Improved owner quality of life following surgical repair of canine myxomatous mitral valve disease.

OBJECTIVE: To determine quality-of-life changes in owners of dogs undergoing mitral valve repair for myxomatous mitral valve disease, up to 12 months postoperatively. SAMPLE: Owners of 26 dogs undergoing mitral valve repair at a single UK veterinary referral hospital. METHODS: Dogs underwent mitral valve repair under cardiopulmonary bypass as previously described. Owner quality of life was assessed by self-completion of a previously validated questionnaire preoperatively and at 1, 3, 6, and 12 months postoperatively. RESULTS: There was a statistically significant improvement in quality-of-life scores from preoperatively up to 3 months postoperatively and a statistically significant improvement in individual question scores up to 6 months postoperatively. CLINICAL RELEVANCE: Results suggested that owner quality of life is significantly improved following surgical repair of their pet's myxomatous mitral valve disease, and this improvement continues beyond the immediate postoperative period. These results may be useful when counseling owners of surgical candidates and is another useful outcome measure.

Use of the Functional Evaluation of Cardiac Health questionnaire to assess health-related quality of life before and after mitral valve repair in dogs with myxomatous mitral valve disease.

OBJECTIVE: To determine changes in health-related quality of life up to 12 months after surgery in dogs with myxomatous mitral valve disease that undergo mitral valve repair. ANIMALS: 54 dogs that underwent mitral valve repair at a United Kingdom referral hospital. PROCEDURES: Health-related quality of life was assessed with a previously validated, owner-completed questionnaire before and 1, 3, 6, and 12 months after surgery. Results: There was a significant decrease in total score (corresponding to reduced negative impact of cardiac disease on quality of life) between the preoperative timepoint and all postoperative timepoints. A significant decrease in total score was also demonstrated between the 1- and 3-month timepoints, but no additional significant changes in total score between adjacent timepoints were identified beyond 3 months after surgery. Significant improvements in individual question scores were found up to 12 months after surgery. CLINICAL RELEVANCE: Health-related quality of life was significantly improved following mitral valve repair in dogs with myxomatous mitral valve disease and this improvement persisted for up to a year after surgery. These results may be useful when counseling owners of dogs considered candidates for this procedure.

Immunohistological Evaluation of Von Willebrand Factor in the Left Atrial Endocardium and Atrial Thrombi from Cats with Cardiomyopathy.

Aortic thromboembolism (ATE) occurs in cats with cardiomyopathy and often results in euthanasia due to poor prognosis. However, the underlying predisposing mechanisms leading to left atrial (LA) thrombus formation are not fully characterised. von Willebrand Factor (vWF) is a marker of endothelium and shows increased expression following endothelial injury. In people with poor LA function and LA remodelling, vWF has been implicated in the development of LA thrombosis. In this study we have shown (1) the expression of endocardial vWF protein detected using immunohistofluorescence was elevated in cats with cardiomyopathy, LA enlargement (LAE) and clinical signs compared to cats with subclinical cardiomyopathy and control cats; (2) vWF was present at the periphery of microthrombi and macrothrombi within the LA where they come into contact with the LA endocardium and (3) vWF was integral to the structure of the macrothrombi retrieved from the atria. These results provide evidence for damage of the endocardial endothelium in the remodelled LA and support a role for endocardial vWF as a pro-thrombotic substrate potentially contributing to the development of ATE in cats with underlying cardiomyopathy and LAE. Results from this naturally occurring feline model may inform research into human thrombogenesis.

Ambulatory electrocardiographic evaluation of the occurrence of arrhythmias in healthy Salukis.

OBJECTIVE To determine the frequency and complexity of ventricular arrhythmias in a group of healthy Salukis evaluated by means of continuous Holter monitoring for 7 days. DESIGN Prospective case series. ANIMALS 25 healthy Salukis > 18 months old. PROCEDURES In all dogs, a history was obtained and a physical examination and transthoracic echocardiography were performed to verify the absence of structural cardiac disease. Dogs then underwent Holter monitoring for 7 days. Data recorded included heart rate parameters and the occurrence of conduction disturbances, ventricular premature complexes, ventricular couplets, ventricular triplets, ventricular bigeminy, ventricular trigeminy, and ventricular tachycardia. RESULTS 25 dogs (13 sexually intact females, 2 spayed females, and 10 sexually intact males) were enrolled in the study. All 25 dogs had at least one 24-hour period during which ventricular premature complexes were detected. Median number of ventricular premature complexes during any 24-hour period in all dogs was 2 (interquartile [25th to 75th percentile] range, 0 to 4). There were no significant differences between males and females in regard to median number of ventricular premature complexes per 24-hour period or recorded heart rate parameters. CONCLUSIONS AND CLINICAL RELEVANCE For Salukis in the study population, 7-day Holter monitoring revealed infrequent ventricular arrhythmias. These findings suggested that detection of a ventricular arrhythmia in a healthy Saluki may be an indication for further diagnostic evaluation.

Common Arterial Trunk in a 3-Day-Old Alpaca Cria.

A 3-day-old alpaca cria presented for progressive weakness and dyspnea since birth. Complete bloodwork, thoracic radiographs, and endoscopic examination of the nasal passages and distal trachea revealed no significant findings. Echocardiogram and contrast study revealed a single artery overriding a large ventricular septal defect (VSD). A small atrial septal defect or patent foramen ovale was also noted. Color flow Doppler and an agitated saline contrast study revealed bidirectional but primarily right to left flow through the VSD and bidirectional shunting through the atrial defect. Differential diagnosis based on echocardiographic findings included common arterial trunk, Tetralogy of Fallot, and pulmonary atresia with a VSD. Postmortem examination revealed a large common arterial trunk with a quadricuspid valve overriding a VSD. Additionally, defect in the atrial septum was determined to be a patent foramen ovale. A single pulmonary trunk arose from the common arterial trunk and bifurcated to the left and right pulmonary artery, consistent with a Collet and Edwards' type I common arterial trunk with aortic predominance. Although uncommon, congenital cardiac defects should be considered in animals presenting with clinical signs of hypoxemia, dyspnea, or failure to thrive.

Comparison of the diuretic effect of furosemide by different methods of administration in healthy dogs.

OBJECTIVE: To compare the diuretic effects of subcutaneous (s.c.) administration of furosemide to conventional methods of administration including intravenous (i.v.), per os (p.o.), and constant rate infusion (CRI) in healthy dogs. DESIGN: Prospective, randomized, cross-over study. SETTING: Veterinary university research facility. ANIMALS: Seven healthy, adult mongrel dogs (3 males, 4 females). INTERVENTION: Each dog in the study was randomly assigned to receive a 2 mg/kg dose of furosemide via a single s.c., i.v., or p.o. dose at the beginning (time 0) of an 8-hour study, or via CRI during an 8-hour study period. Urine was collected by emptying the bladder using an indwelling catheter and blood samples were obtained via venipuncture at time 0 for baseline measurements and at 1, 2, 4, 6, and 8 hours into the study. Hourly urine output was calculated in all dogs for each study. Complete blood count, plasma total protein, blood urea nitrogen, creatinine, and renin concentration were measured for each sample. MEASUREMENTS AND MAIN RESULTS: The s.c. administration of furosemide resulted in a urine output per hour (UOP/h) that peaked at 1 hour with UOP/h returning to baseline at 4 hours after injection. Following i.v. administration, UOP/h also peaked at 1 hour but returned more rapidly to baseline levels at 2 hours after injection. With p.o. administration, UOP/h reached a maximum UOP/h at 2 hours but time to return to baseline levels was prolonged to 6 hours after administration. With CRI administration, the time to the maximum UOP/h was delayed to 4 hours after injection but UOP/h was then maintained throughout the study period. CONCLUSIONS: Total urine output following s.c. administration of furosemide in healthy dogs was similar when compared to the i.v. and p.o. route. Subcutaneous route may be an effective means for administration of furosemide in dogs, particularly when i.v. access is difficult.

Imaging diagnosis--acquired pectus excavatum secondary to laryngeal paralysis in a dog.

A 13-year-old neutered female Labrador retriever had inspiratory dyspnea secondary to bilateral laryngeal paralysis. Radiographically, there was pectus excavatum with a mediastinal shift to the right. Arytenoid lateralization was performed, relieving the upper respiratory obstruction, and the sternal deformity also resolved. Chronic upper respiratory obstruction should be considered in dogs with pectus excavatum. Furthermore, correction of upper respiratory obstruction has the potential to result in resolution of pectus excavatum.