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Feature October 2015 Issue

On the Horizon

A new test offers the potential of earlier diagnosis and treatment of feline kidney disease; stem cell therapy for IBD.

Earlier test for kidney disease

Recently, IDEXX Laboratories, Inc. revealed that a new kidney function test — called symmetric dimethylarginine (or SDMA) — will now be included in all routine chemistry panels from IDEXX Reference Laboratories in the United States. It will be at no additional cost, and with the same turnaround time as routine chemistry panels.

It is hoped that this new renal biomarker will be able to identify the onset of kidney disease months or even years earlier than traditional methods, which may greatly expand clinical insights and treatment options in cats and dogs. The test went through several years of research and clinical studies, and its pilot launch involved over 600 veterinary practices in which more than 50,000 SDMA tests were successfully run and used to diagnose potential kidney disease.

Chronic kidney disease (CKD) is a leading cause of death in cats and dogs. It has been generally accepted that approximately one in three cats (and one in 10 dogs) will develop some form of kidney disease. However, recent studies suggest that CKD is even more common. These studies indicate that CKD affects 40 percent of cats less than 15 years of age and up to 80 percent of cats over 15 years of age. These results indicate that CKD has previously been under-diagnosed.

Kidney disease has been routinely diagnosed in part by measuring blood creatinine. However, creatinine cannot detect kidney disease until late in the disease process, which often limits the opportunity to extend the life of the pet through treatment options. Traditionally, a diagnosis is made when 75 percent of kidney function has been irreversibly lost —and at this point, the prognosis can be poor.

The SDMA test will hopefully change that. In recent clinical studies at Texas A&M University and Oregon State University, research revealed that SDMA was able to identify the disease much earlier in its progression, when the kidney had suffered considerably less damage. The Oregon State University study demonstrated SDMA detected CKD up to four years earlier in at least one animal. On average, SDMA detected kidney disease when only 40 percent — and in some cases 25 percent — of function had been lost.

THINKSTOCK

Chronic kidney disease is a leading cause of death in cats. It is believed that one in three cats will develop kidney disease in the course of his lifetime.

“In my opinion, SDMA is the best thing that’s happened in kidney disease management in decades,” explained Travis Pond, DVM, of American Pet Hospital in Las Vegas, Nevada. “The ability to detect kidney disease early in the disease process is a real game changer for my patients and their families. This kind of innovation is really helping to raise the standard of care.”

Additional research also identified SDMA as a good indicator of renal function in animals that have lost muscle mass because of age or disease because SDMA is not impacted by body mass (whereas creatinine levels are).

Through earlier detection, veterinarians will likely be able to recommend potentially effective intervention that could add months — and maybe even years — to the lives of pets.

“SDMA appears to be a major step forward in our diagnostic approach to chronic kidney disease,” said Greg Grauer, DVM, MS, DACVIM, professor and Jarvis chair of small animal internal medicine, Kansas State University. “The potential role of SDMA in diagnosing chronic kidney disease, especially early chronic kidney disease, is a promising new direction in veterinary nephrology.”

Participating veterinarians and the pets in their care have already begun to benefit from the opportunity SDMA offers for early diagnosis of CKD.

“SDMA is a result of our industry-leading investment in advancing veterinary medicine and represents a significant achievement in preventive care diagnostics,” said Jonathan W. Ayers, president and chief executive officer of IDEXX Laboratories. “Customers participating in our pilot launch have told us that SDMA has already transformed the way kidney disease is diagnosed and treated, and will help their patients live longer, happier lives.”

THINKSTOCK

Stem cell therapy continues to be controversial in human medicine, but in veterinary medicine, the stem cells are taken from fat.

For more information, you can visit idexx.com/sdma.

Benefits of stem cell therapy

Although stem cell therapy continues to be controversial in human medicine, the Winn Feline Foundation and other groups are funding research on how it might be helpful in treating various illnesses in cats.

During a Winn symposium in Toronto, Canada, Dr. Craig Webb — an associate professor in the Department of Clinical Sciences at Colorado State University College of Veterinary Medicine and Biomedical Sciences — reported on his research to use stem cells to help cats with GI issues. Chronic hairballs, diarrhea and vomiting are common symptoms in cats, and many are ultimately diagnosed with idiopathic inflammatory bowel disease (IBD).

“In human medicine, there’s much that is misunderstood (regarding stem cells). In veterinary medicine, we use adipose derived mesenchymal stem cells, taken from fat. There’s no connection with embryonic stem cells, which years ago caused all the controversy on the human side,” explained Dr. Webb.

Recently, Dr. Webb (along with his wife, Dr. Tracy Webb) conducted a double-blind placebo study of several cats with intestinal problems, in which neither the owners of the cats nor the Webbs knew which were receiving a placebo treatment or stem cell therapy.

“Our first goal was to determine that stem cell therapy would be safe in cats, and naturally, we wanted to help these cats,” Dr. Craig Webb said. After only two treatments, five of the seven cats in the study improved significantly, two improved slightly and one remained about the same. None of the cats suffered any side effects. — Catnip staff

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