Clinical bleeding diathesis, laboratory haemostatic aberrations and survival in dogs infected with Angiostrongylus vasorum: 180 cases (2005-2019).

OBJECTIVES: Bleeding diathesis is a complication in dogs infected with Angiostrongylus vasorum. This retrospective study investigated clinical and laboratory haemostatic differences in A. vasorum-positive dogs with and without signs of bleeding and impact of bleeding on survival. MATERIALS AND METHODS: Demographics, type of clinical bleeding, haematocrit and a range of haemostatic tests, including thromboelastography and derived velocity curves were retrospectively registered from A. vasorum-positive dogs. All parameters were compared between dogs with and without signs of bleeding using univariable analyses. Binomial and multinomial regression models were applied to examine specific indicators in the bleeding dogs. P-values were false discovery rate adjusted, and adjusted P<0.05 was considered significant. RESULTS: One hundred and eighty dogs entered the study, including 65 dogs (36.1%) presenting with bleeding diathesis. Different types of cutaneous and mucosal bleeding were the most common clinical findings. Twenty dogs presented with neurological signs associated with intracranial and intra-spinal bleeding. One hundred and thirty-seven dogs had haematological and/or haemostatic laboratory analyses performed. Haematocrit, platelet count, thromboelastographic angle, maximum amplitude, global clot strength, maximum rate of thrombin generation and total thrombin generation were decreased, while prothrombin time was prolonged in bleeding dogs. Survival rate of bleeding dogs was lower at hospital discharge (76.9%) and 1 month after diagnosis (66.0%) than in dogs without signs of bleeding (94.8% and 90.1% at discharge and at 1 month, respectively). CLINICAL SIGNIFICANCE: Several haemostatic aberrations were detected in A. vasorum-positive dogs with bleeding diathesis. Bleeding was identified as an important negative prognostic indicator in A. vasorum-positive dogs.

Non-invasive assessment of left ventricular relaxation property using color M-mode-derived intraventricular pressure gradients in cats.

INTRODUCTION: Diastolic dysfunction is an early clinical feature of feline hypertrophic cardiomyopathy (HCM). The left ventricular filling in early diastole is facilitated by the diastolic intraventricular pressure gradient (IVPG). The study objectives were to evaluate color Doppler M-mode-derived IVPG calculation in cats as a non-invasive assessment of the left ventricular relaxation property to determine the normal ranges of peak IVPG in cats and investigate the influence of left ventricular function and heart rate (HR). ANIMALS: One hundred and six client-owned apparently healthy cats. METHODS: Prospective cross-sectional study. Quantitative analysis of color Doppler M-mode images was used to estimate total and segmental IVPGs non-invasively. RESULTS: The total IVPG was 0.76 mmHg (95% reference interval (RI): 0.28-1.29 mmHg), the basal IVPG 0.34 mmHg (95% RI: 0.07-0.63 mmHg), and the mid-apical IVPG 0.42 mmHg (95% RI: 0.15-0.71 mmHg). Total and segmental IVPG increased with HR (P < 0.003), while segmental percent IVPG was HR independent. A short isovolumic relaxation time (IVRT) and a high mitral annular velocity in early diastole were associated with an increase in total IVPG (P = 0.008 and P = 0.009, respectively) adjusted for HR. An increase in IVPG was associated with an increase in mitral inflow velocity (P < 0.001). CONCLUSIONS: Feline IVPGs increase with HR and a short IVRT, which was believed to be a normal physiologic adrenergic response associated with an increased sympathetic tone. Future studies of segmental IVPG changes in feline HCM are needed to evaluate the clinical applicability of color Doppler M-mode estimated IVPGs in feline cardiology.

Epidemiology of heart disease in English Bull Terriers and echocardiographic characteristics of mitral valve abnormalities.

OBJECTIVES: To present the prevalence and distribution of heart disease as well as echocardiographic findings in English Bull Terriers. MATERIALS AND METHODS: One hundred and one English Bull Terriers were retrospectively included to evaluate the prevalence and distribution of heart disease. Secondly, a retrospective study on mitral valve abnormalities was performed on three groups: a control group (n=120, 19 breeds) used to establish reference intervals for mean transmitral gradient; a healthy English Bull Terriers group (n=25) and an English Bull Terriers group with mitral valve abnormalities (n= 18). Healthy English Bull Terriers for which mitral inflow parameters were not obtainable and English Bull Terriers with other types of heart disease were excluded. RESULTS: The prevalence of heart disease in English Bull Terriers was 65% (66/101), with mitral valve abnormalities (47%, 47/101) and aortic stenosis (29%, 29/101) being most common. The cut-off value for normal mean transmitral gradient was 3.5 mmHg in the control group. The mean transmitral gradient for healthy English Bull Terriers was higher than for other dog breeds. Healthy English Bull Terriers had a smaller mitral valve area and mitral annulus diameter compared with dogs with a similar body surface area. A high heart rate, smaller mitral valve area, mitral regurgitation, and volume overload are associated with increased mean transmitral gradient in English Bull Terriers with mitral valve abnormalities. CLINICAL SIGNIFICANCE: We suggest that mitral valve area, mitral annulus diameter and mean transmitral gradient measurements should be included in the echocardiographic protocol for English Bull Terriers.

Outcome clinical audit: analyses of interventional closure of patent ductus arteriosus in dogs.

OBJECTIVES: The objectives of this study were to determine whether conducting a clinical audit was achievable in a group of centres that perform interventional cardiac procedures and to report the success and complications rates in dogs diagnosed with patent ductus arteriosus. METHODS: This was a multicentre, European-wide, prospective study. Patient data were entered into a bespoke database prior to commencing interventional closure of patent ductus arteriosus in all animals undergoing this procedure during the study period. The database was designed to gather clinical audit information, after completion of the procedure, such as discharge outcome, complication rate, and medium-term outcome. RESULTS: A total of 339 cases were included from five participating centres. The process of performing clinical audit was achieved in all centres. Successful discharge outcome was 95.9% with a complication rate of 4.1%. The procedure-related mortality was 0.6%. 149 cases (43.9%) were either lost to follow-up or had not yet had a follow-up within the time period. Of the remaining 169 cases in which follow-up was available, 157 (92.9%) cases had a successful medium-term outcome CONCLUSIONS: This study demonstrates that the process of performing a clinical audit is achievable in veterinary clinical interventions across different centres. These results provide a benchmark for future comparison in our ongoing clinical audit and validate the process of clinical audit for other centres performing cardiac interventions. The use of clinical audit should be considered in other aspects of veterinary medicine.

Detection of congestive heart failure by mitral annular displacement in cats with hypertrophic cardiomyopathy - concordance between tissue Doppler imaging-derived tissue tracking and M-mode.

INTRODUCTION: The left ventricular systolic longitudinal function, traditionally measured by M-mode-derived mitral annular plane systolic excursion (MAPSE), is reduced in feline hypertrophic cardiomyopathy (HCM) and further reduced in cats with left-sided congestive heart failure (CHF). The objectives of this study were to compare longitudinal displacement measured by tissue tracking (TT-LD) and MAPSE in feline HCM and assess these methods' ability to differentiate CHF from preclinical HCM. A further objective was to provide preliminary reference intervals for TT-LD. ANIMALS: Eighty-five client-owned cats. METHODS: A retrospective case-control study. Anatomical M-mode was used to record MAPSE, and TT-LD was recorded by tissue tracking. RESULTS: Reduced longitudinal displacement measured by either MAPSE or TT-LD was significantly associated with CHF in cats with HCM (p < 0.036). Receiver-operating characteristic analysis indicated that TT-LD (AUC: 92.9%-97.9%) was more sensitive and specific than MAPSE (AUC: 85.8%-89.1%) for the detection of CHF. A diagnostic cut-off of 2.89 mm for maximal TT-LD in the left ventricular septum resulted in a sensitivity and specificity of 100% and 83.3%, while a diagnostic cut-off of 2.41 mm in the left ventricular posterior wall resulted in a sensitivity of 100% and a specificity of 90%. CONCLUSIONS: M-mode-derived mitral annular plane systolic excursion and TT-LD were strongly correlated, but not interchangeable. Longitudinal displacement measured by tissue tracking decreased more with disease severity than traditional MAPSE. Longitudinal displacement may help detect CHF in cats with HCM - with the maximal TT-LD of the left ventricular posterior wall achieving the highest AUC value.

Transthoracic two-dimensional and three-dimensional echocardiography for the measurement of mitral valve area planimetry in English Bull Terriers with and without heart disease.

INTRODUCTION: Mitral valve area (MVA) planimetry is used to diagnose and classify mitral stenosis (MS) in humans using two-dimensional and three-dimensional echocardiography (MVA2D and MVA3D). This study aimed to evaluate agreement, feasibility, and observer variability between MVA2D and MVA3D in English Bull Terriers (BT). Our hypotheses were (1) that the MVA of BT is generally smaller than that of breeds with similar body weight and (2) that these techniques could be used to diagnose MS in BTs. ANIMALS: Twenty healthy BTs, 15 healthy Boxers, and 49 BTs with heart disease. MATERIALS AND METHODS: A prospective diagnostic agreement study was conducted. All dogs underwent a thorough clinical examination, conventional transthoracic echocardiography, and three-dimensional echocardiography. RESULTS: Bland-Altman plots (limits of agreement: 0.12-1.5) showed consistent bias and poor agreement between MVA2D and MVA3D. For the 69 BTs, MVA3D (2.1 ± 0.50 cm2) measurements were significantly lower than MVA2D measurements (2.9 ± 0.60 cm2), and healthy BTs had significantly lower MVA parameters than healthy Boxers (p < 0.001). Intraobserver and interobserver variability were excellent for both MVA2D and MVA3D (intraclass correlation coefficient >0.9). Six BTs were diagnosed with MS, with MVA3D less than 1.8 cm2 and a mean transmitral gradient (MTG) of more than 5 mmHg. CONCLUSIONS: Both MVA2D and MVA3D are feasible, have low observer variability and can be used to diagnose MS in BTs. For assessing the narrowest orifice area, the preferred method is MVA3D. The smaller MVA in BTs compared to Boxers may indicate some degree of MS.

Aortic stenosis in the Dogue de Bordeaux.

OBJECTIVES: To evaluate the occurrence of aortic stenosis and establish echocardiographic reference values in the Dogue de Bordeaux in Denmark. METHODS: Fifty-three dogs were auscultated for evidence of a cardiac murmur and a full echocardiographic examination was performed. The criterion for the diagnosis of aortic stenosis was a peak aortic velocity greater than 2.5 m/s from a subcostal transducer location. RESULTS: A left-basilar ejection murmur was detected in 38 (72 per cent) of the dogs. An aortic ejection velocity greater than 2.5 m/s was identified in 9 (17 per cent) of the dogs from a subcostal view. The aortic annulus in Dogue de Bordeaux was smaller than that considered normal in other breeds with comparable body size. Furthermore, a decreased aortoseptal angle was noticed in dogs with aortic stenosis. CLINICAL SIGNIFICANCE: The Dogue de Bordeaux may be highly predisposed to aortic stenosis. The small aortic annulus noted in healthy and affected Dogue de Bordeaux and a decreased aortoseptal angle noted in affected dogs in this study might reflect key aetiological features in the development of aortic stenosis.

Efficacy and safety of imidacloprid/moxidectin spot-on solution and fenbendazole in the treatment of dogs naturally infected with Angiostrongylus vasorum (Baillet, 1866).

A randomized, blinded, controlled multicentre field trial study was conducted to evaluate the efficacy and safety of imidacloprid 10%/moxidectin 2.5% spot-on solution and fenbendazole in treating dogs naturally infected with Angiostrongylus vasorum. Dogs were randomly treated either with a single dose of 0.1 ml/kg bodyweight of imidacloprid 10%/moxidectin 2.5% spot-on solution or with 25 mg/kg bodyweight fenbendazole per os for 20 days. The study period was 42 days with dogs being examined on days 0, 7 and 42. The primary efficacy parameter was the presence of L1 larvae in faecal samples evaluated by a Baermann test from three consecutive days. Thoracic radiographs performed on each visit were being taken as a paraclinical parameter to support the results of the Baermann test. Twenty-seven dogs in the imidacloprid/moxidectin group and 23 dogs in the fenbendazole group completed the study according to protocol. The efficacies of the two treatment protocols were 85.2% (imidacloprid/moxidectin) and 91.3% (fenbendazole) with no significant difference between treatment groups. On radiographic evaluation pulmonary parenchyma showed similar improvement in each group. No serious adverse effects to treatment were recorded: most of the minor adverse effects were gastrointestinal such as diarrhea (nine dogs), vomitus (eight dogs) and salivation (three dogs). In general, these adverse effects were of short duration (1-2 days) within the first few days after treatment start and required little or no treatment. This prospective study demonstrates that both treatment protocols used are efficacious under field conditions, that treatment of mildly to moderately infected dogs with either of these protocols is safe and yields an excellent prognosis for recovering from the infection.

Left atrial volume and function in dogs with naturally occurring myxomatous mitral valve disease.

OBJECTIVE: Myxomatous mitral valve disease (MMVD) induces progressive left atrial (LA) enlargement. The LA modulates left ventricular filling and performance through its reservoir, conduit, and contractile function. Assessment of LA size and function may provide valuable information on the level of cardiac compensation. Left atrial function in dogs with naturally occurring MMVD remains largely unexplored. The objective of this study was to evaluate LA volume and function in dogs with naturally occurring MMVD. ANIMALS: This prospective study included 205 client-owned dogs of different breeds, 114 healthy dogs, and 91 dogs with MMVD of different disease severities. METHODS: Using two-dimensional echocardiography, the biplane area-length method was applied to assess LA volume and calculate volumetric indices of LA reservoir, conduit, and contractile function. RESULTS: Left atrial volume and LA stroke volume increased, whereas LA reservoir and contractile function decreased with increasing disease severity. A maximal LA volume <2.25mL/kg was the optimal cut off identified for excluding congestive heart failure in dogs with chronic MMVD with a sensitivity of 96% and a specificity of 100%. An active LA emptying fraction <24% and/or a LA expansion index <126% were suggestive of congestive heart failure in dogs with chronic MMVD with a sensitivity of 77% and a specificity of 89% and a sensitivity of 82% and a specificity of 82%, respectively. CONCLUSION: Dogs with MMVD appear to have larger LA volumes with poorer LA function. Deteriorating LA function, characterized by a decreasing reservoir and active contractile function, was evident in dogs with MMVD with increasing disease severity.

Cardiac Troponins in Dogs and Cats.

Cardiac troponins are sensitive and specific markers of myocardial injury. The troponin concentration can be thought of as a quantitative measure of the degree of injury sustained by the heart, however, it provides no information on the cause of injury or the mechanism of troponin release. Conventionally, the cardiac troponins have been used for diagnosis of acute myocardial infarction in humans and have become the gold standard biomarkers for this indication. They have become increasingly recognized as an objective measure of cardiomyocyte status in both cardiac and noncardiac disease, supplying additional information to that provided by echocardiography and ECG. Injury to cardiomyocytes can occur through a variety of mechanisms with subsequent release of troponins. Independent of the underlying disease or the mechanism of troponin release, the presence of myocardial injury is associated with an increased risk of death. As increasingly sensitive assays are introduced, the frequent occurrence of myocardial injury is becoming apparent, and our understanding of its causes and importance is constantly evolving. Presently troponins are valuable for detecting a subgroup of patients with higher risk of death. Future research is needed to clarify whether troponins can serve as monitoring tools guiding treatment, whether administering more aggressive treatment to patients with evidence of myocardial injury is beneficial, and whether normalizing of troponin concentrations in patients presenting with evidence of myocardial injury is associated with reduced risk of death.

Comparison of four echocardiographic methods to determine left atrial size in dogs.

OBJECTIVES: To compare a linear and three volume-based two-dimensional echocardiographic methods for measuring LA size: left atrium to aorta ratio (LA/Ao ratio), biplane area-length, biplane modified Simpson and monoplane area-length. ANIMALS: One hundred seventy-six client-owned dogs of different breeds, 88 healthy dogs and 88 dogs with myxomatous mitral valve disease of different disease severity. METHODS: The left apical four- and two-chamber views were used to measure LA volumes. The right parasternal short-axis view at the level of the heart base was used to measure the LA/Ao ratio. RESULTS: The biplane area-length method yielded 2.8% larger values than those of the biplane modified Simpson method, consistent across the full range of LA volumes. The monoplane area-length method derived on average 5.8% larger values of LA volume than the biplane area-length method. The difference between these two methods was most pronounced at larger LA volumes. The relation between the LA/Ao ratio and LA volume was curvilinear and with increasing LA size these two methods derived very dissimilar values. CONCLUSIONS: All methods showed good feasibility and reproducibility, with the volume-based methods having the most favourable intra- and inter-observer variabilities. The LA/Ao ratio underestimates at higher values of LA size compared to the biplane area-length method. LA volume methods may be superior to the LA/Ao ratio in quantification of LA size. The biplane area-length method and biplane modified Simpson method can be used interchangeably. The monoplane area-length measurement may be used as a quick and reliable method for assessment of LA size in clinical practice.

The prevalence of the electrocardiographic J wave in the Petit Basset Griffon Vendéen compared to 10 different dog breeds.

INTRODUCTION: To investigate the prevalence and amplitudes of the electrocardiographic J wave in the Petit Basset Griffon Vendéen compared to 10 other dog breeds. ANIMALS: Electrocardiograms from 206 healthy dogs representing 11 dog breeds were included in the study. Besides Petit Basset Griffon Vendéen (PBGV; n = 23) 10 other dog breeds were included. MATERIALS AND METHODS: An electrocardiogram ruler was used for measuring the amplitudes of the J waves. The definition of a J wave was a positive deflection at the J point of ≥0.1 mV in more than 1 lead of the bipolar standard limb leads (I, II, III) or the unipolar standard limb leads (aVL and aVF). RESULTS: The prevalence of J waves in the PBGV (n = 23) was 91% (n = 21, standard error (SE) = 5.9%), which was significantly higher compared to seven other dog breeds (p < 0.05). The overall prevalence of J waves in all 11 dog breeds (n = 206) was 43% (n = 89, robust SE = 7.8%). There was no significant difference in the prevalence between male and female dogs (p = 0.79). Neither did age (p = 0.22) nor heart rate (p = 0.25) significantly affect the prevalence of J wave. CONCLUSIONS: The PBGV had the highest prevalence of J waves and the highest amplitudes compared to 10 other dog breeds. However J waves were also seen in other breeds. Therefore, J waves may be considered a normal variant on the canine electrocardiogram and should not be interpreted as cardiac disease.

Genotype-phenotype correlation between the cardiac myosin binding protein C mutation A31P and hypertrophic cardiomyopathy in a cohort of Maine Coon cats: a longitudinal study.

OBJECTIVES: A missense mutation (A31P) in the cardiac myosin binding protein C gene has been associated with hypertrophic cardiomyopathy (HCM) in Maine Coon cats. The aim of this study was to investigate the effect of A31P on development of HCM, myocardial diastolic dysfunction detected by color tissue Doppler imaging and occurrence of cardiac death during longitudinal follow-up in a cohort of Maine Coon cats. ANIMALS: The original cohort comprised 282 cats (158 of wild-type genotype, 99 heterozygous for A31P and 25 homozygous for A31P). METHODS: Prospective longitudinal study including echocardiography and registration of survival. RESULTS: The median age at the initial examination was 1.7 years (range, 0.8-9.2 years) and 6.4% (18/282) of the cats were diagnosed with HCM. One hundred sixty-five cats were eligible for echocardiographic re-examination, and during an average follow-up period of 2.7 years an additional 6.7% (11/165) of the cats developed HCM. Survival data could be obtained for 262 of the cats originally included, and among these 9.2% (24/262) died of causes that met the study criteria for cardiac death. In the homozygous group 80% (20/25) of cats included were diagnosed with HCM and 48% (12/25) suffered cardiac death during follow-up. These results corresponded to a significantly higher risk for cats homozygous for A31P to develop HCM (p<0.001) and die from cardiac-related causes compared with both other genotypes (p<0.001). CONCLUSIONS: Homozygosity for A31P was associated with a high penetrance of HCM and a substantial risk for cardiac death in the study population.

Cardiac troponin I and T as prognostic markers in cats with hypertrophic cardiomyopathy.

BACKGROUND: Myocardial injury detected by cardiac troponin I and T (cTnI and cTnT) in cardiac disease is associated with increased risk of death in humans and dogs. HYPOTHESIS: Presence of myocardial injury predicts long-term death in cats with hypertrophic cardiomyopathy (HCM), and ongoing myocardial injury reflects change in left ventricular wall thickness over time. ANIMALS: Thirty-six cats with primary HCM. METHODS: Prospective cohort study. Cats with HCM were included consecutively and examined every 6 months. Echocardiography, ECG, blood pressure, and serum cTnI and cTnT were evaluated at each visit. Cox proportional hazards regression analysis was performed to evaluate prognostic potential of serum troponin concentrations at admission and subsequent examinations. Correlations were used to examine associations between troponin concentrations and cardiac hypertrophy. RESULTS: Troponin concentrations at admission were median [range] 0.14 [0.004-1.02] ng/mL for cTnI, and 13 [13-79.5] ng/L for cTnT. Both were prognostic for death (P = .032 and .026) as were the last available concentrations of each (P = .016 and .003). The final cTnT concentration was a significant predictor of death even when adjusting for the admission concentration (P = .043). In a model containing both markers, only cTnT remained significant (P = .043). Left ventricular free wall thickness at end-diastole (LVFWd) at admission was correlated with cTnI at admission (r = 0.35, P = .035), however no significant correlations (r = 0.2-0.31, P = .074-.26) were found between changes in troponin concentrations and left ventricular thickness over time. CONCLUSIONS AND CLINICAL IMPORTANCE: Myocardial injury is part of the pathophysiology leading to disease progression and death. Low sensitivities and specificities prevent outcome prediction in individual cats.

Prediction of long-term outcome by measurement of serum concentration of cardiac troponins in critically ill dogs with systemic inflammation.

BACKGROUND: Myocardial injury, detected by cardiac troponin I and T (cTnI and cTnT), has been associated with long-term death in the noncardiac human intensive care unit (ICU). HYPOTHESIS: Presence of myocardial injury predicts 1-year case fatality in critically ill dogs with systemic inflammation. ANIMALS: Thirty-eight dogs with evidence of systemic inflammation and no primary cardiac disease. METHODS: Prospective cohort study. In dogs admitted to the ICU with evidence of systemic inflammation, blood samples were obtained at ICU admission for measurement of cTnI and cTnT, and cTnI was measured once daily during ICU hospitalization. Receiver operating characteristic (ROC) curves were used to examine prognostic capacity of admission cTnI, admission cTnT, and peak cTnI concentrations. RESULTS: One-year case fatality rate was 47% (18/38 dogs). Admission cTnI concentrations were (median [range]) 0.48 [0.004-141.50] ng/mL, and peak cTnI concentrations were 1.21 [0.021-141.50] ng/mL. Admission cTnT concentrations were 15 [<13-3744] ng/L. For each marker, non-survivors had significantly higher concentrations than survivors (P = .0082-.038). ROC analyses revealed areas under curves [95% CI] of 0.707 [0.537-0.843] for peak cTnI and 0.739 [0.571-0.867] for admission cTnT, respectively. At the optimal cut-off, concentrations were 1.17 ng/mL (peak cTnI) and 23 ng/L (admission cTnT), sensitivities were 72% and 72%, and specificities were 70% and 80%, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: While peak cTnI and admission cTnT are significantly related to 1-year case fatality in critically ill dogs with systemic inflammation, low sensitivities and specificities prevent their prediction of long-term outcome in individual patients. Troponins might play a role in identification of dogs at long-term risk of death.

Left atrial volume and phasic function in clinically healthy dogs of 12 different breeds.

The left atrium (LA) of the heart is a validated marker of clinical and subclinical cardiovascular disease. Since the LA is a three-dimensional structure, volume-based methods of chamber quantification might be more accurate than linear methods. The aims of this study were to establish the feasibility and reproducibility of biplane two-dimensional echocardiographic LA volume measurements and to provide reference ranges for LA volume and phasic function in adult dogs (n=237) without cardiovascular disease. The study also assessed the effects of bodyweight (BW), breed, sex, age and heart rate (HR) on LA volume and function. The biplane area-length method was used to calculate LA volumes from the left apical four- and two-chamber views. LA volume and function were correlated with body size and there were significant breed differences. For dogs of all sizes and breeds, LA maximal volume had a 95th percentile of 0.92 mL/kg. There was no correlation between age or sex and LA volume or LA reservoir function, but conduit function decreased and booster pump function increased with age. LA volume and function varied with HR. LA size was calculated using the biplane area-length method, with good reproducibility and little inter-observer variability. The reference ranges presented for LA volume and function in healthy dogs could be used to refine the diagnostic criteria for the assessment of LA enlargement and altered function by conventional echocardiography.

Prognostic importance of myocardial injury in critically ill dogs with systemic inflammation.

BACKGROUND: In noncardiac critical disease in humans, myocardial injury as detected by cardiac troponin I and T (cTnI and cTnT) has been linked to high intensive care unit (ICU) death independent of prognostic composite scoring. HYPOTHESIS: Presence of myocardial injury predicts short-term death in critically ill dogs with systemic inflammation and provides additional prognostic information when combined with established canine prognostic composite scores. ANIMALS: Forty-two dogs admitted to the ICU with evidence of systemic inflammation and no primary cardiac disease. METHODS: Prospective cohort study. Blood samples were obtained at ICU admission for the measurement of cTnI and cTnT, C-reactive protein, and several cytokines. The acute patient physiologic and laboratory evaluation (APPLE) score and the survival prediction index were calculated within the first 24 hours of admission. Receiver operating characteristic (ROC) curves were used to examine the prognostic capacity of each biomarker and severity score. Multiple logistic regression analysis was performed to evaluate whether cardiac markers significantly contributed to severity scores. RESULTS: Twenty-eight day case fatality rate was 26% (11/42 dogs). cTnI concentrations were (median [range]) 0.416 [0.004-141.5] ng/mL and cTnT concentrations were 13.5 [<13-3,744] ng/L. cTnI, cTnT, and the APPLE score were all significant prognosticators with areas under the ROC curves [95% CI] of 0.801 [0.649; 0.907], 0.790 [0.637; 0.900], and 0.776 [0.621; 0.889], respectively. cTnI significantly contributed to the APPLE score in providing additional prognostic specificity (P = .025). CONCLUSIONS AND CLINICAL IMPORTANCE: Markers of myocardial injury predict short-term death in dogs with systemic inflammation and cTnI significantly contributes to the APPLE score.

Prevalence of respiratory signs and identification of risk factors for respiratory morbidity in Swedish Yorkshire terriers.

Yorkshire terriers may be prone to respiratory disease; however, limited epidemiological information is available. A cross-sectional study design was used to compare the prevalence of respiratory signs in Yorkshire terriers with the prevalence in a population of dogs in general and to identify risk factors for respiratory clinical signs within the Swedish population of Yorkshire terriers. Data on clinical signs and risk factors were obtained from a questionnaire. The prevalence of respiratory signs in general (RS) was significantly higher among Yorkshire terriers compared with control dogs (RS 56.3 per cent and 23.0 per cent), and likewise more frequent respiratory signs (FRS) (26.0 per cent and 5.0 per cent). Age, sex and breed were shown to be significant risk factors, and an interaction between age and sex was discovered. The study indicated a sex ratio reversal in the prevalence of RS - the probability of females having RS increased with advancing age, while the probability for males was fairly constant.