1
|
Crofton AE, Kovacs SL, Stern JA. Subvalvular Aortic Stenosis: Learning From Human and Canine Clinical Research. Cardiol Res 2023; 14:319-333. [PMID: 37936623 PMCID: PMC10627371 DOI: 10.14740/cr1547] [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: 07/12/2023] [Accepted: 10/03/2023] [Indexed: 11/09/2023] Open
Abstract
Subvalvular aortic stenosis (SAS) is the most common congenital heart disease (CHD) in dogs and is also prevalent in human children. A fibrous ridge below the aortic valve narrows the left ventricular outflow tract (LVOT) and increases blood flow velocity, leading to devastating side effects in diseased patients. Due to the similarities in presentation, anatomy, pathophysiology, cardiac development, genomics, and environment between humans and dogs, canine SAS patients represent a critical translational model of human SAS. Potential adverse outcomes of SAS include arrhythmias, left-sided congestive heart failure, endocarditis, exercise intolerance, syncope, and sudden cardiac death. The greatest divergence between canine and human SAS clinical research has been the standard of care regarding treatment of these outcomes, with pharmacological intervention dominating best practices in veterinary medicine and surgical intervention comprising the standard practice for human SAS patients. Regardless of the species, the field has yet to identify a treatment option to prevent disease progression or permanently remove the fibrous ridge, but historical leaps in SAS research support a continued translational approach as the most promising method for achieving this goal.
Collapse
Affiliation(s)
- Amanda E. Crofton
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, CA 95616, USA
| | - Samantha L. Kovacs
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, Davis, CA 95616, USA
| | - Joshua A. Stern
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
| |
Collapse
|
2
|
Tjostheim SS, Showers A, Obernberger C, Shear M. Association of sotalol versus atenolol therapy with survival in dogs with severe subaortic stenosis. J Vet Cardiol 2023; 48:19-30. [PMID: 37307692 DOI: 10.1016/j.jvc.2023.05.003] [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: 08/25/2022] [Revised: 04/17/2023] [Accepted: 05/04/2023] [Indexed: 06/14/2023]
Abstract
INTRODUCTION/OBJECTIVES Dogs with severe subaortic stenosis (SAS) are at risk of dying suddenly from fatal arrhythmias. Survival is not improved when treated with pure beta-adrenergic receptor (β)-blockers; however, the effect of other antiarrhythmic drugs on survival is unknown. Sotalol is both a β-blocker and a class III antiarrhythmic drug; the combination of these differing mechanisms may provide benefit to dogs with severe SAS. The primary objective of this study was to compare survival in dogs with severe SAS that were treated with either sotalol or atenolol. The secondary objective was to evaluate the effect of pressure gradient (PG), age, breed, and aortic regurgitation on survival. ANIMALS Forty-three client-owned dogs. MATERIALS AND METHODS Retrospective cohort study. Medical records of dogs diagnosed with severe SAS (PG ≥ 80 mmHg) between 2003 and 2020 were reviewed. RESULTS No statistical difference was identified in survival time between dogs treated with sotalol (n = 14) and those treated with atenolol (n = 29) when evaluating all-cause mortality (p=0.172) or cardiac-related mortality (p=0.157). Of the dogs that died suddenly, survival time was significantly shorter in dogs treated with sotalol compared to those treated with atenolol (p=0.046). Multivariable analysis showed that PG (p=0.002) and treatment with sotalol (p=0.050) negatively influenced survival in the dogs that died suddenly. CONCLUSIONS Sotalol did not have a significant effect on survival overall but may increase the risk of sudden death in dogs with severe SAS compared to atenolol.
Collapse
Affiliation(s)
- S S Tjostheim
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr., Madison, WI 53706, USA.
| | - A Showers
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr., Madison, WI 53706, USA
| | - C Obernberger
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr., Madison, WI 53706, USA
| | - M Shear
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr., Madison, WI 53706, USA
| |
Collapse
|
3
|
Hellemans A, Schittekatte M, Covents M, Smets P. Diagnosis and management of arrhythmias in dogs: A cross-sectional online survey among Flemish veterinary practitioners. Vet Rec Open 2022; 9:e35. [PMID: 35463460 PMCID: PMC9016169 DOI: 10.1002/vro2.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/26/2022] [Accepted: 03/23/2022] [Indexed: 11/06/2022] Open
Abstract
Background Diagnosis as well as management of arrhythmias in dogs can be challenging for veterinary practitioners. The aim was to describe ECG availability and use, as well as the diagnostic and therapeutic experiences and preferences of Flemish veterinarians regarding cardiac arrhythmias in dogs. Methods Cross-sectional online survey among veterinarians in Flanders (Belgium). Results An ECG device was available for 55 out of 102 respondents (54%) and 41 (43%) claimed to use it in case of arrhythmia suspicion. Insufficient knowledge about ECG interpretation and immediate patient referral upon detection of an abnormal heart rhythm were the most important reasons for not having, or not using, an ECG. About half of the respondents (56%) had never used anti-arrhythmic drugs in dogs, although only a few reported having had a negative experience. Frequently provided reasons for not using anti-arrhythmic drugs included insufficient knowledge and a low number of dogs with arrhythmias. Conclusion Most veterinarians reported having little or no expertise with arrhythmias in dogs. Electrocardiogram availability and use among respondents was moderate and too often restricted by insufficient ECG interpretation skills. Continued efforts are needed to increase the confidence and knowledge of veterinarians about arrhythmias in dogs.
Collapse
Affiliation(s)
- Arnaut Hellemans
- Small Animal Department Faculty of Veterinary Medicine Ghent University, Salisburylaan 133 Merelbeke Belgium
| | - Mark Schittekatte
- Research Support Office Faculty of Psychology and Educational Sciences Ghent University, Henri Dunantlaan 2 Ghent Belgium
| | - Marc Covents
- Research Support Office Faculty of Psychology and Educational Sciences Ghent University, Henri Dunantlaan 2 Ghent Belgium
| | - Pascale Smets
- Small Animal Department Faculty of Veterinary Medicine Ghent University, Salisburylaan 133 Merelbeke Belgium
| |
Collapse
|
4
|
Echocardiographic and electrocardiographic effects of atenolol versus sotalol in dogs with severe subaortic stenosis. J Vet Cardiol 2022; 41:199-208. [DOI: 10.1016/j.jvc.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 11/19/2022]
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Abstract
Subvalvular aortic stenosis (SAS) is one of the most common congenital heart defects of dogs. The disease is characterized by obstruction of the left ventricular outflow tract, resulting in pressure overload on the left ventricle. The etiology of obstruction is a fibromuscular nodule, ridge, or ring of tissue that increases aortic outflow tract velocity. This review is focused on the prevalence, inheritance pattern, and current genetic insights of canine SAS. The prevalence of this disease was reported at 4.7 % in a large veterinary referral hospital. The mode of inheritance for this disease has also been described in breeds with a high disease prevalence such as the Bullmastiff, Bouvier des Flandres, Dogue de Bordeaux, Golden Retriever, Newfoundland, and Rottweiler. Genetic investigations seeking to identify causative mutations for SAS are lacking with only a single published variant associated with SAS in Newfoundlands.
Collapse
|
8
|
A novel hybrid stent technique to treat canine pulmonic stenosis. J Vet Cardiol 2020; 32:1-6. [PMID: 33031996 DOI: 10.1016/j.jvc.2020.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 08/11/2020] [Accepted: 08/18/2020] [Indexed: 11/24/2022]
Abstract
Balloon valvuloplasty is routinely performed in dogs with severe pulmonic stenosis using a transvenous approach. We report a novel transventricular approach to stent the right ventricular outflow tract. An 18-month old Havanese with frequent syncope was referred with a diagnosis of severe valvular pulmonic stenosis. Transvenous approaches were unsuccessful; therefore, two Palmaz XL 29 mm by 12 mm transhepatic biliary stents were deployed across the valve using a direct right ventricular approach. The echocardiographically derived systolic pressure gradient decreased from 133 mmHg to 39 mmHg with resolution of clinical signs. The patient continues to do well after 3 years with occasional syncope when extremely excited despite pressure gradient increases to 130 mmHg at 12 months and 174 mmHg at 22 months.
Collapse
|
9
|
Sykes KT, Gordon SG, Saunders AB, Vitt JP, O'Brien MT, Fries RC. Palliative combined cutting and high-pressure balloon valvuloplasty in six dogs with severe, symptomatic subaortic stenosis. J Vet Cardiol 2020; 31:36-50. [PMID: 32977126 DOI: 10.1016/j.jvc.2020.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 08/08/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION/OBJECTIVES Severe subaortic stenosis (SAS) is a congenital heart defect in dogs that often results in clinical signs and reduced survival. The objective of this study was to describe characteristics of dogs with severe, symptomatic SAS who underwent combined cutting and high-pressure balloon valvuloplasty (CB/HPBV). ANIMALS, MATERIALS, AND METHODS Retrospective description of the clinical characteristics, CB/HPBV procedural deviations from reported methodology and outcomes in a series of six client-owned dogs with severe, symptomatic SAS. RESULTS Breeds included two each of Newfoundland, Golden retriever, and German shepherd. Median age was 10.1 months (range: 5-72.3 months), and median weight was 25.5 kg (range: 21.8-36.4 kg). Before CB/HPBV, clinical signs were present in all dogs; four were managed for congestive heart failure (CHF). Three dogs had concurrent congenital heart disease. Median Doppler-estimated left ventricular outflow tract pressure gradient was pre-operatively 149.7 mmHg (range: 89.9-254.7 mmHg) and post-operatively 134.1 mmHg (range: 83.9-181.2 mmHg). Median aortoseptal angle was steep at 136° (range: 109-143°). Clinical improvement was documented in all dogs, based on temporary discontinuation of diuretics and/or owner-perceived reduction in clinical signs. At the time of writing, three dogs had died suddenly, one was euthanized because of recurrence of clinical signs, and one died in CHF. Median survival time was 26.4 months after procedure (range: 6.3-45.8 months). One dog remained alive at 44 months after procedure. CONCLUSIONS Palliative CB/HPBV is a potential therapeutic option for dogs with severe, symptomatic SAS complicated by concurrent congenital heart disease, arrhythmias, or CHF.
Collapse
Affiliation(s)
- K T Sykes
- College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA
| | - S G Gordon
- College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA
| | - A B Saunders
- College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA.
| | - J P Vitt
- University of Illinois College of Veterinary Medicine, 1008 West Hazelwood Drive, Urbana, IL 61802, USA
| | - M T O'Brien
- Charles River Laboratories, 15 Worman's Mill Ct Suite I, Frederick, MD 21701, USA
| | - R C Fries
- University of Illinois College of Veterinary Medicine, 1008 West Hazelwood Drive, Urbana, IL 61802, USA
| |
Collapse
|
10
|
Treseder JR, LeBlanc NL, Scollan KF. Inotropic and chronotropic effects of sotalol in healthy dogs. J Vet Cardiol 2019; 25:14-24. [PMID: 31442634 DOI: 10.1016/j.jvc.2019.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 07/09/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Sotalol is an anti-arrhythmic drug commonly used for the treatment of pathologic tachyarrhythmias in dogs. The β-adrenergic blockade associated with sotalol administration may result in reduced myocardial contractility, which is clinically relevant for treating dogs with arrhythmias and concurrent myocardial dysfunction. The inotropic properties of sotalol are not well characterized in dogs. ANIMALS, MATERIALS, AND METHODS Ten healthy, adult, large breed dogs were prospectively enrolled. All dogs underwent physical examination, blood pressure measurement, electrocardiography, 24-h Holter monitoring, and echocardiography including three-dimensional left ventricular volume measurements. Dogs were subsequently administered sotalol (1-2 mg/kg) orally twice daily for 12-16 days, and the same diagnostic tests were performed. Paired statistical analysis was used to compare parameters at baseline and after treatment with sotalol. RESULTS Standard echocardiographic parameters of systolic function were reduced on sotalol compared to baseline, including ejection fraction via Simpson's method of disks which was 5.8% (95% confidence interval [CI]: 2.77-8.83%, p = 0.002) lower post-treatment. Maximum heart rate on Holter monitor was 17 bpm (95% CI: 9-37 bpm, p = 0.002) lower post-treatment than at baseline. CONCLUSIONS Sotalol has a mild negative inotropic effect in healthy dogs based on standard echocardiographic measurements. There is also a negative chronotropic effect at higher heart rates based on 24-h Holter monitoring.
Collapse
Affiliation(s)
- J R Treseder
- Oregon State University, Carlson College of Veterinary Medicine, Department of Clinical Sciences, 105 Magruder Hall, 700 SW 30th Street, Corvallis, Oregon, 97331, USA
| | - N L LeBlanc
- Oregon State University, Carlson College of Veterinary Medicine, Department of Clinical Sciences, 105 Magruder Hall, 700 SW 30th Street, Corvallis, Oregon, 97331, USA.
| | - K F Scollan
- Oregon State University, Carlson College of Veterinary Medicine, Department of Clinical Sciences, 105 Magruder Hall, 700 SW 30th Street, Corvallis, Oregon, 97331, USA
| |
Collapse
|
11
|
Watson CE, Payne JR, Borgeat K. Valvular aortic stenosis in three cats. J Vet Cardiol 2019; 25:1-6. [PMID: 31437784 DOI: 10.1016/j.jvc.2019.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 01/04/2023]
Abstract
Aortic stenosis affects 0.028% of cats in a shelter population, with valvular aortic stenosis compromising almost half of these cases. Of congenital heart diseases reported in cats, aortic stenosis is the second most common one, affecting 17% of these cases. Existing literature on valvular aortic stenosis is scant, and thus, presentation and prognosis of affected animals is poorly understood. In this case series, we describe three cats with confirmed valvular aortic stenosis. All cases were diagnosed echocardiographically, and all three had visible aortic valve leaflet fusion and a poststenotic dilation of the ascending aorta. Congestive heart failure developed in all three cases, and prognosis was poor. This case report highlights the existence of aortic valve dysplasia in cats and may allow clinicians a better understanding of the clinical presentation of this congenital abnormality.
Collapse
Affiliation(s)
- C E Watson
- Langford Vets, University of Bristol, Stock Lane, Lower Langford, North Somerset, BS40 5DU, United Kingdom
| | - J R Payne
- Langford Vets, University of Bristol, Stock Lane, Lower Langford, North Somerset, BS40 5DU, United Kingdom
| | - K Borgeat
- Langford Vets, University of Bristol, Stock Lane, Lower Langford, North Somerset, BS40 5DU, United Kingdom.
| |
Collapse
|
12
|
Rishniw M, Caivano D, Dickson D, Swift S, Rouben C, Dennis S, Sammarco C, Lustgarten J, Ljungvall I. Breed does not affect the association between murmur intensity and disease severity in dogs with pulmonic or subaortic stenosis. J Small Anim Pract 2019; 60:493-498. [PMID: 31032935 DOI: 10.1111/jsap.13015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 03/01/2019] [Accepted: 03/28/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To determine whether breed affects the ability of murmur intensity to predict the severity of stenosis in dogs with pulmonic stenosis or subaortic stenosis. MATERIALS AND METHODS Retrospective multi-investigator study of dogs with pulmonic stenosis or subaortic stenosis. Murmur intensity, assessed by a four-level classification scheme, was compared with echocardiographically-determined pressure gradient across the affected valve. Breeds represented by at least 10 dogs at any murmur intensity were compared to determine the effect, if any, of breed. RESULTS A total of 1088 dogs (520 with pulmonic stenosis and 568 with subaortic stenosis, representing 106 breeds and the mixed breed group) were included; 208 dogs had soft, 210 had moderate, 283 had loud and 387 had palpable murmurs. Fifteen breeds were represented by at least 10 dogs: five breeds with at least 10 dogs had soft murmurs (132 dogs), nine breeds had moderate murmurs (149 dogs), 10 breeds had loud murmurs (188 dogs), and 11 breeds had palpable murmurs (286 dogs). No breeds differed in stenosis severity from any other breeds within any murmur grade. Post hoc power calculations suggested that we would have been able to detect at least a moderate or large effect size, had one existed. Several dogs with soft murmurs had more-than-mild disease severity. CLINICAL SIGNIFICANCE Despite anecdotally perceived differences in the detection of heart murmurs between breeds, which have been proposed to potentially affect the interpretation of stenosis severity, we found no obvious breed effect in the ability to predict severity of stenosis.
Collapse
Affiliation(s)
- M Rishniw
- Veterinary Information Network, Davis, California, 95616, USA
| | - D Caivano
- Department of Veterinary Medicine, University of Perugia, Perugia, 06126, Italy
| | - D Dickson
- HeartVets, Porthcawl, Wales, CF36 5LD, UK
| | - S Swift
- Department of Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, 32610, USA
| | - C Rouben
- Department of Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, 32610, USA
| | - S Dennis
- Hope Veterinary Specialists, Malvern, Pennsylvania, 19355, USA
| | - C Sammarco
- Red Bank Veterinary Hospital, Tinton Falls, New Jersey, 07724, USA
| | - J Lustgarten
- Red Bank Veterinary Hospital, Tinton Falls, New Jersey, 07724, USA
| | - I Ljungvall
- Department of Clinical Sciences, University Animal Hospital, Swedish University of Agricultural Science, Uppsala, SE-750 07, Sweden
| |
Collapse
|
13
|
Waterman MI, Abbott JA, De Rezende AE, Wilcke JR. Duration of β-adrenoceptor blockade associated with once-daily oral administration of atenolol in healthy dogs. Am J Vet Res 2019; 80:270-274. [PMID: 30801219 DOI: 10.2460/ajvr.80.3.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To test the hypothesis that once-daily oral administration of atenolol would attenuate the heart rate response to isoproterenol for 24 hours. ANIMALS 20 healthy dogs. PROCEDURES A double-blind randomized placebo-controlled crossover study was conducted. Dogs were assigned to receive atenolol (1 mg/kg, PO, q 24 h) or a placebo for 5 to 7 days. After a washout period of 7 days, dogs then received the other treatment. Heart rate at rest (HRr) and heart rate induced by administration of isoproterenol (HRi) as a constant rate infusion (0.2 μg/kg/min for 5 to 7 minutes) were obtained by use of ECG 0, 0.25, 3, 6, 12, 18, and 24 hours after administration of the final dose of atenolol or the placebo. A mixed-model ANOVA was used to evaluate effects of treatment, time after drug or placebo administration, treatment-by-time interaction, period, and sequence on HRr and HRi. RESULTS Effects of sequence or period were not detected. There was a significant effect of treatment and the treatment-by-time interaction on HRi. Atenolol significantly attenuated HRi for 24 hours but did so maximally at 3 hours (least squares mean ± SE, 146 ± 5 beats/min and 208 ± 5 beats/min for atenolol and placebo, respectively). The effect at 24 hours was small (193 ± 5 beats/min and 206 ± 5 beats/min for atenolol and placebo, respectively). Atenolol had a small but significant effect on HRr. CONCLUSIONS AND CLINICAL RELEVANCE This study of healthy dogs receiving atenolol supported a recommendation for a dosing interval < 24 hours.
Collapse
|
14
|
Abstract
There remain areas of uncertainty in optimal technique, preferred candidates, and expected outcome for small animal patients undergoing cardiac intervention. This article highlights issues within interventional cardiology that are in need of study and offers the author's opinion and experience on topics such as variants of pulmonary valve anatomy and alternatives to conventional balloon dilation for pulmonary valve stenosis, patient selection for cutting or high-pressure balloon dilation of aortic valvar or subaortic stenosis, occlusion of patent ductus arteriosus in very small dogs, ductal stenting in conditions with reduced pulmonary blood flow, and alternative considerations for vascular access and closure.
Collapse
|
15
|
An online health survey of Dogue de Bordeaux owners and breeders with special emphasis on cardiac disease. Vet J 2018; 232:78-82. [PMID: 29428097 DOI: 10.1016/j.tvjl.2017.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 12/13/2017] [Accepted: 12/17/2017] [Indexed: 12/12/2022]
Abstract
A questionnaire-based study was undertaken to assess health problems affecting the Dogue de Bordeaux breed of dog and, in particular, the potential impact of cardiac disease. An online survey tool was used to design a questionnaire for Dogue de Bordeaux owners and breeders. After 1year of response time, information was collected on 278 dogs owned by 215 individuals, mostly based in the United Kingdom. Of the 278 dogs, veterinary attention had been sought for chronic skin disease in 63 (22.7%), lameness in 43 (15.5%), gastrointestinal signs in 37 (13.3%) and neoplasia in 28 (10.1%). Cardiac disease was reported in 13/278 dogs (4.7%). At the time of completion of the survey, 55 (19.8%) dogs were dead, 17 (31%) of which were reported to have died suddenly and unexpectedly. Respondents expressed interest in a formal cardiac health screening scheme in the Dogue de Bordeaux breed, but would be reluctant to volunteer for such a scheme if information on disease detected during screening was open access. The incidence of sudden unexpected death was high; although there was no corroboration that the sudden deaths were related to cardiac disease, a possible connection should be explored further.
Collapse
|
16
|
|
17
|
Aoki T, Sunahara H, Sugimoto K, Ito T, Kanai E, Fujii Y. Peripheral pulmonary artery stenosis in three cats. J Vet Med Sci 2015; 77:487-91. [PMID: 25650057 PMCID: PMC4427753 DOI: 10.1292/jvms.14-0388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Case 1 involved a 4-month-old intact male Somali cat in which peripheral pulmonary artery
stenosis (PPS) was recognized after a cardiac murmur remained following patent ductus
arteriosus ligation. Case 2, which involved a 1-year-old neutered male Norwegian Forest
cat, and Case 3, which involved a 6-month-old intact female American Curl cat, were
referred, because of cardiac murmurs. Grades III to IV/VI systolic heart murmurs were
auscultated at the left heart base in all 3 cats. All cases showed bilateral pulmonary
artery stenosis, although there were no associated clinical signs. In Cases 1 and 2, the
pressure gradient through the stenosis decreased after treatment with atenolol.
Collapse
Affiliation(s)
- Takuma Aoki
- Laboratory of Veterinary Surgery I, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-shi, Kanagawa 252-5201, Japan
| | | | | | | | | | | |
Collapse
|
18
|
|