Dogs meeting VAKI stage 1-3 criteria were less likely to survive to discharge. Small increases in plasma creatinine concentration may be clinically relevant even when absolute values are within reference intervals.

A 12-year-old castrated male, domestic long-haired cat weighing 4.93 kg was evaluated for weight loss and an abdominal mass. The cat had a 3-month history of diabetes mellitus treated with 2 units of ultralente insulin a twice daily. Hypokalemia, mild azotemia, mild hyperglycemia, and glucosuria were noted on recent laboratory evaluations.Physical examination findings included a thin, greasy haircoat, dermal and epidermal atrophy, cutaneous fragility, a III/VI left peristernal systolic heart murmur, and a cranial abdominal mass. Clinicopathologic abnormalities included hyperglycemia (460 mg/dL, reference range 52-153 mg/ dL), azotemia (blood urea nitrogen 76 mg/dL, reference range 17-35 mg/dL; creatinine 3.1 mg/dL, reference range 0.50-2.20 mg/dL), hypokalemia (2.5 mmol/L, reference range 3.0-4.0 mmol/L), hypochloremia (110 mmol/L, reference range 114-122 mmol/L), hyperphosphatemia (6.1 mmol/L, reference range 2.0-5.3 mmol/L), increased total CO 2 (27 mmol/L, reference range 11-22 mmol/L), and glucosuria. Venous blood gas analysis was consistent with a metabolic alkalosis (pH 7.38, HCO 3 ϭ 28.2 mmol/L) with respiratory compensation (partial pressure of carbon dioxide [PCO 2 ] ϭ 48.7). Serum total thyroxine (T 4 ) concentration, magnesium concentration, creatine phosphokinase activity, and CBC were within reference ranges. A mass cranial to the right kidney (Fig 1) and mild cardiomegaly were noted on abdominal and thoracic radiographs, respectively. The mass, measuring 2 ϫ 2.5 cm by ultrasound, was identified as the right adrenal gland (Fig 2). Echocardiography was unremarkable. Mild hypertension was identified on an initial reading (blood pressure 170 mm Hg, systolic). However, considering the fractious nature of this cat during blood pressure measurement and a lack of ocular manifestations of hypertension, therapy was deemed unnecessary at the time.Endocrinologic testing was performed to investigate functionality of the adrenal tumor. Surgical exploration and tumor removal was planned. Potassium gluconate e supplementation was initiated (2 mEq q24h PO) and insulin therapy continued pending surgery. Serum potassium concentrations did not normalize before surgery despite supplementation. At surgery, the right adrenal gland contained a 1.5 ϫ 2.0-cm mass that appeared encapsulated but closely associated with the vena cava. Extension of tumor thrombi was evident into the phenicoabdominal vein but not into the vena cava. The phenicoabdominal vein was ligated at the level of the vena cava and tumor excision was accomplished with a combination of blunt dissection and the use of hemoclips. The left adrenal gland was grossly normal, and no evidence was found of gross metastasis to any abdominal organ. Histopathology of the right adrenal gland (Fig 3) was consistent with a cortical adrenal gland carcinoma.Initial postoperative treatment included insulin, dexamethasone f (0.25 mg/kg q24h IV), and a balanced electrolyte solution g with potassium supplementation (20 mEq/L IV). Insulin administration was discontinued after ...

No abstract

Administration of HSA resulted in profound reactions in 2 of 9 dogs administered a single infusion and in 2 of 2 dogs administered a second infusion. This indicates that there is risk of life-threatening adverse reactions to HSA infusion in healthy dogs.