A 13-year-old 6-kg (13.2-lb) sexually intact female mixed-breed dog was evaluated because of a 2-week history of lethargy and inappetence. On physical examination, the dog was alert and responsive, with a body condition score of 5 on a scale of 1 to 9. Mucous membranes were slightly pale, capillary refill time was < 2 seconds, and rectal temperature was 38.3°C (100.9°F). Mean heart rate was approximately 128 beats/min, and no femoral pulse irregularities were identified. Mucopurulent vulvar discharge was present, and abdominal distension and signs of pain were detected on palpation. Auscultation of the left hemithorax revealed a grade 3/6
A 7-year-old 23-kg (51-lb) sexually intact male English Bulldog was evaluated at the Cardiology Unit of the Veterinary Teaching Hospital of the University of Bologna because of recurrent ascites secondary to right congestive heart failure and ventricular arrhythmias. A presumptive diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC)1 had been made a few months prior on the basis of findings of echocardiography, electrocardiography, and 24-hour Holter monitoring. The dog was currently being treated with torsemidea (0.2 mg/kg [0.09 mg/lb], PO, q 12 h), benazepril hydrochlorideb (0.5 mg/kg [0.23 mg/lb], PO, q 24 h), spironolactonec
A 14-year-old spayed female mixed-breed dog was referred to the Clinica Veterinaria Malpensa because of frequent episodes of syncope (frequency, 1 to 5 episodes/d). At the initial evaluation, the dog appeared mildly depressed. The femoral pulse was bradyarrhythmic with a mean heart rate of 40 beats/min. Results of auscultation of the heart and lungs were considered normal, and no other clinical abnormalities were detected. Thoracic radiographic and echocardiographic findings were also considered normal. Twelve-lead surface ECG (6 peripheral standard leads and 6 precordial leads as previously described1; Figure 1) was performed with the dog placed in
A2-year-old 30-kg (66-lb) sexually intact male Golden Retriever was referred to the Clinica Veterinaria Malpensa because of exercise intolerance and episodic weakness of 1 month's duration. During 1 episode of weakness, an ECG examination performed by the primary veterinarian revealed a narrow-QRS complex tachycardia with a cycle length of 200 milliseconds. The patient was treated with sotalola (2 mg/kg [0.9 mg/lb], PO, q 12 h) to control episodic supraventricular tachycardia and to reduce clinical signs.
At the initial evaluation, a physical examination revealed no abnormalities. Findings of survey thoracic radiography and transthoracic echocardiography were considered normal. An initial
Procedures—Nonsedated cats were positioned in dorsal and left lateral recumbency to obtain ultrasonographic measurements of the gallbladder via the subcostal and right intercostal acoustic windows, respectively. Gallbladder volume was calculated from linear measurements by use of an ellipsoid formula (volume [mL] = length [mm] × height [mm] × width [mm] × 0.52). Measurements were recorded after food was withheld for 12 hours (0 minutes) and at 5, 15, 30, 45, 60, and 120 minutes after cats were fed 50 g of a standard commercial diet (protein, 44.3%; fat, 30.3%; and carbohydrate, 15.6% [dry matter percentage]).
Results—Agreement between gallbladder linear measurements or GBV obtained from the subcostal and right intercostal windows was good. Feeding resulted in linear decreases in gallbladder linear measurements and GBV. Via the subcostal and intercostal windows, mean ± SD GBV was 2.47 ± 1.16 mL and 2.36 ± 0.96 mL, respectively, at 0 minutes and 0.88 ± 0.13 mL and 0.94 ± 0.25 mL, respectively, at 120 minutes. Gallbladder width most closely reflected postprandial modification of GBV.
Conclusions and Clinical Relevance—Results indicated that ultrasonographic assessment (via the subcostal or right intercostal acoustic window) of postprandial changes in GBV can be used to evaluate gallbladder contractility in cats. These data may help identify cats with abnormal gallbladder emptying.
Objective—To evaluate the diagnostic accuracy of radiographically derived measurements of vertebral heart score (VHS) and sphericity index (SI) in the detection of pericardial effusion (PE) in dogs.
Design—Retrospective case-control study.
Animals—51 dogs with PE associated with various cardiac disorders, 50 dogs with left- or right-sided cardiac disorders without PE, 50 dogs with bilateral cardiac disorders without PE, and 50 healthy dogs.
Procedures—Measurements of VHS on lateral (lateral VHS) and ventrodorsal (ventrodorsal VHS) radiographs, SI on lateral (lateral SI) and ventrodorsal (ventrodorsal SI) radiographs, and global SI (mean of lateral SI and ventrodorsal SI) were obtained. Receiver operating characteristic curves were calculated to evaluate the diagnostic accuracy of the radiographic indexes at differentiating dogs with PE from those with other cardiac disorders without PE.
Results—Measurements of lateral and ventrodorsal VHS were significantly higher in dogs with PE, compared with values for all dogs without PE. Measurements of lateral, ventrodorsal, and global SI were significantly lower in dogs with PE, compared with values for all dogs without PE. Cutoff values of > 11.9, > 12.3, and ≤ 1.17 for lateral VHS, ventrodorsal VHS, and global SI, respectively, were the most accurate radiographic indexes for identifying dogs with PE.
Conclusions and Clinical Relevance—Cardiac silhouettes of dogs with PE were larger and more rounded, compared with those of dogs with other cardiac disorders without PE. Objective radiographic indexes of cardiac size and roundness were only moderately accurate at distinguishing dogs with PE from dogs with other cardiac disorders without PE.
To determine variability of global longitudinal strain (GLS) and strain rate (SR) measurements in dogs with and without cardiac disease derived from 2-D speckle tracking echocardiography (STE) by use of various software.
2 cohorts comprising 44 dogs (23 cardiovascularly healthy and 21 with cardiac disease) and 40 dogs (18 cardiovascularly healthy and 22 with cardiac disease).
Transthoracic echocardiographic images in each cohort were analyzed with vendor-independent software and vendor-specific 2-D STE software for each of 2 vendors. Values for GLS and SR obtained from the same left parasternal apical views with various software were compared. Intraobserver and interobserver variability was determined, and agreement among results for the various software was assessed.
Strain analysis was not feasible with vendor-independent software for 20% of images obtained with the ultrasonography system of vendor 1. Intraobserver and interobserver coefficient of variation was < 10% for GLS values, whereas SR measurements had higher variance. There was a significant difference in GLS and SR obtained for each cohort with different software. Evaluation of Bland-Altman plots revealed wide limits of agreement, with variance for GLS of up to 6.3 units in a single dog.
CONCLUSIONS AND CLINICAL RELEVANCE
Results of longitudinal strain analysis were not uniform among software, and GLS was the most reproducible measurement. Significant variability in results among software warrants caution when referring to reference ranges or comparing serial measurements in the same patient because changes of < 6.5% in GLS might be within measurement error for different postprocessing software.
OBJECTIVE To determine the sensitivity, specificity, and interobserver variability of survey thoracic radiography (STR) for the detection of heart base masses (HBMs) in dogs.
DESIGN Retrospective case-control study.
ANIMALS 30 dogs with an HBM and 120 breed-matched control dogs (60 healthy dogs and 60 dogs with heart disease and no HBM).
PROCEDURES In a blinded manner, 2 observers (designated as A and B) evaluated STR views from each dog for a mass-like opacity cranial to the heart, tracheal deviation, cardiomegaly, findings suggestive of pericardial effusion or right-sided congestive heart failure, and soft tissue opacities suggestive of pulmonary metastases. Investigators subsequently provided a final interpretation of each dog's HBM status (definitely affected, equivocal, or definitely not affected).
RESULTS Considering equivocal interpretation as negative or positive for an HBM, the sensitivity of STR for diagnosis of an HBM was 40.0% (95% confidence interval [CI], 22.5% to 57.5%) and 56.7% (95% CI, 38.9% to 74.4%), respectively, for observer A and 63% (95% CI, 46.1% to 80.6%) and 80.0% (95% CI, 65.7% to 94.3%), respectively, for observer B. The corresponding specificity was 96.7% (95% CI, 93.5% to 99.9%) and 92.5% (95% CI, 87.8% to 97.2%), respectively, for observer A and 99.2% (95% CI, 97.5% to 100%) and 92.5% (95% CI, 87.8% to 97.2%), respectively, for observer B. The presence of a mass-like opacity cranial to the heart or tracheal deviation, or both, was significantly associated with a true diagnosis of HBM.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that STR is a highly specific but not a highly sensitive predictor of HBM in dogs.
OBJECTIVE To compare stroke volume (SV) calculated on the basis of cardiac morphology determined by MRI and results of phase-contrast angiography (PCA) of ventricular inflow and outflow in dogs.
ANIMALS 10 healthy Beagles.
PROCEDURES Cardiac MRI was performed twice on each Beagle. Cine gradient echo sequences of both ventricles in short-axis planes were used for morphological quantification of SVs by assessment of myocardial contours. From the long-axis plane, SVs in 4-chamber and left ventricular 2-chamber views were acquired at end diastole and end systole. For calculation of SV on the basis of blood flow, PCA was performed for cardiac valves.
RESULTS Mean ± SD values for SV quantified on the basis of blood flow were similar in all valves (aortic, 17.8 ± 4.1 mL; pulmonary, 17.2 ± 5.4 mL; mitral, 17.2 ± 3.9 mL; and tricuspid, 16.9 ± 5.1 mL). Morphological quantification of SV in the short-axis plane yielded significant differences between left (13.4 ± 2.7 mL) and right (8.6 ± 2.4 mL) sides. Morphological quantification of left ventricular SV in the long-axis plane (15.2 ± 3.3 mL and 20.7 ± 3.8 mL in the 4- and 2-chamber views) yielded variable results, which differed significantly from values for flow-based quantification, except for values for the morphological 4-chamber view and PCA for the atrioventricular valves, for which no significant differences were identified.
CONCLUSIONS AND CLINICAL RELEVANCE In contrast to quantification based on blood flow, calculation on the basis of morphology for the short-axis plane significantly underestimated SV, probably because of through-plane motion and complex right ventricular anatomy.