The echocardiographic pulmonary to left atrial ratio: A noninvasive variable for the hemodynamic classification of pulmonary hypertension in dogs.

BACKGROUND: Hemodynamic classification of pulmonary hypertension (PH) has important clinical implications. However, only a few echocardiographic variables have been used to hemodynamically classify PH in dogs. OBJECTIVE: To evaluate the echocardiographic pulmonary to left atrial ratio index (ePLAR) in dogs with PH. ANIMALS: Forty-six dogs with intermediate to high probability of PH. METHODS: Cross-sectional study. Variables were compared between dogs with precapillary PH [PrePH (n = 24)] vs postcapillary PH [PostPH (n = 22)], and with combined PH [CombPH (n = 14)] vs isolated PH [IsoPH (n = 8)] using the t-, Mann-Whitney, Pearson's Chi, or Fisher's exact test. The receiver operating characteristic curve and Youden index were used to identify the optimal ePLAR cutoff value to differentiate among the groups, intraclass correlation coefficients (ICC) were used to determine the reliability of measurements. RESULTS: The mean (SD) ePLAR of the PrePH was higher than that of the PostPH group [0.36 (0.13) vs 0.26 (0.09), respectively; P = .005]. The median (interquartile range) ePLAR of the CombPH was higher than that of the IsoPH subgroup [0.29 (0.24-0.38), vs 0.20 (0.16-0.23), respectively; P = .001]. The best cutoff value of ePLAR for identifying IsoPH was <0.245 [AUC at cutoff point = 0.86; sensitivity (95% confidence interval [CI]) = 0.71 (0.47-0.95); specificity (95% CI) = 1 (0.76-1)]. The ICC analysis indicated a high degree of reliability. CONCLUSIONS AND CLINICAL IMPORTANCE: ePLAR can be considered a valid noninvasive variable to hemodynamically classify PH in dogs with an intermediate to high probability of PH. Assessment of ePLAR can be useful in the therapeutic management of PH in dogs.

Coagulation Abnormalities in Dogs with Parvoviral Enteritis.

Hemostatic alterations have been documented in dogs with canine parvoviral enteritis. This study's aims were to measure the standard coagulation parameters, and to assess the relationship between them and the clinical variables in dogs with canine parvoviral enteritis. Nine client-owned dogs with a canine parvoviral infection were included in a prospective, observational clinical study. Clinical score and coagulation status were assessed at admission. All nine dogs showed alterations of three or more standard coagulation variables. A correlation analysis evidenced a significantly high positive correlation between the activated partial thromboplastin time and clinical score. The present study concurs that dogs with canine parvoviral enteritis have coagulation disorders that are detectable by measuring the standard coagulation parameters.

Strain Elastography of Injured Equine Superficial Digital Flexor Tendons: A Reliability Study of Manual Measurements.

Early diagnosis of tendon injuries and accurate long-term monitoring of the healing process are key for equine veterinarians that use conventional ultrasonography. The development of strain elastography could improve the management of clinical cases. The aim of the study was to assess the intraobserver repeatability and interobserver reproducibility of manual measurements of the colored areas of the tendons within elastograms and to standardize this manual modality by comparing the analysis of the images with ImageJ. Twenty elastograms of the injured superficial digital flexor tendons (SDFTs) of horses were analyzed by two different operators after an acute injury was diagnosed with ultrasonography. Statistical analysis demonstrated excellent intraobserver repeatability (intraclass correlation coefficient, ICC = 0.949) and good interobserver reproducibility (ICC = 0.855) for manual measurements performed with tools available on the ultrasound unit. A good agreement between manual measurements and measurements performed with ImageJ (ICC = 0.849) was then demonstrated. Despite its subjectivity, the manual modality proved to be a valid method for analyzing images obtained with strain elastography.

Molecular survey of parvovirus, astrovirus, coronavirus, and calicivirus in symptomatic dogs.

Gastrointestinal disorders caused by enteric viruses are frequently reported in dogs worldwide, with significant mortality rates in unvaccinated individuals. This study reports the identification and molecular characterization of Canine parvovirus (CPV-2), Canine coronavirus (CcoV), Canine astrovirus (AstV), and Canine calicivirus (CcaV) in a panel of dogs showing severe enteric clinical signs sampled in a typical Mediterranean environment (Sardinia, Italy). At least one of these viral species was detected in 92.3% samples. CPV-2 was the most frequently detected virus (87.2%), followed by AsTv (20.5%), CCoV-IIa (18%), and CCoV-I (10.3%). CCoV-IIb and CaCV were not detected in any sample. Single infection was detected in 24 samples (66.7%), mainly related to CPV-2 (91.7%). Coinfections were present in 33.3% samples with constant detection of CPV-2. Canine coronavirus was present only in coinfected animals. The VP2 sequence analysis of CPV-2 positive samples confirmed the presence of all variants, with CPV-2b most frequently detected. Phylogeny based on the CcoV-IIa spike protein (S) gene allowed to identify 2 different clades among Sardinian isolates but failed to distinguish enteric from pantropic viruses. Study on presence and prevalence of enteroviruses in dogs increase our knowledge about the circulation of these pathogens in the Mediterranean area and highlight the need for dedicated routine vaccine prophylaxis. Molecular analyses of enteric viruses are fundamental to avoid failure of vaccines caused by frequent mutations observed in these enteroviruses.

Molecular characterization and phylogenetic analysis of Babesia and Theileria spp. in Sardinian ruminants.

Tick-borne diseases (TBDs) caused by Theileria and Babesia spp. are common in tropical and subtropical regions. This study investigates the presence of Theileria and Babesia spp. in ruminants from a subtropical Mediterranean region (Sardinia, Italy), a hotspot for ticks infestations. A total of 141 blood samples from healthy and symptomatic ruminants (showing symptoms consistent with tick-borne disease) were screened using a polymerase chain reaction test based on the amplification of the 18 s rRNA fragment. A total of 19/50 sheep (38%), 34/43 bovine (79.1%), and 5/48 goats (10.4%) tested positive to Babesia/Theileria. Phylogenetic analysis assigned all sequences obtained from sheep to the T. ovis cluster, while bovine and goats sequence types grouped in the Theileria buffeli/sergenti/orientalis group. One sequence type, isolated from a symptomatic bovine, clustered with B. major. Information on presence and frequency of piroplasms in ruminants increase our knowledge about the circulation of these pathogens in Sardinian animals and add up to previous studies conducted in ticks in the same area. Results also highlight the importance of subtropical Mediterranean environments as hotspots for ruminants piroplasmosis with potential impact on Veterinary Health.

Αcute visceral cysticercosis caused by Taenia hydatigena in lambs: ultrasonographic findings.

BACKGROUND: Cysticercosis caused by cysticercus tenuicollis is a metacestode infection that affects several species of ungulates. It is caused by the larval stage of Taenia hydatigena, an intestinal tapeworm in dogs and wild canids. In the intermediate host, the mature cysticerci are usually found in the omentum, mesentery, and peritoneum, and less frequently in the pleura and pericardium. The migrating larvae can be found mostly in the liver parenchyma causing traumatic hepatitis in young animals. Most infections are chronic and asymptomatic, and are diagnosed at the abattoir. The acute form of infection is unusual in sheep and reports of death in lambs are rare. METHODS: In March 2018, fifteen female lambs presented anorexia, weakness, lethargy, and death secondary to acute visceral cysticercosis. Twelve of them underwent hepatic ultrasonography. Examinations were performed on standing or left lateral recumbent animals. RESULTS: Livers of affected animals presented rounded margins and a thickened, irregular and hyperechoic surface. Hepatic parenchyma appeared to be wholly or partially affected by lesions characterized by heterogeneous areas crossed by numerous, irregular, anechoic tracts ranging from 1 to 2 cm in length and 0.1 to 0.2 cm in width. Superficial and intraparenchymal cystic structures were also visualized. The presence of lesions was confirmed by anatomopathological examination, and T. hydatigena cysticerci was identified by morphological and molecular characterization of isolates. CONCLUSIONS: Our results highlighted that hepatic ultrasonography is effective for an intra-vitam diagnosis of acute cysticercosis in lambs.

Ultrasonographic assessment of abdominal aortic elasticity in hypertensive dogs.

BACKGROUND: Systemic hypertension (SH) is a persistent and pathological increase in arterial blood pressure (BP). Chronic SH leads to an increase in aortic (Ao) stiffness, and measuring Ao elasticity is useful for estimating Ao stiffness in humans. Currently, no literature in veterinary medicine describes noninvasive assessment of abdominal Ao elasticity in dogs with SH. OBJECTIVE: Compare ultrasonographic-derived abdominal Ao strain (AoSt) between hypertensive (HT) and normotensive (NT) dogs. ANIMALS: Fifty privately-owned dogs with clinical signs, conditions, or both potentially associated with SH. METHODS: Prospective observational case-control study. Aortic stiffness was estimated by calculating AoSt as follows: AoSt = ([AoDs - AoDd]/AoDd) × 100, where AoDs and AoDd are the Ao diameter in systole and in diastole, respectively. Aortic stiffness was calculated from 2 different Ao transverse sections, the first caudal to the left renal artery (K_AoSt), and the second cranial to the external iliac arteries (I_AoSt). RESULTS: Thirty-two dogs were included in the HT group and 18 in the NT group. Both K_AoSt and I_AoSt in HT dogs were significantly lower (P < .05) than in NT dogs (7.4 ± SD 3.6) vs 10.3 (±3.8) and 5.7 (interquartile range [IQR], 3.9-7.5) vs 8.1 (IQR, 7-10.3), respectively. Only K_AoSt was significantly influenced by age. CONCLUSIONS AND CLINICAL IMPORTANCE: Ultrasonographic Ao elasticity assessment was feasible to compare HT and NT dogs. Results indicated that K_AoSt and I_AoSt indices can be used to assess SH-related Ao stiffness, especially when indirect BP measurements are inconsistent or inaccurate. Additional studies to assess the AoSt in healthy dogs of various ages are needed.

Repeatability of ultrasound examination of the optic nerve sheath diameter in the adult cat: comparison between healthy cats and cats suffering from presumed intracranial hypertension.

OBJECTIVES: The objectives of this study were to test: (1) the repeatability of ultrasonographic examination of the optic nerve sheath diameter (ONSD) in the cat; (2) the association between the ONSD and age, sex and body weight in healthy cats; and (3) the difference in the ONSD between healthy cats and those suffering from presumed intracranial hypertension (ICH). METHODS: This study had a prospective, blinded, observational cross-sectional study design. Two groups of animals were considered: healthy cats (group A) and cats with a diagnosis of presumed ICH (group B). The ONSD was evaluated, measured and compared between the two groups via an ultrasonographic transpalpebral approach. Repeatability of the procedure was evaluated through the intraclass correlation coefficient (ICC). Data were statistically compared using the Student's t-test and linear regression analysis. RESULTS: A strong inter- and intraobserver ICC indicating good repeatability was observed. The interobserver ICC was 0.965 (P <0.05) for the right eye and 0.956 (P <0.05) for the left eye. The intraobserver ICC was 0.988 (P <0.05) and 0.984 (P <0.05) for the right and left eyes, respectively. In healthy cats the mean ± SD ONSD was 1.23 ± 0.11 mm (range 1-1.47 mm) and 1.23 ± 0.10 (range 1-1.4 mm) for right and left eyes, respectively. The ONSD was not related to sex or weight; a weak relationship was observed with age. In group B, the mean ONSD was 1.68 ± 0.13 mm (range 1.5-1.9 mm) and 1.61 ± 0.15 mm (range 1.4-1.9 mm) for the right and left eyes, respectively. In group B, the ONSD was statistically significantly larger than in group A, the healthy cats (P <0.001). CONCLUSIONS AND RELEVANCE: The transpalpebral ultrasonographic technique is a non-invasive, feasible and reproducible method to measure ONSD both in healthy cats and in cats suffering from suspected ICH.

Molecular epidemiology of Anaplasma spp. related to A. phagocytophilum in Mediterranean small ruminants.

The genus Anaplasma currently comprises 6 bacterial species mostly pathogenic to animals and/or human, including the zoonotic species Anaplasma phagocytophilum, the causative agent of tick-borne fever (TBF) of ruminants, and of granulocytic anaplasmosis of horses, dogs and human. Recently, novel potentially non-pathogenic strains related to A. phagocytophilum have been identified in Japan, China, and Tunisia. This paper reports the identification, molecular typing, and evolutionary history of novel Anaplasma strains (A. phagocytophilum-like 1 and 2), related to but distinct from A. phagocytophilum in Mediterranean area of Europe and Africa. PCR-RFLP and phylogenetic analyses based on 16S rRNA provided evidence for the circulation of A. phagocytophilum-like 1 strains in Europe. Phylogeny based on groEL gene showed the inclusion of Sardinian and Tunisian A. phagocytophilum-like 1 strains in a unique clade distinct from, but related to that of Japanese strains. Results suggest that genetic diversity within the genus Anaplasma is much greater than expected and provide information useful for the development of specific and effective diagnostic and prophylactic tools.

A pilot study evaluating the effect of mannitol and hypertonic saline solution in the treatment of increased intracranial pressure in 2 cats and 1 dog naturally affected by traumatic brain injury.

OBJECTIVE: To evaluate the effects of iso-osmolar doses of 18% mannitol and 3% sodium chloride (NaCl) solutions in decreasing intracranial pressure (ICP) in animals with severe traumatic brain injury (TBI). DESIGN: Prospective uncontrolled interventional study. SETTING: Veterinary university teaching hospital. ANIMALS: Two cats and 1 dog with TBI with a modified Glasgow Coma Scale score ≤8 after hemodynamic stabilization, and with brain magnetic resonance imaging changes suggestive of intracranial hypertension. INTERVENTIONS: Animals were surgically instrumented for direct ICP measurement, then randomly treated with iso-osmolar doses of 18% mannitol or 3% NaCl. Direct ICP and cerebral perfusion pressure (CPP) were recorded both before treatment and for 120 minutes following drug administration. MEASUREMENTS AND MAIN RESULTS: Direct ICP and CPP were recorded both before treatment and at 5 additional time points following administration over the subsequent 120 minutes. Case 1 received 3% NaCl without any response to therapy; refractory posttraumatic hypertension was suspected. Case 2 was treated with 3% NaCl; ICP decreased by 40.7% and CPP increased by 15%; however, these effects were transient. Case 3 received 18% mannitol, and ICP decreased by 19% and CPP increased to normal. However, there was a rebound increase in ICP that was higher than pretreatment values, and CPP decreased slightly before it gradually increased to normal values towards the end of the study. CONCLUSIONS: Both mannitol and hypertonic saline decrease ICP and improve CPP, but the effect observed in this pilot study suggests that there might be differences in the duration of these effects. Appropriately designed studies in a larger and homogeneous population are warranted to further investigate these findings.

Pulmonary arterial response to Angiostrongylus vasorum in naturally infected dogs: echocardiographic findings in two cases.

BACKGROUND: Angiostrongylus vasorum is a nematode living in the pulmonary arteries of canids. Infected dogs develop severe pulmonary lesions which can potentially lead to pulmonary hypertension (PH). However, reports of PH in natural infected dogs are scant. One of the possible causes of the low prevalence of PH in A. vasorum-infected dogs could be the establishment of large diameter intrapulmonary arteriovenous anastomoses (IPAVAs), which attenuate pulmonary vascular resistance, thus reducing the pulmonary arterial pressure. The present report describes the pulmonary arterial pressure (PAP) response to A. vasorum natural infection in two dogs, assessed by echocardiography and by the saline contrast echocardiographic test (SCE). RESULTS: Both dogs showed clinical signs of respiratory disease. At presentation, case 1 did not show echocardiographic signs of PH and the SCE test was positive proving the presence of IPAVAs. However, at the follow-up visit, despite A. vasorum infection resolution, the same dog showed PH and the SCE test resulted negative, which ruled out the presence of IPAVAs. Case 2 suffered from severe pulmonary arterial hypertension and right-side congestive heart failure since the day of presentation. Saline contrast echocardiography was negative both at the time of presentation and at the follow-up visit. CONCLUSIONS: In the two cases described above, the PH was not associated with IPAVAs. During A. vasorum infection, IPAVAs recruitment mechanism is able to contrast the rise of PAP until a certain level. It probably represents an initial escape mechanism of PH that, over time, exhausts its compensatory capacities allowing PAP to rise and to be detectable on echocardiography.

Use of 2-dimensional speckle-tracking echocardiography to assess left ventricular systolic function in dogs with systemic inflammatory response syndrome.

BACKGROUND: Early identification of systolic dysfunction in dogs with systemic inflammatory response syndrome (SIRS) potentially could improve the outcome and decrease mortality. OBJECTIVE: To compare 2-dimensional speckle tracking (2D-STE) with 2-dimensional (2D) and M-mode echocardiography in the evaluation of systolic function in SIRS dogs. ANIMALS: Seventeen SIRS and 17 healthy dogs. METHODS: Prospective observational case-control study. Each dog underwent physical examination, conventional echocardiography, 2D-STE, and C-reactive protein measurement. RESULTS: Dogs with SIRS had lower 2D-STE ejection fraction (X4D-EF; 44 ± 8 versus 53 ± 8; P = .003), endocardial global longitudinal strain (ENDO-G-Long-St; -14.6 ± 3.2 versus -18.5 ± 4.1; P = .003), and normalized left ventricular diameter in diastole (1.38 ± 0.25 versus 1.54 ± 0.17; P = .04) and systole (0.85 ± 0.18 versus 0.97 ± 0.11; P = .03) as compared to healthy dogs. Simpson method of disks (SMOD) right parasternal EF (55 ± 9 versus 60 ± 6; P = .07) and end systolic volume index (ESVI; 23 ± 10 versus 21 ± 6; P = .61), SMOD left apical EF (59 ± 9 versus 59 ± 6; P = .87) and ESVI (20 ± 8 versus 22 ± 6; P = .25), fractional shortening (FS; 34 ± 5 versus 33 ± 4; P = .39), M-mode EF (64 ± 7 versus 62 ± 5; P = .35), and ESVI (23 ± 11 versus 30 ± 9; P = .06) were not significantly different between SIRS and control group, respectively. CONCLUSION AND CLINICAL IMPORTANCE: Speckle tracking X4D-EF and ENDO-G-Long-St are more sensitive than 2D and M-Mode FS, EF, and ESVI in detecting systolic impairment in dogs with SIRS.

Vaginal fold prolapse in a dog with pyometra and ovarian papillary cystadenocarcinoma.

CASE DESCRIPTION: A 7-year-old 42-kg (92.4-lb) sexually intact nulliparous female Italian Mastiff was examined because of a history of vaginal prolapse during diestrus. CLINICAL FINDINGS: A physical examination revealed vaginal fold prolapse. Abdominal ultrasonography revealed an enlarged uterus with hypoechogenic content, corpora lutea in the ovaries, and a cyst in the right ovary. Hematologic abnormalities included leukocytosis, neutrophilia, mild anemia, and low Hct. Progesterone and estradiol concentrations were 9.36 ng/mL and 30.42 pg/mL, respectively, in serum and 72.72 ng/mL and 792 pg/mL, respectively, in the ovarian cystic fluid. TREATMENT AND OUTCOME: Ovariohysterectomy was performed; the prolapsed tissue was repositioned by external manipulation and maintained in situ by temporary apposition of the vulvar lips with a retention suture. Anatomic and histologic examinations of the excised tissues revealed pyometra and papillary cystadenocarcinoma in the right ovary. The vaginal hyperplasia completely regressed at 35 days after surgery; 5 months after surgery, the dog's general condition was considered good. CLINICAL RELEVANCE: Findings in this case were indicative of a hormonally active ovarian papillary cystadenocarcinoma in a female dog in diestrus. Hormone production by the cystadenocarcinoma was the predisposing factor that induced pyometra, mucosal hyperplasia, and vaginal fold prolapse in the dog. On the basis of these concurrent disorders, ovariohysterectomy was an appropriate treatment.

Cisternal cerebrospinal fluid analysis in 24 sheep with chronic coenurosis.

Coenurosis, a neurological parasitic infection of ruminants caused by the larval stage of Taenia multiceps, is commonly reported in Sardinia, the most representative region for ovine population in Italy. Chronic form appears as a consequence of cyst development, frequently reported in the brain and spinal cord. Diagnostic suspect of coenurosis is based on physical and neurological examination. The aim of this article is to describe physical, biochemical and cytological aspects of cisternal cerebrospinal fluid of 24 sheep with chronic coenurosis and to evaluate whether these alterations are helpful in the diagnosis of coenurosis. Cerebrospinal fluid was altered in 20 animals (83.3%). Increase of total protein was revealed in 7 animals (29.2%); an increase of total nucleated cell count was observed in 18 samples (75%). Cytological examination revealed mononuclear pleocytosis in 17 animals (70.1%). Eosinophils were observed in 16 animals in various degree (66.7%). Our results show that cerebrospinal fluid confirms signs of Central Nervous System inflammation in 20 animals out of 24 (83.3%) and in particular it was useful to identify a parasitic inflammation in 66.7% of the animals in which eosinophils were observed. Considering the results of this study, the very absence of significant neutrophilic pleocytosis could be considered useful to diagnose chronic cerebral coenurosis.

Molecular investigation and phylogeny of Anaplasma spp. in Mediterranean ruminants reveal the presence of neutrophil-tropic strains closely related to A. platys.

Few data are available on the prevalence and molecular typing of species belonging to the genus Anaplasma in Mediterranean ruminants. In this study, PCR analysis and sequencing of both 16S rRNA and groEL genes were combined to investigate the presence, prevalence, and molecular traits of Anaplasma spp. in ruminants sampled on the Island of Sardinia, chosen as a subtropical representative area. The results demonstrate a high prevalence of Anaplasma spp. in ruminants, with animals infected by at least four of six Anaplasma species (Anaplasma marginale, A. bovis, A. ovis, and A. phagocytophilum). Moreover, ruminants host a number of neutrophil-tropic strains genetically closely related to the canine pathogen A. platys. The high Anaplasma spp. prevalence and the identification of as-yet-unclassified neutrophil-tropic strains raise concerns about the specificity of serological tests routinely used in ruminants and provide additional background for reconstructing the evolutionary history of species genetically related to A. phagocytophilum.

Equine and canine Anaplasma phagocytophilum strains isolated on the island of Sardinia (Italy) are phylogenetically related to pathogenic strains from the United States.

The presence of Anaplasma phagocytophilum, a tick-transmitted zoonotic pathogen, was investigated in Sardinia using a molecular approach. Phylogenetic analysis revealed that Sardinian strains are genetically distinct from the two lineages previously described in Europe and are closely related to strains isolated in different areas of the United States.