unrelated to gastrostomy. In four cases (10 per cent), gastrostomy failed with respect to correct tube placement or tube feeding. Overall complications occurred in 18 of 41 animals. Severe procedural complications occurred in two cats; a cardiorespiratory arrest during pharyngeal manipulation and erroneous tube placement through the distal oesophagus. Moderate late complications included peristomal food leakage (n = 2), peristomal abscess (n = 2) and pyloric outflow obstruction by a migrated tube (n = 1). Complications associated with the feeding procedure, nausea and vomiting (n = 3), led to aspiration pneumonia in one case.

Animals↗

Therapeutic plasmapheresis.

Plasmapheresis is the process by which plasma containing components causing or thought to cause disease is removed from the circulation, and the remaining blood components are returned with plasma or a harmless plasma substitute to the donor. It primarily removes protein-bound solutes or high-molecular-weight solutes such as circulating protein-bound toxins, autoantibodies, immune complexes, or other abnormally occurring molecules. Plasmapheresis has been used in the treatment of more than 100 diseases in human medicine, including immune-mediated diseases, neoplasia, infectious diseases, sepsis, hyperlipidemia, thyrotoxicosis, and removal of toxins. In immune-mediated disease, it is most useful to rapidly decrease plasma concentrations of antibodies or immune complexes, whereas other immunosuppressive measures are used to prolong the effect.

Anemia, Hemolytic↗

Effects of time and dilution on concentration of xanthine in frozen urine and plasma of dogs.

OBJECTIVE: To evaluate the effects of dilution on stability of xanthine in canine urine stored at -20 C, and to evaluate the effects of storage at -20 C on stability of xanthine in canine plasma. ANIMALS: 6 reproductively intact female Beagles, 3.9 to 4.2 years old and weighing 8.5 to 10.1 kg. PROCEDURE: Dogs were fed a 31.4% protein (dry weight), meat-based diet for 21 days, and administered allopurinol (15 mg/kg of body weight, q 12 h) during days 14 to 21; urine and plasma samples were obtained on day 22. Urine samples were preserved undiluted or diluted, and divided into 1-ml aliquots for storage at -20 C for 1 to 12 weeks. Plasma samples were divided into 1-ml aliquots for storage at -20 C for 1 to 12 weeks. Urine and plasma xanthine concentrations were measured on day of collection (baseline) and after 1, 2, 4, 6, 9, and 12 weeks. RESULTS: Dilution of urine samples did not have a significant effect on consistency of xanthine concentration measured for up to 12 weeks of storage. Although xanthine concentration did not differ significantly between undiluted and diluted urine samples, average xanthine concentration measured in diluted samples was consistently higher, compared with that in undiluted samples. Compared with baseline values, plasma xanthine concentration was significantly lower at 6, 9, and 12 weeks of storage. CONCLUSIONS: Measurement of xanthine concentration is reproducible in undiluted or diluted urine samples for up to 12 weeks, although dilution may provide better results. Measurement of plasma xanthine concentration is reproducible in samples stored for up to 4 weeks. CLINICAL RELEVANCE: To ensure reproducibility of measurements of xanthine concentration in urine samples collected from dogs that are affected with urate uroliths and receiving allopurinol, urine should be diluted 1:20 with deionized water. These measurements may be useful for monitoring dogs that are receiving allopurinol for dissolution or prevention of urate uroliths.

Animals↗

Bioavailability and pharmacokinetics of intravenously and orally administered allopurinol in healthy beagles.

OBJECTIVES: To determine bioavailability and pharmacokinetic parameters for allopurinol and its active metabolite, oxypurinol. ANIMALS: 6 healthy, reproductively intact female Beagles, 4.9 to 5.2 years old, and weighing 9.5 to 11.5 kg. PROCEDURE: In the first part of the study, allopurinol was administered IV at a dosage of 10 mg/kg of body weight to 3 dogs and 5 mg/kg to 3 dogs; the sequence was then reversed. In the second part of the study, allopurinol was administered orally at a dosage of 15 mg/kg to 3 dogs and 7.5 mg/kg to 3 dogs; the sequence was then reversed. In the third part of the study, allopurinol was administered IV (10 mg/kg), orally (15 mg/kg) with food, and orally (15 mg/kg) without food. Plasma samples were obtained at timed intervals, and concentrations of allopurinol and oxypurinol were determined. RESULTS: Maximal plasma allopurinol concentration and area under plasma allopurinol and oxypurinol concentration-time curves were 2 times greater when dogs were given 10 mg of allopurinol/kg IV, compared with 5 mg/kg, and when dogs were given 15 mg of allopurinol/kg orally, compared with 7.5 mg/kg. Allopurinol elimination half-life, time to reach maximal plasma oxypurinol concentration, and oxypurinol elimination half-life were significantly greater when dogs received 10 mg of allopurinol/kg IV, compared with 5 mg/kg, and when dogs received 15 mg of allopurinol/kg orally, compared with 7.5 mg/kg. CONCLUSIONS: Elimination of allopurinol is dependent on nonlinear enzyme kinetics. The bioavailability of allopurinol, and pharmacokinetic parameters of allopurinol and oxypurinol after oral administration of allopurinol, are not affected by administration with food. CLINICAL RELEVANCE: A dose threshold exists beyond which additional allopurinol would not substantially further inhibit xanthine oxidase activity. Oral administration of > 15 mg of allopurinol/kg to dogs would not be expected to result in greater reduction of plasma and urine uric acid concentrations. Also, allopurinol may be administered to dogs for dissolution or prevention of urate uroliths without regard to time of feeding.

Administration, Oral↗

Influence of two diets on pharmacokinetic parameters of allopurinol and oxypurinol in healthy beagles.

OBJECTIVES: To determine whether diet influences the metabolism of IV administered allopurinol in healthy dogs. ANIMALS: 6 healthy female Beagles, 4.9 to 5.2 years old and weighing 9.6 to 11.5 kg. PROCEDURES: Allopurinol was administered IV (10 mg/kg) while dogs consumed a 10.4% protein (dry weight), casein-based diet or a 31.4% (dry weight), meat-based diet. After each dose, plasma samples were obtained at timed intervals, and concentrations of allopurinol and its active metabolite, oxypurinol, were determined by high-performance liquid chromatography. An iterative, nonlinear regression analytical program was used to determine the weighted least-squares, best-fit curves for plasma allopurinol and oxypurinol concentration-time data. From these data, pharmacokinetic parameters were calculated. RESULTS: Pharmacokinetic parameters for allopurinol and oxypurinol were not different when comparing the effect of diet. CONCLUSION: There is no influence of diet on pharmacokinetic parameters of allopurinol or oxypurinol. CLINICAL RELEVANCE: In contrast to observations in human beings, allopurinol metabolism is not influenced by diet. Therefore, formation of xanthine-containing calculi in dogs consuming a high-protein diet and receiving allopurinol is probably not attributable to alteration of allopurinol metabolism.

Allopurinol↗

Reliability of using random urine samples for "spot" determination of fractional excretion of electrolytes in cats.

OBJECTIVE: To determine whether the "spot" method of determining fractional excretion (FE) of electrolytes in cats is accurate. ANIMALS: 5 clinically normal young adult female cats. PROCEDURE: Cats were acclimated to metabolism cages, and 2 consecutive 72-hour collections of urine were made to determine FE of total calcium, potassium, total magnesium, sodium, and phosphorus by conventional methods, using endogenous creatinine clearance as an estimate of glomerular filtration rate. During collections, small samples of urine were obtained by cystocentesis at 8 AM, 3 PM, and 9 PM for determination of FE of the electrolytes by use of the "spot" method. RESULTS: Values from "spot" determinations were highly variable, compared with 72-hour values, with a high percentage falling outside the range of mean +/- 2 SD for 72-hour FE values. CONCLUSIONS AND CLINICAL RELEVANCE: The "spot" method for determining FE is not precise, and if used, caution and judgement should be exercised in interpretation of the results.

Animals↗

Medical management of feline urethral obstruction.

A step-by-step priority of procedures is recommended when attempting to restore urethral patency in an obstructed male cat. In order of priority they are: (1) massage of the distal urethra, (2) attempts to induce voiding by gentle palpation of the urinary bladder, (3) cystocentesis, (4) retrograde urethral flushing, (5) combinations of 1 through 4, (6) diagnostic radiology to determine if the cause of urethral obstruction is intraluminal, mural or extramural, and if absolutely necessary, (7) surgical procedures.

Animals↗

Management of postrenal azotemia.

Postrenal azotemia is a potentially life-threatening consequence of urinary obstruction Its most serious consequences include fluid volume deficits, hyperkalemia, and metabolic acidosis. Immediate therapy should be directed at restoring urine flow, correcting extracellular fluid volume deficits, minimizing the cardiac toxicity of hyperkalemia, and ameliorating the cardiovascular effects of metabolic acidosis. Most patients respond quickly and completely to such therapeutic intervention.

Acidosis↗

Diagnosis, medical treatment, and prognosis of feline urolithiasis.

Radiographic or ultrasonographic evaluation of the urinary tract is required to consistently detect feline uroliths. Evaluation of clinical, laboratory, and radiographic findings facilitate "guesstimation" of the mineral composition of uroliths. Therapy should not be initiated before appropriate samples have been collected for diagnosis. The objectives of medical management of uroliths are to arrest further growth and to promote urolith dissolution by correcting or controlling underlying abnormalities. For therapy to be effective, it must induce undersaturation of urine with calculogenic crystalloids by (1) increasing the solubility of crystalloids in urine, (2) increasing the volume of urine in which crystalloids are dissolved or suspended, and (3) reducing the quantity of calculogenic crystalloids in urine.

Animals↗

Hypertension and renal disease.

Systemic hypertension is commonly associated with chronic renal failure in dogs and cats. Consequences of systemic hypertension are manifested by pathologic changes involving the eyes, heart, central nervous system, and/or kidneys. These changes may be prevented or reversed by diagnosing and treating systemic hypertension. Therefore, blood pressure determination and ophthalmic examination should be performed routinely in animals with chronic renal failure. Therapy for systemic hypertension associated with chronic renal failure should be initiated cautiously with the goal being to lower arterial pressure below values considered to be hypertensive. Therapy may involve nonpharmacologic strategies and/or hypertensive drugs. This article discusses pathophysiologic mechanisms, consequences, diagnosis, and treatment of systemic hypertension associated with chronic renal failure in dogs and cats.

Animals↗

Percutaneous needle biopsy of the kidney. Indications, applications, technique, and complications.

During the past three decades, percutaneous renal biopsy has evolved as a valuable method of clinical evaluation of patients with various forms of glomerular proteinuria and primary renal failure. The advent of automated core biopsy needles and ultrasound guidance has substantially improved the safety of needle biopsy techniques and almost eliminated the need for surgical wedge biopsy.

Animals↗