Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, CO, USA.
Parasit Vectors. 2023 Jun 9;16(1):191. doi: 10.1186/s13071-023-05779-0.
Canine heartworm disease (CHD) caused by Dirofilaria immitis remains a common preventable disease with increasing incidence in some parts of the USA. The treatment guidelines of the American Heartworm Society (AHS) currently recommend monthly macrocyclic lactone administration, 28 days of doxycycline given orally every 12 h and three injections of melarsomine dihydrochloride (1 injection on day 2 of treatment followed 30 days later by 2 injections 24 h apart). Minocycline has also been utilized when doxycycline is unavailable. The systemic effects of CHD, which particularly impact cardiac and renal function, have been described, with infected dogs often experiencing renal damage characterized by an increase in serum concentrations of renal biomarkers. Although the AHS treatment protocol for CHD has been shown to be safe and effective in most cases, the potential for complications remains. No study as of yet has evaluated changes in symmetric dimethylarginine (SDMA), a sensitive marker of renal function, during treatment for CHD. The purpose of the present study was to evaluate renal function in dogs by measuring serum creatinine and SDMA concentrations during the adulticide treatment period.
Serum creatinine and SDMA concentrations were measured in 27 client-owned dogs affected by CHD at the following time points: prior to starting doxycycline or minocycline therapy (baseline), during doxycycline or minocycline therapy (interim), at the time of the first dose of melarsomine (first dose), at the time of the second dose of melarsomine (second dose) and at the dog's follow-up visit after treatment, occurring between 1 and 6 months after completion of therapy (post-treatment). Concentrations of creatinine and SDMA were compared between time points using a mixed effects linear model.
Mean SDMA concentrations following the second dose of melarsomine were significantly lower (-1.80 ug/dL, t-test, df = 99.067, t = -2.694, P-Value = 0.00829) than baseline concentrations. There were no other statistically significant differences in the concentration of either biomarker between the baseline and the other time points in CHD dogs undergoing treatment.
The results suggest that the current AHS protocol may not have a substantial impact on renal function.
犬心丝虫病（CHD）由犬恶丝虫引起，仍然是一种可预防的常见疾病，在美国某些地区发病率不断上升。美国心脏虫协会（AHS）的治疗指南目前建议每月使用大环内酯类药物，每 12 小时口服 28 天多西环素，以及 3 次注射盐酸米安色林（第 2 天治疗 1 次，30 天后再间隔 24 小时注射 2 次）。当无法使用多西环素时，也可以使用米诺环素。CHD 的全身影响，特别是对心脏和肾功能的影响，已有描述，受感染的狗通常会出现肾脏损伤，表现为肾脏生物标志物血清浓度升高。尽管 AHS 治疗 CHD 的方案在大多数情况下是安全有效的，但仍存在并发症的可能性。迄今为止，尚无研究评估犬心丝虫治疗期间对称二甲基精氨酸（SDMA）的变化，SDMA 是肾功能的敏感标志物。本研究的目的是通过测量接受杀丝虫剂治疗期间的血清肌酐和 SDMA 浓度来评估狗的肾功能。
在以下时间点测量 27 只患有 CHD 的患犬的血清肌酐和 SDMA 浓度：开始多西环素或米诺环素治疗前（基线）、多西环素或米诺环素治疗期间（中期）、第 1 次注射米安色林时（第 1 次剂量）、第 2 次注射米安色林时（第 2 次剂量）和治疗后犬的随访时（治疗后），治疗后 1 至 6 个月。使用混合效应线性模型比较各时间点的肌酐和 SDMA 浓度。
米安色林第 2 次剂量后 SDMA 浓度明显降低（-1.80ug/dL，t 检验，df=99.067，t=-2.694，P 值=0.00829），低于基线浓度。在接受治疗的 CHD 犬中，两种生物标志物的浓度在基线和其他时间点之间没有其他统计学上的显著差异。
结果表明，目前的 AHS 方案可能对肾功能没有实质性影响。
Zotero 插件