Primary cardiac tumor presenting as left ventricular outflow tract obstruction and complex arrhythmia.

An adult female mixed breed dog presented for recurrent collapsing episodes over several weeks. Holter evaluation revealed periods of sinus arrest and echocardiography identified a soft tissue mass with subsequent severe dynamic obstruction of the left ventricular outflow tract. The patient was euthanized five days after presentation for severe dyspnea. Necropsy revealed an irregular mass circumferentially lining the left ventricular outflow tract as well as multiple myocardial metastases. The final diagnosis was an undifferentiated pleomorphic endocardial sarcoma.

Utility of transesophageal echocardiography for transcatheter occlusion of patent ductus arteriosus in dogs: influence on the decision-making process.

BACKGROUND: Appropriate device selection for transcatheter occlusion of patent ductus arteriosus (PDA) is essential to procedural success. OBJECTIVES: To determine if transesophageal echocardiography (TEE) influences device selection for PDA occlusion and to report benefits, limitations, and complications associated with TEE. ANIMALS: Twenty-two client-owned dogs with left-to-right shunting PDA. METHODS: PDA dimensions were obtained via transthoracic echocardiography (TTE) and then TEE followed by angiography. Based solely on information from TTE and angiography, an initial device type and size were selected. After initial device selection, TEE measurements were disclosed and changes in device selection were recorded. After device release, angiography, TEE, or both were performed to assess occlusion. RESULTS: An Amplatz canine duct occluder (ACDO) was securely positioned and released in 21 dogs and an embolization coil was deployed in 1 dog. Based on TEE evaluation, initial selected device type was unchanged but ACDO size was changed in 3 dogs. TEE was utilized throughout the procedure allowing real time visualization of device deployment, release and assessment of closure in 17 dogs. No complications occurred related to TEE. Complete PDA closure was achieved in all dogs. CONCLUSIONS AND CLINICAL IMPORTANCE: TEE provided anatomic information regarding PDA morphology that closely approximated angiographic ductal dimensions while aiding in device deployment, release and confirmation of closure. We conclude that TEE provides complementary anatomical and intraprocedural information and is well tolerated in dogs.

Transcatheter atrial septal defect closure with the Amplatzer atrial septal occluder in 13 dogs: short- and mid-term outcome.

BACKGROUND: Transcatheter atrial septal defect (ASD) closure in the dog was first reported in 2005. OBJECTIVES: Describe the technique and both short- and mid-term outcome of transcatheter ASD closure with the Amplatzer atrial septal occluder (ASO). ANIMALS: Thirteen client-owned dogs with ASD. METHODS: Records of the initial 13 dogs in which transcatheter ASD closure was attempted at Texas A&M University were reviewed. RESULTS: All dogs had hemodynamically relevant septum secundum ASD. Two dogs had concurrent congenital abnormalities. ASOs were deployed in 13 dogs and released in 12. Eleven were released by a right jugular approach and 1 by a transatrial approach through a right lateral thoracotomy. Transthoracic echocardiographic estimates of ASD size were 14.0 + or - 5.4 mm (mean + or - 1 standard deviation) with a range of 7-22 mm. Accidental right atrial release occurred in 1 dog and embolization after release occurred in 2 dogs. Transcatheter ASD closure was successful in 10 dogs. Transthoracic color Doppler echocardiography the day after ASD closure indicated complete occlusion in 5 dogs, trivial to mild residual shunting in 4 dogs, and moderate residual shunting in 1 dog. Follow-up echocardiograms (mean of 12.4 + or - 7.4 months postprocedure) were available for 9 dogs. There was no residual ASD shunting in 6 dogs. In 3 of the 5 dogs with postoperative residual shunting it was judged to be decreased and hemodynamically unimportant relative to the dogs' postoperative evaluations. The mean length of event-free survival in the 10 dogs that underwent successful transcatheter ASD closure was 22.2 + or - 10.2 months.

Transarterial ductal occlusion with the Amplatzer vascular plug in 31 dogs.

BACKGROUND: Transarterial ductal occlusion with the Amplatzer vascular plug was first reported in dogs by Hogan et al in 2005. HYPOTHESIS: Use of the Amplatzer vascular plug is a safe, efficacious method of patent ductus arteriosus (PDA) occlusion. ANIMALS: Thirty-one client-owned dogs with PDA. METHODS: Records of 31 dogs in which transarterial occlusion of PDA with an Amplatzer vascular plug was attempted were reviewed. RESULTS: All dogs had a type II PDA, with 27 dogs having type IIA morphology and 4 dogs having type IIB morphology. Appropriate device deployment was achieved in 29 of 31 dogs. Postdeployment angiography in 21 dogs documented complete occlusion in 10 dogs, trivial residual flow in 5 dogs, mild residual flow in 2 dogs, moderate residual flow in 3 dogs, and severe residual flow in 1 dog. Transthoracic color Doppler echocardiography documented complete occlusion in 22 dogs, whereas 2 dogs had trivial residual flow, 2 dogs had mild residual flow, 2 dogs had mild to moderate residual flow, and 1 dog had severe residual flow. Of the 7 dogs with residual flow, 2 had complete occlusion 2-4 months postoperatively, 1 had moderate residual flow 1 month postoperatively, and 4 were lost to follow-up. One dog required a larger device than was able to be deployed through the largest sheath placed in the femoral artery. Pulmonary embolization of the device occurred in 1 dog. CONCLUSION: We conclude that ductal occlusion with an Amplatzer vascular plug is a safe and efficacious therapy for PDA in dogs.

Clorazepate use may prevent alcohol withdrawal convulsions.

Clorazepate dipotassium was administered orally for the five-day prophylactic treatment of potential, incipient and overt withdrawal signs and symptoms in 226 patients on admission to an inpatient alcohol treatment unit. Conservative estimates based on these patients' histories and on literature reports predicted that between 7 and 40 (3% to 18%) of these persons would be expected to have a withdrawal convulsion. No patients experienced convulsions. This complete absence of seizures suggests that clorazepate is effective in counteracting convulsive and other manifestations of the alcohol withdrawal syndrome.