Evaluation of the use of a heparin dose-response test in dogs to determine the optimal heparin dose during intravascular procedures and assessment of the in vitro heparin response in healthy dogs.

BACKGROUND: No guidelines for administering and monitoring anticoagulants intraprocedurally are currently available in dogs, despite the prevalence of procedures necessitating systemic anticoagulation with heparin. OBJECTIVES: To evaluate an activated clotting time (ACT)-based heparin dose-response (HDR) test to predict the individual required heparin dose in dogs during intravascular procedures, and to investigate both the in vitro heparin - ACT and in vitro heparin - factor anti-Xa activity (anti-Xa) relationships in dogs. METHODS: Blood was collected from eight healthy beagles undergoing a cardiac procedure and utilised to establish baseline ACT and for in vitro evaluation. Subsequently, 100 IU/kg heparin was administered intravenously (IV) and ACT was remeasured (HDR test). The required heparin dose for an ACT target response ≥300 s was calculated for each individual and ACT was remeasured after administration of this dose. For in vitro testing, a serial heparin blood dilution (0-0.5-1-2-4 international unit (IU)/mL) was prepared and ACT and anti-Xa were determined using whole blood and frozen plasma, respectively. RESULTS: The HDR test overestimated the required heparin dose in 3/7 dogs. In vitro, ACT and anti-Xa increased significantly with increasing blood heparin concentration. Heparin - ACT was nonlinear in 4/8 dogs at heparin concentrations >2 IU/mL, whereas heparin - anti-Xa remained linear throughout the tested range. CONCLUSIONS: The HDR test poorly estimated the required heparin dose in dogs. This is most likely attributed to a nonlinear heparin - ACT relationship, as observed in vitro. Anti-Xa is a promising alternative for ACT; however, unavailability as a point-of-care test and lack of in vivo target values restrict its current use.

Surgical correction of an infundibular pulmonic stenosis and ventricular septal defect in a Shetland Sheepdog.

A four-month-old male Shetland Sheepdog presented with exercise intolerance. Physical examination revealed an IV/VI left cranial systolic heart murmur. Echocardiography showed a severe infundibular pulmonic stenosis and a concomitant restrictive ventricular septal defect. As clinical signs of congestive right-sided heart failure worsened and were refractory to medical treatment, surgical correction was advised. Via sternotomy, with cardiopulmonary bypass and cardioplegic cardiac arrest, ventricular septal defect closure and resection of the stenotic infundibular band were performed through right ventriculotomy, followed by patch enlargement. Postoperative recovery was uneventful and echocardiography showed complete resolution of the stenosis and successful closure of the ventricular septal defect. Follow-up echocardiography revealed restenosis after seven weeks and recurrence of right-sided heart failure three months postoperatively. Stenting of the restenosis was attempted via a hybrid procedure with sternotomy and direct transventricular approach. The dog developed fatal ventricular fibrillation during stent deployment. This is the first dog in which surgical right ventricular patch enlargement under cardiopulmonary bypass is reported for the treatment of a primary infundibular pulmonic stenosis.

Serum insulin-like growth factor-1 as a marker of improved liver function and surgical outcome in dogs with congenital extrahepatic portosystemic shunts.

Serum insulin-like growth factor-1 concentration (sIGF-1c) is reduced in various hepatopathies in humans and dogs. This work aimed to evaluate sIGF-1c in dogs before and after congenital extrahepatic portosystemic shunt (cEHPSS) attenuation, in relation to surgical outcome (closed vs. persistent shunting). Secondarily, it aimed to assess if sIGF-1c can discriminate between cEHPSS and portal vein hypoplasia (PVH) and finally compare sIGF-1c ratio (postoperative/preoperative sIGF-1c) to pre-prandial serum bile acids (preBA), post-prandial bile acids (postBA), bile acid stimulation test (BAST) and fasting ammonia (FA), regarding surgical outcome. Thirty-nine dogs were included: 15 with closed cEHPSS, 15 with persistent shunting and nine with PVH. Transplenic portal scintigraphy was used to classifiy surgical outcome. There was no significant difference in sIGF-1c between dogs with cEHPSS and those with PVH (P > 0.05). Postoperative sIGF-1c increased in all dogs (P < 0.001 and P = 0.023 for closed and persistent shunting, respectively) and the increase was more pronounced in closed cEHPSS than in persistent shunting (P = 0.006). Using an optimal sIGF-1c ratio cut-off of 2.23, the sensitivity was 93.3% and the specificity was 66.7% for differentiation between surgical outcomes. Serum pre-prandial bile acids, postBA BAST and FA had sensitivities of 80%, 86.7%, 86.7%, 60%; and specificities of 100%, 93.3%, 93.3%, 100%, respectively. There was a greater increase in sIGF-1c after shunt closure than during persistent shunting; nevertheless sIGF-1c ratio was inferior to advanced imaging to assess surgical outcome.

Serum hyaluronic acid, a marker for improved liver perfusion after gradual surgical attenuation of extrahepatic portosystemic shunt closure in dogs.

Current liver function tests used in dogs do not consistently normalise after successful surgical attenuation of portosystemic shunts (PSS). Serum hyaluronic acid (sHA) concentrations in dogs with PSS are reported to be higher at diagnosis than in healthy dogs. The objective of this study was to assess sHA as a marker of liver perfusion by measuring sHA concentrations in dogs before and after gradual surgical attenuation of extrahepatic (EH)PSS and by determining whether sHA concentrations could differentiate closed EHPSS from persistent shunting. Specificity of sHA was assessed by comparing sHA concentrations in dogs with EHPSS to those in dogs with other liver diseases. Twenty dogs with EHPSS had sHA concentrations measured at diagnosis, 1, 3, and 6 months postoperatively. In addition, sHA concentrations were determined in 10 dogs with other liver diseases. At EHPSS diagnosis, median sHA concentration was 335.6 ng/mL (43.0-790.7 ng/mL). All dogs had a significant decrease in sHA concentrations from 1 month postoperatively onwards (P < 0.05), regardless of surgical outcome. At all postoperative follow-up visits, there was a significant difference between the median sHA concentration in dogs with closed EHPSS vs. those with persistent shunting (P < 0.05). Median sHA concentration in dogs with other liver diseases was 89.8 ng/mL (22.9-160.0 ng/mL), which was significantly lower than dogs with EHPSS at diagnosis (P < 0.001). In conclusion, sHA is a promising non-invasive biomarker that can help to determine liver perfusion after surgical attenuation of EHPSS. In addition, sHA could potentially be used to differentiate dogs with EHPSS from dogs with other liver diseases.

Comparison of a 5-mm and 10-mm vessel sealing device in an open ovariectomy model in dogs.

The objectives of this study were to compare (1) the extent of thermal damage and (2) the time between the 5-mm LigaSure V (LS5) and 10-mm LigaSure Atlas (LS10) vessel sealing devices (VSD) when performing open ovariectomy in dogs. A prospective, randomised, clinical trial was performed in 40 client-owned sexually entire female dogs. In each dog, one ovary was randomly assigned to be surgically removed using LS5 and the contralateral using LS10. The depth of thermal spread, measured on histopathological preparations, was significantly larger for LS10 (LS10 1.35±0.23 mm v LS5 0.82±0.10 mm; P<0.001). Mean ovariectomy time was significantly faster when using LS10 (LS5 2.58±1.32 minutes v LS10 2.07±1.27 minutes; P=0.008). Bodyweight was positively correlated with the time required for ovariectomy using LS5 (P=0.004), but no such correlation was present for LS10 (P=0.611). In conclusion, during open ovariectomy using VSD, LS10 causes significantly more thermal spread but surgical time is shorter compared with LS5. When using LS5, the ovariectomy time increases with increasing bodyweight.

Transdiaphragmatic pericardiectomy in dogs.

In patients with recurrent pericardial effusions, pericardiectomy is indicated. The purpose of this study was to describe a transdiaphragmatic approach for subtotal pericardiectomy in dogs and to evaluate its feasibility. In total, 20 canine cadavers weighing less than 10 kg (group S) and 20 weighing more than 20 kg (group L) were used. Within each group, half underwent a subphrenic pericardiectomy via an intercostal approach and half via a transdiaphragmatic approach. For each approach and within each weight group, the percentage of resected pericardium was calculated and compared. Additionally, a case series of nine consecutive client-owned dogs that underwent a transdiaphragmatic pericardiectomy for pericardial effusion was reported. Exposure of pericardium and associated phrenic nerves was excellent in cadavers and clinical patients. In group S, the percentage of resected pericardium was not significantly different between the two approaches. In group L, on the other hand, the percentage of resected pericardium was lower with the transdiaphragmatic approach compared with the intercostal approach (P=0.001). In the clinical patients, no intraoperative complications were encountered and no recurrence of pericardial effusion was seen. Subtotal pericardiectomy via a transdiaphragmatic approach is straightforward and a safe surgical procedure to obtain permanent pericardial drainage in small and large breed dogs.

Embryonal Rhabdomyosarcoma of the Oesophagus in a Young Dog.

A 15-month-old great Dane dog, showing clinical signs related to hypertrophic osteopathy, was diagnosed radiographically with a mass in the region of the thoracic oesophagus. Exploratory thoracotomy revealed an extensive, highly vascularized and locally invasive oesophageal mass and the presence of nodules in adjacent lung lobes. The dog was humanely destroyed intra-operatively. Histological examination revealed that the mass was an embryonal rhabdomyosarcoma. This is the first report of rhabdomyosarcoma of the oesophagus of a dog. Rhabdomyosarcoma should be considered a differential diagnosis when a mass adjacent to the oesophagus is diagnosed.

Seasonal feeding activity of the tree-hole tick, Ixodes arboricola.

Bird-specific ticks do not infest humans and livestock, but these ticks often share their avian hosts with generalist ticks that do. Therefore, their feeding activity may have an impact on the transmission of pathogens outside bird-tick transmission cycles. Here we examined the seasonal feeding activity of the tree-hole tick (Ixodes arboricola) in relation to the activity of its hole-breeding hosts (Parus major and Cyanistes caeruleus). We analysed data on ticks derived from birds, on the abundance of engorged ticks inside nest boxes, and on bird nests that were experimentally exposed to ticks. We observed a non-random pattern of feeding associated with the tick instar and host age. The majority of adult ticks fed on nestlings, while nymphs and larvae fed on both free-flying birds and nestlings. Due to their fast development, some ticks were able to feed twice within the same breeding season. The highest infestation rates in free-flying birds were found during the pre-breeding period and during autumn and winter when birds roost inside cavities. Except during winter, feeding of I. arboricola overlapped in time with the generalist Ixodes ricinus, implying that tick-borne microorganisms that are maintained by I. arboricola and birds could be bridged by I. ricinus to other hosts.