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Abstract
CASE DESCRIPTION
A 15-year-old sexually intact female ring-tailed lemur (Lemur catta) was evaluated for a heart murmur and progressive radiographic cardiomegaly.
CLINICAL FINDINGS
The lemur was clinically normal at the time of initial evaluation. Results of transthoracic echocardiography performed when the animal was anesthetized indicated mitral valve stenosis and severe left atrial dilation. Three months later, signs of left-sided congestive heart failure (CHF; coughing, exercise intolerance, and tachypnea) were observed and confirmed by the presence of radiographic pulmonary edema.
TREATMENT AND OUTCOME
Medical treatment that consisted of aspirin, benazepril, furosemide, pimobendan, spironolactone, and ultimately torsemide in lieu of furosemide successfully controlled the lemur's clinical signs for 33 months after the development of CHF. Euthanasia was then elected on the basis of perceived poor quality of life because tachypnea became refractory to progressively higher dosages of diuretic. Necropsy confirmed mitral stenosis with severe left atrial dilation and chronic pulmonary congestion.
CLINICAL RELEVANCE
The present report described the long-term medical management of CHF secondary to mitral stenosis in a lemur. Mitral stenosis was suspected to be a congenital defect, similar to the cause of mitral stenosis reported for dogs and cats, rather than to be an acquired change in association with rheumatic heart disease as commonly occurs for people. The lemur's CHF was well managed for 33 months with treatment, including pimobendan, which was well tolerated.
Abstract
OBJECTIVE
To determine whether a dose-response relationship exists between short-term oral prednisone administration and common clinicopathologic variables, cardiovascular biomarkers, and systolic arterial blood pressure (SAP) in healthy dogs.
ANIMALS
8 healthy Beagles.
PROCEDURES
Dogs underwent five 5-day experiments (no prednisone treatment [control condition] and prednisone administration at 0.5, 1, 2, and 4 mg/kg, PO, q 24 h), with a 9-day washout period between protocols. Analyses performed before and after treatments included a CBC, serum biochemical analysis, and determination of SAP, fractional excretion of electrolytes, urine protein-to-creatinine ratio, glomerular filtration rate (GFR), serum N-terminal pro B–type natriuretic peptide (NT-proBNP) and plasma cortisol concentrations, and plasma renin activity. Linear mixed-effects modeling was used to compare changes in variables from baseline (day 1 for the same experiment) among treatment conditions.
RESULTS
Changes in serum glucose concentration and GFR were significantly greater after administration of prednisone at 4 mg/kg than for the control condition. Fractional excretion of sodium was decreased from baseline when dogs received 0.5, 1, or 4 mg of prednisone/kg, compared with results for the control condition. Several expected changes in clinicopathologic values were observed after prednisone administration at any dose. Changes in serum NT-proBNP concentration, plasma renin activity, and SAP did not differ from changes for the control condition at any prednisone dose.
CONCLUSIONS AND CLINICAL RELEVANCE
Oral prednisone administration did not affect SAP, NT-proBNP concentration, or measures of renin-angiotensin-aldosterone system activation in healthy laboratory-housed dogs but was associated with relative increases in GFR and serum glucose concentration.
Abstract
OBJECTIVES
To compare the use of curvilinear-array (microconvex) and phased-array transducers for ultrasonographic examination of the lungs in dogs.
ANIMALS
13 client-owned dogs with left-sided congestive heart failure.
PROCEDURES
In a prospective methods comparison study, 24 ultrasonographic examinations of the lungs (4 sites/hemithorax) were performed with both curvilinear-array and phased-array transducers at 3 clinical time points. Two observers independently assessed the number of B lines (scored per site and in total), number of sites strongly positive for B lines (ie, those with > 3 B lines/site), and image quality (scored on a 5-point scale). Analyses included assessment of interobserver agreement with κ analysis, comparison of quality scores between transducers with mixed-effects modeling, and investigation of agreement and bias for B-line data and quality scores between transducers with Passing-Bablok regression.
RESULTS
Interobserver agreement for total B-line scores and number of strong-positive sites was excellent (κ > 0.80) for both transducers. There was no evidence of analytic bias for the number of B lines or strong-positive sites between transducers. Interobserver agreement for image quality scores was moderate (κ, 0.498 and 0.517 for the curvilinear-array and phased-array transducers, respectively). Both observers consistently assigned higher-quality scores to curvilinear-array images than to phased-array images.
CONCLUSIONS AND CLINICAL RELEVANCE
Results indicated both curvilinear-array (microconvex) and phased-array transducers can be used by experienced sonographers to obtain diagnostic ultrasonographic images of the lungs in dogs with acute or resolving left-sided congestive heart failure and suggested the former transducer may be preferred, particularly to aid identification of anatomic landmarks for orientation.
