Looking for a portable ketometer for use in dogs and cats, evaluated with a clinical trial.
Urine test strips have traditionally been used for detecting and monitoring ketonemia in dogs. The nitroprusside reaction with these test strips, however, only measures one of the major ketoacids, acetoacetate, in a semi-quantitative manner. The other major ketoacid, beta-hydroxybutyrate (βHOB), does not react with the urine test strips.Use of test strips, therefore, could underestimate the degree of ketonuria. Additionally, it may be difficult to obtain a urine sample from small or dehydrated patients.
The current recommendation of the American Diabetic Association for detecting ketonemia in humans is the measurement of serum βHOB levels.A point-of-care (POC) sensor has been validated for this use.Some human intensive care units, especially with pediatric patients, prefer this sensor for monitoring ketonemia instead of the reference laboratory analyzer because of its accuracy, small sample requirement, and rapid results.Additionally, measurement of POC βHOB levels may also be used to monitor resolution of metabolic acidosis caused by ketonemia.
A previously published report on the use of this POC βHOB sensor in a small population of 17 dogs and 3 cats showed good correlation between sensor values and reference laboratory values.The purpose of the study reported here was to compare the use of this POC βHOB sensor with a reference laboratory analyzer method for detection of βHOB in a larger population of dogs.
Materials and methods
Data from 46 dogs presenting to a large private veterinary hospital were included in the study. All blood samples were collected after obtaining owner consent. Patients were selected at random from the general hospital population and included diabetic ketoacidotic (DKA) patients (n = 8), stable diabetics (n = 11), healthy patients presented for wellness examination or vaccination (n = 14), and patients presented for illness unrelated to diabetes (n = 13). These groups were included to provide a wide range of βHOB concentrations.
Jugular venous blood samples were collected into a syringe via direct venipuncture and analyzed within 24 h of collection. For the laboratory analyzer βHOB levels, blood was immediately transferred to serum separator tubes and centrifuged within 30 min. These samples were submitted to the reference laboratory and analysis for βHOB was performed by an automated analyzer with the use of a standard liquid reagent (Dade Dimension Chemistry Analyzer, Beta-hydroxybutyrate Kit; Pointe Scientific, Chicago, Illinois, USA). This method is based on the oxidation of βHOB to acetoacetate by the enzyme β-hydroxybutyrate dehydrogenase. During this reaction, an equimolar amount of nicotinamide adenine dinucleotide (NAD+) is reduced to nicotine adenine dinucleotide (NADH). The NADH absorbs light at 340 nm, and the increase in absorbance is directly proportional to the βHOB concentration in the sample. The POC βHOB sensor (Medisense Presision Xtra; Abbott Laboratories, Bedford, Massachusetts, USA) analysis was performed immediately after venipuncture with 5.0 μL of whole blood from the same sample. The POC sensor uses the same reaction as the serum chemistry analyzer, but an electrochemical strip is used instead of spectrophotometry to detect βHOB concentration .Results are displayed in 30 s.
References
· Debra W. Henderson and Daniel P. Schlesinger.Use of a point-of-care beta-hydroxybutyrate sensor for detection of ketonemia in dogs. CVJ / VOL 51 / SEPTEMBER 2010
· Di Tommaso M1, Aste G, Rocconi F, Guglielmini C, Boari A.Evaluation of a portable meter to measure ketonemia and comparison with ketonuria for the diagnosis of canine diabetic ketoacidosis. J Vet Intern Med. 2009 May-Jun;23(3):466-71. doi: 10.1111/j.1939-1676.2009.0302.x.
Thank you so much for the answer but I think these two studies evaluated the same sensor (Medisense Precision Xtra, Abbott) , that here in Europe is named Optium Exceed.
Thank you anyway!!
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