Molecular detection of rickettsial agents in Amblyomma maculatum ticks (Ixodida: Ixodidae) from Ecuador.

Rickettsiales are obligate intracellular bacteria that need vertebrates and arthropods to maintain their life cycles. Some species of the genera Anaplasma, Ehrlichia, and Rickettsia are transmitted by ticks to both animals and humans and can cause mild to severe and even fatal cases. In the Americas, there is substantial data on rickettsial agents, encompassing both clinical cases and the detection of these agents in ticks, but in Ecuador, the information about them remains poorly understood. Therefore, the objective of this study was to detect molecularly rickettsial agents in Amblyomma maculatum ticks in both parasitic and free-living phases collected from domestic animals and pasture in five localities across three coastal provinces of Ecuador. Rickettsia parkeri, Candidatus Rickettsia andeanae, and Ehrlichia sp. were recorded in A. maculatum for the first time in Ecuador. These records were made in a region where antibodies to the Spotted Fever Rickettsia Group were detected in humans. Additional studies are needed to characterize Ehrlichia sp. at a specific level. Furthermore, recognizing the specific Rickettsiales species circulating in the ticks and the hosts within a region is crucial for assessing potential contact risks.

Echocardiographic indicators of fluid responsiveness in hospitalized dogs with compromised hemodynamics and tissue hypoperfusion.

OBJECTIVE: To evaluate the accuracy of selected echocardiographic variables used to predict fluid responsiveness in hospitalized dogs with compromised hemodynamics and tissue hypoperfusion. DESIGN: Diagnostic test study in a prospective cohort of hospitalized dogs. SETTING: Veterinary referral clinics. ANIMALS: Forty-four hospitalized dogs with compromised hemodynamics and tissue hypoperfusion were utilized in this study. INTERVENTIONS: Echocardiographic examination before and after fluid replacement with 30 ml/kg of lactated Ringer's solution. MEASUREMENTS AND MAIN RESULTS: Pre-fluid replacement measurements of velocity of transmitral E wave (E-peak), the left ventricular end-diastolic internal diameter normalized to body weight (LVIDdN), and the left ventricular end-systolic internal diameter normalized to body weight (LVIDsN) were significantly lower in fluid-responsive patients compared with nonresponders (P < 0.001). The area under the receiver operating characteristic curve (AUROC) with its 95% confidence interval (CI) for each significant predictor was as follows: E-peak 0.907 (0.776-1.000, P < 0.001) and LVIDdN 0.919 (0.801-1.000, P < 0.001). The predictive capacity of LVIDsN was not significantly better than chance (AUROC, 0.753; 95% CI, 0.472-1.000, P = 0.078). A significant negative linear correlation was observed between the percentage of increase in velocity-time integral after expansion and the echocardiographic variables LVIDdN (rs  = -0.452, P = 0.023) and E-peak (rs  = -0.396, P = 0.008) pre-fluid replacement. The intraobserver and interobserver variability was very low (<5 %) for all measurements. CONCLUSIONS: In this study using critically ill dogs with compromised hemodynamics and tissue hypoperfusion, pre-fluid replacement measurements of LVIDdN and E-peak adequately predict fluid responsiveness. Because a small number of fluid nonresponders were involved in the present study (11.4%), further studies that include larger numbers of fluid-nonresponsive animals are required.

Left-dominant arrhythmogenic cardiomyopathy in a Fila Brasileiro dog.

Background: In human medicine, arrhythmogenic left ventricular cardiomyopathy was described as a primary disease of the heart characterized by fibroadipose replacement of the myocardium.. Case Description: We report the case of a dog, with history of syncope and irregular cardiac rhythm. Electrocardiogram, echocardiography, and a 24-hour Holter monitoring showed, respectively, the presence of premature ventricular complexes with right bundle branch block morphology, an increase of the left ventricle end-diastolic diameter with preserved fractional shortening and ejection fraction, and a sinus arrhythmia as baseline rhythm with supraventricular tachycardia episodes and ventricular complexes with left bundle branch block morphology. After the death of the canine, a postmortem examination showed cardiomegaly. Fibroadipose replacement of the septum and both ventricles, with left ventricle myocardial fibrosis, suggestive of previous necrosis, was observed. Conclusion: These findings are suggestive of left-dominant arrhythmogenic cardiomyopathy which, to the best of our knowledge, has not been described in veterinary medicine.

Findings suggestive of coronary microvascular dysfunction in cats with myocardial ischemia.

Background: Myocardial infarction (MI) is an important cause of death and disability among humans worldwide. Few studies have reported the occurrence of MI in small animals as well. Reports in human medicine indicate that up to 30% of patients with clinical signs compatible with myocardial ischemia suggestive of coronary disease exhibit normal epicardial arteries at angiography. These symptoms have been associated with a syndrome characterized by alterations in cardiac microvasculature, known as coronary microvascular dysfunction (CMD). Aim: This study aimed to describe the necropsy findings and clinical-pathological characterization (when available) of cats with histopathological findings suggesting CMD. Methods: Necropsy records of cats presenting histopathological diagnosis compatible with acute and/or chronic MI, with normal epicardial arteries and microvascular disorders were evaluated. Results: Twenty animals met the inclusion criteria. Eight cats (40%) exhibited findings compatible with mild hypertrophic cardiomyopathy (HCM) without left atrial enlargement, one (5%) presented restrictive cardiomyopathy, and another one (5%) had lesions consistent with histiocytoid cardiomyopathy. The remaining cats (50%) showed alterations compatible with severe HCM with left atrial enlargement. In all cases, epicardial arteries were normal (without obstruction). All the evaluated hearts exhibited myocardial multifocal fibrosis along with replacement of cardiomyocytes by adipose tissue and blood vessels with hyperplasia and hypertrophy of the muscular layer with protrusion of the nuclei of the endothelial cells. Conclusion: These findings suggest the presence of microvascular dysplasia of the coronary arteries. Further studies are necessary to confirm and clinically characterize these results.

Sizing the lung in dogs: the inspiratory capacity defines the tidal volume. / Avaliação do tamanho do pulmão em cães: a capacidade inspiratória define o volume corrente.

OBJECTIVE: To evaluate a novel physiological approach for setting the tidal volume in mechanical ventilation according to inspiratory capacity, and to determine if it results in an appropriate mechanical and gas exchange measurements in healthy and critically ill dogs. METHODS: Twenty healthy animals were included in the study to assess the tidal volume expressed as a percentage of inspiratory capacity. For inspiratory capacity measurement, the mechanical ventilator was set as follows: pressure control mode with 35cmH2O of inspired pressure and zero end-expiratory pressure for 5 seconds. Subsequently, the animals were randomized into four groups and ventilated with a tidal volume corresponding to the different percentages of inspiratory capacity. Subsequently, ten critically ill dogs were studied. RESULTS: Healthy dogs ventilated with a tidal volume of 17% of the inspiratory capacity showed normal respiratory mechanics and presented expected PaCO2 values more frequently than the other groups. The respiratory system and transpulmonary driving pressure were significantly higher among the critically ill dogs but below 15 cmH2O in all cases. CONCLUSIONS: The tidal volume based on the inspiratory capacity of each animal has proven to be a useful and simple tool when setting ventilator parameters. A similar approach should also be evaluated in other species, including human beings, if we consider the potential limitations of tidal volume titration based on the calculated ideal body weight.

OBJETIVO: Avaliar uma nova abordagem fisiológica para a determinação do volume corrente em ventilação mecânica, de acordo com a capacidade inspiratória, e determinar se isso resulta em medidas mecânicas e de troca gasosa adequadas em cães saudáveis e em estado crítico. MÉTODOS: Incluíram-se, neste estudo, 24 animais para avaliar o volume corrente expresso como porcentagem da capacidade inspiratória. Para mensuração da capacidade inspiratória, o ventilador mecânico foi regulado como segue: modo controle de pressão, com 35cmH2O de pressão de inspiração e pressão expiratória final de zero, por 5 segundos. Subsequentemente, estudaram-se dez cães em condições clínicas críticas. RESULTADOS: Cães saudáveis ventilados com volume corrente que correspondia a 17% da capacidade inspiratória demonstraram mecânica respiratória normal e apresentaram os valores previstos de PaCO2 mais frequentemente do que os animais nos demais grupos. A pressão no sistema respiratório e a pressão transpulmonar foram significantemente mais elevadas nos cães em condição crítica, porém em todos os casos, estiveram abaixo de 15cmH2O. CONCLUSÕES: O volume corrente calculado com base na capacidade inspiratória de cada animal comprovou ser uma ferramenta útil e simples para o estabelecimento dos parâmetros do ventilador. Convém também realizar abordagem semelhante em outras espécies, inclusive no ser humano, quando se consideram as potenciais limitações da titulação do volume corrente, com base no peso corpóreo ideal calculado.

Avaliação do tamanho do pulmão em cães: a capacidade inspiratória define o volume corrente / Sizing the lung in dogs: the inspiratory capacity defines the tidal volume

RESUMO Objetivo: Avaliar uma nova abordagem fisiológica para a determinação do volume corrente em ventilação mecânica, de acordo com a capacidade inspiratória, e determinar se isso resulta em medidas mecânicas e de troca gasosa adequadas em cães saudáveis e em estado crítico. Métodos: Incluíram-se, neste estudo, 24 animais para avaliar o volume corrente expresso como porcentagem da capacidade inspiratória. Para mensuração da capacidade inspiratória, o ventilador mecânico foi regulado como segue: modo controle de pressão, com 35cmH2O de pressão de inspiração e pressão expiratória final de zero, por 5 segundos. Subsequentemente, estudaram-se dez cães em condições clínicas críticas. Resultados: Cães saudáveis ventilados com volume corrente que correspondia a 17% da capacidade inspiratória demonstraram mecânica respiratória normal e apresentaram os valores previstos de PaCO2 mais frequentemente do que os animais nos demais grupos. A pressão no sistema respiratório e a pressão transpulmonar foram significantemente mais elevadas nos cães em condição crítica, porém em todos os casos, estiveram abaixo de 15cmH2O. Conclusões: O volume corrente calculado com base na capacidade inspiratória de cada animal comprovou ser uma ferramenta útil e simples para o estabelecimento dos parâmetros do ventilador. Convém também realizar abordagem semelhante em outras espécies, inclusive no ser humano, quando se consideram as potenciais limitações da titulação do volume corrente, com base no peso corpóreo ideal calculado.

ABSTRACT Objective: To evaluate a novel physiological approach for setting the tidal volume in mechanical ventilation according to inspiratory capacity, and to determine if it results in an appropriate mechanical and gas exchange measurements in healthy and critically ill dogs. Methods: Twenty healthy animals were included in the study to assess the tidal volume expressed as a percentage of inspiratory capacity. For inspiratory capacity measurement, the mechanical ventilator was set as follows: pressure control mode with 35cmH2O of inspired pressure and zero end-expiratory pressure for 5 seconds. Subsequently, the animals were randomized into four groups and ventilated with a tidal volume corresponding to the different percentages of inspiratory capacity. Subsequently, ten critically ill dogs were studied. Results: Healthy dogs ventilated with a tidal volume of 17% of the inspiratory capacity showed normal respiratory mechanics and presented expected PaCO2 values more frequently than the other groups. The respiratory system and transpulmonary driving pressure were significantly higher among the critically ill dogs but below 15 cmH2O in all cases. Conclusions: The tidal volume based on the inspiratory capacity of each animal has proven to be a useful and simple tool when setting ventilator parameters. A similar approach should also be evaluated in other species, including human beings, if we consider the potential limitations of tidal volume titration based on the calculated ideal body weight.

Miopatía severa y rabdomiolisis por estatinas / Severe Myopaty and rhabdomyolisis for estatins

Cada vez se destacan más las bondades del uso de las estatinas en la reducción del riesgo cardiovascular en prevención primaria y secundaria. Se presenta tres pacientes hospitalizados que desarrollaron rabdomiolisis o miopatía severa, un efecto infrecuente pero bien conocido de estos medicamentos.