[Diagnosis and treatment of feline persistent ductus arteriosus: a retrospective evaluation of 17 cats]. / Diagnose und Therapie eines persistierenden Ductus arteriosus: Eine retrospektive Evaluation bei 17 Katzen.

OBJECTIVE: The objective of this study was to evaluate the signalement, clinical features, and echocardiographic findings of cats diagnosed with patent ductus arteriosus (PDA) as well as short- and medium-term outcome after successful ligation of the PDA. MATERIAL AND METHODS: Over a 10-year period 17 cats were diagnosed with PDA by transthoracic echocardiography. Thirteen cats were surgically treated by thoracotomy and ligation of the PDA. RESULTS: In all cats, a heart murmur was detected. In 88.2% of the cases, this presented as grade 4 out of 6 murmur (15/17 cats). A continuous murmur was more common (10/17 cats; 58.9%) than a systolic murmur (7/17 cats; 41.1%). Echocardiography showed that left ventricular internal diameter end diastole (LVIDd) and left ventricular internal diameter end systole (LVIDs) were significantly above reference values in the majority of cats. Mean diameter of the PDA measured at the widest point of the vessel was 3.4 mm (± 1.08 mm) and mean maximum flow velocity amounted to 5,06 m/sec (2,6m/sec-6,4m/sec). Surgery was successfully performed in all cats treated by surgical ligation and all of these patients were discharged after postoperative inpatient therapy. One cat experienced perioperative bleeding from the PDA, which was stopped efficaciously. This cat exhibited a residual shunt directly postoperatively; this could no longer be visualized in a re-check echocardiography 3 months later. Six cats were followed over a longer period of time. CONCLUSIONS: The surgical prognosis in this case study is very good with a postoperative survival rate of 100%. CLINICAL RELEVANCE: Surgical treatment of PDA is curative in animals not displaying advanced cardiac lesions. The auscultation of a heart murmur can provide initial findings indicative of PDA. Therefore, cardiac auscultation is warranted at every first presentation of a kitten. It must however be taken into consideration that not every cat with PDA necessarily has a continuous murmur but may display a systolic heart murmur. Therefore, it is important give utmost attention to the patients' clinical signs.

[Esophageal stenosis as a result of a right aortic arch in 2 cats]. / Ösophagusstenose infolge eines persistierenden rechten Aortenbogens bei 2 Katzen.

A 3-month-old and a 4-year-old cat were presented in the clinic due to regurgitation. The kitten had displayed the symptoms since it had been fed solid foods and was smaller than the litter mates. The 4-year-old cat showed sudden-onset symptoms for 5 days prior to presentation and had a good general condition. Positive contrast thoracic radiographs of both cats in lateral recumbency showed an esophageal dilatation cranial to the heart base and raised a suspicion of foreign material with soft tissue density in this area. In the 4-year-old cat, findings of ventrodorsal thoracic radiographs were compatible with a dextroposition of the aorta and a slightly marked focal left curve of the trachea. The echocardiographic examination of the kitten pictured a right sided aorta, hence a vascular ring anomaly with a dextroposition from the aorta was suspected. Aberrant blood flow as it is seen in a persistent ductus arteriosus was not apparent in the echocardiography. As a result of the sudden development of the clinical signs in the older cat without displaying any former history of regurgitation, an esophagoscopy was performed to exclude an intraluminal esophageal cause for the stricture as well as to extract the foreign material. In this cat, computed tomography imaging also displayed an aberrant left subclavian artery. Both cats recovered well after surgical correction.The diagnosis of a ring anomaly in the kitten via echocardiography is a rare situation. As is the diagnosis of a high-grade esophageal stricture due to a vascular ring anomaly at the age of 4 without a former history of regurgitation.Recovery was excellent in the younger cat. There were no signs of regurgitation 6 months after surgery. The adult cat was in good general condition without clinical symptoms according to the owners when presented for stitch removal. Unfortunately, the adult cat was lost to follow up.

Increased phosphorylation of eNOS in nasal polyps of chronic rhinosinusitis patients can be diminished by 1,8-cineol.

INTRODUCTION: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a significant health problem, but the pathogenesis remains unclear to date. Nitric oxide (NO) has known airway modulating functions. Therefore, we investigated nitric oxide production to determine the role of eNOS in nasal polyps, with additional analysis of the effect of the monoterpene oxide 1,8-cineol on the possible regulation of eNOS signaling and thus NO production. METHODS: We determined eNOS expression, as well as regulatory and effector proteins like NOSTRIN and CASP8, using whole genome microarray, immunohistochemistry and western blot. To evaluate the influence of 1,8-cineol on eNOS signaling, we examined tissue samples of nasal polyps of patients with CRSwNP incubated with 100 µM 1,8-cineol using quantitative real-time PCR, western blot and phosphorylation arrays. RESULTS: Microarray analysis revealed an increased gene expression of eNOS (1.40-fold) as well as a decreased gene expression of NOSTRIN (0.53-fold) and CASP8 (0.44-fold) in nasal polyps. At the protein level, we detected 2.3-fold higher protein expression of eNOS and significant higher phosphorylation levels of eNOS in nasal polyps (19.7-fold, p ≤ 0.001) compared to inferior turbinates. Additionally, 1,8-cineol did not influence NOSTRIN and CASP8, but decreased the eNOS phosphorylation significantly (p ≤ 0.05). DISCUSSION: Our study demonstrated for the first time that nasal polyps exhibit an increased phosphorylation of eNOS, which could be important for vascular permeability and the associated edema and elevated inflammation. Additionally, we detected that 1,8-cineol affects the eNOS phosphorylation significantly and thus its activation. This could be important to handle the elevated inflammation and edema formation by regulating the vascular permeability.