IntroductionAtrial fibrillation secondary to dilated cardiomyopathy (DCM) frequently affects large-breed dogs. The aim of the present study was to identify risk factors for the development of atrial fibrillation in dogs of different breeds with an echocardiographic diagnosis of DCM.MethodsIn this multicenter retrospective study, we searched the electronic databases of five cardiology referral centers for dogs with an echocardiographic diagnosis of DCM. A comparison of clinical and echocardiographic variables was performed between dogs developing atrial fibrillation and those not developing atrial fibrillation and the ability to distinguish between these two groups of dogs was evaluated by receiver operating characteristic curve analysis. Univariate and multivariable logistic regression analysis estimated the odds ratio (OR) with 95% confidence interval (CI) of developing atrial fibrillation.ResultsWe included 89 client-owned dogs with occult and overt echocardiographic DCM. Of these, 39 dogs (43.8%) had atrial fibrillation, 29 dogs (32.6%) maintained a sinus rhythm, and 21 dogs (23.6%) showed other cardiac arrhythmias. Left atrial diameter had high accuracy (area under the curve = 0.816, 95% CI = 0.719–0.890) to predict the development of atrial fibrillation at the cut-off of >4.66 cm. After multivariable stepwise logistic regression analysis, only increased left atrial diameter (OR = 3.58, 95% CI = 1.87–6.87; p < 0.001) and presence of right atrial enlargement (OR = 4.02, 95% CI = 1.35–11.97; p = 0.013) were significant predictors of atrial fibrillation development.DiscussionAtrial fibrillation is a common complication of DCM in the dog and is significantly associated with increased absolute left atrial diameter and right atrial enlargement.
The aim of this report was to describe the clinical findings and therapeutic management of a case of papillary adenocarcinoma of the descending colon in a Beagle. The patient presented soft stools, haematochezia, tenesmus, and dyschezia. Clinical examination revealed alterations on the ultrasonographic features of the descending colon suggestive of colitis and neoplasia. Following local mass resection, histopathology analysis revealed mild lymphoplasmocytic enteritis and papillary adenocarcinoma of the colon. Enterectomy for tumoral resection and biopsy of locoregional lymph nodes were carried out. Subsequent to the surgical procedure, it was possible to confirm the previous diagnosis and the tumor was classified as intestinal intraluminal papillary adenocarcinoma, with incomplete surgical margins. Adjuvant chemotherapy was performed using carboplatin, cyclophosphamide, and piroxicam, leading to remission of clinical signs and absence of any clinical or imaging alterations compatible with the patient's previous clinical condition. Palavras-chave: canino, neoplasia intestinal, oncologia
ResumoO presente trabalho tem como objetivo realizar uma análise dos métodos indiretos da avaliação da pressão da artéria pulmonar com base na literatura científica. Por meio de levantamento bibliográfico, artigos científicos foram selecionados conforme a sua relevância para o tema. A avaliação da pressão da artéria pulmonar permite inferir se o paciente apresenta hipertensão arterial pulmonar (HAP), a qual está associada a um prognóstico ruim em cães. O exame padrão é a cateterização da artéria pulmonar, porém este método não tem Development, v. 9, n. 3, e44932309, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i3.2309 2 sido utilizado na rotina da medicina veterinária porque o quadro clínico do animal comumente não permite a sedação e por se tratar de um procedimento oneroso. O diagnóstico da HAP em pequenos animais por meio da ecodopplercardiografia pode ser obtido com a avaliação da regurgitação da valva tricúspide ou pulmonar, características subjetivas e mensuração do tempo de aceleração (TA) e relação entre o tempo de aceleração e o tempo de ejeção do fluxo pulmonar (TA:TE), relação entre a artéria pulmonar e a veia pulmonar, distensibilidade da artéria pulmonar direita (RPAD), e ainda por avaliação da função do ventrículo direito, principalmente o índice de TEI e o strain. O objetivo desta revisão foi demonstrar as principais técnicas ecocardiográficas para estimar HAP, com o intuito de contribuir com o cardiologista no diagnóstico da HAP. Todas as técnicas apresentam fatores positivos e negativos, porém é importante ressaltar que não existe uma técnica ideal, e a forma mais assertiva de se chegar ao diagnóstico é associando as diversas técnicas. Palavras-chave: Hipertensão Arterial Pulmonar; Índice de Distensibilidade da Artéria Pulmonar Direita; Regurgitação da Pulmonar; Regurgitação da Tricúspide. Abstract This paper aims to perform an analysis of the indirect methods of pulmonary artery pressure assessment based on the scientific literature. Through bibliographic survey, scientific articles were selected according to their relevance to the theme.The assessment of pulmonary artery pressure allows to infer whether the individual has pulmonary arterial hypertension (PAH), which is associated with a poor prognosis in dogs diagnosed with mitral valve degeneration. The standard examination is pulmonary artery catheterization, but this method has not been used in routine veterinary medicine because the clinical status of the animal usually does not allow sedation and it is a costly procedure. The diagnosis of PAH in small animals through Doppler echocardiography can be obtained by evaluating the regurgitation of the tricuspid or pulmonary valve, subjective characteristics and measurement of the acceleration time (AT) and the acceleration time-to-ejection time ratio of pulmonary artery (AT:ET), pulmonary artery-to-pulmonary vein ratio, distensibility of the right pulmonary artery (RAPD), and assessment of right ventricular function, especially TEI index and strain. The aim of this...
Mitral valve disease (MVD) is a progressive disease that can reduce cardiac output. Activation of the sympathetic autonomic nervous system is one of the body's first responses in order to maintain cardiac output, but may have deleterious effects on the cardiovascular system. This study investigated the effect of metoprolol on heart rate variability and quality of life in dogs with severe MVD (stage C, according to the guidelines of the American College of Veterinary Internal Medicine). Eight dogs between nine and thirteen years of age were enrolled and screening tests such as complete blood count, serum biochemistry profile, systolic blood pressure, thoracic radiographs, electrocardiogram, echocardiogram and long-term electrocardiography (24 hours) were performed. The patients were treated with enalapril, furosemide, spironolactone, and pimobendan until considered clinically stable, and metoprolol was then added to the therapy. One month later, all animals were re-assessed. Owners responded to a questionnaire about their dog's quality of life before and after beta-blocker therapy. The value for pNN50 (percentage difference between adjacent N-N intervals more than 50 ms) was significantly higher (P=0.039) after treatment with metoprolol, indicating higher heart rate variability as indicated by the increased parasympathetic component. Furthermore, quality of life was improved in 30% of patients after metoprolol was initiated. The results suggest that treatment with beta-blockers in dogs with stage C MVD may yield additional benefits in comparison to standard CHF treatment.
Pulmonary hypertension (PH) in dogs is a syndrome that can occur secondary to several causes, including left heart disease (postcapillary) and chronic respiratory disease (precapillary). This study evaluates morphological and functional consequences in the right ventricle (RV) of dogs with pre- and postcapillary PH through echocardiography, and also considers the severity of PH (mild, moderate or severe). Echocardiography was performed on 66 dogs of various breeds and weights (age >3 years old) which were assigned to three groups: postcapillary PH, which included mitral valve disease/endocardiosis, precapillary PH, which included chronic respiratory diseases (bronchitis, collapse of the trachea and primary lung cancer or metastasis), and finally, a healthy group of controls. The parameters for RV morphology were RV1, RV2, and RV3 for systole and diastole. The following measurements were used to assess RV systolic function: tricuspid annular plane systolic excursion (TAPSE), TAPSE:Ao (aorta), maximum velocity of the tricuspid systolic wave obtained by tissue Doppler (S’), S’:Ao, right ventricle end-diastolic area (RVEDA); RVEDA:BSA (body surface area); flow velocity integral (FVI) and FVI:Ao. The variables were assessed using ANOVA. The results showed that RV3d, RV1s, S’:Ao, S’, and FVI were able to distinguish cases of pre- and postcapillary PH in this study. Remodeling of the RV of dogs with PH was observed, which can be influenced by the pre- or postcapillary origin of the PH, with dilation in dogs with postcapillary PH and severe PH. The results for RV systolic function were similar, with FVI and FVI:Ao showing that RV ejection function is reduced in dogs with postcapillary PH and with severe PH.
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