Today's Veterinary Practice

MAR-APR 2018

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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35 MARCH/APRIL 2018 ● TVPJOURNAL.COM FEATURES system. Prolonged fluid replacement is often poorly tolerated by patients with CKD because of poor renal perfusion and a limited ability to excrete surplus volume. ■ Is the patient eating and drinking enough? A good appetite supports a good quality of life. Find palatable diets, avoid high-salt foods, and try appetite stimulants. In cats with concurrent cardiac and renal disease, feeding tubes may improve nutritional status and make administering multiple medications easier. TAKEAWAYS: ■ When you diagnose pathology in the cardiovascular or renal system, especially in an older animal, look for concurrent disease in the other system. ■ If both systems are involved, focus your management strategy on the system causing the most severe clinical signs. ■ Because therapy for one system may be counterproductive for the other, monitor the patient closely. ■ According to history, physical examination findings, and diagnostic test results, adjust therapy (eg, fluids, electrolytes, drug dosages) as needed. References 1. Pouchelon JL, Atkins CE, Bussadori C, et al. Cardiovascular-renal axis disorders in the domestic dog and cat: a veterinary consensus statement. J Small Anim Pract 2015;56(9):537-552. 2. Reynolds BS, Lefebvre HP. Feline CKD: pathophysiology and risk factors—what do we know? J Feline Med Surg 2013;15(Suppl 1):S3-S14. 3. Hsu A, Kittleson MD, Paling A. Investigation into the use of plasma NT-proBNP concentration to screen for feline hypertrophic cardiomyopathy. J Vet Cardiol 2009;11(Suppl 1):S63-S70. 4. Fox PR, Rush JE, Reynolds CA, et al. Multicenter evaluation of plasma N-terminal probrain natriuretic peptide (NT-pro BNP) as a biochemical screening test for asymptomatic (occult) cardiomyopathy in cats. J Vet Intern Med 2011;25(5):1010-1016. 5. Lalor SM, Connolly DJ, Elliott J, Syme HM. Plasma concentrations of natriuretic peptides in normal cats and normotensive and hypertensive cats with chronic kidney disease . J Vet Cardiol 2009;11(Suppl 1):S71-S79. 6. Bijsmans ES, Jepson RE, W heeler C, et al. Plasma N-terminal probrain natriuretic peptide, vascular endothelial growth factor, and cardiac troponin I as novel biomarkers of hypertensive disease and target organ damage in cats. J Vet Intern Med 2017;31(3):650-660. 7. International Renal Interest Society. IRIS guidelines. iris-kidney.com/ guidelines/index.html. Accessed April 2017. 8. Relford R, Roberston J, Clements C. Symmetric dimethylarginine: improving the diagnosis and staging of chronic kidney disease in small animals. Vet Clin Sm Anim 2016;46(6):941-960. 9. Atkins C, Bonagura J, Ettinger S, et al. Guidelines for the diagnosis and treatment of canine chronic valvular heart disease. J Vet Intern Med 2009;23(6):1142-1150. 10. Brown S, Elliott J, Francey T, et al. Consensus recommendations for standard therapy of glomerular disease in dogs. J Vet Intern Med 2013;27(Suppl 1:S27-S43. 11. Lefebvre HP, Brown SA, Chetboul V, et al. Angiotensin-converting enzyme inhibitors in veterinary medicine. Curr Pharmaceut Design 2007;13(13):1347-1361. 12. Rush J, Freeman LM, Brown DJ, et al. The use of enalapril in the treatment of feline hypertrophic cardiomyopathy. JAAHA 1998;34(1):38-41. 13. Gordon SG, Cote E. Pharmacotherapy of feline cardiomyopathy: chronic management of heart failure. J Vet Cardiol 2015;17(Suppl 1):S159-S172. 14. MacGregor JM, Rush JE, Laste NJ, et al. Use of pimobendan in 170 cats (2006-2010). J Vet Cardiol 2011;13(4):251-260. 15. Gordon SG, Saunders AB, Roland RM, et al. Effect of oral administration of pimobendan in cats with CHF. JAVMA 2012;241(1):89-94. 16. Reina-Doreste Y, Stern JA, Keene BW, et al. Case-control study of the effects of pimobendan on survival time in cats with hypertrophic cardiomyopathy and congestive heart failure. JAVMA 2014;245(5):534- 539. 17. Davis H, Jensen T, Johnson A, et al. 2013 AAHA/AAFP fluid therapy guidelines for dogs and cats. JAAHA 2013;49(3):149-159. 18. Brown S, Atkins C, Bagley R, et al. Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats. J Vet Intern Med 2007;21(3):542-558. 19. Taylor SS, Sparkes AH, Briscoe K, et al. ISFM consensus guidelines on the diagnosis and management of hypertension in cats. J Fel Med Surg 2017;19(3):288-303. 20. Syme HM, Barber PJ, Markwell PJ, et al. Prevalence of systolic hypertension in cats with chronic renal failure at initial evaluation. JAVMA 2002;220(12):1799-1804. 21. Jepson RE, Syme HE, Elliott J. Plasma renin activity and aldosterone concentrations in hypertensive cats with and without azotemia and in response to treatment with amlodipine besylate. J Vet Intern Med 2014;28(1):144-153. 22. Chetboul V, Lefebvre HP, Pinhas C, et al. Spontaneous feline hypertension: clinical and echocardiographic abnormalities, and survival rate. J Vet Intern Med 2003;17(1):89-95. 23. Atkins CE, Rausch WP, Gardner SY, et al. The effect of amlodipine and the combination of amlodipine and enalapril on the renin-angiotensin- aldosterone system in the dog. J Vet Pharmacol Ther 2007;30(5):394-400. Audrey K. Cook Audrey K. Cook is a Diplomate of both ACVIM and ECVIM and is Board Certified in Feline Practice (ABVP). She is currently an associate professor of small animal internal medicine at Texas A&M, with particular interests in endocrinology, gastroenterology, feline medicine and endoscopy. Dr. Cook routinely speaks at national meetings and is a recipient of the Texas A&M University Distinguished Achievement Award in Teaching. Ashley B. Saunders Ashley B. Saunders, DVM, Diplomate ACVIM (Cardiology), is an associate professor of cardiology at Texas A&M University's College of Veterinary Medicine and Biomedical Sciences. Her interests include interventional cardiology and advanced imaging, heart failure management, and innovative teaching. She is a Montague Center for Teaching Excellence Scholar and has been awarded a Texas A&M University Distinguished Achievement Award in Teaching.

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