Successful transcatheter retrieval of embolized Amplatz Canine Duct Occluders in two dogs.

Transcatheter occlusion of patent ductus arteriosus (PDA) using an Amplatz® Canine Duct Occluder (ACDO) is routinely performed in dogs. Pulmonary embolization of the device is a rarely reported complication of this procedure. We report here the first two cases of successful transcatheter retrieval of an embolized ACDO. An 8-month-old, 21-kg, German shepherd (case 1) was referred for pulmonary edema secondary to a large PDA with left-to-right shunting. After medical stabilization, an emergency procedure for PDA closure was recommended. An 8-mm ACDO was deployed under general anesthesia. The device was released after confirming its stability with a gentle tug test but migrated into the pulmonary trunk. A 10-mm ACDO was subsequently successfully deployed and released. Vascular access was then obtained from the right jugular vein so that a vascular snare could be used to capture the ACDO waist and pull it back toward the right ventricle and then the right atrium. It was then removed through the jugular vein. The dog recovered uneventfully and was discharged after confirmation of complete ductal occlusion. The same complication occurred in a second case (case 2, asymptomatic 6-month-old, 7.9-kg, cocker spaniel), and a similar procedure was used to successfully retrieve the embolized device. Both dogs are still doing well 9 and 21 months, respectively, after the procedure. These cases illustrate that transcatheter retrieval of ACDO devices embolized in the pulmonary artery using vascular snares is technically feasible in the dog.

Aortic dissecting aneurysm associated with systemic arterial hypertension in a cat.

INTRODUCTION: Aortic dissection is characterized by a tear in the aortic wall resulting in blood from the aortic lumen penetrating into the media, which causes dissection. When aortic dissection does not cause rupture, it provokes localized dilation of the aorta or aneurism, also called dissecting aortic aneurism (DAA). This case report describes a DAA in a cat associated with systemic arterial hypertension (SAHT). A 10-year-old male Domestic shorthair cat was presented for cardiac evaluation. Anamnestic clinical complaints were a syncope associated with paraparesis and weak femoral pules. Cardiomegaly had been found radiographically, and cardiogenic arterial thromboembolism had been suspected. Upon presentation physical abnormalities were tachycardia and a heart murmur. Measurement of systolic systemic arterial blood pressure (SABP) revealed severe SAHT. Echocardiographic images showed severe DAA, and marked aortic valve insufficiency. Palliative antihypertensive treatment resulted in fast clinical improvement and significant decrease in blood pressure. Four months later, acute severe respiratory distress due to cardiogenic pulmonary edema led to the cat's euthanasia. In human medicine, DAA is a well-reported complication of SAHT. This is the second case of DAA with congestive heart failure reported in a hypertensive cat.

Intracardiac echocardiography: use during transcatheter device closure of a patent ductus arteriosus in a dog.

Intracardiac echocardiography (ICE) is used in humans for percutaneous interventional procedures, such as transcatheter device closures. Intracardiac echocardiography provides high-resolution imaging of cardiac structures with two-dimensional, M-mode, Doppler, and also three-dimensional modalities. The present report describes application of ICE during transcatheter occlusion of patent ductus arteriosus using a canine ductal occluder in a dog for which transesophageal echocardiography could not provide an optimal acoustic window.

Systemic arterial hypertension secondary to chronic kidney disease in two captive-born large felids.

Systemic arterial hypertension (SHT) has been widely described in the domestic cat (Felis catus). In these feline patients, SHT is considered as the most common vascular disorder of middle-aged to older animals, and secondary SHT related to chronic kidney disease (CKD) represents the most common form of the disease. We describe here the first two cases of spontaneous SHT in large felids, i.e. one 18-year old, 34.4 kg, male North-Chinese leopard (Panthera pardus japonensis, case #1) and one 20-year old, 28.7 kg, female snow leopard (Panthera uncia, case #2), both captive-bred and previously diagnosed with CKD. Both animals underwent complete echocardiographic examination under general anesthesia due to abnormal cardiac auscultation (heart murmur and/or gallop sound), and recurrent lethargy in case #1. The combination of left ventricular remodeling with moderate aortic regurgitation of high velocity was highly suggestive of SHT, which was confirmed by indirect blood pressure measurement (systolic arterial blood pressure of 183 mmHg for case #1 and 180 mmHg for case #2). Amlodipine was prescribed (0.35-0.70 mg/kg/day orally) for 31 and 6 months respectively after the initial diagnosis. In case #1, concurrent amlodipine and benazepril treatment was associated with decreased heart murmur grade and reduced aortic insufficiency severity. These reports illustrate that, similarly to domestic cats, SHT should be suspected in old large felids with CKD and that amlodipine is a well-tolerated antihypertensive drug in these species.

Effect of physiological determinants and cardiac disease on plasma adiponectin concentrations in dogs.

BACKGROUND: In humans, a high concentration of adiponectin is associated with a favorable cardiovascular risk profile whereas, in patients with heart failure (HF), a high concentration of adiponectin is associated with a less favorable prognosis. HYPOTHESIS/OBJECTIVES: To evaluate the physiological determinants of plasma adiponectin concentration in dogs and the influence of heart disease, myxomatous mitral valve disease (MMVD), and dilated cardiomyopathy (DCM). ANIMALS: One hundred and fourteen client-owned dogs and 9 Beagles from the research colony of the Clinical Veterinary Unit of the University of Liège. METHODS: We prospectively measured circulating adiponectin concentration in healthy control dogs (n = 77), dogs with MMVD (n = 22) and dogs with DCM (n = 15) of various degrees of severity. Diagnosis was confirmed by Doppler echocardiography. Plasma adiponectin concentration was measured by a canine-specific sandwich ELISA kit. RESULTS: An analysis of covariance showed an association between adiponectin concentration and age, neuter status, and heart disease. No association between adiponectin concentration and class of HF, sex, body condition score, body weight, circadian rhythm, or feeding was found. Plasma adiponectin concentration was negatively correlated with age (P = .001). Adiponectin was lower in neutered (P = .008) compared to intact dogs. Circulating adiponectin concentration was increased in dogs with DCM compared to healthy dogs (P = .018) and to dogs with MMVD (P = .014). CONCLUSIONS AND CLINICAL IMPORTANCE: Age and neutering negatively influence circulating adiponectin concentration. Plasma adiponectin concentration increased in dogs with DCM. Additional research is required to investigate if this hormone is implicated in the pathophysiology of DCM and associated with clinical outcome.

Effect of body weight loss on cardiopulmonary function assessed by 6-minute walk test and arterial blood gas analysis in obese dogs.

BACKGROUND: Few studies show the detrimental effect of canine obesity on cardiopulmonary function (CPF). The 6-Minute Walk Test (6MWT) is a noninvasive exercise test easy to perform in clinical settings. OBJECTIVE: The aim of this study was to investigate the effect of obesity and body weight loss (BWL) on CPF assessed by the 6MWT and arterial blood gas analysis. ANIMALS: Six experimental Beagles and 9 privately owned obese dogs were enrolled in a diet-induced BWL program. METHODS: Arterial blood gas analysis and 6MWT were repeated in obese subjects (BCS 8-9/9), in the middle of BWL (overweight, BCS 6-7/9), and in lean dogs (BCS 5/9). Heart rate (HRp) and oxygen saturation (SpO2 ) were measured by pulse oximetry before the 6MWT, at midtest, and during a 5-minute recovery period. RESULTS: Twelve dogs completed the BWL program (initial BW, 27.3 ± 2.9 kg; final BW, 20.85 ± 2.9, lsmeans ± SE, P ≤ .001). BWL caused a significant increase in 6MWT walked distance (WD; obese: 509 ± 35 m; overweight: 575 ± 36 m; lean: 589 ± 36 m; P ≤ .05). Resting arterial blood gas results were not influenced by BWL. Including all time points, obese dogs showed higher HRp and lower SpO2 compared to overweight and lean dogs. SpO2 at the end of the walk was significantly lower in obese dogs. CONCLUSION AND CLINICAL IMPORTANCE: Obesity negatively affects 6MWT performances in dogs. The 6MWT may be used to demonstrate the efficacy of BWL to improve CPF and quality of life in obese dogs. Although BWL induced significant improvement of cardiopulmonary parameters before ideal BW, WD improved until the end of the BWL program.

Effect of heart failure on dipeptidyl peptidase IV activity in plasma of dogs.

BACKGROUND: In congestive heart failure (HF), plasma B-type natriuretic peptide (BNP) seems devoid of biological effectiveness. BNP(1-32) could be truncated into BNP(3-32) by dipeptidyl peptidase IV (DPP4), and BNP(3-32) has reduced biological activities. HYPOTHESIS: Increased DPP4 activity is associated with pathophysiology of HF. ANIMALS: One hundred twenty-eight client-owned dogs and 9 experimental Beagles from the Clinical Veterinary Unit of the University of Liège. METHODS: We prospectively measured plasma DPP4 activity in 5 groups of dogs: normal growing dogs (n = 21), normal adult dogs (n = 60), healthy Beagle (n = 9), dogs with myxomatous mitral valve disease (n = 35), and dogs with dilated cardiomyopathy (n = 12). The final diagnosis and the severity of HF were determined by Doppler echocardiography. Plasma DPP4 activity was measured kinetically by a fluorimetric method. RESULTS: In growing dogs, DPP4 activity was higher than in adults (P < .001) and inversely correlated with age (r = -0.57, P < .01). In adults, DPP4 activity increased linearly with body weight (r = 0.39, P < .01), but there was no influence of age or sex. No effect of the circadian rhythm was noted. DPP4 activity was significantly higher in HF ISACHC I (16.3 ± 1.14 U/L) compared with healthy adults (12.4 ± 0.65 U/L, P < .05) and HF ISACHC III (11.0 ± 1.50 U/L, P < .05). Mean DPP4 activity in ISACHC II was 15.1 ± 1.4 U/L. CONCLUSION AND CLINICAL IMPORTANCE: We did not find evidence that plasma DPP4 activity is responsible for the "BNP resistance" in overt congestive HF, but it may be implicated in early stages.