Abstract
BACKGROUND: In human patients, cumulative urine volume (uVol) and urine sodium (uNa) can be predicted using spot urine samples and these quantitative measures help detect low diuretic responsiveness (LDR). HYPOTHESIS/OBJECTIVES: Formulas using spot urine samples predict cumulative uVol and uNa output after oral administration of furosemide to dogs. ANIMALS: Eight healthy dogs, 6 dogs with congestive heart failure (CHF). METHODS: Prospective interventional study. Spot urine samples at 180 and 270 minutes after furosemide (3 mg/kg PO) were used to predict cumulative uVol and uNa output over 7 hours. Differentiation of dogs fulfilling predefined criteria for LDR was examined using receiver operating characteristic (ROC) curves. RESULTS: Predicted uNa output at 180 minutes (r(s) = 0.763, [95% confidence interval [CI], 0.375-0.923], P = .002) and 270 minutes (r = 0.816, [95% CI, 0.503-0.940], P < .001) was highly correlated to 7-hour uNa output. Predicted uVol at 180 minutes (r = 0.598, [95% CI, 0.098-0.857], P = .02) and 270 minutes (r = 0.791, [95% CI, 0.450-0.931], P < .001) was moderately correlated to 7-hour uVol. Predicted uNa using 180-minute (area under the curve [AUC], 0.933 [95% CI, 0.804-1.000]) and 270-minute (AUC, 0.911 [95% CI, 0.756-1.000]) samples identified dogs with LDR (n = 5) with high accuracy. CONCLUSIONS AND CLINICAL IMPORTANCE: Urinary Na excretion and uVol are complementary but distinct aspects of diuretic responsiveness in dogs. Quantification of diuretic responsiveness in the clinical setting opens new diagnostic, treatment, and monitoring strategies.