Integrative echocardiographic assessment of post-operative obstruction severity and restenosis after balloon valvuloplasty in 81 dogs with pulmonary stenosis.

INTRODUCTION/OBJECTIVES: Pulmonary stenosis (PS) is a congenital defect in the dog that is managed with balloon valvuloplasty (BV). Obstruction severity is routinely assessed using transthoracic echocardiography. The objectives of this study were to describe the short-term changes and long-term restenosis by retrospectively evaluating flow-dependent and flow-independent echocardiographic variables for dogs with PS after BV. ANIMALS, MATERIALS, AND METHODS: Medical records and stored echocardiographic images were reviewed from dogs that received BV for PS. The following echocardiographic variables were measured or calculated: maximum systolic ejection velocity (VmaxPV) and velocity-derived maximal pressure gradient (PV maxPG) across the pulmonary valve; ratio of aortic to pulmonary velocity time integral (VTIAV/VTIPV); ratio of aortic to pulmonary maximal velocity. RESULTS: Eighty-one dogs with PS that had a BV were included. Each of these dogs had pulmonary obstruction severity assessed in at least three timepoints. Forty-nine dogs had at least one additional examination performed, the last of which occurred a median of 504 days after the BV. Echocardiographic variables at the first follow-up had increased by a clinically relevant quantity in 20-34% of the dogs when comparing to the immediate post-BV examination. The last follow-up examination identified valve restenosis in 18-38% of the dogs in this study. Valve type and pre-BV obstruction severity did not have a significant effect (P > 0.1). CONCLUSIONS: For the assessment of BV efficacy, the immediate post-BV echocardiogram may not be as useful as the first follow-up examination several months later. Pulmonary restenosis after BV may be more prevalent than previously reported.

Hybrid balloon valvuloplasty for management of severe mitral stenosis in four symptomatic, adult dogs.

Four adult dogs weighing <10 kg presented for the evaluation of severe mitral valve stenosis with clinical signs. Owing to the size of the dogs, a hybrid surgical and interventional approach was utilized for balloon valvuloplasty. A left lateral thoracotomy was performed to allow direct entry through the left atrial wall. Transesophageal echocardiography was utilized for the entirety of the procedure in all dogs, and fluoroscopy was additionally used in two dogs. One dog had mild to moderate intra-operative bleeding from the left atrial wall during the procedure, but no other intra-operative complications were observed. No dogs developed a clinically relevant amount of worsened mitral regurgitation. Based on mitral leaflet mobility and transmitral flow profiles, there was perceived improvement in all four dogs. One dog died 6 h after extubation due to respiratory arrest. The remaining dogs survived to discharge and had resolution of clinical signs at home and discontinuation of heart failure medications. One dog died of an unknown cause at five months and another developed atrial fibrillation, and the owners elected to euthanize at ten months after the procedure. One dog continues to do well six months after the procedure as of the time of this writing. Hybrid balloon valvuloplasty can be a viable management option for small breed dogs with severe mitral stenosis exhibiting clinical signs, and both transesophageal echocardiography and fluoroscopy can be used intra-operatively to assist in successful procedural outcomes.

Transient high-grade second-degree atrioventricular block secondary to transvenous atrial septal defect occlusion in a dog.

A 1.2-year-old male-intact Standard Poodle underwent transvenous placement of an Amplazter™ atrial septal occluder for correction of a large secundum atrial septal defect. Thirty-six hours post-operatively, the dog developed high-grade Mobitz type II second-degree atrioventricular block, which resolved with time and corticosteroid administration by 12 days after the procedure. This case report outlines the observation, treatment, and resolution of high-grade Mobitz type II second-degree atrioventricular block, a known complication of atrial septal occluder placement in humans, not previously reported in veterinary literature.

Long-term relief of obstruction in a dog with double-chambered right ventricle using combined cutting balloon and high-pressure balloon dilation.

A 4-month-old intact female Golden Retriever dog was diagnosed with double-chambered right ventricle (DCRV) without infundibular stenosis, tricuspid valve dysplasia, and subsequent severe right atrial enlargement and was referred for combined cutting balloon and high-pressure balloon dilation. On presentation, these diagnoses were confirmed, and the peak systolic pressure gradient across the DCRV obstructive lesion assessed by continuous wave Doppler interrogation was 80 mm Hg. The obstructive lesion within the mid-right ventricle had a diameter of 6 mm through which blood flowed from the proximal right ventricular (RV) chamber to the distal RV chamber. The following day, general anesthesia was induced, and a minimally invasive balloon dilation was performed. A cutting balloon was inflated across the mid-RV obstructive lesion, followed by an inflation of a high-pressure balloon across this lesion. The high-pressure balloon catheter that was used had a diameter roughly 1.5 times the diameter of the pulmonary annulus. The following day, echocardiographic evaluation of the patient revealed a peak systolic pressure gradient across the DCRV obstructive lesion of 16 mm Hg, with a RV diameter at the level of obstruction of 11 mm. Twelve months later, the dog remains asymptomatic, right atrial size has decreased, and has a peak systolic pressure gradient across the DCRV lesion of 20 mm Hg.

Repeat balloon valvuloplasty for dogs with recurrent or persistent pulmonary stenosis.

INTRODUCTION/OBJECTIVES: Pulmonary stenosis (PS) is a common congenital defect in the dog. Severe valvar PS can be treated with balloon valvuloplasty (BV) to reduce obstruction severity and improve clinical signs. Repeat BV is often unnecessary, as restenosis is uncommon. Repeated pulmonary BV in people is generally successful and safe, but outcomes in dogs with recurrent or persistent stenosis have not been reported. The objectives of this study were to retrospectively evaluate outcomes of repeat BV in dogs. ANIMALS, MATERIALS, AND METHODS: Medical records and stored echocardiographic images were reviewed from dogs that received repeat BV for pulmonary valvar restenosis or persistent stenosis. Echocardiographic variables included maximum systolic ejection velocity (PVmax), velocity-derived maximal pressure gradient (PGmax) and velocity time integral (VTI) across the pulmonary valve, and ratios of pulmonic to aortic maximum velocity (PVmax/AVmax) and VTI (VTIPV/VTIAV). RESULTS: Twenty-three dogs were included; one underwent three BV procedures. The median time between BV procedures was 18.3 months (interquartile range, 6.3-43.6). One dog died during repeat BV, but no others experienced adverse effects. Reductions in PVmax, PGmax, and VTIPV after initial and repeat BV were 1.85 m/s, 76.2 mmHg, and 44.7 cm and 1.33 m/s, 55.6 mmHg, and 30.2 cm, respectively (all p < 0.01). Differences between pre-BV and post-BV PVmax, PGmax, VTIPV, PVmax/AVmax, and VTIPV/VTIAV were not different comparing initial to repeat BV (all p > 0.10). CONCLUSIONS: Repeat BV for recurrent or persistent PS is well tolerated and effective in a majority of dogs.

Using pregnancy associated glycoproteins (PAG) for pregnancy detection at day 24 of gestation in beef cattle.

The objective of this experiment was to determine if circulating concentrations of pregnancy associated glycoproteins (PAG) on day 24 of gestation can be utilized to diagnose pregnancy and embryo viability in beef cattle. Postpartum beef cows (n = 677) and heifers (n = 127) were exposed to a 7-day CO-Synch + CIDR estrus synchronization protocol followed by fixed-time AI (FTAI) on day 0. Blood samples were collected at day 24 after TAI to assess circulating concentrations of PAG utilizing an in-house ELISA. Pregnancy diagnosis was performed 30 and 100 days after FTAI via transrectal ultrasonography. Mean circulating PAG concentration at day 24 differed (P < 0.001) between animals diagnosed pregnant and non-pregnant at day 30 (1.69 ±â€¯0.10 ng/mL vs 0.30 ng/mL ±â€¯0.07 ng/mL; mean ±â€¯SEM; respectively). Pregnant heifers had increased PAG concentration at day 24 compared with pregnant cows (P < 0.01; 3.29 ±â€¯0.36 ng/mL vs 1.39 ±â€¯0.10 ng/mL, respectively). Based on receiver operating characteristic (ROC) curve analysis, serum concentration of PAG at day 24 ≥ 0.33 ng/mL in cows and ≥0.54 ng/mL in heifers was 95% accurate at determining pregnancy status at day 30. Heifers that experienced late embryonic mortality between day 30 and 100 of gestation had decreased circulating concentrations of PAG on day 24 (2.02 ng/mL ±â€¯0.73) compared with heifers that maintained an embryo until day 100 (3.69 ng/mL ±â€¯0.39; P = 0.02). However, there was no difference in day 24 PAG concentration (P = 0.39) between cows that maintained or lost a pregnancy (1.31 ng/mL ±â€¯0.25 vs 0.92 ng/ml ±â€¯0.50). In summary, circulating PAG concentration on day 24 of gestation may be a useful marker for early pregnancy detection in beef cattle, and might be a potential marker for predicting embryonic loss.

Bidirectional flow across a perforate cor triatriatum dexter in a dog with concurrent pulmonary, tricuspid, and mitral valve dysplasia.

A 10-week-old male intact mixed breed dog presented for evaluation of suspected right-sided congestive heart failure. Echocardiographic imaging revealed a perforate cor triatriatum dexter (CTD), along with pulmonary valve stenosis and tricuspid and mitral valve dysplasia. In typical CTD cases, there is unidirectional blood flow across the dividing membrane, from the caudal into the cranial right atrial chambers. Owing to right-sided pressure alterations caused by the concurrent valvar defects, color Doppler imaging demonstrated bidirectional flow across the CTD membrane.

Effect of Body Position, Exercise, and Sedation on Estimation of Pulmonary Artery Pressure in Dogs with Degenerative Atrioventricular Valve Disease.

BACKGROUND: Severity of pulmonary hypertension (PH) in dogs is related to clinical signs and prognosis. HYPOTHESIS/OBJECTIVES: We hypothesized that Doppler echocardiographic (DE) indices of pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) are influenced by independent factors that create clinically important variability of DE-based estimates of PH in dogs. ANIMALS: Thirty-eight client owned dogs with naturally acquired degenerative atrioventricular valve disease and tricuspid regurgitation (TR). METHODS: Dogs were prospectively enrolled, and target variables were acquired during 4 echocardiographic study periods (lateral recumbency, standing, lateral recumbency after a 6-minute walk test [6MWT], and lateral recumbency after sedation with butorphanol 0.25 mg/kg IM). Statistical methods included repeated measures ANOVA, mixed model analysis, and Chi-squared test of association. RESULTS: There was a significant increase in peak TR flow velocity (TRFV; P < 0.01) after sedation in 78% of dogs, with TRFV increasing by >0.4 m/s in 42% of dogs, independent of stroke volume. A significant effect of study period on DE-estimated PVR was not found (P = 0.15). There were negligible effects of sonographer, body position, and 6MWT on echocardiographic variables of PH. Clinically relevant cyclic variation of TRFV was found. There was an association between estimation of right atrial pressure based on subjective assessment and estimation based on cranial vena cava collapsibility (P = 0.03). CONCLUSIONS AND CLINICAL IMPORTANCE: The increase in TRFV observed with sedation could change assessment of PH severity and impact prognostication and interpretation of treatment response. Further studies with invasive validation are needed.

Relationships among temperament, acute and chronic cortisol and testosterone concentrations, and breeding soundness during performance testing of Angus bulls.

The aim of this study was to examine relationships among temperament, endocrinology, and reproductive parameters of bulls enrolled in an 84-day performance test. Angus bulls (n = 60) were housed in six pens grouped by age and weight. Pen scores (PS; 1 = docile to 5 = very aggressive) were assigned on Days -1, 27, 55, and 83 of the performance test. On the following day, blood and hair samples were collected, and body weight (BW) and exit velocity (EV) were recorded. Bulls were split into two categories based on; Day -1 PS (PScalm = PS 1 or 2; PSexcitable = PS 3 or 4) and Day 0 EV (EVcalm = slowest 20 bulls; EVexcitable = fastest 20 bulls). Cortisol and testosterone concentrations in serum and hair did not differ (P > 0.10) between PS or EV temperament categories. Sampling day differences (P < 0.01) occurred for serum testosterone, hair cortisol, and hair testosterone concentration; however, serum cortisol concentration did not differ (P > 0.10) over the sampling days. Serum testosterone concentration increased (P < 0.01) from Day 0 to 28, decreased from Day 28 to 56, but Day 84 did not differ from Day 0, 28, or 56. Hair cortisol concentration was greatest (P < 0.01) on Day 0, decreased from Day 28 to 56 but did not differ from Day 56 to 84. Hair testosterone concentration was greatest (P < 0.01) on Day 0 and remained constant from Day 28 to 84. Bulls categorized as PScalm had a greater (P < 0.01) percentage of normal sperm and secondary defects (P < 0.01) when compared with PSexcitable bulls. However, EVcalm bulls had fewer (P < 0.01) primary defects but more (P < 0.01) secondary defects than EVexcitable bulls. In conclusion, bulls exhibited physiological evidence of acclimation during the test as indicated by a reduction in hair cortisol concentration. In addition, the ability of the bulls to acclimate while residing at the testing center may have contributed to little differences observed during the breeding soundness examination portion of the performance test.

Relationships among temperament, behavior, and growth during performance testing of bulls.

Excitable cattle are dangerous to personnel and have reduced individual performance. The aim of this study was to 1) identify objective criteria for evaluating bull temperament and 2) examine relationships among temperament, behavior, and performance of bulls during an 84-d performance test. Angus bulls ( = 60) were reared in 6 pens based on BW and age. Pen scores (PS; 1 = docile and 5 = very aggressive) were assigned on d -1, 27, 55, and 83. Exit velocity (EV), BW, time to exit the chute, and order through the chute were recorded on d 0, 28, 56, and 84. The ADG was calculated for the 84-d test period, and ultrasound data and frame score calculations were recorded on d 84. Dataloggers measured steps taken, lying time, number of lying bouts, and lying bout duration of bulls ( = 27; 3 pens) from d 3 to 28 and d 59 to 84. Bulls with a d -1 PS of 1 or 2 were categorized as calm (PScalm; = 40), whereas bulls with a PS of 3 or 4 were categorized as excitable (PSexcitable; = 20). Bulls were separated into 2 groups based on the bottom 20 EV (EVcalm) and top 20 EV (EVexcitable) on d 0. Mixed model ANOVA (SAS 9.3) was used to compare groups for the two temperament assessment methods, behavior, and growth performance. Mean EV decreased ( < 0.05) by d 84. Total lying time from d 3 to 28 was greater ( < 0.05) for PScalm bulls when compared with PSexcitable bulls. However, total lying time from d 59 to 84 was greater ( < 0.05) for EVexcitable bulls when compared with EVcalm bulls. Regardless of initial contemporary group assignment, all bulls exited the chute slower ( < 0.001) on d 84 than on d 0. The PSexcitable bulls had greater ( < 0.01) frame scores and greater ADG than PScalm bulls. The PSexcitable bulls had more ( < 0.01) backfat than PScalm bulls. However, ribeye area was smaller ( < 0.01) in EVexcitable bulls than EVcalm bulls. Based on these results, bulls appeared to have habituated over the testing period. Additionally, the potential lack of innate temperament variation may have attributed to the little difference seen among the behavioral and performance data. Therefore, temperament should be reassessed within a novel environment with new handlers to differentiate between the bull's true temperament and its ability to habituate.

Exposure of beef females to the biostimulatory effects of bulls with or without deposition of seminal plasma prior to AI.

The objective of this experiment was to evaluate the biostimulatory effect of bull exposure, with or without the deposition of seminal plasma, on expression of estrus and pregnancy rate to AI in cattle. Beef heifers (n=86) and cows (n=193) were allocated to one of three treatments: (1) no bull exposure (CON; n=95), (2) exposure to a bull with a surgically-deviated penis for 21 d prior to AI (DB; n=88), or (3) exposure to a vasectomized bull for 21 d prior to AI (VB; n=96). The DB treatment provided the physical presence of a bull but prevented intromission, whereas the VB treatment allowed for intromission and deposition of seminal plasma but not spermatozoa. The estrous cycles of all females were synchronized using the Select Synch+CIDR protocol (GnRH+CIDR-7d-CIDR removal+PGF(2α), detection of estrus+AI 12h later for 84 h-clean-up TAI+GnRH). Pregnancy was detected via transrectal ultrasonography on d 35 post-AI. At the onset of the experiment, 75.7% of heifers and 86.1% of cows were estrous cycling. The percentages of females that displayed estrus were similar (P>0.05) among treatments (71.4%, 76.8%, and 74.4% for CON, DB, and VB, respectively). Pregnancy rates tended to be greater (P=0.06) in females in the DB treatment (60.5%) compared to females in the VB treatment (42.2%), with the control group intermediate (49.5%). In conclusion, biostimulation did not affect the expression of estrus but females exposed to the DB treatment tended to have an increased pregnancy rate.

Effect of weaning regimen on energy profiles and reproductive performance of beef cows.

The effect of shifting calf-weaning age on profiles of energy status (BW, BCS, and rib and rump fat) and reproductive performance of beef cows was evaluated in a 3-yr study. Pregnant and lactating crossbred beef cows (n = 408), mainly of Angus and Hereford breeding, were stratified by age and by sex and BW of their calves and assigned randomly into 2 treatments: weaning at approximately 180 d (early weaning) and normal weaning 45 d later (control). Cows were managed together on native range pastures and supplemented with harvested forage during the winter months. Cow BW, BCS, rib fat, and rump fat were measured periodically from early weaning through the next breeding. Reproductive performance was evaluated by calving intervals (CI), days from initiation of breeding to calving (BCI), retention in the herd, and adjusted 205-d weaning BW of the subsequent calf. Early weaned cows had greater (P < 0.001) BW at normal weaning than control cows, but the overall pattern of cow BW did not differ (P > 0.05) among treatments. Peak and nadir BCS occurred at precalving and postcalving periods, respectively and were greater (P < 0.001) at each period in early weaned than in control cows and in cows > or =5-yr-old than in younger cows. Patterns for rib fat and rump fat were nearly identical to those of BCS except for the 3-way interaction (P < 0.001) of treatment, age, and period on rump fat. Mean CI (372.4 +/- 2.1 d) and BCI (299.7 +/- 1.9 d) were not affected (P = 0.42) by treatment but varied (P < 0.001) with age of the cow. Age of cow accounted for 16% of total variation in CI and 12% of total variation in gestation length (P < 0.001). The intervals were longer (P < 0.001) in primiparous cows than in older cows. Early weaning decreased risk of culling in cows and thereby increased (P < 0.05) overall persistence by 11% over control cows. Earlier weaning of cows in the previous year increased (P < 0.001) weaning weight of the subsequent calf by 8.6 kg per cow per yr. Shifting weaning time increased storage of consumed energy as evidenced by increased rump fat, for use later during high-energy demand, ultimately improving overall productivity of the cow-calf system.

Low peripheral progesterone and late embryonic/early fetal loss in suckled beef and lactating dairy cows.

Pregnancy failure during placentation in lactating dairy cows was associated with low concentrations of serum progesterone. Beef cows have greater serum progesterone and less pregnancy failure. Experiment 1 determined that reduction of serum progesterone affected late embryonic/early fetal loss in suckled beef cows. Cows (n=40) received progesterone from two new or used controlled internal drug releasing devices, replaced every 5d, beginning on Day 28 of gestation (mating=Day 0); CL were enucleated on Day 29. Retention of pregnancy was 77% in treated cows and 97% in 78 control cows (P<0.05). Experiment 2 determined how pregnant, lactating dairy cows with high or low progesterone concentrations during Days 28-34 differed in luteal function or in serum progesterone during replacement therapy. Luteal tissue from such cows was assayed for progesterone and expression of mRNA for genes of endothelin and prostaglandin (PG) systems. Secretion of progesterone and prostaglandins by dispersed luteal cells was determined during incubation with LH, endothelin-1, or arachidonic acid. Neither luteal progesterone nor mRNAs for endothelin or prostaglandin systems differed. Endothelin-1 inhibited secretion of progesterone more (P<0.05) in luteal cells from cows with low versus high serum progesterone, when incubated with arachidonic acid. Secretion of prostaglandin F(2)alpha was increased and that of 6-keto-PGF(1)alpha decreased by endothelin-1 in vitro. Serum progesterone during replacement was lower (P<0.05) for cows with low than high serum progesterone at lutectomy. Thus, clearance, more than luteal production, determined peripheral progesterone in pregnant, lactating dairy cows.