Taurine deficiency and dilated cardiomyopathy in golden retrievers fed commercial diets.

INTRODUCTION: Golden retrievers are over-represented in cases of taurine-deficient dilated cardiomyopathy and recently a surge in cases has prompted further investigation. OBJECTIVE: To describe the clinical, dietary, and echocardiographic features in golden retrievers diagnosed with taurine deficiency and dilated cardiomyopathy, and to determine specific dietary associations. A second aim was to determine the whole blood taurine concentrations in a representative sample of healthy golden retrievers. ANIMALS: Twenty-four client-owned golden retrievers with documented taurine deficiency and dilated cardiomyopathy and 52 healthy client-owned golden retrievers. METHODS: In this multicenter prospective observational study, baseline and follow-up echocardiographic data, complete diet and medical histories, and whole blood, plasma, or serum taurine concentrations were obtained. Baseline and follow-up echocardiographic data were compared. Associations were evaluated between specific diets and taurine deficiency or congestive heart failure. The prevalence of low whole blood taurine concentrations in the healthy golden retrievers was calculated. RESULTS: Twenty-three of 24 dogs diagnosed with taurine deficiency and dilated cardiomyopathy were fed diets that were either grain-free, legume-rich, or a combination of these factors. None of these diets were feeding trial tested using Association of American Feed Control Officials (AAFCO) procedures. Twenty-three of 24 dogs had significant improvement in their echocardiographic parameters and normalization of taurine concentrations following diet change and taurine supplementation. Nine of 11 dogs diagnosed with congestive heart failure (CHF) had resolution of their congestion at follow-up with five no longer requiring diuretic therapy and four tolerating diuretic dose reduction by >50%. CONCLUSIONS: Certain diets and diet characteristics were associated with the development of taurine deficiency. Taurine deficiency and dilated cardiomyopathy in golden retrievers is likely multifactorial, including a combination of dietary, metabolic, and genetic factors.

Correction: Taurine deficiency and dilated cardiomyopathy in golden retrievers fed commercial diets.

[This corrects the article DOI: 10.1371/journal.pone.0209112.].

Effect of torsemide and furosemide on clinical, laboratory, radiographic and quality of life variables in dogs with heart failure secondary to mitral valve disease.

OBJECTIVES: Diuretic therapy reduces preload and relieves congestion secondary to cardiac dysfunction. Torsemide (torasemide) is a loop diuretic with longer duration of action, decreased susceptibility to diuretic resistance, and adjunctive aldosterone antagonist properties compared with furosemide. We hypothesized that torsemide would be well tolerated and no less effective than furosemide at diuresis, control of clinical signs, and maintenance of quality of life (QOL) in dogs with congestive heart failure (CHF). ANIMALS, MATERIALS AND METHODS: Seven client-owned dogs with stable CHF receiving twice daily oral furosemide and adjunctive medications. Utilizing a double-blinded, randomized, crossover design, dogs were administered either oral furosemide at their current dose or an equivalent oral dose of torsemide (1/10 of the daily furosemide dose divided into twice daily dosing) on day 0. Crossover occurred at day 7 and the study ended on day 14. Clinical, laboratory, radiographic, and QOL variables were evaluated on days 0, 7 and 14. RESULTS: No dogs developed recurrent CHF during the study. Mean furosemide dose on day 0 was 5.13 mg/kg/day (range 2.8-9.6). Following torsemide treatment, creatinine (P = 0.020), urea nitrogen (P = 0.013), phosphorus (P = 0.032), albumin (P = 0.019), carbon dioxide (P = 0.015) and anion gap (P = 0.005) were significantly increased, and urine specific gravity (P = 0.004) and chloride (P = 0.021) were significantly decreased compared with furosemide dosing. No differences in QOL were found. CONCLUSIONS: Results indicate that torsemide is equivalent to furosemide at controlling clinical signs of CHF in dogs and is likely to achieve greater diuresis vs. furosemide. Larger clinical trials evaluating torsemide as a first or second-line loop diuretic for congestive heart failure in dogs are warranted.

Use of the loop diuretic torsemide in three dogs with advanced heart failure.

Diuretics are a mainstay of therapy in dogs with heart failure. In dogs with advanced heart failure, moderate to high doses of loop diuretics such as furosemide are used with diminishing effects as profound activation of neuroendocrine systems promote signs of congestive heart failure. The loop diuretic torsemide has several characteristics that make it suitable for treatment of advanced heart failure including longer half-life, increased potency of diuretic action, and anti-aldosterone effects. This case report details the administration of torsemide in 3 dogs with advanced heart failure and apparent furosemide resistance.

Cardiac troponin-I concentrations in dogs with bradyarrhythmias before and after artificial pacing.

OBJECTIVES: To quantify cardiac troponin-I (cTnI) concentration in dogs with symptomatic bradyarrhythmias before and after artificial pacing and to correlate cTnI concentration with diagnosis, echocardiographic parameters, serology, and outcome. ANIMALS, MATERIALS AND METHODS: Medical records from the University of Pennsylvania from 2006 to 2009 were reviewed, and 14 dogs with cTnI assay results before and after pacemaker were identified. The ECG diagnosis included complete atrioventricular block (AVB), sick sinus syndrome, 2nd degree AVB, and atrial standstill. Serology, presence of premature beats, echocardiographic measurements, and pacing modality were recorded. RESULTS: Mean cTnI concentration was elevated both pre- and post-pacing, and was significantly higher pre-pacing vs. post-pacing. Post-pacing cTnI concentration in 9 of 14 dogs (64%) remained above the reference range. Four dogs yielded high serum titers for Bartonella spp. Four dogs with markedly increased cTnI concentration had progressive left ventricular enlargement and myocardial failure as compared to pre-pacing examination. CONCLUSIONS: Elevated cTnI concentration suggests that cardiac injury persists after artificial pacing in dogs with bradyarrhythmias. Myocarditis secondary to Bartonella spp. or other causes may be an important cause of AVB in dogs. Prospective studies investigating the correlation of cTnI to potential etiology and development of post-pacing LV dysfunction and outcome are needed.

Diagnosis and treatment of congestive heart failure secondary to hypertrophic cardiomyopathy in a kinkajou (Potos flavus).

An adult castrated male pet kinkajou (Potos flavus) presented with dyspnea due to congestive heart failure and was diagnosed with hypertrophic cardiomyopathy (HCM) and suspected pulmonary arterial hypertension. Diagnosis was based on history, clinical signs, clinical pathology, radiographs, abdominal ultrasonography, abdominal fluid analysis, electrocardiography, and echocardiogram. An undetermined hepatopathy also was found at presentation and resolved after metronidazole antimicrobial treatment. Cardiopulmonary medical treatment, including a loop diuretic, an angiotensin-converting enzyme inhibitor, a beta-adrenergic receptor blocker, and a bronchodilator provided improvement of the clinical signs. To the best of our knowledge, this is the first reported case of antemortem diagnosis and treatment of congestive heart failure and cardiomyopathy in a member of the family Procyonidae, suggesting that HCM should be considered as a differential diagnosis in kinkajous displaying clinical signs of dyspnea and exercise intolerance.

Acquired atrial septal defects secondary to rupture of the atrial septum in dogs with degenerative mitral valve disease.

Acquired atrial septal defects (ASDs) secondary to atrial septal rupture are uncommon in dogs with degenerative mitral valve disease. Echocardiographic diagnosis of these defects has not previously been described. The echocardiographic features in two cases identified antemortem are presented in this report. ASDs can be difficult to identify on two-dimensional echocardiogram when relatively small in size and may be underreported. Acquired ASDs may alter the physiology, treatment plan and prognostic implications for the dogs in which they occur and their presence should be considered in all cases of degenerative mitral valve disease that develop signs of right-sided heart failure.

Association of periodontal disease, oral procedures, and other clinical findings with bacterial endocarditis in dogs.

OBJECTIVE: To identify risk factors potentially associated with the development of bacterial endocarditis in dogs and determine whether periodontal disease and surgical procedures (oral and nonoral) were associated with bacterial endocarditis. DESIGN: Retrospective case-control study. ANIMALS: 76 dogs with (cases) and 80 dogs without (controls) bacterial endocarditis. PROCEDURES: Medical records were reviewed for information on signalment, physical examination findings, recent medical history, and results of echocardiography, clinicopathologic testing, and necropsy. RESULTS: None of the dogs with endocarditis had a history of undergoing any dental or oral procedure in the 3 months prior to the diagnosis of endocarditis, and no significant difference was found between groups with regard to the prevalence of oral infection. Dogs with endocarditis were significantly more likely to have undergone a nonoral surgical procedure that required general anesthesia in the preceding 3 months or to have developed a new heart murmur or a change in intensity of an existing heart murmur. Preexisting cardiac dis-ease (congenital or acquired) was not found to be a risk factor. CONCLUSIONS AND CLINICAL RELEVANCE: Results did not provide any evidence of an association between bacterial endocarditis in dogs and either dental or oral surgical procedures or oral infection. Findings suggested that the routine use of prophylactic antimicrobial administration in dogs undergoing oral procedures needs to be reevaluated.

Gerbode type defect and third degree atrioventricular block in association with bacterial endocarditis in a dog.

Gerbode type defects are rare left ventricular outflow tract-right atrial communications in people that may be congenital or acquired; they have been reported only once previously in dogs. Acquired forms in humans have been reported secondary to bacterial endocarditis, trauma, and valve replacement surgery, among other causes. We report a case of left ventricular outflow tract to right atrium and right ventricle communications (Gerbode type defect) in association with aortic and tricuspid valve bacterial endocarditis in a geriatric dog. The dog also developed third degree atrioventricular block and had underlying subaortic stenosis. The authors hypothesize that the Gerbode type defect in this case was acquired secondary to invasion and destruction of the membranous interventricular septum due to bacterial endocarditis.