Clinical and histopathological features of myocarditis in dogs with visceral leishmaniasis / Aspectos clínicos e histopatológicos da miocardite em cães com leishmaniose visceral

Visceral leishmaniasis (VL) is a cosmopolitan parasitic zoonosis that can promote myocarditis and heart rate changes in canine and human hosts. Thus, histopathological aspects of the myocardium and clinical, hematological, biochemical, radiological and electrocardiographic data were evaluated in a group of 36 dogs naturally infected with VL (VLG) and compared to data from 15 non-infected dogs (CG=Control Group). A prevalence of asymptomatic dogs was present in the CG (100%) and polysymptomatic dogs in the VLG (66%). In addition, two dogs in the VLG demonstrated systolic murmurs in the mitral valve region: one with a II/VI intensity and the other with a III/VI intensity. The mean values of RBC, hemoglobin and hematocrit were lower in dogs in VLG and were associated with higher values of total protein, total leukocytes, neutrophils, creatine kinase overall (CK) and the CK-MB fraction (CK-MB). The absence of radiographic changes was accompanied by a predominance of respiratory sinus arrhythmia associated with episodes of migratory pacemaker and sinus arrest in dogs in VLG (75%), sinus rhythm in dogs in CG (60%) and decreased P wave amplitude in VLG electrocardiography. Mononuclear cell infiltration was detected in the myocardium of 77,8% of dogs in GVL and classified primarily as mild multifocal lymphohistioplasmacytic. Amastigotes were detected in only one dog, which did not allow the association between myocarditis and parasitism, although the myocardial lesions that were found constitute irrefutable evidence of myocarditis in the VLG dogs, accompanied by lenient electrocardiographic changes compared to CG.

A leishmaniose visceral (LV) é uma zoonose parasitária cosmopolita capaz de promover miocardite e alterações no ritmo cardíaco em cães e seres humanos. Dessa forma, os aspectos clínicos, hematimétricos, bioquímicos, radiográficos, eletrocardiográficos e histopatológicos do miocárdio foram avaliados em 36 cães naturalmente infectados com LV (GLV) e comparados a 15 cães não infectados (GC). Houve predomínio de cães assintomáticos no GC (100%) e polissintomáticos no GLV (66%). Dois cães do GLV apresentaram sopro sistólico de intensidade II/VI e III/VI, em região de foco mitral. Os valores médios de hemácia, hemoglobina e hematócrito foram inferiores nos cães do GLV, associados a maiores valores de proteína total, leucócitos totais, neutrófilos, creatinina quinase total (CK) e fração MB (CK-MB). Ausência de alterações radiográficas foi acompanhada de predomínio de arritmia sinusal respiratória associada a episódios de marcapasso migratório e sinus arrest nos cães do GLV (75%), ritmo sinusal nos cães do GC (60%) e diminuição da amplitude da onda P no GLV à eletrocardiografia. Infiltrado inflamatório mononuclear foi detectado no miocárdio de 77,8% dos cães do GLV, classificados, em sua maioria, como linfoistioplasmocitário multifocal leve. A forma amastigota foi detectada em apenas um cão, não permitindo a associação entre a miocardite e a parasitose, ainda que as lesões miocárdicas encontradas constituam prova irrefutável da miocardite nos cães do GLV, acompanhadas por alterações eletrocardiográficas brandas em comparação ao GC.

Selenium deficiency associated porcine and human cardiomyopathies.

Selenium (Se) is a trace element playing an important role in animal and human physiological homeostasis. It is a key component in selenoproteins (SeP) exerting multiple actions on endocrine, immune, inflammatory and reproductive processes. The SeP family of glutathione peroxidases (GSH-Px) inactivates peroxides and thereby maintains physiological muscle function in humans and animals. Animals with high feed conversion efficiency and substantial muscle mass have shown susceptibility to Se deficiency related diseases since nutritional requirements of the organism may not be covered. Mulberry Heart Disease (MHD) in pigs is an important manifestation of Se deficiency often implicating acute heart failure and sudden death without prior clinical signs. Post-mortem findings include hemorrhagic and pale myocardial areas accompanied by fluid accumulation in the pericardial sac and pleural cavity. Challenges in MHD are emerging in various parts of the world. Se is of fundamental importance also to human health. In the 1930s the Se deficiency associated cardiomyopathy named Keshan Disease (KD) was described for the first time in China. Various manifestations, such as cardiogenic shock, enlarged heart, congestive heart failure, and cardiac arrhythmias are common. Multifocal necrosis and fibrous replacement of myocardium are characteristic findings. Pathological findings in MD and KD show striking similarities.

Toxicokinetics and pathology of plant-associated acute selenium toxicosis in steers.

Sixteen of approximately 500 yearling steers died of acute selenium (Se) toxicosis after grazing on a Se-contaminated range for only a few days. Field studies and chemical analyses identified the predominant toxic plant as western aster (Symphyotrichum ascendens, previously Aster ascendens), which contained over 4,000 ppm Se (dry weight). Several dead animals that were necropsied had acute severe myocardial necrosis characterized by edema and myocyte swelling, with hypereosinophilia, clumping, and coagulation of myocardial proteins. Whole blood from 36 surviving steers was collected and analyzed, and 10 steers with elevated Se concentrations were selected for close monitoring and clinical evaluations. Each steer was weighed, and serum, blood, liver, skeletal muscle, and hair were regularly collected after removal from the Se-contaminated range. One animal that died 18 days after exposure was necropsied and exhibited severe multifocal myocardial fibrosis with extensive hepatic congestion, degeneration, and hemosiderosis. At 180 days postexposure, 2 of the 10 steers were euthanized, and tissue samples were collected. Both steers had rare, small fibrotic foci in their hearts. The Se elimination half-lives from serum, whole blood, liver, and muscle of the recovering steers were 40.5 ± 8.2, 115.6 ± 25.1, 38.2 ± 5.0, and 98.5 ± 19.1 days, respectively. The Se concentration in hair reached a peak of 11.5 ± 5.3 ppm at 22 days postexposure. The findings indicate that cattle are sensitive to acute Se toxicosis caused by ingestion of Se-accumulator plants, with myocardial necrosis as the primary lesion. Some poisoned animals may develop congestive heart failure weeks after the toxic exposure, and in the current study, Se was slowly excreted requiring a relatively long withdrawal time.

Cardiomyopathy and right-sided congestive heart failure in a red-tailed hawk (Buteo jamaicensis).

A 15-year-old female red-tailed hawk (Buteo jamaicensis) was evaluated because of dyspnea, anorexia, and coelomic distension. Diagnostic imaging results confirmed severe coelomic effusion and revealed a markedly dilated right ventricle. The diagnosis was right-sided congestive heart failure. Results of measurements of vitamin E, selenium, lead, zinc, and cardiac troponin levels were normal or nondiagnostic. The hawk was treated with furosemide, antifungal and antimicrobial agents, and supplemental fluids and oxygen, but euthanasia was elected because of the poor prognosis and the practical difficulties associated with intensive case management. To our knowledge, this is the first described case of cardiomyopathy and congestive heart failure in a captive red-tailed hawk.

Field investigation of perinatal mortality in friesian cattle associated with myocardial degeneration and necrosis.

Perinatal mortality and stillbirths were investigated in an extensively managed herd of Friesian cows and heifers calving over a 2-year period: 504 cows were calved and 215 heifers. Cows were bred to Friesian and Jersey bulls using natural service. The perinatal fetal mortality rate was 7.5% for cows and 30% for heifers. An experienced stockman managed these calvings and veterinary assistance was required only on nine occasions. All stillborn fetuses were examined post-mortem by the Veterinary Laboratories Agency, Carmarthen and no infectious agent was identified on any occasion. Thyroid hyperplasia was found in two fetuses. In blood samples taken from 10 late pregnant heifers, mean glutathione peroxidase values were 7.9 +/- 1.7 IU/ml Packed Cell Volume (PCV). Tissues from eight fetuses were submitted to the University of Liverpool for histopathological examination; all presented lesions consistent with myocardial degeneration and necrosis of the left ventricle. Following treatment of 205 late pregnant heifers with sodium selenite and vitamin E, the overall perinatal mortality rate in these cattle fell to below 11%.

Doxorubicin and BAY 12-9566 for the treatment of osteosarcoma in dogs: a randomized, double-blind, placebo-controlled study.

BACKGROUND: This study was designed to assess the efficacy of a matrix metalloproteinase inhibitor in prolonging posttreatment survival for dogs with appendicular osteosarcoma after treatment with amputation and doxorubicin chemotherapy. HYPOTHESIS: Survival will be prolonged in dogs receiving BAY 12-9566. ANIMALS: The study included 303 dogs with appendicular osteosarcoma. METHODS: Dogs were treated with doxorubicin (30 mg/m2) every 2 weeks for 5 treatments starting 2 weeks after amputation. Dogs were randomly allocated to receive a novel nonpeptidic biphenyl inhibitor of matrix metalloproteinases (MMPs, BAY 12-9566; 4-[4-4-(chlorophenyl)phenyl]-4-oxo-2S-(phenylthiomethyl) butanoic acid) or placebo after doxorubicin chemotherapy. RESULTS: Median survival for all 303 dogs was 8 months; and 1-year, 2-year, and 3-year survival rates were 35%, 17%, and 9%, respectively. Treatment with BAY 12-9566 did not influence survival. Multivariate analysis revealed that increasing age (P = .004), increasing weight (P = .006), high serum alkaline phosphatase (ALP) (P = .012) and high bone ALP (P < .001) were independently associated with shorter median survival times. Additional analyses on available data indicated that as the number of mitotic figures in the biopsy increased (P = .013), and as plasma active MMP-2 concentrations increased (P = .027), the risk of dying increased. CONCLUSIONS AND CLINICAL IMPORTANCE: Doxorubicin is an effective adjuvant to amputation in prolonging survival for dogs with appendicular osteosarcoma.

Dietary patterns of cats with cardiac disease.

OBJECTIVE: To determine nutrient intake and dietary patterns in cats with cardiac disease. DESIGN: Prospective study. ANIMALS: 95 cats with congenital cardiac disease or primary cardiomyopathy. PROCEDURES: Owners completed a standardized telephone questionnaire regarding their cat's diet and a 24-hour food recall to determine daily intake of calories, fat, protein, sodium, magnesium, and potassium. RESULTS: Of the 95 cats, 18 (19%) had a history of congestive heart failure and 73 (77%) had no clinical signs of cardiac disease. Fifty-five percent (52/95) of cats had concurrent disease. Inappetance was reported in 38% (36/95) of all cats and in 72% (68/95) of cats with a history of congestive heart failure. Most (57% [54/95]) cats received treats or table scraps on a regular basis. Approximately half the cats were receiving orally administered medications, supplements, or both. Only 34% (32/68) of owners used food to administer medications to cats. Cats consumed more than the Association of American Feed Control Officials (AAFCO) minimums for protein, sodium, potassium, and magnesium, and nearly all cats consumed more than the AAFCO minimum for fat. Daily nutrient intake was variable for all of the nutrients assessed. CONCLUSIONS AND CLINICAL RELEVANCE: Dietary intake in cats with cardiac disease was variable, but results for dietary supplement use, food use for medication administration, and treat feeding were different from those found in a similar study of dogs with cardiac disease. This information may be useful for treating and designing nutritional studies for cats with cardiac disease.

Interactive effects of dietary sodium and chloride on the incidence of spontaneous cardiomyopathy (round heart) in turkeys.

Two pen trials were conducted in Utah, altitude 1,630 m, with Large White female turkey poults to evaluate effects of dietary Na and chloride (Cl) concentrations on live performance and deaths caused by spontaneous cardiomyopathy (STC, "round heart") from 0 to 35 d of age. A randomized block 2 x 2 factorial arrangement with four replicate pens per treatment was used. Pen size was 3.8 x 5.6 m. In each trial, four starter diets were formulated from a common basal diet (corn-soy-meat) to obtain the following sodium and chloride concentrations: High Na (0.24%):High Cl (0.40%); High Na (0.24%):Low Cl (0.16%); Low Na (0.14%):High Cl (0.40%); and Low Na (0.14%):Low Cl (0.16%). Supplements were NaCl, NaHCO3, NH4Cl, or combinations. After laboratory analysis, true values of Na were slightly lower than expected, Cl was near expected values to slightly low, and K was 1.145%. Body weight and feed conversion ratio at 35 d of age were unaffected in both trials. In both experiments, STC mortality was significantly reduced by the Low Na:High Cl treatment compared to the other treatments. In conclusion, a diet containing 0.10 to 0.12% Na and 0.38 to 0.40% Cl, significantly improved poult livability by reducing STC mortality without adverse effects on poult weight or feed conversion ratio.

Deep hypothermic low flow cardiopulmonary bypass in small dogs.

OBJECTIVE: To evaluate the feasibility of and morbidity and mortality associated with cardiopulmonary bypass (CPB) using deep hypothermia and low flow perfusion in adult dogs weighing less than 10 kg. STUDY DESIGN: Prospective, descriptive study. ANIMALS: Two groups of three dogs underwent CPB. Group 1 dogs underwent deep hypothermia (15 to 18 degrees C), 45 minutes of low perfusion flow (20 mL/kg/min) and 1 hour of aortic cross clamp time. In group 2, ultrafiltration of perfusate before discontinuation of bypass was added to the standard treatment. Complete blood counts, serum biochemistry, urine output, ejection fraction, and cardiac output were monitored before and for 7 days after surgery. RESULTS: All dogs were successfully weaned from bypass. Four of six dogs survived, three without major complications. One dog developed and recovered from septic pleuritis. Two dogs died or were euthanatized after surgery because of respiratory or gastrointestinal complications. Minor complications included anemia, hypoproteinemia, and electrolyte disturbances. Transfusion requirements and edema formation were reduced by ultrafiltration. CONCLUSIONS: The observations in this study support the feasibility of low flow hypothermic CPB. Meticulous tissue handling, precise equipment, ultrafiltration, and aggressive postoperative potassium supplementation are recommended for smaller patients. CLINICAL RELEVANCE: Increased sensitivity to adverse sequelae of CPB may be associated with small patient size. Further evaluation is necessary before routine clinical application of low flow hypothermic CPB in this patient population.

Hypophosphatemia. Causes and clinical consequences.

Severe hypophosphatemia (i.e., serum phosphorus concentration below 1 mg/dl) occurs infrequently in veterinary patients. It is most often associated with diabetic ketoacidosis in small animals. Phosphate is necessary for the production of 2,3 diphosphoglycerate (2,3-DPG) and adenosine triphosphate (ATP); both are important for normal cellular metabolism. Consequences of severe hypophosphatemia may include hemolytic anemia, seizures, altered mentation, cardiomyopathy, and skeletal muscle weakness. Parenteral phosphate therapy is necessary in most cases of severe hypophosphatemia.

Vitamin E and selenium status of guinea pigs with myocardial necrosis.

Myocardial necrosis and mineralization has been identified in a colony of guinea pigs which were subsequently tested for vitamin E and selenium deficiency. Serum vitamin E and whole blood selenium levels were within normal ranges. The erythrocyte glutathione peroxidase test has potential as a predictor of whole blood selenium levels in the guinea pig. The red blood cell hemolysis test used in this study did not correlate consistently with the serum vitamin E levels. We suspect that myocardial necrosis and mineralization may have resulted from inbreeding guinea pigs within the closed colony.

Influence of thiamin supplements on furazolidone-induced cardiomyopathy in turkey poults.

Furazolidone (700 ppm) was fed to turkey poults from 2 to 5 weeks of age. The drug produced a cardiomyopathy and reduced the feed intake and growth of the birds. Thiamin was concurrently injected into the furazolidone-fed poults to determine whether the vitamin would prevent or reduce the severity of the cardiotoxic effect of the drug. Supplemental injections of thiamin had no significant effect on feed consumption or growth of the birds nor did they protect the heart against the cardiotoxicity. The conclusion is that furazolidone-induced cardiomyopathy is not caused by a thiamin deficiency.

Cardiomyopathy and vitamin E deficiency in zoo animals and birds.

Cardiomyopathy associated with vitamin E deficiency was diagnosed in more than 100 ruminants and primates and in 106 embryos and newly hatched chicks and ducklings. Affected bird embryos failed to pip the eggshell and died inside. Newly hatched chicks and ducklings and neonatal ruminants were weak, had difficulty standing or rising, and died within a few days. Death usually occurred without premonitory signs of disease in juvenile and adult animals. On gross examination, the hearts of the neonatal ruminants had areas of mottled, pinkish-tan myocardium. The hearts of the embryos and newly hatched birds were edematous, pinkish, and pale. In the juvenile ruminants, irregular, whitish patches or pale areas were seen in the myocardium. Histologically, there was multifocal myocytolysis in the myocardium of the neonatal and juvenile ruminants and embryos and newly hatched birds. Focal disseminated or diffuse myocardial fibrosis and myocytolysis were observed in the hearts of the adult animals. Plasma alpha tocopherol values were low enough in all species to be considered deficient. These values increased significantly after the addition of alpha tocopherol and/or vitamin E to the diets of the animals. Cardiomyopathy has not been diagnosed in any of the same groups of animals since supplementation was initiated.

Cardiac lesions of selenium-vitamin E deficiency in animals.

Necrosis of myocardium and skeletal muscle is a consistent finding in the numerous animal species in which spontaneous or experimental selenium-vitamin E (Se-E) deficiency has been described. Etiologic factors in the development of these lesions include: low dietary levels of Se, vitamin E, and sulfur-containing amino acids; high dietary concentrations of polyunsaturated fats; exposure to prooxidant conditions (toxicity by O2, O3, Fe, doxorubicin, and radiation injury); and intake of Se antagonists (Ag, Cu, Co, Cd, Te, Sb, and Zn). Myocardial lesions in Se-E deficient animals are most frequently seen in calves, lambs, turkey poults, and ducklings. In calves and lambs with cardiac lesions, the clinical finding usually is sudden death after vigorous exercise. At necropsy, affected calves have areas of necrosis and calcification in the left ventricular free wall and ventricular septum, while in lambs these lesions are seen in the right ventricular subendocardium. Histologically, areas of myocardial damage have hyaline necrosis with or without calcification, subsequent macrophagic invasion, and eventual fibrosis. In growing pigs, the hearts may have scattered pale streaks in the ventricular myocardium, but the most striking alterations are widespread epicardial and myocardial hemorrhages ("mulberry heart"). Histologically, both vascular and myocyte lesions are present. Vascular changes include fibrinoid necrosis of small arteries and arterioles and fibrin microthrombi in capillaries. The myocyte lesions in pigs and in birds consist of multifocal hyaline necrosis with calcification, followed by macrophagic invasion and fibrosis. Ultrastructural study of these lesions reveals myocyte alterations, which include mitochondrial swelling and mineralization, myofibrillar lysis, and necrosis with contraction bands.

Myodegeneration in Kentucky white-tailed deer.

Skeletal or cardiac myodegeneration, or both, was observed in 4 free-ranging female white-tailed deer that were found dead or recumbent and unable to rise. Gross pathologic findings included white or chalky streaks in heart or skeletal musculature. Degeneration, necrosis, and mineralization were observed microscopically in affected striated muscles. Although the precise cause of myodegeneration was not determined, changes were considered compatible with nutritional or exertional myopathy.

Furazolidone-induced congestive cardiomyopathy in ducklings: lack of protection from selenium, vitamin E, and taurine supplements.

Newly hatched male White Pekin ducklings (n = 108) were allotted to 6 groups of 18 each and were fed for 4 weeks diets containing 750 mg of furazolidone (FZ)/kg of feed either alone or with supplements of vitamin E (250 IU of dl-alpha-tocopheryl acetate/kg), selenium (2.5 mg as selenite/kg) or taurine (1%). Control groups were fed diets without FZ and with or without added taurine (1%). Ducklings in the 4 FZ-fed groups had retarded growth, mortality, ascites, and cardiac alterations of congestive cardiomyopathy. Supplements of vitamin E, selenium, or taurine did not protect against the development of the cardiac and extracardiac alterations of FZ toxicosis. These findings could indicate that the development of FZ-induced congestive cardiomyopathy is not mediated by low tissue concentrations of selenium, vitamin E, or taurine.