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Abstract

CASE DESCRIPTION

A 5-year-old 4.1-kg (9.0-lb) spayed female Toy Poodle was referred because of a 6-month history of sporadic signs of neck pain.

CLINICAL FINDINGS

Diagnostic imaging with MRI and CT revealed a dilated radicular artery connecting the right and left vertebral arteries and causing mild compression of the spinal cord. The left subclavian artery caudal to the origin of the left vertebral artery was absent. Subclavian steal syndrome (SSS) was suspected.

TREATMENT AND OUTCOME

The owner declined surgical treatment; thus, the dog was treated conservatively with glucocorticoids and analgesics. Eight months later, the dog’s clinical signs were unchanged but palliated with the administration of glucocorticoids and analgesics, and 4-dimensional (4-D) magnetic resonance angiography (MRA) revealed that the left vertebral artery received blood supply from the right vertebral artery through the dilated radicular artery and that the left vertebral artery caudal to this site had retrograde flow and drained into the left subclavian artery, confirming the diagnosis of SSS. The owner again declined surgery, and conservative treatment continued. The dog’s condition was unchanged at the last follow-up communication 11 months after 4-D MRA.

CLINICAL RELEVANCE

Subclavian steal syndrome is an extremely rare condition in dogs, and our findings suggested that 4-D MRA could be used to definitively diagnose SSS in dogs.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To determine repeatability, reproducibility, and reference intervals of indices of right atrial longitudinal strain (RALS) derived from speckle-tracking echocardiography (STE) in dogs without heart disease.

ANIMALS

110 client-owned dogs and 10 laboratory Beagles.

PROCEDURES

To determine intraobserver within-day (repeatability) and interobserver (reproducibility) coefficients of variation, RALS during ventricular systole (εS), ventricular early diastole (εE), and atrial systole (εA), as derived with STE, were obtained by 2 investigators for 5 randomly selected client-owned dogs and analyzed by linear regression. Reference intervals were estimated from the results of all dogs. Correlations between RALS indices (εS, εE, and εA) and sex, age, body weight, heart rate, and blood pressure were determined.

RESULTS

RALS derived from STE showed good intraobserver within-day repeatability and interobserver reproducibility, with coefficients of variation of < 20%. Both εS and εE were significantly negatively correlated with age, but εA was not correlated with age. Indices were not correlated with sex, body weight, or blood pressure.

CONCLUSIONS AND CLINICAL RELEVANCE

RALS indices derived from STE were repeatable and reproducible and were affected by the age of dogs without heart disease. Age should be considered in the interpretation of RALS indices in clinical settings. Further studies are needed to apply RALS indices for assessing dogs with heart disease.

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in American Journal of Veterinary Research

A 14-year-old 7.2-kg (15.8-lb) spayed female West Highland White Terrier with previously diagnosed sick sinus syndrome (SSS), idiopathic pulmonary fibrosis, and right-sided congestive heart failure underwent a routine recheck examination (day 0). All of these diseases had been concomitantly identified 2 years earlier as causes of chronic mild physical inactivity, coughing, dyspnea, and ascites. The dog's physical activity level and ascites had partially improved as a result of treatment with enalapril maleate (0.31 mg/kg [0.14 mg/lb], PO, q 24 h), pimobendan (0.31 mg/kg, PO, q 12 h), furosemide (1.3 mg/kg [0.59 mg/lb], PO, q 12 h), spironolactone (0.80 mg/kg [0.36

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To determine the effects of IV administration of pimobendan on hemodynamic indices and indices of left atrial (LA) longitudinal strain by speckle-tracking echocardiography in healthy dogs.

ANIMALS

6 healthy Beagles.

PROCEDURES

After the dogs were anesthetized, the right heart was catheterized and 2-D conventional and speckle-tracking echocardiography were performed before and after IV administration of 0.15 mg of pimobendan/kg. Speckle-tracking echocardiography was performed to assess the 3 LA phasic functions through LA deformation (longitudinal strain and strain rate) and volumetric analyses.

RESULTS

Pimobendan significantly increased stroke volume and cardiac output and decreased systemic vascular resistance. Pimobendan significantly improved left ventricular function assessed by the Tei index and LA booster pump function assessed by LA longitudinal strain and change in fractional volume during atrial systole. Indices of LA reservoir and conduit function were unchanged.

CONCLUSIONS AND CLINICAL RELEVANCE

In healthy dogs, IV administration of pimobendan improved the indices of LA booster pump function but had no effect on the indices of LA reservoir and conduit functions. Further studies are needed to validate whether these results can be extrapolated to dogs with myxomatous mitral valve disease.

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in American Journal of Veterinary Research

Abstract

OBJECTIVE

To assess liver and spleen stiffness in healthy dogs by use of a novel 2-D shear wave elastography (SWE) technique and to investigate the repeatability and reproducibility of the technique.

ANIMALS

8 healthy adult Beagles.

PROCEDURES

2-D SWE was performed on each dog to assess liver and spleen stiffness. Repeatability (intraday variability) and reproducibility (interday variability) of 2-D SWE were investigated. For all 8 dogs, 2-D SWE was performed 3 times in 1 day (4-hour intervals) and on 3 separate days (1-week interval). Data were expressed as mean ± SD values for shear wave velocity and the Young modulus in the liver and spleen. Intraday and interday coefficients of variation were assessed for all variables.

RESULTS

Mean ± SD shear wave velocity obtained for the liver and spleen was 1.51 ± 0.08 m/s and 2.18 ± 0.27 m/s, respectively. Mean value for the Young modulus obtained for the liver and spleen was 6.93 ± 0.79 kPa and 14.66 ± 3.79 kPa, respectively. Elasticity values were significantly higher for the spleen than for the liver. Intraday and interday coefficients of variation for all variables were < 25% (range, 3.90% to 20.70%).

CONCLUSIONS AND CLINICAL RELEVANCE

2-D SWE was a feasible technique for assessing liver and spleen stiffness of healthy dogs. Future studies on the application of 2-D SWE for dogs with chronic hepatitis, cirrhosis, and portal hypertension are needed to evaluate the clinical applicability of 2-D SWE.

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in American Journal of Veterinary Research

Abstract

OBJECTIVE To evaluate the effects of dobutamine, esmolol, milrinone, and phenylephrine on left atrial phasic function of healthy dogs.

ANIMALS 9 healthy Beagles.

PROCEDURES Following sedation with propofol on each of 4 experimental days, dogs were administered a constant rate infusion of dobutamine (5 μg/kg/min), esmolol (500 μg/kg/min), milrinone (25 μg/kg, IV bolus, followed by 0.5 μg/kg/min), or phenylephrine (2 μg/kg/min). There was at least a 14-day interval between experimental days. Each drug was administered to 6 dogs. Conventional and 2-D speckle tracking echocardiography were performed before (baseline) and after administration of the cardiovascular drug, and time–left atrial area curves were derived to calculate indices for left atrial reservoir, conduit, and booster pump functions (left atrial phasic function) and left ventricular contractility and lusitropy.

RESULTS Compared with baseline values, indices for left atrial reservoir and booster pump functions and left ventricular contractility and lusitropy were significantly increased following dobutamine administration; indices for left atrial phasic function and left ventricular lusitropy were changed insignificantly, and indices for left ventricular contractility were significantly impaired following esmolol administration; indices for left atrial phasic function and left ventricular relaxation were changed insignificantly, and indices for left ventricular systolic function were significantly augmented following milrinone administration; and indices for left atrial phasic function and left ventricular lusitropy were changed insignificantly, and indices of ventricular contractility were significantly impaired following phenylephrine administration.

CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that, following administration of dobutamine, esmolol, milrinone, or phenylephrine to healthy dogs, left atrial phasic function indices were fairly stable and did not parallel changes in left ventricular function indices.

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in American Journal of Veterinary Research

Abstract

OBJECTIVE

To investigate the association between changes in cerebral blood flow and electrographic epileptic seizure in dogs using transcranial Doppler ultrasonography (TCD).

ANIMALS

6 healthy Beagle dogs.

PROCEDURES

Each dog was administered pentetrazol (1.5 mg/kg/min) or saline (0.9% NaCl) solution under general anesthesia with continuous infusion of propofol. Both pentetrazol and saline solution were administered to all 6 dogs, with at least 28 days interval between the experiments. Blood flow waveforms in the middle cerebral artery and the basilar artery were obtained using TCD at baseline, after pentetrazol administration, and after diazepam administration. TCD velocities, including peak systolic velocity, end-diastolic velocity, and mean velocity and resistance variables, were determined from the Doppler waveforms.

RESULTS

During ictal-phase of pentetrazol-induced seizures, the TCD velocities significantly increased in the basilar and middle cerebral arteries while TCD vascular resistance variables did not change in either artery. The TCD velocities significantly decreased after diazepam administration. Systemic parameters, such as the heart rate, mean arterial pressure, systemic vascular resistance, cardiac index, end-tidal carbon dioxide, oxygen saturation, and body temperature, did not change significantly during seizures.

CLINICAL RELEVANCE

This study showed that cerebral blood flow, as obtained from TCD velocities, increased by 130% during ictal-phase of pentetrazol-induced seizures in dogs. The elevated velocities returned to baseline after seizure suppression. Thus, TCD may be used to detect electrographic seizures during the treatment of status epilepticus in dogs, and further clinical studies clarifying the association between changes in cerebral blood flow and non-convulsive seizure cases are needed.

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in American Journal of Veterinary Research

Abstract

OBJECTIVE To determine the relationship between acute volume overload and echocardiographic indices of right ventricular (RV) function and dyssynchrony in healthy dogs.

ANIMALS 7 healthy Beagles.

PROCEDURES Right heart catheterization and echocardiography were performed in 7 healthy anesthetized Beagles at baseline and after induction of volume overload. Volume overload was induced by IV infusion of lactated Ringer solution (150 mL/kg/h for 90 minutes). Echocardiographic indices of RV function, including peak velocity of systolic tricuspid annular motion, tricuspid annulus plane systolic excursion, fractional area change, RV Tei index, RV longitudinal strain (RVLS), and systolic RV longitudinal strain rate (RVLSR), were obtained by use of speckle tracking echocardiography (STE). In addition, SD of the systolic shortening time of the right ventricle for the 6 segments (RV-SD6) was determined with STE.

RESULTS Volume overload significantly increased the RV end-diastolic pressure, compared with the baseline value. Echocardiographic indices of RV function, except for septal RVLSR, were significantly enhanced by volume overload. In contrast, RV-SD6 did not change with volume overload. Although echocardiographic indices of RV function, except for septal RVLSR, were correlated with RV end-diastolic pressure, RV-SD6 was not correlated.

CONCLUSIONS AND CLINICAL RELEVANCE Echocardiographic indices of RV function, including RVLS and RVLSR, were affected by acute short-term volume overload. Therefore, results for assessment of RV function by use of STE in dogs with clinical conditions associated with right-sided chronic volume overload, such as tricuspid and pulmonic regurgitation, should be interpreted with caution.

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in American Journal of Veterinary Research

Abstract

OBJECTIVE To elucidate the relationship between acute volume overload and left atrial phasic function in healthy dogs.

ANIMALS 6 healthy Beagles.

PROCEDURES Dogs were anesthetized. A Swan-Ganz catheter was placed to measure mean pulmonary capillary wedge pressure (PCWP). Cardiac preload was increased by IV infusion with lactated Ringer solution at 150 mL/kg/h for 90 minutes. Transthoracic echocardiography was performed before (baseline) and at 15, 30, 45, 60, 75, and 90 minutes after volume loading began. At each echocardiographic assessment point, apical 4-chamber images were recorded and analyzed to derive time–left atrial area curves. Left atrial total (for reservoir function), passive (for conduit function), and active (for booster-pump function) fractional area changes were calculated from the curves.

RESULTS Volume overload resulted in a significant increase from baseline in PCWP from 15 to 90 minutes after volume loading began. All fractional area changes at 15 to 90 minutes were significantly increased from baseline. In multiple regression analysis, quadratic regression models were better fitted to the relationships between PCWP and each of the total and active fractional area changes than were linear regression models. A linear regression model was better fitted to the relationship between PCWP and passive fractional area change.

CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that left atrial phasic function assessed on the basis of left atrial phasic areas was enhanced during experimental cardiac volume loading in healthy dogs. The effect of volume load should be considered when evaluating left atrial phasic function by indices derived from left atrial phasic sizes.

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in American Journal of Veterinary Research

Abstract

OBJECTIVE To evaluate repeatability and reproducibility of right ventricular Tei index (RTX) values derived from dual pulsed-wave Doppler, conventional pulsed-wave Doppler, and tissue Doppler echocardiography and to investigate relationships and repeatability among the 3 methods in healthy dogs.

ANIMALS 6 healthy adult Beagles.

PROCEDURE Echocardiography was performed on each dog on different days for 2 weeks (3 times/d) by 2 echocardiographers. Intraobserver within- and between-day and interobserver coefficients of variation (CVs) and intraclass correlation coefficients (ICCs) for RTXs derived from dual pulse-waved Doppler (RTXDPD), conventional pulsed-wave Doppler (RTXPD), and tissue Doppler (RTXTD) methods were determined. Degrees of agreement among RTX values derived from the 3 methods were assessed by modified Bland-Altman analysis.

RESULTS Least squares mean (95% confidence interval) RTXtd was 0.50 (0.46 to 0.54), which was significantly higher than that for RTXDPD (0.27 [0.23 to 0.31]) and RTXPD (0.25 [0.21 to 0.29]). Agreement between RTXDPD and RTXPD was good (bias [mean difference], 0.04 [95% confidence interval, −0.03 to 0.10]). The RTXdpd had high within-day (CV, 6.1; ICC, 0.77) and interobserver (CV, 3.5; ICC, 0.83) repeatability, but between-day repeatability was not high. The RTXtd had high within-day repeatability (CV, 6.0; ICC, 0.80), but between-day and interobserver repeatability were not high. Within-day, between-day, and interobserver repeatability of RTXPD were not high.

CONCLUSIONS AND CLINICAL RELEVANCE RTXdpd measurement was a repeatable and reproducible method of cardiac evaluation in healthy dogs. The RTXTD values were significantly higher than the RTXDPD and RTXPD values; therefore, RTX values derived from different echocardiographic methods should be interpreted with caution.

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in American Journal of Veterinary Research