Association between echocardiographic indexes and urinary Neutrophil Gelatinase-Associated Lipocalin (uNGAL) in dogs with myxomatous mitral valve disease.

Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker of tubular damage, and its elevation has been described in human and canine cardiorenal syndrome. The aim was to evaluate the association between echocardiographic indexes and urine NGAL (uNGAL) and uNGAL normalized to urine creatinine (uNGALC) in dogs with MMVD. This is a multicentric prospective cross-sectional study. A total of 77 dogs with MMVD at different ACVIM stages were included. All dogs underwent echocardiography, serum chemistry, and urinalysis. Echocardiographic data analyzed were shortening fraction (SF), left ventricular diastolic (LVIDDn) and systolic (LVIDSn) diameters normalized for body weight, left atrium to aortic root ratio (LA/Ao), maximal (LAVMax) and minimal (LAVMin) left atrial volumes, LA stroke volume (LASV), early diastolic mitral peak velocity (EVmax), EVmax to tissue Doppler E' wave (E/E'), aortic (VTIAo) and mitralic (VTIMit) velocity time integrals and their ratio (VTIMit/VTIAo), and tricuspid regurgitation velocity (TRVmax). In the univariate analysis LASV, TRVmax, LAVMax, LVIDDn, and VTIMit/VTIAo were independent predictors of increased uNGAL and uNGALC; however, only LASV [(OR: 1.96, 95% CI: 1.16 to 3.31) P = 0.01 for NGAL, and (OR: 2.79, 95% CI: 1.50 to 5.17) P < 0.001 for NGALC] and TRVmax [(OR: 1.73, 95% CI: 1.20-2.51) P = 0.002 for NGAL, and (OR: 1.50, 95% CI: 10.07-2.10) P = 0.015 for NGALC] remained statistically significant in the multivariable analysis. Based on our results, LASV and TRVmax are associated with increased uNGAL and uNGALC. These parameters might detect dogs with MMVD at higher risk of developing kidney damage.

Lung ultrasound score in dogs and cats: A reliability study.

BACKGROUND: Lung ultrasound (LUS) is a noninvasive tool for examining respiratory distress patients. The lung ultrasound score (LUSS) can be used to quantify and monitor lung aeration loss with good reliability. HYPOTHESIS/OBJECTIVES: Assess the reliability of a new LUSS among raters with different levels of experience and determine how well the same raters agree on identifying patterns of LUS abnormalities. ANIMALS: Forty LUS examinations of dogs and cats and 320 videos were reviewed from a digital database. METHODS: Retrospective reliability study with post hoc analysis. Protocolized LUS were randomly selected; intrarater and interrater reliability of the LUSS and pattern recognition agreement among 4 raters with different levels of experience in LUS were tested. RESULTS: The intrarater intraclass correlation coefficient (ICC) single measurement, absolute agreement, and 2-way mixed effects model was 0.967 for the high-experience rater (H-Exp), 0.963 and 0.952 for the medium-experience raters (M-Exp-1; M-Exp-2), and 0.950 for the low-experience rater (L-Exp). The interrater ICC average measurement, absolute agreement, and 2-way random effects model among the observers was 0.980. The Fleiss' kappa (k) values showed almost perfect agreement (k = 1) among raters in identifying pleural effusion and translobar tissue-like pattern, strong agreement for A-lines (k = 0.881) and B-lines (k = 0.806), moderate agreement (k = 0.693) for subpleural loss of aeration, and weak agreement (k = 0.474) for irregularities of the pleural line. CONCLUSIONS AND CLINICAL IMPORTANCE: Our results indicate excellent intra- and interrater reliability for LUS scoring and pattern identification, providing a foundation for the use of the LUSS in emergency medicine and intensive care.

Evaluation of the caudal vena cava diameter to abdominal aortic diameter ratio and the caudal vena cava respiratory collapsibility for predicting fluid responsiveness in a heterogeneous population of hospitalized conscious dogs.

Fluid responsiveness, defined as the response of stroke volume to fluid loading, is a tool to individualize fluid administration in order to avoid the deleterious effects of hypovolemia or hypervolemia in hospitalized patients. To evaluate the accuracy of two ultrasound indices, the caudal vena cava to abdominal aorta ratio (CVC/Ao) and the respiratory collapsibility of the caudal vena cava (cCVC), as independent predictors of fluid responsiveness in a heterogeneous population of spontaneously breathing, conscious, hospitalized dogs. A prospective, multicenter, observational, cross-sectional study was designed in twenty-five dogs. The accuracy of CVC/Ao and cCVC in predicting fluid responsiveness was evaluated by the area under the receiver operating characteristic curve (AUROC) in a group of hospitalized dogs after receiving a mini-fluid bolus of 4 ml/kg of Hartmann's solution. Dogs with an increased aortic velocity time integral >15% were classified as fluid responders. Twenty-two dogs were finally included. Ten were classified as responders and 12 as non-responders. The AUROC curves were 0.88 for the CVC/Ao ratio (95% confidence interval, CI, 0.67-0.98; P=0.0001) and 0.54 for cCVC (95% CI 0.32-0.75; P=0.75). The CVC/Ao threshold optimized for best sensitivity (SE) and specificity (SP) values was 0.83 (SE 100%; SP 75%). In spontaneously breathing hospitalized dogs, the CVC/Ao measurement predicted stroke volume increase after a fluid bolus, while the respiratory variations in the cCVC did not discriminate between fluid responders and non-responders.

Echocardiographic evaluation of four giant Aldabra tortoises (Aldabrachelys gigantea).

OBJECTIVES: In recent years echocardiography has become a good diagnostic tool in Zoo Medicine but in some cases, it is still a challenge. In Aldabra giant tortoise (Aldabrachelys gigantea) the big size of animals and the few individuals hosted in Zoo are critical points for the application of this diagnostic technique.The purposes of this research were: to evaluate the feasibility of the diagnostic imaging technique on big-sized turtles; to define the echographic parameters for this species; and to describe the morphofunctional and physiological echographic characteristics of their cardiovascular system. DESIGN: Repeated measures in vivo. SETTING: Ultrasonography systematic description and Doppler analysis of the cardiovascular system of Aldabra giant tortoise were carried out; B-mode examination allowed the evaluation of the kinetics of the ventricle, the atria and the atrioventricular valves. PARTICIPANTS: 4 Aldabra giant tortoises (two adult males and two young females) hosted in two zoological gardens. INTERVENTIONS: Echocardiography was performed placing the animals in ventral on a restraining platform raised from the floor, to provide adequate accessibility to the thoracic windows where the probe was placed. No chemical restraint was used. PRIMARY AND SECONDARY OUTCOME MEASURES: Heart rate, systolic and diastolic areas and volumes, vessel diameters and blood flow velocity were measured. RESULTS: Heart rate was 21±4 bpm (range 14-25 bpm). The averages of the diastolic and systolic area indexes linked to the subject weight were: 21±3 cm2 and 9±1 cm2.The aortic annulus diameter in female specimens measured 11.2±0.8 mm, while it measured 21.5±0.3 mm in male species. CONCLUSION: Results confirm the effectiveness of echocardiography as a means to study and evaluate the cardiovascular system of this species even if more studies on a bigger number of patients would be necessary to develop the echocardiography technique.

Usefulness of focused cardiac ultrasonography for predicting fluid responsiveness in conscious, spontaneously breathing dogs.

OBJECTIVE: To evaluate the diagnostic usefulness of focused cardiac ultrasonography and selected echocardiographic variables for predicting fluid responsiveness in conscious, spontaneously breathing dogs with various clinical conditions. ANIMALS: 26 dogs (15 males and 11 females) with a median age of 84 months (range, 12 to 360 months) and median body weight of 8 kg (range, 2 to 35 kg) referred for various clinical conditions. PROCEDURES: Left ventricular end-diastolic internal diameter normalized to body weight (LVIDDn), left ventricular volume score (LVVS), left ventricular end-diastolic volume index (EDVI), aortic velocity time integral (VTIAo), and aortic peak flow velocity (VmaxAo) were echocardiographically measured before and after IV administration of a bolus of lactated Ringer solution (4 mL/kg) over a 1-minute period. Dogs were classified on the basis of the observed change in aortic stroke volume following fluid administration as responders (≥ 15%) or nonresponders (< 15%) to fluid administration. Receiver operating characteristic curves were generated for the ability of LVVS, LVIDDn, EDVI, VTIAo, and VmaxAo to predict responder status. RESULTS: 13 dogs were classified as responders and 13 as nonresponders. Areas under the receiver operating characteristic curves (95% confidence intervals) for predicting fluid responsiveness were as follows: VTIAo, 0.91 (0.74 to 0.99); LVIDDn, 0.85 (0.66 to 0.96); EDVI, 0.85 (0.65 to 0.96); LVVS, 0.85 (0.65 to 0.96); and VmaxAo, 0.75 (0.54 to 0.90). CONCLUSIONS AND CLINICAL RELEVANCE: The evaluated echocardiographic variables were useful for noninvasive prediction of fluid responsiveness in conscious dogs and could be valuable for informing clinical decisions regarding fluid therapy.