JOURNAL/mgres/04.03/01612956-990000000-00084/figure1/v/2026-03-26T165950Z/r/image-tiff Antiplatelet therapy is extensively used in the prevention and treatment of cardiovascular and cerebrovascular diseases; however, life-threatening hemorrhage requires urgent reversal of platelet dysfunction. Desmopressin acetate has been proposed as a rescue strategy, yet its efficacy and underlying mechanisms remain incompletely understood, particularly regarding redox regulation. A mouse carotid artery blood flow injury model was employed to evaluate the effects of desmopressin acetate on platelet and coagulation dysfunction induced by antiplatelet therapy. Proteomic analyses were performed in both patients and mice to identify differentially expressed proteins. Genetic knockout and pharmacological inhibition approaches were used to investigate the mechanistic pathways involved. Desmopressin acetate effectively restored platelet function and coagulation capacity in antiplatelet-treated mice. Proteomic profiling identified peroxiredoxin-5, a key antioxidant enzyme, as significantly upregulated following antiplatelet therapy but markedly downregulated after desmopressin acetate administration; these findings were validated in plasma samples from 10 patients who received dual antiplatelet therapy for unruptured intracranial aneurysms. Functional studies demonstrated that proteomic profiling identified peroxiredoxin-5 supplementation impaired platelet function, whereas proteomic profiling identified peroxiredoxin-5 knockout or inhibition significantly improved platelet activity. Notably, desmopressin acetate primarily suppressed liver-derived proteomic profiling identified peroxiredoxin-5 expression. Mechanistically, desmopressin acetate enhanced platelet glycolysis via phosphofructokinase-2/ fructose-2,6-bisphosphatase 3 activation, leading to increased intracellular reactive oxygen species levels. Inhibition of phosphofructokinase-2/fructose-2,6- bisphosphatase 3 attenuated glycolysis, reduced reactive oxygen species generation, and restored proteomic profiling identified peroxiredoxin-5 expression, thereby abolishing the platelet-rescuing effects of desmopressin acetate. Desmopressin acetate rescued platelet dysfunction induced by antiplatelet therapy through a glycolysis-reactive oxygen species-proteomic profiling identified peroxiredoxin-5 axis, in which glycolysis-driven reactive oxygen species generation plays a central regulatory role. These findings indicate redox modulation as a critical mechanism underlying desmopressin acetate-mediated platelet rescue and suggest a potential therapeutic strategy for managing severe bleeding associated with antiplatelet therapy.

Rationale:Severe burns trigger sustained hypermetabolism marked by protein hypercatabolism, insulin resistance, and relative insulin deficiency. These effects are exacerbated in diabetic patients, increasing susceptibility to acute metabolic crises.Patient concerns:We report the first case of a burn patient with type 2 diabetes mellitus (T2DM) concurrently presenting with euglycemic diabetic ketoacidosis (EDKA), central diabetes insipidus (CDI), and non-thyroidal illness syndrome (NTIS). Following severe burn and inhalation injury, he exhibited agitation, delirium, and hypotonic polyuria.Diagnoses:Lab tests confirmed EDKA and NTIS. The EDKA was resolved with standard treatment, but persistent polyuria prompted further evaluation. A positive water deprivation test with desmopressin challenge confirmed CDI, despite unremarkable pituitary MRI.Interventions:Oral desmopressin acetate and hydrochlorothiazide reduced daily urine output to 3000 mL. Thyroid function normalized post-stabilization. The wound healing was achieved through 2 skin grafts.Outcomes:The patient received long-term oral administration of metformin, desmopressin acetate, and hydrochlorothiazide. Blood glucose and urine output were well controlled, with no adverse events observed. Only mild scarring was observed, and the patient successfully reintegrated into society and daily life following satisfactory functional recovery.Lessons:Severe burns disrupt the neuro-immuno-endocrine axis through mechanisms such as stress, inflammation, infection, and inadequate caloric intake. This case highlights the necessity of metabolic monitoring and vigilance for metabolic crises in severely burned patients with diabetes. Key lessons include: EDKA, a rare endocrine emergency, should be suspected in cases of metabolic acidosis/elevated anion gap even in the absence of marked hyperglycemia; Persistent hypotonic polyuria unrelated to blood glucose warrants evaluation for diabetes insipidus, with a water deprivation test with desmopressin challenge distinguishing CDI from nephrogenic diabetes insipidus and osmotic diuresis; NTIS requires treatment only for the underlying condition without specific hormone interventions, though structural or functional thyroid pathologies must be excluded before attributing thyroid dysfunction solely to NTIS.

Monosymptomatic nocturnal enuresis (MNE) imposes a notable clinical and psychosocial burden, yet no economic evaluations have been conducted in Thailand. This study conducted the cost-utility analysis (CUA) and budget impact analysis (BIA) of desmopressin acetate compared with imipramine and no treatment in children aged ≥ 7 years with MNE who have not responded to behavioural management and not responded, or expected not to respond, to alarm therapy. A CUA was conducted from a partial societal perspective, and a BIA was undertaken from a payer perspective. Model parameters were source from published evidence and expert opinion. Desmopressin yielded the highest quality-adjusted life years (QALYs) (9.77) and costs ($740.54). The incremental cost-effectiveness ratios were $2,385/QALY versus no treatment and $2,226/QALY versus imipramine, both below Thailand’s willingness-to-pay threshold ($4,733.73/QALY). Probabilistic sensitivity analysis indicated a 73.5–74.0% probability of cost-effectiveness. The five-year budget impact of introducing desmopressin was estimated at $26.998 million. These findings suggest that desmopressin may represent a cost-effective option for managing MNE, although its adoption would careful consideration of budgetary implications. The results provide context-specific evidence to inform policy deliberations in Thailand and may offer insights for other low- and middle-income countries.

Silent hemorrhage: Unraveling the insidious rectal bleeding in hermansky-pudlak syndrome

Background and Aims: Desmopressin acetate (DDAVP) intranasal spray has been a cornerstone treatment for over three decades in managing bleeding episodes and surgical prophylaxis in patients with von Willebrand disease (VWD) type 1 and non-severe hemophilia A. A recent meta-analysis (>70 studies, 1,770 patients) reported a pooled response rate of 71% (95% CI: 64–78%), with higher efficacy in VWD and some variability across subtypes. Despite its inclusion in the WHO Essential Medicines List for its safety, ease of use, and clinical value, the intranasal formulation (Stimate) was discontinued in 2020, leaving intravenous administration as the only alternative and creating a critical treatment gap. Recent global estimates suggest that over 220,000 bleeding episodes could be prevented annually by DDAVP in type 1 VWD and non-severe hemophilia A patients. New chemical and functional characterization studies, along with real-world clinical data, have been collected to support the development of a newly formulated intranasal DDAVP (HEM006), aimed at addressing the global shortage and restoring access to this essential therapy. Methods: Following advocacy from patient groups in response to the ongoing shortage, STAQ Pharma—an FDA-registered and inspected outsourcing facility—developed a new intranasal desmopressin spray under Section 503B of the U.S. Federal Food, Drug, and Cosmetic Act. Since September 2021, over 6,400 vials have been distributed in the United States. This formulation was further developed into a fully characterized nasal spray solution (HEM006, Hemorare, Italy), filled using a novel spray device designed to prevent evaporation and avoid risks of over-potency. Pump performance validation and stability studies are ongoing. Results: HEM006 delivers 150 mcg of desmopressin acetate per spray (1.5 mg/mL, 0.1 mL per actuation), suitable for both pediatric and adult use. It currently has a 12-month shelf life and a 3-month in-use stability.In a previously reported single-center experience involving 261 patients with VWD, the rate of biological response did not significantly differ from historical series treated with Stimate (n=623). Real-world pharmacovigilance data have confirmed a favorable safety profile. Among 169 desmopressin-related adverse event reports in the FDA database (with VWD or hemophilia A as indications), only one serious event was attributed to HEM006 — a case involving fatigue and decreased appetite in a pediatric patient receiving weekly dosing. Conclusions: The newly formulated intranasal DDAVP (HEM006) demonstrates a favorable safety and efficacy profile in real-world use. Manufactured under cGMP standards, it offers a practical, non-invasive alternative to intravenous DDAVP and clotting factor concentrates. This formulation holds the potential to restore consistent global access to intranasal desmopressin, reduce reliance on costly and invasive therapies, and address a persistent unmet medical need in bleeding disorders.

Disclosure: M. Iwabuchi: None.Background: Chordoid glioma is a rare low-grade tumor that arises from the anterior wall or roof of the third ventricle. Gross total resection is the ideal treatment, although tumor size and location often impede radical resection. The risk of surgical morbidity cannot be ignored. Therefore, incompletely resected tumors will continue to grow slowly and may require later resection. Diabetes insipidus (DI) is one of complications and desmopressin acetate hydrate (DDAVP) tablets are a synthetic analogue of the natural pituitary hormone, 8-arginine vasopressin, an antidiuretic hormone affecting renal water conservation. In 2021, Goswami and coauthors reported that seasonal rhythms of vasopressin release and aquaporin-2 excretion assure appropriate water conservation, and plasma AVP levels are nearly double in the warmer season compared with the colder season and these seasonal fluctuations correlate with parallel modulation in AQP2 excretion. CLINICAL CASE: A 34-year-old woman underwent resection of chordoid glioma of third ventricle in 2011. However, MRI revealed tumor regrowth in the hypothalamic region in 2015 and 2023. Therefore, each time a new tumor recurred, resection and 50 Gy radiation therapy were performed. Post-operatively, she evolved with DI. At this time, her plasma had 153 mEq/L of sodium and 311 mOsm/kg H2O of osmolality. She started to take DDAVP tablets, and the dose of the tablets increased gradually up to 480 microgram per day. Rittig and coauthors reported the effect of food intake on the pharmacokinetics and antidiuretic activity of oral desmopressin in hydrated normal subjects. The total absorption of oral desmopressin was significantly higher when taken during the fasting state compared with its administration with or 1.5 hours after a standard meal. Her prescription of DDAVP tablet was changed to take the tablets before meals and bedtime. This change produced improvement of her general condition, plasma sodium concentration to 140 mEq/L and osmolality to 281 mOsm/kg H2O respectively. Appropriate timing of oral administration was adjusted to increase the absorption efficiency of DDAVP, while the dose of DDAVP was adjusted considering physiological seasonal rhythms. DDAVP oral doses of 480 micrograms in summer and 240 micrograms in winter were sufficient to maintain normal serum osmolarity. Naturally, minor adjustments were made considering her physical condition. CLINICAL LESSON: Treatment aligned with the seasonal rhythms of vasopressin release and aquaporin-2 excretion assures adequate water conservation in humans. The physiological seasonal rhythm of vasopressin and the bioavailability of DDAVP oral tablets should be considered in the treatment of diabetes insipidus. This is the first report demonstrating the efficacy of pharmacokinetic and physiological assessment of DDAVP tablet in treating diabetes insipidus complicated with chordoid glioma.Presentation: Sunday, July 13, 2025

Abstract Background and Aims Percutaneous ultrasound-guided kidney biopsies are the gold standard for diagnosing native and transplant kidney parenchymal diseases. Despite advancements in biopsy techniques, post-biopsy bleeding remains a concern. Desmopressin acetate, a selective V2 receptor agonist, has shown transient hemostatic benefits by increasing von Willebrand factor (VWF) and factor VIII levels. While desmopressin is proven effective in uremic bleeding, evidence in the context of kidney biopsies is conflicting. Few randomized controlled trials (RCTs) have addressed its role in reducing post-biopsy bleeding. This study evaluates the efficacy and safety of intranasal desmopressin in reducing bleeding risk in kidney biopsy patients with varying eGFR levels. Methods This double-blind, randomized, placebo-controlled trial was conducted between February 2020 and January 2023 at a tertiary nephrology center in India. Adults aged 18–65 years undergoing kidney biopsy for glomerular hematuria, proteinuria, or unexplained renal failure were included. Exclusions were coronary artery disease, CKD with small kidneys, congenital anomalies, coagulopathies, pregnancy, or refusal to consent. Dialysis patients were included if dialysis was performed ≥24 hours before biopsy without heparin. Patients were randomized (1:1) to desmopressin (300 µg intranasal) or placebo, stratified by eGFR >30 or ≤30 ml/min/1.73m². All biopsies were percutaneous, ultrasound-guided, and performed using automated biopsy devices. Blinding was maintained for participants, investigators, and nephrologists. Outcomes included bleeding incidence, hematoma formation, hemoglobin drop >1 g/dL, hypotension, gross hematuria, transfusion, or interventions. Factor VIII, VWF, and thromboelastography were assessed at baseline, 2 hours, and 4 hours post-intervention. Results Of 1,200 screened patients, 203 were randomized to desmopressin (n = 101) or placebo (n = 102). Baseline characteristics were comparable. Overall bleeding incidence was significantly lower in the desmopressin group (11.9%) than placebo (33.3%) (P = 0.0003), with a relative risk reduction of 64.4% (RR 0.356, 95% CI: 0.196–0.648). Hematomas were less frequent in the desmopressin group (11.9% vs. 30.4%, P = 0.001), with smaller mean hematoma sizes (2.12 cm vs. 3.51 cm, P = 0.01). Hemoglobin drops >1 g/dL were more common in desmopressin patients (30.7% vs. 17.6%, P = 0.03). Stratified analyses showed consistent bleeding reduction across eGFR categories. Desmopressin significantly increased VWF and factor VIII levels at 2 hours post-administration, but effects waned by 4 hours. Hyponatremia (28.7% vs. 5.8%, P < 0.001) and headaches (7.9% vs. 1.9%, P = 0.04) were more frequent in the desmopressin group. No serious adverse events occurred. Conclusions Desmopressin effectively reduced post-biopsy bleeding and hematomas, particularly in patients with reduced eGFR, with manageable side effects. The higher dose (300 µg) demonstrated superior efficacy, likely due to enhanced VWF and factor VIII levels. Safety analysis confirmed the transient nature of adverse effects, with no impact on major complications or tissue yield. This robust RCT adds to the limited evidence supporting desmopressin in reducing minor bleeding risks during kidney biopsies. Future research should focus on optimal dosing, long-term outcomes, and cost-effectiveness to establish desmopressin as a standard adjunct in kidney biopsies.

Approximately one-third of the children with primary monosymptomatic enuresis (PMNE) do not respond to first-line treatment. We aimed to investigate the short-term and six-month effectiveness of combining desmopressin acetate with parasacral transcutaneous electrical nerve stimulation (PTENS)in these children and adolescents. Participants aged six-17 years with PMNE were randomly assigned to receive desmopressin acetate with active or sham PTENS. Both groups participated in weekly 30-minute electrotherapy sessions for 15 weeks. The intervention group (IG) received electrotherapy at a frequency of 10 Hz and pulse width of 700 µs. A dry and wet nights calendar assessed the frequency of wet nights in the short term and six months after the intervention ended. Of 66 participants, 34 were randomized to the IG. The median age was 10.3 years(8.8 - 12), and 53% were male. Intention-to-treat analysis showed a significant reduction in the frequency of wet nights after the interventions (p < 0.001) in both groups, with the IG demonstrating significant improvement, immediately after the interventions (p=0.005) and after six months (p< 0.001) compared to the placebo group (PG). The Kaplan-Meier survival analysis showed improvement in the IG that became more pronounced from the 15th week onwards (log-rank test, p < 0.01). Conclusions: A 15-week treatment with desmopressin acetate and PTENS significantly reduced wet nights in children and adolescents with PMNE, and this improvement was maintained six months after the interventions.

Managing surgical cases of acute spontaneous intracerebral hemorrhage (ICH) in patients with antiplatelet therapy presents significant challenges due to the heightened risk of bleeding. Desmopressin acetate (DDAVP) is commonly employed as a management strategy. This multi-center study aims to compare the functional and safety outcomes in patients with or without preoperative DDAVP administration after spontaneous antiplatelet-associated ICH. From January 2016 to November 2023, we enrolled patients with spontaneous ICH who were under antiplatelet therapy and needed neurosurgical interventions in the emergency departments. Patients were excluded for traumatic brain injury, ICH from subarachnoid hemorrhage, arteriovenous malformation, intracranial tumors, coagulopathies, and anticoagulant use. The primary outcome was the modified Rankin Scale (mRS) 4 - 6 at discharge. Secondary endpoints included safety outcomes, in-hospital and follow-up outcomes. A total of 75 patients were included, comprising 26 patients treated with DDAVP and 49 patients in the control group. After inverse probability of treatment weighting adjustment, there were no significant differences in baseline characteristics. There were no significant differences in mRS of 4 - 6 at discharge between groups (84.3% vs 88.2%; p = 0.692). Multivariable generalized estimating equations logistic regression demonstrated DDAVP was not significantly associated with improved functional outcome, safety outcomes, in-hospital or follow-up outcomes. This study demonstrated no significant difference in mRS at discharge or SAEs between patients with and without DDAVP administration. However, this null finding should be interpreted cautiously due to the study being underpowered. Further randomized controlled trials are warranted to validate our findings.

Background: Meniere’s disease (MD) is a rare inner ear disorder characterized by endolymphatic hydrops and symptoms such as vertigo and hearing loss, with no curative treatment currently available. XuanYunNing tablets (XYN) have been clinically used to treat MD, but their molecular mechanisms remain unclear. Objective: This study aimed to systematically evaluate the pharmacological effects of XYN in a guinea pig model of MD and to elucidate the underlying molecular mechanisms of both MD pathogenesis and XYN intervention through integrated multi-omics analyses, including transcriptomics, proteomics, and bioinformatics. Methods: A guinea pig model of endolymphatic hydrops was induced by intraperitoneal injection of desmopressin acetate (dDAVP). Pharmacodynamic efficacy was evaluated via behavioral scoring and histopathological analysis. The differentially expressed genes (DEGs) and differentially expressed proteins (DEPs) modulated by XYN treatment were identified using high-throughput transcriptomic and proteomic sequencing. These data were integrated through multi-omics bioinformatic analysis. Key molecular targets and signaling pathways were further validated using RT-qPCR and Western blotting. Results: Pharmacological evaluations showed that guinea pigs in the model group exhibited a 26% increase in endolymphatic hydrops area, while high-dose XYN treatment reduced this area by 19% and significantly improved functional parameters, including overall physiological condition (e.g., weight and general appearance), auricular reflexes to low-, medium-, and high-frequency sound stimuli, nystagmus, and the righting reflex. High-throughput sequencing combined with integrative omics analysis identified 513 potential molecular targets of XYN. Subsequent network and module analyses pinpointed the JAK-STAT signaling pathway as the central axis. Mendelian randomization (MR) analysis further supported a causal relationship between MD and metabolic, immune, and inflammatory traits, reinforcing the central role of JAK-STAT signaling in both MD progression and XYN-mediated intervention. Mechanistic studies confirmed that XYN downregulated IFNG, IFNGR1, JAK1, p-STAT3/STAT3, and AOX at both mRNA and protein levels, thereby inhibiting aberrant JAK-STAT pathway activation in MD model animals. In addition, a total of 125 chemical constituents were identified in XYN by UHPLC-MS analysis. ZBTB20 and other molecules were identified as potential blood-based biomarkers for MD. Conclusions: This study reveals that XYN alleviates MD symptoms by disrupting a pathological cycle driven by JAK-STAT signaling, inflammation, and metabolic dysfunction. These findings support the clinical potential of XYN in the treatment of Meniere’s disease and may inform the development of novel therapeutic strategies.

Abstract An 8‐year‐old spayed female Spanish Mastiff dog presented with a five‐month history of polyuria, polydipsia, persistent isosthenuria to hyposthenuria, urinary incontinence, and bilateral otitis externa, progressing to acute vestibular dysfunction. Endocrine testing excluded hypo‐ and hyperadrenocorticism, and the clinical signs were inconsistent with primary psychogenic polydipsia. Magnetic resonance imaging revealed severe left‐sided otitis media and interna and mild pituitary enlargement with signal characteristics suggestive of depleted arginine vasopressin stores. Transient central diabetes insipidus (CDI) was diagnosed secondary to chronic otitis media/interna based on imaging findings and a rapid response to desmopressin acetate. Treatment consisted of targeted otitis therapy, desmopressin acetate (DDAVP), and anti‐inflammatory glucocorticoids. Although glucocorticoids transiently reduced DDAVP responsiveness, this resolved after the course of glucocorticoids was completed. Following resolution of the otitis, DDAVP was discontinued and the dog’s water balance normalized without recurrence, confirming a reversible CDI secondary to localized inflammatory disease.

ABSTRACTDesmopressin (DDAVP), which indirectly increases Coagulation Factor VIII concentrations in the blood, is a common treatment for bleeding disorders such as von Willebrand disease or hemophilia A. However, DDAVP exhibits significant variability in response due to interindividual differences in pharmacokinetics. Consequently, exploring its pharmacokinetics is of primary importance to better understand the relationship between DDAVP administration and therapeutic outcomes. To that end, the measurement of DDAVP concentration is essential. This article describes the development and validation of a liquid chromatography method coupled with high‐resolution mass spectrometry detection for quantifying DDAVP in human plasma. After sample pretreatment involving protein precipitation followed by solid‐phase extraction, quantification was based on the four most intense isotopes, utilizing targeted single ion monitoring, with a method range of 20–2000 pg.mL−1. For the four QC levels, accuracy and precision for both inter‐ and intra‐assay measurements were below 11.6% and 13.8%, respectively, meeting FDA recommendations. After validation, this method was applied to a cohort of 10 patients with a deficiency in Coagulation Factor VIII, who received 0.3 μg.kg−1 of desmopressin acetate. The mean volume of distribution at steady state was 18.8 L (CV% 26.7), the mean clearance was 7.8 L.h−1 (CV% 25.1), and the mean half‐life was 1.8 h (CV% 14.7). Offering valuable insights into the pharmacokinetics of DDAVP, this method will be useful for further studies and holds promise for optimizing treatment regimens in this patient population.

Differentiating central diabetes insipidus (CDI), nephrogenic diabetes insipidus (NDI), and primary polydipsia (PP) in pediatric patients with polyuria-polydipsia syndrome (PPS) remains a clinical challenge. The water deprivation test (WDT) is the traditional gold standard; however, it is time-consuming, burdensome, and prone to equivocal results. Stimulated copeptin, a surrogate marker of vasopressin, has emerged as a promising diagnostic alternative. We conducted a prospective, observational, cross-sectional study involving 27 pediatric patients (ages 2-17) presenting with PPS. Each patient underwent a WDT with desmopressin and hypertonic saline infusion (3% NaCl) for stimulated copeptin testing. Diagnostic accuracy was assessed using clinical diagnoses as a reference. The WDT showed high accuracy with an area under the curve (AUC) of 0.97, and there was an increased optimal threshold of ≥14% urine osmolality after desmopressin acetate (1-deamino-8-D-arginine vasopressin, DDAVP) administration (sensitivity 88.9%, specificity 100%). Stimulated copeptin at a threshold of <6.5 pmol/L demonstrated 100% sensitivity and specificity (AUC = 1.00) for CDI versus PP. Basal copeptin ≥21.4 pmol/L accurately identified all NDI cases. The agreement between the WDT and copeptin was low (κ = 0.06, McNemar p = 0.021), suggesting that copeptin has greater specificity, particularly for borderline or partial CDI. These results support the use of stimulated copeptin as a first-line diagnostic tool in pediatric PPS, offering improved objectivity, tolerability, and diagnostic clarity compared with the WDT. Basal copeptin also demonstrated excellent performance in rapid noninvasive NDI identification.

Nocturnal enuresis (NE) is a socially stigmatizing and stressful childhood condition. Many drugs have been applied for NE treatments. We aimed to assess the efficacy of multiple drugs in pediatric NE through a network meta-analysis (NMA). Under PRISMA guidelines and the PROSPERO registration number CRD42024581022, we systematically searched the Cochrane Library, Embase, PubMed, and Web of Science from inception to September 9, 2024, for randomized controlled trials (RCTs). Studies involving patients aged 5 to 18 and diagnosed with NE and using at least one drug treatment were included. The NIH Quality Assessment Tools were used to assess the quality of the included studies. Bayesian NMA was organized with R software 4.3.3. Twenty-three RCTs with 1658 participants were enrolled. The complete and partial response rates of combination therapy were higher than those of monotherapy. SUCRA ranking showed that desmopressin (DES) plus propiverine (75.24%), DES plus solifenacin (68.83%), and DES plus tolterodine (66.46%) ranked among the top six in terms of complete response rate. None of the four included interventions significantly improved the relapse rate of NE. All treatments yielded few adverse events. Moreover, combination therapy with DES (RR [95%CrI] = 3.55 [2.28, 5.64]) or without DES (RR [95%CrI] = 3.74 [1.19, 12.06]) seemed to be superior to DES monotherapy in terms of complete response rate. Small number/sample size and inconsistency among included trials might impair the strength of evidence. Combination therapy may be superior to monotherapy in NE management. The most frequently used combination therapy is desmopressin plus anticholinergic agents. All drugs seemed to be safe.

WCN25-4063 Effect of Desmopressin on Post-Kidney Biopsy Bleeding (DEPOST-KB): A Randomized, Double-Blind, Placebo-Controlled Study

ABSTRACT This work reports a case of an 11-month-old spayed, female mongrel with polyuria, polydipsia, polakiuria and nocturia. Serum biochemistry (alkaline phosphatase, ALT, urea, creatinine, GGT, globulins, triglycerides, cholesterol, total proteins), hemogram, urinalysis and abdominal ultrasound were requested. Blood exams were within the normal range and the urinalysis resulted in urine density of 1.009. Therefore, SDMA, bile acids, bilirubin (total and fractions), urinary protein: creatinine ratio, urinary GGT, Antinuclear Antibodies (ANA), and a new urinalysis were performed. All the measured parameters were within the normal range, except for the urine density of 1.010, suggesting Diabetes Insipidus. The 12-hour water deprivation test associated with desmopressin acetate revealed an increase in urine density to 1.028 and 1.029, one and two hours after administration of the medicine. Treatment was initiated with 3 drops of DDAVP daily in each eye, resulting in a slight improvement in clinical signs, and the dose was increased to 4 drops daily, resulting in the disappearance of the clinical signs and decreased the daily water intake by over 50%.

Abstract A 7‐month‐old, male, entire Great Dane was presented for surgical treatment of bilateral scrolled cartilage abnormality of the nictitating membranes with concurrent macroblepharon and early‐entropion complex. The patient underwent two separate surgical interventions and experienced excessive haemorrhage, which was difficult to control after both procedures. A reduction in haemorrhage was observed following the administration of desmopressin acetate infusion. Von Willebrand disease type I was strongly suspected. This report discusses the importance of functional coagulation testing in contrast to reliance on results of prothrombin time and activated partial thromboplastin time clotting assays alone in diagnosing the underlying cause of prolonged surgical haemorrhage in dogs, particularly in breeds with hereditary coagulation disorders. It provides a brief summary on primary and secondary haemostasis, causes for delayed surgical haemorrhage and possible treatment options.

Combatt HMB-Recon: Combination Therapy in Adolescents to Treat Heavy Menstrual Bleeding-Review of Charts to Observe Treatment Patterns

Abstract Two related juvenile deerhounds were evaluated 2 years apart because of polydipsia, pollakiuria and periuria. Until shortly before presentation, each dog lived outdoors from 6 weeks of age with its littermates, and each litter shared a single drinking water source. Physical examination findings were unremarkable. The most noteworthy laboratory finding was hyposthenuria, although both dogs also had serum sodium concentrations at the upper end of the laboratory reference range. Both dogs responded to treatment with desmopressin acetate eye drops, which relieved their clinical signs and increased their urine specific gravities, confirming a diagnosis of central diabetes insipidus. To the best of the authors’ knowledge this is the first report of diabetes insipidus in deerhounds and only the third report to suggest that central diabetes insipidus might be heritable in dogs, as it is in humans.

Antiplatelet Reversal Is Not Associated With Decreased Progression of Intracranial Hemorrhage in Near-Isolated Traumatic Brain Injury: A Retrospective Clustered Analysis From Two Trauma Centers