OBJECTIVE To evaluate accuracy of quantification of right ventricle volume (RVV) by use of 3-D echocardiography (3DE) and ECG-gated multidetector CT (MDCT).
ANIMALS 6 healthy hound-cross dogs.
PROCEDURES ECG-gated MDCT and complete 3DE examinations were performed on each dog. Right ventricular end-diastolic volumes (EDVs), end-systolic volumes (ESVs), stroke volume (SV), and ejection fraction (EF) were measured for 3DE and MDCT data sets by use of software specific for RVV quantification. Correlation and level of agreement between methods were determined. Intraobserver and interobserver variability were assessed for 3DE.
RESULTS No significant differences were detected between SV and EF obtained with MDCT and 3DE. Significant differences were detected between right ventricular EDV and ESV obtained with MDCT and 3DE. No significant difference in heart rate was detected between methods. The correlation between MDCT and 3DE was very good (r = 0.87) for EDV and ESV, moderate (r = 0.60) for EF, and poor (r = 0.31) for SV. Bland-Altman analysis revealed a systematic underestimation of RVV derived by use of 3DE, compared with the RVV derived by use of MDCT (mean bias, 15 and 10.3 mL for EDV and ESV, respectively). Intraobserver (EDV, 12%; ESV, 18%) and interobserver (EDV, 14%; ESV, 11%) variability were acceptable for 3DE.
CONCLUSIONS AND CLINICAL RELEVANCE There was substantial variance for RVV measured by use of 3DE in healthy dogs and a significant underestimation of volumes, compared with results for MDCT, despite the fact there were no significant differences in SV and EF.
Objective—To characterize ocular findings in hypertensive dogs, determine prevalence of hypertension in dogs with ocular disease suggestive of hypertension, and examine possible relationships between degree of hypertension and ocular disease.
Design—Retrospective case series.
Animals—65 dogs initially referred for blood pressure measurement (n = 22), ophthalmic examination (25), or both (18).
Procedures—Medical records were reviewed to identify dogs examined at the teaching hospital that underwent a complete ophthalmic examination and blood pressure measurement within a 24-hour period between January 1, 2005, and December 31, 2007. Signalment, history, blood pressure measurements, ophthalmic examination findings, and any vasoactive drug treatments were recorded. Ocular lesions considered likely to be associated with systemic hypertension included retinal hemorrhage, retinal detachment, hyphema, tortuous vessels, and subretinal edema.
Results—Of the 65 dogs, 42 were hypertensive (systolic blood pressure ≥ 160 mm Hg) and 23 were normotensive. Sixty-two percent (26/42) of hypertensive dogs had ≥ 1 type of ocular lesion identified. Retinal hemorrhage was the most common ocular lesion in hypertensive dogs (17/42 [40%]). The presence of ≥ 1 type of ocular lesion had moderate sensitivity and specificity of 62% and 61 %, respectively, for identification of hypertension. Fifteen of the 25 (60%) dogs referred for blood pressure measurement after initial ophthalmic examination were found to be hypertensive.
Conclusions and Clinical Relevance—Ocular lesions are common in dogs with systemic hypertension. Dogs with hypertension or diseases associated with hypertension should be monitored carefully for evidence of ocular target organ damage, and hypertension should be systematically ruled out in dogs with characteristic ocular lesions.
To compare left atrial volume (LAV) and right atrial volume (RAV) determined by 2-D and 3-D echocardiographic methods with the LAV and RAV determined by ECG-gated multidetector CT (MDCT) for healthy dogs.
11 healthy purpose-bred young adult hound-type dogs.
Each dog was anesthetized and underwent MDCT and a complete echocardiographic examination. Modality-specific software was used to measure the respective atrial volumes at ventricular end systole, and LAV and RAV measurements were subsequently indexed to body weight and compared among imaging modalities.
The LAV determined by echocardiographic methods did not differ significantly from the LAV determined by MDCT. However, the RAV determined by 3-D echocardiography and 2-D echocardiography via the left apical and left cranial windows differed significantly from the RAV determined by MDCT. Bland-Altman analyses indicated that the indexed LAV and RAV determined by echocardiographic methods were systematically underestimated, compared with MDCT measurements, but the bias was much smaller for LAV than for RAV.
CONCLUSIONS AND CLINICAL RELEVANCE
Results suggested that, for dogs, echocardiography might be an acceptable alternative to MDCT for measurement of LAV but not for measurement of RAV. However, the study population was small and homogenous in terms of breed, age, and weight. These findings need to be validated in a larger, more varied population of dogs with and without cardiac disease.
To investigate associations between short-term treatment with a previously described compounded transdermal formulation of atenolol and heart rate in cats.
11 healthy adult cats.
Cats received the atenolol gel formulation (gradually increased from 12.5 mg/cat, q 24 h to 25 mg/cat, q 12 h) by application to the pinnae at home over a 10-day period in a prospective, experimental study. On day 10, cats were hospitalized for measurement of serum atenolol concentrations 3, 6, and 12 hours after the morning treatment. Mean heart rate measured at the 3- and 6-hour time points was compared with a baseline value (measured at enrollment).
All cats completed the study; 4 were excluded from analyses after an apparent formulation error was detected in 1 batch. Two cats had minor adverse effects (localized erythema of the pinna). Five of 7 cats had serum atenolol concentrations ≥ 260 ng/mL (considered therapeutic) at ≥ 1 time point. Heart rate had a strong negative correlation (r =–0.87) with serum atenolol concentration. A 90-day drug stability investigation of 4 formulations (identical to the intended study treatment except for pH [range, 6.5 to 7.7]) revealed an apparent decrease in atenolol concentration at a pH of 7.7.
CONCLUSIONS AND CLINICAL RELEVANCE
Topical administration of the formulation as described resulted in targeted serum atenolol concentrations in most cats, with attendant HR reduction. Validation of these preliminary results in a larger sample and investigation of the treatment in cats with structural heart disease is needed. Verification of appropriate pH (target, 7.0) is likely essential for the compound's stability.
OBJECTIVE To evaluate the accuracy of cardiac output (CO) estimated by use of ECG-gated multidetector CT (MDCT) and 1-, 2-, and 3-D echocardiography and by use of thermodilution.
ANIMALS 6 healthy hound-cross dogs.
PROCEDURES Electrocardiogram-gated contrast-enhanced 64-slice MDCT and 1-, 2-, and 3-D echocardiography were performed on each dog. The CO for ECG-gated MDCT was calculated as volumetric measurements of stroke volume multiplied by mean heart rate. Echocardiographic left ventricle end-diastolic volumes and end-systolic volumes were measured by use of the Teichholz method (1-D echocardiography) and a single-plane method of disks (2-D echocardiography). Real-time 3-D echocardiographic left ventricle volumes were measured with 3-D functional analysis software on right long-axis and left apical views. The CO of each dog was measured in triplicate by use of thermodilution. Mean CO values, correlations, and limits of agreement for MDCT, echocardiographic modalities, and thermodilution were compared.
RESULTS CO measured by use of MDCT, 2-D echocardiography, and 3-D echocardiography had the strongest correlations with CO measured by use of thermodilution. No significant difference in CO was detected between MDCT, any echocardiographic method, and thermodilution. Bland-Altman analysis revealed a systematic underestimation of CO derived by use of MDCT, 2-D echocardiography, and 3-D echocardiography.
CONCLUSIONS AND CLINICAL RELEVANCE Use of MDCT, 2-D echocardiography, and 3-D echocardiography to measure CO in healthy dogs was feasible. Measures of CO determined by use of 3-D echocardiography on the right long-axis view were strongly correlated with CO determined by use of thermodilution, with little variance and slight underestimation.
To describe qualitative and quantitative cardiothoracic values in geriatric Sika deer (Cervus nippon) using digital radiography, 6-lead ECG (sECG), and smartphone-based ECG (aECG).
10 healthy geriatric Sika deer (9 females and 1 male).
Deer were chemically immobilized, thoracic radiographs were obtained, and inhalant anesthesia was initiated. An sECG and aECG were simultaneously recorded for each animal using the same ECG specifications. Results were compared between devices.
Radiographically, no deer had any cardiopulmonary abnormalities. Median (range) values for the most important cardiac measurements were 170 (153–193) mm for cardiac height, 135 (122–146) mm for cardiac width, 9 (8–9) for vertebral heart score, and 99 (69–124) mm for cardiosternal contact. All deer had a normal sinus rhythm with no pathological arrhythmias noted. A significant difference between sECG and aECG was identified for minimum heart rate (49 vs 51 beats/min, respectively), P wave duration (0.05 vs 0.03 seconds), P wave amplitude (0.28 vs 0.10 mV), PR interval (0.15 vs 0.12 seconds), and QT interval (0.39 vs 0.30 seconds).
Thoracic radiographs were suitable to evaluate basic cardiothoracic morphology in Sika deer. The aECG was useful for assessing heart rate and rhythm but, compared with sECG, proved no substitute for evaluating duration and amplitude of ECG waveforms.
OBJECTIVE To compare effects of tiletamine-zolazepam, alfaxalone, ketamine-diazepam, and propofol for anesthetic induction on cardiorespiratory and acid-base variables before and during isoflurane-maintained anesthesia in healthy dogs.
ANIMALS 6 dogs.
PROCEDURES Dogs were anesthetized with sevoflurane and instrumented. After dogs recovered from anesthesia, baseline values for cardiorespiratory variables and cardiac output were determined, and arterial and mixed-venous blood samples were obtained. Tiletamine-zolazepam (5 mg/kg), alfaxalone (4 mg/kg), propofol (6 mg/kg), or ketamine-diazepam (7 and 0.3 mg/kg) was administered IV in 25% increments to enable intubation. After induction (M0) and at 10, 20, 40, and 60 minutes of a light anesthetic plane maintained with isoflurane, measurements and sample collections were repeated. Cardiorespiratory and acid-base variables were compared with a repeated-measures ANOVA and post hoc t test and between time points with a pairwise Tukey test.
RESULTS Mean ± SD intubation doses were 3.8 ± 0.8 mg/kg for tiletamine-zolazepam, 2.8 ± 0.3 mg/kg for alfaxalone, 6.1 ± 0.9 mg/kg and 0.26 ± 0.04 mg/kg for ketamine-diazepam, and 5.4 ± 1.1 mg/kg for propofol. Anesthetic depth was similar among regimens. At M0, heart rate increased by 94.9%, 74.7%, and 54.3% for tiletamine-zolazepam, ketamine-diazepam, and alfaxalone, respectively. Tiletamine-zolazepam caused higher oxygen delivery than propofol. Postinduction apnea occurred in 3 dogs when receiving alfaxalone. Acid-base variables remained within reference limits.
CONCLUSIONS AND CLINICAL RELEVANCE In healthy dogs in which a light plane of anesthesia was maintained with isoflurane, cardiovascular and metabolic effects after induction with tiletamine-zolazepam were comparable to those after induction with alfaxalone and ketamine-diazepam.
OBJECTIVE To compare rates of major intraoperative complications and survival to hospital discharge between surgical ligation (SL) and canine ductal occluder (CDO) implantation for treatment of dogs with left-to-right shunting patent ductus arteriosus (PDA).
DESIGN Retrospective cohort study.
ANIMALS 120 client-owned dogs with left-to-right shunting PDA (62 treated by SL and 58 treated by CDO implantation).
PROCEDURES Data were retrieved from medical records of included dogs regarding signalment, medical history, vertebral heart scale, preoperative echocardiographic findings, complications encountered during surgery, and durations of anesthesia and surgery (SL or CDO implantation). Data were compared between dogs treated by SL and those treated by CDO implantation.
RESULTS Dogs treated by CDO implantation were significantly older and heavier than dogs treated by SL and had more pathological cardiac remodeling (as indicated by mitral regurgitation scores, left atrial-to-aortic root diameter ratios, and fractional shortening values). Durations of anesthesia and surgery were also significantly longer for CDO implantation versus SL. The major complication rate for dogs treated by SL (6/62 [10%]) was significantly greater than that for dogs treated by CDO implantation (0/58 [0%]). One dog in the SL group died during surgery. Overall rate of survival to hospital discharge was 99% (119/120).
CONCLUSIONS AND CLINICAL RELEVANCE Both SL and CDO implantation were viable methods for PDA attenuation in the evaluated dogs. Although a greater proportion of dogs had major complications during the SL procedure, the 2 procedures had comparable rates of survival to hospital discharge.