[Prevalence of heart murmurs, aortic and pulmonic stenosis in boxers presented for pre-breeding exams in Switzerland]. / Prävalenz von Herzgeräuschen, Aorten- und Pulmonalstenosen bei Zuchtuntersuchungen von Boxern in der Schweiz.

Boxer are predisposed to subaortic (SAS) and pulmonic stenosis (PS). To decrease the prevalence, pre-breeding cardiologic exams were performed in the last years. In our study the results of 309 pre-breeding exams of boxers presented between 1999 and 2008 were evaluated retrospectively. The overall prevalence of heart murmurs was 26.5 %. A SAS was diagnosed in 25 (8.1 %) and a PS in 10 (3.3 %) dogs. A combination of both defects was found in 7 (2.3 %) Boxers. Animals with a heart murmur of at least grade 3/6 had a significantly higher peak aortic flow velocity (VmaxAo) than animals without or only soft heart murmurs. Over the study period both the frequency of heart murmurs and diagnosis of SAS and PS decreased.

Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST study.

BACKGROUND: Myxomatous mitral valve disease (MMVD) continues to be an important cause of morbidity and mortality in geriatric dogs despite conventional therapy. HYPOTHESIS: Pimobendan in addition to conventional therapy will extend time to sudden cardiac death, euthanasia for cardiac reasons, or treatment failure when compared with conventional therapy plus benazepril in dogs with congestive heart failure (CHF) attributable to MMVD. ANIMALS: Two hundred and sixty client-owned dogs in CHF caused by MMVD were recruited from 28 centers in Europe, Canada, and Australia. METHODS: A prospective single-blinded study with dogs randomized to PO receive pimobendan (0.4-0.6 mg/kg/d) or benazepril hydrochloride (0.25-1.0 mg/kg/d). The primary endpoint was a composite of cardiac death, euthanized for heart failure, or treatment failure. RESULTS: Eight dogs were excluded from analysis. One hundred and twenty-four dogs were randomized to pimobendan and 128 to benazepril. One hundred and ninety dogs reached the primary endpoint; the median time was 188 days (267 days for pimobendan, 140 days for benazepril hazard ratio = 0.688, 95% confidence limits [CL]=0.516-0.916, P= .0099). The benefit of pimobendan persisted after adjusting for all baseline variables. A longer time to reach the endpoint was also associated with being a Cavalier King Charles Spaniel, requiring a lower furosemide dose, and having a higher creatinine concentration. Increases in several indicators of cardiac enlargement (left atrial to aortic root ratio, vertebral heart scale, and percentage increase in left ventricular internal diameter in systole) were associated with a shorter time to endpoint, as was a worse tolerance for exercise. CONCLUSIONS AND CLINICAL IMPORTANCE: Pimobendan plus conventional therapy prolongs time to sudden death, euthanasia for cardiac reasons, or treatment failure in dogs with CHF caused by MMVD compared with benazepril plus conventional therapy.

Heart failure in two West Highland white terriers caused by congenital angiomatous cardiac anomaly.

The paper describes the clinical and pathological characteristics of an unusual cystic congenital cardiac anomaly that caused clinical signs of congestive heart failure, respiratory distress and cardiac arrhythmias in two West Highland white terrier puppies. In both dogs a definitive diagnosis was made postmortem.

Prevalence of heart disease in symptomatic cats: an overview from 1998 to 2005.

A total of 408 cats with various cardiovascular problems has been presented to two investigational clinics during the last 8 years. The number of yearly examinations has steadily increased during this period. Definitive cardiovascular disease was diagnosed in 287 cats, whereby hypertrophic cardiomyopathy (HCM) was the most common diagnosis with 67.6%. Congenital cardiovascular malformations were found in 11.8% of the cases. Ventricular septal defect (VSD) was the most frequent anomaly, in contrast to previously published studies. The ECG was found to be relatively non-specific and insensitive for the diagnosis of heart disease: Its usefulness lies in the recognition and diagnosis of cardiac arrhythmias. The radiographically recognized changes were also non-specific for certain heart diseases. Radiographs of the thorax are especially useful in the evaluation of cardiomegaly, and secondary signs of congestion.

Echocardiographic screening of purebred cats: an overview from 2002 to 2005.

During the last 3 years, a total of 144 cats underwent echocardiographic screening at two investigational clinics before being admitted for breeding. The number of cats presented for that purpose has constantly increased. 8.3% of cats were diagnosed as having hypertrophic cardiomyopathy and 6.9% were diagnosed as suspicious. Male cats were more affected than females (9.4% vs 7.7%). In 4.2 of all presented cats, a congenital cardiac malformation was recognised, most often tricuspid valve dysplasia.

An unusual univentricular heart in an Angus calf.

A 6-month-old Angus heifer was found to have a univentricular heart on postmortem examination. In addition, there was medial thickening of the pulmonary arteries. The heart lesion differed fundamentally from previously described cases of univentricular hearts in domesticated animals and probably had a different embryogenesis. The comparative aspects of univentricular heart in man and animals are discussed.

Blood pressure, electrocardiogram and echocardiogram measurements in the growing pony foal.

Twelve newborn pony foals underwent cardiovascular examinations (auscultation, arterial blood pressure measurements, electrocardiograms and M-mode echocardiograms) on their first day of life and then on Days 7, 14, 21, 30, 60 and 90. An age dependent, statistically significant, rapid increase of the arterial blood pressure in the first month was documented together with a slower decrease of the resting heart rate after two and three months of life. Innocent soft systolic murmurs were audible over the left heart base in a large number of the foals. The electrocardiograms showed age dependent increases of the PR-, QRS- and QT- intervals and a trend of the mean electrical axis in the frontal plane to rotate towards the left side. The ventricular dimensions, measured by M-mode echocardiography, increased with the growth of the pony foals. Linear regression equations were calculated for the right and left ventricular internal dimensions in relation to body weight (bwt). The other echocardiographic parameter had low correlations with bwt.

Cardiomyopathy in dystrophin-deficient hypertrophic feline muscular dystrophy.

A colony of cats affected with hypertrophic feline muscular dystrophy was used to study the occurrence of cardiomyopathy associated with dystrophin deficiency. Affected male and female cats, obligate carrier females, and unaffected healthy littermates were followed from 12 weeks of age into adulthood. Thoracic radiography, 2-D echocardiography, and 2-D-derived M-mode echocardiography were performed at 3-month intervals until 12 months of age and regularly thereafter. From 9 months of age, all affected cats had larger hearts than normal and carrier animals. Left ventricular wall thickness in systole and in diastole and interventricular septal thickness in systole were greater in affected cats 12 months and older when compared with normal or heterozygous animals (P < .05). The myocardium of affected cats was diffusely hypoechoic and thickened. Multiple hyperechoic foci were in the myocardium and papillary musculature. Shortening fraction was normal in all cats. Changes seen in carrier females included enlargement and hyperechogenicity of the papillary musculature after the age of 2 years. Gross and light microscopic examination revealed left ventricular wall thickening with multiple foci of mineralization in 2 of 5 hearts from dystrophin-deficient cats. Although approximately 10% of the normal dystrophin amount was present in the skeletal muscle, dystrophin could not be detected in the myocardium. Early onset concentric myocardial hypertrophy was present in all adult cats. Lesions were mainly localized in the myocardium of the left ventricular free wall and interventricular septum, papillary musculature, and the endocardium. Clinical signs of heart failure developed only infrequently in cats with hypertrophic feline muscular dystrophy.

Recommendations for standards in transthoracic two-dimensional echocardiography in the dog and cat. Echocardiography Committee of the Specialty of Cardiology, American College of Veterinary Internal Medicine.

Recommendations are presented for standardized imaging planes and display conventions for two-dimensional echocardiography in the dog and cat. Three transducer locations ("windows") provide access to consistent imaging planes: the right parasternal location, the left caudal (apical) parasternal location, and the left cranial parasternal location. Recommendations for image display orientations are very similar to those for comparable human cardiac images, with the heart base or cranial aspect of the heart displayed to the examiner's right on the video display. From the right parasternal location, standard views include a long-axis four-chamber view and a long-axis left ventricular outflow view, and short-axis views at the levels of the left ventricular apex, papillary muscles, chordae tendineae, mitral valve, aortic valve, and pulmonary arteries. From the left caudal (apical) location, standard views include long-axis two-chamber and four-chamber views. From the left cranial parasternal location, standard views include a long-axis view of the left ventricular outflow tract and ascending aorta (with variations to image the right atrium and tricuspid valve, and the pulmonary valve and pulmonary artery), and a short-axis view of the aortic root encircled by the right heart. These images are presented by means of idealized line drawings. Adoption of these standards should facilitate consistent performance, recording, teaching, and communicating results of studies obtained by two-dimensional echocardiography.

Normal values of the canine M-mode echocardiogram.

M-mode echocardiograms were recorded from 40 healthy dogs, awake and unsedated, in left lateral recumbent position. Fifteen echocardiographic measurements were taken and correlated with body weights using linear regression equations. The left ventricular internal dimension in systole and diastole, the left ventricular wall thickness, the aortic root dimension, and the left atrial dimension had high correlation coefficients (r2), ranging from 0.756 to 0.619. The fractional shortening of the left ventricle in systole (39% +/- 6%) and the left atrial to aortic root ratio (0.99 +/- 0.10) were not linearly related to body weights and had constant values.

Electrocardiographic values from clinically normal, anesthetized ferrets (Mustela putorius furo).

Electrocardiograms were recorded from 25 clinically normal male ferrets anesthetized with ketamine and xylazine and from 7 ferrets anesthetized with ketamine alone. Ferrets anesthetized with ketamine alone had excessive salivation, open eyes, muscle tremors, muscle twitching, paddling motions, attempts to stand, and an unstable ECG baseline. Because ketamine/xylazine combination resulted in induction and good muscle relaxation, the ECG had little interference resulting from muscular movement.

Ventricular septal defects in the horse.

Clinical, echocardiographic, and right-side cardiac catheterization data were collected in 6 horses with ventricular septal defects. The defects were confirmed by necropsy in 5 horses. On echocardiography, the cardiac dimensions were normal in 3 horses and enlarged in 2 others. A step-up in partial oxygen pressure between right atrium and right ventricle suggested a left-to-right shunt in 3 of the 4 horses catheterized. In 1 foal, a small defect without PO2 step-up was documented by angiocardiography. The oxymetry and pressure data were compared with previous cases from the reviewed literature, and the importance of pressure measurements to rule out concomitant defects was emphasized.

Results of continuous ambulatory electrocardiography in a cat with hypertrophic cardiomyopathy.

An 8-year-old neutered male cat with a history of intermittent collapse and dyspnea was evaluated. Hypertrophic cardiomyopathy was diagnosed on the basis of findings from physical examination, radiography, and echocardiography. Cardiac arrhythmias were not recorded during routine electrocardiography. Continuous ambulatory electrocardiography documented severe ventricular arrhythmias (ventricular premature complexes, ventricular bigeminy, and paroxysmal ventricular tachycardia). Continuous ambulatory electrocardiography can detect intermittent and potentially life-threatening cardiac arrhythmias.

Pulmonic stenosis and right-to-left atrial shunt in three dogs.

Using cardiac catheterization, pulmonic stenosis and right-to-left atrial shunt were diagnosed in 3 young dogs that were evaluated because of weakness, cyanosis, and polycythemia. Injection of contrast material into the caudal vena cava or crossing the atrial septal defect with the catheter tip from the right atrium into the left atrium confirmed the diagnosis. Tetralogy of Fallot, with right-to-left shunt through a ventricular septal defect, is a more common congenital malformation associated with the aforementioned clinical signs. Differentiation between the 2 defects is important, because surgical decompression of the right ventricle will lead to reduction of right atrial pressure and diminishment of the shunt.

Echocardiographic evaluation of cardiac tamponade in dogs before and after pericardiocentesis: four cases (1984-1986).

The echocardiographic (M-mode and 2-dimensional) features (before and after pericardiocentesis) of 4 dogs with pericardial effusion and clinical evidence of cardiac tamponade were reviewed. M-Mode echocardiography revealed pericardial effusion, with exaggerated swinging motion of the heart and abnormal septal motion in all 4 dogs. In each case, 2-dimensional echocardiography demonstrated right ventricular diastolic free-wall collapse. Three dogs had right atrial diastolic collapse as well. Clinical signs improved, and right ventricular and right atrial diastolic collapse subsided after pericardiocentesis. Two-dimensional echocardiographic features of right atrial and ventricular collapse were used as indicators for determining the presence of cardiac tamponade.

Effects of benazepril in the treatment of feline hypertrophic cardiomyopathy Results of a prospective, open-label, multicenter clinical trial.

OBJECTIVES: To evaluate the efficacy of benazepril on clinical signs and echocardiographic parameters in cats with primary hypertrophic cardiomyopathy (HCM). BACKGROUND: ACE-inhibitors have positive effects in man with HCM, and contribute to a reduction of myocardial hypertrophy. Addition of an ACE-inhibitor to the standard treatment of HCM in cats may have beneficial effects. METHODS: A total of 32 cats which were either asymptomatic or in stabilised congestive heart failure (ISACHC* class Ib, II or IIIa) were included in a one-year, prospective, open-label, clinical trial in 5 centres in Switzerland. 28 of these cats were allocated to one of two treatment groups: 1) standard therapy (ST) alone (n=9), consisting of a long-acting formulation of diltiazem (6-9 mg/kg sid) and optional acetylsalicylic acid (50 mg twice weekly, or 2) the same ST plus benazepril (0.33 - 0.75 mg/kg sid, n=19). RESULTS: Cats treated with benazepril showed a statistically significant decrease (mean +/- SEM, 0.11 +/- 0.03 mm/month, p = 0.002) in the left ventricular wall thickness (LVWD) from baseline, while no change (increase of 0.02 +/- 0.04 mm/month, p=0.66) was observed in cats on ST alone. Differences in LVWD between the two groups reached statistical significance (p=0.02). Benazepril treated cats showed more improvement in clinical signs (20-53%) than cats receiving ST alone (0-20%) but differences between the groups were not statistically significant (p>0.1). No change in septal thickness (IVSD) or left atrial to aortic root ratio (LA/Ao) was observed in either group. CONCLUSIONS: Benazepril had some beneficial effects on clinical signs and cardiac remodelling in cats with HCM and was well tolerated. These results, however, need to be confirmed in additional controlled studies. * ISACHC classification is described in the previous paper (Bench-study).

Plexogenic pulmonary arteriopathy in a Pembroke Welsh corgi.

A 21-month-old, male Pembroke Welsh corgi was referred for investigation of respiratory distress and progressive lethargy. Cardiac evaluation revealed a grade 4 pansystolic murmur over the left and right heart base. A heart murmur, dyspnoea, cyanosis, prolonged capillary refill time and ascites led to the tentative diagnosis of a cardiac malformation with a right-to-left shunt, with likely additional pulmonary disease. Pulmonary hypertension became evident during echocardiography, when the estimated systolic pulmonary artery pressure was over 70 mmHg. Angiography revealed abnormal pulmonary vascular markings consistent with pulmonary hypertension and a small right-to-left shunting patent ductus arteriosus (PDA). The diagnosis of PDA was confirmed at postmortem examination. Histology of the pulmonary arteries showed lesions of plexogenic pulmonary arteriopathy. The question of whether both conditions were separate or part of the same clinical syndrome is discussed in this report.

[The use of memoprint in the cat]. / Utilisation du Memoprint chez le chat.

In this study, done in the context of normal veterinary practice, the possibilities of using Memoprint have been evaluated. The values of systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and pulse rate (PR) in healthy cats (n = 72) have been determined, as well as the values of SAP, DAP and PR before (n = 26), during (n = 40) and after (n = 16) an anaesthesia for routine surgery. The results show that Memoprint allows a quick, convenient and correct determination of SAP (average: 122.7 mmHg) and DAP (88.5), but an imprecise determination of the PR. The measures are not highly repeatable with conscious cats (SAP: 0.68, DAP: 0.51), unlike that obtained before (0.90, 0.86), during (0.96, 0.90) and after (0.88, 0.58) the anaesthesia, indicating once again the importance of the cats' familiarity and cooperation with the veterinarian. An analysis of the variance of the values of blood pressure shows their direct relationship with age, sex, breed and style of life of the cats and an increase in pressure in those over ten years of age.

[Tricuspid valve dysplasia in fifteen dogs]. / Trikuspidaldysplasie bei fünfzehn Hunden.

Clinical findings in fifteen dogs with tricuspid valve dysplasia are described. Thirteen dogs had loud systolic heart murmurs. Eleven of them hat a palpable precordial thrill over the same location. In 14 dogs, right heart enlargement was suspected on thoracic radiographs and electrocardiography. Right atrial dilation was seen echocardiographically in all dogs. Fourteen dogs had additional right ventricular dilatation, some with hypertrophy as well. Doppler echocardiography revealed tricuspid valve regurgitation. Seven dogs remained free of clinical symptoms to date. If symptoms of decompensation develop with tricuspid dysplasia, diuretics, ACE inhibitors and eventually positive inotrope drugs are indicated. Antiarrhythmic drugs may become necessary in cases of supraventricular tachyarrhythmias.

[Palliative treatment of tetralogy of Fallot using a PTFE (polytetrafluoroethylene) vascular graft]. / Palliative Behandlung von Fallotscher Tetralogie mit einer PTFE-(Polytetrafluorethylene-) Gefässprothese.

The application of a PTFE (polytetrafluorethylene) vascular graft for palliative surgical treatment in a case of tetralogy of Fallot in a dog is described. The surgical procedure took place after an attempt to perform a Blalock anastomosis failed. The surgical technique, the postoperative care and the outcome are presented. The technique and its indications are discussed.