Objective—To evaluate sensitivity and specificity of echocardiography for diagnosis of cardiac masses in dogs with pericardial effusion.
Design—Retrospective case series.
Animals—107 dogs with pericardial effusion.
Procedures—Records of dogs with pericardial effusion examined at the University of California-Davis Veterinary Medical Teaching Hospital from 1985 to 2006 were reviewed. Dogs were included when echocardiography and pericardectomy or necropsy were performed. Sensitivity, specificity, and metastatic rates were calculated for various causes of pericardial effusion.
Results—107 dogs with pericardial effusion were evaluated by surgery (n = 48 dogs), necropsy (44), or both (15). Echocardiography revealed no mass (n = 41 dogs), a right atrial (RA) mass (38), a heart base (HB) mass (23), a pericardial mass (2), an HB and an RA mass (2), and a right ventricular mass (1). Sensitivity and specificity were 82% and 100%, respectively, for detection of a cardiac mass; 82% and 99%, respectively, for detection of an RA mass; and 74% and 98%, respectively, for detection of an HB mass. Most HB masses were neuroendocrine or ectopic thyroid gland tissue, but 3 were hemangiosarcomas and 4 were mesotheliomas. Most RA masses were hemangiosarcomas, but this group also included a neuroendocrine tumor, ectopic thyroid gland tissue, mesothelioma, lymphosarcoma, and sarcoma. Metastatic rates did not differ (50% to 66%) among neoplastic causes.
Conclusions and Clinical Relevance—Echocardiography had high sensitivity and specificity for diagnosis and differentiation of RA or HB masses in dogs with pericardial effusion. There was a high rate of metastasis for cardiac masses of all causes.
Objectives—To evaluate clinical, laboratory, and necropsy findings in dogs with infective endocarditis (IE).
Design—Retrospective case series.
Animals—71 dogs with possible or definite IE.
Procedures—Medical records were reviewed for signalment, clinical features, and results of clinicopathologic testing and diagnostic imaging. Yearly incidence and the effect of variables on survival were determined by use of survival curve analysis.
Results—The overall incidence of IE was 0.05%. Most affected dogs were of large breeds, and > 75% were older than 5 years. The aortic valve was affected in 36 of the 71 (51%) dogs, and the mitral valve was affected in 59%. Lameness caused by immune-mediated polyarthritis, septic arthritis, or peripheral arterial thromboembolism was observed in 53% of the dogs. Neurologic complications were diagnosed in 17 of 71 (24%) dogs. Thromboembolic disease was suspected in 31 of 71 (44%) of dogs. The mortality rate associated with IE was 56%, and median survival time was 54 days. Factors negatively associated with survival included thrombocytopenia, high serum creatinine concentration, renal complications, and thromboembolic complications.
Conclusions and Clinical Relevance—A diagnosis of IE should be suspected in dogs with fever, systolic or diastolic murmur, and locomotor problems. Dogs with thrombocytopenia, high serum creatinine concentration, thromboembolism, or renal complications may have a shorter survival time.
Objective—To quantify myocardial contrast enhancement
(MCE) of the left ventricle (LV) by use of cardiac
magnetic resonance imaging (CMRI) in healthy cats
and cats with hypertrophic cardiomyopathy (HCM)
and to compare MCE between the 2 groups.
Animals—10 healthy cats and 26 Maine Coon cats
with moderate to severe HCM but without clinical evidence
of congestive heart failure.
Procedure—Anesthetized cats underwent gradient
echo CMRI examination. Short-axis images of the LV
were acquired before and 7 minutes after IV administration
of gadolinium dimeglumine. Regions of interest
were manually traced in the quadrants of 5 mid-LV
slices acquired at end systole, and the MCE percentage
was calculated from summed weight-averaged
data from all slices. Doppler tissue imaging echocardiography
was performed to measure the early diastolic
myocardial velocity (Em) as an index of diastolic
function. Three-way repeated-measures ANOVA was
used to determine differences in MCE between cats
with HCM and healthy cats. Simple linear regression
was used to assess whether MCE was correlated
with LV mass, LV mass index (LVMI), or Em. A
Student t test was used to compare the SDs of the
postcontrast myocardial signal intensity between the
Results—There was no difference in MCE between
cats with HCM and healthy cats. There was no correlation
of MCE with LV mass, LVMI, or Em. There was
no difference in heterogeneity of signal intensities of
LV myocardium between the 2 groups.
Conclusions and Clinical Relevance—Contrastenhancement
CMRI was not useful in detecting diffuse
myocardial fibrosis in cats with HCM. (Am J Vet
Objective—To evaluate microbiologic findings in dogs with infective endocarditis (IE) and determine whether there were differences in clinical features of disease caused by different groups of infective agents.
Design—Retrospective case series.
Animals—71 dogs with suspected or definite IE.
Procedures—Medical records were reviewed for results of bacterial culture and susceptibility testing, serologic assays for vector-borne disease, and PCR testing on vegetative growths. Cases were grouped by causative organism and relationships among infectious agent group, and various hematologic, biochemical, and clinical variables were determined. Survival analyses were used to determine associations between infecting organisms and outcome.
Results—Causative bacteria were identified in 41 of 71 (58%) dogs. Gram-positive cocci were the causative agents in most (21/41; 51%) infections, with Streptococcus canis associated with 24% of infections. Gramnegative organisms were detected in 9 of the 41 (22%) dogs. Infection with Bartonella spp was detected in 6 of 31 (19%) dogs with negative results for microbial growth on blood culture. Aortic valve involvement and congestive heart failure were more frequent in dogs with endocarditis from Bartonella spp infection, and those dogs were more likely to be afebrile. Infection with Bartonella spp was negatively correlated with survival. Mitral valve involvement and polyarthritis were more frequent in dogs with streptococcal endocarditis.
Conclusions and Clinical Relevance—Streptococci were the most common cause of IE and were more likely to infect the mitral valve and be associated with polyarthritis. Dogs with IE secondary to Bartonella spp infection were often afebrile, more likely to develop congestive heart failure, rarely had mitral valve involvement, and had shorter survival times.
Objective—To develop, validate, and evaluate a questionnaire (Cats’ Assessment Tool for Cardiac Health [CATCH] questionnaire) for assessing health-related quality of life in cats with cardiac disease.
Animals—275 cats with cardiac disease.
Procedures—The questionnaire was developed on the basis of clinical signs of cardiac disease in cats. A CATCH score was calculated by summing responses to questionnaire items; possible scores ranged from 0 to 80. For questionnaire validation, owners of 75 cats were asked to complete the questionnaire (10 owners completed the questionnaire twice). Disease severity was assessed with the International Small Animal Cardiac Health Council (ISACHC) classification for cardiac disease. Following validation, the final questionnaire was administered to owners of the remaining 200 cats.
Results—Internal consistency of the questionnaire was good, and the CATCH score was significantly correlated with ISACHC classification. For owners that completed the questionnaire twice, scores were significantly correlated. During the second phase of the study, the CATCH score ranged from 0 to 74 (median, 7) and was significantly correlated with ISACHC classification.
Conclusions and Clinical Relevance—Results suggested that the CATCH questionnaire is a valid and reliable method for assessing health-related quality of life in cats with cardiac disease. Further research is warranted to test the tool's sensitivity to changes in medical treatment and its potential role as a clinical and research tool.
Objective—To determine signalment, clinical signs,
diagnostic findings, treatment, and outcome for cats
with atrial fibrillation (AF).
Procedure—Medical records of cats that met criteria
for a diagnosis of AF (ECG consisting of at least 2
leads, clear absence of P waves, supraventricular
rhythm, and convincingly irregularly irregular rhythm)
and had undergone echocardiography were reviewed.
Results—There were 41 males (37 castrated) and 9
females (7 spayed). Forty-one were of mixed breeding;
9 were purebred. Mean ± SD age was 10.2 ± 3.7 years.
The most common chief complaints were dyspnea,
aortic thromboembolism, and lethargy. In 11 cats, AF
was an incidental finding. Mean ± SD ventricular rate
was 223 ± 36 beats/min. The most common echocardiographic
abnormalities were restrictive or unclassified
cardiomyopathy (n = 19), concentric left ventricular
hypertrophy (18), and dilated cardiomyopathy (6). Mean
± SD left atrial-to-aortic diameter ratio (n = 39) was 2.55
± 0.80. The most common thoracic radiographic findings
were cardiomegaly, pleural effusion, and pulmonary
edema. Median survival time (n = 24) was 165
days (range, 0 to 1,095 days). Eight of 24 cats lived for
≥ 1 year after a diagnosis of AF was made.
Conclusions and Clinical Relevance—Results suggest
that AF occurs primarily in older adult male cats
with structural heart disease severe enough to lead to
atrial enlargement. Atrial fibrillation in these cats was
most commonly first detected when signs of decompensated
cardiac disease were evident, but also was
commonly identified as an incidental finding. (J Am
Vet Med Assoc 2004;225:256–260)