Efficacy and tolerability of the American Heartworm Society therapeutic protocol in dogs affected by heartworm disease without caval syndrome.

OBJECTIVES: The American Heartworm Society medical protocol represents the current standard of therapy for canine heartworm disease without caval syndrome. However, data on the tolerability of this protocol are limited. This study aimed to describe efficacy and prevalence of possible treatment-related side effects in dogs with heartworm disease treated using the American Heartworm Society protocol. MATERIALS AND METHODS: For this retrospective multi-centre cohort study, dogs diagnosed with classes 1 to 3 heartworm disease that completed the American Heartworm Society medical protocol were searched in four medical databases. Demographic, clinical, diagnostic, therapeutic and outcome data, including the number and type of possible treatment-related side effects, were retrieved. RESULTS: Thirty-five dogs were included. The median age and bodyweight were 6 years (1 to 13 years) and 17.3 kg (4.9 to 50 kg), respectively. Heartworm disease was classified as classes 1, 2 and 3 in 20 of 35, 11 of 35 and four of 35 dogs, respectively. In addition to the therapeutic recommendations of the American Heartworm Society, eight of 35 dogs underwent sedation to favour melarsomine administration, and 30 of 35 received ice at the injection site. After adulticide therapy, all dogs were hospitalised with cage rest [median time 12 hours (6 to 48 hours)]. All dogs survived the treatment. All dogs with long-term follow-up (32/35) became negative. Furthermore, treatment-related side effects were rare, mild and rapidly recovered without the need for supporting therapies; these included depression/lethargy (4/35 dogs), cough (2/35 dogs) and lameness, pain and gastrointestinal signs (1/35 dog each). CLINICAL SIGNIFICANCE: The American Heartworm Society medical protocol is efficient and safe in dogs with classes 1 to 3 heartworm disease.

Transient myocardial thickening: a retrospective analysis on etiological, clinical, laboratory, therapeutic, and outcome findings in 27 cats.

INTRODUCTION/OBJECTIVE: Transient myocardial thickening (TMT) in cats is a poorly characterized clinical entity. Therefore, this study aimed to provide descriptions of additional cats diagnosed with this clinical phenomenon. ANIMALS, MATERIALS, AND METHODS: For this multicenter observational retrospective study, cats diagnosed with TMT were searched in three medical databases. TMT was defined for cats with at least two echocardiograms showing an increased end-diastolic left ventricular wall thickness (LVWTd; i.e. ≥6 mm) at presentation and subsequent echocardiographic normalization (i.e. LVWTd <5.5 mm). Signalment, history, clinical, laboratory, therapeutic, and outcome data were retrieved. RESULTS: Twenty seven cats were included. The median age was 3 years. In 9/27 cats, an antecedent event was documented. At admission, 27/27 cats had evidence of myocardial injury (median value of cardiac troponin I 5.5 ng/mL), 25/27 cats had congestive heart failure, 13/27 cats had hypothermia, 8/27 cats had systemic hypotension, 7/27 cats had bradycardia, and 7/27 cats had electrocardiographic evidence of an arrhythmia. The median LVWTd was 6.4 mm. A potential cause of myocardial injury was identified in 14/27 cats. The median time from diagnosis to a significant reduction in LVWTd was 43 days. DISCUSSION: TMT can be diagnosed in a wide range of cats, including young subjects. An antecedent predisposing event and/or a possible causative trigger can be identified in some. The reduction in LVWTd that defines this phenomenon usually occurs over a variable time frame. CONCLUSIONS: This study represents the largest investigation of TMT in cats and provides additional information on this uncommon clinical entity.

The canine T wave: a retrospective analysis on qualitative and quantitative T wave variables obtained in 129 healthy dogs and proposed reference intervals.

INTRODUCTION/OBJECTIVE: The T wave is a poorly characterized electrocardiographic variable in small animals. Therefore, this study aimed to describe T wave features in a large population of healthy dogs. ANIMALS, MATERIALS, AND METHODS: Medical records were reviewed to identify healthy dogs ≥one-year-olds that underwent an electrocardiogram. T wave qualitative (morphology, polarity, and concordance between R and T waves) and quantitative (duration, amplitude, mean electrical axis, ratio between T and R waves amplitudes, interval from the peak to the end of the T wave, and ratio between the duration of the latter interval and that of the QT) variables were evaluated. Continuous and categorical variables were compared between dogs of distinct sex, body weight (BW), age and somatotype using the Mann-Whitney U test and χ2 test, respectively. Spearman's correlation coefficients between quantitative variables and age and BW were calculated. Reference intervals of quantitative variables were determined in the overall population. RESULTS: One hundred and twenty-nine dogs were enrolled. Concerning morphology, the asymmetrical (slow/fast) pattern occurred more frequently than the symmetrical and biphasic ones. Concerning polarity, positive T waves occurred more frequently than negative and neutral ones. T and R waves were predominantly concordant. No meaningful differences were found when comparing qualitative and quantitative variables between dogs of distinct sex, BW, age and somatotype. No significant correlations were found between quantitative variables and age and BW. Reference intervals of quantitative variables are provided. CONCLUSIONS: Canine T wave features were addressed and statistically reliable reference intervals made available for clinical use.

Retrospective evaluation of the ST segment electrocardiographic features in 180 healthy dogs.

OBJECTIVES: Normal features of the ST segment are poorly characterised in dogs. This study aimed to describe ST segment characteristics in a population of healthy dogs. MATERIALS AND METHODS: Medical records were reviewed to identify healthy dogs that underwent an electrocardiogram. Several ST segment qualitative parameters were evaluated: presence/absence of deviation, type of deviation (depression/elevation) and morphological patterns of depression (horizontal, downsloping, upsloping and sagging) and elevation (horizontal, concave and convex). Moreover, the amplitude of ST segment depression/elevation was measured. The potential effect of sex, bodyweight, age and somatotype on the presence/absence of ST segment deviation was evaluated through binary logistic regression. RESULTS: One hundred and eighty dogs were enrolled. The deviation was evident in 43 of 180 dogs (23.9%), among which 36 showed depression and seven showed elevation. The median depression amplitude was 0.1 (range 0.05 to 0.3) mV. The mean elevation amplitude was 0.136 ±0.055 mV. Concerning depression morphology, the horizontal pattern was overrepresented, followed by the downsloping and upsloping ones. Concerning elevation morphology, all dogs showed a concave pattern. No meaningful effect of sex, bodyweight, age and somatotype on the presence/absence of ST segment deviation was documented. CLINICAL SIGNIFICANCE: Normal features of canine ST segment were described and made available for clinical use.

Physiological shift of the ventricular mean electrical axis in healthy French Bulldogs: a retrospective electrocardiographic analysis of 80 healthy dogs.

INTRODUCTION/OBJECTIVES: Whether a brachymorphic conformation may lead to electrocardiographic peculiarities diverging from generic reference intervals (RIs) cited in textbooks remains to be established. Therefore, this study aimed at evaluating electrocardiographic variables in one of the most common brachymorphic breed, namely the French Bulldog (FB). ANIMALS, MATERIALS AND METHODS: Medical records were retrospectively reviewed to identify healthy FBs ≥1-year-old that underwent an electrocardiogram. The Mann-Whitney U test or the Student's t-test was used to compare continuous variables among male and female dogs, while the χ2 test was used for categorical variables. Spearman's correlation coefficients between electrocardiographic measurements and age and body weight were also calculated. Moreover, electrocardiographic RIs were determined. RESULTS: Eighty healthy FBs were enrolled; their electrocardiographic variables fitted with generic RIs, with the exception of the QRS-complex mean electrical axis (QRS-MEA). The median QRS-MEA value was 43.5° (from -18° to +90°). A QRS-MEA shift was found in 24/80 (30%) dogs; in all cases, it was a left shift (median 26°, from -18° to +39°). Specifically, 20 dogs showed a slight left shift (from +39° to +14°), while four dogs showed a marked one (from +9° to -18°). No meaningful differences were found when comparing electrocardiographic variables between males and females. No significant correlations between electrocardiographic variables and age or body weight were found, with the exceptions of the P-wave amplitude, PQ-interval duration and QT-interval duration. CONCLUSIONS: Healthy FBs can present a left shift of QRS-MEA. These data should be considered when interpreting FBs' electrocardiograms.

Cor triatriatum sinister in a dog.

This report describes the transthoracic and transesophageal echocardiographic features of cor triatriatum sinister in an asymptomatic 6-year-old male French bulldog. Although cor triatriatum sinister represents a well-known and widely described cardiac malformation in humans, its description in the canine population is rare. In this clinical case, non-invasive echocardiographic techniques were helpful in visualizing and characterizing the lesion, allowing a valuable assessment of the malformation, and its hemodynamic consequences.

[The follow-up in adulthood of subjects with progressive rheumatic disease in childhood. Considerations of secondary prevention]. / Controllo in età adulta di soggetti con pregressa malattia reumatica nell' infanzia. Considerazioni sulla profilassi secondaria.

We reviewed 57 patients who had previously suffered from rheumatic fever (RF) after an average period of 7.2 (+/- 2.8) years without penicillin prophylaxis. In 24 cases (42%) RF began with carditis and in 9 patients valvular damage remained after hospital discharge. Prophylaxis with retard penicillin every four week was carried out for 5.5 +/- 1.8 years. At present the patients are all asymptomatic. There was in 7 cases mild valvular damage without clinical and instrumental involvement. There was not recurrency after the end of prophylaxis, except for a doubtful case, analysed in the Discussion. Although our cases are not numerous, we believe that a regular prophylactic treatment over 5 or 6 years is sufficient to avoid any recurrency in patients with previous RF. After this period of treatment, only subjects with valvular damage should have further extensive treatment until their 20th year and always for a period not shorter than ten years.

[Behavior of blood folate in children with thalassemia major under transfusion therapy and in thalassemia trait]. / Comportamento della folemia in bambini affetti da talassemia mayor in regime trasfusionale e in portatori di tratto talassemico.

The folic acid plasma level in 12 out of 13 children with thalassemia major was lower than 3 ng/ml. This deficiency is not due to intestinal malabsorption. Folate deficiency should then be provoked by an increased allowance due to the compensatory erythropoiesis and to the lack of. Folic acid level less then 3 ng/ml in 24% and not more then 6 ng/ml in 50% of thalassemic heterozygotic children has been found. Therefore the necessity of folic acid treatment in thalassemic children with a low blood transfusional therapy and in beta-thalassemic heterozygotic children has been recommended.

[Environmental health risks in a marble-working shop]. / Rischi igienico-ambientali in un laboratorio per la lavorazione di marmi.

With regard to the "Inquiry industrial accidents and respiratory pathology of marble workers", promoted by the "Regione Toscana" and being made by the preventive medicine services for workers acting in Massa Carrara and Lucca Provinces, the AA. relate about the sanitary environment conditions in a modern marble manufacture workshop and compare them with the ones in other workshop less advanced from the technological point of view.