QT interval instability and QRS interval dispersion in healthy cats and cats with a hypertrophic cardiomyopathy phenotype.

OBJECTIVES: Hypertrophic cardiomyopathy (HCM) is the most common heart disease in cats. Electrocardiographic (ECG) analysis can help with the diagnosis of HCM and also in the investigation of the secondary consequences of the disease. This study investigated ECG markers of QT interval variability (total instability [TI], short-term instability [STI], long-term instability [LTI], QT variance [QTv]), mean QT interval (QTa) and QT interval corrected for heart rate (QTac), as well as the duration (QRSd) and dispersion (QRSv) of the QRS interval in healthy cats and in those with HCM. METHODS: Data were collected from 63 domestic cats: 40 in the control group and 23 in the HCM group. Fifty consecutive QT intervals were recorded for all cats and then QTa, QTac, QTv, TI, LTI and STI were calculated. QRSd and QRSv were also obtained for all animals. A Mann-Whitney U-test was used for group comparison. Receiver operating characteristic curves were plotted to evaluate the sensitivity and specificity of all markers for HCM. Logistic regression analysis was performed to assess the risks of cats having HCM, based on the studied indexes. RESULTS: QTa (P <0.01), QTac (P <0.01), QRSd (P <0.01) and STI (P = 0.02) were higher in the HCM group. QTa >158.8 ms, QTac >27.4 ms and QRSd >0.045 s had an accuracy of 77.4%, 68.2% and 80.9%, respectively, in detecting HCM. Logistic regression showed that cats with QTa >158 ms, QTac >27.4 ms and QRSd >0.045 s had a 1.58-, 1,23- and 6.5-fold higher risk, respectively, of developing HCM. CONCLUSIONS AND RELEVANCE: Cats with HCM had higher ventricular instability as assessed by STI and showed a prolongation of the QT and QRS intervals via the QTa, QTac and QRSd markers. These markers show potential as ancillary screening tools for identifying the presence of HCM.

QT interval instability and variability in dogs with naturally-occurring hypercortisolism.

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.

Role of echocardiographic views adapted for lung evaluation in diagnosis of cardiogenic pulmonary edema in Dogs.

The objective of this study was to determine whether echocardiographic views adapted for lung evaluation may aid in diagnosis of dyspnea in dogs. Fifteen chronic valvular heart disease (CVHD) dogs without cardiac remodeling, 30 CVHD dogs with cardiac remodeling, 15 CVHD dogs with cardiogenic pulmonary edema and 15 dogs with pulmonary disease were prospectively enrolled. Loop recordings of pericardial-lung ultrasound were gathered during echocardiographic evaluation, and four videos of 4 different adapted views were recorded for each dog. Chest X-rays were used as reference-standard for pulmonary edema and/or disease. The videos were classified based on the number of B- lines as NEGATIVE (0, 1, 2 or 3) or POSITIVE (> 3 or confluent). Accuracy of a POSITIVE classification in identifying pulmonary edema and/or disease was calculated. Multivariate analyses were performed using echocardiographic variables that reflect increased left ventricular filling pressure (LVFP) to distinguish pulmonary edema from disease. Results showed that a POSITIVE classification distinguished dogs with pulmonary edema or disease from asymptomatic CVHD dogs in all four views. The best views were right parasternal short axis at papillary muscle level and long axis 4- chamber view, both with the same sensitivity (86.7%) and a specificity of 95.6% and 82.2%, respectively. Multivariate analyses showed that adding cutoff values of peak E wave > 130, E/IVRT > 2.5 or LA/Ao > 2.0 distinguished pulmonary edema from disease with 100% specificity. In conclusion, echocardiographic views adapted for lung evaluation, in addition to conventional echocardiography, may help identify the cause of dyspnea in dogs.

Tpeak-Tend, a novel electrocardiographic marker in cats with hypertrophic cardiomyopathy-a brief communication.

Hypertrophic cardiomyopathy (HCM) is the most common heart disease in feline species. ECG allows assessing parameters that can help in the diagnosis and risk stratification of conditions that occur secondary to this disease. This study aimed to evaluate electrocardiographic markers Tpte and Tpte/QT in leads I, II, III, aVR, aVL and aVF in control and HCM cats. Data were obtained from 63 domestic cats allocated in a Control (n = 40) and an HCM (n = 23) group. Tpte and Tpte/QT of all individuals were measured in all limb leads (I, II, III, aVR, aVL, aVF). We constructed ROC curves to evaluate the sensitivity and specificity of markers to identify HCM-affected cats. Logistic regression analysis was performed to assess the risks of cats having HCM based on Tpte indexes. Tpte in leads II (p < 0.01), aVR (p < 0.01), aVL (p < 0.01), and aVF (p < 0.01) had significantly higher results in the HCM group. Tpte/QT showed no statistical difference between groups in any of the derivations evaluated. A Tpte > 27.5ms in lead aVF showed an accuracy of 83.3% to identify individuals with HCM in our study. Univariable logistic regression reveals that cats with Tpte in aVR and aVF > 27.5ms and in aVL > 26.5ms had 1.28, 12 and 1.16 respectively, more chances of having HCM. The prolongation of Tpte may be a noninvasive electrocardiographic complementary tool to help differentiate patients with and without hypertrophic cardiomyopathy.

Timolol 0.5% ophthalmic solution influences cardiac function in healthy cats.

OBJECTIVES: The aim of this study was to ascertain the effect of a drop of timolol 0.5% ophthalmic solution on the systolic function of the left ventricle (LV) and left atrium (LA), and to confirm if timolol helped appraisal of diastolic function by reducing heart rate (HR) and separating the transmitral outflow waves from tissue Doppler imaging (TDI). METHODS: A total of 41 client-owned healthy cats underwent two echocardiograms 20 mins apart. The timolol group (33 cats) received a drop of timolol solution after the first examination. Standard and speckle-tracking echocardiography evaluated the LV and LA function of both groups at the two time points evaluated. RESULTS: Timolol reduced HR (19%), and fractional shortening from LV (20.3%) and LA (16.6%). Septal S' decreased by 51% (from 7.7 to 5.2 cm/s) and lateral S' dropped by 43.1% (7.3 to 5.1 cm/s). Most longitudinal techniques did not change after timolol, including the mitral annular plane systolic excursion from the interventricular annulus, tricuspid annular plane systolic excursion, LV longitudinal strain and LV tissue motion annular displacement. The isovolumic relaxation time increased by 15.2% (from 54 to 64.6 ms), with most cats presenting this variable above the reference (>60 ms). Timolol did not support diastolic assessment, enabling evaluation in only 2/11 cats when using lateral TDI and 1/9 cats using septal TDI. Regarding side effects, miosis occurred in 18 cats (54.5%). CONCLUSIONS AND RELEVANCE: Timolol reduced systolic function, decreasing standard echocardiographic variables. Regarding diastolic evaluation, although timolol decreased HR, it did not separate the mitral diastolic waves, as expected.

Tissue motion annular displacement to assess the left ventricular systolic function in healthy cats.

The tissue motion annular displacement (TMAD) measures the longitudinal displacement of the mitral annulus during systole, using speckle-tracking echocardiography (STE). The main objective was to determine the TMAD means in healthy cats, exploring the correlations with systolic surrogates. The influence of age, body surface area (BSA), heart rate, and systemic blood pressure on the indices was also analyzed. One hundred ninety-three healthy, client-owned cats participated in this prospective, cross-sectional observational study undergoing conventional and STE. Apical four-chamber (AP4) and two-chamber (AP2) images were recorded for offline calculations. Mean TMAD values were similar to mitral annulus plane systolic excursion (MAPSE), varying between 4 to 4.8 mm depending on the annulus and image used. No significant differences between age and BSA categories were detected, except for AP4 MP%, reduced in the heavier group. TMAD variables showed moderate correlation with longitudinal strain (LSt) and MAPSE, but not with fraction shortening (FS) and ejection fraction (EF). The median time required for the offline calculation was 12.2 s for AP4 and 11.8 s for AP2. The technique showed moderate inter and intraobserver variation, proving a reliable tool for assessing left ventricular longitudinal systolic function in cats.

Conventional vs. advanced echocardiographic parameters for predicting fluid responsiveness in healthy dogs

Background: Volume replacement is considered an essential component in the treatment of critically ill patients, but excess f luid administration can be as harmful as the lack of fluid therapy. Therefore, the volume replacement is only beneficial in patients deemed to be fluid responsive, that is, when the individual has an increase in their stroke volume after administration of a volume challenge. This study aim to assess whether conventional and advanced echocardiographic parameters for assessing left ventricular systolic function are able to predict fluid responsiveness in healthy spontaneously breathing dogs. The hypothesis was that some of these parameters would differ between responsive and non-responsive animals and could be used as a complementary measure for assessment of fluid responsiveness. Materials, Methods & Results: A prospective study was carried out in which 22 client-owned healthy dogs over 1 year of age that presented to the Veterinary Medical Teaching Hospital for elective neutering procedure were included. All dogs underwent conventional and advanced echocardiographic examination to obtain the left ventricular internal diameter in diastole normalized (LVIDDn), left ventricular internal diameter in systole normalized (LVIDSn), ejection fraction (EF) and shortening fraction (SF) according to the Teischholz methodology, global longitudinal strain (GLS) and tissue motion annular displacement (TMAD). There parameters were evaluated before and after administration of a volume challenge with 10 mL/kg lactate ringer intravenously for 20 min. Based on the variation in aortic velocity integral time, 31.82% of dogs were considered responsive and 68.18% were non-responsive to the volume challenge. For advanced echocardiography, TMAD indexed by body weight (mm/kg) > 0.89 (P = 0.004) and body surface area (mm/m2) >18.9 (P = 0.004) after volume challenge had the best area...

Characterization of Doppler spectrum of hepatic veins and correlation with structural and functional variables of the right ventricle in healthy dogs.

BACKGROUND: Spectral Doppler assessment of hepatic veins may provide information on heart function. HYPOTHESIS/OBJECTIVES: To assess the normal pattern of hepatic venous flow using spectral Doppler ultrasound examination; to correlate this information with structural and functional variables of the right ventricle (RV), and to analyze the impact of age, sex, body weight quartiles, heart rate, cardiac rhythm, and systolic arterial pressure on the results in healthy dogs. ANIMALS: Sixty-five healthy dogs. METHODS: Cross-sectional observational study. The direction and maximum velocity of each of the 4 possible components of venous flow were determined from pulsed-wave Doppler examination of the hepatic veins. In addition, structural and functional parameters (TAPSE, longitudinal strain, FAC%, S', Et /At, and E't / A't ) of the RV were evaluated. RESULTS: The same phase patterns for different waves were seen in all animals: A and V were retrograde waves, and S and D were anterograde waves. The velocity of the spectral waves increased with body weight (P < .05) and could be correlated with functional indices of the RV. A significant difference was found when comparing morphometric indices with body weight quartiles (P < .05). In addition, intra-and inter-observer assessments showed low variability. The mean duration of the examinations was 5.2 minutes. CONCLUSIONS AND CLINICAL IMPORTANCE: Hepatic spectral Doppler findings can be correlated with systolic and diastolic indices of the RV and vary with body weight.

Use of computed radiology as a screening test for the identification of congenital heart disease in dogs / Utilização da radiologia computadorizada como exame de triagem na identificação de cardiopatias congênitas em cães

The objectives of this study were to evaluate the accuracy of thoracic radiology as a screening test for congenital heart diseases in dogs, to identify the main contributions and limitations of this modality, and to verify the reproducibility of the evaluations by three observers with different levels of training. An interobserver, observational, retrospective and prospective study was carried out, including ninety dogs: thirty healthy animals, thirty with acquired heart diseases and thirty with congenital heart diseases, which all had thoracic radiographs and a confirmed echocardiographic diagnosis. The cases were separated and randomized by a mediator who did not participate in the reading of the radiographic examinations, and no evaluator had access to the patients' data. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of each observer were calculated in relation to the correct classification of dogs to groups of normal or acquired and congenital heart diseases, as well as identification of enlargement of the cardiac silhouette and large vessels of dogs with congenital heart diseases. Finally, the Kappa coefficient was obtained between the observers to verify the reproducibility of the radiological evaluations performed. In general, sensitivity, PPV and accuracy were unsatisfactory ( 70%), and the agreement ranged from poor to reasonable (between 0 and 0.39). Although greater accuracy was achieved in the differentiation of healthy dogs from those with acquired and congenital heart diseases by thoracic radiography, when compared to the other studies, the modality was able only to identify healthy patients, and could not differentiate the individuals with different forms of heart disease or define the cardiac malformations. In addition, there was low reproducibility between observers, therefore, this technique should not be used as a sole screening method in dogs with suspected congenital heart diseases.(AU)

Os objetivos do estudo foram avaliar a acurácia da técnica radiográfica de tórax como exame de triagem nas cardiopatias congênitas em cães, identificar as principais contribuições e limitações dessa modalidade, e verificar a reprodutibilidade das avaliações realizadas por três observadores com diferentes graus de treinamento. Realizou-se um estudo interobservador, observacional, retrospectivo e prospectivo, o qual foram selecionados 90 cães, sendo 30 saudáveis, 30 com cardiopatias adquiridas e 30 com cardiopatias congênitas, que possuíam radiografia de tórax e diagnóstico ecocardiográfico confirmado. Os casos foram separados e randomizados por um mediador que não participou da leitura dos exames radiográficos, sendo que nenhum avaliador obteve acesso aos dados dos pacientes. Calculou-se os índices de sensibilidade, especificidade, valor preditivo positivo (VPP), valor preditivo negativo (VPN) e acurácia de cada observador em relação a identificação dos pacientes saudáveis, com cardiopatias adquiridas e congênitas, bem como para identificação de aumento da silhueta cardíaca e região de grandes vasos dos cães com cardiopatias congênitas. Por fim, foi obtido o coeficiente de Kappa entre os observadores a fim de verificar a reprodutibilidade das avaliações radiográficas realizadas. De modo geral, a sensibilidade, VPP e acurácia foram insatisfatórios (< 70%), enquanto a especificidade e VPN foram satisfatórios (> 70%), sendo que a concordância variou de ruim a razoável (entre 0 e 0,39). Apesar de ter sido alcançado acurácia maior na identificação de cães saudáveis, com cardiopatias adquiridas e congênitas pela radiografia de tórax quando comparado aos demais estudos, confirma-se que essa modalidade se mostrou capaz apenas de identificar o paciente saudável, não de diferenciar os indivíduos cardiopatas entre si ou de definir com maior detalhe as malformações cardíacas especificamente. Além disso, o exame radiográfico de tórax apresentou baixa reprodutibilidade entre os observadores, portanto, essa técnica não deve ser considerada como método único de triagem na suspeita de cães com cardiopatias congênitas.(AU)

Use of measurements from thoracic radiographs to identify high mean left atrium pressure in dogs with myxomatous mitral valve disease / Uso de medidas obtidas de radiografias torácicas em cães para identificar aumento da pressão média do átrio esquerdo na doença mixomatosa da valva mitral

The aim of this study was to estimate echocardiographic elevated mean left atrium pressure (MLAP) based on measurements from thoracic radiographs and to determine a cut-off value for each radiographic measurement that suggests a high MLAP. A retrospective cross-sectional study was performed to include cases admitted from January 2015 to December 2016. Thoracic radiographic examinations from 93 dogs with and without a high MLAP were included. Specific measurements were made from thoracic radiographs and compared with echocardiographic variables known to indicate high MLAP. This comparison was used to generate equations that allowed the estimation of echocardiographic surrogates from the radiographic measurements. The values indicative of high MLAP were obtained using a regression curve. Formulas that indicated high MLAP were generated using a number of radiographic measurements. Positive echocardiographic findings of high MLAP were used as the gold standard. These formulas helped to predict high MLAP in myxomatous mitral valve disease (MMVD) without the need for echocardiographic examination. The best formula was left atrium (LA):aorta (Ao)echo = 0.03×(vertebral heart score,VHS) + 0.14×(LA) + 0.27×(LA:caudal vena cava (CVC)rad). Values ≥ 12.2v for VHS, ≥ 4.5cm for LA, ≥ 3.3 for LA:Ao rad and ≥ 3.2 for LA:CVC rad suggested high MLAP. Thus, we propose equations, based on measurements from thoracic radiographs, to identify high MLAP. Simple radiographic thoracic measurements, such as LA:CVCrad, can be used to define overload and a high MLAP in dogs with MMVD.(AU)

O objetivo desse estudo foi estimar o aumento da pressão média do átrio esquerdo (PMAE) na ecocardiografia usando equações baseadas em medidas obtidas das radiografias torácicas e determinar um valor de corte para cada uma dessas variáveis radiográficas. Foi realizado um estudo retrospectivo, observacional e transversal de casos atendidos de janeiro de 2015 a dezembro de 2016. Foram selecionados 93 exames radiográficos do tórax de cães, com ou sem aumento da PMAE. As medidas especificas foram feitas de radiografias torácicas e comparadas com variáveis ecocardiográficas que podem indicar um aumento da PMAE. Foi gerado equações que estimam medidas ecocardiográficas a partir das variáveis radiográficas. Os valores que indicam aumento da PMAE foram obtidos por meio das curvas de regressão. Foram usadas como "padrão ouro" as medidas ecocardiográficas que indicam aumento da PMAE. As fórmulas ajudam a predizer o aumento da PMAE em cães com doença mixomatosa da valva mitral (DMVM) sem a necessidade do exame ecocardiográfico. A melhor fórmula obtida foi: Átrio Esquerdo (AE):Aorta (Ao)eco=0.03×(VHS)+0.14×(AE)+0.27×(AE:Veia Cava Caudal (VCC)rad). Os valores ≥ 12.2 para VHS, ≥ 4.5cm para AE; ≥ 3.3 para AE:Ao rad e ≥ 3.2 para AE:VCC rad sugerem um aumento da PMAE. Essas equações, a partir de medidas radiográficas torácicas, auxilia na identificação do aumento da PMAE. Algumas medidas radiográficas simples, como a AE:VCC rad pode ser usada para definir sobrecarga e aumento da PMAE em cães com DMVM.(AU)

Use of measurements from thoracic radiographs to identify high mean left atrium pressure in dogs with myxomatous mitral valve disease / Uso de medidas obtidas de radiografias torácicas em cães para identificar aumento da pressão média do átrio esquerdo na doença mixomatosa da valva mitral

The aim of this study was to estimate echocardiographic elevated mean left atrium pressure (MLAP) based on measurements from thoracic radiographs and to determine a cut-off value for each radiographic measurement that suggests a high MLAP. A retrospective cross-sectional study was performed to include cases admitted from January 2015 to December 2016. Thoracic radiographic examinations from 93 dogs with and without a high MLAP were included. Specific measurements were made from thoracic radiographs and compared with echocardiographic variables known to indicate high MLAP. This comparison was used to generate equations that allowed the estimation of echocardiographic surrogates from the radiographic measurements. The values indicative of high MLAP were obtained using a regression curve. Formulas that indicated high MLAP were generated using a number of radiographic measurements. Positive echocardiographic findings of high MLAP were used as the gold standard. These formulas helped to predict high MLAP in myxomatous mitral valve disease (MMVD) without the need for echocardiographic examination. The best formula was left atrium (LA):aorta (Ao)echo = 0.03×(vertebral heart score,VHS) + 0.14×(LA) + 0.27×(LA:caudal vena cava (CVC)rad). Values ≥ 12.2v for VHS, ≥ 4.5cm for LA, ≥ 3.3 for LA:Ao rad and ≥ 3.2 for LA:CVC rad suggested high MLAP. Thus, we propose equations, based on measurements from thoracic radiographs, to identify high MLAP. Simple radiographic thoracic measurements, such as LA:CVCrad, can be used to define overload and a high MLAP in dogs with MMVD.

O objetivo desse estudo foi estimar o aumento da pressão média do átrio esquerdo (PMAE) na ecocardiografia usando equações baseadas em medidas obtidas das radiografias torácicas e determinar um valor de corte para cada uma dessas variáveis radiográficas. Foi realizado um estudo retrospectivo, observacional e transversal de casos atendidos de janeiro de 2015 a dezembro de 2016. Foram selecionados 93 exames radiográficos do tórax de cães, com ou sem aumento da PMAE. As medidas especificas foram feitas de radiografias torácicas e comparadas com variáveis ecocardiográficas que podem indicar um aumento da PMAE. Foi gerado equações que estimam medidas ecocardiográficas a partir das variáveis radiográficas. Os valores que indicam aumento da PMAE foram obtidos por meio das curvas de regressão. Foram usadas como "padrão ouro" as medidas ecocardiográficas que indicam aumento da PMAE. As fórmulas ajudam a predizer o aumento da PMAE em cães com doença mixomatosa da valva mitral (DMVM) sem a necessidade do exame ecocardiográfico. A melhor fórmula obtida foi: Átrio Esquerdo (AE):Aorta (Ao)eco=0.03×(VHS)+0.14×(AE)+0.27×(AE:Veia Cava Caudal (VCC)rad). Os valores ≥ 12.2 para VHS, ≥ 4.5cm para AE; ≥ 3.3 para AE:Ao rad e ≥ 3.2 para AE:VCC rad sugerem um aumento da PMAE. Essas equações, a partir de medidas radiográficas torácicas, auxilia na identificação do aumento da PMAE. Algumas medidas radiográficas simples, como a AE:VCC rad pode ser usada para definir sobrecarga e aumento da PMAE em cães com DMVM.

Renal capsulotomy associated with omentopexy for treatment of bilateral perinephric abscess in a bitch: case report / Capsulotomia renal associada à omentopexia para tratamento de abcesso perirrenal bilateral em uma cadela: relato de caso

A perinephric abscess is a rare and difficult to treat disease in veterinary medicine. The aim of this paper is to report a case of successful treatment using capsulotomy and omentopexy for bilateral perinephric abscess in a dog.(AU)

Abscesso perinéfrico é uma condição rara na medicina veterinária e de difícil tratamento. O objetivo deste trabalho é relatar um caso de sucesso no tratamento de abscesso perinéfrico bilateral em um cão, usando capsulotomia e omentopexia.(AU)

Polymorphism, coupling interval and prematurity index in dogs with degenerative mitral valve disease and ventricular arrhythmias.

Ventricular arrhythmias (VA) are a recognized concern in dogs with degenerative mitral valve disease (DMVD). The coupling interval (CI) and the prematurity index (PI) have been shown to accurately differentiate between benign and malignant VA in people, where ventricular arrhythmias are known to be associated with an increased risk of development of signs of heart failure or sudden death. In this study, we characterized ventricular arrhythmias in dogs with symptomatic and asymptomatic DMVD. Seventy dogs with naturally-occurring DMVD and ventricular arrhythmias were retrospectively studied. A cross-sectional investigation including dogs with either symptomatic (stages C/D; n = 41) or asymptomatic (stages B1/B2; n = 29) DMVD was performed. Electrocardiographic tracings were reviewed to calculate both the CI and PI. In eight dogs these indices were compared with those obtained from both a Holter recording and a standard ECG tracing and no statistical differences were found (CI, p = 0.97; PI, p = 0.17). Even though CI and PI were determined in all animals enrolled in the study, VPC characteristics were only compared between symptomatic and asymptomatic dogs when a 24-h Holter recording was available (n = 49). The PI was different (p = 0.01) between symptomatic (0.65 ± 0.17) and asymptomatic (0.56 ± 0.18) dogs, but CI was considered similar (p = 0.91). Also, the symptomatic dogs had more polymorphic VPC (p = 0.002) and supraventricular arrhythmias (p = 0.0002) than the asymptomatic animals. Polymorphism, and repeating patterns of ventricular premature complexes, were characteristics frequently present in overtly symptomatic animals affected by mitral endocardiosis.

Hipertensão arterial pulmonar em felino com cardiomiopatia restritiva - relato de caso / Pulmonary arterial hypertension in a cat with restrictive cardiomyopathy - a case report / Hipertensión arterial pulmonar en un felino con cardiomiopatía restrictiva - relato de caso

A hipertensão arterial pulmonar (HAP) nos felinos é uma desordem incomum e pouco relatada, que pode levar a insuficiência ventricular direita e morte. Na espécie felina, a HAP foi relatada secundariamente a casos de dirofilariose, tromboembolismo pulmonar, e persistência do dueto arterioso. Este relato refere-se a um felino idoso com histórico de cansaço, dispneia e efusão pleural, diagnosticado por meio de ecocardiografia com cardiomiopatia restritiva e hipertensão pulmonar. A cardiomiopatia restritiva pode ter curso insidioso devido à inabilidade dos tutores para reconhecer os sinais clínicos atribuíveis à insuficiência cardíaca. Embora pouco relatada em felinos, é razoável que a exclusão da hipertensão arterial pulmonar faça parte da investigação em gatos com sinais clínicos de descompensação cardiopulmonar.(AU)

Feline pulmonary arterial hypertension (PAH) is an unusual and minimally reported condition that can lead to right ventricular insufficiency and death. In cats, PAH was reported in cases in which it was secondary to heartworm disease, pulmonary thromboembolism and patent ductus arteriosus. This is a case report of an elderly domestic cat with medical history of dyspnea, fatigue and pleural effusion, which was diagnosed with restrictive cardiomyopathy and PAH upon echocardiography. The progression of restrictive cardiomyopathy can be silent due to the owners' inability to recognize clinical signs of heart failure. In spite of the few reports in cats, it is reasonable that PAH be part of differential diagnosis on patients presenting signs of cardiopulmonary decompensation.(AU)

La hipertensión arterial pulmonar (HAP) en los felinos es una enfermedad poco frecuente y poco relatada que puede llevar a una insuficiencia ventricular derecha y muerte del paciente. En los gatos, la HAP ha sido relatada en casos de dirofilariosis, tromboembolismo pulmonar y persistencia del ducto arterioso. Este trabajo presenta el caso de un felino de edad avanzada con histórico de cansancio, disnea y efusión pleural, en el que se diagnostico una cardiomiopatía restrictiva e hipertensión pulmonar a través de ecocardiografía. La cardiomiopatía restrictiva puede pasar desapercibida debido, en parte, a que los dueños no reconocen los signos clínicos de una insuficiencia cardíaca. A pesar de ser poco relatada en felinos, es razonable que la HAP forme parte del diagnostico diferencial en gatos con signos clínicos de descompensación cardiopulmonar.(AU)

Hipertensão arterial pulmonar em felino com cardiomiopatia restritiva - relato de caso / Pulmonary arterial hypertension in a cat with restrictive cardiomyopathy - a case report / Hipertensión arterial pulmonar en un felino con cardiomiopatía restrictiva - relato de caso

A hipertensão arterial pulmonar (HAP) nos felinos é uma desordem incomum e pouco relatada, que pode levar a insuficiência ventricular direita e morte. Na espécie felina, a HAP foi relatada secundariamente a casos de dirofilariose, tromboembolismo pulmonar, e persistência do dueto arterioso. Este relato refere-se a um felino idoso com histórico de cansaço, dispneia e efusão pleural, diagnosticado por meio de ecocardiografia com cardiomiopatia restritiva e hipertensão pulmonar. A cardiomiopatia restritiva pode ter curso insidioso devido à inabilidade dos tutores para reconhecer os sinais clínicos atribuíveis à insuficiência cardíaca. Embora pouco relatada em felinos, é razoável que a exclusão da hipertensão arterial pulmonar faça parte da investigação em gatos com sinais clínicos de descompensação cardiopulmonar.

Feline pulmonary arterial hypertension (PAH) is an unusual and minimally reported condition that can lead to right ventricular insufficiency and death. In cats, PAH was reported in cases in which it was secondary to heartworm disease, pulmonary thromboembolism and patent ductus arteriosus. This is a case report of an elderly domestic cat with medical history of dyspnea, fatigue and pleural effusion, which was diagnosed with restrictive cardiomyopathy and PAH upon echocardiography. The progression of restrictive cardiomyopathy can be silent due to the owners' inability to recognize clinical signs of heart failure. In spite of the few reports in cats, it is reasonable that PAH be part of differential diagnosis on patients presenting signs of cardiopulmonary decompensation.

La hipertensión arterial pulmonar (HAP) en los felinos es una enfermedad poco frecuente y poco relatada que puede llevar a una insuficiencia ventricular derecha y muerte del paciente. En los gatos, la HAP ha sido relatada en casos de dirofilariosis, tromboembolismo pulmonar y persistencia del ducto arterioso. Este trabajo presenta el caso de un felino de edad avanzada con histórico de cansancio, disnea y efusión pleural, en el que se diagnostico una cardiomiopatía restrictiva e hipertensión pulmonar a través de ecocardiografía. La cardiomiopatía restrictiva puede pasar desapercibida debido, en parte, a que los dueños no reconocen los signos clínicos de una insuficiencia cardíaca. A pesar de ser poco relatada en felinos, es razonable que la HAP forme parte del diagnostico diferencial en gatos con signos clínicos de descompensación cardiopulmonar.

Renal capsulotomy associated with omentopexy for treatment of bilateral perinephric abscess in a bitch: case report / Capsulotomia renal associada à omentopexia para tratamento de abcesso perirrenal bilateral em uma cadela: relato de caso

A perinephric abscess is a rare and difficult to treat disease in veterinary medicine. The aim of this paper is to report a case of successful treatment using capsulotomy and omentopexy for bilateral perinephric abscess in a dog.

Abscesso perinéfrico é uma condição rara na medicina veterinária e de difícil tratamento. O objetivo deste trabalho é relatar um caso de sucesso no tratamento de abscesso perinéfrico bilateral em um cão, usando capsulotomia e omentopexia.

Arterial thromboembolism secondary to subaortic stenosis in a persian kitten

Background: Aortic stenosis refers to several types of anatomic and functional obstructions of the left ventricular outflow tract. In small animals, this anomaly is most commonly documented as either a congenital lesion or an obstruction that develops soon after birth. It is a hereditary disease, caused by a dominant autosomal gene and modifying genes that interfere with phenotype expression. Even though aortic thromboembolism may be a potential complication in cats with cardiac diseases, aortic stenosis is deemed rare in that species. In this paper, we report an unusual case of a Persian kitten with aortic stenosis that eventually developed arterial thromboembolism.Case: A 7-month-old Persian kitten (3.1 kg) was admitted to a Veterinary Teaching Hospital with a history of hindlimbs paralysis over the past 48 h, as well as excessive vocalization. Also, the cat presented with inappetence, adipsia, urine incontinence, and hematuria. On physical examination, we observed hypothermia and cold paws. The footpads were cyanotic and there were no palpable femoral pulses. Cardiac auscultation disclosed a regular fast pace (200 bpm) and a grade 2/6 murmur heard best over the left cardiac base, but irradiating to the contralateral hemithorax. Prothrombin time and activated partial thromboplastin time were within the normal reference range, but the complete blood count showed microcytosis, lymphopenia, and hyperproteinemia. Also, elevated alanine aminotransferase and BUN were identified. On the echocardiogram, we observed a subvalvular aortic stenosis, which resulted in concentric remodeling of the left ventricle and a mild left atrial dilation. The stenotic lesion was classified as mild. Also, the thoracic radiography unveiled cardiomegaly. The recommended therapy included atenolol(6.25 mg/cat PO, q24h), clopidogrel (18.7 mg/cat PO, q24h), enoxaparin (1 mg/kg SC, q24 h), methadone (0.2 mg/kg IM, q8h) and amoxicillin + potassium clavulanate (20 mg/kg SC, q12h).[...]

Estenose de valva mitral associada a um trombo na aurícula esquerda em cão / Mitral valve stenosis associated with a left auricle thrombus in a dog

Background: Mitral valve stenosis is a congenital or acquired condition characterized by the narrowing of the orifice of the mitral valve of the heart. It causes flow obstruction and inadequate left ventricular filling, leading to increased left atrial pressure, left atrial and auricle enlargement, pulmonary venous congestion, and left-sided congestive heart failure. Mitral valve stenosis is extremely rare in dogs, and mitral valve stenosis associated with thrombus is even less common in this species. The etiology of thrombus development in mitral valve stenosis in dogs is still not clear. In human beings, mitral valve stenosis associated with thrombus has been related to rheumatic fever. This paper aims to report a case of mitral valve stenosis associated with a left auricle thrombus in a dog.Case: A small mixed-breed, 9-year-old, spayed female dog was received by the emergency service of the veterinary hospital a few hours after a syncopal episode. The dog presented dyspnea, apathy, and appetite loss for a week. At physical examination, the dog had pale and cyanotic mucous membranes, 92 mmHg systolic blood pressure, 7% dehydration, and 36.9°C rectal temperature. Cardiac auscultation revealed tachyarrhythmia and diastolic murmur grade IV/VI on the left cardiac apex. During pulmonary auscultation, bilateral crackles were noted. Electrocardiography showed sinus tachycardia with supraventricular tachycardia episodes, increased P wave amplitude and duration, and increased QRS complex duration. Generalized cardiomegaly was noted in thoracic radiography with enlarged left atrium, left cardiac edge bulging, pulmonary hypertension and congestion signs, as well as areas of pulmonary opacification.[...]

P wave dispersion in obese dogs with and without mitral valve disease / Dispersão da onda P em cães obesos apresentando ou não doença valvar mitral

Pwave dispersion (Pd) is an electrocardiographic index defined as the difference between the minimum and maximum Pwave duration in multiple leads. The augmentation of Pd reflects the discontinuous and inhomogeneous atrial depolarization resulting from cardiac and non-cardiac conditions. In humans, an increased Pd is associated with the development of cardiac arrhythmias, particularly atrial fibrillation. To investigate Pd in obese dogs, we enrolled 76 dogs, which were classified in four distinct categories according to body condition and the existance of valve insufficiency: obese dogs (O), dogs with both obesity and cardiac disease (O+CD), lean dogs with cardiac disease (CD) and healthy controls (H). To be included in the study, all dogs underwent an electrocardiographic and echocardiographic assessment. We reported significantly higher Pd in the animals included in categories O, O+CD and CD (18.0±7.6ms, 16.1±4.4ms, 12.1±4.3ms, respectively) as compared to the healthy subjects (7.3±2.2ms). Also, significant correlations between Pd and both the body mass index and body fat percentage were documented for the obese dogs. However, no association between Pd and LA/Ao could be identified in patients belonging to the O, O+CD and H categories. Thus, we have demonstrated that obese dogs, regardless of their valvular competency status, present high Pd values, suggesting an impaired propagation of atrial electrical impulse.(AU)

A dispersão da onda P (Pd) é um índice eletrocardiográfico definido como a diferença entre as durações máxima e mínima da onda P em múltiplas derivações. O aumento da Pd reflete a despolarização discontínua e não homogênea resultante de condições cardíacas e não cardíacas. Em seres humanos, uma Pdaumentada está associada com o desenvolvimento de arritmias cardíacas, particularmente fibrilação atrial. Com o intuito de investigar a Pd em cães obesos, foram selecionados 76 cães, os quais foram classificados em quatro categorias distintas, de acordo com sua condição corporal e a existência de insuficiência valvar: cães obesos (O), cães com obesidade e doença cardíaca (O+CD), cães magros com doença cardíaca (CD) e cães saudáveis usados como controle (H). Uma vez selecionados para o estudo, todos os cães foram submetidos às avaliações eletrocardiográfica e ecocardiográfica. Os resultados mostraram maior Pd nos animais pertencentes aos grupos O, O+CD e CD (18.0±7.6ms, 16,1±4,4ms, 12,1±4,3ms, respectivamente) quando comparados aos cães saudáveis (7.3±2.2ms). Além disso, foram verificadas correlações significativas entre Pde tanto o índice de massa corporal quanto o percentual de gordura corporal nos cães obesos. Entretanto, não se identificou associação entre Pd e a relação AE/Ao nos pacientes das categorias O, O+CD e H. Dessa forma, foi possível demonstrar que cães obesos, independentemente do estado de competência valvar, apresentam Pd elevada, fato que sugere comprometimento da propagação do impulso elétrico atrial.(AU)

Estenose de valva mitral associada a um trombo na aurícula esquerda em cão / Mitral valve stenosis associated with a left auricle thrombus in a dog

Background: Mitral valve stenosis is a congenital or acquired condition characterized by the narrowing of the orifice of the mitral valve of the heart. It causes flow obstruction and inadequate left ventricular filling, leading to increased left atrial pressure, left atrial and auricle enlargement, pulmonary venous congestion, and left-sided congestive heart failure. Mitral valve stenosis is extremely rare in dogs, and mitral valve stenosis associated with thrombus is even less common in this species. The etiology of thrombus development in mitral valve stenosis in dogs is still not clear. In human beings, mitral valve stenosis associated with thrombus has been related to rheumatic fever. This paper aims to report a case of mitral valve stenosis associated with a left auricle thrombus in a dog.Case: A small mixed-breed, 9-year-old, spayed female dog was received by the emergency service of the veterinary hospital a few hours after a syncopal episode. The dog presented dyspnea, apathy, and appetite loss for a week. At physical examination, the dog had pale and cyanotic mucous membranes, 92 mmHg systolic blood pressure, 7% dehydration, and 36.9°C rectal temperature. Cardiac auscultation revealed tachyarrhythmia and diastolic murmur grade IV/VI on the left cardiac apex. During pulmonary auscultation, bilateral crackles were noted. Electrocardiography showed sinus tachycardia with supraventricular tachycardia episodes, increased P wave amplitude and duration, and increased QRS complex duration. Generalized cardiomegaly was noted in thoracic radiography with enlarged left atrium, left cardiac edge bulging, pulmonary hypertension and congestion signs, as well as areas of pulmonary opacification.[...](AU)