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Postmortem evaluation of renal tubular vacuolization in critically ill dogs
Author(s) -
Schmid Sarah M.,
Cianciolo Rachel E.,
Drobatz Kenneth J.,
Sanchez Melissa,
Price Josh M.,
King Lesley G.
Publication year - 2019
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/vec.12837
Subject(s) - medicine , furosemide , creatinine , critically ill , mannitol , organic chemistry , chemistry
Objective To describe the frequency of renal tubular vacuolization (RTV) as a surrogate of osmotic nephrosis and assess hyperosmolar agents as predictors of RTV severity. Design Retrospective study (February 2004–October 2014). Setting Veterinary teaching hospital. Animals Fifty‐three client‐owned, critically ill dogs that had a postmortem examination. Interventions None. Measurements and Main Results The frequency, severity, and location of RTV were determined in small group of critically ill dogs postmortem. Logistic regression was performed to assess cumulative 6% HES (670/0.75) and mannitol dose as predictors for RTV severity with presenting serum creatinine concentration, cumulative furosemide dose, and duration of hospitalization as covariates. RTV was noted in 45 (85%) of 53 critically ill dogs and was most commonly located to the medullary rays (68%). Cumulative 6% HES (670/0.75) dose ( P = 0.009) and presenting serum creatinine concentration ( P = 0.027) were significant predictors of RTV severity. For every 1 mL/kg increase in 6% HES (670/0.75) dose that a dog received, there was 1.6% increased chance of having more severe RTV (OR 1.016; 95% CI 1.004–1.029). In addition, for every 88.4 μmol/L (1 mg/dL) increase in presenting serum creatinine, there was a 22.7% increased chance of having more severe RTV (OR 1.227; 95% CI 1.023–1.472). Cumulative mannitol ( P = 0.548) and furosemide ( P = 0.136) doses were not significant predictors of RTV severity. Conclusion In a small group of critically ill dogs, there was a high frequency of RTV identified on postmortem examination. Administration of 6% HES (670/0.75) and presenting serum creatinine concentration were significant predictors of RTV severity. Larger prospective studies are needed to determine the etiology and significance of RTV in dogs.