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Abstract

Objective

To develop a protocol for reliably inducing atrioventricular (AV) block (ideally first- or second-degree), using radiofrequency energy.

Design

An electrosurgical unit was coupled to an ammeter, which was connected to the distal pole of an electrode catheter positioned at the AV node. Control settings had previously been calibrated to the power output in a circuit with a 100-ohm resistance.

Animals

10 clinically normal dogs.

Procedure

Transcatheter AV nodal modification was attempted, using progressive power applications of 10 to 20 W for progressive durations of 10 to 30 seconds. Atrioventricular nodal conduction and refractivity were measured before and 20 minutes and 1 month after ablation. Electrocardiograms were monitored throughout the 1-month period.

Results

Eight of the 10 dogs developed complete AV block, 1 developed stable 2:1 AV block, and another had no long-term change in AV nodal conduction. Four dogs attained their maximal degree of AV block in 2 to 5 days. Three of these had no AV nodal conduction changes until 2 to 4 days after ablation.

Conclusions

An electrosurgical unit can be economically modified for radiofrequency transcatheter ablation. Stable, incomplete AV block was rarely induced using this protocol, whereas complete AV block often developed. A major finding was frequent delay between energy delivery to the AV nodal region and induction of AV block.

Clinical Relevance

Induction of complete AV block using this technique, followed by permanent pacemaker placement, is an effective alternative to long-term antiarrhythmic treatment in animals with chronic atrial arrhythmias. Transcatheter ablation could be used to treat other forms of tachycardia, as it is in human medicine.

Free access
in American Journal of Veterinary Research

Objective—

To evaluate results of a combined dexa-methasone suppression/thyrotropin-releasing hormone (TRH) stimulation test in horses suspected clinically to have a pars intermedia pituitary adenoma (PIPA).

Design—

Case-control study.

Animals—

7 healthy adult horses and 5 horses suspected to have a PIPA.

Procedure—

A baseline blood sample was collected, and dexamethasone (40 μg/kg [18 μg/lb] of body weight, IV) was administered; a second blood sample was collected 3 hours later, and TRH (1.1 mg, IV) was administered; serial blood samples were collected 15, 30, 45, 60, and 90 minutes and 21 hours after TRH administration (24 hours after dexamethasone injection). Cortisol concentration was determined for all blood samples.

Results—

Baseline Cortisol concentration was significantly lower in horses suspected to have a PIPA than in healthy horses. Cortisol concentration was suppressed by dexamethasone in both groups; however, after TRH administration, Cortisol concentration returned to baseline values in horses suspected to have a PIPA, but not in healthy horses. Concentration was still less than the baseline value 24 hours after dexamethasone administration in healthy horses.

Clinical Implications—

The combined dexamethasone suppression/TRH stimulation test may be a useful diagnostic test in horses suspected to have a PIPA. For clinical application, collection of a blood sample 30 minutes after TRH administration is recommended. (J Am Vet Med Assoc 1997;211:79–81)

Free access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine whether substantial interobserver variation exists among diagnostic pathologists for descriptions of intestinal mucosal cell populations and whether histopathologic descriptions accurately predict when a patient does not have clinically evident intestinal disease.

Design—Comparative survey.

Sample Population—14 histologic slides of duodenal, ileal, or colonic tissue from 10 dogs and 3 cats.

Procedure—Each histologic slide was evaluated independently by 5 pathologists at 4 institutions. Pathologists, who had no knowledge of the tissues' origin, indicated whether slides were adequate for histologic evaluation and whether the tissue was normal or abnormal. They also identified the main infiltrating cell type in specimens that were considered abnormal, and whether infiltrates were mild, moderate, severe, or neoplastic.

Results—Quality of all slides was considered adequate or superior by at least 4 of the 5 pathologists. For intensity of mucosal cellular infiltrates, there was uniformity of opinion for 1 slide, near-uniformity for 6 slides, and nonuniformity for 7 slides. Five dogs did not have clinical evidence of intestinal disease, yet the pathologists' descriptions indicated that their intestinal tissue specimens were abnormal.

Conclusions and Clinical Relevance—Substantial interobserver variation was detected. Standardization of pathologic descriptions of intestinal tissue is necessary for meaningful comparisons with published articles. Clinicians must be cautious about correlating clinical signs and histopathologic descriptions of intestinal biopsy specimens. (J Am Vet Med Assoc 2002;220:1177–1182)

Full access
in Journal of the American Veterinary Medical Association