ABSTRACT
A pioneer of veterinary radiology, she was a born teacher and a role model.
ABSTRACT
BACKGROUND: Currently, the pathogenesis of congestive heart failure (CHF) in cats is not fully understood. OBJECTIVE: To identify novel biomarkers for CHF in cats caused by primary cardiomyopathy, particularly related to cardiovascular-renal axis disorder and systemic inflammatory response. ANIMALS: Twenty-five cats in CHF caused by primary cardiomyopathy, 12 cats with preclinical cardiomyopathy, and 20 healthy controls. METHODS: Case control and observational case series. The following serum biomarkers were compared among the 3 cat groups: a cardiorenal profile that included N-terminal pro-brain natriuretic peptide (NT-proBNP), symmetric dimethylarginine (SDMA), and creatinine and an inflammatory profile that included 7 acute-phase proteins (APPs). Survival analyses and longitudinal studies were performed in CHF cats. RESULTS: All cardiorenal biomarkers were positively correlated and higher in CHF cats, and high NT-proBNP and SDMA were associated with poor clinical outcome. Cats with CHF had significantly higher leucine-rich alpha-2-glycoprotein 1, serum amyloid A, and ceruloplasmin, and these APPs were positively correlated with NT-proBNP and left atrial size. In a multivariable survival analysis, alpha-1-acid glycoprotein concentration (P = .01), body weight (P = .02) and left atrial-to-aortic root ratio (P = .01) were independent prognostic factors for CHF in these cats. CONCLUSIONS AND CLINICAL IMPORTANCE: In cats, CHF is an inflammatory disorder and outcome in CHF may be determined by the extent of inflammation and possibly the amount of residual renal function. These novel biomarkers have potential use for the clinical management, prognosis, and future research into CHF and cardiomyopathy in cats.
Subject(s)
Acute-Phase Proteins/analysis , Cardiomyopathies/veterinary , Cat Diseases/diagnosis , Heart Failure/veterinary , Animals , Arginine/analogs & derivatives , Arginine/blood , Biomarkers/blood , Cardiomyopathies/blood , Cardiomyopathies/diagnosis , Case-Control Studies , Cat Diseases/blood , Cat Diseases/pathology , Cats , Creatinine/blood , Female , Heart Failure/blood , Heart Failure/diagnosis , Inflammation/veterinary , Kidney Diseases/blood , Kidney Diseases/veterinary , Male , Natriuretic Peptide, Brain/blood , Peptide Fragments/bloodABSTRACT
OBJECTIVE: The aim of this article is to review Angiostrongylus vasorum infection in dogs, including the life cycle, signalment, clinical signs, diagnosis, and treatment. Apparent changes in the epidemiology of this unique parasite are considered, alongside information available regarding its recent geographic spread. ETIOLOGY: A. vasorum is a metastrongyloid parasite capable of causing an array of clinical problems in dogs, including cardiorespiratory, coagulopathic, and neurologic signs. Currently, the parasite has a worldwide distribution; however, it usually arises in small pockets of enzootic foci. Recent reports suggest a changing distribution of this parasite, which has renewed interest in its epidemiology and in the risk of expansion to new areas including mainland North America. DIAGNOSIS: A definitive diagnosis of angiostrongylosis is usually made using the modified Baermann technique either using feces or tracheobronchial secretions; however, this review also discusses novel methods such as serologic and molecular techniques. THERAPY: Once a diagnosis of angiostrongylosis is made, prompt treatment should follow with anthelmintic drugs (such as moxidectin/imidacloprid, milbemycin oxime, or fenbendazole) and supportive care dependent upon the patient's clinical signs. Currently, there is no proven prophylactic regime. PROGNOSIS: The prognosis appears to be very dependent upon the severity of clinical signs at presentation. A. vasorum can be fatal and death may be sudden. However, if a prompt diagnosis is made and appropriate treatment is administered complete clinical resolution is possible.
