Successful closure of left-to-right patent ductus arteriosus in three dogs with concurrent pulmonary hypertension

Seibert, Rachel; Maisenbacher, Herbert W.; Prosek, Robert A.; Adin, Darcy B.; Arsenault, Wendy G.; Estrada, Amara H.

doi:10.1016/j.jvc.2009.12.002

Cited by 14 publications

(13 citation statements)

References 19 publications

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“…Closure will not be possible if PVR exceeds systemic vascular resistance. In some cases, shunt flow may reverse (ie, become left‐to‐right) after administration of a pulmonary artery vasodilator, thus permitting safer closure or occlusion of the shunt . However, a pulmonary artery vasodilator might induce pulmonary edema in some dogs in this scenario if they have “reactive” or “responsive” pulmonary arteries (or arterioles) and substantial irreversible PVD has not developed.…”

Section: Treatmentmentioning

confidence: 99%

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs

Reinero

Visser

Kellihan

et al. 2020

Veterinary Internal Medicne

179

383

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Pulmonary hypertension (PH), defined by increased pressure within the pulmonary vasculature, is a hemodynamic and pathophysiologic state present in a wide variety of cardiovascular, respiratory, and systemic diseases. The purpose of this consensus statement is to provide a multidisciplinary approach to guidelines for the diagnosis, classification, treatment, and monitoring of PH in dogs. Comprehensive evaluation including consideration of signalment, clinical signs, echocardiographic parameters, and results of other diagnostic tests supports the diagnosis of PH and allows identification of associated underlying conditions. Dogs with PH can be classified into the following 6 groups: group 1, pulmonary arterial hypertension; group 2, left heart disease; group 3, respiratory disease/hypoxia; group 4, pulmonary emboli/pulmonary thrombi/pulmonary thromboemboli; group 5, parasitic disease (Dirofilaria and Angiostrongylus); and group 6, disorders that are multifactorial or with unclear mechanisms. The approach to treatment of PH focuses on strategies to decrease the risk of progression, complications, or both, recommendations to target underlying diseases or factors contributing to PH, and PH‐specific treatments. Dogs with PH should be monitored for improvement, static condition, or progression, and any identified underlying disorder should be addressed and monitored simultaneously.

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Section: Treatmentmentioning

confidence: 99%

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs

Reinero

Visser

Kellihan

et al. 2020

Veterinary Internal Medicne

179

383

View full text Add to dashboard Cite

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“…From the total number of studies evaluated, 30 were excluded due to the fact that they were literature reviews, 13 were letters and 10 were meeting abstracts. Papers by Lee et al (2010) and Seibert et al (2010), despite having been obtained in the search, were excluded because the main objective in these studies was not to evaluate the efficacy of sildenafil in the treatment of PH.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of sildenafil therapy for pulmonary hypertension in dogs: a systematic review

Silva¹,

Oberlender²,

Mantovani³

et al. 2014

Arch. med. vet.

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RESUMENEl objetivo de esta revisión sistemática fue evaluar la eficacia del sildenafil en el tratamiento de la hipertensión pulmonar (HP) en perros y, cuando posible, proponer recomendaciones a favor o en contra de su uso. Se realizaron búsquedas electrónicas en seis bases de datos internacionales. El criterio de inclusión fue estudios clínicos in vivo que evaluaron la eficacia del sildenafil en el tratamiento de la HP de origen natural. El sistema de clasificación se diseñó para considerar aspectos como la forma de distribución y enmascaramiento de los tratamientos experimentales, número de animales empleados, asociación con otros medicamentos, métodos de diagnóstico para HP, evaluaciones de la respuesta clínica al tratamiento y efectos adversos. Un total de cinco artículos fueron obtenidos. En general, la condición clínica y la calidad de vida de los animales mejoraron después de la terapia con el sildenafil, y la incidencia de efectos adversos fue poco común. Los hallazgos ecocardiográficos proporcionaron evidencia de cambios en la presión arterial pulmonar que podrían asociarse con alteraciones en la actividad física y tiempo de supervivencia. Aún así, la calidad metodológica de los estudios fue baja, ya que sólo un estudio fue un ensayo clínico al azar, placebo-controlado y doble ciego. Con poca evidencia, este estudio permitió establecer que el sildenafil es una terapia importante que puede tener un papel terapéutico positivo en el tratamiento de HP canina. Se recomienda realizar estudios prospectivos al azar, ciegos y controlados con un mayor número de animales para evaluar la actividad física y los efectos adversos del sildenafil y otras drogas, así como la eficacia de este medicamento en perros.Palabras clave: caninos, enfermedad pulmonary, terapia, sildenafil. SUMMARYThis systematic review aimed to assess the efficacy of sildenafil in the treatment of pulmonary hypertension (PH) in dogs and, when possible, to propose recommendations for or against its use. Electronic searches were carried out using six international databases. The inclusion criterion was in vivo clinical trials that assessed the efficacy of sildenafil in the treatment of naturally occurring PH. The scoring system was designed to take into account aspects such as the form of distribution and masking of experimental treatments, the number of animals, association with other drugs, diagnostic methods for PH, evaluations of the clinical response to treatment and adverse effects. A total of five papers were found. In general, the clinical condition and quality of life of the animals improved after sildenafil therapy, and the occurrence of adverse effects was uncommon. Echocardiographic findings provided evidence for changes in pulmonary arterial pressure which could be associated with alterations in physical activity and survival time. Still, the methodological quality of the studies was low, only one of them was a randomised, placebo-controlled and double-blind clinical trial. Furthermore, with modest evidence, this study allowed the recomm...

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“…In the presence of complete right-to-left flow, occlusion of the ductus is contraindicated. However, positive outcomes have been reported in dogs with left-to-right flow and moderate to severe pulmonary hypertension (Seibert and others 2010). …”

Section: Discussionmentioning

confidence: 99%

Case example: Patent ductus arteriosus in a Shetland Sheepdog

Borgeat¹

2012

In Practice

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Signalment, presentation, history and clinical examination A five-month-old entire female Shetland Sheepdog was referred for investigation of a loud heart murmur that had been incidentally detected at the time of primary vaccination. No exercise intolerance, tachypnoea, cough, syncope or other clinical signs of disease were reported. Its appetite, thirst, behaviour and growth were considered normal. On presentation, the dog was bright and alert. It weighed 6•35 kg and had a body condition score of 5/9. The mucous membranes were pink and moist, with a vigorous capillary refill time of one second. The respiratory rate was 28 breaths per minute at rest and effort was normal. Thoracic palpation detected a palpable thrill in the region of the left heart base. Auscultation revealed a continuous grade V/VI heart murmur, with a point of maximum intensity dorsal to the left base, beneath the caudal aspect of the triceps muscle. It radiated widely but in places only the systolic component was audible. Pulmonary auscultation was unremarkable and the femoral and peripheral pulse character was hyperkinetic. The rectal temperature was normal at 38•2°C.

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Successful closure of left-to-right patent ductus arteriosus in three dogs with concurrent pulmonary hypertension

Cited by 14 publications

References 19 publications

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs

Efficacy of sildenafil therapy for pulmonary hypertension in dogs: a systematic review

Case example: Patent ductus arteriosus in a Shetland Sheepdog

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