Interatrial septal aneurysm associated with patent foramen ovale in a dog - case report / Aneurisma de septo interatrial associado a forame oval patente em cão - relato de caso

Atrial septal aneurysm (ASA) is a rare congenital deformity of variable clinical relevance, often reported in association with patent foramen ovale (PFO). Transthoracic Doppler echocardiography (TTE) is the first choice for diagnosis, but complementary techniques, such as microbubble contrast, should be used. Despite its importance, in Veterinary Medicine, there is little information related to the subject, and the present study is the second report of this condition in dogs. The objective was to report a case of ASA type IV LR associated with PFO in a Shar Pei bitch, diagnosed by a combined approach of transthoracic echocardiography backed by agitated saline solution (microbubbles). During clinical care, the owners reported episodes of seizures as their main complaint. Echocardiographic examination revealed a type 4 LR atrial septal aneurysm and left ventricular systolic dysfunction. The use of microbubble contrast showed right-to-left shunt, confirming PFO. The recommended treatment was medication. It was concluded that the rarity of ASA in dogs may be due to incomplete diagnoses and the transthoracic echocardiographic examination allows its analysis and classification. Furthermore, ASA can be found in animals with or without evidence of heart disease and it should be investigated in patients with neurological alterations.

O aneurisma do septo atrial (ASA) é uma rara deformidade congênita, de relevância clínica variável, frequentemente relatado em associação a forame oval patente (PFO). O ecodopplercardiograma transtorácico (TTE) é a primeira escolha para o diagnóstico, mas técnicas complementares, como o contraste por microbolhas, devem ser utilizadas. Apesar da importância, em medicina veterinária existe uma carência de informações relacionadas ao tema, sendo esse o segundo relato dessa condição em cão. Objetivou-se relatar um caso de ASA tipo IV LR, associado a PFO, em uma cadela Shar Pei, diagnosticado por uma abordagem combinada por ecodopplercardiograma transtorácico e costrastado com solução salina agitada (microbolhas). Ao atendimento clínico, os proprietários relataram, como queixa principal, episódios de crises convulsivas. O exame ecocardiográfico revelou aneurisma de septo atrial tipo 4 LR e disfunção sistólica em ventriculo esquerdo. A utilização de contraste por microbolhas constatou shunt direita-esquerda, confirmando PFO. O tratamento recomendado foi medicamentoso. Concluiu-se que a raridade do ASA em cães pode ser devido a diagnósticos incompletos, e o exame ecocardiográfico transtorácico permite sua análise e classificação. Ainda, ASA pode ser encontrado em animais com ou sem evidências de cardiopatia e sua investigação deve ser feita em pacientes com alterações neurológicas.

Anasarca associated with restrictive cardiomyopathy in cats

Background: Cardiomyopathies are a primary heart disorder and are one of the most causes of heart failure and sudden death in cats. Restrictive cardiomyopathy is a diastolic dysfunction resulting from endomyocardial fibrosis, with filling restriction and ventricular distention. In these cases, a poor outcome is expected. Anasarca in animals is often associated with dystocia secondary to congenital changes. In adults, this is a rare condition, since subcutaneous edema in animals with congestive heart failure is an uncommon finding. Therefore, this report describes clinical and pathological findings in an unusual presentation of anasarca in two adult cats with restrictive cardiomyopathy. Cases: A 12-year-old female mixed breed cat (case 1) and a 6-year-old male mixed-breed cat (case 2) were present on an emergent basis at the veterinary hospital with a history of respiratory distress. Case 1 showed on physical examination intense restrictive mixed dyspnea and lethargy, with muffled heart sounds and respiratory noises in cardiorespiratory auscultation. The cat exhibited abdominal distension resulting from ascites. Generalized subcutaneous edema was evident mainly in the abdominal and submandibular areas and the thoracic and pelvic limbs. In these regions, a positive Godet signal was observed. Thoracic radiography revealed pleural effusion, and the cat underwent fluid drainage on both sides of the thoracic cavity. Drainage material was sent to the laboratory for clinical analysis, which indicated that it was a modified transudate. The clinical signs worsened, and the cat was euthanized. In case 2, physical examination showed severe restrictive mixed dyspnea, lethargy, and low body temperature (< 32°C). Abdominal distension resulting from ascites and generalized edema in the subcutaneous tissue with a positive Godet sign was observed. On cardiorespiratory auscultation, cardiac sounds and breathing noises were muffled. Thoracic radiography revealed pleural effusion. The cat was immediately placed in an incubator for clinical stabilization with oxygen therapy and warm-up. After 2 h of hospitalization, thoracentesis and drainage of cavity fluids were performed, which were classified as modified transudate. The patient remained in critical condition during hospitalization, evolving to death. The two cats were referred for a complete post mortem examination. Grossly, both cats showed distension of the abdomen and marked edema of subcutaneous tissue, mainly in the abdominal, ventral cervical, and thoracic and pelvic members. In the abdominal and thoracic cavities, a moderate amount of serous-free liquid, slightly reddish was observed. The heart of both cats was enlarged, with a globose appearance and a slightly whitish epicardium. The left ventricular endocardium was mild and diffusely thick and whitish, in addition to moderate dilation of the left atrium. Histological analyses of the heart showed in both cats moderate and diffuse proliferation of fibrous connective tissue in the endocardial region. Discussion: Restrictive cardiomyopathy has major importance in feline medicine due to its severity and poor outcome. Pleural effusion, pulmonary edema, and ascites are common findings in cats with congestive heart failure; however, generalized subcutaneous edema is uncommon. To the author's knowledge, there are no published cases in the literature of anasarca in adult cats with restrictive cardiomyopathy. In human cardiology, this presentation is commonly related to congestive heart failure, and it is reported under several conditions, such as restrictive cardiomyopathy and constrictive pericarditis. The present study suggests that anasarca should be included in the list of associated clinical signs suggestive of severe congestive heart failure, mainly related to restrictive cardiomyopathy.

Echocardiographic diagnosis of interventricular septum defect with Eisenmenger syndrome in an adult dog - case report / Diagnóstico ecocardiográfico de defeito do septo interventricularcom agravo de síndrome de Eisenmenger em cão adulto ­ relato de caso

Interventricular septal defect (IVSD) is a congenital heart disease characterized by communication or non-closure of the interventricular septum in the embryonic or postnatal period, causing a failure in the separation between the systemic and pulmonary circulation. The severity of the hemodynamic consequences depends on the extent of the defect and the magnitude of the flow through it. Blood flow commonly occurs from left to right, because systemic vascular resistance is greater than pulmonary resistance. This report describes the echocardiographic findings in a 4-year-old male Poodle treated at the Veterinary Hospital with a history of exercise intolerance, cyanosis and episodes of syncope. On echocardiography, perimembranous IVSD was diagnosed with atrial and right ventricular dilatation, discontinuity of the interventricular septum in the subaortic region measuring approximately 5 mm. In the Doppler evaluation, reverse turbulent flow was evidenced, characterizing shunt from right to left (Eisenmenger syndrome). Despite preserved systolic function, abnormal relaxation was observed. Doppler echocardiography was a fundamental complementary imaging test for the diagnosis of this congenital heart disease since its suspicion is not commonly raised in adult patients. Doppler echocardiography allowed us to identify the defect, define its size and extension, determine the direction of blood flow as well as its hemodynamic consequences.(AU)

O defeito do septo interventricular (DSIV) é uma cardiopatia congênita caracterizada pela comunicação ou não fechamento do septo interventricular no período embrionário ou pós-natal, causando falha na separação entre a circulação sis-têmica e pulmonar. A gravidade das consequências hemodinâmicas depende da extensão do defeito e da magnitude do fluxo através dele. O fluxo sanguíneo comumente ocorre da esquerda para a direita, porque a resistência vascular sistêmica é maior do que a pulmonar. Este relato descreve os achados ecocardiográficos em um Poodle, macho, de 4 anos atendido no Hospital Veterinário com história de intolerância ao exercício, cianose e episódios de síncope. Ao ecocardiograma foi diagnosticado DSIV do tipo perimembranoso com dilatação atrial e ventricular direita, descontinuidade do septo interventricular em região subaórtica medindo aproximadamente 5 mm. Na avaliação Doppler, evidenciou-se fluxo turbulento reverso, caracterizando shunt da direita para a esquerda (síndrome de Eisenmenger). Apesar da função sistólica preservada, foi observado relaxamento anormal. A ecocardiografia Doppler foi um exame de imagem complementar fundamental para o diagnóstico dessa cardio-patia congênita, uma vez que sua suspeita não é comumente levantada em pacientes adultos. A ecocardiografia Doppler per-mitiu identificar o defeito, definir seu tamanho e extensão, determinar a direção do fluxo sanguíneo, bem como suas conse-quências hemodinâmicas.(AU)

Risk of arrhythmias in dogs with structural heart disease / Potencial arrítmico de cardiopatias em cães

Presently, pet life expectancy is becoming longer and several diseases inherent to age have been diagnosed, with heart disease being a frequent finding. Although various heart diseases have different pathophysiologies, many morphological and hemodynamic changes can predispose patients to arrhythmias. The presence of arrhythmias can worsen the underlying heart disease and predispose patients to develop new alterations, making arrhythmia detection important for establishing adequate therapeutic protocols and a better prognosis. The present study aimed to determine the arrhythmias most frequently found in dogs treated at the Cardiology and Respiratory Diseases Service (SCDR) of the Small Animals Sector of the Veterinary Hospital of the Federal Rural University of Rio de Janeiro (UFRRJ), during the period from January to 2014 to December 2017, relating them to sex, age group, size, and the presence or absence of heart disease. A total of 586 medical records of dogs treated with SCDR-UFRRJ were retrospectively evaluated. Of these, 15.4% had arrhythmias, 95.6% had diagnoses of heart disease, 61.1% (55/90) were diagnosed with mitral valve disease, and 27.8% (25/90) had dilated cardiomyopathies. The most frequent rhythm disturbances were premature ventricular complexes associated with chronic degenerative mitral valve disease or dilated cardiomyopathy. Statistical analysis confirmed the risk of a cardiac patient developing rhythm or conduction alterations (OR, 4.46; p = 0.0003). In conclusion, the pathophysiology of heart failure can lead to the development of rhythm and conduction disorders.

Com a maior expectativa de vida dos animais de estimação, diversas enfermidades inerentes a idade têm sido diagnosticadas, sendo as cardiopatias um achado frequente. Apesar das diferentes cardiopatias terem fisiopatologias distintas, diversas alterações morfológicas e hemodinâmicas podem ocorrer predispondo ao aparecimento de arritmias. A presença de arritmias pode agravar a doença cardíaca de base e predispor ao desenvolvimento de novas alterações, tornando-se importante a sua detecção para instituição de protocolos terapêuticos adequados e melhor prognóstico da doença. O presente estudo teve como objetivo determinar as arritmias mais frequentemente encontradas em cães atendidos no Serviço de Cardiologia e Doenças Respiratórias (SCDR) do Setor de Pequenos Animais do Hospital Veterinário da Universidade Federal Rural do Rio de Janeiro (UFRRJ), no período de janeiro de 2014 a dezembro de 2017, relacionando-as com sexo, faixa etária, porte e presença ou não de cardiopatias. De maneira retrospectiva, foram avaliados 586 prontuários de cães atendidos no SCDR-UFRRJ. Destes, 15.4% apresentavam alguma arritmia e 95,6% apresentavam diagnostico de alguma cardiopatia, sendo 61.1% (55/90) diagnosticados com endocardiose de mitral e 27.8% (25/90) com cardiomiopatia dilatada. O distúrbio de ritmo mais frequente foram os complexos ventriculares prematuros associados a doença valvar degenerativa crônica de mitral ou a cardiomiopatia dilatada. Na análise estatística, o risco de um paciente cardiopata desenvolver alterações de ritmo ou de condução foi confirmado (OR: 4,46; p=0,0003). Conclui-se que a fisiopatologia da insuficiência cardíaca pode levar ao desenvolvimento de distúrbios de ritmo e também distúrbios de condução.

Short-term heart rate variability analysis in healthy dogs of different ages

Background: The modulation of heart rate by autonomic nervous system may be evaluated by the heart rate variability(HRV), which illustrates the fluctuations between RR intervals. To evaluate this analysis, the intervals between 2 QRScomplexes are measured. In general, high HRV values are expected in healthy individuals; otherwise, low values are indicative of organism dysfunction. Studies conducted in healthy humans show that HRV suffers reduction with ageing andthat there is autonomic immaturity in neonates. The aim of this study was to describe the characteristic pattern of cardiacautonomic behavior in healthy dogs in different age groups through short-term HRV analysis.Materials, Methods & Results: A total of 87 healthy dogs were studied. HRV was analyzed in time and frequency domain,using Holter and heart rate monitor. It was observed that puppies (below one year old) presented a lower parasympatheticpredominance and, consequently, lower HRV values on time domain (SDNN, PNN50% e RMSSD) compared to the other2 groups and on frequency domain (LF, HF and LF/HF) compared to the adult animals group (between 1 and 7-year-old),which presented higher HRV values when compared to the other groups. Elderly dogs (over 8-year-old) exhibited a naturaltendency to decrease cardiac parasympathetic HRV indexes.Discussion: The use of the HRV method as a prognostic index and as an arrhythmogenic marker for various canine heartdiseases presents interesting perspectives. However, before it may be employed for these purposes, a better understandingshould be established regarding the physiological behavior of autonomic cardiac modulation in different age groups toserve as a basis for future analyses. This study observed that puppies presented higher values for HR and, therefore, shorter...

Short-term heart rate variability analysis in healthy dogs of different ages

Background: The modulation of heart rate by autonomic nervous system may be evaluated by the heart rate variability(HRV), which illustrates the fluctuations between RR intervals. To evaluate this analysis, the intervals between 2 QRScomplexes are measured. In general, high HRV values are expected in healthy individuals; otherwise, low values are indicative of organism dysfunction. Studies conducted in healthy humans show that HRV suffers reduction with ageing andthat there is autonomic immaturity in neonates. The aim of this study was to describe the characteristic pattern of cardiacautonomic behavior in healthy dogs in different age groups through short-term HRV analysis.Materials, Methods & Results: A total of 87 healthy dogs were studied. HRV was analyzed in time and frequency domain,using Holter and heart rate monitor. It was observed that puppies (below one year old) presented a lower parasympatheticpredominance and, consequently, lower HRV values on time domain (SDNN, PNN50% e RMSSD) compared to the other2 groups and on frequency domain (LF, HF and LF/HF) compared to the adult animals group (between 1 and 7-year-old),which presented higher HRV values when compared to the other groups. Elderly dogs (over 8-year-old) exhibited a naturaltendency to decrease cardiac parasympathetic HRV indexes.Discussion: The use of the HRV method as a prognostic index and as an arrhythmogenic marker for various canine heartdiseases presents interesting perspectives. However, before it may be employed for these purposes, a better understandingshould be established regarding the physiological behavior of autonomic cardiac modulation in different age groups toserve as a basis for future analyses. This study observed that puppies presented higher values for HR and, therefore, shorter...(AU)

Electrocardiographic, echocardiographic and heart biomarker parameters in sheep experimentally poisoned by Palicourea marcgravii (Rubiaceae) / Parâmetros eletrocardiográficos, ecocardiográficos e de biomarcadores cardíacos em ovinos intoxicados experimentalmente por Palicourea marcgravii (Rubiaceae)

The present study aimed to identify and describe cardiac alterations in sheep experimentally poisoned with Palicourea marcgravii through analysis of serum cardiac biomarkers (serum troponin I and creatine kinase - CK-MB) and electro and echocardiographic assessments to contribute to a better understanding of the poisoning pathophysiology. P. marcgravii is the main plant within a group of 22 species that cause sudden death in Brazil; its toxic principle is sodium monofluoroacetate. Eight healthy crossbreed male sheep, aged between five and twelve months, weighing 14 to 27kg, were evaluated. The animals received 1g kg-1 of P. marcgravii plants orally. The sheep were evaluated before administering the plant (T0) through electro and echocardiography and blood collection to assess cardiac biomarkers (CK-MB and cTnI). Collections and analyses were repeated every four hours until the animal's death. During the study, there was the presence of extravasation of serum troponin I carried out in a qualitative test, with positive values at time T4, and the serum CK-MB biomarker had a peak at T4 and slightly decreased at T8. The electro and echocardiographic examinations showed that the cause of death in these animals was due to acute heart failure characterized by arrhythmias, tachycardia/ventricular fibrillation, drop in cardiac output, left ventricular (LV) systolic dysfunction by the progressive decrease in the LV ejection fraction (EF), decrease in LV fractional shortening (FS), and decrease in aortic flow velocity and aortic flow gradient. This study seems to be the first to evaluate cardiac alterations in sheep poisoned by P. marcgravii through cardiac biomarkers and electro and echocardiographic exams.

O presente estudo objetivou identificar e descrever as alterações cardíacas de ovinos intoxicados experimentalmente por Palicourea marcgravii através das análises de biomarcadores cardíacos séricos (troponina I sérica e a creatinoquinase - MB) e das avaliações eletro e ecocardiográficas contribuindo para o melhor entendimento da fisiopatologia da intoxicação. Palicourea marcgravii é a principal planta dentro de um grupo de 22 espécies que causam "morte súbita" no Brasil e seu princípio tóxico é o monofluoracetato de sódio. Foram utilizados oito ovinos saudáveis machos, sem raça definida, com idades entre cinco e doze meses e peso de 14 a 27kg. Os animais receberam 1g/kg de Palicourea marcgravii por via oral. Os ovinos foram avaliados momentos antes da administração da planta (T0) através de eletro e ecocardiograma e coleta de sangue para avaliação dos biomarcadores cardíacos (CK-MB e cTnI). As análises e coletas foram repetidas a cada quatro horas até o óbito do animal. Durante o estudo observou-se extravasamento de troponina I sérica realizada em teste qualitativo, com valores positivos já em T4, assim como o biomarcador CK-MB sérico teve seu pico de aumento em T4 e em T8 houve uma leve redução. Aos exames eletro e ecocardiográfico foi possível determinar que a causa do óbito nestes animais ocorreu devido à insuficiência cardíaca aguda caracterizada por arritmias, taquicardia/fibrilação ventricular, queda no débito cardíaco, disfunção sistólica do ventrículo esquerdo (VE) pela diminuição progressiva da fração de ejeção (EF) do VE, diminuição na fração de encurtamento (FS) do VE, diminuição da velocidade do fluxo aórtico e do gradiente do fluxo aórtico. Este é o primeiro estudo que avalia as alterações cardiológicas de ovinos intoxicados por P. marcgravii através de biomarcadores cardíacos e exames eletro e ecocardiográficos.

Main risk factors of dogs with congestive heart failure diagnosed by doppler echocardiographic parameters / Principais fatores de risco em cães com insuficiência cardíaca congestiva diagnosticada por parâmetros ecocardiográficos

Nowadays, congestive heart failure is one of the major complications of heart disease in small animals, which is characterized by a clinical condition in which the heart is unable to eject the blood efficiently. At long term, some compensatory mechanisms it will eventually become detrimental and, mainly, due to the congestion caused by it. In dogs, the main cause of CHF is chronic mitral valve degeneration, it is responsible for the degeneration of collagen present in the mitral valve structure that will have detrimental consequences on the entire circulatory system. The aim of the present study was to perform a retrospective study of 498 echocardiographic reports collected at a veterinary cardiology service of the Bauru region, from January 2017 to June 2019. Two groups were formed according to the Doppler echocardiographic alterations found, one that included animals with characteristics of congestive heart failure (CHF), and the other formed by non-CHF patients. Of the total number of animals evaluated, 61 were classified as affected by congestive heart failure and after classification, it was considered the main epidemiological factors (race, sex and age) of animals belonging to this group. Small breed animals were overrepresented and also elderly animals, with no apparent sexual predisposition. In addition, animals with CHF presented higher values when compared to animals without CHF of LA/Ao ratio (2.31 ± 0.30 vs. 1.46 ± 0.35), E/IRTV ratio (2.96 ± 0.39 vs. 1.16 ± 0.43) and E-wave velocity (1.45 m/s ± 0.18 vs. 0.75 m/s ± 0.22) on echocardiographic examination.(AU)

A insuficiência cardíaca congestiva (ICC) é uma das principais complicações das cardiopatias em pequenos ani-mais atualmente, sendo que é caracterizada por uma condição clínica em que o coração não é capaz de bombear a quantidade necessária de sangue para todo o corpo. A longo prazo, alguns mecanismos compensatórios acabam se tornando prejudiciais ao mesmo principalmente por decorrência do quadro de congestão que ela ocasiona. Em cães, a principal causa de ICC é a degeneração valvar crônica mitral, a qual é responsável pela degeneração do colágeno presente na estrutura da valva mitral que trará consequências prejudiciais a todo o sistema circulatório. O presente trabalho teve por objetivo a realização de um estudo retrospectivo de 498 laudos ecodopplercardiográficos provenientes de serviço de cardiologia veterinária da região de Bauru, no período de janeiro de 2017 a junho de 2019. Foi realizada a classificação em dois grupos, de acordo com as alterações ecodop-plercardiográficas encontradas, sendo os grupos formados por animais portadores de insuficiência cardíaca congestiva e animais não portadores. Do número total de animais, 61 foram classificados como acometidos por insuficiência cardíaca congestiva e, após a classificação, foram avaliados os principais fatores epidemiológicos (raça, sexo e idade) dos animais pertencentes a esse grupo. As raças de pequeno porte foram as mais representadas, sendo os animais idosos mais acometidos, sem predisposição sexual aparente. Além disso, animais com ICC apresentaram valores maiores quando comparados aos animais sem ICC of LA/Ao razão (2.31 ± 0.30 vs. 1.46 ± 0.35), E/IRTV razão (2.96 ± 0.39 vs. 1.16 ± 0.43) e velocidade E-wave (1.45 m/s ± 0.18 vs. 0.75 m/s ± 0.22) no exame ecocardiográfico.(AU)

Estudo retrospectivo dos achados cardiorrespiratórios e laboratoriais de cães atendidos para avaliação pré-operatória em um serviço de cardiologia e doenças respiratórias (2017-2021) / Retrospective study of cardiorespiratory and laboratory findings in dogs treated for preoperative evaluation in a cardiology and respiratory disease service (2017-2021)

Os cães idosos são acometidos com frequência por enfermidades no sistema cardiovascular e respiratório, estando muita das vezes assintomáticos até terem indicação para algum procedimento cirúrgico que requer a avaliação pré-operatória, momento este que muitos achados clínicos poderão ser detectados, ao ponto da necessidade de tratamento prévio à intervenção cirúrgica. Diante disso, o trabalho tem por objetivo detectar as principais manifestações cardiorrespiratórias e sua correlação aos dados encontrados nos exames complementares e informações epidemiológicas de 138 cães atendidos em um serviço especializado em cardiologia e doenças respiratórias, no período de 2017 a 2021, para fins de risco cirúrgico. Foi possível observar maior predominância de animais idosos, de pequeno porte e do sexo feminino. Dentre as doenças cardíacas, a doença degenerativa crônica de mitral foi a mais prevalente, seguida da dirofilariose. Em relação as afecções respiratórias, a bronquite crônica e o colapso de traqueia foram mais diagnosticadas, seguidas da broncopneumonia e da síndrome braquicefálica. Quando da observação do ritmo cardíaco por meio do eletrocardiograma, a arritmia sinusal, ritmo sinusal e sinus arrest foram os principais achados. Quanto aos achados laboratoriais, foi possível observar aumento da média de hematimetria, redução da média do hematócrito e das plaquetas. Entretanto, alguns animais apresentaram azotemia, leucocitose e eosinofilia. Observou-se que pacientes com doenças cardíacas em estágios de congestão possuem redução da pressão arterial, aumento da hematimetria e taquiarritmias, como taquicardia sinusal e/ou complexos atriais prematuros. Pacientes com idade mais avançada tendem a ter redução dos valores de leucometria global e maior probabilidade de manifestação de aumento da pressão arterial. Portadores de dirofilariose cursam com aumento de eosinófilos.

Elderly dogs are frequently affected by diseases in the cardiovascular and respiratory system, being often asymptomatic until they are indicated for a surgical procedure that requires preoperative evaluation, at which point many clinical findings can be detected, to the point of need for treatment prior to surgical intervention. Therefore, the work aims to detect the main cardiorespiratory manifestations and their correlation to data found in complementary exams and demographic information of 138 animals treated at a service specialized in cardiology and respiratory diseases, from 2017 to 2021, for risk purposes surgical. It was possible to observe a greater predominance of elderly, small and female animals. Among heart diseases, chronic degenerative mitral disease was the most prevalent, followed by heartworm disease. Regarding respiratory affections, chronic bronchitis and tracheal collapse were more commonly diagnosed, followed by bronchopneumonia and brachycephalic syndrome. When observing the cardiac rhythm through the electrocardiogram, sinus arrhythmia, sinus rhythm and sinus arrest were the main findings. As for laboratory findings, it was possible to observe an increase in mean hematimetry, a reduction in mean hematocrit and platelets. However, some animals showed azotemia, leukocytosis and eosinophilia. It was observed that patients with cardiac diseases in stages of congestion have reduced blood pressure, increased hematimetry and tachyarrhythmias, such as sinus tachycardia and/or premature atrial complexes. Older patients tend to have reduced global white blood cell values and more likely to manifest increased blood pressure. Heartworm patients have an increase in eosinophils.

Morphoquantitative evaluation of the heart of cutia (Dasyprocta agouti) and capybara (Hydrochoerus hydrochaeris) / [Avaliação morfoquantitativa do coração da cutia (Dasyprocta agouti) e da capivara (Hydrochoerus hydrochaeris)]

The cutia (Dasyprocta agouti) and capybara (Hydrochoerus hydrochaeris ) are hystricomorphic rodents of the Brazilian fauna. The wild animal anatomy is essential to the clinic and surgery practices and conservation programs. This work aimed to evaluate the heart quantitative morphology of the cutia and the capybara. For this, three hearts of cutia and three of capybaras were used from the collection of the Anatomy Sector of Domestic and Wild Animals of the Faculty of Veterinary Medicine and Animal Science of the University of São Paulo. The hearts were weighted and measured with a pachymeter. The left ventricle volume was estimated through the Cavalieri method. The hearts' mean weight was 16.76g (cutias) and 104.2g (capybaras). The mean values for the axis, width and base dimensions were of the cutia 4.3cm, 3.3cm and 3.3cm and for the capybara were 7.6cm, 6.0cm and 6.1cm, respectively. The mean volume of the left ventricle of the cutia and the capybara was 5.03cm3 and 54.55cm3, respectively. The quantitative results of the hearts were compatible with the average body weight of the rodents. Thus, these numerical data can be applied to veterinary cardiology.(AU)

A cutia (Dasyprocta agouti) e a capivara (Hydrochoerus hydrochaeris) são roedores histricomorfos da fauna brasileira. A anatomia de animais silvestres é essencial para a prática clínico-cirúrgica e programas conservacionistas. Este trabalho objetivou avaliar a morfologia quantitativa do coração da cutia e da capivara. Para isso, foram utilizados três corações de cutias e três de capivaras, provenientes do acervo do Setor de Anatomia dos Animais Domésticos e Silvestres da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo. Os corações foram pesados e as mensurações foram realizadas com paquímetro. O volume do ventrículo esquerdo foi calculado pelo método de Cavalieri. O peso médio dos corações foi de 16,76g (cutias) e de 104,2g (capivaras). Os valores médios para as dimensões eixo, largura e base foram, para a cutia, de 4,3cm, 3,3cm e 3,3cm e para a capivara, de 7,6cm, 6,0cm e 6,1cm, respectivamente. O volume médio do ventrículo esquerdo da cutia e da capivara foi respectivamente de 5,03cm3 e de 54,55cm3. Os resultados quantitativos dos corações foram compatíveis com o peso corporal médio dos roedores. Assim, esses dados numéricos podem ser aplicados à cardiologia veterinária.(AU)

Variabilidade interobservador entre três métodos de eletrocardiografia (convencional, digital e digital impresso) em gatos saudáveis / Variability inter-observer between three methods of electrocardiographic (conventional, computerized and computerized printed) on healthy cats

Background: Electrocardiography is an exam widely used in feline medicine. It consists of recording the electrical activity of the heart in waves representing myocardial depolarization and repolarization. Two electrocardiographic evaluation methods are employed in dogs and cats: computerized and conventional. However, possible differences in ECG results performed by the different methods have been reported. This paper aims to evaluate the observer’s interference in the interpretation of the electrocardiographic exams and possible differences between the methods: conventional single channel, computerized screen and computerized printed of healthy cats. Materials, Methods & Results: Electrocardiographic tracings were obtained from 58 healthy cats, aged between 1 and 10 years-old, of both sexes, of the Persian and mixed breed and therefore interpreted by 4 observers with similar degree of experience. The examinations were performed in a sequential manner, the computerized method first, and then the conventional method. The animals were gently contained in the right lateral decubitus position. The tracings obtained by the conventional method were printed on thermally sensitive graph paper. The computerized method was performed in computer by means of specific software (TEB® ECGPC version 6.2), being the waves delimited by the observer. The tracings were also printed by means of a jet printer, and also interpreted. The morphology of P waves, QRS complexes and T waves were analyzed in the derivations: I, II, III, aVR, aVL and aVF. Heart rate, amplitude and duration of the P, QRS and T waves, PR, QT and heart rate (HR) intervals were calculated in derivation II. Mean electric axis was determined in leads I and III. Comparing the methods, there was a difference observed in the values of P and R waves, QRS complex, QT and PR intervals and T wave polarity. The interpretation of the evaluators presented statistical differences in the duration of the P...

Standard electrocardiographic data of peccaries (Tayassu tajacu)

Background: Peccaries (Tayassu tajacu, Linnaeus, 1758) are wild suiformes that belong to the Tayassuidae family. Electrocardiography is an important technique for cardiovascular evaluation. Analysis of various intervals, segments, complexesand waveforms of electrocardiographic (ECG) traces aids in the diagnosis of cardiac alterations and in the differentiationof congenital and acquired heart diseases from physiological cases. However, in wild animal medicine, the various patternsof normality and the evaluation of electrical traces associated with heart disease have not yet been sufficiently elucidated.The purpose of this study was to characterize the electrocardiographic (ECG) traces of peccaries sedated using ketamineand xylazine.Materials, Methods & Results: Fourteen healthy adult animals that were subjected to digital ECG examination wereused. Animals with evidence of systemic diseases, cardiovascular abnormalities (murmurs or arrhythmias), or any degreeof valve insufficiency observed on echocardiogram and animals that exhibited excessive stress during the examinationwere excluded from the study. All animals presented with a normal sinus rhythm. A combination of 15 mg/kg of ketaminehydrochloride and 3 mg/kg of midazolam maleate was applied intramuscularly for chemical immobilization. The animalswere manipulated after 15 min, when the onset of the anaesthetic effect was verified, for a duration of 45 min, and noreinforcement dose was necessary to complete the electrocardiographic examination. No significant differences wereobserved in the P-wave duration, PR interval and QT interval between genders (P > 0.05). No significant differences werefound between the amplitudes of the P and R waves between males and females (P > 0.05). The observed P waves weresmall, monophasic and positive. The QRS complex was positive in the DI, DII, DIII, aVF, V4 and V10 derivations andnegative in the aVR, aVL, V1 and V2 derivations...

Standard electrocardiographic data of peccaries (Tayassu tajacu)

Background: Peccaries (Tayassu tajacu, Linnaeus, 1758) are wild suiformes that belong to the Tayassuidae family. Electrocardiography is an important technique for cardiovascular evaluation. Analysis of various intervals, segments, complexesand waveforms of electrocardiographic (ECG) traces aids in the diagnosis of cardiac alterations and in the differentiationof congenital and acquired heart diseases from physiological cases. However, in wild animal medicine, the various patternsof normality and the evaluation of electrical traces associated with heart disease have not yet been sufficiently elucidated.The purpose of this study was to characterize the electrocardiographic (ECG) traces of peccaries sedated using ketamineand xylazine.Materials, Methods & Results: Fourteen healthy adult animals that were subjected to digital ECG examination wereused. Animals with evidence of systemic diseases, cardiovascular abnormalities (murmurs or arrhythmias), or any degreeof valve insufficiency observed on echocardiogram and animals that exhibited excessive stress during the examinationwere excluded from the study. All animals presented with a normal sinus rhythm. A combination of 15 mg/kg of ketaminehydrochloride and 3 mg/kg of midazolam maleate was applied intramuscularly for chemical immobilization. The animalswere manipulated after 15 min, when the onset of the anaesthetic effect was verified, for a duration of 45 min, and noreinforcement dose was necessary to complete the electrocardiographic examination. No significant differences wereobserved in the P-wave duration, PR interval and QT interval between genders (P > 0.05). No significant differences werefound between the amplitudes of the P and R waves between males and females (P > 0.05). The observed P waves weresmall, monophasic and positive. The QRS complex was positive in the DI, DII, DIII, aVF, V4 and V10 derivations andnegative in the aVR, aVL, V1 and V2 derivations...(AU)

Disfunção miocárdica secundária a sepse em cão: relato de caso / Myocardial dysfunction secondary to sepsis in dog: case report

A redução do empenho do miocárdio é um achado frequente em casos de sepse ou choque séptico, sendo a piometra uma das principais causas de sepse em cães. No presente trabalho relata-se um caso de sepse secundária à piometra levando à disfunção miocárdica em um canino, fêmea, da raça White West Highland Terrier, de dez anos de idade com histórico de prostração e hiporexia. Ao exame físico foi observada presença de secreção vulvar purulenta, abdômen abaulado e tenso à palpação. Foram realizados exames complementares, incluindo hemograma com resultado compatível com quadro infeccioso, bioquímica revelando hipocalemia e hipocalcemia, e exames de imagem. Observou-se por meio do exame ultrassonográfico presença de grande quantidade de líquido com celularidade em cornos e corpo uterino, compatível com piometra. Alterações compatíveis com sepse foram observadas durante o atendimento e estabilização do animal. No exame ecocardiográfico foi observado aumento dos diâmetros sistólico e diastólico do ventrículo esquerdo com diminuição da fração de encurtamento e ejeção, compatível com disfunção sistólica do ventrículo esquerdo. A referida paciente recebeu alta médica após correção cirúrgica e estabilização dos parâmetros clínicos, incluindo a disfunção sistólica, sendo relatado óbito sete dias após. Sugere-se que a causa mortis tenha sido a disfunção sistólica causada pela sepse. Conclui-se que a disfunção miocárdica é um fator determinante de prognóstico em casos de sepse, o que ressalta a importância de seu diagnóstico e tratamento precoce.

The reduction of myocardial commitment is a frequent finding in cases of sepsis or septic shock, and piometra is one of the main causes of sepsis in dogs. In the present study, the case of sepsis secondary to piometra is reported leading to myocardial dysfunction in a canine, female, of the 10-year-old White West Highland Terrier with a history of prostration and hyporexia. On physical examination, the presence of purulent vulvar secretion, bulging abdomen and taut palpation was observed. Complementary tests were performed, including blood count, biochemistry and imaging tests. It was observed through ultrasound examination the presence of a large amount of fluid with cellularity in horns and uterine body, compatible with piometra. Alterations compatible with sepsis were observed during the care and stabilization of the animal. On echocardiographic examination, an increase in systolic and diastolic diameters of the left ventricle was observed with decreased shortening and ejection fraction, compatible with systolic dysfunction of the left ventricle. The patient received medical discharge after surgical correction and stabilization of clinical parameters, and died seven days later. It is suggested that the cause of death was systolic dysfunction caused by sepsis. It is concluded that myocardial dysfunction is a prognostic determinant factor in cases of sepsis, emphasizing the importance of its diagnosis and early treatment.

Estenose da artéria pulmonar em cães: revisão de literatura

A estenose da artéria pulmonar corresponde uma doença cardíaca congênita, de maior frequência na espécie canina. Caracteriza-se por estreitamento do lúmen arterial pulmonar. Nos cães, corresponde à terceira patologia cardíaca de maior frequência e acomete principalmente o Buldogue inglês. Os animais acometidos geralmente não apresentam sintomatologia, e em casos mais graves é possível observar sinais de insuficiência cardíaca congênita direita e ate mesmo sincope. O método de escolha para o correto diagnóstico da doença é o exame ecocardiográfico, o qual permite detectar a lesão, classifica-la e ainda determinar o se grau de gravidade e as alterações secundarias.(AU)

Pulmonary artery stenosis corresponds to a congenital heart disease, more frequent in the canine species. It is characterized by narrowing of the pulmonary arterial lumen. In dogs, it corresponds to the third most frequent cardiac pathology and affects mainly the English Bulldog. Affected animals generally do not show symptoms, and in more severe cases it is possible to observe signs of right congenital heart failure and even syncope. The method of choice for the correct diagnosis of the disease is the echocardiographic examination, which allows to detect the lesion, classify it and also determine its degree of severity and secondary changes.(AU)

Estenose da artéria pulmonar em cães: revisão de literatura

A estenose da artéria pulmonar corresponde uma doença cardíaca congênita, de maior frequência na espécie canina. Caracteriza-se por estreitamento do lúmen arterial pulmonar. Nos cães, corresponde à terceira patologia cardíaca de maior frequência e acomete principalmente o Buldogue inglês. Os animais acometidos geralmente não apresentam sintomatologia, e em casos mais graves é possível observar sinais de insuficiência cardíaca congênita direita e ate mesmo sincope. O método de escolha para o correto diagnóstico da doença é o exame ecocardiográfico, o qual permite detectar a lesão, classifica-la e ainda determinar o se grau de gravidade e as alterações secundarias.

Pulmonary artery stenosis corresponds to a congenital heart disease, more frequent in the canine species. It is characterized by narrowing of the pulmonary arterial lumen. In dogs, it corresponds to the third most frequent cardiac pathology and affects mainly the English Bulldog. Affected animals generally do not show symptoms, and in more severe cases it is possible to observe signs of right congenital heart failure and even syncope. The method of choice for the correct diagnosis of the disease is the echocardiographic examination, which allows to detect the lesion, classify it and also determine its degree of severity and secondary changes.

Use of computed radiology as a screening test for the identification of congenital heart disease in dogs / Utilização da radiologia computadorizada como exame de triagem na identificação de cardiopatias congênitas em cães

The objectives of this study were to evaluate the accuracy of thoracic radiology as a screening test for congenital heart diseases in dogs, to identify the main contributions and limitations of this modality, and to verify the reproducibility of the evaluations by three observers with different levels of training. An interobserver, observational, retrospective and prospective study was carried out, including ninety dogs: thirty healthy animals, thirty with acquired heart diseases and thirty with congenital heart diseases, which all had thoracic radiographs and a confirmed echocardiographic diagnosis. The cases were separated and randomized by a mediator who did not participate in the reading of the radiographic examinations, and no evaluator had access to the patients' data. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of each observer were calculated in relation to the correct classification of dogs to groups of normal or acquired and congenital heart diseases, as well as identification of enlargement of the cardiac silhouette and large vessels of dogs with congenital heart diseases. Finally, the Kappa coefficient was obtained between the observers to verify the reproducibility of the radiological evaluations performed. In general, sensitivity, PPV and accuracy were unsatisfactory ( 70%), and the agreement ranged from poor to reasonable (between 0 and 0.39). Although greater accuracy was achieved in the differentiation of healthy dogs from those with acquired and congenital heart diseases by thoracic radiography, when compared to the other studies, the modality was able only to identify healthy patients, and could not differentiate the individuals with different forms of heart disease or define the cardiac malformations. In addition, there was low reproducibility between observers, therefore, this technique should not be used as a sole screening method in dogs with suspected congenital heart diseases.(AU)

Os objetivos do estudo foram avaliar a acurácia da técnica radiográfica de tórax como exame de triagem nas cardiopatias congênitas em cães, identificar as principais contribuições e limitações dessa modalidade, e verificar a reprodutibilidade das avaliações realizadas por três observadores com diferentes graus de treinamento. Realizou-se um estudo interobservador, observacional, retrospectivo e prospectivo, o qual foram selecionados 90 cães, sendo 30 saudáveis, 30 com cardiopatias adquiridas e 30 com cardiopatias congênitas, que possuíam radiografia de tórax e diagnóstico ecocardiográfico confirmado. Os casos foram separados e randomizados por um mediador que não participou da leitura dos exames radiográficos, sendo que nenhum avaliador obteve acesso aos dados dos pacientes. Calculou-se os índices de sensibilidade, especificidade, valor preditivo positivo (VPP), valor preditivo negativo (VPN) e acurácia de cada observador em relação a identificação dos pacientes saudáveis, com cardiopatias adquiridas e congênitas, bem como para identificação de aumento da silhueta cardíaca e região de grandes vasos dos cães com cardiopatias congênitas. Por fim, foi obtido o coeficiente de Kappa entre os observadores a fim de verificar a reprodutibilidade das avaliações radiográficas realizadas. De modo geral, a sensibilidade, VPP e acurácia foram insatisfatórios (< 70%), enquanto a especificidade e VPN foram satisfatórios (> 70%), sendo que a concordância variou de ruim a razoável (entre 0 e 0,39). Apesar de ter sido alcançado acurácia maior na identificação de cães saudáveis, com cardiopatias adquiridas e congênitas pela radiografia de tórax quando comparado aos demais estudos, confirma-se que essa modalidade se mostrou capaz apenas de identificar o paciente saudável, não de diferenciar os indivíduos cardiopatas entre si ou de definir com maior detalhe as malformações cardíacas especificamente. Além disso, o exame radiográfico de tórax apresentou baixa reprodutibilidade entre os observadores, portanto, essa técnica não deve ser considerada como método único de triagem na suspeita de cães com cardiopatias congênitas.(AU)

Disfunção miocárdica secundária a sepse em cão: relato de caso / Myocardial dysfunction secondary to sepsis in dog: case report

A redução do empenho do miocárdio é um achado frequente em casos de sepse ou choque séptico, sendo a piometra uma das principais causas de sepse em cães. No presente trabalho relata-se um caso de sepse secundária à piometra levando à disfunção miocárdica em um canino, fêmea, da raça White West Highland Terrier, de dez anos de idade com histórico de prostração e hiporexia. Ao exame físico foi observada presença de secreção vulvar purulenta, abdômen abaulado e tenso à palpação. Foram realizados exames complementares, incluindo hemograma com resultado compatível com quadro infeccioso, bioquímica revelando hipocalemia e hipocalcemia, e exames de imagem. Observou-se por meio do exame ultrassonográfico presença de grande quantidade de líquido com celularidade em cornos e corpo uterino, compatível com piometra. Alterações compatíveis com sepse foram observadas durante o atendimento e estabilização do animal. No exame ecocardiográfico foi observado aumento dos diâmetros sistólico e diastólico do ventrículo esquerdo com diminuição da fração de encurtamento e ejeção, compatível com disfunção sistólica do ventrículo esquerdo. A referida paciente recebeu alta médica após correção cirúrgica e estabilização dos parâmetros clínicos, incluindo a disfunção sistólica, sendo relatado óbito sete dias após. Sugere-se que a causa mortis tenha sido a disfunção sistólica causada pela sepse. Conclui-se

The reduction of myocardial commitment is a frequent finding in cases of sepsis or septic shock, and piometra is one of the main causes of sepsis in dogs. In the present study, the case of sepsis secondary to piometra is reported leading to myocardial dysfunction in a canine, female, of the 10-year-old White West Highland Terrier with a history of prostration and hyporexia. On physical examination, the presence of purulent vulvar secretion, bulging abdomen and taut palpation was observed. Complementary tests were performed, including blood count, biochemistry and imaging tests. It was observed through ultrasound examination the presence of a large amount of fluid with cellularity in horns and uterine body, compatible with piometra. Alterations compatible with sepsis were observed during the care and stabilization of the animal. On echocardiographic examination, an increase in systolic and diastolic diameters of the left ventricle was observed with decreased shortening and ejection fraction, compatible with systolic dysfunction of the left ventricle. The patient received medical discharge after surgical correction and stabilization of clinical parameters, and died seven days later. It is suggested that the cause of death was systolic dysfunction caused by sepsis. It is concluded that myocardial dysfunction is a prognostic determinant factor in cases of sepsis, emphasizing the importance of its diagnosis and early treatment.(AU)

Disfunção miocárdica secundária a sepse em cão: relato de caso / Myocardial dysfunction secondary to sepsis in dog: case report

A redução do empenho do miocárdio é um achado frequente em casos de sepse ou choque séptico, sendo a piometra uma das principais causas de sepse em cães. No presente trabalho relata-se um caso de sepse secundária à piometra levando à disfunção miocárdica em um canino, fêmea, da raça White West Highland Terrier, de dez anos de idade com histórico de prostração e hiporexia. Ao exame físico foi observada presença de secreção vulvar purulenta, abdômen abaulado e tenso à palpação. Foram realizados exames complementares, incluindo hemograma com resultado compatível com quadro infeccioso, bioquímica revelando hipocalemia e hipocalcemia, e exames de imagem. Observou-se por meio do exame ultrassonográfico presença de grande quantidade de líquido com celularidade em cornos e corpo uterino, compatível com piometra. Alterações compatíveis com sepse foram observadas durante o atendimento e estabilização do animal. No exame ecocardiográfico foi observado aumento dos diâmetros sistólico e diastólico do ventrículo esquerdo com diminuição da fração de encurtamento e ejeção, compatível com disfunção sistólica do ventrículo esquerdo. A referida paciente recebeu alta médica após correção cirúrgica e estabilização dos parâmetros clínicos, incluindo a disfunção sistólica, sendo relatado óbito sete dias após. Sugere-se que a causa mortis tenha sido a disfunção sistólica causada pela sepse. Conclui-se

The reduction of myocardial commitment is a frequent finding in cases of sepsis or septic shock, and piometra is one of the main causes of sepsis in dogs. In the present study, the case of sepsis secondary to piometra is reported leading to myocardial dysfunction in a canine, female, of the 10-year-old White West Highland Terrier with a history of prostration and hyporexia. On physical examination, the presence of purulent vulvar secretion, bulging abdomen and taut palpation was observed. Complementary tests were performed, including blood count, biochemistry and imaging tests. It was observed through ultrasound examination the presence of a large amount of fluid with cellularity in horns and uterine body, compatible with piometra. Alterations compatible with sepsis were observed during the care and stabilization of the animal. On echocardiographic examination, an increase in systolic and diastolic diameters of the left ventricle was observed with decreased shortening and ejection fraction, compatible with systolic dysfunction of the left ventricle. The patient received medical discharge after surgical correction and stabilization of clinical parameters, and died seven days later. It is suggested that the cause of death was systolic dysfunction caused by sepsis. It is concluded that myocardial dysfunction is a prognostic determinant factor in cases of sepsis, emphasizing the importance of its diagnosis and early treatment.

Cardiac fibroelastosis associated with thromboembolism and paresis in a cat: case report

A two-year-old, male, non-castrated cat was referred to the veterinary hospital with a three-month history of paresis of the pelvic limbs. Clinical examination revealed a discreet muffling of cardiac sounds and the presence of a degree III/VI holosystolic murmur. The animal was hospitalized and died of cardiorespiratory arrest. The heart had a thickened left ventricular endocardium characterized by the deposition of a fibrous white matter that was firmly adhered to the endocardium and also observed on the epicardium. Renal infarctions and thrombi in the atrium and bifurcation of the aorta were found. Microscopically, in the endocardium of the left ventricular chamber there was a diffuse and disorganized deposition of fibrous connective tissue filled with elastic fibers of varying thickness. In the left ventricular epicardium, the same lesion was observed, but with less extension. Clinical and anatomopathological findings were consistent with primary left ventricular endocardial and left ventricular epicardial fibroelastosis with secondary left ventricular congestive heart failure, thromboembolism and paresis.