Determination of radiographic vertebral heart score and vertebral left atrial size cutoffs based on echocardiographic left atrial size in dogs with myxomatous mitral valve disease.

Progression of myxomatous mitral valve disease (MMVD) in dogs is a common cause of left atrial enlargement. Recently, a classification of left atrial (LA) size based on echocardiographic measurement has been proposed. This study aims to determine the radiographic LA size by reporting the cutoff values of VHS and VLAS for different groups of echocardiographic-measured LA size in dogs with MMVD. This retrospective analytical cross-sectional study included dogs diagnosed with MMVD grouped based on the echocardiographic LA size into normal (LA/Ao < 1.6), mild (1.6-1.89), moderate (1.9-2.2), and severe enlargement (>2.2) and were compared with ACVIM classification. VHS and VLAS were measured on the right lateral radiograph for each dog and cutoff values were calculated. One hundred and three dogs with MMVD were included in the study. A very strong positive correlation was observed between LA/Ao ratio and VHS (rs , 0.823, P < .01) or VLAS (rs , 0.834, P < .01). For VHS, a cutoff of 10.7 v, 11 v, and 11.5 v were established for echocardiographic LA thresholds of 1.6, 1.9, and 2.2 with a sensitivity of 79%, 92%, and 90% and a specificity of 97%, 90.7%, and 78.1%, respectively. For VLAS, a cutoff of 2.5 v, 2.7 v, and 2.9 v were established for echocardiographic LA cutoffs of 1.6, 1.9, and 2.2 with a sensitivity of 73%, 80%, and 83.3% and a specificity of 94%, 92%, and 86.3%, respectively. The results of this study may facilitate clinical decisions based on radiographic examination in dogs with myxomatous mitral valve disease.

Analysis of Poincaré plot derived from 5-min electrocardiography in dogs with myxomatous mitral valve disease.

BACKGROUND: Evaluation of heart rate variability (HRV) is used for risk assessment in a variety of cardiac diseases including myxomatous mitral valve degeneration (MMVD). OBJECTIVES: To compare the geometric analysis of HRV using visual patterns of Poincaré plot among different classes of MMVD in dogs and to analyse the differences in beat-to-beat variability using tachograms and sequential Poincaré plots among different shapes. ANIMALS AND METHODS: Healthy and MMVD dogs were retrospectively reviewed. Five-minute ECG data was used to create Poincaré plots and shapes were compared among groups. Furthermore, a sub-analysis of 50 consecutive R-R intervals was performed. Pearson Chi-square with adjusted standardized residuals was used to compare the categorical data between groups. RESULTS: Fifteen healthy dogs and 157 dogs with MMVD were included in the study. Normal and B1 groups showed a predominance of triangular shape (73% and 60% respectively; p < 0.05). In B2 group the predominant shape was comet (40%; p < 0.05) while comet and torpedo were predominant in Ca group (41% and 36% respectively; p < 0.05). Visual geometric analysis revealed a lower dispersion of the cloud clustering towards the left lower corner of the plot with MMVD progression. Diamond and triangle revealed a lower mean heart rate compared to comet and torpedo shapes (p < 0.01). Interclass correlation between 3 observers was 0.906 (95% CI of 0.8 - 0.96). CONCLUSIONS: Poincaré plot shape changes with MMVD progression suggesting that geometrical analysis of HRV in dogs with cardiac conditions could be a useful tool in the risk assessment and further studies are warranted.

Seronegative Myasthenia Gravis with Concomitant SARS-CoV-2 Infection in a Dog.

Myasthenia gravis (MG) is a disorder of neuromuscular transmission affecting the neuromuscular junction. The majority of cases involve an autoimmune attack against AChR, but a limited number of patients are seronegative for AChR antibodies. Viral infection is incriminated as a trigger for MG occurrence, and in a limited number of reports, infection with SARS-CoV-2 was found to be associated with MG expression in humans. In this report, we describe case of seronegative generalized MG in a 2-year-old crossbred female dog associated with SARS-CoV-2 infection due to close exposure to an infected owner.

Vagally Associated Second Degree Atrio-Ventricular Block in a Dog with Severe Azotemia and Evidence of Sympathetic Overdrive.

A 14 years old, 6 kg, mix-breed male dog with severe azotemia due to urinary bladder herniation was presented to our Veterinary Teaching Hospital (VTH). Electrocardiography revealed normal heart rate of 100 bpm, evidence of sinus respiratory arrhythmia (SRA) and frequent second degree atrio-ventricular block following peak inspiratory phase suggestive of vagally-induced atrio-ventricular conduction delay. Echocardiographic examination showed mild mitral regurgitation without any other cardiac changes, and systolic (SAP) and diastolic (DAP) blood pressure values were 185/90 mmHg (SAP/DAP). Cardiac troponin I (cTnI) was increased to 7.3 ng/mL, suggesting a myocardial injury. A Holter examination revealed evidence of overall decrease in heart rate variability with evidence of sympathetic overdrive on time and frequency domain as well as when the non-linear Poincaré plot was analyzed. Based on the author's knowledge, this is the first report of a second degree atrio-ventricular block associated with vagal activity in a dog, with evidence of sympathetic overdrive and severe azotemia.

Vertebral heart size and vertebral left atrial size reference ranges in healthy Maltese dogs.

The most common cardiac measurements on thoracic radiography in veterinary medicine are vertebral heart size (VHS) and vertebral left atrial size (VLAS). Previously published studies have demonstrated evidence that reference ranges for these measures vary among different dog breeds, however reference ranges for Maltese breed dogs are currently lacking. We hypothesized that VHS and VLAS in healthy Maltese dogs would not be influenced by sex, age, or bodyweight. This retrospective, reference interval study aimed to describe reference intervals for VHS and VLAS in a sample of clinically healthy Maltese dogs and assess the intra- and interobserver variabilities for VLAS and VHS measurements. A total of 81 clinically healthy Maltese dogs were included, with healthy status being based on a complete cardiologic examination. Thoracic radiography in right lateral recumbency was performed for all dogs. The intra- and interobserver variability assessments of VHS and VLAS were based on measurements independently performed by three observers. The mean VHS was 9.53 ± 0.46 vertebrae (v). The median and interquartile range (IQR) for VLAS was 2 v (IQR, 1.8-2.1v). A statistically significant moderate positive correlation was observed between VHS and VLAS (P < .01, r = 0.416). Both VHS and VLAS showed an almost perfect intraobserver agreement. Interobserver agreement was almost perfect for VHS and substantial for VLAS. Findings supported previous studies recommending the use of breed-specific reference values for VHS and VLAS, and provided background data for future radiographic evaluations of Maltese dogs with clinical signs of cardiac disease.

The Impact of COVID-19 Pandemic During Lockdown on the Veterinary Profession in Romania: A Questionnaire-Based Survey.

The lockdown period in Romania lasted for 60 days and had the purpose of limiting the spread of SARS-CoV-2 virus outbreak and manage its consequences through emergency measures on many important areas of activity. This study aimed to gather, assess, analyze and disseminate relevant social, economic, and medical aspects on the impact of COVID-19 pandemic during lockdown on the veterinary profession in Romania. A survey was created using an online questionnaire platform, and disseminated. The survey was completed by a total of 409 individuals. A high number of respondents (71.64%; n = 293) felt exposed to medium or high risk of infection with SARS-CoV-2 at their workplace and many (56.97%; n = 233) felt that their professional environment was more stressful than usual during lockdown. Almost all respondents (89.73%; n = 367) declared the implementation of several control measures recommended by FECAVA and FVE (e.g., social distancing, wearing protective equipment, hand washing), but few mentioned the opportunity of remote work or visiting restrictions. Overall, the results show that the impact of lockdown lies directly on four main categories of importance on veterinarian professional's life-human resource, activity management, relationship between veterinarian and authorities, and continuing education.

Retrospective evaluation of notched and fragmented QRS complex in dogs with naturally occurring myxomatous mitral valve disease.

Myxomatous mitral valve disease (MMVD) is the most common cardiac disease in dogs. The association of QRS notching (nQRS) or fragmentation (fQRS) with disease severity is currently unknown. The study objective was to assess the prevalence of nQRS and fQRS in dogs with MMVD and its severity according to ACVIM classification and to compare the results with a group of healthy dogs. This retrospective cross-sectional study included 34 healthy control dogs and 155 dogs with spontaneous MMVD (42% of dogs in class B1, 23% in class B2 and 35% in class C). fQRS was defined as nQRS complexes in two contiguous leads in the frontal plane (leads I and aVL) and (II, III or aVF). A one-way ANOVA with Bonferroni post-hoc test was used to assess the differences in continuous data between control and MMVD groups. Of the MMVD group, 58% showed nQRS in at least one lead and 27% presented fQRS. There was no difference between the number of leads with a nQRS and disease severity (p = 0.75) nor did the number of leads with a nQRS correlate with left atrial size (r = 0.48; p = 0.5). The number of dogs with fQRS did not differ among classes of MMVD (p = 0.21). nQRS and fQRS were more prevalent in dogs with MMVD compared to control dogs (p < 0.01). This study did not identify any relationship between the number of leads with a nQRS and disease severity. However, dogs with MMVD had a higher prevalence of nQRS and fQRS compared to control group.

Short-term Heart-rate Variability in Healthy Small and Medium-sized Dogs Over a Five-minute Measuring Period.

INTRODUCTION: Five-minute heart-rate variability (HRV) measurement is a useful tool for assessing the autonomic nervous system (ANS) balance in humans, but there are no studies on healthy dogs. The aim of the study was, therefore, to provide the reference ranges in small and medium-sized breeds for short-term HRV time and frequency domain (TFD) analyses. MATERIAL AND METHODS: A total of 79 healthy dogs were included in the study between 2015 and 2019. Grouping by age with the breakpoint at six years and subgrouping by reproductive status and sex was imposed. All the dogs were included after physical and cardiological examinations and blood analyses. The TFD of HRV were analysed from a five-minute-long digital ECG recording after removal of non-sinus complexes. RESULTS: There were no statistically significant differences in any TFD parameters between age, reproductive status or sex groups. A mild increase in all time domain parameters and the high-frequency (HF) band was observed in older dogs, and the low frequency (LF):HF ratio decreased in these dogs. In males, the time domain parameters and HF band increased slightly. CONCLUSION: The normal ranges for HRV derived from short-term ECG recording in the usual clinical environment now have proposed reference ranges. Our findings suggest that accommodation time, age, sex, or reproductive status do not influence the results derived from these recordings, indicating that this method is reliable for assessing the ANS function in small and medium-sized dog breeds.

A rare case of intracardiac fibrosarcoma with myxoid features inducing venous occlusion in a dog - a case report.

BACKGROUND: In both humans and animals, cardiac fibrosarcoma is rare among primary cardiac malignant neoplasia. The overall prevalence of cardiac neoplasia in dogs is low, reported to be between 0.17% and 0.19% of hospital admissions. The aim of this report is to describe the clinical and pathological findings of a dog presenting signs of right sided congestive heart failure due to an intracardiac and venous obstructing mass, diagnosed by histopathology as cardiac fibrosarcoma with myxoid features. CASE PRESENTATION: A 7 years old male mix breed Husky weighing 23 kg was presented to our Veterinary Teaching Hospital the owner reporting weight loss, inappetence and exercise intolerance and on presentation exhibited breathlessness and an enlarged abdomen. A 5 minutes six leads electrocardiogram and cardiac ultrasonography were performed using standard, established techniques. Complete blood count, serum liver enzyme activities and renal parameters were assessed. Shortly after the cardiologic examination, the dog died and necropsy examination of the cardiovascular system revealed an elongated and branched mass attached dorsally to the endocardial insertion of the septal tricuspid valve leaflet. This mass extended retrogradely into the lumen of the cervical veins, obstructing the venous flow. Histological diagnosis of the mass was cardiac fibrosarcoma with myxoid features. Multiple metastases were found inside the lungs only. CONCLUSION: This is the first report describing a right cardiac fibrosarcoma with myxoid features and venous obstruction in a dog. Cardiac fibrosarcoma is a rare finding, however should be considered when an intracardiac mass is diagnosed.