Predictive formulas for food base excess and urine pH estimations of cats

Food base excess (BE, mEq/kg) can be calculated from the diet macroelements, together with either the sulfur amino acids methionine and cysteine (BEaa) or total sulfur (BEs) concentrations. The present study compared the use of sulfur or methionine and cysteine for calculating the food BE (experiment 1) and investigated the influence of food BE on blood gas analysis and the urine pH of cats, and proposes a prediction equation to estimate the urine pH of cats fed kibble diets based on the calculated food BE (experiments 2 and 3). In experiment 1, nine healthy, adult cats were used in a change-over design and fed with nine commercial dry cat foods. The cats were housed in metabolism cages over seven days for adaptation and three days for total urine collection. All of the urine produced over 24h was pooled by cat and diet. The cats' acid-base status was assessed through blood gas analysis after 10 days of diet consumption. A mean difference of -115mEq/kg between BEs and BEaa was observed, which could be explained by a greater concentration of sulfur in the whole diet than in methionine and cysteine. Urine pH presented a stronger correlation with food BEs (R2=0.95; P<0.001) than with food BEaa (R2=0.86; P<0.001). Experiment 2 included 30 kibble diets, and each diet was tested in six cats. The food BEs varied between -180 and +307mEq/kg, and the urine pH of the cats varied between 5.60 and 7.74. A significant correlation was found between the measured urine pH and the food BEs (urinary pH=6.269+[0.0036×BEs]+[0.000003×BEs2]; R2=0.91; P<0.001). In experiment 3, eight kibble diets were tested (food BEs between -187mEq/kg and +381mEq/kg) to validate the equation proposed in experiment 2 and to compare the obtained results with previously published formulae. The results of the proposed formula presented a high concordance correlation coefficient (0.942) and high accuracy (0.979) with the measured values, and the estimates of urine pH did not differ from the values obtained in cats (P>0.05). The cats' venous blood pH, bicarbonate, and blood BE were correlated with food BEs (P<0.001); the consumption of diets with low food BEs induced a reduction in these parameters. In conclusion, food macroelement composition has a strong influence on cats' acid-base equilibrium and food BEs calculation is a useful tool to formulate and balance kibble diets for felines. © 2013 Elsevier B.V.

Mechanism of urinary calcium regulation by urinary magnesium and pH.

Urinary magnesium and pH are known to modulate urinary calcium excretion, but the mechanisms underlying these relationships are unknown. In this study, the data from 17 clinical trials in which urinary magnesium and pH were pharmacologically manipulated were analyzed, and it was found that the change in urinary calcium excretion is directly proportional to the change in magnesium excretion and inversely proportional to the change in urine pH; a regression equation was generated to relate these variables (R(2) = 0.58). For further exploration of these relationships, intravenous calcium chloride, magnesium chloride, or vehicle was administered to rats. Magnesium infusion significantly increased urinary calcium excretion (normalized to urinary creatinine), but calcium infusion did not affect magnesium excretion. Parathyroidectomy did not prevent this magnesium-induced hypercalciuria. The effect of magnesium loading on calciuria was still observed after treatment with furosemide, which disrupts calcium and magnesium absorption in the thick ascending limb, suggesting that the effect may be mediated by the distal nephron. The calcium channel TRPV5, normally present in the distal tubule, was expressed in Xenopus oocytes. Calcium uptake by TRPV5 was directly inhibited by magnesium and low pH. In summary, these data are compatible with the hypothesis that urinary magnesium directly inhibits renal calcium absorption, which can be negated by high luminal pH, and that this regulation likely takes place in the distal tubule.

Inter-relação entre o balanço cátion-aniônico do alimento e o ph urinário de gatos

Studies for the food development of formulations for pets, look for key components to maintaining healthy way of life and safety of products, including these, elements capable of preventing the risk of certain metabolic disorders associated with diet. Feline urinarytract disorders, highlights the urolithiasis, have high incidence in clinical series. Studies linking dietary factors such as ingredients, digestibility and chemical composition, changing the volume, density and pH of urine and consequent induction training for urolithiasis. A highly significant correlation between the mineral composition of the diet and urine pH of cats began to be studied, using the association between the cation-anion balance of the diet (DCAB) and regulation of acid-base balance of the body. The DCAB can be defined as the difference between the total fixed anions and cations present in the diet, important tool for estimating the urinary pH and to determine the range of pH that favors the food used, thereby linking the trigger and the prevention of struvite and calcium oxalate urolithiasis in the urinary tract of cats. Thus, this review aims to clarify the effects of the nutritional composition of diet on urine pH in cats.

Relação entre o excesso de bases do alimento e o PH urinário de gatos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação do pH na amostra isolada e na urina de 24h de pacientes litiásicos em uso de citrato de potássio

Pós-graduação em Bases Gerais da Cirurgia - FMB

[Urinary specific gravity--comparative measurements using reagent strips and refractometer in 340 morning urine samples]

The specific gravity of urine (SG) indicates the number and weight of solute particles in urine; its measurement is helpful in interpreting proteinuria detected by dipstick tests and in monitoring adequate hydration in patients with nephrolithiasis. Four methods for measuring SG or osmolality of urine are currently available (depression of the freezing-point, urometry, refractometry, cation exchange on a reagent strip). Using a recently developed reagent strip, we have measured SG in morning urines of 340 non-selected outpatients and compared the results with SG measurements by refractometry of the same urines. In 86.2% of all urines, a good positive correlation between SG measured by reagent strip and refractometry was noted (r = 0.913, p = 0.0001). In 13.8% of the urines, however, the SG measured by reagent strip deviated by more than +/- 5 from the value obtained by refractometry; in 90% of these urines, glucosuria (reagent strip values too low or too high), proteinuria (values too high), or bacteriuria/leukocyturia (values too low or too high) could be found. In alkaline urine (pH > 7.0), SG values obtained by reagent strip have to be corrected by +5.

Lithiases d'infection [Infective lithiasis].

We report the case of a 69-year-old woman, with a BMI of 42.9, suffering from bilateral struvite calculi and who raised end stage renal failure. Urease-synthesizing bacteria, leading to the hydrolysis of urea into ammonium and to an alkaline urine (pH > 7.2), are required for struvite stone formation in humans. Struvite component constitutes the majority of staghom calculi. Patients with struvite stones could lose renal function because of obstructive or pyelonephritic episodes and surgical interventions on the kidney. Therapeutic success needs a follow up by a specialized uro-nephrologist team as soon as possible.

Digestibility and metabolizable energy of maize gluten feed for dogs as measured by two different techniques

Maize gluten feed (MGF) is a co-product of wet milling of maize, and is composed of structures that remain after most starch, gluten and germ has been extracted from the grain. Although currently used in dog foods, its digestibility and energy values have not been documented. Two techniques were used to determine nutrient digestibility of MGF for dog foods. Both techniques used extruded diets fed to Beagle dogs, with six replicates per diet. The first study used a difference method in which 300 g/kg of a reference diet was replaced by MGF. Based on the difference method, the coefficient of total tract apparent digestibility (CTTAD) of MGF was 0.53 for dry matter (DM), 0.69 for crude protein (CP), 0.74 for fat, 0.99 for starch, and 0.55 for gross energy (GE). The calculated metabolizable energy (ME) of MGF was 7.99 MJ/kg (as-fed). The second study used a regression method and included a basal diet and a basal diet with 70, 140 and 210 g MGF/kg of diet (as a substitute for maize starch). Maize gluten feed inclusion resulted in a linear reduction of CTTAD of DM (R(2)=0.99; P<0.001), CP (R(2)=0.95; P=0.002), fat (R(2)=0.87; P=0.009). starch (R(2)=0.81; P<0.001), and GE (R(2)=0.99; P<0.001). Faecal production increased linearly from 56 g to 107 g/dog/d (R(2)=0.99; P<0.001), with a linear reduction of faecal DM (R(2)=0.99: P<0.001) and a linear increase in faecal lactic acid concentration (P<0.02). Both urine (R(2)=0.77; P=0.029) and faeces (R(2)=0.92: P=0.019) showed a linear reduction in pH. Results of ingredient MAD obtained by the regression and difference methods were close (6% or less of variation) for CP, fat, and starch, and also for ME content (1.4% higher for the difference method), but the two methods disagreed on calculated CTTAD of DM and organic matter. The high dietary fiber content of MGF (382 g/kg) may explain the low digestibility of this ingredient. Maize gluten feed could be a useful ingredient for formulations designed to have low energy or reduce the urine pH of dogs. (C) 2011 Elsevier B.V. All rights reserved.

Parâmetros bioquímicos sanguíneos, balanço de nitrogênio e metabolizabilidade da energia bruta em suínos alimentados com dietas contendo diferentes balanços eletrolíticos

The aim of this study was to evaluate different dietary electrolyte balance (DEB) on the blood biochemical parameters, nitrogen balances and crude metabolizable energy of swine in the initial phase. Sixteen barrows were used, averaging 27.95 kg of initial weight, allotted individually in metabolic cages in a randomized blocks design with four treatments (DEB of 160, 208, 257 and 305 mEq/kg) and 4 replicates. The blood biochemical parameters analyzed were chloride, potassium, sodium and urea in blood. Urine pH was also evaluated, and the parameters evaluated in nitrogen (N) balance were N intake, fecal N, N excreted in urine, absorbed N, N retention, retained N/absorbed N and total excretion of N. The gross energy digestibility and metabolizibility coefficients were determined, and the respectives values of digestible and metabolizable energy. The values of urinary pH increased (P < 0.01) linearly with increasing levels of DEB, ranging from 6.90 to 8.03. The results for chloride, potassium and nitrogen balances of variables and gross energy were similar (P > 0.05) between the evaluated DEB. A linear increase (P < 0.01) was also observed for sodium concentrations in blood serum due to the increase of DEB, with values of 2.91, 3.03, 3.27 and 3.18 g/l, respectively for the different treatments. Urea levels in blood serum increased linearly (P < 0.01), with values of 26.21, 28.64, 34.32 and 32.89 mg/dl. It was concluded that increasing the dietary electrolyte balance, from 160 to 305 mEq/kg resulted in higher concentrations of urea and sodium in blood serum, and higher pH values in the urine of swine in the initial phase.

Nephrocalcinosis induced by hyperoxaluria in rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação metabólica em litíase urinária: papel do magnésio e sódio urinários como fatores de risco na litogênese

Pós-graduação em Bases Gerais da Cirurgia - FMB

Avaliação comparativa do uso da furosemida em bolus ou infusão contínua no tratamento de cães com doença degenerativa valvar

Pós-graduação em Medicina Veterinária - FCAV

Metabolic investigation of patients with staghorn calculus: is it necessary?

To evaluate the prevalence of metabolic disorders in patients with staghorn calculi treated at the Regional Center of Lithiasis Metabolic Studies in central region of Såo Paulo State, Brazil. Between February 2000 and February 2008, 630 patients with urinary calculi were evaluated in the lithiasis outpatient clinic. Thirty-seven of them had staghorn calculi (35 women and 2 men). The inclusion criteria for the metabolic investigation included the absence of urological manipulation 30 days before the examination, negative urine culture and creatinine clearance > 60 mL/min. The protocol for metabolic investigation consisted of qualitative search for cystinuria. Two non-consecutive 24-hour urine samples collected to measure calcium, phosphorus, uric acid, sodium, potassium, magnesium, oxalate and citrate, and serum calcium levels, phosphorus, uric acid, sodium, potassium, magnesium, chloride, parathormone and urine pH. Among patients with lithiasis, 5.9% (37/630) had staghorn calculus and in 48.6% (18/37) were diagnosed with urinary infection. The females were predominant for 94.5% of cases. The calculi were unilateral in 31 of cases and bilateral in six. Metabolic abnormalities were found in 68.2% of patients with hypercalciuria (64.2%) and hypocitraturia (53.3%) being the most common disorders. The presence of metabolic disorders in nearly 70% of patients with staghorn calculus reinforces the necessity for evaluation of these patients. The diagnosis and treatment of identified metabolic abnormalities can contribute to the prevention of recurrent staghorn calculi.

Metabolic changes in ruminant calves fed cation-anion diets with different proportions of roughage and concentrate

Two experiments were carried out with twenty-four male weaned Holstein calves to verify the influence of different dietary cation-anion concentrate and roughage proportions on calves metabolism. In the first experiment, calves were fed rations with -100, +200 and +400 mEq cation-anion balance/kg of dry matter, containing 60% of roughage and 40% of concentrate. In the second experiment, calves (117.6±20.8 kg average weight) received rations with similar dietary cation-anion balance but in diets of 40% roughage and 60% concentrate. As the dietary cation-anion balance became more positive, there was a quadratic response of blood pH in both diets with 60 and 40% roughage. A linear increase following increased dietary cation-anion balance was observed on bicarbonate concentration, carbon dioxide tension, carbon dioxide partial pressure and urine pH on both experiments, while anion gap decreased linearly. Blood urea nitrogen and base excess increased quadratically according to increased dietary cation-anion balance on 60% roughage, whereas those same parameters showed a linear increase on 40% roughage. Growing ruminant metabolism both in cationic and anionic diets was modified when the roughage:concentrate ratio was altered.

Prevalence and densitometric characteristics of incomplete distal renal tubular acidosis in men with recurrent calcium nephrolithiasis

The aim of this study was to assess the prevalence of incomplete distal renal tubular acidosis (idRTA) in men with recurrent calcium nephrolithiasis and its potential impact on bone mineral density. We conducted a retrospective analysis of 150 consecutive, male idiopathic recurrent calcium stone formers (RCSFs), which had originally been referred to the tertiary care stone center of the University Hospital of Berne for further metabolic evaluation. All RCSFs had been maintained on a free-choice diet while collecting two 24-h urine samples and delivered second morning urine samples after 12 h fasting. Among 12 RCSFs with a fasting urine pH >5.8, a modified 3-day ammonium chloride loading test identified idRTA in 10 patients (urine pH >5.32, idRTA group). We matched to each idRTA subject 5 control subjects from the 150 RCSFs, primary by BMI and then by age, i.e., 50 patients, without any acidification defect (non-RTA group) for comparative biochemistry and dual energy X-ray absorptiometry (DEXA) analyses. The prevalence of primary idRTA among RCSFs was 6.7% (10/150). Patients with idRTA had significantly higher 2-h fasting and 24-h urine pH (2-h urine pH: 6.6 ± 0.4 vs. 5.2 ± 0.1, p = 0.001; 24-h urine pH: 6.1 ± 0.2 vs. 5.3 ± 0.3, p = 0.001), 24-h urinary calcium excretion (7.70 ± 1.75 vs. 5.69 ± 1.73 mmol/d, p = 0.02), but significantly lower 24-h urinary urea excretion (323 ± 53 vs. 399 ± 114 mmol/d, p = 0.01), urinary citrate levels (2.32 ± 0.82 vs. 3.01 ± 0.72 mmol/d, p = 0.04) and renal phosphate threshold normalized for the glomerular filtration rate (TmPO(4)/GFR: 0.66 ± 0.17 vs. 0.82 ± 0.21, p = 0.03) compared to non-RTA patients. No significant difference in bone mineral density (BMD) was found between idRTA and non-RTA patients for the lumbar spine (LS BMD (g/cm(2)): 1.046 ± 0.245 SD vs. 1.005 ± 0.119 SD, p = 0.42) or femoral neck (FN BMD (g/cm(2)): 0.830 ± 0.135 SD vs. 0.852 ± 0.127 SD). Thus, idRTA occurs in 1 in 15 male RCSFs and should be sought in all recurrent calcium nephrolithiasis patients. Bone mineral density, however, does not appear to be significantly affected by idRTA.