Evaluation of Gamavit effectiveness for correction of renal anemia in cats with chronic kidney disease: a controlled randomized study

Abstract

Renal anemia is one of the most common complications of chronic kidney disease (CKD) in cats, which significantly reduces their life quality. Most often, the mechanism of renal anemia development is associated with insufficiency of endogenous erythropoietin (EPO), or with a reduction in the life of red blood cells caused by uremic intoxication. Since anemia increases the severity of renal hypertension and other CKD symptoms, the search for effective drugs that can stimulate erythropoiesis in CKD and do not have nephrotoxic properties is particularly relevant. The aim of the work was to study the effectiveness of Gamavit in the treatment regimen for cats with CKD compared with the standard treatment protocol. Active ingredients of Gamavit are sodium nucleinate and denaturated placenta extract. The study included 20 cats of different breeds aged from 5 to 16 years with CKD stage III-IV according to the IRIS classification, accompanied by anemia and a decrease in hematocrit in the range from 25 to 16%. Patients were randomly divided into 2 equal groups - control (n=10) and experimental (n=10) using the block randomization method. In the control group a standard nephroprotective therapy regimen was used. In the experimental group Gamavit was added to the standard regimen. Gamavit was administered at a dose of 0.5 ml/kg 1 time per day, at the same time, during 14 consecutive days (7 days i/v and 7 days s/c). The conditions for feeding and keeping animals of the experimental and control groups were identical. For feeding, we used a standardized serial diet ― Purina CatChow Adult with chicken/turkey/salmon. Access to drinking water ― ad libitum. The initial number of red blood cells, as well as the hematocrit index and hemoglobin level in the experimental and control groups were at the lower limit of the norm or below the reference values. During the study, in the experimental group of the patients, these indicators returned to normal after 2 weeks, while in the control group there were no significant changes. The statistically significant difference between the experimental and control groups remained until the end of the observation (p=0.001). Levels of creatinine and urea in the blood serum of the patients of both groups consistently high throughout the study, but in the experimental group a significant decrease in these indicators was found. The initial level of EPO in both groups was significantly lower than in healthy cats. During the experiment, it was not possible to reach the lower limit of the normal value, which allows us to conclude that the stimulation of erythropoiesis indicators in the experimental group, observed under the influence of Gamavit, is not associated with the stimulation of endogenous EPO production. Thus, the study revealed that Gamavit stimulates erythropoiesis in cats with CKD stage III-IV, significantly increasing the number of red blood cells, and the levels of hematocrit and hemoglobin. This effect, combined with a decrease in uremic intoxication values (creatinine and urea levels), lead to an improvement in the general condition of patients and regression in a number of important clinical manifestations. Since no nephrotoxic effects and undesirable interactions with drugs of standard nephroprotective therapy were detected in the process of this study, Gamavit can be recommended for widespread use in cats as one of the pathogenetic, symptomatic, and therapeutic and prophylactic drugs in the complex therapy of CKD at the preclinical and clinical stages of the disease.