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      Hemolytic anemia caused by hereditary pyruvate kinase deficiency in a West Highland White Terrier dog Translated title: Anemia hemolítica causada por la deficiencia de piruvato quinasa hereditaria en un perro West Highland White Terrier

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          Abstract

          Inherited erythrocytic pyruvate kinase (PK) deficiency is an autosomal recessive hemolytic disorder described in dogs and cats. Pyruvate kinase is one of two key-regulatory enzymes in the anaerobic glycolytic pathway, and its deficiency causes premature destruction of the ATP-depleted red cells. This case study reports the clinical and laboratory findings in a West Highland White Terrier (WHWT) dog with a life-long history of weakness and exercise intolerance from Brazil. The dog was found to have persistently profound pallor, a highly regenerative hemolytic anemia and osteosclerosis. PK deficiency was confirmed by a breed-specific DNA test for the previously described 6 bp insertion at 3' end of exon 10 in red blood cell (RBC) R- PK gene sequence. The dog was euthanized at 20 months of age due to the deterioration of its clinical condition including anemia and blood incompatibility. Other PK-deficient WHWTs have lived as long as 9 years. Hereditary red cell defects are important differential diagnoses for chronic hemolytic anemias in younger animals after excluding immune-mediated and infectious causes. Furthermore, purebred dogs for which DNA tests for hereditary diseases are available should be screened prior to breeding in order to limit the spread of the mutant allele and to avoid future production of PK-deficient animals.

          Translated abstract

          La deficiencia de piruvato quinasa (PK) es un desorden hemolítico autosómico recesivo descrito en perros y gatos. La piruvato quinasa es una de las enzimas regulatorias esenciales de la glicólisis anaeróbica, la deficiencia de esta enzima causa una destrucción prematura de los eritrocitos. El presente es un estudio de caso y relata los hallazgos clínicos y paraclínicos en un perro brasileño de la raza West Highland White Terrier (WHWT) con historia de debilidad e intolerancia al ejercicio. El paciente presentaba mucosas pálidas, anemia hemolítica bastante regenerativa y osteoclerosis. La deficiencia de PK fue confirmada a través de una prueba de ADN raza específica para la inserción 6bp en el extremo 3' del exón 10 de la secuencia del gen de la piruvato quinasa eritrocitaria (R-PK) como fue descrito. Al perro se le practicó eutanasia a los 20 meses de edad debido al deterioro de su estado clínico, el cual incluyó anemia e incompatibilidad sanguínea. En otros casos descritos en perros de la raza WHWT con esta deficiencia, existen relatos hasta de nueve años de sobrevivencia. Los defectos hereditarios deben ser objeto de diagnóstico diferencial importante en casos de anemias hemolíticas crónicas en animales jóvenes después de la exclusión diagnóstica de disturbios inmunomediados y causas infecciosas. Adicionalmente, perros de razas puras para las cuales la prueba de ADN está disponible para enfermedades hereditarias deben ser evaluados antes de la edad reproductiva para limitar la diseminación del alelo mutante y la generación futura de animales deficientes.

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          Most cited references36

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          Dog erythrocyte antigens 1.1, 1.2, 3, 4, 7, and Dal blood typing and cross-matching by gel column technique.

          Testing for canine blood types other than dog erythrocyte antigen 1.1 (DEA 1.1) is controversial and complicated by reagent availability and methodology.
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            Canine Dal blood type: A red cell antigen lacking in some Dalmatians.

            Based upon alloantibodies produced after sensitizing dogs with transfused blood, more than a dozen blood group systems have been recognized thus far, and some have been classified as dog erythrocyte antigens (DEA).
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              Pathogenesis, laboratory diagnosis, and clinical implications of erythrocyte enzyme deficiencies in dogs, cats, and horses.

              Deficiencies of enzymes involved in erythrocyte metabolism can have significant effects on erythrocyte function and survival. Animals with pyruvate kinase (PK) or phosphofructokinase (PFK) deficiencies have shortened erythrocyte life spans and regenerative anemia. PK-deficient dogs (but not PK-deficient cats) develop progressive myelofibrosis and osteosclerosis of bone marrow and hemochromatosis and cirrhosis of the liver. PFK-deficient dogs have sporadic episodes of hyperventilation-induced intravascular hemolysis and hemoglobinuria. Cytochrome b5 reductase (Cb5R) deficiency in dogs and cats results in persistent methemoglobinemia and cyanotic mucous membranes. Severe deficiency of glucose-6-phosphate dehydrogenase, the rate-controlling enzyme in the pentose phosphate pathway, resulted in anemia with eccentrocytosis in an American saddlebred colt. Horses with erythrocyte flavin adenine dinucleotide (FAD) deficiency have both eccentrocytosis (attributable to severe deficiency in glutathione reductase activity) and methemoglobinemia (attributable to Cb5R deficiency); the dual enzyme deficiency occurs because FAD is a required cofactor for both enzymes. Erythrocyte enzyme deficiencies do not usually shorten life expectancy, except for PK-deficient dogs and potentially PFK-deficient dogs during a hemolytic crisis. Although enzyme deficiencies are rare causes of anemia and methemoglobinemia, the ability to diagnose deficient animals allows for the possibility of eliminating these undesirable traits in future breeding. DNA-based assays are available for PK and PFK deficiencies; whereas, biochemical tests of enzyme activity are required for other deficiencies. Continued research is needed to document additional enzyme deficiencies that likely occur and to develop additional DNA-based assays to detect heterozygous animals.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                amv
                Archivos de medicina veterinaria
                Arch. med. vet.
                Facultad de Ciencias Veterinarias, Universidad Austral de Chile (Valdivia )
                0301-732X
                2012
                : 44
                : 2
                : 195-200
                Affiliations
                [1 ] Universidade Federal Rio Grande do Sul Brasil
                [2 ] Universidade Federal Rio Grande do Sul Brasil
                [3 ] PetLab Ltda Brasil
                [4 ] University of Pennsylvania United States
                Article
                S0301-732X2012000200015
                10.4067/S0301-732X2012000200015
                e9967253-9f0d-4252-8ace-bb26e0285920

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Chile

                Self URI (journal page): http://www.scielo.cl/scielo.php?script=sci_serial&pid=0301-732X&lng=en
                Categories
                VETERINARY SCIENCES

                General veterinary medicine
                pyruvate kinase,erythroenzymopathies,genetic disease,regenerative anemia,piruvato quinasa,eritroenzimopatías,enfermedades genéticas,anemia regenerativa

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