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Ando T, Mihara K, Kanemoto I, Akiyoshi H. Perioperative changes in plasma cardiac troponin I concentration during mitral valvuloplasty for severe mitral regurgitation in dogs. Open Vet J 2024; 14:1625-1633. [PMID: 39175974 PMCID: PMC11338622 DOI: 10.5455/ovj.2024.v14.i7.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/09/2024] [Indexed: 08/24/2024] Open
Abstract
Background Mitral valvuloplasty (MVP) is a surgical procedure for treating severe mitral regurgitation in dogs. Although MVP is considered highly invasive, the extent of myocardial injury, postoperative complications, and recovery has not been evaluated. Aim This study examined the degree of MVP invasiveness, the extent of myocardial damage, postoperative complications, cardiomyocyte recovery, and timing of hospital discharge. Methods Cardiac troponin I (cTnI) was used to investigate the myocardial damage caused by cardiac arrest associated with a surgical approach to the myocardium in 13 patients with MVP and five controls with patent ductus arteriosus (PDA) who underwent similar anesthesia and thoracotomy. Results The level of cTnI peaked 1 day after surgery and was significantly higher in the MVP group (median, 19.90 ng/ml) than in the control group (median, 1.50 ng/ml p < 0.001). At day 7, the cTnI level was significantly higher in the MVP group (1.9 ng/ml) than in the control group (0.1 ng/ml) (p < 0.001), and recovery to the preoperative level took 10 days in the MVP group but returned to the preoperative level at day 7 in the control group. Although the mean arterial pressure of cardiopulmonary bypass (CPB) at the time of use was 42.92 mmHg, the peak cTnI levels in the two patients who exhibited a temporary decrease of 20 mmHg or less (46.03 ng/ml) were significantly higher than in the other 11 patients (19.70 ng/ml) (p < 0.05). Preoperative cTnI levels were correlated with the severity of postoperative complications (P = 0.03, F = 0.71). Conclusion The results showed that MVP caused temporary greater myocardial tissue damage than thoracotomy, but postoperative recovery was smoother. A high preoperative cTnI level requires relatively more careful postoperative management, and measuring the level of cTnI over time after surgery can provide information about the extent of myocardial damage and recovery from surgery and help determine the time of discharge.
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Affiliation(s)
- Takeki Ando
- Ando Animal Hospital, 8-20 Kuruma, Awaji, Hyogo 656-2311, Japan
- Laboratory of Veterinary Surgery, Graduate School of Veterinary Science, Osaka Metropolitan University, Osaka, Japan
| | - Kippei Mihara
- Chayagasaka Animal Hospital, 1-1-5 Shinnishi, Chikusa-ku, Nagoya, Aichi 464-0003, Japan
| | - Isamu Kanemoto
- Chayagasaka Animal Hospital, 1-1-5 Shinnishi, Chikusa-ku, Nagoya, Aichi 464-0003, Japan
| | - Hideo Akiyoshi
- Laboratory of Veterinary Surgery, Graduate School of Veterinary Science, Osaka Metropolitan University, Osaka, Japan
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2
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Oikonomidis IL, Theodorou K, Papaioannou E, Xenoulis PG, Adamama-Moraitou KK, Steiner JM, Kritsepi-Konstantinou M, Suchodolski JS, Rallis T, Soubasis N. Serial measurement of cardiac troponin I in hospitalised dogs with canine parvoviral enteritis: Association with outcome and canine pancreas-specific lipase concentration. Res Vet Sci 2023; 157:1-5. [PMID: 36827790 DOI: 10.1016/j.rvsc.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 01/19/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023]
Abstract
The aim of this study was to serially evaluate serum cardiac troponin I (cTnI) concentrations in dogs with parvoviral enteritis (CPVE), and investigate the association with outcome and serum pancreas-specific lipase (Spec cPL) concentrations. Dogs with CPVE that were hospitalised for at least 5 days were included. cTnI and Spec cPL concentrations were measured on days 1, 3 and 5 of hospitalisation. Twenty-nine dogs (20 survivors, 9 non-survivors) were included. Spec cPL was indicative of pancreatitis (>400 μg/L) on at least one day in 10/29 (34.5%) dogs. Serum median (range) cTnI concentration was higher (P = 0.021) in non-survivors on day 5 [0.032 (0.001-0.395) ng/mL] compared to day 1 [0.012 (0.003-0.196) ng/mL]. Non-survivors had higher (P = 0.014) cTnI concentrations on day 5 [0.032 (0.001-0.395) ng/mL] compared to survivors [0.001 (0.001-0.042) ng/mL], but not at admission or on day 3 (P > 0.05). Serum cTnI concentrations were not significantly different (P = 0.465) between the three Spec cPL groups [group 1 (Spec cPL ≤ 200 μg/L): 0.007 (0.001-0.527) ng/mL; group 2 (Spec cPL: 201-399 μg/L): 0.0045 (0.001-0.196) ng/mL; group 3 (Spec cPL ≥ 400 μg/L): 0.011 (0.001-0.278) ng/mL]. cTnI and Spec cPL concentrations were not significantly correlated (rho = -0.043, P = 0.703). Serial measurement of cTnI had prognostic value in the examined cohort. However, cTnI was not correlated with spec cPL.
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Affiliation(s)
- I L Oikonomidis
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - K Theodorou
- Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Papaioannou
- Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - P G Xenoulis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Karditsa, Greece; Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, TX, USA
| | - K K Adamama-Moraitou
- Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - J M Steiner
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, TX, USA
| | - M Kritsepi-Konstantinou
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - J S Suchodolski
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, TX, USA
| | - T Rallis
- Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - N Soubasis
- Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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3
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McCobb E, Dowling-Guyer S, Pailler S, Intarapanich NP, Rozanski EA. Surgery in a veterinary outpatient community medicine setting has a good outcome for dogs with pyometra. J Am Vet Med Assoc 2022; 260:S36-S41. [PMID: 35389875 DOI: 10.2460/javma.21.06.0320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the outcome of canine pyometra surgeries performed at referral hospitals with those performed at community clinics (outpatient settings), and to evaluate factors that impact outcome. ANIMALS 133 client-owned dogs with pyometra treated with ovariohysterectomy (OHE) at 2 community clinics or 2 referral hospitals between July 1, 2017, and June 30, 2019. PROCEDURES A retrospective electronic medical record search was used to identify eligible cases. Data about patient demographics and clinical characteristics were collected and analyzed for factors that could have impacted outcome. RESULTS Eighty-three dogs were treated at referral hospitals; 50 dogs were treated at community clinics. Survival to hospital discharge for all dogs was 97% (129/133) and did not differ between treatment facility type. Dogs treated at both types of facilities were similar in age, body weight, and clinical signs. Median duration between diagnosis and OHE was significantly shorter for dogs treated at referral hospitals (0 day; range, 0 to 0.7 days) versus community clinics (1.0 day; range, 0 to 14.0 days); however, delay was not related to survival to hospital discharge. Duration of hospitalization did not impact survival to hospital discharge nor survival for at least 1 week after surgery. CLINICAL RELEVANCE Results indicated that OHE for pyometra in dogs has a good outcome and that, although prompt surgical treatment remains a goal, in cases where limitations to performing surgery exist, a delay until surgery or discharging patients the same day is still associated with a high degree of success.
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Affiliation(s)
- Emily McCobb
- Section of Community Medicine, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA.,Center for Animals and Public Policy, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA.,Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Seana Dowling-Guyer
- Center for Animals and Public Policy, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA.,Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Sharon Pailler
- American Society for the Prevention of Cruelty to Animals, New York City, NY
| | - Nida P Intarapanich
- Section of Community Medicine, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Elizabeth A Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
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4
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Kilkenny E, Watson C, Dukes-McEwan J, Bode EF, Hezzell MJ, Payne JR, Borgeat K. Evaluation of serum cardiac troponin-I concentrations for diagnosis of infective endocarditis in dogs. J Vet Intern Med 2021; 35:2094-2101. [PMID: 34374458 PMCID: PMC8478062 DOI: 10.1111/jvim.16234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 07/14/2021] [Accepted: 07/20/2021] [Indexed: 11/28/2022] Open
Abstract
Background Infective endocarditis (IE) in dogs is associated with severe disease and a high case fatality rate but often presents with nonspecific clinical signs. Hypothesis/Objectives Serum concentration of cardiac troponin‐I (cTnI) is elevated in dogs with IE and can differentiate dogs with IE from dogs with other diseases with similar clinical features. Concentration of serum cTnI is negatively correlated with survival time in dogs with IE. Animals Seventy‐two client‐owned dogs; 29 with IE, 27 with stage‐B myxomatous mitral valve disease (MMVD), and 16 with immune‐mediated disease (IMD). Methods Retrospective clinical cohort study. Concentration of serum cTnI was measured in all dogs at time of diagnosis. Clinical findings and echocardiographic interpretation were also recorded. Statistical analyses included Kruskal‐Wallis test, pairwise Mann‐Whitney U tests, receiver operator characteristic, and Cox proportional hazards. Results Serum concentration of cTnI was significantly higher in the IE group (0.69 ng/mL [0.03‐80.8]) than in the MMVD (0.05 ng/mL [0.02‐0.11], P < .001) and IMD groups (0.05 ng/mL [0.03‐0.57], P < .001). Increased cTnI was a moderately accurate predictor of IE (area under the curve 0.857 (95% confidence interval [CI] 0.745‐0.968, P < .001). A cTnI cutoff of 0.625 ng/mL had 100% specificity (95% CI 90%‐100%) and 52% sensitivity (95% CI 33%‐70%) in this study sample. There was no association between cTnI concentration and survival time in dogs with IE (hazard ratio 1.013, 95% CI 0.993‐1.034, P = .2). Conclusions and Clinical Importance Cardiac troponin‐I concentrations are higher in dogs with IE compared to dogs with preclinical MMVD or IMD. In dogs with a compatible clinical presentation, serum cTnI concentrations >0.625 ng/mL are supportive of IE.
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Affiliation(s)
- Eoin Kilkenny
- Langford Vets, University of Bristol, Bristol, UK.,CVS Ltd, Norfolk, UK
| | | | - Joanna Dukes-McEwan
- Department of Small Animal Clinical Science, School of Veterinary Science, University of Liverpool, Liverpool, UK
| | - Elizabeth F Bode
- CVS Ltd, Norfolk, UK.,Department of Small Animal Clinical Science, School of Veterinary Science, University of Liverpool, Liverpool, UK
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5
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Fausak ED. A Mapping Study of Veterinary Literature on Perceptions and Attitudes of Female Canine Spaying. Front Vet Sci 2020; 7:559659. [PMID: 33344522 PMCID: PMC7746841 DOI: 10.3389/fvets.2020.559659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 11/04/2020] [Indexed: 12/16/2022] Open
Abstract
This is a mapping study conducted to evaluate the characteristics of where content that engages in perspectives or attitudes on female dog spaying is published. Three databases, CAB Direct, PubMed, and Scopus, were systematically searched. There were 84 out of 642 papers identified and screened for relevance on attitudes or perceptions on female canine spaying. These 84 articles were then examined for recurring authors, institutional representation, and publisher information. Additionally, information regarding the population being addressed, veterinarian or client, was noted with most literature addressing the veterinary perspective. Many important articles were published in a wide array of journals from many countries, which suggests the importance of not only browsing journals but also searching for relevant literature in databases like CAB Abstracts and MEDLINE.
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Affiliation(s)
- Erik Davis Fausak
- University Library, University of California, Davis, Davis, CA, United States
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6
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Pugliese M, La Maestra R, Passantino A, Cristarella S, De Majo M, Biondi V, Quartuccio M. Electrocardiographic Findings in Bitches Affected by Closed Cervix Pyometra. Vet Sci 2020; 7:vetsci7040183. [PMID: 33233788 PMCID: PMC7711823 DOI: 10.3390/vetsci7040183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/07/2020] [Accepted: 11/18/2020] [Indexed: 11/16/2022] Open
Abstract
Pyometra is considered the most common disease in intact bitches, being associated with potentially life-threatening disorders. Myocardial damage is a potentially life-threatening consequence of pyometra. The aim of this study was to describe the electrocardiographic patterns in bitches affected by closed cervix pyometra, to assess the clinical relevance of electrocardiographic changes with the occurrence of pyometra, and to relate their severity with laboratory and clinical findings. A total of 39 bitches with closed cervix pyometra and 10 healthy female dogs were included in this study. During the hospitalization, bitches underwent a complete physical examination. An electrocardiographic examination before the ovariohysterectomy was performed. Blood samples for biochemical and hematological analysis were also evaluated. Bitches suffering pyometra at least one arrhythmia 31/39 (79.4%), sinus tachycardia (22/39, 56.4%), ventricular premature complexes (9/39, 23%), increased amplitude of T wave (7/39, 17.9%), ST depression (4/39, 10.2%), second-degree atrioventricular block (2/39, 5.1%), increase of QT interval (2/39, 5.1%), sinus bradycardia (2/39, 5.1%), and first-degree atrioventricular block (1/39, 2.5%). Some bitches were also detected with low wave amplitude (17/39, 43.5%). Cardiac arrhythmias associated with canine pyometra are frequent events. These data suggest that arrhythmias may be the consequence of one or more factors that can occur during pyometra, such as myocardial damage, electrolyte/metabolic disorders, and/or sepsis.
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7
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Gommeren K, Desmas I, Garcia A, Clercx C, Mc Entee K, Merveille AC, Peeters D. Cardiovascular biomarkers in dogs with systemic inflammatory response syndrome. J Vet Emerg Crit Care (San Antonio) 2019; 29:256-263. [PMID: 31034737 DOI: 10.1111/vec.12833] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 02/28/2017] [Accepted: 03/06/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To measure plasma N-terminal fragments of pro-B-type natriuretic peptides (NT-proBNP) and cardiac troponin T (cTnT) concentration in hospitalized dogs and relate these markers to underlying conditions and evaluate their potential as prognostic markers in dogs with systemic inflammatory response syndrome (SIRS). DESIGN Prospective, observational, clinical study. SETTING Emergency department of a university teaching hospital. ANIMALS Sixty-nine dogs with SIRS examined in the emergency department were prospectively studied. Patient age ranged from 5 months to 15 years, and weight ranged from 5.5 to 75 kg. MEASUREMENTS AND MAIN RESULTS Blood samples were obtained at presentation, during hospitalization until discharge or death, and at a "control" visit (T1m) at least 1 month after hospital discharge. NT-proBNP was assayed with a commercially available canine ELISA, while cTnT was measured with an automated immunoassay previously used in dogs. A correlation procedure, mixed procedure on a linear model, and a logistic procedure were performed. Forty-four patients survived, 19 of which had control visits. cTnT concentrations were significantly higher than T0 and T1m at T12, T24, and T72. In 28 dogs, cTnT was detected during hospitalization, but cTnT was not detected in any dog at the control visits. Higher concentrations of cTnT were negatively associated with survival, irrespective of disease category. NT-proBNP concentrations were significantly higher than T0, T6, T12, and T1m at T24, T72, and T120, but were not associated with survival. CONCLUSIONS NT-proBNP and cTnT increased significantly in dogs with SIRS, regardless of the underlying disease process. Nonsurvivors displayed significantly higher cTnT concentrations during hospitalization.
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Affiliation(s)
- Kris Gommeren
- Department of Clinical Sciences, School of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Isabelle Desmas
- Department of Clinical Sciences, School of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Alexandra Garcia
- Department of Clinical Sciences, School of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Cécile Clercx
- Department of Clinical Sciences, School of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Kathleen Mc Entee
- Faculty of Medicine, Laboratory of Physiology, Université Libre de Bruxelles, Brussels, Belgium
| | - Anne-Christine Merveille
- Department of Clinical Sciences, School of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Dominique Peeters
- Department of Clinical Sciences, School of Veterinary Medicine, University of Liège, Liège, Belgium
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8
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Cardiac troponin I in dogs anaesthetized with propofol and sevoflurane: the influence of medetomidine premedication and inspired oxygen fraction. Vet Anaesth Analg 2018; 45:745-753. [PMID: 30309716 DOI: 10.1016/j.vaa.2018.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 06/28/2018] [Accepted: 07/03/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate changes in serum cardiac troponin I (cTnI) concentrations in dogs in which medetomidine was used for sedation or for premedication prior to anaesthesia with propofol and sevoflurane. STUDY DESIGN Prospective clinical study. ANIMALS A total of 66 client-owned dogs. METHODS The dogs were sedated with medetomidine (0.04 mg kg-1) intravenously (IV) (group M; n = 20) and left to breath room air or anaesthetized with propofol (6.5 ± 0.76 mg kg-1 IV) and sevoflurane (4.5% vaporizer setting) in oxygen (group P + S; n = 20) or with medetomidine (0.04 mg kg-1 IV), propofol (1.92 ± 0.63 mg kg-1) and sevoflurane (3% vaporizer setting) in oxygen (group M + P + S; n = 26), respectively. After 35 minutes, medetomidine was antagonized with atipamezole (0.1 mg kg-1 intramuscularly). Blood samples for serum cTnI determination were taken before sedation or anaesthesia, 6 and 12 hours and 4 days thereafter. Serum cTnI concentrations were measured with the Architect STAT Troponin-I assay. RESULTS Before sedation or anaesthesia, cTnI concentrations were above the detection limit in 22 out of 66 (33%) of dogs. Compared to basal values, cTnI concentrations significantly increased at 6 and 12 hours in all groups and at day 4 in group M. There were no differences in cTnI concentration between groups at baseline, at 6 hours and at 4 days. At 12 hours, cTnI concentrations were significantly higher in groups M and P + S, respectively, compared to group M + P + S. CONCLUSIONS AND CLINICAL RELEVANCE Oxygenation during anaesthesia and reduction of propofol and sevoflurane dose due to the sparing effects of medetomidine might have played a role in alleviation of myocardial hypoxic injury as indicated by the less severe and short-lived increase of cTnI in the M + P + S group.
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9
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Pelander L, Häggström J, Ley CJ, Ljungvall I. Cardiac Troponin I and Amino-Terminal Pro B-Type Natriuretic Peptide in Dogs With Stable Chronic Kidney Disease. J Vet Intern Med 2017; 31:805-813. [PMID: 28370332 PMCID: PMC5435054 DOI: 10.1111/jvim.14703] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/06/2017] [Accepted: 02/27/2017] [Indexed: 01/17/2023] Open
Abstract
Background Increased concentrations of N‐terminal pro B‐type natriuretic peptide (NT‐proBNP) and cardiac troponin I (cTnI) in dogs with azotemia have been documented. Knowledge of mechanisms behind increased concentrations of cardiac biomarkers in dogs with azotemia is warranted for correct interpretation of test results. Objectives The aim of the article was to investigate possible associations between plasma concentrations of cTnI and NT‐proBNP, respectively, and patient characteristics, glomerular filtration rate (GFR), a plasma volume factor (PVF) derived from scintigraphic examination (PVf), systolic blood pressure (SBP), selected hematologic and biochemical variables, and echocardiographic measurements in dogs with stable chronic kidney disease (CKD) and in healthy dogs. Animals Fifty student‐, staff‐, and client‐owned dogs were included. Twenty‐three of the dogs were healthy and 27 were diagnosed with CKD. Methods In this cross‐sectional observational study, dogs with a previous diagnosis of CKD and healthy control dogs were included. At inclusion, all dogs were characterized by physical examination, repeated blood pressure measurements, complete urinalysis, hematology and biochemistry panel, echocardiography, abdominal ultrasound examination of the entire urinary tract, and scintigraphic examination for measurement of GFR. Results Plasma volume factor and PCV were independently associated with NT‐proBNP (Radj2 = 0.42; P < .0001). Age, body weight (BW), and SBP were independently associated with cTnI (Radj2 = 0.50; P < .0001). Conclusions and Clinical Importance Neither NT‐proBNP nor cTnI concentrations were independently associated with measured GFR. Thus, findings were not suggestive of passive accumulation of either marker, suggesting that increased circulating concentrations of cTnI and NT‐proBNP can be interpreted similarly in dogs with stable CKD as in dogs without CKD.
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Affiliation(s)
- L Pelander
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - J Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - C J Ley
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - I Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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10
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Keller SP, Kovacevic A, Howard J, Schweighauser A, Francey T. Evidence of cardiac injury and arrhythmias in dogs with acute kidney injury. J Small Anim Pract 2016; 57:402-8. [DOI: 10.1111/jsap.12495] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 01/25/2016] [Accepted: 03/15/2016] [Indexed: 11/28/2022]
Affiliation(s)
- S. P. Keller
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary MedicineVetsuisse Faculty University of Bern Laenggassstrasse 128 CH‐3001 Bern Switzerland
| | - A. Kovacevic
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary MedicineVetsuisse Faculty University of Bern Laenggassstrasse 128 CH‐3001 Bern Switzerland
| | - J. Howard
- Diagnostic Laboratory, Department of Clinical Veterinary MedicineVetsuisse Faculty University of Bern Laenggassstrasse 128 CH‐3001 Bern Switzerland
| | - A. Schweighauser
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary MedicineVetsuisse Faculty University of Bern Laenggassstrasse 128 CH‐3001 Bern Switzerland
| | - T. Francey
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary MedicineVetsuisse Faculty University of Bern Laenggassstrasse 128 CH‐3001 Bern Switzerland
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11
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Langhorn R, Willesen JL. Cardiac Troponins in Dogs and Cats. J Vet Intern Med 2015; 30:36-50. [PMID: 26681537 PMCID: PMC4913658 DOI: 10.1111/jvim.13801] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 09/04/2015] [Accepted: 11/03/2015] [Indexed: 11/26/2022] Open
Abstract
Cardiac troponins are sensitive and specific markers of myocardial injury. The troponin concentration can be thought of as a quantitative measure of the degree of injury sustained by the heart, however, it provides no information on the cause of injury or the mechanism of troponin release. Conventionally, the cardiac troponins have been used for diagnosis of acute myocardial infarction in humans and have become the gold standard biomarkers for this indication. They have become increasingly recognized as an objective measure of cardiomyocyte status in both cardiac and noncardiac disease, supplying additional information to that provided by echocardiography and ECG. Injury to cardiomyocytes can occur through a variety of mechanisms with subsequent release of troponins. Independent of the underlying disease or the mechanism of troponin release, the presence of myocardial injury is associated with an increased risk of death. As increasingly sensitive assays are introduced, the frequent occurrence of myocardial injury is becoming apparent, and our understanding of its causes and importance is constantly evolving. Presently troponins are valuable for detecting a subgroup of patients with higher risk of death. Future research is needed to clarify whether troponins can serve as monitoring tools guiding treatment, whether administering more aggressive treatment to patients with evidence of myocardial injury is beneficial, and whether normalizing of troponin concentrations in patients presenting with evidence of myocardial injury is associated with reduced risk of death.
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Affiliation(s)
- R Langhorn
- Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - J L Willesen
- Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Frederiksberg C, Denmark
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12
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Hamacher L, Dörfelt R, Müller M, Wess G. Serum cardiac troponin I concentrations in dogs with systemic inflammatory response syndrome. J Vet Intern Med 2015; 29:164-70. [PMID: 25619514 PMCID: PMC4858082 DOI: 10.1111/jvim.12474] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 08/22/2014] [Accepted: 09/02/2014] [Indexed: 11/29/2022] Open
Abstract
Background Myocardial injury can be detected by cardiac troponin I (cTnI) concentration, which appears to be a predictor of short‐term death in critically ill patients. It is unknown if the best prognostic indicator of short‐term survival is cTnI measurement at admission or at later time points. Hypothesis/Objectives Measuring cTnI with a high‐sensitivity (HS) test at different time points after admission may be a better short‐term prognostic indicator than a single cTnI measurement at admission in dogs with systemic inflammatory response syndrome (SIRS). Animals Prospective, observational clinical study of 60 dogs with SIRS. Methods Cardiac troponin I concentration was measured in 133 serum samples, collected at days 1, 2, 3, and 5. Additionally, the acute patient physiologic and laboratory evaluation (APPLE) fast score was evaluated at admission. Prognostic capabilities of cTnI measurement and APPLE fast score for 28‐day mortality were assessed by receiver operating characteristic curve analysis. Results Forty‐one dogs with SIRS that survived 28 days had significantly lower serum cTnI concentrations at admission (median, 0.09 ng/mL; P = .004) and at the peak time point (median, 0.23 ng/mL; P = .01) compared to 19 nonsurvivors (median at admission, 0.63 ng/mL; median at peak, 1.22 ng/mL). Area under the curve to predict survival, using cTnI was similar at admission (0.732) and at peak (0.708), and was 0.754 for the APPLE fast score. Conclusions and Clinical Importance Increased cTnI concentration in dogs with SIRS is associated with poor outcome. Daily follow‐up measurement of cTnI concentration provides no additional prognostic information for short‐term mortality.
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Affiliation(s)
- L Hamacher
- Department of Clinical Veterinary Medicine, Clinic of Small Animal Medicine, LMU University Munich, Munich, Germany
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Cartwright JA, Gow DJ, Gow AG, Handel I, Reed N, Brown AJ, Cash R, Foote A, Mackenzie D, Bell R, Mellanby RJ. Serum cardiac troponin I concentrations decrease following treatment of primary immune-mediated haemolytic anaemia. J Small Anim Pract 2015; 56:516-20. [PMID: 26134761 DOI: 10.1111/jsap.12379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 04/27/2015] [Accepted: 04/30/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The measurement of serum cardiac troponin I concentrations in dogs with a range of non-primary cardiac illnesses suggests that cardiac myocyte damage is commonplace. Dogs with primary immune-mediated haemolytic anaemia have increased serum cardiac troponin I concentrations at the time of diagnosis. However, it is unclear whether biochemical evidence of cardiac myocyte damage improves following successful treatment of anaemia. METHODS A haematology profile was performed and serum cardiac troponin I concentrations were measured in 19 dogs with primary immune-mediated haemolytic anaemia before and after treatment. RESULTS The haematocrit increased significantly (P = 0 · 0001) following treatment of primary IMHA (median pre: 0 · 13 L/L, median post: 0 · 33 L/L). The serum cardiac troponin I concentrations decreased significantly (P < 0 · 05) after treatment (median pre: 0 · 26 ng/mL, median post: 0 · 16 ng/mL). CLINICAL SIGNIFICANCE Serum cardiac troponin I concentration decreases following successful treatment of primary immune-mediated haemolytic anaemia. The clinical and prognostic significance of serum cardiac troponin I concentrations before and after treatment in dogs with primary immune-mediated haemolytic anaemia merits further investigation.
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Affiliation(s)
- J A Cartwright
- Division of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG
| | - D J Gow
- Division of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG
| | - A G Gow
- Division of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG
| | - I Handel
- Division of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG
| | - N Reed
- Division of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG
| | - A J Brown
- Division of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG
| | - R Cash
- Rossdale & Partners, Beaufort Cottage Laboratories, Suffolk CB8 8JS
| | - A Foote
- Rossdale & Partners, Beaufort Cottage Laboratories, Suffolk CB8 8JS
| | | | - R Bell
- Dick White Referrals, Station Farm, Cambridge CB8 0UH
| | - R J Mellanby
- Division of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG
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Smith KF, Quinn RL, Rahilly LJ. Biomarkers for differentiation of causes of respiratory distress in dogs and cats: Part 1 - Cardiac diseases and pulmonary hypertension. J Vet Emerg Crit Care (San Antonio) 2015; 25:311-29. [DOI: 10.1111/vec.12318] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 03/22/2015] [Indexed: 12/18/2022]
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Sant'Anna M, Giordano L, Flaiban K, Muller E, Martins M. Prognostic markers of canine pyometra. ARQ BRAS MED VET ZOO 2014. [DOI: 10.1590/1678-6859] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The pyometra is a disease that affects middle age and elderly female dogs during diestrus. Hormonal, microbiological, biochemical and hematological aspects are well described. However, few studies have evaluated the role of each in the prognosis of canine pyometra. The aim of this study was to identify markers associated with clinical worsening of dogs with pyometra. We prospectively evaluated 80 dogs with pyometra treated surgically. Group 1 consisted of dogs that were discharged within 48 hours after surgery and Group 2 consisted of those who required prolonged hospitalization or died. The findings of hematological, biochemical and blood lactate levels were compared between groups and variables such as bacterial multidrug resistance, systemic inflammatory response syndrome (SIRS), hyperlactatemia and increased creatinine were analyzed through the dispersion of frequencies between groups. Among the variables studied, the presence of SIRS and elevated serum creatinine >2.5mg/mL were effective in predicting the worsening of the disease and can be used as prognostic markers of canine pyometra.
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Langhorn R, Thawley V, Oyama MA, King LG, Machen MC, Trafny DJ, Willesen JL, Tarnow I, Kjelgaard-Hansen M. Prediction of long-term outcome by measurement of serum concentration of cardiac troponins in critically ill dogs with systemic inflammation. J Vet Intern Med 2014; 28:1492-7. [PMID: 25041343 PMCID: PMC4895575 DOI: 10.1111/jvim.12402] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 05/02/2014] [Accepted: 05/29/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Myocardial injury, detected by cardiac troponin I and T (cTnI and cTnT), has been associated with long-term death in the noncardiac human intensive care unit (ICU). HYPOTHESIS Presence of myocardial injury predicts 1-year case fatality in critically ill dogs with systemic inflammation. ANIMALS Thirty-eight dogs with evidence of systemic inflammation and no primary cardiac disease. METHODS Prospective cohort study. In dogs admitted to the ICU with evidence of systemic inflammation, blood samples were obtained at ICU admission for measurement of cTnI and cTnT, and cTnI was measured once daily during ICU hospitalization. Receiver operating characteristic (ROC) curves were used to examine prognostic capacity of admission cTnI, admission cTnT, and peak cTnI concentrations. RESULTS One-year case fatality rate was 47% (18/38 dogs). Admission cTnI concentrations were (median [range]) 0.48 [0.004-141.50] ng/mL, and peak cTnI concentrations were 1.21 [0.021-141.50] ng/mL. Admission cTnT concentrations were 15 [<13-3744] ng/L. For each marker, non-survivors had significantly higher concentrations than survivors (P = .0082-.038). ROC analyses revealed areas under curves [95% CI] of 0.707 [0.537-0.843] for peak cTnI and 0.739 [0.571-0.867] for admission cTnT, respectively. At the optimal cut-off, concentrations were 1.17 ng/mL (peak cTnI) and 23 ng/L (admission cTnT), sensitivities were 72% and 72%, and specificities were 70% and 80%, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE While peak cTnI and admission cTnT are significantly related to 1-year case fatality in critically ill dogs with systemic inflammation, low sensitivities and specificities prevent their prediction of long-term outcome in individual patients. Troponins might play a role in identification of dogs at long-term risk of death.
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Affiliation(s)
- R Langhorn
- Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Frederksberg C, Denmark
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Tivers MS, Handel I, Gow AG, Lipscomb VJ, Jalan R, Mellanby RJ. Hyperammonemia and systemic inflammatory response syndrome predicts presence of hepatic encephalopathy in dogs with congenital portosystemic shunts. PLoS One 2014; 9:e82303. [PMID: 24392080 PMCID: PMC3879253 DOI: 10.1371/journal.pone.0082303] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 10/22/2013] [Indexed: 12/29/2022] Open
Abstract
Hepatic encephalopathy (HE) is an important cause of morbidity and mortality in patients with liver disease. The pathogenesis of he is incompletely understood although ammonia and inflammatory cytokines have been implicated as key mediators. To facilitate further mechanistic understanding of the pathogenesis of HE, a large number of animal models have been developed which often involve the surgical creation of an anastomosis between the hepatic portal vein and the caudal vena cava. One of the most common congenital abnormalities in dogs is a congenital portosystemic shunt (cpss), which closely mimics these surgical experimental models of HE. Dogs with a cPSS often have clinical signs which mimic clinical signs observed in humans with HE. Our hypothesis is that the pathogenesis of HE in dogs with a cPSS is similar to humans with HE. The aim of the study was to measure a range of clinical, haematological and biochemical parameters, which have been linked to the development of HE in humans, in dogs with a cPSS and a known HE grade. One hundred and twenty dogs with a cPSS were included in the study and multiple regression analysis of clinical, haematological and biochemical variables revealed that plasma ammonia concentrations and systemic inflammatory response syndrome scores predicted the presence of HE. Our findings further support the notion that the pathogenesis of canine and human HE share many similarities and indicate that dogs with cPSS may be an informative spontaneous model of human HE. Further investigations on dogs with cPSS may allow studies on HE to be undertaken without creating surgical models of HE thereby allowing the number of large animals used in animal experimentation to be reduced.
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Affiliation(s)
- Mickey S. Tivers
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Ian Handel
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, Midlothian, United Kingdom
| | - Adam G. Gow
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, Midlothian, United Kingdom
| | - Vicky J. Lipscomb
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Rajiv Jalan
- UCL Institute for Liver and Digestive Health, UCL Medical School, London, United Kingdom
| | - Richard J. Mellanby
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, Midlothian, United Kingdom
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
- * E-mail:
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Abedi GR, Sotoudeh A, Bazzazan A, Ganjai A. Experimental ovarian transplantation on stomach for bone repair in ovariohysterectomized rabbits. Acta Cir Bras 2013; 28:412-8. [PMID: 23743677 DOI: 10.1590/s0102-86502013000600002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 05/17/2013] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate the bone repair process in ovariohysterectomized rabbit submitted to an ovarian transplant to stomach that may supplying some quantity of estrogen occurs to improve bone healing. METHODS In 20 female rabbits three holes of 1, 2 and 3mm diameter in tibial shaft were made and after that all animals received OHE through a ventral incision and they were randomly divided into two groups of ten rabbits each. In group one, animals received one of their self-ovaries that transplanted on serosal layer of stomach and group two did not receive treatment. Animals were kept during bone healing for a period of 45 days and radiological, biochemical, biomechanical and histopathological evaluation. RESULTS The tibial defects in group one healed completely after 45 days and had more callous than second group. There is significant difference between two groups after operation in 21, 28 and 35 days about estrogen, progesterone and phosphatase Alkaline. The maximum forces in group one, were significantly higher than that for the group two. CONCLUSION Ovarian transplantation prevents the effects of ovariohysterectomized on bone healing of rabbit tibia, suggesting that unilateral transplanted ovaries can substitute for the action of ovaries on the skeleton in ovariohysterectomized animals.
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Affiliation(s)
- Gholam Reza Abedi
- Department of Surgery, Faculty of Specialized Veterinary Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran
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Slack J, Boston R, Driessen B, Reef V. Effect of general anesthesia on plasma cardiac troponin I concentrations in healthy horses. J Vet Cardiol 2011; 13:163-9. [PMID: 21821476 DOI: 10.1016/j.jvc.2011.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 02/18/2011] [Accepted: 04/19/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the effect of general anesthesia on plasma cTnI concentrations in horses. ANIMALS, MATERIALS AND METHODS Thirty-two horses undergoing general anesthesia and either elective surgery or MRI without surgery were prospectively studied. Twenty-nine horses (22 surgical, 7 imaging) completed the study. Plasma cTnI concentrations were determined prior to anesthesia and at 6, 12 and 24 h following discontinuation of the inhalant anesthetic. RESULTS All horses had cTnI values within the reference range at all time points. Six horses (21%) developed detectable cTnI 6 or 12 h following anesthesia. Risk factors for detectable cTnI include increasing age and dorsal recumbency. Horses with detectable cTnI had significantly lower mean and diastolic arterial blood pressures than those without detectable cTnI. CONCLUSION Uncomplicated general anesthesia with or without surgery does not result in cardiac troponin I elevations above the reference range in the first 24 h postoperatively.
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Affiliation(s)
- Joann Slack
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, USA.
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Payne EE, Roberts BK, Schroeder N, Burk RL, Schermerhorn T. Assessment of a point-of-care cardiac troponin I test to differentiate cardiac from noncardiac causes of respiratory distress in dogs. J Vet Emerg Crit Care (San Antonio) 2011; 21:217-25. [DOI: 10.1111/j.1476-4431.2011.00632.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gow DJ, Gow AG, Bell R, Spratt D, Cash R, Ricketts S, Archer J, Mellanby RJ. Serum cardiac troponin I in dogs with primary immune-mediated haemolytic anaemia. J Small Anim Pract 2011; 52:259-64. [DOI: 10.1111/j.1748-5827.2011.01061.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
BACKGROUND The acute phase protein, α-1-acid glycoprotein (AGP), has been proposed to have a role in immunomodulation and to be a nonspecific antimicrobial agent. We suggest that AGP may be increased in dogs with pyometra and possibly to a greater extent in dogs also manifesting signs of systemic inflammatory response syndrome (SIRS). OBJECTIVES Our objectives were to evaluate serum AGP concentrations in dogs diagnosed with pyometra compared with clinically healthy female dogs and to determine if AGP concentrations were correlated with severity of disease. METHODS Twenty-six dogs with pyometra and 18 clinically healthy intact female dogs were included in this prospective study. A diagnosis of pyometra was verified by histopathologic examination after ovariohysterectomy in the pyometra group. A commercially available single radial immunodiffusion test was used for AGP analysis. Clinical findings, laboratory variables, and hospitalization times were compared. RESULTS Mean AGP concentration in dogs with pyometra (1943 ± 913 mg/L, mean ± SD), was significantly higher (P<.001) than in healthy dogs (495 ± 204 mg/L). Mean AGP concentration in dogs in the pyometra group with (n=18) or without (n=8) SIRS did not differ. Animals with a prolonged hospital stay had higher AGP concentrations. CONCLUSIONS Pyometra was associated with increased serum concentrations of the acute phase protein AGP. AGP concentrations were associated with severity of disease as measured by duration of hospitalization. As AGP binds basic drugs, further studies of its pharmacokinetic and pharmacodynamic propreties in cases of pyometra may be of clinical interest.
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Affiliation(s)
- Ragnvi Hagman
- Department of Clinical Sciences, Division of Small Animals, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden.
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Pelander L, Ljungvall I, Häggström J. Myocardial cell damage in 24 dogs bitten by the common European viper (Vipera berus
). Vet Rec 2010; 166:687-90. [DOI: 10.1136/vr.b4817] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- L. Pelander
- Department of Clinical Sciences; University of Agricultural Sciences; 750 07 Uppsala Sweden
| | - I. Ljungvall
- Department of Clinical Sciences; University of Agricultural Sciences; 750 07 Uppsala Sweden
| | - J. Häggström
- Department of Clinical Sciences; University of Agricultural Sciences; 750 07 Uppsala Sweden
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Kent M, Reiss C, Blas-Machado U. Elevated cardiac troponin I in a dog with an intracranial meningioma and evidence of myocardial necrosis. J Am Anim Hosp Assoc 2010; 46:48-55. [PMID: 20045837 DOI: 10.5326/0460048] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 10-year-old, spayed female Weimaraner was referred for an acute onset of generalized tremors, seizures, and obtundation. Neurological examination revealed severe obtundation and a right-sided menace response deficit. Neuroanatomical diagnosis was consistent with a left prosencephalic lesion. The serum cardiac troponin I level was high, indicative of acute myocardial necrosis. With magnetic resonance imaging, a mass was observed in the left olfactory bulb and tract, with extensive edema in the white matter of the left cerebrum. The hippocampus was hyperintense on T2-weighted and T2-weighted fluid-attenuated inversion recovery images. At necropsy, a meningioma of the left olfactory bulb and ischemic cell change in the neurons of the hippocampus were identified. In the heart, microscopic lesions consistent with myocardial necrosis were observed. This is the first case to document an elevated cardiac troponin I level in a dog with intracranial disease and myocardial necrosis.
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Affiliation(s)
- Marc Kent
- Department of Small Animal Medicine and Surgery, Veterinary Teaching Hospital, College of Veterinary Medicine, The University of Georgia, 501 D.W. Brooks Drive, Athens, Georgia 30602, USA
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Saunders AB, Hanzlicek AS, Martinez EA, Stickney MJ, Steiner JM, Suchodolski JS, Fosgate GT. Assessment of cardiac troponin I and C-reactive protein concentrations associated with anesthetic protocols using sevoflurane or a combination of fentanyl, midazolam, and sevoflurane in dogs. Vet Anaesth Analg 2009; 36:449-56. [PMID: 19709049 DOI: 10.1111/j.1467-2995.2009.00483.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To report serum cardiac troponin I (cTnI) and C-reactive protein (CRP) concentrations in dogs anesthetized for elective surgery using two anesthetic protocols. STUDY DESIGN Prospective, randomized clinical study. ANIMALS Twenty client-owned dogs presenting for elective ovariohysterectomy or castration. METHODS The dogs were randomized into two groups. All dogs were premedicated with glycopyrrolate (0.011 mg kg(-1)) and hydromorphone (0.1 mg kg(-1)) i.m. approximately 30 minutes prior to induction of anesthesia. Anesthesia in dogs in group 1 was induced with propofol (6 mg kg(-1)) i.v. to effect and in dogs in group 2 with diazepam (0.2 mg kg(-1)) i.v. followed by etomidate (2 mg kg(-1)) i.v. to effect. For maintenance of anesthesia, group 1 received sevoflurane (adjustable vaporizer setting 0.5-4%) and group 2 received a combination of fentanyl (0.8 microg kg(-1) minute(-1)) and midazolam (8.0 microg kg(-1) minute(-1)) i.v. plus sevoflurane (adjustable vaporizer setting 0.5-4%) to maintain anesthesia. Serum cTnI and CRP concentrations were measured at baseline and 6, 18, and 24 hours post-anesthetic induction. Biochemical analysis was performed at baseline. Lactate was obtained at baseline and 6 hours post-anesthetic induction. Heart rate and mean arterial blood pressure were measured intra-operatively. RESULTS Baseline serum cTnI and CRP concentrations were comparable between groups. A significant difference in serum cTnI or CRP concentrations was not detected post-operatively between groups at any time point. Serum CRP concentrations were significantly increased post-anesthetic induction in both groups, which was attributed to surgical trauma. CONCLUSIONS AND CLINICAL RELEVANCE There was no significant difference in serum cTnI and CRP concentrations between anesthetic protocols. Further investigation in a larger number of dogs is necessary to confirm the current findings.
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Affiliation(s)
- Ashley B Saunders
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX 77843-4474, USA.
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Hagman R, Reezigt BJ, Bergström Ledin H, Karlstam E. Blood lactate levels in 31 female dogs with pyometra. Acta Vet Scand 2009; 51:2. [PMID: 19134167 PMCID: PMC2630309 DOI: 10.1186/1751-0147-51-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2008] [Accepted: 01/09/2009] [Indexed: 11/10/2022] Open
Abstract
Background Canine pyometra is a life-threatening disease common in countries where spaying of dogs is not routinely performed. The disease is associated with endotoxemia, sepsis, systemic inflammatory response syndrome (SIRS) and a 3–4% mortality rate. Blood lactate analysis is clinically valuable in predicting prognosis and survival, evaluating tissue perfusion and treatment response in human and veterinary critical care settings. The aims of the present study were to investigate 1) the blood lactate levels of female dogs with pyometra by a hand-held analyser and 2) if these levels are related with the clinical status or other biochemical or hematological disorders. Methods In total 31 female dogs with pyometra admitted for surgical ovariohysterectomy and 16 healthy female control dogs were included in the present study. A complete physical examination including SIRS-status determination was performed. Blood samples for lactate concentrations, hematological and biochemical parameters, acid-base and blood gas analysis and other laboratory parameters were collected and subsequently analysed. The diagnosis pyometra was verified with histopathological examination of the uterus and ovaries. Increased hospitalisation length and presence of SIRS were used as indicators of outcome. Results In the pyometra group the median blood lactate level was 1,6 mmol l-1 (range <0.8–2.7 mmol l-1). In the control group the median lactate level was 1,2 mmol l-1 (range <0.8–2.1 mmol l-1). Of the 31 bitches 19 (61%) fulfilled 2 or more criteria for SIRS at inclusion, 10 bitches (32%) fulfilled 3 of the SIRS criteria whereas none accomplished more than 3 criteria. Lactate levels did not differ significantly between the pyometra and control group, or between the SIRS positive and SIRS negative dogs with pyometra. Increased lactate concentration (>2.5 mmol l-1) was demonstrated in one female dog with pyometra (3%), and was not associated with longer hospitalisation or presence of SIRS. Lactate measurement was not indicative of peritonitis. None of the bitches died during or within two months of the hospital stay. The measurements of temperature, heart rate, respiratory rate, percentage bandforms of neutrophilic granulocytes, α2-globulins, creatinin, pvCO2, TCO2 and base excess showed significant differences between the SIRS positive and the SIRS negative pyometra cases. Conclusion Increased blood lactate concentrations were demonstrated in 3% (1/31), and SIRS was present in 61% (19/31) of the female dogs with pyometra. Preoperative lactate levels were not related with presence of SIRS or prolonged hospitalisation. Lactate measurement was not indicative of peritonitis. The value of a single and repeated lactate analysis in more severely affected cases remains to be determined.
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Pelander L, Hagman R, Häggström J. Concentrations of cardiac Troponin I before and after ovariohysterectomy in 46 female dogs with pyometra. Acta Vet Scand 2008; 50:35. [PMID: 18786242 PMCID: PMC2546406 DOI: 10.1186/1751-0147-50-35] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Accepted: 09/11/2008] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Canine pyometra is a common disease in countries where routine spaying of young dogs is not common practice. This disease is known to lead to systemic inflammation potentially affecting multiple organs in the body, including the heart. Cardiac-specific Troponin I (cTnI) is a sensitive marker of myocardial cell damage, which can result from ischemia, trauma, toxins or inflammation. Dogs with pyometra are also exposed to anaesthesia which can potentially result in myocardial cell damage. The aims of the study were 1) to evaluate the occurrence of myocardial cell damage as indicated by increased serum concentrations of cTnI in dogs with pyometra and relate these to presence of systemic inflammation and 2) to evaluate the change in cTnI-concentrations after anaesthesia and surgery. METHODS Serum cTnI concentration was measured preoperatively and one day after surgery in 46 female dogs with pyometra and 15 female dogs that underwent surgery for other reasons (ovariohysterectomy and mammary tumours). RESULTS Forty-six female dogs of different breeds diagnosed with pyometra were included. The dogs had a median age of 8.5 years (IQR 7.5-10) and a median weight of 29 kg (IQR 9-32). Of the 46 dogs, 37 (80%) fulfilled the chosen criteria for systemic inflammatory response syndrome (SIRS) at inclusion. Thirteen (28%) of the dogs had increased cTnI concentrations (> 0.2 microg/l) before surgery and 18 (39%) had increased cTnI-concentrations the day after surgery. The cTnI concentrations in the 13 dogs with increased preoperative cTnI concentrations decreased in 8 dogs, increased in 4 dogs, and was unchanged in one dog. Seven dogs with nondetectable preoperative cTnI concentrations had increased postoperative concentrations. The only significant association between the studied laboratory or clinical variables (including SIRS) and cTnI concentration was preoperative percentage band neutrophils (PBN) and postoperative cTnI concentration (P = 0.016). In total, 20 dogs (43%) had increased pre- or postoperative cTnI concentrations. Seven dogs (15%) had pre-or postoperative concentrations of cTnI of 1.0 microg/l or higher. CONCLUSION Mild to moderate increases in cTnI appears to be common in dogs with pyometra before and after surgery, but the clinical importance of this finding is uncertain. None of the studied clinical variables were found to reliably predict increased preoperative cTnI concentrations. Because of the pre- and postoperative variation in cTnI concentrations, it was not possible to identify a negative effect of anaesthesia and surgery on myocardial cell integrity.
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Affiliation(s)
- Lena Pelander
- University Teaching Hospital, Swedish University of Agricultural Science, Uppsala, Sweden
- Department of Clinical Sciences, Swedish University of Agricultural Science, Uppsala, Sweden
| | - Ragnvi Hagman
- Department of Clinical Sciences, Swedish University of Agricultural Science, Uppsala, Sweden
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Science, Uppsala, Sweden
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