Balloon Valvuloplasty of Tricuspid Stenosis: A Retrospective Study of 5 Labrador Retriever Dogs.

BACKGROUND: There are limited reports of severe tricuspid valve stenosis in dogs and limited data regarding treatment and outcome. OBJECTIVE: To evaluate clinical signs, echocardiographic features, and outcome of balloon valvuloplasty (BV) in dogs with severe tricuspid valve stenosis (TVS) in which BV was attempted. ANIMALS: Five client-owned dogs with severe TVS. METHODS: Records were retrospectively reviewed and data collected regarding signalment, clinical signs, diagnostic findings, procedures, and outcome. RESULTS: All dogs were Labrador Retrievers. Presenting complaints included episodic weakness/syncope (4/5), abdominal distension (4/5), lethargy (2/5), and exercise intolerance (2/5). The median and range of measurements before BV were as follows: TV mean velocity 1.5 m/s (range 1.4-1.7 m/s); velocity-time integral (VTI) 79.8 cm (42.4-99.1 cm); and TV maximum velocity 2.9 m/s (2.3-3.2 m/s). Measurements (available for 3 of 5 dogs) after BV were as follows: TV mean velocity 1.15 m/s (0.9-1.4 m/s); VTI 44.95 cm (41.4-54.8 cm); and TV maximum velocity 1.15 m/s (1.9-2.3 m/s). The procedure was attempted in all dogs and completed in 4/5 dogs. The largest balloon diameter ranged from 15 mm to 25 mm, and length ranged from 4 cm to 5 cm. Right atrial pressure decreased in 4/5 dogs. All but 1 dog had clinical improvement after BV, but recurrence of clinical signs occurred (2/5). Tricuspid regurgitation worsened in 1 dog culminating in right heart failure and euthanasia. CONCLUSIONS AND CLINICAL IMPORTANCE: BV can be an effective treatment; however, clinical signs can recur. Right heart failure due to worsened TR is a potential complication in dogs with pre-existing moderate-to-severe TR.

Standardization of the two-dimensional transcoelomic echocardiographic examination in the central bearded dragon (Pogona vitticeps).

OBJECTIVES: To objectively and subjectively describe the normal spectrum of two-dimensional echocardiographic findings in the central bearded dragon (Pogona vitticeps). ANIMALS: Sixteen central bearded dragons. METHODS: Central bearded dragons were prospectively evaluated under manual restraint in right and left lateral recumbency to identify imaging planes for reproducible measurements of cardiac chambers, subjective two-dimensional analysis and color Doppler assessment. RESULTS: Echocardiography can be performed through windows in the left and right axillae. The window in the left axilla allows for a subjective and objective assessment of cardiac structure and function. The right axillary window allows for evaluation of pulmonary artery flow. Both views provide data for the presence of pericardial effusion or valvular insufficiency. With optimized imaging planes, cardiac chambers and fractional area change along with fractional shortening in the longitudinal and transverse planes can be calculated. Body weight and cardiac chamber dimensions of males were significantly larger than females. Ventricular fractional area change was the most consistent functional assessment. The majority of animals were found to have no evidence of valvular insufficiency, while approximately half had evidence of pericardial fluid. Pulmonary artery flow was assessed in all patients. Left and right aortic velocities cannot be reliably obtained. CONCLUSIONS: This study is the first to generate reference values for cardiac structure and function in clinically healthy central bearded dragons. Valvular insufficiency is not a normal finding in central bearded dragons, while mild pericardial effusion may be.

Atrial Fibrillation in Eight New World Camelids.

BACKGROUND: There is limited information on the incidence of clinical signs, concurrent illness and treatment options for atrial fibrillation (AF) in New World Camelids (NWC). OBJECTIVE: Describe clinical signs and outcome of AF in NWC. ANIMALS: Eight New World Camelids admitted with AF. METHODS: A retrospective observational study of camelids diagnosed with AF based on characteristic findings on electrocardiogram (ECG). RESULTS: All animals had an irregularly irregular heart rhythm detected on physical examination and 4 cases had obtunded mentation on admission. Three camelids were diagnosed with AF secondary to oleander intoxication, 3 animals had underlying cardiovascular disease, 1 was diagnosed with lone AF and 1 had AF diagnosed on examination for a urethral obstruction. Five of eight animals survived to discharge and nonsurvivors consisted of animals which died or were euthanized as a result of cardiovascular disease (2/8) or extra-cardiac disease unrelated to the AF (1/8). CONCLUSIONS AND CLINICAL IMPORTANCE: Atrial fibrillation occurs in NWC in association with cardiovascular disease, extra-cardiac disease or as lone AF. Amiodarone and transthoracic cardioversion were attempted in one llama with lone AF, but were unsuccessful. Atrial fibrillation was recorded in 0.1% of admissions.

Atrial Fibrillation as a Prognostic Indicator in Medium to Large-Sized Dogs with Myxomatous Mitral Valvular Degeneration and Congestive Heart Failure.

BACKGROUND: The prevalence and prognostic importance of atrial fibrillation (AF) on survival in nonsmall breed dogs with myxomatous mitral valvular disease (MMVD) and congestive heart failure (CHF) remain unknown. AIM: To identify the prevalence of AF in nonsmall breed dogs with CHF because of MMVD and to characterize the impact of AF on survival outcome. ANIMAL: Sixty-four client-owned dogs (>15 kg) with MMVD and CHF. METHODS: Retrospective review of medical records for dogs weighing >15 kg with MMVD treated for CHF. RESULTS: Thirty-three dogs presented with AF or developed AF during follow-up examinations, and 31 dogs were free of AF until cardiac-related death. For dogs with AF, median survival time (MST) was 142 days (range: 9-478) while dogs without AF lived 234 days (range: 13-879 days). AF increased risk of cardiac-related death (HR = 2.544; 95% CI = 1.41-4.59; P = .0019) when compared to dogs without AF. MST was significantly prolonged for dogs with AF whose rates were adequately controlled (<160 bpm; 171 days; n = 13) when compared to dogs that failed to respond to negative chronotropic agents (61 days; n = 20; P = .032). The administration of combination treatment (diltiazem and digoxin) significantly decreased median HR to 144 bpm (range: 84-218 bpm) in dogs with AF and significantly prolonged MST (diltiazem+digoxin: 130 days versus diltiazem: 35 days, P = .0241) when compared to diltiazem alone. CONCLUSIONS AND CLINICAL IMPORTANCE: Inadequately controlled AF is associated with a higher rate of mortality. Optimization of therapeutic strategies for the rate control of AF remains determined.

Occlusion devices and approaches in canine patent ductus arteriosus: comparison of outcomes.

BACKGROUND: A comparison of transvascular occlusion methods for closing patent ductus arteriosus (PDA) in dogs has not been done. OBJECTIVES: To determine if clinically important differences exist between the approaches and devices currently used. ANIMALS: A total of 112 client-owned dogs with left-to-right shunting PDA. METHODS: Retrospective study. Records from dogs that underwent attempted transvascular PDA occlusion from January 2006 to December 2009 were examined. Dogs were placed into 4 groups: Group 1: Amplatz Canine Duct Occluder (ACDO) (transarterial) - 36 dogs; Group 2: Gianturco or MReye Flipper Detachable Embolization (Flipper) coil (transarterial) - 38 dogs; Group 3: Amplatzer Vascular Plug (AVP) (transarterial) - 23 dogs; Group 4: Flipper coil (transvenous) - 15 dogs. RESULTS: The overall success rate of the procedures was high (92%) with comparable success rates among groups (87-97%). There were significantly fewer complications (P < .0001) in dogs receiving an ACDO than in the remaining groups (3% for ACDO versus 26-33% for the other groups). Fluoroscopy time for the transvenous method was significantly longer (median, 13 minutes) than for the other groups (median, 6 minutes) (P < .0001). Severity of residual flow 24 hours postprocedure was significantly less in the ACDO group than in the remaining groups (P = .0001-.05). CONCLUSIONS: The ACDO appears superior in ease of use, complication rate, and completeness of occlusion. The remaining limiting factor with this device is patient size. Until a smaller ACDO device is marketed, coils remain the only choice for interventional closure in very small dogs.

A long-term study of knowledge, risk, and ethics for students enrolled in an introductory biotechnology course.

Since 1989, an undergraduate course addressing issues concerning biotechnology in agriculture has been taught annually. To determine the extent to which students were engaged in classroom instruction and assimilated knowledge from the course, students were asked to complete an "Attitudes About Biotechnology" questionnaire. Students were queried about their knowledge of biotechnology, perceptions of risks associated with biotechnology, and ethics and attitudes toward the use of biotechnology in agriculture. Responses to the survey questions were evaluated both pre-and postcourse. Data were collected from 13 classes over a 10-yr period. Inspection of the precourse grade point average and the course grades for these students revealed no trends up or down over the period of this study. Similarly, inspection of the data revealed no effect from problem-based learning, student-facilitated group work, or technology on student attainment of knowledge, perception of risk, or ethical views. For each of the five knowledge questions, the average score increased as a result of taking the course. On two of the knowledge questions, the average score increase for females from pre- to postcourse was greater than for males. Based on our measurements using the postcourse questionnaire, the correlation between perceived and actual knowledge was not significantly different from zero. In two of the four risk questions, there was no change in average score as a result of the course; however, student perception of risk associated with genetic engineering of plants increased. Although average scores for student perception of risk due to the perceived impact of genetically engineered products on people or the environment decreased from pre- to postcourse assessment, the average score was higher (P < 0.01) for females than for males. Males were more accepting of genetic manipulation of cells in a laboratory than were females both pre- and postcourse. Although student knowledge of biotechnology was increased and the perceived risk due to biotechnology was altered, there was no evidence that students altered their ethical position on biotechnology as a result of this course.

Evaluation of once daily treatment with cyclosporine for anal furunculosis in dogs.

Twenty-four dogs with anal furunculosis were treated with cyclosporine once daily for 13 weeks at dosages of 1.5, 3.0, 5.0 or 7.5 mg/kg, and re-examined after six and 12 months. After 13 weeks the disease in six of the dogs was in remission, 11 were controlled or improved and seven had failed to respond. The response of the dogs given the highest dose was significantly better than the response of the other groups taken together (P < 0.014), and better than the responses of the groups given 1.5 mg/kg and 5 mg/kg (P < 0.05). The dogs improved clinically during the treatment, most rapidly during the first five weeks. Of the six dogs that were in remission after 13 weeks, three relapsed after one, two and six months. The 11 dogs that were improved or controlled after 13 weeks were either left untreated or were continued on cyclosporine medication for one to three months at a dosage of 1.5 to 7.5 mg/kg; the disease went into remission in four cases and remained controlled in the other seven, but four of the 11 cases relapsed during the 12 months following the treatment. The side effects observed included increased coat turnover and transient vomiting.

A comparison of the effects of unilateral thyroarytenoid lateralization versus cricoarytenoid laryngoplasty on the area of the rima glottidis and clinical outcome in dogs with laryngeal paralysis.

OBJECTIVE: To compare the clinical effects of unilateral thyroarytenoid lateralization versus unilateral cricoarytenoid laryngoplasty for the treatment of canine laryngeal paralysis. Study Design-A prospective, clinical trial. ANIMALS: Twenty client-owned dogs admitted to Glasgow University Veterinary Hospital (GUVH) between 1997 and 1999 with a diagnosis of laryngeal paralysis. METHODS: A thorough evaluation of each dog was undertaken that included history, physical and neurologic examinations, complete blood count, serum biochemistry profile, serum thyroxine (T4) level, and thyroid-stimulating hormone (TSH) assay. The exercise tolerance of each dog was investigated by assessing respiratory rate and arterial blood gas analysis at rest and after 5 minutes of mild exercise. Animals were included in the study on the basis of a definitive diagnosis of laryngeal paralysis made by endoscopic observation of the larynx in the lightly anesthetized patient. The animals were randomly assigned to 1 of 2 treatment groups: unilateral thyroarytenoid lateralization or unilateral cricoarytenoid laryngoplasty, with all procedures being performed by the same surgeon. Video images of the rima glottidis were recorded pre- and postoperatively using video endoscopy. Video images were digitized and the area of the rima glottidis measured using image-analysis software. An increase in the area of the rima glottidis was expressed as a percentage of the preoperative area. All animals were reassessed 6 weeks' postoperatively, and exercise tolerance tests were repeated. RESULTS: The mean increase in the area of the rima glottidis postoperatively when compared with the preoperative area was 140% for those animals undergoing unilateral thyroarytenoid lateralization (range, 120%-158%) and 207% for those animals undergoing unilateral cricoarytenoid laryngoplasty (range, 183%-228%). This difference was statistically significant (P < .0001). At the 6-week postoperative examination, there was no significant difference in improvement between the 2 groups when compared on either a clinical basis or exercise tolerance tests. The mean surgical time in the 2 groups was 25 minutes for thyroarytenoid lateralization and 43 minutes for cricoarytenoid laryngoplasty. This was a statistically significant difference (P = .002). CONCLUSION: Although increase in area of the rima glottidis was significantly greater after unilateral cricoarytenoid laryngoplasty compared with unilateral thyroarytenoid lateralization, no difference in clinical outcome could be detected. However, the cricoarytenoid laryngoplasty procedure required significantly more surgical time. CLINICAL RELEVANCE: Both unilateral cricoarytenoid laryngoplasty and unilateral thyroarytenoid lateralization are successful methods for the treatment of laryngeal paralysis; however, thyroarytenoid lateralization requires less surgical time to perform.

Bilateral overlapping mucosal single-pedicle flaps for correction of soft palate defects.

The clinical outcomes of bilateral overlapping single-pedicle flaps used for repair of congenital cleft of the soft palate in 10 animals (nine dogs and one cat) are reported. Six animals had concurrent cleft of the hard palate repaired using a previously described mucoperiosteal flap technique. Animals ranged from one to 13 months of age at surgery, with follow-up ranging from two to 12 months. Healing was uncomplicated in all cases and provided excellent functional results.

Oropharyngeal penetrating injuries in 50 dogs: a retrospective study.

OBJECTIVES: To summarize the presenting complaints and clinical signs associated with traumatic penetrating injuries to the canine oropharynx. To determine how the site of injury, causative agent, and duration of disease affect the presentation and clinical outcome of treatment. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: 50 client-owned dogs. METHODS: The medical records of 50 dogs with oropharyngeal penetrating injuries referred to Glasgow University Veterinary Hospital (GUVH) between 1979-1999 were reviewed. Data regarding signalment, owners' presenting complaint, history, physical examination, radiographic and endoscopic findings, surgical findings, and outcome were recorded and compared with the GUVH population. Estimates of individual breed-specific odds ratios were calculated. Outcome was evaluated by reexamination 6 weeks after surgery with recurrence of disease recorded as failure. RESULTS: Oropharyngeal injuries occurred most often in medium to large breed dogs. The majority of dogs presented with chronic disease (82%). The common findings on clinical examination were discharging sinus (72%) and swelling (70%). Acute cases typically presented with dysphagia and oral pain. The original site of injury was evident in only 34% of dogs, with the sublingual area the most frequently traumatized. The apparent cause of injury to the oropharynx was most commonly a piece of wood (72%). Other causes were metallic foreign bodies (3 dogs) and bones (2 dogs). In the remaining 9 dogs, the cause was not determined. The clinical signs resolved in all dogs that presented acutely compared with only 62% in dogs with chronic signs. CONCLUSION: Medium to large breed dogs appear to be prone to oropharyngeal injuries caused mainly by wooden foreign bodies. This may be attributable to stick chewing or retrieving behavior in these animals. CLINICAL RELEVANCE: History of trauma, stick retrieval, submandibular/cervical swelling, and discharging sinus are commonly encountered in the presentation of this condition. The sublingual area was the most frequent portal of entry recorded, although in chronic cases the initial site of injury was often unclear. Radiography and endoscopy, while offering definitive diagnosis with positive findings, often provide false negative findings. Aggressive surgical debridement of all sinus tracts is essential in obtaining a successful result, but recovery of a foreign body is not necessarily a determinant of success.

Spontaneous laryngeal paralysis in four white-coated German shepherd dogs.

Four cases of spontaneous laryngeal paralysis in juvenile white-coated German shepherd dogs are described. The presenting signs were typical for laryngeal paralysis, with stridor present in all four cases. Laryngoscopy revealed bilateral laryngeal paralysis in three cases, and unilateral paralysis in one. Concurrent megaoesophagus was also identified in one dog. All dogs underwent surgical treatment for laryngeal paralysis. Euthanasia was performed in one case due to intractable regurgitation and aspiration pneumonia. A possible association with white coat colour is discussed.

Cyclosporin as the sole treatment for anal furunculosis: preliminary results.

Cyclosporin was used, as the sole agent, to treat six cases of anal furunculosis, allowing the clinical response to the drug to be evaluated. The initial dose was 7.5 mg/kg twice a day. Following one week of treatment, whole blood cyclosporin trough levels were measured and the dose was adjusted to obtain a stable trough level of 400 to 600 ng/ml. In all dogs, the lesions were found to follow a similar pattern of resolution throughout the course of treatment. The presenting signs disappeared within one week of treatment, with a reduction in lesion size of 50 to 90 per cent. Lesions then gradually healed over the remainder of the treatment, which lasted from 10 to 20 weeks. One case required cryosurgical treatment to resolve a 2 mm diameter persistent ulcerated lesion following 18 weeks of treatment. The length of follow-up was four to 14 months (mean 7.7 months). One case developed recurrence of the lesions eight weeks post-treatment.

Intrathoracic tracheal avulsion and pseudodiverticulum following pneumomediastinum in a cat.

A case of tracheal avulsion with pneumomediastinum and pseudodiverticulum formation in a cat is described. Radiographs taken at initial presentation showed a pneumomediastinum with fractures of the right first to sixth ribs. Conservative treatment resolved the pneumomediastinum but following initial improvement the cat developed dyspnoea. Radiography and image intensification at this time showed a tracheal diverticulum at the level of the fourth rib. Surgical resection of the diverticulum and stenotic tracheal ends was performed via a right fourth intercostal lateral thoracotomy. The airway was maintained throughout the procedure using a bridging endotracheal tube. The cat made an unremarkable recovery following surgery.

Preliminary experience with diacetylrhein in the treatment of osteoarthritis.

A single-blind, placebo controlled study was carried out over a 12-week period in 12 patients with osteoarthritis of the hip or knee to assess the effectiveness of 50 mg diacetylrhein per day. The 4 weeks of active treatment were preceded and followed by periods on placebo. Response to treatment as assessed by pain score, walking time and the number of 'rescue' analgesic tablets (paracetamol) consumed showed that 6 patients improved, 4 were unchanged and 2 deteriorated. Improvement was not apparent for several weeks after starting active treatment and remission lasted for 2 weeks to 3 or more months after the drug was withdrawn. The action of diacetylrhein is not yet established, but it does not appear to be related to analgesia or inhibition of prostaglandin synthetase activity. It is considered that further studies of this interesting drug are warranted to determine the most effective dose and duration of treatment.