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Brown C, Stefaniuk-Szmukier M, Decloedt A, Beijerink N, Hamilton NA, Velie BD. Congenital heart defects in Arabian horses and the prospects of genetic testing: A review. Equine Vet J 2024; 56:884-891. [PMID: 38272847 DOI: 10.1111/evj.14062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/04/2024] [Indexed: 01/27/2024]
Abstract
Congenital heart defects (CHDs) can have profound and potentially life-threatening consequences on horses' health and performance capability. While CHDs are rare in the general horse population, the Arabian breed is disproportionately overrepresented and thus is widely suspected to be genetically predisposed. This review discusses the most common CHDs in Arabian horses, including ventricular septal defect (VSD), tetralogy of Fallot (TOF), patent duct arteriosus (PDA), tricuspid valve atresia (TVA) and atrial septal defect (ASD). This review also explores how future research into the genetic factors that likely underpin many CHDs can revolutionise the way these disorders are managed in Arabian horses.
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Affiliation(s)
- Caitlin Brown
- Equine Genetics and Genomics Group, School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Monika Stefaniuk-Szmukier
- Department of Animal Molecular Biology, National Research Institute of Animal Production, Balice, Poland
| | - Annelies Decloedt
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Niek Beijerink
- Veterinaire Specialisten Vught, Vught, The Netherlands
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia
| | - Natasha A Hamilton
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia
| | - Brandon D Velie
- Equine Genetics and Genomics Group, School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia
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2
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Ciccozzi M, Stauthammer CD, Gavic E, Masters A. Trans-pulmonary stent placement for pulmonary stenosis in a dog with a type R2A coronary artery anomaly. J Vet Cardiol 2024; 55:19-25. [PMID: 39116587 DOI: 10.1016/j.jvc.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 06/29/2024] [Accepted: 07/09/2024] [Indexed: 08/10/2024]
Abstract
A one-year-old male intact American bulldog was presented for evaluation of previously diagnosed pulmonary stenosis. Echocardiography identified ultra-severe stenosis with an instantaneous trans-pulmonary pressure gradient of 240 mmHg. Angiography confirmed the presence of an anomalous coronary artery with a prepulmonic course of the left coronary artery arising from a single right coronary ostium consistent with a type R2A coronary anomaly. A trans-pulmonary stent was successfully placed transvenously with diameter sizing based on coronary compression testing. No coronary compression was present on postimplantation angiography. A marked reduction in the pressure gradient was obtained on postoperative echocardiography (reduction to 68 mmHg), despite selecting a stent diameter less than the pulmonary annulus diameter. This is the first report of the use of coronary compression testing in transvenous trans-pulmonic stent implantation in a dog with a type R2A coronary artery anomaly. Selection of a stent diameter less than the pulmonary annulus diameter conveyed a clinically relevant reduction in the trans-pulmonic pressure gradient while avoiding coronary compression in this case.
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Affiliation(s)
- M Ciccozzi
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1365 Gortner Ave, St Paul, MN 55108, USA.
| | - C D Stauthammer
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1365 Gortner Ave, St Paul, MN 55108, USA
| | - E Gavic
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1365 Gortner Ave, St Paul, MN 55108, USA
| | - A Masters
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1365 Gortner Ave, St Paul, MN 55108, USA
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Maneval KL, Winter RL, Jung SW. Correlation of transthoracic echocardiographic and angiographic measurements of pulmonary valve annular diameter in dogs with pulmonary stenosis. J Vet Cardiol 2024; 55:1-8. [PMID: 39032328 DOI: 10.1016/j.jvc.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 05/07/2024] [Accepted: 05/15/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION/OBJECTIVES Dogs with severe pulmonary stenosis (PS) are routinely treated with balloon valvuloplasty. Success and safety of these procedures require an accurate assessment of the pulmonary valve annulus (PVA) diameter for proper balloon catheter selection. PVA diameter is assessed with angiography (PVA-Ang) and transthoracic echocardiography (PVA-TTE), and both may impact procedural planning for balloon valvuloplasty. The objective of this study was to describe the relationship between PVA-Ang and PVA-TTE in dogs with PS. ANIMALS, MATERIALS AND METHODS Observational, retrospective study of 59 client-owned dogs. Medical records of dogs diagnosed with PS were reviewed. Images from selective right ventricular angiography and transthoracic echocardiography were reviewed. The PVA diameters were measured at the time of angiography (PVA-Ang) and by a single operator for this study (PVA-TTE). Image quality scores were assigned to echocardiographic images of the PVA based on visualization of PVA margins and valve leaflet hinge points. RESULTS In 41/59 (70%) dogs, the diameter of the PVA-Ang was larger than the PVA-TTE, and the median absolute difference between measurements was 1.9 mm (range 0.1-8.4). With worse echocardiographic image quality, the difference in measurement between modalities increased. Dogs with poor echocardiographic image quality had greater differences (range -7.7 to 8.4 mm) between PVA-Ang and PVA-TTE compared to those with excellent image quality (range -2.2 to 3.8 mm), and the absolute differences between poor (median 2.8 mm, range 1.5-8.4 mm) and excellent (median 1.4 mm, 0.2-3.8 mm) image quality were significant (P=0.005). CONCLUSIONS Diameters of PVA-Ang are greater than PVA-TTE in most dogs, and these differences are most apparent with worse echocardiographic image quality. These differences may be clinically relevant to interventional procedure planning.
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Affiliation(s)
- K L Maneval
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Rd, Auburn, AL, 36849, USA
| | - R L Winter
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Rd, Auburn, AL, 36849, USA.
| | - S W Jung
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Rd, Auburn, AL, 36849, USA
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van Staveren MDB, Muis E, Szatmári V. Self-Reported Management of Incidentally Detected Heart Murmurs in Puppies: A Survey among Veterinarians. Animals (Basel) 2024; 14:1821. [PMID: 38929440 PMCID: PMC11200448 DOI: 10.3390/ani14121821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/10/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Heart murmurs in puppies can be innocent or pathologic; the latter is almost always related to a congenital heart disease. Differentiating between these murmurs can be challenging for practicing veterinarians, but this differentiation is essential to ensure the best prognosis for puppies having a congenital heart disease. Our study aimed to reveal how veterinarians manage puppies with a heart murmur. METHODS A web-based questionnaire was sent to Dutch and Belgian veterinary practices. RESULTS Data from 452 respondents were analyzed. Though 88% of the respondents find detecting a heart murmur easy, only 9% find differentiating innocent murmurs from pathologic murmurs in puppies easy. Of the respondents, only 80% recommend immediate additional examination when detecting a loud heart murmur during the first veterinary health check at 6 weeks of age. Most of the respondents are aware that normal growth and the absence of clinical signs do not exclude severe congenital heart disease. Of the respondents, 31% were uncertain whether early surgical intervention could lead to improved outcomes. CONCLUSIONS Veterinarians are aware of the importance of echocardiography for puppies with a loud heart murmur, and recognize their limitations when differentiating an innocent from a pathological heart murmur in a puppy.
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Affiliation(s)
| | | | - Viktor Szatmári
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands
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Aoki T, Terakado T, Jingya Y, Iwasaki K, Shimoda H, Fukamachi N, Miyamoto T. Surgical Correction of Infundibular Muscular Ventricular Septal Defect in a Cat: A Case Report. Animals (Basel) 2024; 14:1736. [PMID: 38929355 PMCID: PMC11201194 DOI: 10.3390/ani14121736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/07/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
Ventricular septal defects (VSDs) can lead to congestive heart failure and pulmonary hypertension, particularly in patients with large shunts. However, no surgical treatment for feline VSD has been reported. Here, we elucidated the first surgical correction of an infundibular muscular VSD in a one-year-old Ragdoll cat, atypically located and classified under the Soto classification rather than the standard Kirklin classification, through cardiac arrest using cardiopulmonary bypass-a method rarely used in feline cardiac surgery. Detailed echocardiography revealed that the defect required intervention owing to left heart and main pulmonary artery enlargement. Despite the VSD being located on the contralateral side, as anticipated in the preoperative examinations, the choice of median sternotomy allowed for the successful closure of the defect. Conversely, the insertion of two cannulas into the ascending aorta resulted in damage to the adjacent thoracic duct, causing transient chylothorax, which was resolved with conservative treatment. Cardiac arrest induced by a cardioplegic solution facilitated the surgical procedure, although it leads to anemia in cats. However, on postoperative day 490, the patient exhibited only minor residual shunting, with normalized heart size, and remained healthy. This technique appears to be a viable treatment option for congenital heart disease in cats.
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Affiliation(s)
- Takuma Aoki
- Laboratory of Small Animal Surgery, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, Sagamihara City 252-5201, Kanagawa, Japan; (T.T.); (Y.J.); (K.I.)
- Azabu University Veterinary Teaching Hospital, Azabu University, Sagamihara City 252-5201, Kanagawa, Japan
| | - Tomomi Terakado
- Laboratory of Small Animal Surgery, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, Sagamihara City 252-5201, Kanagawa, Japan; (T.T.); (Y.J.); (K.I.)
| | - Yao Jingya
- Laboratory of Small Animal Surgery, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, Sagamihara City 252-5201, Kanagawa, Japan; (T.T.); (Y.J.); (K.I.)
- Azabu University Veterinary Teaching Hospital, Azabu University, Sagamihara City 252-5201, Kanagawa, Japan
| | - Kentaro Iwasaki
- Laboratory of Small Animal Surgery, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, Sagamihara City 252-5201, Kanagawa, Japan; (T.T.); (Y.J.); (K.I.)
| | - Hayato Shimoda
- Gunma Children’s Medical Center, Shibukawa City 377-8577, Gunma, Japan; (H.S.); (N.F.)
| | - Naoyuki Fukamachi
- Gunma Children’s Medical Center, Shibukawa City 377-8577, Gunma, Japan; (H.S.); (N.F.)
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Shimada K, Hirose M, Hamabe L, Takai S, Jin D, Yilmaz Z, Kocaturk M, Tanaka R. Evaluation of Alacepril Administration in Canine Patent Ductus Arteriosus According to Plasma Chymase Activity. Animals (Basel) 2024; 14:1078. [PMID: 38612317 PMCID: PMC11010901 DOI: 10.3390/ani14071078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Chymase in the renin-angiotensin system (RAS) actively contributes to cardiac disease progression. Chymase is activated to produce angiotensin II during tissue injury and is involved in hemodynamics. A recent study demonstrated that plasma chymase activity reflects hemodynamic changes and aids in understanding patent ductus arteriosus (PDA) pathophysiology. The present study examined the relationship between plasma chymase activity and the administration of angiotensin-converting enzyme (ACE) inhibitor. Alacepril was administered to 13 puppies with PDA. Conventional echocardiographic parameters and non-invasive blood pressure were measured before and after medication. Plasma chymase activity was calculated using the colorimetric absorbance method. Plasma chymase activity significantly increased, but blood pressure significantly decreased. We detected an increase in plasma chymase activity due to ACE inhibition in PDA cases treated with alacepril. Plasma chymase activity was affected and altered by alacepril. In veterinary medicine, plasma chymase activity may be a novel method for assessing the pathology of and therapy for cardiac diseases.
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Affiliation(s)
- Kazumi Shimada
- Department of Veterinary Medicine, Facility of Agriculture, Tokyo University of Agriculture and Technology, Fuchu 183-8509, Japan; (K.S.); (M.H.); (R.T.)
| | - Miki Hirose
- Department of Veterinary Medicine, Facility of Agriculture, Tokyo University of Agriculture and Technology, Fuchu 183-8509, Japan; (K.S.); (M.H.); (R.T.)
| | - Lina Hamabe
- Department of Veterinary Medicine, Facility of Agriculture, Tokyo University of Agriculture and Technology, Fuchu 183-8509, Japan; (K.S.); (M.H.); (R.T.)
| | - Shinji Takai
- Department of Innovative Medicine, Graduate School of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Japan; (S.T.); (D.J.)
| | - Denan Jin
- Department of Innovative Medicine, Graduate School of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Japan; (S.T.); (D.J.)
| | - Zeki Yilmaz
- Department of Internal Medicine, Faculty of Veterinary Medicine, Bursa Uludag University, Bursa 16059, Turkey; (Z.Y.); (M.K.)
| | - Meric Kocaturk
- Department of Internal Medicine, Faculty of Veterinary Medicine, Bursa Uludag University, Bursa 16059, Turkey; (Z.Y.); (M.K.)
| | - Ryou Tanaka
- Department of Veterinary Medicine, Facility of Agriculture, Tokyo University of Agriculture and Technology, Fuchu 183-8509, Japan; (K.S.); (M.H.); (R.T.)
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Masche A, Breit P, Höpfner R, Schmerbach K. [Diagnosis and treatment of feline persistent ductus arteriosus: a retrospective evaluation of 17 cats]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2024; 52:88-97. [PMID: 38701804 DOI: 10.1055/a-2290-2441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
OBJECTIVE The objective of this study was to evaluate the signalement, clinical features, and echocardiographic findings of cats diagnosed with patent ductus arteriosus (PDA) as well as short- and medium-term outcome after successful ligation of the PDA. MATERIAL AND METHODS Over a 10-year period 17 cats were diagnosed with PDA by transthoracic echocardiography. Thirteen cats were surgically treated by thoracotomy and ligation of the PDA. RESULTS In all cats, a heart murmur was detected. In 88.2% of the cases, this presented as grade 4 out of 6 murmur (15/17 cats). A continuous murmur was more common (10/17 cats; 58.9%) than a systolic murmur (7/17 cats; 41.1%). Echocardiography showed that left ventricular internal diameter end diastole (LVIDd) and left ventricular internal diameter end systole (LVIDs) were significantly above reference values in the majority of cats. Mean diameter of the PDA measured at the widest point of the vessel was 3.4 mm (± 1.08 mm) and mean maximum flow velocity amounted to 5,06 m/sec (2,6m/sec-6,4m/sec). Surgery was successfully performed in all cats treated by surgical ligation and all of these patients were discharged after postoperative inpatient therapy. One cat experienced perioperative bleeding from the PDA, which was stopped efficaciously. This cat exhibited a residual shunt directly postoperatively; this could no longer be visualized in a re-check echocardiography 3 months later. Six cats were followed over a longer period of time. CONCLUSIONS The surgical prognosis in this case study is very good with a postoperative survival rate of 100%. CLINICAL RELEVANCE Surgical treatment of PDA is curative in animals not displaying advanced cardiac lesions. The auscultation of a heart murmur can provide initial findings indicative of PDA. Therefore, cardiac auscultation is warranted at every first presentation of a kitten. It must however be taken into consideration that not every cat with PDA necessarily has a continuous murmur but may display a systolic heart murmur. Therefore, it is important give utmost attention to the patients' clinical signs.
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Affiliation(s)
- Anja Masche
- Kleintierspezialisten, Dres. Schmerbach & Höpfner GmbH, Berlin
| | - Peter Breit
- Kleintierspezialisten, Dres. Schmerbach & Höpfner GmbH, Berlin
| | - Robert Höpfner
- Kleintierspezialisten, Dres. Schmerbach & Höpfner GmbH, Berlin
| | - Kay Schmerbach
- Kleintierspezialisten, Dres. Schmerbach & Höpfner GmbH, Berlin
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Hallman C, Baumwart R, Hallman RM. 64-Slice ECG-gated computed tomographic angiography for assessment of coronary arteries in brachycephalic dogs with pulmonary stenosis. Vet Rec 2024; 194:e3857. [PMID: 38379246 DOI: 10.1002/vetr.3857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 01/02/2024] [Accepted: 01/05/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Brachycephalic dogs with pulmonary stenosis are known to have a higher incidence of concurrent coronary artery abnormalities than non-brachycephalic breeds, which increases risk when performing balloon valvuloplasty. The use of ECG-gated CT angiography has been reported for the evaluation of coronary arteries in normal dogs and dogs with pulmonary stenosis. The purpose of this study was to report findings of coronary artery origination and morphology of main branches using ECG-gated CT angiography in brachycephalic dogs with pulmonary stenosis. METHODS An ECG-gated CT angiographic protocol was used to image coronary artery anatomy in nine brachycephalic dogs with pulmonary stenosis. Images were assessed for quality as well as coronary artery morphology by one veterinary radiologist, one veterinary cardiologist and one veterinary radiology resident. RESULTS All nine dogs had good to excellent image quality. Coronary artery anomalies were identified in three of nine dogs: one R2A anomaly, one L2A anomaly and one L2C anomaly. Two dogs were assessed to be poor balloon valvuloplasty candidates based on CT angiographic images. LIMITATION Coronary artery morphology was not confirmed via postmortem examination in all patients. CONCLUSION ECG-gated CT angiography is a minimally invasive imaging modality capable of diagnosing various coronary artery anomalies in brachycephalic dogs with pulmonary stenosis and aiding in the determination of patient candidacy for balloon valvuloplasty.
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Affiliation(s)
- Clay Hallman
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Ryan Baumwart
- Department of Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Ruth Mackenzie Hallman
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
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Denton M, Vitt JP, Saunders AB, Wesselowski S. Double Outlet Right Atrium in an American Domestic Shorthair Cat. CASE (PHILADELPHIA, PA.) 2024; 8:241-246. [PMID: 38524989 PMCID: PMC10955103 DOI: 10.1016/j.case.2023.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
•DORA should be considered in cases with radiographic evidence of LA enlargement. •TTE can diagnose DORA. •Cats with DORA may remain undiagnosed until adulthood.
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Affiliation(s)
- Matthew Denton
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Jordan P. Vitt
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Ashley B. Saunders
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Sonya Wesselowski
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
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Winter RL, Hlusko KC, Tillson DM, Maneval KL, Ferrel CS, Rajeev M, Castro D. Hybrid Balloon Mitral Valvuloplasty in an Adult Dog with Congenital Mitral Stenosis and Left Atrial Thrombus. CASE (PHILADELPHIA, PA.) 2024; 8:236-240. [PMID: 38524966 PMCID: PMC10955085 DOI: 10.1016/j.case.2023.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
•Congenital MS is a rare cardiac disease in canines. •BMV may improve the mobility of stenotic mitral leaflets. •AF and LA thrombi may occur in congenital MS.
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Affiliation(s)
- Randolph L. Winter
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama
| | - Katelyn C. Hlusko
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama
| | - D. Michael Tillson
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama
| | - Kara L. Maneval
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama
| | - Claudia Serrano Ferrel
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama
| | - Meenakshi Rajeev
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama
| | - Douglas Castro
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama
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Toborowsky C, Markovic LE. Large Secundum Atrial Septal Defect Managed Conservatively in an Adult Dog. CASE (PHILADELPHIA, PA.) 2024; 8:226-230. [PMID: 38524968 PMCID: PMC10955082 DOI: 10.1016/j.case.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
•ASDs can be medically managed in dogs if interventional options are not selected. •3D modeling can be used for canine congenital heart disease. •3D imaging helps with preprocedural planning for ASD.
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Affiliation(s)
- Carl Toborowsky
- University of Georgia, College of Veterinary Medicine, Athens, Georgia
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12
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Wesselowski S, Saunders AB. Transesophageal echocardiography using a microprobe for determination of transcatheter procedural candidacy, device selection, and procedural monitoring in small dogs with patent ductus arteriosus. J Vet Cardiol 2024; 52:35-42. [PMID: 38422726 DOI: 10.1016/j.jvc.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 01/29/2024] [Accepted: 02/04/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Small dogs with patent ductus arteriosus (PDA) may be unable to undergo transesophageal echocardiography (TEE) with traditional probes. OBJECTIVES To report the utility of TEE using a microprobe in dogs weighing less than 4 kg diagnosed with PDA for determination of transcatheter procedural candidacy, device selection, and intraoperative procedural guidance. ANIMALS Eight dogs weighing less than 4 kg diagnosed with PDA. MATERIALS AND METHODS All dogs had standard transthoracic echocardiography and microprobe TEE imaging. The quality of TEE images was graded as optimal, adequate, or poor. The ability of TEE to assess PDA anatomy, determine procedural candidacy, provide procedural guidance, detect deployed devices, and assess residual flow was recorded. RESULTS The median age of included dogs was 6.4 months (range: 3.2-15.7 months) and the median body weight was 2.2 kg (range: 1.4-3.8 kg). Microprobe TEE images were adequate or optimal in all dogs and were integral for guiding procedural candidacy decisions. Transcatheter procedures were not pursued in two dogs based on TEE images. In the other six dogs, TEE procedural guidance was useful during transvenous (n = 5) and transarterial (n = 1) PDA occlusion attempts. Each deployed device (n = 4) was easily detected with the TEE microprobe. Real-time confirmation of adequate device sizing and placement was possible prior to release and residual flow could be monitored after release. CONCLUSIONS Transesophageal echocardiography using a microprobe in dogs weighing less than 4 kg diagnosed with PDA allowed for characterization of PDA anatomy and determination of transcatheter procedural candidacy. Microprobe TEE images were integral for PDA device selection and offered valuable intraoperative procedural guidance.
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Affiliation(s)
- S Wesselowski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA.
| | - A B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA
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Torres RSG, Vilá J, MacLean RA, Cutler DC. MITRAL REGURGITATION IN SADDLE-BILLED STORKS ( EPHIPPIORHYNCHUS SENEGALENSIS) IN HUMAN CARE: DIAGNOSIS, ECHOCARDIOGRAPHIC MEASUREMENTS, AND MANAGEMENT. J Zoo Wildl Med 2024; 54:845-854. [PMID: 38252011 DOI: 10.1638/2023-0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2023] [Indexed: 01/23/2024] Open
Abstract
The asymptomatic and slow progressive nature of cardiopathies represents a risk to the welfare of avian species in human care. Diagnosis and treatment of cardiac disease in birds pose a challenge due to unique anatomic and physiologic characteristics. Comprehensive cardiac assessments with diagnostic tools such as echocardiography, color-Doppler, the biomarker cardiac troponin I (cTn1), and cholesterol serum concentrations have been utilized in different bird species with varying success. Saddle-billed storks (Ephippiorhynchus senegalensis) have been maintained in human care for over 80 yrs and several institutions have noted heart murmurs and cardiomegaly. Despite these findings, peer-reviewed literature describing cardiopathies is lacking for this species. This case series documents the identification of mitral valve regurgitation in saddle-billed storks in a breeding center. Transcoelomic echocardiography using a ventromedial approach with a two-chambered view and color Doppler was utilized. Echocardiographic measurements were taken and compared 1 yr later in most of the birds. There was left atrial enlargement and worsened mitral regurgitation in one geriatric patient, and no progression of the disease in two young birds. Serum samples showed that cTn1 had different concentrations depending on the severity of the disease, whereas cholesterol was within reference range for all birds. Treatment with digoxin and pimobendan was recommended in one bird, serum concentrations of digoxin were tested in a 6-mon span, results were within therapeutic range, and there were no overt adverse effects. There was a suspected genetic component in this population, as four of the five birds with confirmed mitral regurgitation were related.
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Scansen BA. Advances in the Treatment of Pulmonary Valve Stenosis. Vet Clin North Am Small Anim Pract 2023; 53:1393-1414. [PMID: 37453894 DOI: 10.1016/j.cvsm.2023.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Pulmonary valve stenosis represents the most common congenital heart defect of dogs and appears to be increasing in prevalence due to the growing popularity of brachycephalic breeds. Current treatments include beta-blockade and balloon pulmonary valvuloplasty, though evidence-based approaches to this disease are lacking. Balloon pulmonary valvuloplasty is most effective for fused, doming valves leaving a large population of dogs with thick, dysplastic valves that fail to respond adequately to balloon dilation. Transpulmonary stent implantation is an emerging therapy to consider for dogs with valve dysplasia or who have failed balloon pulmonary valvuloplasty; current experience with transpulmonary stent implantation is provided.
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Affiliation(s)
- Brian A Scansen
- Cardiology & Cardiac Surgery, Department of Clinical Sciences, Colorado State University, 200 West Lake Street, 1678 Campus Delivery, Fort Collins, CO 80523-1678, USA.
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15
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Winter RL, Maneval KL, Ferrel CS, Clark WA, Herrold EJ, Rhinehart JD. Evaluation of right ventricular diastolic function, systolic function, and circulating galectin-3 concentrations in dogs with pulmonary stenosis. J Vet Intern Med 2023; 37:2030-2038. [PMID: 37767953 PMCID: PMC10658516 DOI: 10.1111/jvim.16890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Cardiovascular diseases with increased right ventricular (RV) afterload induce RV diastolic and systolic dysfunction, and myocardial fibrosis in humans. Studies in dogs with pulmonary stenosis (PS) evaluating RV diastolic function and markers of myocardial fibrosis are lacking. HYPOTHESIS/OBJECTIVES Dogs with PS have echocardiographic evidence of RV diastolic and systolic dysfunction and increased serum concentrations of galectin-3 (Gal-3), a surrogate biomarker for myocardial fibrosis. ANIMALS Forty client-owned dogs (10 controls, 30 with PS). METHODS Prospective study. All dogs had systemic blood pressure measurement, serum biochemical analysis, echocardiography, and measurement of serum Gal-3 concentration performed. RESULTS Variables of RV diastolic function were obtained in 39/40 dogs. Trans-tricuspid flow velocity in early diastole to trans-tricuspid flow velocity in late diastole ratios (RV E/A) were lower (P < .001) in dogs with PS (median, 0.94; range, 0.62-2.04) compared to controls (1.78; 1.17-2.35). Trans-tricuspid flow velocity in early diastole to tricuspid annular myocardial velocity in early diastole ratios (RV E/e') were higher (P < .001) in dogs with PS (11.55; 4.69-28) compared to control (6.21; 5.16-7.21). Variables of RV systolic function were lower in dogs with PS (P = <.001). Serum Gal-3 concentration was higher (P = .002) in dogs with PS (285.1 pg/mL; 94.71-406.97) compared to control dogs (162.83 pg/mL; 52.3-232.82). CONCLUSIONS AND CLINICAL IMPORTANCE Dogs with PS have RV diastolic and systolic dysfunction, and increased Gal-3 concentrations. These findings suggest the presence of RV myocardial fibrosis in dogs with PS, which could impact clinical management.
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Affiliation(s)
| | - Kara L. Maneval
- College of Veterinary MedicineAuburn UniversityAuburnAlabamaUSA
| | | | - William A. Clark
- Veterinary Clinical SciencesThe Ohio State UniversityColumbusOhioUSA
| | - Emily J. Herrold
- Veterinary Clinical SciencesThe Ohio State UniversityColumbusOhioUSA
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16
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Szatmári V, Hofman ZMM, van Bijsterveldt NJ, Tellegen AR, Vilaplana Grosso FR. A Novel Standardized Method for Aiding to Determine Left Atrial Enlargement on Lateral Thoracic Radiographs in Dogs. Animals (Basel) 2023; 13:2178. [PMID: 37443976 DOI: 10.3390/ani13132178] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Left atrial enlargement indicates severe cardiac disease. Although the gold standard for determining left atrial size is echocardiography, many veterinary practices lack the necessary equipment and expertise. Therefore, thoracic radiography is often used to differentiate cardiogenic pulmonary edema from primary respiratory diseases and to facilitate distinguishing dogs with stage B1 and B2 mitral valve degeneration. METHODS The goal was to test a new standardized method for identifying radiographic left atrial enlargement. On a lateral radiograph, a straight line was drawn from the dorsal border of the tracheal bifurcation to the crossing point of the dorsal border of the caudal vena cava and the most cranial crus of the diaphragm. If a part of the left atrium extended this line dorsally, it was considered enlarged. Echocardiographic left atrial to aortic ratio (LA:Ao) was used as a reference. Thirty-nine observers with various levels of experience evaluated 90 radiographs, first subjectively, then applying the new method. RESULTS The new method moderately correlated with LA:Ao (r = 0.56-0.66) in all groups. The diagnostic accuracy (72-74%) of the subjective assessment and the new method showed no difference. CONCLUSIONS Though the new method was not superior to subjective assessment, it may facilitate learning and subjective interpretation.
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Affiliation(s)
- Viktor Szatmári
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands
| | - Zelie M M Hofman
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands
| | - Nynke J van Bijsterveldt
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands
| | - Anna R Tellegen
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands
| | - Federico R Vilaplana Grosso
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands
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17
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Alessandro F, Andrea M, Fabrizio D, Laura M, Enrico MG, Matteo C. Supravalvular mitral stenosis in a cat: clinical, diagnostic and pathologic findings. J Ultrasound 2023; 26:65-70. [PMID: 35809203 PMCID: PMC10063711 DOI: 10.1007/s40477-022-00702-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/22/2022] [Indexed: 10/17/2022] Open
Abstract
The present case report describes a rare case of a cardiac abnormality diagnosed as Supravalvular Mitral Stenosis in an asymptomatic cat. An 11-years old cat was presented for orthopedic evaluation, and during general clinical examination a heart rate of 180 bpm and left diastolic cardiac murmur grade III-IV/VI, between the mitral and aortic foci, were found. Radiographic, echocardiographic, angiocardiographic and post-mortem (the patient died during anesthesia performed to diagnose the orthopedic condition) magnetic resonance and pathologic findings are reported herein.
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Affiliation(s)
- Fruganti Alessandro
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Matelica, MC Italy
| | - Marchegiani Andrea
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Matelica, MC Italy
| | - Dini Fabrizio
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Matelica, MC Italy
| | | | - Magi Gian Enrico
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Matelica, MC Italy
| | - Cerquetella Matteo
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Matelica, MC Italy
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18
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Keating S, Eberhard J, Friederich J, Wess G. Systolic function in dogs with pulmonic stenosis of different severities and the effect of balloon valvuloplasty. J Vet Cardiol 2023; 46:40-54. [PMID: 37058905 DOI: 10.1016/j.jvc.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 04/07/2023]
Abstract
INTRODUCTION/OBJECTIVES Pulmonic stenosis (PS) is one of the most common congenital heart diseases in dogs leading to right ventricular (RV) pressure overload, myocardial remodeling, and potential RV dysfunction. Our objectives were to investigate the extent of RV systolic dysfunction in canine PS and to examine the immediate influence of balloon valvuloplasty (BV) on systolic function. ANIMALS, MATERIALS AND METHODS This prospective study evaluated 72 dogs with PS and 86 healthy dogs. Echocardiographic parameters of systolic function included normalized tricuspid annular plane systolic excursion (N-TAPSE), normalized systolic myocardial tissue Doppler velocity of the lateral tricuspid annulus (N-RVFW-S'), fractional area change, and speckle-tracking longitudinal endocardial RV strain. Forty-four dogs underwent BV and were re-examined after surgery. RESULTS Systolic function at the basal segment of the RV was significantly lower in the PS group when compared to healthy dogs (mean N-TAPSE 4.29 ± standard deviation 1.18 mm/kg0.285 vs. 5.60 ± 1.29 mm/kg0.285; median N-RVFW-S' 5.28 [lower-upper 25% quantile 4.35-6.43 cm/s/kg0.186] vs. 7.82 [6.73-8.79 cm/s/kg0.186]; all P<0.001). Global longitudinal RV endocardial strain showed no significant difference between the two groups (-28.50 ± 6.23% vs. 28.61 ± 4.64%; P=0.886), but segmental strain analyses revealed basal hypo- and potential compensatory hyperkinesis of the apical RVFW. Furthermore, BV affected most parameters of systolic function, but not the segmental strain values and N-TAPSE. CONCLUSIONS Right ventricular basal longitudinal systolic function is decreased in dogs with PS in comparison to a healthy cohort. Regional and global function does not necessarily coincide.
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Szatmári V, Dirven M, Aupperle-Lellbach H. Progressive Right Ventricular Obstruction Caused by a Double-Chambered Right Ventricle Resulting in Shunt-Reversal via a Concomitant Congenital Ventricular Septal Defect and Subsequent Erythrocytosis in a Dog. Vet Sci 2023; 10:vetsci10030174. [PMID: 36977213 PMCID: PMC10053892 DOI: 10.3390/vetsci10030174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
A 3-year-old Chihuahua was presented because of exercise intolerance, respiratory distress, and syncopal episodes. At the age of 10 weeks, the dog was diagnosed with a congenital small left-to-right shunting ventricular septal defect and a mild right ventricular outflow tract obstruction via echocardiography. At that time, the dog was asymptomatic, but the breeder’s veterinarian heard a murmur. Both cardiac defects were judged to be clinically non-relevant at that time. However, at 3 years of age, echocardiography revealed a severe right ventricular obstruction, known as a double-chambered right ventricle, along with right-to-left shunting via the ventricular septal defect. Because of chronic hypoxemia due to the right-to-left shunting, erythrocytosis developed. Flow reversal via the shunt was caused by a progressively worsening right ventricular obstruction leading to a supra-systemic right ventricular systolic pressure. Because of the poor prognosis, the dog was euthanized, and the heart was submitted for post-mortem examination. Gross pathologic findings revealed the close proximity of the right ventricular obstructive lesion to the ventricular septal defect. Histopathology revealed localized muscular hypertrophy and severe endocardial fibrosis. The suspected pathogenesis of the progressive obstruction was infiltrative myocardial fibrosis due to turbulent blood flow from the left-to-right shunting ventricular septal defect, as described in humans.
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Affiliation(s)
- Viktor Szatmári
- Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584CM Utrecht, The Netherlands
- Correspondence:
| | - Mark Dirven
- Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584CM Utrecht, The Netherlands
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20
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Winter RL, Clark WA, Cutchin E, Rhinehart JD. Integrative echocardiographic assessment of post-operative obstruction severity and restenosis after balloon valvuloplasty in 81 dogs with pulmonary stenosis. J Vet Cardiol 2023; 45:71-78. [PMID: 36716612 DOI: 10.1016/j.jvc.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 12/27/2022] [Accepted: 12/29/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION/OBJECTIVES Pulmonary stenosis (PS) is a congenital defect in the dog that is managed with balloon valvuloplasty (BV). Obstruction severity is routinely assessed using transthoracic echocardiography. The objectives of this study were to describe the short-term changes and long-term restenosis by retrospectively evaluating flow-dependent and flow-independent echocardiographic variables for dogs with PS after BV. ANIMALS, MATERIALS, AND METHODS Medical records and stored echocardiographic images were reviewed from dogs that received BV for PS. The following echocardiographic variables were measured or calculated: maximum systolic ejection velocity (VmaxPV) and velocity-derived maximal pressure gradient (PV maxPG) across the pulmonary valve; ratio of aortic to pulmonary velocity time integral (VTIAV/VTIPV); ratio of aortic to pulmonary maximal velocity. RESULTS Eighty-one dogs with PS that had a BV were included. Each of these dogs had pulmonary obstruction severity assessed in at least three timepoints. Forty-nine dogs had at least one additional examination performed, the last of which occurred a median of 504 days after the BV. Echocardiographic variables at the first follow-up had increased by a clinically relevant quantity in 20-34% of the dogs when comparing to the immediate post-BV examination. The last follow-up examination identified valve restenosis in 18-38% of the dogs in this study. Valve type and pre-BV obstruction severity did not have a significant effect (P > 0.1). CONCLUSIONS For the assessment of BV efficacy, the immediate post-BV echocardiogram may not be as useful as the first follow-up examination several months later. Pulmonary restenosis after BV may be more prevalent than previously reported.
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Affiliation(s)
- R L Winter
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Rd, Auburn, AL, 36849, USA.
| | - W A Clark
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, 43220, USA
| | - E Cutchin
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, 43220, USA
| | - J D Rhinehart
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, 43220, USA
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21
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Stoner CH, Saunders AB. Evaluation of two probes for transesophageal echocardiography in small dogs: imaging capabilities, image quality, and usability. J Vet Cardiol 2023; 45:41-49. [PMID: 36696791 DOI: 10.1016/j.jvc.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 12/12/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTIONS Patient size is a limiting factor for transesophageal echocardiography (TEE) in small dogs. The objective of this study was to describe imaging capabilities of two probes for TEE in small dogs. ANIMALS, MATERIALS, AND METHODS Prospective study in 10 client-owned dogs weighing <4 kg with congenital heart disease (CHD). Dogs had TEE performed with a microprobe (10T-D, GE Medical) and intracardiac echocardiography (ICE) catheter-based probe (AcuNav™, Biosense Webster) in the esophagus in alternating order. Ease of placement, ability to acquire images of the CHD, image quality, and probe limitations were recorded. RESULTS Median weight was 2.4 kg (range, 1.0-3.2). Congenital abnormalities included patent ductus arteriosus (n = 9) and pulmonary valve stenosis (n = 1). The 10T-D microprobe was easy to place (n = 8) or achievable with gentle manipulation (n = 2), and image quality of the CHD was optimal (n = 8), adequate (n = 1), or poor (n = 1). The ICE probe was difficult to place in the esophagus even with an external support system (n = 9) or could not be placed (n = 1), and image quality of the CHD was optimal (n = 2), adequate (n = 3), or poor (n = 5). Both probes provided images in a 1.0-kg dog. Probe limitations included lack of lateral motion (microprobe), the need for an external support system (ICE probe) and inability to consistently maintain contact with the esophagus (ICE probe). CONCLUSION The 10T-D microprobe provided high-quality TEE images more consistently than the ICE probe in the majority of dogs in this study; however, the lack of lateral motion can diminish its utility in some dogs.
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Affiliation(s)
- C H Stoner
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - A B Saunders
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA.
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Berrezaie M, Connolly D, Cruzado J, Mederska E, Dukes-McEwan J, Humm K. Infective endocarditis in dogs in the UK: 77 cases (2009-2019). J Small Anim Pract 2023; 64:78-87. [PMID: 36336849 PMCID: PMC10099803 DOI: 10.1111/jsap.13561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/05/2022] [Accepted: 09/12/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To determine the causative organisms, clinical features and outcome of canine infective endocarditis in the UK. MATERIALS AND METHODS Medical records of three veterinary referral hospitals were searched for dogs with infective endocarditis between December 2009 and December 2019. Signalment, clinical signs, causative organism, valve affected, treatment and survival data were recorded. RESULTS Seventy-seven cases with possible or definite infective endocarditis (according to the modified Duke criteria) were included. The majority were large breed (40/77 - 51.9%). There were 47 of 77 (61%) male dogs and the mean age was 7.3 ±3 years. A causative organism was identified in 26 of 77 (33.8%) cases. The most common organisms were Escherichia coli (7/27 - 25.9%), Pasteurella spp. (5/27 - 18.5%), Staphylococcus spp. (4/27 - 14.8%) and Corynebacterium spp. (4/27 - 14.8%). Bartonella spp. were not detected in any patients. The mitral valve was most commonly affected (48/77 - 62.3%). Clinical features were non-specific, with lethargy being the most common clinical sign observed (53/77 - 68.8%). Fifty-three dogs (68.8%) survived to discharge. The median survival time post discharge was 425 days (2 to 3650 days). The development of congestive heart failure was associated with a poorer outcome. Cardiac troponin concentration, antithrombotic use and the development of thromboembolism or arrhythmias were not significantly associated with outcome. CLINICAL SIGNIFICANCE Some dogs with infective endocarditis that survive to discharge can have a long lifespan. The inability to detect an underlying organism is common and Bartonella spp. may be a less prevalent cause of canine infective endocarditis in the UK than in the USA.
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Affiliation(s)
- M Berrezaie
- Department of Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL9 7TA, UK
| | - D Connolly
- Department of Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL9 7TA, UK
| | - J Cruzado
- Southern Counties Veterinary Specialists, Unit 6, Forest Corner Farm, Hangersley, Ringwood, Hampshire, BH24 3JW, UK
| | - E Mederska
- Department of Small Animal Clinical Science, School of Veterinary Science, Leahurst Campus, University of Liverpool, Chester High Road, Neston, CH64 7TE, UK
| | - J Dukes-McEwan
- Department of Small Animal Clinical Science, School of Veterinary Science, Leahurst Campus, University of Liverpool, Chester High Road, Neston, CH64 7TE, UK
| | - K Humm
- Department of Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL9 7TA, UK
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Chetboul V, Bernard P, Passavin P, Tissier R. Congenital ventricular outflow tract obstructions in Boxer dogs: Results of a 17-year cardiovascular breed screening program in France (3126 dogs). PLoS One 2023; 18:e0285458. [PMID: 37167326 PMCID: PMC10174479 DOI: 10.1371/journal.pone.0285458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 04/24/2023] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Ventricular outflow tract obstructions including aortic (AS) and pulmonic stenosis (PS) are the most common canine congenital heart diseases, with Boxer dogs being predominantly affected. This has led to the French Boxer club adopting a mandatory national control program against AS and PS. The objective of this retrospective study was to analyze the results of 17 years of this cardiovascular breed screening program (2005-2021). MATERIALS AND METHODS The records of untreated and non-anesthetized adult Boxer dogs screened between 2005 and 2021 were retrospectively reviewed. All dogs underwent physical examination and standard transthoracic echocardiography with concomitant ECG tracing. All examinations were reviewed by one single board-certified specialist in cardiology. RESULTS Out of the 3126 dogs screened during the study period, 3001 dogs (female:male sex ratio = 2.2, median age [IQR] = 1.6 years [1.2-2.1]) were recruited for data analysis. A total of 218 operators were involved in the screening program. For most Boxer dogs (i.e., 93.8% for AS and 94.5% for PS), a single examination was required to obtain a definitive cardiac status, although most operators were non-specialist general practitioners. A left basilar systolic heart murmur was detected in all dogs with AS and PS, but also in 7.4% dogs free of heart diseases. A significantly higher proportion of the latter was detected when operators were board-certified specialists (P<0.001). Lastly, when comparing the start and the end of the breeding program, among dogs diagnosed with AS and PS (n = 364) in a French referral cardiology center, Boxer went from the 1st affected breed by AS to the 3rd, and from the 3rd affected breed by PS to the 6th. CONCLUSION This 17-year screening program has experienced a strong involvement of veterinarians, breeders, and owners throughout France. This may have contributed to reduce AS and PS prevalence in Boxer dogs at the studied referral cardiology center.
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Affiliation(s)
- Valérie Chetboul
- Unité de Cardiologie d'Alfort, CHUV-Ac, École nationale vétérinaire d'Alfort, Maisons-Alfort, France
- Univ Paris Est Créteil, INSERM, IMRB, Créteil, France
| | - Pauline Bernard
- Unité de Médecine Interne, CHUV-Ac, École nationale vétérinaire d'Alfort, Maisons-Alfort, France
| | - Peggy Passavin
- Unité de Cardiologie d'Alfort, CHUV-Ac, École nationale vétérinaire d'Alfort, Maisons-Alfort, France
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Prevalence and Prognosis of Atenolol-Responsive Systolic Anterior Motion of the Septal Mitral Valve Leaflet in Young Cats with Severe Dynamic Left Ventricular Outflow Tract Obstruction. Animals (Basel) 2022; 12:ani12243509. [PMID: 36552429 PMCID: PMC9774653 DOI: 10.3390/ani12243509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Severe dynamic left ventricular outflow tract obstruction (DLVOTO) secondary to the systolic anterior motion of the septal mitral valve leaflet (SAM) can result either from congenital mitral valve disorders or left ventricular concentric hypertrophy of any cause, in cats commonly hypertrophic cardiomyopathy (HCM). Though HCM cannot be reversed, the question remains whether atenolol can cure cats with severe DLVOTO resulting from a presumed mitral valve dysplasia. METHODS In this retrospective case series, client-owned asymptomatic cats younger than 1.5 years with echocardiographic evidence of SAM and severe DLVOTO were included. Oral atenolol therapy and recheck echocardiography after 2-3 months were recommended. The owners and referring veterinarians were called for long-term follow-up information. RESULTS Of the 28 included cats, 23 were treated with atenolol. Recheck echocardiography performed in 17 cats showed a resolution of SAM in 47%. In the long term, SAM remained absent in only 9% of the treated cats. Cardiac-related death occurred in 26% of the atenolol-treated cats. CONCLUSIONS The long term benefit of twice-daily atenolol therapy was documented in 9% of cats. Whether the cats where atenolol failed to resolve DLVOTO on long-term had HCM, or a therapy-resistant congenital primary mitral valve disorder remains unclear.
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Information Provided by Breeders and Referring Veterinarians about the Presence and Meaning of a Murmur to Owners of Newly Purchased Puppies with a Later Confirmed Congenital Heart Disease. Vet Sci 2022; 9:vetsci9120678. [PMID: 36548839 PMCID: PMC9783349 DOI: 10.3390/vetsci9120678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Background: A recent study revealed that only 10% of puppies diagnosed with a congenital heart disease were referred for murmur investigation to a veterinary cardiology specialist while the puppies were in the breeders' possession. Whether the new owners had been informed about the presence of a murmur before purchasing a puppy was not investigated. Methods: New owners whose dogs were diagnosed with a congenital heart disease at the authors' institution in a 1-year period received a questionnaire during the consult after cardiac auscultation but before performing an echocardiogram. The main study aims were to reveal whether the breeders had informed the new owners about the presence of a murmur before purchasing the puppy, and whether the owners would have still chosen to buy that specific puppy if they had known about a potentially present congenital heart disease. Results: Of the 60 interviewed owners, 72% would have refrained from buying the puppy if they had known about the presence of a congenital heart disease. However, only 23% of them were informed about the presence of a cardiac murmur before purchase. Conclusions: Most owners would have chosen to buy a healthy puppy without a heart disease if they had been informed.
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Prevalence and Clinical Significance of Heart Murmurs Detected on Cardiac Auscultation in 856 Cats. Vet Sci 2022; 9:vetsci9100564. [PMID: 36288177 PMCID: PMC9611806 DOI: 10.3390/vetsci9100564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/19/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022] Open
Abstract
Simple Summary Heart murmurs are a common finding in cats and, in many cases, the presence of an audible murmur on cardiac auscultation does not necessarily imply the presence of an underlying heart disease. Several studies have been published in the past to address the prevalence and clinical significance of heart murmurs in cats, but very few have looked into the exact origin of the blood flow turbulence responsible for this finding. We retrospectively reviewed clinical records and echocardiographic examinations of 856 cats with heart murmur and found that the majority of murmurs are caused by systolic anterior motion of the mitral valve (SAM) (39.2%) and dynamic right ventricular outflow tract obstruction (DRVOTO) (32%). These causes of murmur do not appear associated with a structural cardiac abnormality in 56.1% (SAM) and 85.0% (DRVOTO) of murmurs. This study also demonstrated that some heart murmur characteristics (timing, intensity and location) can occasionally discriminate between normal cats and cats with underlying heart disease, with the exception of loud and palpable murmurs, which are inevitably associated with significant cardiac abnormalities. However, since the majority of heart murmurs in cats appear to be systolic and mild–moderate in loudness, echocardiography should always be considered following identification of a heart murmur on physical examination in cats. Abstract Background: Cardiac auscultation is one of the most important clinical tools to identify patients with a potential heart disease. Although several publications have reported the prevalence of murmurs in cats, little information is available in relation to the exact origin of the blood flow turbulences responsible for these murmurs. The aim of this study was to determine the prevalence and clinical significance of murmurs detected during physical examination in cats. Methods: Retrospective evaluation of clinical records and echocardiographic examinations performed in cats for investigation of heart murmurs; Results: Records of 856 cats with full clinical information were available for review. The cause of murmur was identified in 93.1% of cases (72.3% with single blood flow turbulence, 26.4% with two, and 1.3% with three identifiable sources of murmur). Systolic anterior motion of the mitral valve (SAM) was the primary cause of murmur in this population (39.2%), followed by dynamic right ventricular outflow tract obstruction (DRVOTO) (32%) and flow murmurs (6.9%). Most cats with a murmur (56.7%) did not present any structural cardiac abnormality. Conclusions: This study indicates that some heart murmur characteristics (timing, loudness and point of maximal intensity) can potentially predict the presence of an underlying cardiac disease.
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Prevalence of Echocardiographic Evidence of Trace Mitral and Aortic Valve Regurgitation in 50 Clinically Healthy, Young Adult Labrador Retrievers without Heart Murmur. Animals (Basel) 2022; 12:ani12182442. [PMID: 36139302 PMCID: PMC9495225 DOI: 10.3390/ani12182442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/14/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Screening for various disorders lowers the chance for spreading hereditary diseases by selecting individuals for breeding that do not have that specific disorder. Screening examinations, which are typically performed in clinically healthy animals, can pick up diseases in an early stage, when clinical signs are absent. On the other hand, screenings might also reveal anomalies of questionable relevance. In the present study, healthy young Labrador retrievers were screened with cardiac ultrasound for congenital heart defects. In half of the dogs, a small leakage of a cardiac valve was found, which finding is often a sign of a heart disease. However, in this breed and age group, this leaky valve is most likely innocent and represents a variation of normal. Abstract Background—Though physiologic regurgitation of the right-sided cardiac valves is well recognized in dogs and other mammals, the prevalence of trace insufficiency of the mitral and aortic valves in clinically healthy, young adult dogs is unknown. Methods—In this observational cross-sectional study, 50 clinically healthy, young adult Labrador retrievers without an audible heart murmur were enrolled. All dogs were bred and owned by a single organization. Cardiac screening was requested for all dogs that were intended for breeding. These dogs underwent a cardiac auscultation and transthoracic echocardiography by a veterinary cardiology specialist. If mitral or aortic valve regurgitation was noticed, the jet size was subjectively assessed on color Doppler echocardiography. Pedigree analysis was performed to reveal a possible hereditary background of mitral valve regurgitation. Results—The prevalence of trivial mitral valve regurgitation was 52% with no significant predisposition to gender (p = 0.86) or haircoat color (p = 0.68). The prevalence of aortic valve regurgitation was 4%. Pedigree analysis for mitral valve regurgitation showed familial clustering, suggesting a hereditary background of the trait. Conclusions—The prevalence of silent trace mitral valve regurgitation in young adult Labrador retrievers was high. Because the regurgitant jet was trivial in all dogs, it is probably physiologic.
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Croce M, Vezzosi T, Marchesotti F, Patata V, Bini M, Lacava G, Venco L, Domenech O. Abnormalities of External Jugular Veins in Bulldogs with Pulmonary Valve Stenosis. Vet Sci 2022; 9:vetsci9070359. [PMID: 35878376 PMCID: PMC9322589 DOI: 10.3390/vetsci9070359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/10/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary This case series is about two French bulldogs and one English bulldog affected by pulmonary valve stenosis that were diagnosed with different abnormalities of the external jugular veins (EJV) before a pulmonary balloon valvuloplasty. The EJV abnormalities encountered were severe hypoplasia of both external jugular veins and right external jugular vein absence, associated with persistent left cranial vena cava. All cases were diagnosed through computed tomography and vascular ultrasound. The aim of this case series is to describe external jugular veins abnormalities that can affect the decision-making process regarding central venous catheterization needed to perform procedures such as pulmonary balloon valvuloplasty or central catheter placement. Based on the results of the present case series, anomalies of the external jugular veins should be considered in French and English bulldogs when the external jugular veins cannot be clinically identified or when echocardiography shows coronary sinus dilation. Vascular ultrasound or computed tomography may help identify jugular venous anomalies and should be considered in the preoperative evaluation of bulldogs that need to undergo interventional procedures requiring transjugular catheterization. Abstract Two French bulldogs and one English bulldog affected by pulmonary valve stenosis and referred for pulmonary balloon valvuloplasty were diagnosed with different abnormalities of the external jugular veins. The diagnosis included unilateral absence of the right external jugular vein and bilateral hypoplasia of the external jugular veins, associated with persistent left cranial vena cava. Vascular ultrasound and computed tomography were used for the diagnosis. Jugular vein anomalies can affect decision-making regarding the central venous catheterization needed to perform procedures such as pulmonary balloon valvuloplasty or central catheter placement. Based on the results of the present case series, anomalies of external jugular veins should be considered in French and English bulldogs when the external jugular veins cannot be palpated or when echocardiography shows coronary sinus dilation. Vascular ultrasound or computed tomography may help identify jugular venous anomalies and should be considered in the preoperative evaluation of bulldogs that need to undergo interventional procedures requiring transjugular catheterization.
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Affiliation(s)
- Marta Croce
- Anicura Istituto Veterinario Novara, 28060 Novara, Italy; (F.M.); (V.P.); (M.B.); (G.L.); (O.D.)
- Correspondence:
| | - Tommaso Vezzosi
- Department of Veterinary Sciences, University of Pisa, 56122 Pisa, Italy;
| | - Federica Marchesotti
- Anicura Istituto Veterinario Novara, 28060 Novara, Italy; (F.M.); (V.P.); (M.B.); (G.L.); (O.D.)
| | - Valentina Patata
- Anicura Istituto Veterinario Novara, 28060 Novara, Italy; (F.M.); (V.P.); (M.B.); (G.L.); (O.D.)
| | - Martina Bini
- Anicura Istituto Veterinario Novara, 28060 Novara, Italy; (F.M.); (V.P.); (M.B.); (G.L.); (O.D.)
| | - Giuseppe Lacava
- Anicura Istituto Veterinario Novara, 28060 Novara, Italy; (F.M.); (V.P.); (M.B.); (G.L.); (O.D.)
| | - Luigi Venco
- Veterinary Hospital City of Pavia, 27100 Pavia, Italy;
| | - Oriol Domenech
- Anicura Istituto Veterinario Novara, 28060 Novara, Italy; (F.M.); (V.P.); (M.B.); (G.L.); (O.D.)
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Jackson NW, Thomason JD, DiFazio MR, Hallman CC. Atrial septal defect in an Airedale terrier. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Nathan W. Jackson
- Department of Clinical Sciences College of Veterinary Medicine Kansas State University Manhattan Kansas USA
| | - Justin D. Thomason
- Department of Clinical Sciences College of Veterinary Medicine Kansas State University Manhattan Kansas USA
| | - Matthew R. DiFazio
- Department of Clinical Sciences College of Veterinary Medicine Kansas State University Manhattan Kansas USA
| | - Clay C. Hallman
- Department of Clinical Sciences College of Veterinary Medicine Kansas State University Manhattan Kansas USA
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van de Watering A, Szatmári V. Spontaneous closure of an isolated congenital perimembranous ventricular septal defect in two dogs. BMC Vet Res 2022; 18:162. [PMID: 35505347 PMCID: PMC9063103 DOI: 10.1186/s12917-022-03266-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/24/2022] [Indexed: 11/26/2022] Open
Abstract
Background Though spontaneous closure of isolated congenital ventricular septal defects in humans is very common, it has been rarely reported in dogs. Case presentation A 4 month old Havanese dog and a 4.5 month old Chihuahua x Jack Russell terrier cross were presented for murmur evaluation to the authors’ institution. Both puppies were clinically healthy and had a loud systolic murmur on the right hemithorax. Echocardiography in both dogs revealed a small, isolated, restrictive perimembranous congenital ventricular septal defect. No echocardiographic signs of left ventricular volume overload or pulmonary hypertension were present. Re-check auscultation in both dogs revealed the absence of a murmur, and echocardiography showed no flow through the interventricular septum. In the 9 kg Havanese dog and the 4 kg mixed breed dog, spontaneous closure occurred at 13–17 months and 12–30 months, respectively. Conclusions In both dogs the spontaneous closure of a congenital perimembranous ventricular septal defect took place in a young adult age. The mechanism of closure remains unclear.
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Affiliation(s)
- Anne van de Watering
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584, CM, Utrecht, the Netherlands
| | - Viktor Szatmári
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584, CM, Utrecht, the Netherlands.
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Szatmári V. Congenital supravalvular aortic stenosis in a kitten. J Vet Cardiol 2022; 41:227-230. [DOI: 10.1016/j.jvc.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 11/25/2022]
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Gomart S, MacFarlane P, Payne JR, Hezzell MJ, Borgeat K. Effect of preoperative administration of atenolol to dogs with pulmonic stenosis undergoing interventional procedures. J Vet Intern Med 2022; 36:877-885. [PMID: 35302255 PMCID: PMC9151475 DOI: 10.1111/jvim.16403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 02/24/2022] [Accepted: 03/02/2022] [Indexed: 11/28/2022] Open
Abstract
Background Beta‐blockade is sometimes used in dogs with pulmonic stenosis with the intent of reducing frequency of ventricular arrhythmias during right heart catheterization. Objectives To evaluate if pretreatment with atenolol reduces frequency of ventricular arrhythmias, anesthetist interventions, or shortens procedure time. Animals Thirty dogs with pulmonic stenosis scheduled for interventional procedures. Methods Single center, prospective, randomized, open‐label study. Dogs were randomized to treatment with atenolol or no treatment preoperatively for a minimum of 10 days. Variables recorded included heart rate, arrhythmias and complexity, total procedure time and administration of antiarrhythmic treatment, vasopressors, positive chronotropes, or fluid boluses. Results Fifteen dogs were enrolled in each group. Dogs receiving atenolol had lower mean heart rates during the procedure (atenolol 100 ± 11 bpm vs untreated 115 ± 19 bpm, P = .01). There were no significant differences between the atenolol and untreated groups in the frequency of ventricular ectopic complexes (535 [6‐5296] vs 553 [79‐2863], P = .9), ventricular couplets (46 [0‐481] vs 29 [3‐121], P = .59), ventricular triplets (20 [0‐265] vs 16 [1‐82], P = .67), ventricular tachycardia (8 [0‐224] vs 8 [1‐118], P = .99), proportion exhibiting R‐on‐T phenomenon (11/15 vs 14/15, P = .33), proportion receiving intraoperative lidocaine (1/15 vs 3/15, P = .6), vasopressors/positive chronotropes (11/15 vs 5/15, P = .06), or fluid boluses (12/15 vs 7/15, P = .13). The procedure time was similar (atenolol 41 [23‐68] min vs untreated 35 [18‐98] min, P = .91). Conclusions and Clinical Importance No benefit of preoperative atenolol treatment was identified in this small group of dogs.
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Affiliation(s)
- Samantha Gomart
- Highcroft Veterinary Referrals, CVS Group, Bristol, United Kingdom
| | - Paul MacFarlane
- Langford Vets, University of Bristol, Bristol, United Kingdom
| | | | | | - Kieran Borgeat
- Langford Vets, University of Bristol, Bristol, United Kingdom
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Chrai GE, Lawson PB, Köster LS. Pulmonary artery stenosis versus supravalvular pulmonic stenosis: Correctly describing a congenital stenosis of the pulmonic outflow tract in a domestic cat. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Gurcharan Emily Chrai
- University of Tennessee College of Veterinary Medicine Knoxville Tennessee USA
- Colorado Animal Specialty and Emergency Boulder Colorado USA
| | - P. Brent Lawson
- University of Tennessee College of Veterinary Medicine Knoxville Tennessee USA
- Veterinary Cardiopulmonary Care Center Pompano Beach Florida USA
| | - Liza S. Köster
- University of Tennessee College of Veterinary Medicine Knoxville Tennessee USA
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Karn M, Potter BM, Pierce KV, Scansen BA. Medial insertion of the patent ductus arteriosus characterized by computed tomography angiography in a cat and dog. J Vet Cardiol 2022; 41:145-153. [DOI: 10.1016/j.jvc.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 02/11/2022] [Accepted: 02/17/2022] [Indexed: 10/19/2022]
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Clinical and Electrocardiographic Findings for Predicting the Severity of Pulmonary Valve Stenosis in Dogs. Vet Sci 2022; 9:vetsci9020061. [PMID: 35202314 PMCID: PMC8877586 DOI: 10.3390/vetsci9020061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 12/02/2022] Open
Abstract
Pulmonary valve stenosis (PS) in dogs is usually suspected due to the presence of a heart murmur and clinical signs. Echocardiography is needed to confirm the diagnosis and define the severity of PS. This retrospective study evaluated the utility of clinical and electrocardiographic (ECG) findings in the prediction of PS severity. Data regarding heart murmur and ECG analysis were gathered. Ninety-seven dogs with PS were included. A murmur grade ≥IV/VI was predictive of severe PS (area under curve (AUC) = 0.71; sensitivity (Se) = 95%; specificity (Sp) = 33%; p = 0.003). In lead II, P wave amplitude >0.35 mV (AUC = 0.67; Se = 31%; Sp = 100%; p = 0.038), Q wave < 0.15 mV (AUC = 0.70; Se = 70%; Sp = 59%; p = 0.0015), R wave < 0.87 mV (AUC = 0.66; Se = 67%; Sp = 69%; p = 0.006), and S wave > 0.37 mV (AUC = 0.80; Se = 72%; Sp = 85%; p < 0.0001) were predictive of severe PS. The extent of right deviation of the mean electrical axis of the QRS complex was correlated with the pulmonary pressure gradient (r = 0.648; p < 0.0001). In conclusion, a systolic murmur with intensity ≥IV/VI, a P wave amplitude >0.35 mV, low amplitude of Q and R waves, deep S waves in lead II, and right axis deviation of the QRS complex in a young dog are predictive of severe PS.
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Viilmann I, Vettorato E. Propofol‐dexmedetomidine continuous infusion in a dog with pulmonic stenosis undergoing balloon valvuloplasty. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Inga Viilmann
- Dick White Referrals Six Mile Bottom Cambridgeshire UK
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Ackerman LH, Reynolds PS, Aherne M, Swift ST. Right axis deviation in the canine electrocardiogram for predicting severity of pulmonic stenosis: a retrospective cohort analysis. Am J Vet Res 2022; 83:312-316. [PMID: 35038304 DOI: 10.2460/ajvr.21.09.0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the predictive value of right axis deviation of the mean electrical axis (MEA) in assessing the severity of pulmonic stenosis (PS) in dogs. ANIMALS Records for 218 client-owned dogs diagnosed between 2014 and 2020 with PS as determined by Doppler echocardiography. PROCEDURES University of Florida Small Animal Clinic medical records were reviewed, and signalment and clinical risk variables (murmur grade and clinical signs) were extracted. MEA was determined from ECG records by use of leads I and III. Predictive potential of MEA and associated risk factors to diagnose PS severity (mild [< 50 mm Hg], moderate, or severe [> 75 mm Hg]) were assessed by receiver-operating characteristic curve analysis and quantile regression. RESULTS Records for 88 dogs were eligible for analysis. Greater PS severity was associated with smaller breeds presenting with ECG abnormalities, overt clinical signs, and high-category murmur grades (IV and V). Mean MEA increased with stenosis severity category, with an average of 62° for mild, 113° for moderate, and 157° for severe. Each 10° increase in MEA corresponded to an approximately 5-mm Hg increase in PG. Increasing PS severity was associated with MEA right axis deviation > 100° and the more severe cases (PG > 75 mm Hg) with MEA right axis deviation > -180°. CLINICAL RELEVANCE Mean electrical axis right axis deviation may be a useful screening metric for dogs with suspected moderate to severe PS.
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Affiliation(s)
- Leah H Ackerman
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - Penny S Reynolds
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL
| | - Michael Aherne
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - Simon T Swift
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
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Pelzek C, Rhinehart J, Villalba M, Schober K, Winter R, Berman D. Transient high-grade second-degree atrioventricular block secondary to transvenous atrial septal defect occlusion in a dog. J Vet Cardiol 2022; 41:30-38. [DOI: 10.1016/j.jvc.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 11/29/2022]
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Passavin P, Chetboul V, Poissonnier C, Saponaro V, Trehiou-Sechi E, Alvarado MP, Tissier R, Lagrange I, Deshuillers P. Red blood cell abnormalities occur in dogs with congenital ventricular outflow tract obstruction. Am J Vet Res 2021; 83:198-204. [PMID: 34936577 DOI: 10.2460/ajvr.21.11.0188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To document RBC abnormalities in dogs with congenital ventricular outflow tract obstruction. ANIMALS 62 dogs with pulmonic stenosis (PS) or aortic stenosis (AS) and 20 control dogs were recruited. PROCEDURES The proportions of RBCs that were schistocytes, acanthocytes, and keratocytes were assessed. Complete blood cell counts were performed. Tested variables included hemoglobin concentration, hematocrit, and erythrocyte count. RESULTS Median (interquartile range [IQR]) peak systolic Doppler-derived trans-stenotic pressure gradient (∆P) values were 161 mm Hg (108 to 215 mm Hg) and 134 mm Hg (125 to 165 mm Hg) for dogs with PS and AS, respectively. Hematologic abnormalities were detected in most dogs with AS or PS (54/62 [87%]) versus 8/20 [40%] in control dogs, with schistocytes found in 40 of 62 (65%; median, 0.1% RBCs; IQR, 0% to 0.3%), acanthocytes in 29 of 62 (47%; median, 0.3% RBCs; IQR, 0% to 0.9%), keratocytes in 39 of 62 (63%; median, 0% RBCs; IQR, 0% to 0.2%), and hemolytic anemia in 4 dogs with PS. No significant association was identified between these abnormalities and ∆P. However, 3 of 4 dogs with anemia had a ∆P > 200 mm Hg (range, 242 to 340 mm Hg). The dog with the highest ∆P value also had the most severe anemia and schistocytosis, and both resolved after balloon valvuloplasty. CLINICAL RELEVANCE Poikilocytosis is common in dogs with congenital ventricular outflow tract obstruction, with anemia only observed in few dogs with high ∆P values.
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Affiliation(s)
- Peggy Passavin
- Unité de Cardiologie d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Valérie Chetboul
- Unité de Cardiologie d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Institut Mondor de Recherche Biomédicale, U955 Inserm, École Nationale Vétérinaire d'Alfort, UPEC, Maisons-Alfort, France
| | - Camille Poissonnier
- Unité de Cardiologie d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Vittorio Saponaro
- Unité de Cardiologie d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Emilie Trehiou-Sechi
- Unité de Cardiologie d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Maria-Paz Alvarado
- Unité de Cardiologie d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Renaud Tissier
- Institut Mondor de Recherche Biomédicale, U955 Inserm, École Nationale Vétérinaire d'Alfort, UPEC, Maisons-Alfort, France.,Unité de Pharmacie-Toxicologie, École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Isabelle Lagrange
- Unité de Biochimie et Biologie Clinique/Laboratoire BioPôle, École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Pierre Deshuillers
- Unité de Biochimie et Biologie Clinique/Laboratoire BioPôle, École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,UMR Biologie Moléculaire et Immunologie Parasitaires, École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
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Wesselowski S, Cusack K, Saunders AB, Jeffery N. Pre-procedural femoral vessel ultrasound in dogs with patent ductus arteriosus: diameter, image quality and relationship with arterial catheterization. J Vet Cardiol 2021; 39:69-78. [PMID: 34996021 DOI: 10.1016/j.jvc.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION /Objectives: Patent ductus arteriosus (PDA) in dogs is often treated via minimally invasive transvascular occlusion using femoral artery access. This study compared ultrasound-derived diameter and image quality of the right femoral artery (RFA) and vein (RFV) in dogs with PDA using a linear ultrasound probe (L-P) and phased-array transthoracic echocardiography probe (TTE-P). The case outcome was assessed. ANIMALS, MATERIALS & METHODS Forty-five client-owned dogs with PDA were prospectively enrolled. Ultrasound-measured RFA and RFV diameters were obtained on images acquired with both probes pre-operatively and compared using Bland-Altman plots. The image quality of RFA and RFV was scored on L-P and TTE-P images. RESULTS Comparison of RFA and RFV diameter from L-P versus TTE-P images revealed: [Mean difference (limits of agreement): RFA = 0.009 mm (-0.78-0.79 mm), RFV = 0.523 mm (-1.75-2.79 mm)]. Image quality scores were significantly higher for L-P than TTE-P (P < 0.0001). In six small dogs, measurable images were unattainable with TTE-P. Dogs of similar body weight had variable RFA diameters. Twenty-seven dogs had RFA catheterization. In 21/27 dogs, RFA diameter exceeded the external diameter of the introducer used for catheterization, and in 6/27, it was smaller. CONCLUSIONS Pre-procedural ultrasound of the RFA in dogs with PDA is useful given variable RFA diameter relative to body weight. Despite poorer image quality, RFA diameters from TTE-P images were very similar to L-P images on average, suggesting TTE-Ps are suitable for pre-procedural planning in most dogs. Vasospasm, hypotension or differences in the location of ultrasound measurement versus catheterization might produce variation in pre-procedural versus intraoperative RFA size.
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Affiliation(s)
- S Wesselowski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA.
| | - K Cusack
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA
| | - A B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA
| | - N Jeffery
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA
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Abstract
Practical relevance: Hypertrophic cardiomyopathy (HCM) is the most common form of feline
cardiomyopathy observed clinically and may affect up to approximately 15% of
the domestic cat population, primarily as a subclinical disease.
Fortunately, severe HCM, leading to heart failure or arterial
thromboembolism (ATE), only occurs in a small proportion of these cats. Patient group: Domestic cats of any age from 3 months upward, of either sex and of any
breed, can be affected. A higher prevalence in male and domestic shorthair
cats has been reported. Diagnostics: Subclinical feline HCM may or may not produce a heart murmur or gallop sound.
Substantial left atrial enlargement can often be identified radiographically
in cats with severe HCM. Biomarkers should not be relied on solely to
diagnose the disease. While severe feline HCM can usually be diagnosed via
echocardiography alone, feline HCM with mild to moderate left ventricular
(LV) wall thickening is a diagnosis of exclusion, which means there is no
definitive test for HCM in these cats and so other disorders that can cause
mild to moderate LV wall thickening (eg, hyperthyroidism, systemic
hypertension, acromegaly, dehydration) need to be ruled out. Key findings: While a genetic cause of HCM has been identified in two breeds and is
suspected in another, for most cats the cause is unknown. Systolic anterior
motion of the mitral valve (SAM) is the most common cause of dynamic left
ventricular outflow tract obstruction (DLVOTO) and, in turn, the most common
cause of a heart murmur with feline HCM. While severe DLVOTO is probably
clinically significant and so should be treated, lesser degrees probably are
not. Furthermore, since SAM can likely be induced in most cats with HCM, the
distinction between HCM without obstruction and HCM with obstruction (HOCM)
is of limited importance in cats. Diastolic dysfunction, and its
consequences of abnormally increased atrial pressure leading to signs of
heart failure, and sluggish atrial blood flow leading to ATE, is the primary
abnormality that causes clinical signs and death in affected cats. Treatment
(eg, loop diuretics) is aimed at controlling heart failure. Preventive
treatment (eg, antithrombotic drugs) is aimed at reducing the risk of
complications (eg, ATE). Conclusions: Most cats with HCM show no overt clinical signs and live a normal or
near-normal life despite this disease. However, a substantial minority of
cats develop overt clinical signs referable to heart failure or ATE that
require treatment. For most cats with clinical signs caused by HCM, the
long-term prognosis is poor to grave despite therapy. Areas of uncertainty: Genetic mutations (variants) that cause HCM have been identified in a few
breeds, but, despite valiant efforts, the cause of HCM in the vast majority
of cats remains unknown. No treatment currently exists that reverses or even
slows the cardiomyopathic process in HCM, again despite valiant efforts. The
search goes on.
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Affiliation(s)
- Mark D Kittleson
- School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California, Davis, and Veterinary Information Network, 777 West Covell Boulevard, Davis, CA 95616, USA
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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Eason BD, Fine-Ferreira DM, Leeder D, Stauthammer C, Lamb K, Tobias A. Natural history of subaortic stenosis in 166 dogs (1999-2011). J Vet Cardiol 2021; 37:71-80. [PMID: 34634578 DOI: 10.1016/j.jvc.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 07/29/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Subaortic stenosis (SAS) is one of the most common congenital cardiac diseases in dogs. The objective of this study was to provide survival times on a large population of dogs with SAS and to propose a redefined pressure gradient (PG) scale to include a mild, moderate, severe and very severe disease group. ANIMALS, MATERIALS AND METHODS Dogs were divided into four groups based on the Doppler-derived PG across the stenosis. Disease severity was defined as follows: mild = PG < 50 mmHg; moderate = PG range 50-80 mmHg; severe = PG range 80-130 mmHg; and very severe = PG > 130 mmHg. Over the study period (1999-2011), 166 client-owned dogs were diagnosed with SAS of which 129 had follow-up information available. RESULTS Unadjusted median survival time for severity groups were as follows: mild 10.6 years; moderate 9.9 years; severe 7.3 years; and very severe 3.0 years. Univariable analysis examining the effect of the PG, age at diagnosis and sex found only the PG and age at diagnosis had a significant effect on survival. Adjusted survival curves showed that the survival time in the very severe group was decreased compared with all other groups. CONCLUSION Based on the results of this study, a revised SAS classification system with four PG groups is appropriate. Dogs with a PG > 130 mmHg were identified as those with the lowest median survival time.
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Affiliation(s)
- B D Eason
- University of Missouri, College of Veterinary Medicine, 900 E Campus Dr, Columbia, MO, 65211, USA.
| | - D M Fine-Ferreira
- University of Missouri, College of Veterinary Medicine, 900 E Campus Dr, Columbia, MO, 65211, USA
| | - D Leeder
- University of Minnesota, College of Veterinary Medicine, 1365 Gortner Ave, St Paul, MN, 55108, USA
| | - C Stauthammer
- University of Minnesota, College of Veterinary Medicine, 1365 Gortner Ave, St Paul, MN, 55108, USA
| | - K Lamb
- Lamb Statistical Consulting LLC, 404 Thompson Ave W, Saint Paul, MN, 55118, USA
| | - A Tobias
- University of Minnesota, College of Veterinary Medicine, 1365 Gortner Ave, St Paul, MN, 55108, USA
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Rovroy LB, Szatmári V. Age of puppies at referral to veterinary cardiology specialists for murmur investigation. Acta Vet Scand 2021; 63:37. [PMID: 34556139 PMCID: PMC8461946 DOI: 10.1186/s13028-021-00603-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 09/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Cardiac auscultation is an important screening test at the first health examination of puppies because most clinically relevant congenital cardiac anomalies cause a loud murmur from birth. This retrospective study aimed to investigate the age at which dogs with suspected congenital cardiac anomalies were referred to a veterinary cardiology specialist for murmur investigation. A secondary aim was to establish the time interval between the visit to the cardiologist and the first available murmur documentation. The digital archive of a veterinary teaching hospital was searched for dogs with congenital cardiac anomalies and puppies with innocent murmurs during a 5-year period. Dogs had to be referred because of a murmur, and they had to undergo physical examination and echocardiography by a veterinary cardiology specialist. The health certificate section of the pet passport, and the medical records from the referring veterinarian, were reviewed to identify the date when the murmur was first documented. Results Of the 271 included dogs, 94% had a congenital cardiac anomaly and 6% had an innocent murmur. The dogs’ median age was 190 days when they were examined by the cardiologist. Only 10% of the dogs were referred by the breeder’s veterinarian, while 90% of the dogs were referred by the new owner’s veterinarian. The median age of the first available murmur documentation by a first opinion veterinary practitioner was 95 days. Conclusions Only 10% of the puppies in the present study were referred to a veterinary cardiology specialist for murmur investigation before they were sold to a new owner. Referral prior to re-homing would have been feasible if the murmur had been detected and documented by the breeder’s veterinarian, if referral was offered by the breeder’s veterinarian and the referral was accepted by the breeder.
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Kochi M, Sugimoto K, Inoue M, Aoki T. Late recanalization after complete occlusion of patent ductus arteriosus in a Pembroke Welsh Corgi with von Willebrand disease. Vet Med Sci 2021; 8:26-30. [PMID: 34538019 PMCID: PMC8788971 DOI: 10.1002/vms3.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A 36‐month‐old female Pembroke Welsh Corgi with a cardiac murmur weighing 12.6 kg was referred to the Matsubara Animal Hospital cardiology service. Echocardiography revealed a patent ductus arteriosus. The dog underwent ductus arteriosus closure using an Amplatz Canine Duct Occluder. After the operation, we suspected coagulation and a platelet disorder because of the slightly increased haemorrhage during the operation, postoperative purpura around the surgical wound inside of the thigh, and dog breed, which is known to be commonly affected with von Willebrand disease (vWD). Subsequently, type 1 vWD was confirmed. Complete occlusion was achieved 1 month after the operation; however, 2 months after the operation, recanalization appeared. Recanalization progressed gradually; cardiac redilation was not detected 6 years after the operation. The late recanalization was most likely associated with vWD. In canine breeds pre‐disposed to developing vWD, pre‐operative testing may be indicated prior to patent ductus arteriosus occlusion, though the prevalence of vWD is rare.
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Affiliation(s)
- Masaki Kochi
- Division of Cardiology, Matsubara Animal Hospital, Matsubara, Japan
| | - Keisuke Sugimoto
- Department of Internal Medicine 2, Faculty of Veterinary Medicine, Okayama University of Science, Imabari, Japan
| | - Michito Inoue
- Division of Cardiology, Matsubara Animal Hospital, Matsubara, Japan
| | - Takuma Aoki
- Department of Small Animal Surgery, Faculty of Veterinary Medicine, Azabu University, Sagamihara, Japan
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Identification and Clinical Significance of Heart Murmurs in Puppies Involved in Puppy Trade. Vet Sci 2021; 8:vetsci8080139. [PMID: 34437461 PMCID: PMC8402762 DOI: 10.3390/vetsci8080139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 12/02/2022] Open
Abstract
The detection of a congenital heart defect at purchase is an important step in early detection from a clinical and legal standpoint. Indeed, some cardiac abnormalities may be corrected with surgery, and very often, treatment needs to be performed early before congestive heart failure or irreversible heart damage can occur. From a legal viewpoint, if the defect is revealed in a newly purchased puppy, the buyer may be required to return it and receive compensation. Puppies affected with congenital heart defects are likely to die prematurely, causing emotional suffering to the owner. Furthermore, by considering breed predisposition, early recognition allows breeders to avoid breeding from particular dogs with genetic defects and prevent the continuation of genetic defects in breeding lines. Given gaps in the literature about the recognition of murmurs in the puppy trade, the present article describes how to identify a heart murmur in a puppy during a pre-purchase examination and its significance from a clinical and legal viewpoint. In the canine population, the prevalence of cardiac defects ranges between 0.13 and 1.6%. Pulmonic stenosis is the most common defect found in puppies, followed by patent ductus arteriosus, subaortic stenosis, and ventricular septal defect. On the basis of the above considerations, the veterinarian should recognize and identify the murmur following a protocol for routine examination of puppies involved in trade.
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Saunders AB. Key considerations in the approach to congenital heart disease in dogs and cats. J Small Anim Pract 2021; 62:613-623. [PMID: 34180062 DOI: 10.1111/jsap.13360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/12/2021] [Accepted: 04/29/2021] [Indexed: 11/26/2022]
Abstract
Congenital heart disease is an important subset of all cardiovascular disease in dogs and cats that is present at birth and most often detected in young animals but can be diagnosed in adulthood. The range of abnormalities that can occur during development of the heart is vast incorporating simple and complex defects, varying degrees of severity and clinical presentations that include heart failure and cyanosis. While some defects do not result in morbidity in an individual animal, others cause severe clinical signs and death at a young age. Advances in imaging and expanding treatment options offer increasingly more possibilities in the diagnosis and management of congenital heart disease which is the focus of this review. The objective is to provide a broad overview of current practice and highlight key aspects to guide practitioners in their approach to congenital heart disease diagnosis and knowledge of available treatment options.
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Affiliation(s)
- A B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
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Funk LL, Rodriguez KT, Leach SB. Balloon valvuloplasty in 2 juvenile alpacas with severe valvular pulmonic stenosis. J Vet Intern Med 2021; 35:2069-2074. [PMID: 34101907 PMCID: PMC8295714 DOI: 10.1111/jvim.16198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/22/2021] [Accepted: 05/27/2021] [Indexed: 11/27/2022] Open
Abstract
Two juvenile alpacas, 1 male and 1 female, were presented for evaluation of grade V/VI bilateral basilar systolic heart murmurs. Both animals were ultimately diagnosed with severe valvular pulmonic stenosis and a small ventricular septal defect. Transvenous balloon valvuloplasty was performed in each animal using methods described in the dog. A double balloon technique was employed in the first case, with a balloon‐annulus ratio of ~1.55. For the second case, a high‐pressure dilatation balloon catheter with a balloon‐annulus ratio of ~1.33 was selected. Experience with both procedures indicates that balloon pulmonary valvuloplasty is technically feasible in alpacas using techniques extrapolated from those used in dogs. Furthermore, accepted criteria for procedural success were fulfilled for both alpacas, with more than a 50% reduction in the echocardiographically derived transpulmonic pressure gradient after intervention.
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Affiliation(s)
- Logan L Funk
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, Missouri, USA
| | - Kiira T Rodriguez
- University of Tennessee Veterinary Medical Center, Knoxville, Tennessee, USA
| | - Stacey B Leach
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, Missouri, USA
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Balloon valvuloplasty of valvular pulmonary stenosis in a neonatal foal. J Vet Cardiol 2021; 36:48-54. [PMID: 34077876 DOI: 10.1016/j.jvc.2021.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/15/2021] [Accepted: 04/22/2021] [Indexed: 11/21/2022]
Abstract
In a 1-day old filly with a loud heart murmur, transthoracic echocardiography revealed right ventricular hypertrophy associated with severe pulmonary valvular stenosis and a transvalvular pressure gradient (between right ventricle and pulmonary artery) of 125 mmHg. Computed tomographic angiography confirmed the finding, with no evidence of other relevant concurrent abnormalities. Balloon valvuloplasty was performed using a single balloon technique. The foal recovered well from anaesthesia. Following the procedure, the right ventricle-pulmonary artery transvalvular gradient decreased to 38 mmHg. At follow up examinations after 1 month, 1 year and 2 years, the filly showed normal exercise capacity and echocardiography confirmed the persistent substantial improvement in the transvalvular outflow gradient.
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Acquired Stenosis of All Four Heart Valves in a Boxer Mix Dog. CASE 2021; 5:189-192. [PMID: 34195521 PMCID: PMC8236396 DOI: 10.1016/j.case.2021.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Martin-Flores M, Moy-Trigilio KE, Campoy L, Araos J. The use of dexmedetomidine during pulmonic balloon valvuloplasty in dogs. Vet Rec 2021; 188:e75. [PMID: 33969500 DOI: 10.1002/vetr.75] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/08/2020] [Accepted: 12/26/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Information regarding the anaesthetic management for pulmonic balloon valvuloplasty (PBV) in dogs is scarce. We present data from dogs receiving dexmedetomidine combined with inhalational anaesthesia during PBV. METHODS Anaesthetic records from dogs receiving dexmedetomidine (n = 11) and a control group (n = 29) anaesthetised for PBV between 2012 and 2020 were analysed. Intraoperative variables potentially affected by dexmedetomidine administration were compared between groups. RESULTS Demographic characteristic and anaesthetic agents administered were similar between groups. The incidence of hypotension (mean arterial pressure (MAP) < 60 mm Hg) was 25% for dexmedetomidine and 29% for control (p = 0.8); however, dexmedetomidine group received vasopressors for a shorter time (p = 0.02). The incidence of bradycardia was 100% and 96% for dexmedetomidine and control (p = 0.5), but antimuscarinic agents were administered more frequently to the latter (p = 0.014). CONCLUSION Dexmedetomidine may be a useful adjuvant to general anaesthesia during PBV in dogs and reduced the use of vasopressors and antimuscarinics.
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Affiliation(s)
- Manuel Martin-Flores
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | | | - Luis Campoy
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Joaquin Araos
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
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