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Williams ZJ, Pezzanite LM, Chow L, Rockow M, Dow SW. Evaluation of stem-cell therapies in companion animal disease models: a concise review (2015-2023). Stem Cells 2024; 42:677-705. [PMID: 38795363 DOI: 10.1093/stmcls/sxae034] [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: 11/26/2023] [Accepted: 01/25/2024] [Indexed: 05/27/2024]
Abstract
Companion animals in veterinary medicine develop multiple naturally occurring diseases analogous to human conditions. We previously reported a comprehensive review on the feasibility, safety, and biologic activity of using novel stem cell therapies to treat a variety of inflammatory conditions in dogs and cats (2008-2015) [Hoffman AM, Dow SW. Concise review: stem cell trials using companion animal disease models. Stem Cells. 2016;34(7):1709-1729. https://doi.org/10.1002/stem.2377]. The purpose of this review is to provide an updated summary of current studies in companion animal disease models that have evaluated stem cell therapeutics that are relevant to human disease. Here we have reviewed the literature from 2015 to 2023 for publications on stem cell therapies that have been evaluated in companion animals, including dogs, cats, and horses. The review excluded case reports or studies performed in experimentally induced models of disease, studies involving cancer, or studies in purpose-bred laboratory species such as rodents. We identified 45 manuscripts meeting these criteria, an increase from 19 that were described in the previous review [Hoffman AM, Dow SW. Concise review: stem cell trials using companion animal disease models. Stem Cells. 2016;34(7):1709-1729. https://doi.org/10.1002/stem.2377]. The majority of studies were performed in dogs (n = 28), with additional studies in horses (n = 9) and cats (n = 8). Disease models included those related to musculoskeletal disease (osteoarthritis and tendon/ligament injury), neurologic disease (canine cognitive dysfunction, intervertebral disc disease, spinal cord injury) gingival/dental disease (gingivostomatitis), dermatologic disease (atopic dermatitis), chronic multi-drug resistant infections, ophthalmic disease (keratoconjunctivitis sicca, eosinophilic keratitis, immune-mediated keratitis), cardiopulmonary disease (asthma, degenerative valve disease, dilated cardiomyopathy), gastrointestinal disease (inflammatory bowel disease, chronic enteropathy), and renal disease (chronic kidney disease). The majority of studies reported beneficial responses to stem cell treatment, with the exception of those related to more chronic processes such as spinal cord injury and chronic kidney disease. However, it should also be noted that 22 studies were open-label, baseline-controlled trials and only 12 studies were randomized and controlled, making overall study interpretation difficult. As noted in the previous review, improved regulatory oversight and consistency in manufacturing of stem cell therapies are needed. Enhanced understanding of the temporal course of disease processes using advanced-omics approaches may further inform mechanisms of action and help define appropriate timing of interventions. Future directions of stem-cell-based therapies could include use of stem-cell-derived extracellular vesicles, or cell conditioning approaches to direct cells to specific pathways that are tailored to individual disease processes and stages of illness.
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Affiliation(s)
- Zoë J Williams
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, United States
| | - Lynn M Pezzanite
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, United States
| | - Lyndah Chow
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, United States
| | - Meagan Rockow
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, United States
| | - Steven W Dow
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, United States
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Mederska E, Stephenson H, Maddox TW, Dukes-McEwan J. Assessment of right ventricular function in healthy Great Danes and in Great Danes with dilated cardiomyopathy. J Vet Cardiol 2024; 54:44-56. [PMID: 39013250 DOI: 10.1016/j.jvc.2024.05.006] [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: 10/14/2023] [Revised: 05/11/2024] [Accepted: 05/15/2024] [Indexed: 07/18/2024]
Abstract
INTRODUCTION Right ventricular (RV) dysfunction is a significant negative prognostic indicator in human dilated cardiomyopathy (DCM). Many RV indices are weight-dependent, and there is a lack of reference values for the right heart in giant breed dogs (over 50 kg), including Great Danes (GDs). This study aimed to compare indices of RV function in echocardiographically normal GDs, those with preclinical DCM (PC-DCM), and those with DCM and congestive heart failure (DCM-CHF). ANIMALS A total of 116 client-owned adult GDs: 74 normal, 31 with PC-DCM, and 11 with DCM-CHF. METHODS A retrospective, single-center cohort study assessed RV function using free-wall RV longitudinal strain (RVLS), strain rate, fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), and pulsed-wave tissue Doppler imaging-derived systolic myocardial velocity of the lateral tricuspid annulus (TDI S'). Relationships between DCM status and RV function indices were analyzed. RESULTS RV function, measured by TAPSE (P=0.001), FAC (P<0.001), and TDI S' (P<0.001), decreased in dogs with PC-DCM and DCM-CHF compared to healthy dogs, with FAC being lower in DCM-CHF compared to PC-DCM (P=0.048). RVLS impairment was more significant in the DCM-CHF group than in the PC-DCM group (P=0.048). RVLS had the highest area under the curve (0.899) for differentiating between normal and DCM-CHF dogs. CONCLUSION As DCM progresses, echocardiographic variables of RV function, including TAPSE, FAC, TDI S', RVLS, and strain rate, worsen, indicating impaired RV systolic function in GDs affected by DCM.
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Affiliation(s)
- E Mederska
- Small Animal Teaching Hospital, Department of Small Animal Clinical Sciences, School of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK.
| | - H Stephenson
- Small Animal Teaching Hospital, Department of Small Animal Clinical Sciences, School of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK; HS Cardiology Ltd, Dalton House, 9 Dalton Square, Lancaster LA1 1WD, UK
| | - T W Maddox
- Small Animal Teaching Hospital, Department of Small Animal Clinical Sciences, School of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK
| | - J Dukes-McEwan
- Small Animal Teaching Hospital, Department of Small Animal Clinical Sciences, School of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK
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Romito G, Gemma N, Dondi F, Mazzoldi C, Fasoli S, Cipone M. Efficacy and safety of antiarrhythmic therapy in dogs with naturally acquired tachyarrhythmias treated with amiodarone or sotalol: a retrospective analysis of 64 cases. J Vet Cardiol 2024; 53:20-35. [PMID: 38608438 DOI: 10.1016/j.jvc.2024.03.002] [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: 07/22/2023] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 04/14/2024]
Abstract
INTRODUCTION/OBJECTIVE Studies on the use of amiodarone or sotalol are limited in dogs. Therefore, this study aimed to provide data on the efficacy and safety of these drugs in dogs with ventricular tachyarrhythmia (VT) and/or supraventricular tachyarrhythmia (SvT). ANIMALS, MATERIALS, AND METHODS Dogs with VT and/or SvT treated with amiodarone or sotalol as a first-line therapy were retrospectively evaluated. Signalment, clinical, diagnostic, therapeutic, and outcome data were retrieved. For VT, efficacy was demonstrated through a decrease of the Lown-Wolf grade to less than five or a reduction of at least 85% in the number of ventricular premature complexes observed on Holter monitoring. For SvT, efficacy was represented by cardioversion or a reduction in the mean heart rate on Holter monitoring ≤140 beats/min. Treatment-related side effects (TRSEs) were classified as clinically relevant and irrelevant. Statistical analysis was performed to compare data before and after antiarrhythmic prescription. RESULTS Sixty-four dogs were included. Amiodarone and sotalol were efficacious in treating both VT (85.7% and 90.0% of cases, respectively) and SvT (75% and 71.4% of cases, respectively). No significant differences were found when comparing their efficacy rates in dogs with VT and SvT (P=0.531 and 0.483, respectively). Clinically relevant TRSEs were rare with both amiodarone and sotalol (8.3% and 5% of cases, respectively), while clinically irrelevant TRSEs occurred more frequently with amiodarone (29.2%) than with sotalol (10%). DISCUSSION In dogs with tachyarrhythmias, amiodarone and sotalol are generally efficacious and safe, as clinically relevant TRSEs seem rare. CONCLUSIONS This study provides novel data on the effects of amiodarone and sotalol in dogs with tachyarrhythmias.
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Affiliation(s)
- G Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy.
| | - N Gemma
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - F Dondi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - C Mazzoldi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - S Fasoli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - M Cipone
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
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Bagardi M, Ghilardi S, Minozzi G, Fusi E, Locatelli C, Ferrari PL, Drago G, Polli M, Lorenzi E, Zanchi F, Brambilla PG. Study of correlations between serum taurine, thyroid hormones and echocardiographic parameters of systolic function in clinically healthy Golden retrievers fed with commercial diet. PLoS One 2024; 19:e0297811. [PMID: 38753635 PMCID: PMC11098416 DOI: 10.1371/journal.pone.0297811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 04/10/2024] [Indexed: 05/18/2024] Open
Abstract
Taurine deficiency predisposes to the development of nutritional dilated cardiomyopathy and is widespread in dogs fed with non-traditional diets. However, Golden retrievers show lower plasma taurine concentration and an impaired systolic function compared to breeds of the same size and morphotype. For these reasons, it can be difficult to classify a subject from a cardiological point of view, with the risk of considering as pathological characteristics that can be completely normal in this breed. This is a cross-sectional multicenter study. The aims were 1) to identify breed-specific range of serum taurine concentration, 2) to describe a correlation between serum taurine concentration and echocardiographic parameters of systolic function in clinically healthy Golden retrievers fed with traditional diet, 3) to identify a correlation between thyroid hormones, serum taurine concentration and echocardiographic indices. Sixty clinically healthy Golden retrievers (33% males, 67% females) were included. Fifty-three dogs were fed with traditional diets and their range of serum taurine concentration was 398.2 (31.8-430) nmol/ml. Serum taurine concentration was found to be negatively correlated to systolic internal diameter of the left ventricle and systolic and diastolic left ventricular indices and volumes obtained with different methods, whereas was positively correlated to the left ventricle ejection and shortening fractions but difference was not statistically significative. A weak but significant correlation between serum taurine and T4 was demonstrated. Serum taurine median values in dogs with normal systolic function were higher than in dogs with impaired systolic function. A cut-off of serum taurine concentration of 140.6 nmol/ml had a moderate sensitivity and specificity in the identification of an impaired left ventricular systolic function (AUC 0.6, Se 78%, Sp 44%). This study showed that the median serum taurine concentration was significantly lower in dogs with impaired systolic function. Therefore, echocardiographic monitoring is recommended in all dogs with serum taurine concentration lower than 140.6 nmol/ml.
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Affiliation(s)
- Mara Bagardi
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
- Cardiology Unit, Anicura Clinica Veterinaria Malpensa, Samarate, VA, Italy
| | - Sara Ghilardi
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
| | - Giulietta Minozzi
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
| | - Eleonora Fusi
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
| | - Chiara Locatelli
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
| | | | - Giulia Drago
- Cardiology Unit, Anicura Clinica Veterinaria Orobica, Bergamo, Italy
| | - Michele Polli
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
| | - Elisa Lorenzi
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
| | - Francesca Zanchi
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
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Williams ZJ, Chow L, Dow S, Pezzanite LM. The potential for senotherapy as a novel approach to extend life quality in veterinary medicine. Front Vet Sci 2024; 11:1369153. [PMID: 38812556 PMCID: PMC11133588 DOI: 10.3389/fvets.2024.1369153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/30/2024] [Indexed: 05/31/2024] Open
Abstract
Cellular senescence, a condition where cells undergo arrest and can assume an inflammatory phenotype, has been associated with initiation and perpetuation of inflammation driving multiple disease processes in rodent models and humans. Senescent cells secrete inflammatory cytokines, proteins, and matrix metalloproteinases, termed the senescence associated secretory phenotype (SASP), which accelerates the aging processes. In preclinical models, drug interventions termed "senotherapeutics" selectively clear senescent cells and represent a promising strategy to prevent or treat multiple age-related conditions in humans and veterinary species. In this review, we summarize the current available literature describing in vitro evidence for senotheraputic activity, preclinical models of disease, ongoing human clinical trials, and potential clinical applications in veterinary medicine. These promising data to date provide further justification for future studies identifying the most active senotherapeutic combinations, dosages, and routes of administration for use in veterinary medicine.
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Affiliation(s)
- Zoë J. Williams
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Lyndah Chow
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Steven Dow
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Lynn M. Pezzanite
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
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Wrześniewska K, Madany J, Tobolski D, Żylińska B, Milczak A, Sobczyńska-Rak A. A Pilot Study of the Role of Selected Biomarkers of Kidney Injury in Dogs with Dilated Cardiomyopathy. Animals (Basel) 2024; 14:1305. [PMID: 38731309 PMCID: PMC11083564 DOI: 10.3390/ani14091305] [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: 12/15/2023] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Heart and kidney diseases are among the most frequent medical conditions diagnosed in small animals. Due to the functional interconnection between these organs, the concept of the cardio-renal axis has been developed. In this context, renal disease or dysfunction often occurs secondary to heart diseases, such as dilated cardiomyopathy (DCM). DCM is the most common cardiomyopathy and a leading cause of mortality in large-breed dogs. Traditional biomarkers like creatinine or symmetric dimethylarginine concentration are not always effective, especially in the early stages of the disease, underscoring the need for more sensitive markers of renal impairment during heart failure (HF). This study aimed to evaluate the efficacy of selected biomarkers as indicators for early kidney damage in dogs with stage B2 DCM. We measured serum concentrations of cystatin C, KIM-1 (kidney injury molecule-1), and NGAL (neutrophil gelatinase-associated lipocalin) and their ratios to creatinine, analyzing their diagnostic values. Cystatin C was quantified using a sandwich enzyme immunoassay, while KIM-1 and NGAL were measured with enzyme-linked immunosorbent assay kits designed for canine diagnostics. The concentrations were indexed against serum creatinine. The study included 26 dogs: 9 with HF and 17 healthy controls. The mean ± standard deviation for healthy dogs for cystatin C, cystatin C/creatinine ratio, KIM-1, KIM-1/creatinine ratio, NGAL, and NGAL/creatinine ratio were 0.24 ± 0.04, 0.26 ± 0.07, 0.61 ± 0.07, 0.67 ± 0.13, 2.76 ± 1.8, and 2.79 ± 1.81, respectively. For DCM dogs, these values were 0.27 ± 0.1, 0.32 ± 0.12, 0.61 ± 0.08, 0.69 ± 0.17, 6.46 ± 5.22 (p = 0.02), and 7.99 ± 6.53 (p = 0.04). This study's findings suggest that during the asymptomatic phase of DCM, only NGAL concentration and the NGAL/creatinine ratio may serve as diagnostic markers for early-stage kidney injury.
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Affiliation(s)
- Karolina Wrześniewska
- Department and Clinic of Animal Internal Diseases, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 13 Akademicka Street, 20-950 Lublin, Poland; (K.W.); (J.M.); (A.M.)
| | - Jacek Madany
- Department and Clinic of Animal Internal Diseases, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 13 Akademicka Street, 20-950 Lublin, Poland; (K.W.); (J.M.); (A.M.)
| | - Dawid Tobolski
- Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, 14 Oczapowskiego Street, 10-719 Olsztyn, Poland;
| | - Beata Żylińska
- Department and Clinic of Animal Surgery, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 13 Akademicka Street, 20-950 Lublin, Poland;
| | - Andrzej Milczak
- Department and Clinic of Animal Internal Diseases, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 13 Akademicka Street, 20-950 Lublin, Poland; (K.W.); (J.M.); (A.M.)
| | - Aleksandra Sobczyńska-Rak
- Department and Clinic of Animal Surgery, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 13 Akademicka Street, 20-950 Lublin, Poland;
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Di Loria A, Ferravante C, D'Agostino Y, Giurato G, Tursi M, Grego E, Perego M, Weisz A, Ciaramella P, Santilli R. Gene-expression profiling of endomyocardial biopsies from dogs with dilated cardiomyopathy phenotype. J Vet Cardiol 2024; 52:78-89. [PMID: 38508121 DOI: 10.1016/j.jvc.2024.02.008] [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: 02/22/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION The employment of advanced molecular biology technologies has expanded the diagnostic investigation of cardiomyopathies in dogs; these technologies have predominantly been performed on postmortem samples, although the recent use of endomyocardial biopsy in living dogs has enabled a better premortem diagnostic approach to study the myocardial injury. ANIMALS, MATERIALS, AND METHODS Endomyocardial biopsies were collected in nine dogs with a dilated cardiomyopathy phenotype (DCM-p) and congestive heart failure and submitted to histologic examination, next-generation sequencing (NGS), and polymerase chain reaction analysis. Data from three healthy dogs (Fastq files) were retrieved from a previously approved study and used as a control group for ribonucleic acid sequencing. RESULTS Histologic examination revealed endocardial fibrosis in 6 of 9 dogs, whereas lymphocytic interstitial infiltrates were detected in 2 of 9 dogs, and lymphoplasmacytic and macrophage infiltrates were detected in 1 of 9 dogs. On polymerase chain reaction analysis, two dogs tested positive for canine parvovirus 2 and one dog for canine distemper virus. Gene-expression pathways involved in cellular energy metabolism (especially carbohydrates-insulin) and cardiac structural proteins were different in all DCM-p dogs compared to those in the control group. When dogs with lymphocytic interstitial infiltrates were compared to those in the control group, NGS analysis revealed the predominant role of genes related to inflammation and pathogen infection. CONCLUSIONS NGS technology performed on in vivo endomyocardial biopsies has identified different molecular and genetic factors that could play a role in the development and/or progression of DCM-p in dogs.
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Affiliation(s)
- A Di Loria
- Department of Veterinary Medicine and Animal Productions, University Federico II, Napoli, 80130, Italy
| | - C Ferravante
- Department of Veterinary Medicine and Animal Productions, University Federico II, Napoli, 80130, Italy; Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, 84081, Baronissi, SA, Italy; Medical Genomics Program, AOU 'SS. Giovanni di Dio e Ruggi d'Aragona', University of Salerno, 84131 Salerno, Italy
| | - Y D'Agostino
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, 84081, Baronissi, SA, Italy; Medical Genomics Program, AOU 'SS. Giovanni di Dio e Ruggi d'Aragona', University of Salerno, 84131 Salerno, Italy
| | - G Giurato
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, 84081, Baronissi, SA, Italy; Genome Research Center for Health, Campus of Medicine, University of Salerno, 84081 Baronissi, Italy
| | - M Tursi
- Department of Veterinary Sciences, University of Turin, 10095 Turin, Italy
| | - E Grego
- Department of Veterinary Sciences, University of Turin, 10095 Turin, Italy
| | - M Perego
- Clinica Veterinaria Malpensa, Viale Marconi 27, Samarate, 21017 Varese, Italy
| | - A Weisz
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, 84081, Baronissi, SA, Italy; Medical Genomics Program, AOU 'SS. Giovanni di Dio e Ruggi d'Aragona', University of Salerno, 84131 Salerno, Italy; Genome Research Center for Health, Campus of Medicine, University of Salerno, 84081 Baronissi, Italy
| | - P Ciaramella
- Department of Veterinary Medicine and Animal Productions, University Federico II, Napoli, 80130, Italy.
| | - R Santilli
- Clinica Veterinaria Malpensa, Viale Marconi 27, Samarate, 21017 Varese, Italy; Department of Clinical Sciences, Cornell University, 930, Campus Road, 14853, Ithaca, NY, USA
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Wesselowski S, Gordon SG, Fries R, Saunders AB, Sykes KT, Vitt J, Boutet B, Häggström J, Kadotani S, Stack J, Barnett BG. Use of physical examination, electrocardiography, radiography, and biomarkers to predict echocardiographic stage B2 myxomatous mitral valve disease in preclinical Cavalier King Charles Spaniels. J Vet Cardiol 2023; 50:1-16. [PMID: 37913604 DOI: 10.1016/j.jvc.2023.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/18/2023] [Accepted: 10/02/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION Cavalier King Charles Spaniels (CKCS) are predisposed to developing myxomatous mitral valve disease (MMVD). Dogs with stage B2 MMVD benefit from medication. OBJECTIVES To develop (1) breed-specific cut-offs for individual screening tests and (2) predictive models utilizing physical examination (PE), ECG, radiograph, and blood-based biomarker variables in combination for identification of echocardiographic stage B2 MMVD in preclinical CKCS. ANIMALS Adult, preclinical CKCS not receiving cardiac medications (N = 226). MATERIALS AND METHODS Prospective, cross-sectional study. Enrolled CKCS underwent PE, ECG, radiography, Doppler blood pressure measurement, echocardiography, and biomarker testing. Dogs were grouped by MMVD stage using echocardiography only. The discriminatory ability of individual tests to identify stage B2 was assessed, and prediction models were developed using variables derived from four 'tests' (PE, ECG, radiography, and biomarkers). RESULTS N-terminal pro-B-type natriuretic peptide (NT-proBNP) and radiographic vertebral heart size (VHS) had the best discriminatory ability of individual diagnostic tests to differentiate stage A/B1 CKCS from stage B2, with an area under the curve (AUC) of 0.855 and 0.843, respectively. An NT-proBNP ≥1138 pmol/L or a VHS ≥11.5 had high specificity for predicting stage B2 (90.1% and 90.6%, respectively). Prediction models incorporating variables from multiple tests had better discriminatory ability than single tests. The four-test prediction model had an AUC of 0.971. Three and two-test models had AUCs ranging between 0.925-0.959 and 0.895-0.949, respectively. CONCLUSIONS Both NT-proBNP and VHS have good utility for predicting echocardiographic stage B2 MMVD in CKCS as individual tests. Prediction models incorporating multiple test variables have superior discriminatory ability.
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Affiliation(s)
- S Wesselowski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA.
| | - S G Gordon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - R Fries
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, 1008 Hazelwood Drive, Urbana, IL, USA
| | - A B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - K T Sykes
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - J Vitt
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, 1008 Hazelwood Drive, Urbana, IL, USA
| | - B Boutet
- VETMED emergency and specialty veterinary hospital, 20610 N Cave Creek Rd, Phoenix, AZ, USA
| | - J Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7045, 7507 Uppsala, Sweden
| | - S Kadotani
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, 1008 Hazelwood Drive, Urbana, IL, USA
| | - J Stack
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, 1008 Hazelwood Drive, Urbana, IL, USA
| | - B G Barnett
- 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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Papa M, Scarpellini L, Pradelli D, Zanaboni AM, Mattia A, Boz E, Rossi C, Signorelli S, Forti V, Longobardi M, Pasquinelli B, Gendusa MC, Gamba D, Bussadori CM. A Retrospective Cohort Evaluation of Left Ventricular Remodeling, Perioperative Complications and Outcome in Medium and Large Size Dogs with Patent Ductus Arteriosus after Percutaneous Closure. Vet Sci 2023; 10:669. [PMID: 38133219 PMCID: PMC10747699 DOI: 10.3390/vetsci10120669] [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: 10/03/2023] [Revised: 11/15/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
This retrospective cohort study included one hundred fifty-seven medium and large-size dogs with the aim of evaluating the effect of signalment and echocardiographic features on complications, outcomes and left ventricular modifications before and after patent ductus arteriosus (PDA) closure. The patients were divided in two groups based on the heart remodeling after closure: Group A included dogs that had a reduction in the end-systolic volume index (ESVI) after closure compared to the ESVI measured before; Group B included dogs without a reduction in ESVI after closure. Body weight, minimal ductal diameter (MDD) of PDA, end-diastolic volume index and presence of arrhythmias at presentation were significantly higher in Group B compared to Group A. The shortening fraction and ejection fraction after closure were reduced in both groups, but in Group B there was a major reduction, and the mean values indicated a possible systolic dysfunction. Complications during the procedure and death due to cardiac reasons were greater in Group B compared to Group A. In conclusion, a higher body weight, a larger MDD, a more severe heart enlargement or arrhythmias at presentation increased the risk of developing a worsening structural and functional condition after ductal closure, and this can be associated with perioperative complications and cardiac death.
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Affiliation(s)
- Melissa Papa
- Clinica Veterinaria Gran Sasso, 20134 Milan, Italy; (L.S.); (A.M.); (C.R.); (S.S.); (V.F.); (M.L.); (B.P.); (M.C.G.); (D.G.)
| | - Lorenzo Scarpellini
- Clinica Veterinaria Gran Sasso, 20134 Milan, Italy; (L.S.); (A.M.); (C.R.); (S.S.); (V.F.); (M.L.); (B.P.); (M.C.G.); (D.G.)
| | - Danitza Pradelli
- Clinica Veterinaria Gran Sasso, 20134 Milan, Italy; (L.S.); (A.M.); (C.R.); (S.S.); (V.F.); (M.L.); (B.P.); (M.C.G.); (D.G.)
| | - Anna Maria Zanaboni
- Computer Science Department, Università degli Studi di Milano, 20133 Milan, Italy;
- Data Science Research Center DSRC, Università degli Studi di Milano, 20133 Milan, Italy
| | - Alessia Mattia
- Clinica Veterinaria Gran Sasso, 20134 Milan, Italy; (L.S.); (A.M.); (C.R.); (S.S.); (V.F.); (M.L.); (B.P.); (M.C.G.); (D.G.)
| | - Elisabetta Boz
- Clinica Veterinaria Gran Sasso, 20134 Milan, Italy; (L.S.); (A.M.); (C.R.); (S.S.); (V.F.); (M.L.); (B.P.); (M.C.G.); (D.G.)
| | - Cecilia Rossi
- Clinica Veterinaria Gran Sasso, 20134 Milan, Italy; (L.S.); (A.M.); (C.R.); (S.S.); (V.F.); (M.L.); (B.P.); (M.C.G.); (D.G.)
| | - Stefania Signorelli
- Clinica Veterinaria Gran Sasso, 20134 Milan, Italy; (L.S.); (A.M.); (C.R.); (S.S.); (V.F.); (M.L.); (B.P.); (M.C.G.); (D.G.)
| | - Viviana Forti
- Clinica Veterinaria Gran Sasso, 20134 Milan, Italy; (L.S.); (A.M.); (C.R.); (S.S.); (V.F.); (M.L.); (B.P.); (M.C.G.); (D.G.)
| | - Martina Longobardi
- Clinica Veterinaria Gran Sasso, 20134 Milan, Italy; (L.S.); (A.M.); (C.R.); (S.S.); (V.F.); (M.L.); (B.P.); (M.C.G.); (D.G.)
| | - Beatrice Pasquinelli
- Clinica Veterinaria Gran Sasso, 20134 Milan, Italy; (L.S.); (A.M.); (C.R.); (S.S.); (V.F.); (M.L.); (B.P.); (M.C.G.); (D.G.)
| | - Maria Celeste Gendusa
- Clinica Veterinaria Gran Sasso, 20134 Milan, Italy; (L.S.); (A.M.); (C.R.); (S.S.); (V.F.); (M.L.); (B.P.); (M.C.G.); (D.G.)
| | - Davide Gamba
- Clinica Veterinaria Gran Sasso, 20134 Milan, Italy; (L.S.); (A.M.); (C.R.); (S.S.); (V.F.); (M.L.); (B.P.); (M.C.G.); (D.G.)
| | - Claudio Maria Bussadori
- Clinica Veterinaria Gran Sasso, 20134 Milan, Italy; (L.S.); (A.M.); (C.R.); (S.S.); (V.F.); (M.L.); (B.P.); (M.C.G.); (D.G.)
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10
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Cerbu M, Cerbu C, Papuc I. M-Mode Echocardiography in Canine Veterinary Practice: A Comprehensive Review of Left Ventricular Measurements in 44 Different Dog Breeds. Animals (Basel) 2023; 13:2986. [PMID: 37760386 PMCID: PMC10525205 DOI: 10.3390/ani13182986] [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: 08/13/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
This review article focuses on the use of canine M-mode in veterinary medicine, specifically in assessing the left ventricle measurements in several breeds. It traces the historical development of echocardiography techniques, including A-mode, B-mode, and motion mode (M-mode), which provide accurate unidimensional records of cardiac structures. This article highlights the significance of M-mode measurements in diagnosing stage B2 of MMVD, where left ventricular end-diastolic internal diameter corrected with body weight (LVIDdN) is essential for identifying cardiac enlargement. It also explains the role of M-mode in diagnosing DCM, outlining criteria such as left ventricular dilatation. The authors emphasize the importance of breed-specific reference values for echocardiographic measurements due to variations in somatotype among dogs. This review provides a comprehensive table summarizing M-mode measurements of the left ventricle for 44 different dog breeds, including interventricular septum thickness, left ventricular internal diameter, and left ventricular posterior wall thickness during systole and diastole. This review's methodology involves compiling data from various scientific literature sources, providing an extensive tabular representation of M-mode measurements for different breeds, ages, and sexes. Overall, this review highlights the critical role of M-mode echocardiography in diagnosing and managing cardiac diseases in dogs, underscores the importance of breed-specific reference values, and presents a comprehensive summary of M-mode measurements for various dog breeds, aiding both clinicians and researchers.
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Affiliation(s)
- Maria Cerbu
- Department of Comparative Anatomy, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania; (M.C.); (I.P.)
| | - Constantin Cerbu
- Department of Infectious Diseases, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania
| | - Ionel Papuc
- Department of Comparative Anatomy, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania; (M.C.); (I.P.)
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11
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Niskanen JE, Ohlsson Å, Ljungvall I, Drögemüller M, Ernst RF, Dooijes D, van Deutekom HWM, van Tintelen JP, Snijders Blok CJB, van Vugt M, van Setten J, Asselbergs FW, Petrič AD, Salonen M, Hundi S, Hörtenhuber M, Kere J, Pyle WG, Donner J, Postma AV, Leeb T, Andersson G, Hytönen MK, Häggström J, Wiberg M, Friederich J, Eberhard J, Harakalova M, van Steenbeek FG, Wess G, Lohi H. Identification of novel genetic risk factors of dilated cardiomyopathy: from canine to human. Genome Med 2023; 15:73. [PMID: 37723491 PMCID: PMC10506233 DOI: 10.1186/s13073-023-01221-3] [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: 03/09/2023] [Accepted: 08/17/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Dilated cardiomyopathy (DCM) is a life-threatening heart disease and a common cause of heart failure due to systolic dysfunction and subsequent left or biventricular dilatation. A significant number of cases have a genetic etiology; however, as a complex disease, the exact genetic risk factors are largely unknown, and many patients remain without a molecular diagnosis. METHODS We performed GWAS followed by whole-genome, transcriptome, and immunohistochemical analyses in a spontaneously occurring canine model of DCM. Canine gene discovery was followed up in three human DCM cohorts. RESULTS Our results revealed two independent additive loci associated with the typical DCM phenotype comprising left ventricular systolic dysfunction and dilatation. We highlight two novel candidate genes, RNF207 and PRKAA2, known for their involvement in cardiac action potentials, energy homeostasis, and morphology. We further illustrate the distinct genetic etiologies underlying the typical DCM phenotype and ventricular premature contractions. Finally, we followed up on the canine discoveries in human DCM patients and discovered candidate variants in our two novel genes. CONCLUSIONS Collectively, our study yields insight into the molecular pathophysiology of DCM and provides a large animal model for preclinical studies.
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Affiliation(s)
- Julia E Niskanen
- Department of Medical and Clinical Genetics, University of Helsinki, Haartmaninkatu 8, 00290, Helsinki, Finland
- Department of Veterinary Biosciences, University of Helsinki, Agnes Sjöbergin katu 2, 00790, Helsinki, Finland
- Folkhälsan Research Center, Haartmaninkatu 8, P.O.Box 63, 00290, Helsinki, Finland
| | - Åsa Ohlsson
- Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ingrid Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Michaela Drögemüller
- Institute of Genetics, Vetsuisse Faculty, University of Bern, Bern, 3001, Switzerland
| | - Robert F Ernst
- Department of Genetics, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Dennis Dooijes
- Department of Genetics, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Hanneke W M van Deutekom
- Department of Genetics, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - J Peter van Tintelen
- Department of Genetics, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Christian J B Snijders Blok
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
- Regenerative Medicine Centre Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Marion van Vugt
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Jessica van Setten
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Folkert W Asselbergs
- Amsterdam University Medical Centers, Department of Cardiology, University of Amsterdam, Amsterdam, The Netherlands
- Health Data Research UK and Institute of Health Informatics, University College London, London, UK
| | | | - Milla Salonen
- Department of Medical and Clinical Genetics, University of Helsinki, Haartmaninkatu 8, 00290, Helsinki, Finland
- Department of Veterinary Biosciences, University of Helsinki, Agnes Sjöbergin katu 2, 00790, Helsinki, Finland
- Folkhälsan Research Center, Haartmaninkatu 8, P.O.Box 63, 00290, Helsinki, Finland
| | - Sruthi Hundi
- Department of Medical and Clinical Genetics, University of Helsinki, Haartmaninkatu 8, 00290, Helsinki, Finland
- Department of Veterinary Biosciences, University of Helsinki, Agnes Sjöbergin katu 2, 00790, Helsinki, Finland
- Folkhälsan Research Center, Haartmaninkatu 8, P.O.Box 63, 00290, Helsinki, Finland
| | - Matthias Hörtenhuber
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Juha Kere
- Folkhälsan Research Center, Haartmaninkatu 8, P.O.Box 63, 00290, Helsinki, Finland
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
- Research Programs Unit, Stem Cells and Metabolism Research Program, University of Helsinki, Helsinki, Finland
| | - W Glen Pyle
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
- IMPART Investigator Team Canada, Dalhousie Medicine, Saint John, NB, Canada
| | - Jonas Donner
- Wisdom Panel Research Team, Wisdom Panel, Kinship, Helsinki, Finland
| | - Alex V Postma
- Department of Human Genetics, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Department of Medical Biology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Tosso Leeb
- Institute of Genetics, Vetsuisse Faculty, University of Bern, Bern, 3001, Switzerland
| | - Göran Andersson
- Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Marjo K Hytönen
- Department of Medical and Clinical Genetics, University of Helsinki, Haartmaninkatu 8, 00290, Helsinki, Finland
- Department of Veterinary Biosciences, University of Helsinki, Agnes Sjöbergin katu 2, 00790, Helsinki, Finland
- Folkhälsan Research Center, Haartmaninkatu 8, P.O.Box 63, 00290, Helsinki, Finland
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Maria Wiberg
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - Jana Friederich
- LMU Small Animal Clinic, Ludwig Maximilians University of Munich, Munich, Germany
| | - Jenny Eberhard
- LMU Small Animal Clinic, Ludwig Maximilians University of Munich, Munich, Germany
| | - Magdalena Harakalova
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
- Regenerative Medicine Centre Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Frank G van Steenbeek
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
- Regenerative Medicine Centre Utrecht, University of Utrecht, Utrecht, The Netherlands
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, Utrecht, 3584 CM, The Netherlands
| | - Gerhard Wess
- LMU Small Animal Clinic, Ludwig Maximilians University of Munich, Munich, Germany
| | - Hannes Lohi
- Department of Medical and Clinical Genetics, University of Helsinki, Haartmaninkatu 8, 00290, Helsinki, Finland.
- Department of Veterinary Biosciences, University of Helsinki, Agnes Sjöbergin katu 2, 00790, Helsinki, Finland.
- Folkhälsan Research Center, Haartmaninkatu 8, P.O.Box 63, 00290, Helsinki, Finland.
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12
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Dines B, Kellihan H, Allen C, Loynachan A, Bochsler P, Newbury S. Case report: Long-term survival in puppies assessed with echocardiography, electrocardiography and cardiac troponin I after acute death in littermates due to parvoviral myocarditis. Front Vet Sci 2023; 10:1229756. [PMID: 37645673 PMCID: PMC10462392 DOI: 10.3389/fvets.2023.1229756] [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: 05/29/2023] [Accepted: 07/24/2023] [Indexed: 08/31/2023] Open
Abstract
Positive clinical outcomes of a group of surviving puppies from a litter affected by parvoviral myocarditis are detailed in this case report. Past reports focus on the negative outcomes of littermates of puppies who have died of parvoviral myocarditis. In this case, two puppies in a shelter setting, from a litter exposed to parvovirus, died suddenly with parvoviral myocarditis diagnosed at necropsy. The other seven puppies were screened for cardiac health with echocardiogram, electrocardiogram, and cardiac troponin I prior to adoption. All seven puppies had normal echocardiograms, electrocardiograms, and normal initial and recheck cardiac troponin I results. At recheck 2 years after the initial round of testing, two of the puppies were screened and continue to have normal cardiac diagnostics. All seven dogs are alive and thriving at 5 years old in homes with adopters who were given a complete medical history on the dogs prior to adoption. In summary, the outcomes for puppies in litters affected by parvoviral myocarditis are variable but they do not have to be grave. The use of cardiac diagnostics including echocardiogram, electrocardiogram and cardiac troponin I may serve as a prognostic basis for assessing the potential outcomes for the surviving puppies in affected litters.
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Affiliation(s)
- Brenda Dines
- Department of Medical Sciences, University of Wisconsin-Madison School of Veterinary Medicine Shelter Medicine Program, Madison, WI, United States
| | - Heidi Kellihan
- Department of Medical Sciences, University of Wisconsin-Madison School of Veterinary Medicine, Madison, WI, United States
| | - Carolyn Allen
- Department of Medical Sciences, University of Wisconsin-Madison School of Veterinary Medicine Shelter Medicine Program, Madison, WI, United States
| | - Alan Loynachan
- Department of Veterinary Science, University of Kentucky Veterinary Diagnostic Laboratory, Lexington, KY, United States
| | - Philip Bochsler
- Department of Pathobiological Sciences, Wisconsin Veterinary Diagnostic Laboratory, University of Wisconsin-Madison School of Veterinary Medicine, Madison, WI, United States
| | - Sandra Newbury
- Department of Medical Sciences, University of Wisconsin-Madison School of Veterinary Medicine Shelter Medicine Program, Madison, WI, United States
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13
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Barnett BG, Wesselowski SR, Gordon SG, Saunders AB, Promislow DEL, Schwartz SM, Chou L, Evans JB, Kaeberlein M, Creevy KE. A masked, placebo-controlled, randomized clinical trial evaluating safety and the effect on cardiac function of low-dose rapamycin in 17 healthy client-owned dogs. Front Vet Sci 2023; 10:1168711. [PMID: 37275618 PMCID: PMC10233048 DOI: 10.3389/fvets.2023.1168711] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/03/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Geroscience studies of low-dose rapamycin in laboratory species have identified numerous benefits, including reversing age-related cardiac dysfunction. Cardiovascular benefits have been observed in dogs with 10 weeks of treatment, raising questions about possible benefits and adverse effects of long-term use of low-dose rapamycin. The objectives of this study were to assess the impact of 6 months of low-dose rapamycin on echocardiographic indices of cardiac function in healthy dogs and to document the occurrence of adverse events. Methods Seventeen client-owned dogs aged 6-10 years, weighing 18-36 kg, and without significant systemic disease were included in a prospective, randomized, placebo-controlled, masked clinical trial. Low-dose rapamycin (0.025 mg/kg) or placebo was administered three times per week for 6 months. Baseline, 6-month, and 12-month evaluation included physical examination, cardiology examination, and clinicopathology. Three-month evaluation included physical examination and clinicopathology. Owners completed online questionnaires every 2 weeks. Results There were no statistically significant differences in echocardiographic parameters between rapamycin and placebo groups at 6 or 12 months. No clinically significant adverse events occurred. In 26.8% of the bi-weekly surveys owners whose dogs received rapamycin reported perceived positive changes in behavior or health, compared to 8.1% in the placebo group (p = 0.04). Discussion While no clinically significant change in cardiac function was observed in dogs treated with low-dose rapamycin, the drug was well-tolerated with no significant adverse events.
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Affiliation(s)
- Brian G Barnett
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Sonya R Wesselowski
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Sonya G Gordon
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Ashley B Saunders
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Daniel E L Promislow
- Department of Biology, University of Washington, Seattle, WA, United States
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States
| | - Stephen M Schwartz
- Epidemiology Program, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Lucy Chou
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Jeremy B Evans
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Matt Kaeberlein
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States
| | - Kate E Creevy
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
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14
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Guglielmini C, Valente C, Romito G, Mazzoldi C, Baron Toaldo M, Goncalves Sousa M, Wolf M, Beluque T, Domenech O, Patata V, Porciello F, Ferrari P, Caivano D, Contiero B, Poser H. Risk factors for atrial fibrillation in dogs with dilated cardiomyopathy. Front Vet Sci 2023; 10:1183689. [PMID: 37228845 PMCID: PMC10203468 DOI: 10.3389/fvets.2023.1183689] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/21/2023] [Indexed: 05/27/2023] Open
Abstract
Introduction Atrial fibrillation secondary to dilated cardiomyopathy (DCM) frequently affects large-breed dogs. The aim of the present study was to identify risk factors for the development of atrial fibrillation in dogs of different breeds with an echocardiographic diagnosis of DCM. Methods In this multicenter retrospective study, we searched the electronic databases of five cardiology referral centers for dogs with an echocardiographic diagnosis of DCM. A comparison of clinical and echocardiographic variables was performed between dogs developing atrial fibrillation and those not developing atrial fibrillation and the ability to distinguish between these two groups of dogs was evaluated by receiver operating characteristic curve analysis. Univariate and multivariable logistic regression analysis estimated the odds ratio (OR) with 95% confidence interval (CI) of developing atrial fibrillation. Results We included 89 client-owned dogs with occult and overt echocardiographic DCM. Of these, 39 dogs (43.8%) had atrial fibrillation, 29 dogs (32.6%) maintained a sinus rhythm, and 21 dogs (23.6%) showed other cardiac arrhythmias. Left atrial diameter had high accuracy (area under the curve = 0.816, 95% CI = 0.719-0.890) to predict the development of atrial fibrillation at the cut-off of >4.66 cm. After multivariable stepwise logistic regression analysis, only increased left atrial diameter (OR = 3.58, 95% CI = 1.87-6.87; p < 0.001) and presence of right atrial enlargement (OR = 4.02, 95% CI = 1.35-11.97; p = 0.013) were significant predictors of atrial fibrillation development. Discussion Atrial fibrillation is a common complication of DCM in the dog and is significantly associated with increased absolute left atrial diameter and right atrial enlargement.
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Affiliation(s)
- Carlo Guglielmini
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| | - Carlotta Valente
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| | - Giovanni Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Chiara Mazzoldi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Marco Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | | | - Marcela Wolf
- Department of Veterinary Medicine, Federal University of Paraná, Curitiba, Brazil
| | - Tamyris Beluque
- Department of Veterinary Medicine, Federal University of Paraná, Curitiba, Brazil
| | - Oriol Domenech
- Department of Cardiology, AniCura Istituto Veterinario Novara, Novara, Italy
| | - Valentina Patata
- Department of Cardiology, AniCura Istituto Veterinario Novara, Novara, Italy
| | | | - Paolo Ferrari
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - Domenico Caivano
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - Barbara Contiero
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| | - Helen Poser
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
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15
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Schreiber N, Willis R, Glaus T, Baron Toaldo M. Comparison of the diagnostic value of a small, single channel, electrocardiogram monitoring patch with a standard 3-lead Holter system over 24 h in dogs. J Vet Cardiol 2023; 47:47-54. [PMID: 37196397 DOI: 10.1016/j.jvc.2023.04.004] [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: 07/05/2022] [Revised: 04/06/2023] [Accepted: 04/19/2023] [Indexed: 05/19/2023]
Abstract
INTRODUCTION/OBJECTIVES The aim of this study was to compare a novel small event recorder device, the Carnation Ambulatory Monitor (CAM), with a standard Holter. ANIMALS Nineteen adult dogs. MATERIAL AND METHODS Comparative and explorative study. The two devices were simultaneously applied for approximately 24 h. RESULTS analysis time (p=0.013) and percentage of artefacts (p<0.001) were greater for the CAM (110 min [40-264]; and 9% [0-34], respectively) compared to a standard Holter (30 min [18-270]; and 0.3% [0-9], respectively). The total number of beats (p=0.017) and maximum (p=0.02) and mean (p=0.037) heart rates were lower for the CAM (113,806 ± 23,619 beats; 227 ± 35 bpm; and 88 ± 22 bpm, respectively) compared to the standard Holter (131,640 ± 40,037 beats; 260 ± 64 bpm; and 92 ± 26 bpm, respectively). The minimal heart rate (p=0.725), number of pauses (p=0.078), duration of the longest pause (p=0.087), number of ventricular ectopic beats (p=0.55), ventricular couplets (p=0.186), ventricular triplets (p=0.203), ventricular tachycardia (p=0.05), Lown grade (p=0.233), presence or absence of ventricular bigeminy, trigeminy, supraventricular tachycardia, and atrial fibrillation (p=0.98) did not differ. The CAM missed some relevant events, like complex ventricular arrhythmias, and the Lown grade did not match in 5/19 dogs when comparing the devices. CONCLUSIONS CAM can be used to record ECG traces in dogs over a prolonged period, allowing to detect arrhythmias. Due to some clinically relevant limitations, including a higher percentage of artefacts, a longer reading time (which precludes quantitative counts of >300VPCs), and underestimation of complex ventricular arrhythmias, the CAM appears not suitable for quantitative arrhythmia analysis in dogs.
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Affiliation(s)
- N Schreiber
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Switzerland
| | - R Willis
- Sarah Smith Cardiology, Ivy Court, Willington Road, Etwall, Derby, DE65 6JG, UK
| | - T Glaus
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Switzerland
| | - M Baron Toaldo
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Switzerland.
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16
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Matthews DJ, Fries RC, Jeffery ND, Hamer SA, Saunders AB. Cardiac Magnetic Resonance Imaging Detects Myocardial Abnormalities in Naturally Infected Dogs with Chronic Asymptomatic Chagas Disease. Animals (Basel) 2023; 13:ani13081393. [PMID: 37106957 PMCID: PMC10135195 DOI: 10.3390/ani13081393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/03/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Trypanosoma cruzi infection causes inflammation and fibrosis, resulting in cardiac damage in dogs. The objectives of this study were to describe cardiac magnetic resonance imaging (CMR) in naturally infected dogs with chronic Chagas disease and the frequency of abnormalities for CMR and cardiac diagnostic tests. Ten asymptomatic, client-owned dogs seropositive for T. cruzi were prospectively enrolled in an observational study evaluating echocardiography, ECG (standard and ambulatory), cardiac troponin I (cTnI), and CMR. Standard ECG measurements (3/10) and cTnI concentration (1/10) outside the reference range were uncommon. Ambulatory ECG abnormalities were documented more frequently (6/10 dogs) than with standard ECG and included ventricular arrhythmias (4), supraventricular premature beats (3), second-degree atrioventricular block (2), and sinus arrest (1). Echocardiographic abnormalities were documented in 6/10 dogs including mildly increased left ventricular internal dimension in diastole (1) and decreased right ventricular (RV) systolic function based on reductions in tricuspid annular plane systolic excursion (3) and RV S' (4). Abnormalities were detected with CMR in 7/10 dogs including delayed myocardial enhancement in 5 of which 2 also had increased extracellular volume, abnormal wall motion in 5, and loss of apical compact myocardium in 1. In conclusion, CMR abnormalities were common, and the results of this study suggest CMR can provide useful information in dogs with T. cruzi infection and may support naturally infected dogs for future clinical investigation as an animal model for Chagas disease.
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Affiliation(s)
- Derek J Matthews
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4474, USA
| | - Ryan C Fries
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, USA
| | - Nicholas D Jeffery
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4474, USA
| | - Sarah A Hamer
- Department of Veterinary Integrative Biosciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4458, USA
| | - Ashley B Saunders
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4474, USA
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El Sharkawy S, Dukes-McEwan J, Abdelrahman H, Stephenson H. Long-term outcome and troponin I concentrations in Great Danes screened for dilated cardiomyopathy: an observational retrospective epidemiological study. J Vet Cardiol 2023; 47:1-13. [PMID: 37099865 DOI: 10.1016/j.jvc.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 04/08/2023]
Abstract
INTRODUCTION Dilated cardiomyopathy (DCM) is common in Great Danes (GDs) but screening for this condition can be challenging. We hypothesised that cardiac troponin-I (cTnI) concentration is elevated in GDs with DCM and/or ventricular arrhythmias (VAs), and is associated with reduced survival time in GDs. ANIMALS One hundred and twenty-four client-owned GDs assigned echocardiographically as normal (n = 53), equivocal (n = 37), preclinical DCM (n = 21), or clinical DCM (n = 13). MATERIALS AND METHODS A retrospective epidemiological study. Echocardiographic diagnosis, VAs, and contemporaneous cTnI concentrations were recorded. Diagnostic accuracy and cTnI cut-offs were determined with receiver operating characteristic analyses. Effects of the cTnI concentration and disease status on survival and cause of death were explored. RESULTS Median cTnI was greater in clinical DCM (0.6 ng/mL [25th-75th percentiles: 0.41-1.71 ng/mL]) and GDs with VAs (0.5 ng/mL [0.27-0.80 ng/mL], P<0.001). Elevated cTnI detected these dogs with good accuracy (area under the curve: 0.78-0.85; cut-offs 0.199-0.34 ng/mL). Thirty-eight GDs (30.6%) suffered a cardiac death (CD); GDs suffering CD (0.25 ng/mL [0.21-0.53 ng/mL]) and specifically sudden cardiac death (SCD) (0.51 ng/mL [0.23-0.72 ng/mL]) had higher cTnI than GDs dying of other causes (0.20 ng/mL [0.14-0.35 ng/mL]; P<0.001). Elevated cTnI (>0.199 ng/mL) was associated with shorter long-term survival (1.25 years) and increased risk of SCD. Great Danes with VAs had shorter survival times (0.97 years). CONCLUSIONS A cardiac troponin-I concentration is a useful adjunctive screening tool. Elevated cTnI is a negative prognostic indicator.
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Sykes KT, Wesselowski S, Saunders AB, Tjostheim SS, Potter BM, Gelzer ARM, Katz N, Ward JL, Karlin ET, Markovic LE, Magee AN, Abbott JA, Kadotani S, Menciotti G. A multicenter, retrospective study of cardiac disease in Borzoi dogs. Front Vet Sci 2023; 10:1102494. [PMID: 36777677 PMCID: PMC9909344 DOI: 10.3389/fvets.2023.1102494] [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: 11/18/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023] Open
Abstract
Borzoi are large, relatively uncommon sighthounds anecdotally reported to suffer from sudden death. This multicenter retrospective cohort study aimed to describe the sample of Borzoi presenting to veterinary cardiologists for evaluation, with records searched from 14 centers across a study period of up to 20 years. The study sample was comprised of 152 client-owned Borzoi, with dogs most commonly presenting for pre-breed screening in 87/152 (52%), followed by evaluation of an arrhythmia in 28/152 (18%). Of the 131/152 (86%) dogs that had an echocardiogram performed, 85/131 (65%) were structurally normal, with 40/85 (47%) structurally normal dogs having trace or mild atrioventricular valve regurgitation. Tricuspid valve dysplasia was the most commonly diagnosed congenital cardiac disease (n = 6). Myxomatous mitral valve disease (n = 12) and dilated cardiomyopathy (n = 13) were diagnosed at similar frequencies, though 92% of valve disease cases were mild. Only 48/152 (32%) Borzoi had a diagnostic electrocardiogram (ECG) and/or a Holter monitor for arrhythmia screening. Despite this, ventricular arrhythmias were identified during the entirety of the available cardiac evaluation including diagnostic ECG, contemporaneous ECG monitoring during the echocardiogram, and/or Holter monitor in 25/131 (19%) dogs in which an echocardiographic diagnosis was available. Of these 25 Borzoi, 76% had minimal or no structural cardiac disease identified, and five had a family history of sudden death. A sudden death outcome was reported in 3/55 (5%) Borzoi with long-term outcome data available. In conclusion, Borzoi commonly have trace or mild atrioventricular valve insufficiencies, and may develop ventricular arrhythmias and dilated cardiomyopathy.
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Affiliation(s)
- K. Tess Sykes
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX, United States
| | - Sonya Wesselowski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX, United States,*Correspondence: Sonya Wesselowski ✉
| | - Ashley B. Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX, United States
| | - Sonja S. Tjostheim
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI, United States
| | - Brianna M. Potter
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Anna R. M. Gelzer
- Department of Clinical Studies and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Natalie Katz
- College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Jessica L. Ward
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Emily T. Karlin
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, United States
| | - Lauren E. Markovic
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Aliya N. Magee
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, United States
| | - Jonathan A. Abbott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Saki Kadotani
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Giulio Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, United States
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Romito G, Darida S, Valente C, Poser H, Contiero B, Cipone M, Guglielmini C. Prevalence and prognostic role of L wave and selected clinical and echocardiographic variables in dogs with atrial fibrillation. Vet Med (Auckl) 2022; 37:47-57. [PMID: 36480559 PMCID: PMC9889615 DOI: 10.1111/jvim.16584] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/02/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Information regarding the frequency of L waves and their prognostic relevance in dogs with secondary atrial fibrillation (AF) is limited. HYPOTHESIS/OBJECTIVES To determine whether L waves occur and ascertain their prognostic role, as well as the role of other clinical and echocardiographic variables in dogs with AF. ANIMALS Fifty-five dogs with AF associated with myxomatous mitral valve disease or dilated cardiomyopathy. METHODS Retrospective, multicenter observational study. In addition to L waves analysis, other clinical and echocardiographic variables, including type of antiarrhythmic treatment, were evaluated. A survival analysis was performed to test for predictors of cardiac death and all-cause mortality using Cox proportional hazards regression models. RESULTS L waves were evident in 33/55 dogs (60%, 95% confidence interval [CI] = 47%-72%) but their presence did not influence outcome. Increased left ventricular end-systolic diameter normalized for body weight (LVSDn) was a significant predictor of both cardiac death (hazard ratio [HR] = 4.41, 95% CI = 1.18-16.54; P = .03) and all-cause mortality (HR = 9.39, 95% CI = 2.49-35.32; P < .001). Heart rate assessed during echocardiography (Echo-HR) represented an additional significant predictor of cardiac death (HR = 1.01, 95% CI = 1.00-1.01; P = .04) and all-cause mortality (HR = 1.01, 95% CI = 1.00-1.01; P = .04). CONCLUSIONS AND CLINICAL IMPORTANCE L waves occurred frequently in dogs with AF, but held no prognostic relevance. Conversely, LVSDn and Echo-HR represented independent predictors of negative outcome in these animals.
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Affiliation(s)
- Giovanni Romito
- Department of Veterinary Medical SciencesAlma Mater Studiorum—University of Bologna (Romito, Darida, Cipone)BolognaItaly
| | - Stefana Darida
- Department of Veterinary Medical SciencesAlma Mater Studiorum—University of Bologna (Romito, Darida, Cipone)BolognaItaly
| | - Carlotta Valente
- Department of Animal MedicineProduction and Health (Valente, Poser, Contiero, Guglielmini), University of PadovaPaduaItaly
| | - Helen Poser
- Department of Animal MedicineProduction and Health (Valente, Poser, Contiero, Guglielmini), University of PadovaPaduaItaly
| | - Barbara Contiero
- Department of Animal MedicineProduction and Health (Valente, Poser, Contiero, Guglielmini), University of PadovaPaduaItaly
| | - Mario Cipone
- Department of Veterinary Medical SciencesAlma Mater Studiorum—University of Bologna (Romito, Darida, Cipone)BolognaItaly
| | - Carlo Guglielmini
- Department of Animal MedicineProduction and Health (Valente, Poser, Contiero, Guglielmini), University of PadovaPaduaItaly
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Quest BW, Leach SB, Garimella S, Konie A, Clark SD. Incidence of Canine Dilated Cardiomyopathy Diagnosed at Referral Institutes and Grain-Free Pet Food Store Sales: A Retrospective Survey. FRONTIERS IN ANIMAL SCIENCE 2022. [DOI: 10.3389/fanim.2022.846227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Dilated cardiomyopathy (DCM) is considered a predominantly inherited disease in dogs. Recent reports suggest an increased incidence of DCM in atypical breeds eating grain-free and/or legume-rich diets. Emerging communications have noted that there is an apparent increase in the DCM incidence rate in the United States (US). However, little data regarding the incidence of DCM are currently available. To address the gap in the literature, this project examines the DCM incidence rate, over time, by retrospective polling of veterinary cardiologists across the US. Further, grain-free brick-and-mortar pet food market share data from 2011 to 2019 were presented. Fourteen US hospitals, out of 88 that were contacted to participate, provided all cardiology canine cases and of those, which specifically were diagnosed as DCM cases, for as many years as were available (1–20 years, average 8.1 years). This included a total of 68,297 canine patients evaluated by a cardiologist. Of the hospitals that participated, three provided age and breed data. A Poisson regression analysis revealed a statistically significant positive trend in the Mixed Breed group (P = 0.025, RC = 0.082), indicating that this group of dogs had an increased trend of DCM diagnoses over the past 15 years. However, there was no correlation (P = 0.16) for the Mixed Breed group and grain-free pet food sales data. The average incidence rate of DCM, amongst referral cases seen in the participating hospitals, was 3.90% (range 2.53–5.65%), while grain-free diet sales increased from 2011 to 2019. Nationally, the data did not support a significant change in percent DCM over time, from 2000 to 2019. There was no significant correlation between the national DCM incidence rate or the individual breed groups (P>0.05) in relation to the grain-free pet food sales. However, additional studies are necessary to understand whether regional factors contribute to increased DCM incidence rates within smaller cohorts.
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