The present review assesses the methods for diagnosis of proteinuria, evaluates the need for treatment, and critically appraises the evidence for medical and dietary therapies. A search of scientific databases was conducted to source peer-reviewed articles. These were assigned a level of evidence and a grade of recommendation based on National Health and Medical Research Council guidelines. Grades of recommendation were: grade A, excellent; grade B, good; grade C, satisfactory; and grade D, poor. Sulphosalicyclic acid tests and urine dipsticks have high sensitivity and are good for screening for proteinuria in dogs. At low levels of proteinuria, and in cats, more specific assays are recommended. Urine protein to creatinine ratios have high specificity and are used for quantification of proteinuria. Pooled and averaged samples are recommended over single samples. Proteinuria in dogs and cats has detrimental effects and veterinarians are recommended to pursue treatment (grade B). Angiotensin converting enzyme inhibitors are the most supported therapeutic and should be first line treatment (grade A). Angiotensin receptor blockers (grade C), combination therapy (grade D) and aldosterone receptor antagonists (grade D) are lacking evidence in dogs and cats with proteinuria. The presence of adverse effects in people for the latter two should discourage their use. While renal diets provide overall benefits (grade B), the evidence for their effect on proteinuria is weak (grade D).
An 11-year-old, 41-kg female spayed mixed-breed dog was examined for a chronic left hind limb lameness, with swelling of the proximal left tibia. A tibial plateau leveling osteotomy (TPLO) using an angle stable implant had been performed 8 years earlier at the site. Initial radiography showed mild degenerative signs in the stifle joint and osteolytic lesions in the proximal tibial metaphysis. Three weeks later, the clinical and radiographic changes had worsened. A transition from a moth-eaten pattern to permeative bone lysis was radiographically evident, along with an extensive increase of soft tissue swelling. Ultrasonographically-guided fine needle aspiration of the epiperiosteal tissue and lymph nodes, CT with pre-and post-contrast scans, and an incisional biopsy were performed. The radiographic and CT findings were consistent with an aggressive and monostotic bone lesion at the site of previous TPLO. The cytology and histology confirmed the diagnosis of an osteosarcoma (OSA) with a chondroid differentiation. Three months after a palliative hind limb amputation, the dog was euthanased. CONCLUSION We believe that this is the first report of implant-related OSA at the site of a previous TPLO with a new generation angle stable implant
CASE REPORT Surgical management is traditionally not recommended for semitendinosus f ibrotic myopathy because of the high recurrence rate. An active 2-year-old German Shepherd Dog was initially presented for an abnormal bilateral pelvic limb gait. On physical examination, palpably thickened fibrotic bands along the thigh musculature and restricted stifle range of motion were identified bilaterally. A clinical diagnosis of bilateral semitendinosus fibrotic myopathy was based on the distinctive gait anomaly. Conservative management with physiotherapy and non-steroidal anti-inflammatory medications was recommended. The patient was re-presented 3 and 5 years later for left and right cranial cruciate disease, respectively, with no improvement in the gait abnormality. Medial crural fasciotomy and modified triple tibial osteotomy were performed at each time point. The former involving releasing the extensive crural fascial insertion on the tibia. Long-term follow-up 29 and 15 months postoperatively for the respective limbs showed continued resolution of the abnormal gait with only mild restriction in stifle extension.
CASE REPORT Pulmonary lymphomatoid granulomatosis (PLG) is a very rare disease of dogs and humans and only one feline case has been reported. PLG has not previously been associated with pyothorax. A 7-year-old female neutered British Short Hair cat was presented for further investigation and treatment of pleural effusion. Cytology and culture of the fluid identified pyothorax and a large mass/consolidated right caudal lung lobe was found on X-ray, ultrasound and CT scan. Lung lobectomy was performed and a diagnosis of PLG was made (confirmed by histopathology and immunohistochemistry). Despite medical treatment the patient was euthanased because of progression of the disease and deterioration of her clinical signs.
CASE REPORT Paecilomyces variotti, a common environmental saprophytic mould, is one of several fungal genera associated with hyalohyphomycosis. An emerging disease of immunocompromised human patients, paecilomycosis is rarely reported in veterinary species. Here we describe contrasting presentations of P. variotti infection in two Australian dogs. Case 1 was a 3-year-old pregnant female German Shepherd Dog presenting with anorexia and generalised pain subsequently localised to the cervical vertebrae. Postmortem revealed destructive pyogranulomatous discospondylitis, meningitis and osteomyelitis at C5–C6 and disseminated granulomatous disease with intralesional fungi. Case 2 was a 10-year-old female spayed Australian Silky Terrier that presented with chronic lameness and multicentric osteolytic lesions in the foreand hindlimb. Amputation of the hindlimb and draining lymph nodes was performed and histopathology revealed multicentric granulomatous osteomyelitis and synovitis and granulomatous lymphadenitis, with intralesional fungi. This dog was treated with itraconazole and survived to 14 years of age. Cultures confirmed P. variotti in both cases.
CASE REPORT A 12-year-old male neutered Domestic Long-hair cat was treated for alimentary lymphoma with two doses of free doxorubicin. However, ulceration, inflammation, moist exudation and crusting of the left and right forepaws occurred. Analgesia and antibiotics were commenced, and doxorubicin was discontinued. The cutaneous reaction observed appeared clinically similar to the lesions seen with palmar-plantar erythrodysesthesia, a cutaneous side effect of chemotherapy previously reported in dogs and humans, but not previously reported in cats receiving free doxorubicin. Histopathology was unable to be undertaken in this case. The cutaneous signs were successfully managed with discontinuation of treatment and supportive care.
