1
|
Vila BDCP, Vanhoni MS, Sousa MG. QT interval instability and variability in dogs with naturally-occurring hypercortisolism. Vet Res Commun 2023; 47:121-130. [PMID: 35575953 DOI: 10.1007/s11259-022-09936-1] [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: 03/31/2022] [Accepted: 05/04/2022] [Indexed: 01/27/2023]
Abstract
Hypercortisolism is one of the most common endocrine diseases in dogs. In humans, it is clearly associated with a higher risk of cardiovascular events, but studies in dogs are scarce. To investigate the arrhythmogenic risk of dogs with naturally-occurring hypercortisolism (NOHC), indices of variability and instability of the QT interval were retrospectively studied in 38 dogs with NOHC and prospectively studied in 12 healthy dogs: variance (QTv), total instability (TI), short-term (STI) and long-term (LTI), and mean (QTm). Except for QTm, all parameters studied were higher in the NOHC group than in the control group. In addition, STI and QTv showed moderate positive correlation with left ventricle wall thickness. The NOHC group was subdivided according to cortisol suppression pattern in the low-dose dexamethasone suppression test. All electrocardiographic indices of partial and absent suppression patterns were numerically higher than healthy dogs. QTv and TI were lower in the control group than in both NOHC subgroups. LTI and STI were lower in the CG than in the group with the partial suppression pattern. There was no statistical difference between sex groups in any of the electrocardiographic parameters studied. This result might indicate that the etiology of NOHC, and its consequent influence on hypothalamus-pituitary-adrenal axis could interfere on the heterogeneity of ventricular repolarization parameters in different ways, especially in the short-term and the long-term stability; however further studies are necessary to understand the role of cortisol on electrical instability in dogs.
Collapse
Affiliation(s)
- Beatriz de Carvalho Pato Vila
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários, 1540, Curitiba, PR, 80035-050, Brazil.
| | - Marcela Sigolo Vanhoni
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários, 1540, Curitiba, PR, 80035-050, Brazil
| | - Marlos Gonçalves Sousa
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários, 1540, Curitiba, PR, 80035-050, Brazil
| |
Collapse
|
2
|
Szczepankiewicz B, Pasławska U, Siwińska N, Plens K, Pasławski R. Evaluation of the diagnostic value of the renal resistive index as a marker of the subclinical development of cardiorenal syndrome in MMVD dogs. J Renin Angiotensin Aldosterone Syst 2021; 22:1470320321995082. [PMID: 33730896 PMCID: PMC8010829 DOI: 10.1177/1470320321995082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction: Myxomatous mitral valve disease (MMVD) in dogs inevitably causes renal
dysfunction. These interactions are known as the cardiorenal syndrome (CRS).
The main aims of the study were to evaluate whether renal resistive index
(RRI) may be useful as a non-invasive marker in subclinical stage of kidney
injury in dogs with MMVD and to compare RRI with SDMA and Cyst C. Methods: Forty-four dogs were divided into two groups: control—15 healthy dogs
and the heart group—29 dogs with MMVD (ACVIM class Cc). Study
protocol included: anamnesis, clinical examination, electrocardiography,
echocardiography, chest radiography, abdominal ultrasonography with
measurements of the renal resistive index (RRI), urine, and blood
analysis. Results: The RRI in the heart group was significantly higher
0.725 ± 0.035 versus control group
0.665 ± 0.028
(p < 0.00085). The RRI cut-off
point in dogs with stable chronic heart failure (CHF) under 8 years
is 0.775, in older 0.64. RRI was similar in MMVD dogs treated with
ACE-I + furosemide and dogs treated
ACE-I + torasemide + pimobendan + spironolactone.
There was no correlation between RRI and SDMA or Cyst C. Conclusion: RRI is more sensitive than creatinine, SDMA and Cyst C to reveal kidney
injury in MMVD dogs class Cc younger than 8 years.
Collapse
Affiliation(s)
- Barbara Szczepankiewicz
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wrocław, Poland
| | - Urszula Pasławska
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wrocław, Poland.,Institute of Veterinary Medicine, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University in Torun, Torun, Poland
| | - Natalia Siwińska
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wrocław, Poland
| | | | - Robert Pasławski
- Institute of Veterinary Medicine, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University in Torun, Torun, Poland
| |
Collapse
|
3
|
Transabdominal Renal Doppler Ultrasound in Healthy Adult Holstein-Friesian Cows: A Pilot Study. Animals (Basel) 2020; 11:ani11010063. [PMID: 33396331 PMCID: PMC7823255 DOI: 10.3390/ani11010063] [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: 11/30/2020] [Revised: 12/24/2020] [Accepted: 12/27/2020] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Knowledge of the physiological renal blood flow in cattle is essential for interpretation of Doppler ultrasound. In this paper, we describe a protocol for obtaining the renal Doppler parameters resistive index (RI) and pulsatility index (PI) in a systematic ultrasound evaluation of the kidney in cattle and provide preliminary reference values for healthy adult Holstein-Friesian cows. Abstract There is a notable lack of reference values for the renal resistive indices in the bovine kidney. Ultrasound (US) Doppler evaluation of these indices is a powerful, non-invasive technique for assessing, monitoring and diagnosing renal diseases in humans and other animals (e.g., small animals and horses). The aims of the present study were to establish a protocol for renal Doppler US in adult healthy Holstein-Friesian cows and to provide reference values for the renal resistive index (RI) and pulsatility index (PI). In cattle, the right kidney is always visible through a right abdominal window. Nevertheless, the left kidney is rarely accessible by transabdominal ultrasound. Doppler evaluation of the kidneys via a transabdominal approach is possible when accessible, but measurements can only be made in the larger vessels at the renal hilum. Normal RI and PI values were respectively 0.49 ± 0.07 and 0.70 ± 0.15 for the right kidney and 0.53 ± 0.05 and 0.79 ± 0.11 for the left kidney. We suggest an upper cut-off value for the RI of 0.63 and for the PI of 1.00 in healthy Holstein-Friesian cows. This is the first report describing normal values for the renal RI and PI in cattle that may be useful in future studies for characterizing different bovine pathologies that affect the renal parenchyma.
Collapse
|
4
|
García San José P, Arenas Bermejo C, Alonso-Miguel D, Clares Moral I, Cuesta-Alvaro P, Pérez Alenza MD. Changes in systolic blood pressure in dogs with pituitary dependent hyperadrenocorticism during the first year of trilostane treatment. J Vet Intern Med 2020; 35:130-141. [PMID: 33274787 PMCID: PMC7848348 DOI: 10.1111/jvim.15978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/09/2020] [Accepted: 11/19/2020] [Indexed: 12/26/2022] Open
Abstract
Background Systemic hypertension (SH) is common in dogs and humans with hypercortisolism and can persist after treatment. Objectives To evaluate changes in prevalence of SH and systolic blood pressure (SBP) in dogs with pituitary‐dependent hyperadrenocorticism (PDH) during the first year of trilostane treatment, its relationship with disease control and selected laboratory variables, and their response to antihypertensive treatment. Animals Fifty‐one dogs with PDH treated with trilostane Q12h. Methods Prospective case series study. Dogs were evaluated at diagnosis (T0) and 1, 3, 6, and 12 months (T12). Dogs were classified as nonhypertensive (SBP < 160 mm Hg) or hypertensive (SBP≥160 mm Hg) and subclassified according to target organ damage (TOD) risk. Hypertensive dogs were treated with benazepril and, if control of SH was not achieved, amlodipine was added. Results Prevalence of SH decreased from T0 (36/51) to T12 (17/37; P = .01). Changes in SBP during the study were influenced by the risk of TOD at T0. In severely hypertensive (SBP ≥ 180 mm Hg) dogs, the decrease in SBP was more pronounced whereas in normotensive (SBP < 140 mm Hg) dogs SBP increased slightly (P = .00). Blood pressure was not associated with disease control. Antihypertensive treatment was needed in 31/51 dogs, and in 13/31 dogs additional SH control with amlodipine was required. One third of nonhypertensive dogs at T0 required treatment with benazepril because SH developed during follow‐up. Conclusions and Clinical Importance In dogs with PDH, SBP should be measured at every visit, regardless of disease control or SBP at diagnosis. More than 1 drug may be necessary to manage SH in affected dogs.
Collapse
Affiliation(s)
- Paula García San José
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | | | - Daniel Alonso-Miguel
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Irene Clares Moral
- Veterinary Teaching Hospital Complutense, Complutense University of Madrid, Madrid, Spain
| | - Pedro Cuesta-Alvaro
- Computing Services, Research Support, Complutense University of Madrid, Avda de la Complutense s/n, Madrid, Spain
| | - María Dolores Pérez Alenza
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
5
|
García San José P, Arenas Bermejo C, Clares Moral I, Cuesta Alvaro P, Pérez Alenza MD. Prevalence and risk factors associated with systemic hypertension in dogs with spontaneous hyperadrenocorticism. J Vet Intern Med 2020; 34:1768-1778. [PMID: 32614466 PMCID: PMC7517838 DOI: 10.1111/jvim.15841] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 12/14/2022] Open
Abstract
Background Systemic hypertension (SH) is common in dogs with hyperadrenocorticism (HAC) however there are not many studies assessing its prevalence and risk factors. Objectives To determine the prevalence and severity of SH in dogs with HAC and its association with clinical and laboratory findings to identify potential risk factors. Animals Sixty‐six client owned dogs with spontaneous HAC. Methods Retrospective cross‐sectional study. Medical records of dogs with HAC were reviewed. Systolic blood pressure (SBP) was measured using Doppler ultrasonography. Clinical signs, physical examination findings and clinicopathologic data (CBC, serum biochemistry and electrolytes, urinalysis and urinary culture, and adrenal function tests) were reviewed for analysis. Results Prevalence of SH (≥150 mm Hg) was 82% (54/66) and prevalence of severe SH (≥180 mm Hg) was 46% (30/66). All dogs with thrombocytosis had SH (P = .002), and a platelet count ≥438 × 103/μL was 100% specific and 61.1% sensitive to predict SH (AUC = .802, P = .001). Median potassium levels were lower in hypertensive dogs (4.1 mEq/L, range 3.1‐5.4 mEq/L) than in normotensive ones (4.5 mEq/L, range 4.0‐5.0 mEq/L) (P = .007). Dogs with UPC ≥ 0.5 had higher median SBP than those without proteinuria (P = .03). Dogs with concurrent diabetes mellitus seemed to have a reduced risk of SH (OR = .118, 95%CI = .022‐.626, P = .02). Conclusions and Clinical Importance Systemic hypertension is common in dogs with HAC and is frequently severe. Blood pressure should be routinely assessed in these dogs, especially if thrombocytosis, proteinuria or low potassium concentrations are present.
Collapse
Affiliation(s)
- Paula García San José
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | | | - Irene Clares Moral
- Veterinary Teaching Hospital Complutense, Complutense University of Madrid, Madrid, Spain
| | - Pedro Cuesta Alvaro
- Data Processing Center, Department of Political and Public Administration Sciences II, Political Sciences Faculty, Complutense University of Madrid, Madrid, Spain
| | - María Dolores Pérez Alenza
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
6
|
Acierno MJ, Brown S, Coleman AE, Jepson RE, Papich M, Stepien RL, Syme HM. ACVIM consensus statement: Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats. J Vet Intern Med 2018; 32:1803-1822. [PMID: 30353952 PMCID: PMC6271319 DOI: 10.1111/jvim.15331] [Citation(s) in RCA: 265] [Impact Index Per Article: 44.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022] Open
Abstract
An update to the 2007 American College of Veterinary Internal Medicine (ACVIM) consensus statement on the identification, evaluation, and management of systemic hypertension in dogs and cats was presented at the 2017 ACVIM Forum in National Harbor, MD. The updated consensus statement is presented here. The consensus statement aims to provide guidance on appropriate diagnosis and treatment of hypertension in dogs and cats.
Collapse
Affiliation(s)
- Mark J Acierno
- Department of Medicine, College of Veterinary Medicine, Midwestern University, 5715 W. Utopia Rd, Glendale Arizona 85308
| | - Scott Brown
- College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Amanda E Coleman
- College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Rosanne E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Mark Papich
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Rebecca L Stepien
- Department of Medical Sciences, University of Wisconsin School of Veterinary Medicine, Madison, Wisconsin
| | - Harriet M Syme
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| |
Collapse
|
7
|
Priyanka M, Jeyaraja K, Thirunavakkarasu PS. Abnormal renovascular resistance in dogs with diabetes mellitus: correlation with glycemic status and proteinuria. IRANIAN JOURNAL OF VETERINARY RESEARCH 2018; 19:304-309. [PMID: 30774672 PMCID: PMC6361597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 06/27/2018] [Accepted: 07/25/2018] [Indexed: 06/09/2023]
Abstract
Present study was conducted with the objectives of determining the renal vascular resistance in dogs with diabetes mellitus and to study the correlation between the indices of renovascular resistance with glycemic status, systolic blood pressure (SBP) and proteinuria in dogs with diabetes mellitus. This study was conducted on seventeen diabetic dogs and ten apparently healthy dogs. Increased renal resistive index (RI) and pulsatility index (PI) were observed in diabetic dogs as compared to healthy dogs. Systemic hypertension and proteinuria were observed in 10 and 3 out of 17 diabetic dogs, respectively. Significant positive correlation was observed between the indices of renovascular resistance and fasting blood glucose levels and between the indices of renovascular resistance and serum glycated hemoglobin levels. No correlation was observed between the indices of renovascular resistance and SBP as well as the indices of renovascular resistance and proteinuria. As the indices of renovascular resistance correlate significantly with glycemic status, they can be used as the early marker for kidney damage in diabetic patients. Among these indices renal PI was found to be more sensitive than renal RI.
Collapse
Affiliation(s)
- M. Priyanka
- Animal Experimentation Station, Indian Veterinary Research Institute, Regional Campus, Bengaluru, Karnataka, 560024, India
| | - K. Jeyaraja
- Department of Clinics, Madras Veterinary College, TANUVAS, Chennai-600007, India
| | - P. S. Thirunavakkarasu
- Department of Veterinary Clinical Medicine, Ethics and Jurisprudence, Madras Veterinary College, TANUVAS, Chennai-600007, India
| |
Collapse
|