Esophageal motility dysfunction in cats: a study of 44 cases.

A retrospective study evaluated cases of feline esophageal dysfunction. Cats identified had contrast esophagrams performed during a six-year period. Of 56 cases undergoing esophagography, 51 had complete records available for review. Forty-four cases were felt to be abnormal and were included in the study. Cases were analyzed for signalment, presenting complaints, and identifiable causes of abnormal esophageal motility. Response to treatment and case outcome were also reviewed. The signalment of the cases varied widely, especially in age. The occurrence of esophageal motility dysfunction was low, comprising only 0.05% of all feline cases seen in a six-year period. Forty-three percent of cases were considered idiopathic, and 57% were congenital or diagnosed with conditions known to cause esophageal motility dysfunction. The causative disease states included myasthenia gravis, mediastinal masses, vascular ring anomalies, dysautonomia, and esophageal stricture. Seventy-eight percent of those treated with medical therapy (i.e., combinations of sucralfate, H2 receptor antagonists, and either metoclopramide or cisapride) showed clinical improvement.

Cardiovascular pathology possibly associated with ketamine/xylazine anesthesia in Dutch belted rabbits.

BACKGROUND AND PURPOSE: After myocardial necrosis and fibrosis was observed in five rabbits which had been anesthetized a variable number of times, the potential relationship of these lesions and anesthesia was evaluated in 35 other rabbits. METHODS: Anesthesia was induced by intramuscular administration of ketamine and xylazine followed by infusion of lactated Ringer's solution also containing ketamine and xylazine. Group A rabbits (n = 9) were subjected to multiple anesthesias and were evaluated by echocardiography, thoracic radiography, electrocardiography, determination of serum coronavirus titer, vitamin E concentration, and complete necropsy. Prior to a single acute procedure followed by necropsy, group B rabbits (n = 11) were evaluated by echocardiography only. Group C rabbits (n = 10) had never been anesthetized and were necropsied after euthanasia. Group D rabbits (n = 5) had intermediate anesthesia exposure history and were evaluated by echocardiography only. Myocardial fibrosis was scored semi-quantitatively on a scale of 0 to 4. RESULTS: Canine coronavirus test results were negative; hypovitaminosis E was evident, and fibrosis scores were significantly increased in group A, compared with group B or group C, rabbits. CONCLUSION: Etiologic differentials included alpha2-agonist-mediated coronary vasoconstriction with associated myocardial hypoperfusion, hypovitaminosis E and free radical injury, and other anesthetic-induced physiologic trespass.

Factors contributing to the decision for euthanasia of dogs with congestive heart failure.

OBJECTIVE: To determine the prevalence of clinical signs that affect quality of life in dogs with congestive heart failure (CHF), and to characterize the role of these clinical signs in the decision for euthanasia. DESIGN: Prospective study. ANIMALS: 38 dogs with CHF that had been euthanatized within the preceding 22 months. PROCEDURE: Clinical information and factors affecting the decision for euthanasia were reviewed and recorded from medical records of dogs with CHF. Each owner was then interviewed via telephone to determine whether their dog had anorexia or other clinical signs of disease prior to euthanasia, their perception of their dogs' quality of life, and the most important factor and contributing factors that influenced the decision to euthanatize their dog. RESULTS: Of the 38 dogs with CHF, > 70% had weakness (35 dogs), coughing (33), anorexia (32), weight loss (32), dyspnea (30), or exercise intolerance (28) reported by their owners. Factors often named by owners as most important in the decision for euthanasia were poor prognosis given by the attending veterinarian, recurrent clinical signs of CHF (ie, coughing, dyspnea, or ascites), and poor quality of life. Weakness, anorexia, and recurrent clinical signs of CHF were the most common contributing factors in the decision for euthanasia. CLINICAL IMPLICATIONS: Anorexia, weight loss, and exercise intolerance are common in dogs euthanatized because of CHF. The importance of quality of life and poor prognosis in making a decision for euthanasia suggests that addressing these factors may improve patient management.

A retrospective study of 100 cases of feline distal aortic thromboembolism: 1977-1993.

The medical records of 100 cats with distal aortic thromboembolism were reviewed. The average age was 7.7 years, with the neutered male being the most common signalment (63%). Evidence of preexisting cardiac disease was noted in 11% of the cases. A murmur or arrhythmia was noted in 57% of the cases on presentation. Frequent laboratory abnormalities included elevations in blood glucose, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, and creatinine. Radiographic and electrocardiographic abnormalities were common (89% and 85%, respectively). The most frequent, underlying disease was hypertrophic feline cardiomyopathy (58%), with the left atrial size (as measured by M-mode) significantly increased in the majority of cases (mean left atrial-to-aortic ratio, 2.08). The average, long-term survival in the 37% of cases which survived the initial thromboembolic episode was 11.5 months. The remaining cases either died (28%) or were euthanized (35%).

Boxer cardiomyopathy. A review of the long-term benefits of antiarrhythmic therapy.

Antiarrhythmic therapy for Boxer cardiomyopathy both enhances the quality of life and improves life expectancy. The natural course of the disease for most dogs is a progression from mild arrhythmias to serious, potentially life-threatening arrhythmias and eventually to CHF. This process may evolve over a period of months or even years; the factors responsible for the variable rate of progression from one dog to another are not well understood. Once heart failure occurs, the long-term prognosis is dismal, usually no better than 3 to 6 months. Whether the administration of L-carnitine will have a significant effect on functional improvement of the heart, as taurine in dilatative feline cardiomyopathy, awaits the long-term evaluation of this therapy.

Plasma taurine concentrations and M-mode echocardiographic measures in healthy cats and in cats with dilated cardiomyopathy.

M-mode echocardiography was completed and plasma taurine concentrations were determined in 79 healthy cats and 77 cats with dilated cardiomyopathy (DCM). In healthy cats, a relationship was not observed between plasma taurine concentrations and any M-mode echocardiographic measurement. End-systolic and end-diastolic cardiac chamber dimensions were larger; wall thickness measures were smaller; and calculations of fractional shortening were less in cats with DCM than in healthy cats. Plasma taurine concentrations less than 30 nmol/mL were detected in 7/79 healthy cats and in 52/77 cats with DCM. Of the 52 cats with DCM and an initial plasma taurine concentration less than 30 nmol/mL, 23 died or were euthanized during the first post-treatment week, 7 were lost to further study, and 22 improved after taurine supplementation. Of the 25 cats with DCM and an initial plasma taurine concentration greater than or equal to 30 nmol/mL, 9 died or were euthanatized during the first post-treatment week, and 9 were lost to further study. Two cats did not improve, of which one died and one was euthanatized 4 to 8 weeks after initiation of taurine supplementation. Five cats with a plasma taurine concentration greater than or equal to 30 nmol/mL improved after taurine supplementation. Myocardial function subsequently deteriorated in three of these cats. Two of the three cats had signs of congestive heart failure redevelop.

Intestinal and cardiopulmonary forms of parvovirus infection in a litter of pups.

Parvovirus infection caused signs of gastrointestinal illness in all pups in a litter of 12 and death in 6 of them when 12 to 19 days old. The remaining pups recovered from the gastrointestinal infection, but 5 of the 6 died before they were 9 1/2 weeks old, with signs of cardiopulmonary disease. Necropsy findings were cardiomegaly, myocarditis, pulmonary congestion, and interstitial pneumonia. The only surviving pup also had signs of cardiopulmonary disease but was apparently well at 18 months of age.

Hyperthyroidism in the cat: ten cases.

In ten neutered crossbred cats 10 to 14 years old and of both sexes, hyperthyroidism was evidenced by hyperactivity, weight loss despite increased appetite, frequent defecation with bulky stools, thirst, polyuria, moderately elevated temperature, increased heart rate and size, sometimes with murmurs and arrhythmias, and palpable enlargement of one or both thyroid lobes. The diagnosis of hyperthyroidism was confirmed on the basis of high serum concentrations of thyroxine (T4) and triiodothyronine (T3). In seven cats (6 treated by total thyroidectomy, 1 studied at necropsy), both thyroid lobes were variably enlarged, mottled, cystic, or nodular; in three cats, only one lobe required removal. Adenomatous goiter was diagnosed microscopically in all. In two, there also were foci of adenocarcinoma and in two others, foci suggestive of adenocarcinoma. Three of the nine cats having surgery were treated preoperatively to stabilize cardiac function. Most cats recovered from surgery rapidly and without complications but although every effort was made to spare at least one parathyroid gland in cats having bilateral thyroidectomies, two cats had transient signs of hypoparathyroidism, requiring careful monitoring of serum electrolytes and treatment with calcium and vitamin D2. All having bilateral thyroidectomies were subsequently maintained on treatment with l-thyroxine or, in one case, liothyronine (triiodothyronine).