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Romito G, Pane E, Guglielmini C, Poser H, Valente C, Paradies P, Castagna P, Mazzoldi C, Cipone M. Efficacy and tolerability of the American Heartworm Society therapeutic protocol in dogs affected by heartworm disease without caval syndrome. J Small Anim Pract 2024; 65:39-46. [PMID: 37888802 DOI: 10.1111/jsap.13677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/09/2023] [Accepted: 10/01/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVES The American Heartworm Society medical protocol represents the current standard of therapy for canine heartworm disease without caval syndrome. However, data on the tolerability of this protocol are limited. This study aimed to describe efficacy and prevalence of possible treatment-related side effects in dogs with heartworm disease treated using the American Heartworm Society protocol. MATERIALS AND METHODS For this retrospective multi-centre cohort study, dogs diagnosed with classes 1 to 3 heartworm disease that completed the American Heartworm Society medical protocol were searched in four medical databases. Demographic, clinical, diagnostic, therapeutic and outcome data, including the number and type of possible treatment-related side effects, were retrieved. RESULTS Thirty-five dogs were included. The median age and bodyweight were 6 years (1 to 13 years) and 17.3 kg (4.9 to 50 kg), respectively. Heartworm disease was classified as classes 1, 2 and 3 in 20 of 35, 11 of 35 and four of 35 dogs, respectively. In addition to the therapeutic recommendations of the American Heartworm Society, eight of 35 dogs underwent sedation to favour melarsomine administration, and 30 of 35 received ice at the injection site. After adulticide therapy, all dogs were hospitalised with cage rest [median time 12 hours (6 to 48 hours)]. All dogs survived the treatment. All dogs with long-term follow-up (32/35) became negative. Furthermore, treatment-related side effects were rare, mild and rapidly recovered without the need for supporting therapies; these included depression/lethargy (4/35 dogs), cough (2/35 dogs) and lameness, pain and gastrointestinal signs (1/35 dog each). CLINICAL SIGNIFICANCE The American Heartworm Society medical protocol is efficient and safe in dogs with classes 1 to 3 heartworm disease.
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Affiliation(s)
- G Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - E Pane
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - C Guglielmini
- Department of Animal Medicine, Production and Health, University of Padova, viale dell'Università, 35020, Legnaro, Italy
| | - H Poser
- Department of Animal Medicine, Production and Health, University of Padova, viale dell'Università, 35020, Legnaro, Italy
| | - C Valente
- Department of Animal Medicine, Production and Health, University of Padova, viale dell'Università, 35020, Legnaro, Italy
| | - P Paradies
- Department of Emergency and Organ Transplantation, Veterinary Clinics and Animal Production Section, 70010, strada provinciale Valenzano per Casamassima km 3, Valenzano, Italy
| | - P Castagna
- Freelance Veterinary Cardiologist, Bologna, Italy
| | - C Mazzoldi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - M Cipone
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
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Kim J, Jeong J, Park K, Shin K, Jang IS, Yoon H. Evaluation of improved transvenous heartworm extraction brush in dogs with caval syndrome. J Vet Sci 2023; 24:e46. [PMID: 37532294 PMCID: PMC10404712 DOI: 10.4142/jvs.23003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/19/2023] [Accepted: 04/28/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Heartworm infection in dogs is caused by Dirofilaria immitis and common in shelter animals and outdoors dogs. Caval syndrome can develop with severe infection and physical heartworm removal is essential with heartworm burdens. In this study, we used an improved transvenous heartworm extraction brush, which was expected to cause less cardiovascular damage and allow easier manipulation. OBJECTIVES This study aims to evaluate efficacy of this improved transvenous heartworm extraction brush. METHODS The brush was designed to improve upon the limitations of the previous brush-type devices. The brush was made of a polyvinyl chloride tube and threads of polyamides or polyglyconates. Metal material was inserted at the front tip for easy visualization under fluoroscopy. The eight dogs diagnosed with caval syndrome with large numbers of heartworms and pulmonary hypertension were used in this study. The removal procedure began with the dissection of the subcutaneous tissue around the right jugular vein. The device was inserted through the jugular vein. After insertion, the tube was rotated to catch the heartworms and extracted with the heartworms hanging on the threads. The procedure was repeated several times. Lastly, jugular vein and skin sutures were made. Adulticidal therapy was administered after heartworm removal. RESULTS The mean number of removed heartworms was 10.5 ± 4.24 and mean number of remaining heartworms was 0.63 ± 1.06. Total procedure time was 72.63 ± 51.36. Except for three cases, heartworms were not detected on ultrasonography after the procedure. No procedure-related side effects were observed within the 1- to 2-mon. CONCLUSIONS An improved transvenous heartworm extraction brush is efficient for heartworm removal in dogs with caval syndrome.
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Affiliation(s)
- Jihyun Kim
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea
| | | | - Kanghyo Park
- Bundang Leaders Animal Medical Center, Seongnam 13636, Korea
| | | | | | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea.
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Ultrasonography of Parasitic Diseases in Domestic Animals: A Systematic Review. Animals (Basel) 2022; 12:ani12101252. [PMID: 35625097 PMCID: PMC9137995 DOI: 10.3390/ani12101252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/21/2022] Open
Abstract
Simple Summary The aim of this literature review was to summarize the current knowledge on the application of ultrasonography in diagnosis, staging and monitoring of helminthic diseases in domestic animals. We selected and analyzed 122 papers about the application of ultrasonography in parasitic disease in ruminants, equids, swine, and companion animals. Helminths can be recognized in ultrasound images by their morphology, size, and location. In some cases, the parasites are not directly seen by ultrasound, but the lesions caused by them can be easily visualized. Ultrasound imaging is taking on an increasingly important role in veterinary parasitology. Abstract The aim of this review was to summarize the current knowledge on the application of ultrasonography in diagnosis, staging and monitoring of helminthic diseases in domestic animals. Only peer reviewed papers written in English language were included in this systematic review. All papers concerning unicellular parasites, wild animals, non-domestic experimental animals, or ex vivo or in vitro applications of ultrasonography were excluded from the review. A total of 122 papers met the inclusion criteria. Among them 47% concerned nematodes, 37% cestodes, and 16% trematodes with the genus Dirofilaria, Echinococcus, and Fasciola the most represented, respectively. Helminths can be recognized in ultrasound images by their morphology, size, and location. In some cases, the parasite stages are not directly seen by ultrasound, but the lesions caused by them can be easily visualized. Ultrasound imaging is taking on an increasingly important role in the diagnosis, staging, monitoring, and control of parasitic diseases in veterinary medicine. However, it cannot replace the clinical approach and the diagnostic tests commonly used in veterinary parasitology.
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Heat treatment and false-positive heartworm antigen testing in ex vivo parasites and dogs naturally infected by Dirofilaria repens and Angiostrongylus vasorum. Parasit Vectors 2017; 10:476. [PMID: 29143662 PMCID: PMC5688472 DOI: 10.1186/s13071-017-2444-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Heartworm antigen testing is considered sensitive and specific. Currently available tests are reported as detecting a glycoprotein found predominantly in the reproductive tract of the female worm and can reach specificity close to 100%. Main concerns regard sensitivity in the case of light infections, the presence of immature females or cases of all-male infections. Research and development have been aimed at increasing sensitivity. Recently, heat treatment of serum prior to antigen testing has been shown to result in an increase in positive antigen test results, presumably due to disruption of natural antigen–antibody complexes. Cross-reactions in dogs with both natural and experimental infections with Angiostrongylus vasorum and Spirocerca lupi have been reported, but cross-reactions with other helminths have not been extensively studied. In order to evaluate potential cross-reactivity with other canine and feline parasites, two studies were performed. Study 1: Live adults of Dirofilaria immitis, Dirofilaria repens, Toxocara canis, Toxocara cati, Dipylidium caninum, Taenia taeniaeformis and Mesocestoides spp. larvae were washed and incubated in tubes with saline solution. All worms were alive at the time of removal from the saline. Saline solutions containing excretory/secretory antigens were then tested for heartworm with six different, commercially available antigen tests. All results were evaluated blind by three of the authors. Study 2: Sera from dogs with natural infections by A. vasorum or D. repens, living in areas free of heartworm disease, were tested with the same tests before and after heat treatment (103 °C for 10 min). Results Results suggest that antigens detected by currently available tests are not specific for D. immitis. They may give positive results through detection of different parasites’ antigens that are normally not released into the bloodstream or released in a low amount and/or bound to antibodies. Tests may even detect antigens released by male D. immitis adult worms. D. repens appears to release more detectable antigens than the other worms studied. Conclusions Cross-reaction with A. vasorum and D. repens does occur in the field and could potentially occur with other helminths. Heat treatment decreases specificity by enhancing cross-reactivity.
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Cavaliere L, Romito G, Domenech O, Venco L. Heartworm Removal Guided by Transesophageal Echocardiography in a Dog with Naturally Acquired Caval Syndrome. J Am Anim Hosp Assoc 2017; 53:96-100. [DOI: 10.5326/jaaha-ms-6424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
A 14 mo old shih tzu was referred for dyspnea, hemoptysis, and hematuria. Heartworm disease with caval syndrome was diagnosed by laboratory tests, thoracic radiography, and transthoracic echocardiography. The minimally invasive heartworm removal procedure was performed using flexible alligator forceps guided by transesophageal echocardiography. The procedure was successfully performed removing over 94% of heartworms displayed echocardiographically without any intraoperative complication.
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Affiliation(s)
- Leonardo Cavaliere
- From the Dipartimento di Medicina Veterinaria, Università degli Studi di Bari “Aldo Moro,” Valenzano, Italy (L.C.); Istituto Veterinario di Novara, Granozzo con Monticello, Italy (G.R., O.D.); and Ospedale Veterinario Citta' di Pavia, Pavia, Italy (L.V.)
| | - Giovanni Romito
- G. Romito's present affiliation is Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- From the Dipartimento di Medicina Veterinaria, Università degli Studi di Bari “Aldo Moro,” Valenzano, Italy (L.C.); Istituto Veterinario di Novara, Granozzo con Monticello, Italy (G.R., O.D.); and Ospedale Veterinario Citta' di Pavia, Pavia, Italy (L.V.)
| | - Oriol Domenech
- From the Dipartimento di Medicina Veterinaria, Università degli Studi di Bari “Aldo Moro,” Valenzano, Italy (L.C.); Istituto Veterinario di Novara, Granozzo con Monticello, Italy (G.R., O.D.); and Ospedale Veterinario Citta' di Pavia, Pavia, Italy (L.V.)
| | - Luigi Venco
- From the Dipartimento di Medicina Veterinaria, Università degli Studi di Bari “Aldo Moro,” Valenzano, Italy (L.C.); Istituto Veterinario di Novara, Granozzo con Monticello, Italy (G.R., O.D.); and Ospedale Veterinario Citta' di Pavia, Pavia, Italy (L.V.)
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Alho AM, Fiarresga A, Landum M, Lima C, Gamboa Ó, Meireles J, Sales Luís J, Madeira de Carvalho L. A Homemade Snare: An Alternative Method for Mechanical Removal of Dirofilaria immitis in Dogs. Vet Med Int 2016; 2016:5780408. [PMID: 26981316 PMCID: PMC4766349 DOI: 10.1155/2016/5780408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 12/31/2015] [Accepted: 01/14/2016] [Indexed: 11/17/2022] Open
Abstract
Canine dirofilariosis is a life-threatening parasitic disease that is increasingly reported worldwide. Once diagnosed the main treatment goals are to improve the animal's clinical condition and to eliminate all life stages of the parasite with minimal posttreatment side effects. This can be achieved through mechanical, surgical, or chemotherapeutical approaches. Currently, manual extraction is the preferred method to remove adult heartworms due to its diminished invasiveness, reduced damage to the vascular endothelium, and shortened anaesthesia duration. However, it remains an expensive technique that can be highly traumatic. To address this issue, a nontraumatic homemade catheter-guided snare was developed for heartworm removal by adapting and folding a 0.014-inch coronary wire (BMW, Abbott Vascular). Transvenous heartworm extraction was performed on a dog severely infected with adult heartworms by inserting the modified snare into a 6-F Judkins right coronary guiding catheter BMW (Cordis) and advancing it into the right ventricle under fluoroscopic guidance. Fifteen adult specimens of Dirofilaria immitis were successfully extracted from the pulmonary artery and right ventricle without complications. To assure the death of both larvae and adults, postoperative treatment was successfully managed using ivermectin, doxycycline, and melarsomine, with no recurrence after surgery.
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Affiliation(s)
- Ana Margarida Alho
- CIISA, Faculty of Veterinary Medicine, ULisboa, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal
| | - António Fiarresga
- Cardiology Unit, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Rua de Santa Marta 50, 1169-024 Lisboa, Portugal
| | - Miguel Landum
- CIISA, Faculty of Veterinary Medicine, ULisboa, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal
| | - Clara Lima
- Small Animal Teaching Hospital, Faculty of Veterinary Medicine, ULisboa, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal
| | - Óscar Gamboa
- Small Animal Teaching Hospital, Faculty of Veterinary Medicine, ULisboa, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal
| | - José Meireles
- CIISA, Faculty of Veterinary Medicine, ULisboa, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal
| | - José Sales Luís
- CIISA, Faculty of Veterinary Medicine, ULisboa, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal
- Small Animal Teaching Hospital, Faculty of Veterinary Medicine, ULisboa, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal
| | - Luís Madeira de Carvalho
- CIISA, Faculty of Veterinary Medicine, ULisboa, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal
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Transoesophageal echocardiography in the dog. Vet J 2013; 198:329-38. [PMID: 24183715 DOI: 10.1016/j.tvjl.2013.08.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 07/21/2013] [Accepted: 08/10/2013] [Indexed: 11/22/2022]
Abstract
Transoesophageal echocardiography (TEE) allows imaging of the heart through the oesophagus using a special transducer mounted on a modified endoscope. The proximity to the heart and minimal intervening structures enables the acquisition of high-resolution images that are consistently superior to routine transthoracic echocardiography and optimal imaging of the heart base anatomy and related structures. TEE provides high-quality real-time imaging free of ionizing radiation, making it an ideal instrument not only for diagnostic purposes, but also for monitoring surgical or minimally invasive cardiac procedures, non-cardiac procedures and critical cases in the intensive care unit. In human medicine, TEE is routinely used in these settings. In veterinary medicine, TEE is increasingly used in referral centres, especially for perioperative assessment and guidance of catheter-based cardiovascular procedures, such as patent ductus arteriosus, balloon valvuloplasty, and atrial and ventricular septal defect occlusion with vascular devices. TEE can also aid in heartworm retrieval procedures. The purpose of this paper is to review the current uses of TEE in veterinary medicine, focusing on technique, indications and complications.
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Yoon WK, Choi R, Lee SG, Hyun C. Comparison of 2 retrieval devices for heartworm removal in 52 dogs with heavy worm burden. J Vet Intern Med 2013; 27:469-73. [PMID: 23600618 DOI: 10.1111/jvim.12079] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 01/26/2013] [Accepted: 02/20/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND For treating dogs with heavy heartworm infection, mechanical removal using various retrieval devices is useful. However, the efficacy and safety of retrieval devices have rarely been studied. HYPOTHESIS Catheter-based heartworm removal using 2 retrieval devices (basket and tripod grasping forceps) is efficient and safe for treating dogs with heavy worm burden. ANIMALS Fifty-two client-owned dogs with heavy (Class III and IV) worm burden. METHODS A retrospective study was performed on 52 dogs, using a catheter-based heartworm removal approach using 2 types of retrieval devices (ie, the basket and the tripod grasping forceps). The efficacy and complications associated with the 2 devices were assessed. RESULTS The basket device was used on 22 of the study group dogs, and the tripod grasping forceps was used on 30 of the dogs. The postoperative survival rate was 95.5% for the basket device and 80% for the tripod grasping forceps, but the difference was not statistically significant. The worm number captured per attempt was 3.5 ± 1.7 using the basket device and 1.9 ± 0.85 for the tripod grasping forceps (P < .05). Various complications associated with heartworm removal were noticed with both retrieval devices. CONCLUSIONS AND CLINICAL IMPORTANCE This study suggests that catheter-based heartworm removal is not only a relatively safe and efficient therapeutic method in dogs with heavy worm burden, but more efficient using the basket device. Our data do not indicate a clear safety advantage between the 2 devices evaluated, although the survival rate was numerically higher in dogs undergoing a basket intervention.
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Affiliation(s)
- W K Yoon
- Section of Small Animal Internal Medicine, College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University, Chuncheon 201-100, Korea
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Otranto D, Dantas-Torres F, Brianti E, Traversa D, Petrić D, Genchi C, Capelli G. Vector-borne helminths of dogs and humans in Europe. Parasit Vectors 2013; 6:16. [PMID: 23324440 PMCID: PMC3564894 DOI: 10.1186/1756-3305-6-16] [Citation(s) in RCA: 218] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 01/01/2013] [Indexed: 11/10/2022] Open
Abstract
Presently, 45% of the total human population of Europe, as well as their domestic and companion animals, are exposed to the risk of vector-borne helminths (VBH) causing diseases. A plethora of intrinsic biological and extrinsic factors affect the relationship among helminths, vectors and animal hosts, in a constantly changing environment. Although canine dirofilarioses by Dirofilaria immitis and Dirofilaria repens are key examples of the success of VBH spreading into non-endemic areas, another example is represented by Thelazia callipaeda eyeworm, an emergent pathogen of dogs, cats and humans in several regions of Europe. The recent finding of Onchocerca lupi causing canine and human infestation in Europe and overseas renders the picture of VBH even more complicated. Similarly, tick-transmitted filarioids of the genus Cercopithifilaria infesting the skin of dogs were recently shown to be widespread in Europe. Although for most of the VBH above there is an increasing accumulation of research data on their distribution at national level, the overall impact of the diseases they cause in dogs and humans is not fully recognised in many aspects. This review investigates the reasons underlying the increasing trend in distribution of VBH in Europe and discusses the diagnostic and control strategies currently available. In addition, this article provides the authors' opinion on some topics related to VBH that would deserve further scientific investigation.
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Affiliation(s)
- Domenico Otranto
- Dipartimento di Medicina Veterinaria, Università degli Studi di Bari, Bari, Valenzano, Italy.
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Yoon WK, Han D, Hyun C. Catheter-guided percutaneous heartworm removal using a nitinol basket in dogs with caval syndrome. J Vet Sci 2011; 12:199-201. [PMID: 21586882 PMCID: PMC3104177 DOI: 10.4142/jvs.2011.12.2.199] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Carval syndrome is a severe heartworm infection where the worms have migrated to the right atrium and vena cava; this condition is associated with a myriad of clinical signs. Several non-surgical and interventional methods are currently used for mechanical worm removal. However, the success rate and complications related to these methods are heavily dependent on methodology and retrieval devices used. In this study, we developed a catheter-guided heartworm removal method using a retrieval basket that can easily access pulmonary arteries and increase the number of worms removed per procedure. With this technique, we successfully treated four dogs with caval syndrome.
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Affiliation(s)
- Won-Kyoung Yoon
- Section of Small Animal Internal Medicine, and Institute of Veterinary Science, College of Veterinary Medicine, Kangwon National University, Chuncheon 200-701, Korea
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Guglielmini C, Luciani A. Advanced Echocardiographic Techniques in Small Animal Practice. Vet Res Commun 2006. [DOI: 10.1007/s11259-006-0029-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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