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Deacon LJ, Navas de Solis C, Richardson DW, Polkes A, Reef VB. Closure of an Aortocardiac Fistula in a Horse. CASE 2022; 6:43-48. [PMID: 35243200 PMCID: PMC8883141 DOI: 10.1016/j.case.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An ACF developed in a hospitalized horse following orthopedic surgery. Spontaneous closure of the ACF occurred 6 weeks after initial diagnosis. Echocardiography is the primary imaging modality to confirm the presence of ACF in equids.
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2
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Côté E, Zhang RM, Kaiser N, Reinhardt DP, Martin CK. Annuloaortic ectasia in a four-month-old male Newfoundland dog: long-term follow-up and immunofluorescent study. Vet Q 2021; 41:280-291. [PMID: 34607531 PMCID: PMC8526017 DOI: 10.1080/01652176.2021.1961039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
A 4 month-old, 14.8 kg, male Newfoundland dog was presented for cardiovascular evaluation following detection of a heart murmur. Echocardiography revealed enlargement of the sinuses of Valsalva and marked, diffuse dilation of the ascending aorta (annuloaortic ectasia, AAE), with mild/equivocal subaortic stenosis (SAS). The dog was monitored over the duration of its lifetime, with serial echocardiograms performed at 5, 6, and 8 months and 1, 2, 3, 4, 8, and 10 years demonstrating persistent, diffuse dilation of the ascending aorta. The dog lived until it was 10 years old and died of metastatic carcinoma. Postmortem examination confirmed AAE and mild SAS. Hematoxylin and eosin and Weigert van Gieson stains were used to compare the ascending aorta to the descending aorta and left subclavian artery, and to compare aortic samples to those of three control dogs. Histopathologic evaluation revealed mild medial degeneration in the ascending aorta of all four dogs. Immunofluorescent microscopy was used for determining the deposition of proteins known to play a role in aortic aneurysms in humans: fibrillin-1 (FBN1), latent transforming growth factor beta binding protein 4 (LTBP4) and fibronectin. The ascending aorta of the AAE case demonstrated reduced deposition of FBN1, indicating that its loss may have contributed to aortic dilation. Diffuse, primary ascending aortic dilation is uncommonly reported in dogs; when it is, it carries a poor prognosis. This case provides an important example of marked dilation of the ascending aorta in a dog that lived with no associated adverse effects for 10 years.
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Affiliation(s)
- Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Canada
| | - Rong-Mo Zhang
- Faculty of Medicine and Health Sciences, Department of Anatomy and Cell Biology, McGill University, Montreal, Canada
| | - Nicole Kaiser
- Department of Pathology and Microbiology, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Canada
| | - Dieter P Reinhardt
- Faculty of Medicine and Health Sciences, Department of Anatomy and Cell Biology, McGill University, Montreal, Canada.,Faculty of Dentistry, McGill University, Montreal, Canada
| | - Chelsea K Martin
- Department of Pathology and Microbiology, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Canada
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3
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Reef VB. Hypertension and aortic root rupture: Cause and effect? EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- V. B. Reef
- New Bolton Center University of Pennsylvania Kennett Square Pennsylvania USA
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4
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Hsue W, Sharpe AN, Darling SL, Visser LC, Choi E, Stern JA. Aorto-left atrial fistula secondary to infective aortic endocarditis and endarteritis in a cat with valvular aortic stenosis. J Vet Cardiol 2021; 35:101-107. [PMID: 33906113 DOI: 10.1016/j.jvc.2021.03.007] [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: 01/01/2021] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 11/16/2022]
Abstract
A cat previously diagnosed with valvular aortic stenosis developed acute respiratory distress. A new continuous heart murmur was noted on physical exam. Echocardiographic examination revealed vegetative lesions on the aortic valve and continuously shunting blood flow from the aorta into the left atrium. Despite initial treatment for left-sided congestive heart failure, the cat died suddenly. In addition to confirming aortic valve endocarditis and an acquired aorto-left atrial shunt, pathological examination identified vegetative lesions on the luminal surface of the ascending aorta. Although antemortem aerobic blood culture, 16s bacterial ribosomal DNA PCR, and Bartonella PCR failed to identify causative organisms, Escherichia coli was identified on postmortem tissue culture of the aortic lesion. This represented a unique case of primary valvular aortic stenosis with secondary infective aortic endocarditis, infective aortic endarteritis, and aorto-left atrial fistula in a cat. It highlighted potential adverse outcomes of aortic stenosis that are more commonly recognized in humans and dogs.
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Affiliation(s)
- W Hsue
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California - Davis, One Garrod Drive, Davis, CA 95616, USA.
| | - A N Sharpe
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California - Davis, One Garrod Drive, Davis, CA 95616, USA
| | - S L Darling
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California - Davis, One Garrod Drive, Davis, CA 95616, USA
| | - L C Visser
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California - Davis, One Garrod Drive, Davis, CA 95616, USA
| | - E Choi
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California - Davis, One Garrod Drive, Davis, CA 95616, USA
| | - J A Stern
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California - Davis, One Garrod Drive, Davis, CA 95616, USA
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5
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Guglielmini C, Poser H, Tursi M, Janus I. Letter regarding "Aortopulmonary fistula in a Warmblood mare associated with an aortic aneurysm and supravalvular aortic stenosis". J Vet Intern Med 2020; 34:2186. [PMID: 33159468 PMCID: PMC7694833 DOI: 10.1111/jvim.15964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 10/29/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Carlo Guglielmini
- Department of Animal Medicine, Production & Health, University of Padua, Legnaro (PD), Italy
| | - Helen Poser
- Department of Animal Medicine, Production & Health, University of Padua, Legnaro (PD), Italy
| | - Massimiliano Tursi
- Department of Veterinary Sciences, University of Turin, Grugliasco (TO), Italy
| | - Izabela Janus
- Department of Pathology, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
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6
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Navas de Solis C. Ventricular arrhythmias in horses: Diagnosis, prognosis and treatment. Vet J 2020; 261:105476. [PMID: 32741491 DOI: 10.1016/j.tvjl.2020.105476] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 05/26/2020] [Accepted: 05/26/2020] [Indexed: 01/02/2023]
Abstract
Ventricular arrhythmias (VAs) are often incidental or coincidental with systemic disease. Ventricular arrhythmias are also the most likely cause of many sudden cardiac deaths in horses. This dichotomy creates challenges in the management of horses with VAs. This review presents current knowledge of diagnosis, prognosis and treatment of VAs in horses.
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Affiliation(s)
- Cristobal Navas de Solis
- Department of Clinical Studies New Bolton Center, University of Pennsylvania, Kennett Square, PA 19348, USA.
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7
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Vera L, De Clercq D, Van Steenkiste G, Decloedt A, Chiers K, van Loon G. Differences in ultrasound-derived arterial wall stiffness parameters and noninvasive blood pressure between Friesian horses and Warmblood horses. J Vet Intern Med 2020; 34:893-901. [PMID: 32032455 PMCID: PMC7096643 DOI: 10.1111/jvim.15705] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 01/10/2020] [Indexed: 12/26/2022] Open
Abstract
Background Aortic rupture is more common in Friesians compared to Warmbloods, which might be related to differences in arterial wall composition and, as such, arterial wall stiffness (AWS). Currently, nothing is known about differences in AWS between these breeds. Objectives Comparison of AWS parameters and noninvasive blood pressure between Friesians and Warmbloods. Animals One hundred one healthy Friesians and 101 age‐matched healthy Warmbloods. Methods Two‐dimensional and pulsed‐wave Doppler ultrasound examination was performed of the aorta, common carotid artery, and external iliac artery to define local and regional AWS parameters. Regional aortic AWS was estimated using aortic‐to‐external iliac artery pulse wave velocity (PWVa‐e) and carotid‐to‐external iliac artery pulse wave velocity (PWVc‐e). Noninvasive blood pressure and heart rate were recorded simultaneously. Results Systolic, diastolic, and mean arterial blood pressure and pulse pressure were significantly higher in Friesians compared to Warmbloods. No significant difference in heart rate was found. Most local AWS parameters (diameter change, compliance coefficient, distensibility coefficient) were significantly lower in Friesians compared to Warmbloods, indicating a stiffer aorta in Friesians. This difference could be confirmed by the regional stiffness parameters. A higher PWVa‐e and PWVc‐e was found in Friesians. For the cranial and caudal common carotid artery and external iliac artery, most local AWS parameters were not significantly different. Conclusions and clinical importance Results indicate that aortic AWS differs between Friesian and Warmblood horses. Friesians seem to have a stiffer aorta, which might be related to the higher incidence of aortic rupture in Friesians.
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Affiliation(s)
- Lisse Vera
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Equine cardioteam, Ghent University, Merelbeke, Belgium
| | - Dominique De Clercq
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Equine cardioteam, Ghent University, Merelbeke, Belgium
| | - Glenn Van Steenkiste
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Equine cardioteam, Ghent University, Merelbeke, Belgium
| | - Annelies Decloedt
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Equine cardioteam, Ghent University, Merelbeke, Belgium
| | - Koen Chiers
- Department of Pathology, Bacteriology and Poultry Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Gunther van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Equine cardioteam, Ghent University, Merelbeke, Belgium
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8
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Love BA, Thierry F, Schwarz T, Martinez-Pereira Y, Culshaw GJ. Aortic sinus aneurysm communicating with the main pulmonary artery, and a concurrent patent ductus arteriosus, in a dog. J Small Anim Pract 2020; 62:300-304. [PMID: 31943231 DOI: 10.1111/jsap.13103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/22/2018] [Accepted: 11/20/2018] [Indexed: 11/29/2022]
Abstract
This is the first report of an aortic sinus aneurysm with a communication to the main pulmonary artery, resulting in left-to-right shunting, diagnosed in vivo in a dog. There was also a second left-to-right shunt through a patent ductus arteriosus. Computed tomography (CT) angiography was used to confirm both congenital anomalies and assess the relative contributions of the two left-to-right shunts to left-sided volume overload.
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Affiliation(s)
- B A Love
- Wear Referrals, Veterinary Hospital, Bradbury, Stockton-on-Tees, TS21 2ES, UK
| | - F Thierry
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, EH25 9RG, UK
| | - T Schwarz
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, EH25 9RG, UK
| | - Y Martinez-Pereira
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, EH25 9RG, UK
| | - G J Culshaw
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, EH25 9RG, UK
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9
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Vernemmen I, De Clercq D, Decloedt A, Schauvliege S, Taeymans Y, De Wolf D, van Loon G. Percutaneous transcatheter closure of an aorto-cardiac fistula in a six-year-old Warmblood mare with atrial fibrillation. J Vet Cardiol 2019; 24:78-84. [PMID: 31405558 DOI: 10.1016/j.jvc.2019.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 05/21/2019] [Accepted: 06/13/2019] [Indexed: 10/26/2022]
Abstract
This report describes a rare case of an aorto-cardiac fistula in a six-year-old French Warmblood mare presented with atrial fibrillation, decreased performance, ventral oedema, bounding arterial pulsation and pathological jugular venous pulse. A 2.7-cm-diameter fistula connected the right aortic sinus of Valsalva to the right atrium. Atrial fibrillation was likely due to volume overload of the right heart due to left-to-right shunting. The horse was treated by percutaneous transcatheter closure of the fistula delivered under general anaesthesia using a transarterial approach. The operation was initially successful, and clinical signs of congestive heart failure improved immediately. However, the device dislodged six days after procedure, and the general condition of the horse deteriorated quickly. A second closure attempt to deliver the occluder using a transvenous approach in the standing horse failed, and the horse was eventually euthanized. Procedural aspects and several possible risk factors for device dislodgement are discussed.
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Affiliation(s)
- I Vernemmen
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
| | - D De Clercq
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - A Decloedt
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - S Schauvliege
- Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - Y Taeymans
- Department of Pediatric Cardiology, University Hospital Ghent, De Pintelaan 185, 9000 Ghent, Belgium
| | - D De Wolf
- Department of Pediatric Cardiology, University Hospital Ghent, De Pintelaan 185, 9000 Ghent, Belgium
| | - G van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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10
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11
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Pericardial Disease, Myocardial Disease, and Great Vessel Abnormalities in Horses. Vet Clin North Am Equine Pract 2019; 35:139-157. [PMID: 30871834 DOI: 10.1016/j.cveq.2018.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Pericardial, myocardial, and great vessel diseases are relatively rare in horses. The clinical signs are often nonspecific and vague, or related to the underlying cause. Physical examination usually reveals tachycardia, fever, venous distension or jugular pulsation, a weak or bounding arterial pulse, ventral edema, and abnormal cardiac auscultation such as arrhythmia, murmur, or muffled heart sounds. The prognosis depends on the underlying cause and the disease progression, and ranges from full recovery to poor prognosis for survival. This article focuses on the etiology, diagnosis, prognosis, and treatment of pericarditis, pericardial mass lesions, myocarditis, cardiomyopathy, and great vessel aneurysm or rupture.
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12
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Abstract
Despite advances, increased convenience, and availability of echocardiography and other diagnostic techniques in equine cardiology, a comprehensive history and clinical examination still forms the essential first step in any cardiac evaluation. This article summarizes the approach to the cardiac examination at rest, highlighting key areas for the clinician to assess, and stressing the importance of context for assessing the significance of any abnormalities detected. Ancillary techniques, such as blood pressure measurement and the laboratory assessment of cardiac disease in the horse, are also introduced.
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13
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Endoh C, Matsuda K, Okamoto M, Tsunoda N, Taniyama H. Morphometric changes in the aortic arch with advancing age in fetal to mature thoroughbred horses. J Vet Med Sci 2017; 79:661-669. [PMID: 28190824 PMCID: PMC5383194 DOI: 10.1292/jvms.16-0600] [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] [Indexed: 11/30/2022] Open
Abstract
Aortic rupture is a well recognized cause of sudden death in thoroughbred horses. Some microscopic lesions, such as those caused by cystic medial necrosis and
medionecrosis, can lead to aortic rupture. However, these microscopic lesions are also observed in normal horses. On the other hand, a previous study of aortic
rupture suggested that underlying elastin and collagen deposition disorders might be associated with aortic rupture. Therefore, the purpose of this study was to
compare the structural components of the tunica media of the aortic arch, which is composed of elastin, collagen, smooth muscle cells and mucopolysaccharides
(MPS), in fetal to mature thoroughbred horses. The percentage area of elastin was greatest in the young horses and subsequently decreased with aging. The
percentage area of collagen increased with aging, and the elderly horses (aged ≥20) exhibited significantly higher percentage areas of collagen than the young
horses. The percentage area of smooth muscle cells did not change with age. The percentage area of MPS was inversely proportional to the percentage area of
elastin. The fetuses exhibited a markedly larger percentage area of MPS than the mature horses. We concluded that the medial changes seen in the aortic arch,
which included a reduction in the amount of elastin and increases in the amounts of collagen and MPS, were age-related variations.
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Affiliation(s)
- Chihiro Endoh
- Department of Veterinary Pathology, Rakuno Gakuen University, 582 Midori-machi, Bunkyo-dai, Ebetsu, Hokkaido 069-8501, Japan
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14
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Ploeg M, Gröne A, van de Lest CHA, Saey V, Duchateau L, Wolsein P, Chiers K, Ducatelle R, van Weeren PR, de Bruijn M, Delesalle C. Differences in extracellular matrix proteins between Friesian horses with aortic rupture, unaffected Friesians and Warmblood horses. Equine Vet J 2017; 49:609-613. [PMID: 27859600 DOI: 10.1111/evj.12654] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 11/06/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Unlike in Warmblood horses, aortic rupture is quite common in Friesian horses, in which a hereditary trait is suspected. The aortic connective tissue in affected Friesians shows histological changes such as medial necrosis, elastic fibre fragmentation, mucoid material accumulation and fibrosis with aberrant collagen morphology. However, ultrastructural examination of the collagen fibres of the mid-thoracic aorta has been inconclusive in further elucidating the pathogenesis of the disease. OBJECTIVES To assess several extracellular matrix (ECM) components biochemically in order to explore a possible underlying breed-related systemic ECM defect in Friesians with aortic rupture. STUDY DESIGN Cadaver study. METHODS Tissues from affected Friesians (n = 18), unaffected Friesians (n = 10) and Warmblood horses (n = 30) were compared. Samples were taken from the thoracic aorta at the level of the rupture site, from two locations caudal to the rupture and from the deep digital flexor tendon. Total collagen content, post-translational modifications of collagen formation including lysine hydroxylation, and hydroxylysylpyridinoline (HP), lysylpyridinoline (LP) and pyrrole cross-links were analysed. Additionally, elastin cross-links, glycosaminoglycan content and matrix metalloproteinase (MMP) activity were assessed. RESULTS Significantly increased MMP activity and increased LP and HP cross-linking, lysine hydroxylation and elastin cross-linking were found at the site of rupture in affected Friesians. These changes may reflect processes involved in healing and aneurysm formation. Unaffected Friesians had less lysine hydroxylation and pyrrole cross-linking within the tendons compared with Warmblood horses. No differences in the matrix of the aorta were found between normal Warmbloods and Friesian horses. MAIN LIMITATIONS Small sample size. CONCLUSIONS The differences in collagen parameters in tendon tissue may reflect differences in connective tissue metabolism between Friesians and Warmblood horses.
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Affiliation(s)
- M Ploeg
- Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - A Gröne
- Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - C H A van de Lest
- Department of Biochemistry and Cell Biology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.,Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - V Saey
- Department of Pathology, Bacteriology and Poultry Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - L Duchateau
- Department of Comparative Physiology and Biometrics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - P Wolsein
- Institute for Pathology, University of Veterinary Medicine Foundation, Hannover, Germany
| | - K Chiers
- Department of Pathology, Bacteriology and Poultry Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - R Ducatelle
- Department of Pathology, Bacteriology and Poultry Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - P R van Weeren
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - M de Bruijn
- Equine Clinic, Oldeholtpade, the Netherlands
| | - C Delesalle
- Department of Comparative Physiology and Biometrics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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15
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Ploeg M, Saey V, van Loon G, Delesalle C. Thoracic aortic rupture in horses. Equine Vet J 2016; 49:269-274. [PMID: 27783422 DOI: 10.1111/evj.12641] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 10/05/2016] [Indexed: 02/06/2023]
Abstract
The aorta can rupture at the aortic root or aortic arch. In most breeds, the aortic root is the likely site and rupture leads to aortocardiac fistula with communication between the aorta and the right atrium, right ventricle and/or the interventricular septum. There is a high prevalence of aortic rupture in young Friesian horses and rupture occurs at the aortic arch with pseudoaneurysm and potentially aortopulmonary fistulation. Echocardiographic and post-mortem techniques must be adapted to identify aortic arch rupture that is not generally identified with standard approaches. Given the narrow genetic base of the Friesian breed and the significant differences found in extracellular matrix composition and metabolism between Friesians and Warmbloods, genetic factors are likely to contribute to the condition in the Friesian breed.
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Affiliation(s)
- M Ploeg
- Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - V Saey
- Department of Pathology, Bacteriology and Poultry Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - G van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - C Delesalle
- Department of Comparative Physiology and Biometrics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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16
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Abstract
Respiratory and cardiac diseases are common in older horses. Advancing age is a specific risk factor for cardiac murmurs and these are more likely in males and small horses. Airway inflammation is the most common respiratory diagnosis. Recurrent airway obstruction can lead to irreversible structural change and bronchiectasis; with chronic hypoxia, right heart dysfunction and failure can develop. Valvular heart disease most often affects the aortic and/or the mitral valve. Management of comorbidity is an essential element of the therapeutic approach to cardiac and respiratory disease in older equids.
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17
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Saey V, Ploeg M, Delesalle C, van Loon G, Gröne A, Ducatelle R, Duchateau L, Chiers K. Morphometric Properties of the Thoracic Aorta of Warmblood and Friesian Horses with and without Aortic Rupture. J Comp Pathol 2016; 154:225-30. [PMID: 26987511 DOI: 10.1016/j.jcpa.2016.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/01/2016] [Accepted: 02/03/2016] [Indexed: 12/11/2022]
Abstract
Rupture of the aorta is much more common in Friesians compared with other breeds of horse. Rupture always occurs adjacent to the scar of the ligamentum arteriosum. Previous histological examination of ruptured aortic walls suggested the presence of an underlying connective tissue disorder. Therefore, the aim of the present study was to compare the structural characteristics of the tunica media of the mid-thoracic aorta, distant to the lesion, in warmblood and Friesian horses with and without thoracic aortic rupture. In unaffected Friesian horses, the thickness of the tunica media, as well as the percentage area comprised of collagen type I, were significantly higher compared with the warmblood horses, supporting the hypothesis of a primary collagen disorder in the Friesian horse breed. However, in the tunica media of the affected Friesian horses there was no significant wall thickening. Moreover, the percentage area comprised of elastin was significantly lower, while the percentage area comprised of smooth muscle was higher, compared with unaffected Friesian and warmblood horses. These lesions are suggestive of an additional mild elastin deficiency with compensatory smooth muscle cell hypertrophy in affected Friesians.
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Affiliation(s)
- V Saey
- Laboratory of Veterinary Pathology, Department of Pathology, Bacteriology and Poultry Diseases, Ghent University, Merelbeke, Belgium.
| | - M Ploeg
- Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, The Netherlands
| | - C Delesalle
- Department of Comparative Physiology and Biometrics, Belgium
| | - G van Loon
- Department of Large Animal Internal Medicine, Ghent University, Merelbeke, Belgium
| | - A Gröne
- Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, The Netherlands
| | - R Ducatelle
- Laboratory of Veterinary Pathology, Department of Pathology, Bacteriology and Poultry Diseases, Ghent University, Merelbeke, Belgium
| | - L Duchateau
- Department of Comparative Physiology and Biometrics, Belgium
| | - K Chiers
- Laboratory of Veterinary Pathology, Department of Pathology, Bacteriology and Poultry Diseases, Ghent University, Merelbeke, Belgium
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18
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Diel de Amorim M, Nielsen K, McKell B, Huang Y, Card C. Aortic rupture causing cardiac tamponade in a 24-day-old Friesian colt with concurrent colonic Chlamydiosisand Balantidiasis. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M. Diel de Amorim
- Department of Large Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; Saskatoon Canada
| | - K. Nielsen
- Department of Large Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; Saskatoon Canada
| | - B. McKell
- Department of Large Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; Saskatoon Canada
| | - Y. Huang
- Prairie Diagnostic Services Inc.; Saskatoon Canada
| | - C. Card
- Department of Large Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; Saskatoon Canada
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19
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Abstract
Abdominal ultrasound is an invaluable aid in the evaluation of the colic patient but can be heavily influenced by patient preparation, individual horse-to-horse variation, availability of ultrasound transducers, technique, experience level of the examiner, and complexity of the abdominal disorder. This article describes ultrasonographic anatomy of the normal equine abdomen and technique for examination of the equine colic patient. Common abnormalities of the stomach, small intestine, large intestine, and peritoneal cavity are described along with other abnormalities that may be discovered with abdominal ultrasonography of the colic patient, such as masses, urolithiasis, cholelithiasis, and thoracic or cardiac lesions.
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Affiliation(s)
- Sarah le Jeune
- Department of Surgical and Radiological Sciences, University of California, 1 Shields Avenue, Davis, CA 95616, USA.
| | - Mary Beth Whitcomb
- Department of Surgical and Radiological Sciences, University of California, 1 Shields Avenue, Davis, CA 95616, USA
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Reef VB, Bonagura J, Buhl R, McGurrin MKJ, Schwarzwald CC, van Loon G, Young LE. Recommendations for management of equine athletes with cardiovascular abnormalities. J Vet Intern Med 2014; 28:749-61. [PMID: 24628586 PMCID: PMC4895474 DOI: 10.1111/jvim.12340] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 01/28/2014] [Accepted: 01/28/2014] [Indexed: 11/29/2022] Open
Abstract
Murmurs and arrhythmias are commonly detected in equine athletes. Assessing the relevance of these cardiovascular abnormalities in the performance horse can be challenging. Determining the impact of a cardiovascular disorder on performance, life expectancy, horse and rider or driver safety relative to the owner's future expectations is paramount. A comprehensive assessment of the cardiovascular abnormality detected is essential to determine its severity and achieve these aims. This consensus statement presents a general approach to the assessment of cardiovascular abnormalities, followed by a discussion of the common murmurs and arrhythmias. The description, diagnosis, evaluation, and prognosis are considered for each cardiovascular abnormality. The recommendations presented herein are based on available literature and a consensus of the panelists. While the majority of horses with cardiovascular abnormalities have a useful performance life, periodic reexaminations are indicated for those with clinically relevant cardiovascular disease. Horses with pulmonary hypertension, CHF, or complex ventricular arrhythmias should not be ridden or driven.
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Affiliation(s)
- V B Reef
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA
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21
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Scollan K, Sisson D. Multi-detector computed tomography of an aortic dissection in a cat. J Vet Cardiol 2014; 16:67-72. [DOI: 10.1016/j.jvc.2013.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 11/18/2013] [Accepted: 11/25/2013] [Indexed: 11/27/2022]
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Pequito M, Amory H, Serteyn D, Busoni V, de Moffarts B, Sandersen C. Comparison of the Sedative and Hemodynamic Effects of Acepromazine and Promethazine in the Standing Horse. J Equine Vet Sci 2012. [DOI: 10.1016/j.jevs.2012.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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23
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Ploeg M, Saey V, de Bruijn CM, Gröne A, Chiers K, van Loon G, Ducatelle R, van Weeren PR, Back W, Delesalle C. Aortic rupture and aorto-pulmonary fistulation in the Friesian horse: characterisation of the clinical and gross post mortem findings in 24 cases. Equine Vet J 2012; 45:101-6. [PMID: 22607232 DOI: 10.1111/j.2042-3306.2012.00580.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
REASONS FOR PERFORMING STUDY In horses, aortic sinus of Valsalva aneurysms or tears in the aortic root are well-recognised conditions in breeding stallions, often leading to sudden death. A more uncommon form of aortic rupture, located proximal to the ligamentum arteriosum has been reported in 3 Friesian horses. OBJECTIVES The purpose of this study was to phenotypically characterise aortic rupture and aorto-pulmonary fistulation in Friesian horses in terms of clinical and post mortem data based on 24 cases. METHODS Friesian horses that were diagnosed with aortic rupture and aorto-pulmonary fistulation over a period of 13 years (1997-2010) at the Department of Equine Sciences of Utrecht University (n = 15) and Wolvega Equine Hospital (n = 9), were included in this study. Case history, results of clinical examination and gross post mortem findings were screened and analysed. RESULTS Some cases were found dead without prior symptoms, but in several cases signs such as recurrent colic, peripheral oedema and sustained tachycardia were present for several weeks prior to cardiac failure. Clinical examination during hospitalisation revealed increased rectal temperature, peripheral oedema and increased jugular pulse with a bounding arterial pulse. In the majority of horses an aortic rupture of the aortic arch near the ligamentum arteriosum, concurrent with a circumferential cuff of perivascular haemorrhage and aorto-pulmonary fistulation, was found at post mortem examination. CONCLUSIONS Aorto-pulmonary fistulation in conjunction with aortic rupture is more common in Friesians than previously estimated. In some cases findings demonstrate a progressive pathology rather than acute cardiac failure and sudden death. An appropriate approach is necessary during post mortem examination of the heart in order not to overlook the diagnosis. POTENTIAL RELEVANCE Equine practitioners should realise that in Friesian horses presented with a history of recurrent false colic, coughing, sustained tachycardia and/or peripheral oedema, aortic rupture and aorto-pulmonary fistulation should be included in the differential diagnosis.
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Affiliation(s)
- M Ploeg
- Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
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Archer RM, Gordon SJG, Carslake HB, Collett MG. Distal aortic aneurysm presumed to be secondary to an infected umbilical artery in a foal. N Z Vet J 2011; 60:65-8. [PMID: 22175433 DOI: 10.1080/00480169.2011.620546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
CASE HISTORY A 3-month-old female Warmblood foal was presented after displaying signs of colic with pyrexia for 5 days. CLINICAL AND PATHOLOGICAL FINDINGS The foal continued to show signs of colic, frequently passed urine, and was pyrexic with an elevated white blood cell count. The umbilical stalk was thickened but there was no evidence of purulent material. Exploratory laparotomy revealed an enlarged left umbilical artery remnant tightly adhered to the bladder wall. The left umbilical artery continued to an aneurysm involving the distal aorta. The foal was subject to euthanasia and post-mortem examination confirmed a spherical aortic aneurysm, in the dorsal midline caudal to the kidneys that contained a large thrombus. Histopathological examination revealed inflammation and necrosis of the tunica intima and tunica media of the left umbilical artery with suppuration and bacterial colonies evident in the periarterial tissues. DIAGNOSIS Infected aortic aneurysm presumably caused by an umbilical artery infection. CLINICAL RELEVANCE A previously undetected umbilical infection appears to have resulted in an unusual delayed complication causing signs of colic in a foal. Veterinarians should be aware of this condition, and the possibility that it may be a cause of signs of colic in foals. Diagnosis based on ultrasonography should be possible, but may require sedation, visceral analgesia and careful examination.
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Affiliation(s)
- R M Archer
- Massey University Veterinary Teaching Hospital, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
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Javsicas L, Giguère S, Maisenbacher H, Schmidt M, Frederick J, Conway J, Estrada A. Percutaneous Transcatheter Closure of an Aorto-Cardiac Fistula in a Thoroughbred Stallion Using an Amplatzer Occluder Device. J Vet Intern Med 2010; 24:994-8. [DOI: 10.1111/j.1939-1676.2010.0523.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Jenni SD, Vogt P, Jenni R, Glaus TM. Dissection of a Patent Ductus Arteriosus with Right Heart Failure in an Adult Dog. J Vet Intern Med 2007. [DOI: 10.1111/j.1939-1676.2007.tb03001.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Slack JA, McGuirk SM, Erb H, Lien L, Coombs D, Semrad SD, Riseberg A, Marques F, Darien B, Fallon L, Burns P, Murakami MA, Apple FS, Peek SF. Biochemical Markers of Cardiac Injury in Normal, Surviving Septic, or Nonsurviving Septic Neonatal Foals. J Vet Intern Med 2005. [DOI: 10.1111/j.1939-1676.2005.tb02730.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Abstract
A seven-month-old male Standardbred was referred with a 4-month history of left jugular groove distension. On physical examination severely dilated left maxillary, linguofacial and jugular veins were appreciable. Blood gas analysis results indicated higher degree of oxygenation in the left jugular vein. Bi-directional flow signals, with normal systolic and early diastolic flow, and late diastolic retrograde flow, were noted on pulsed-wave Doppler interrogation and color flow mapping of the left jugular blood flow. A systolic-diastolic signal with spectral broadening was detected when positioning the sample gate near the internal jugular wall, in the distal left cervical region. Color Doppler imaging of the same region showed blood flow passage between the left common carotid artery and the left jugular vein through a small carotid-jugular fistula. Markedly increased blood flow velocities and volumetric flow, and decreased resistive index were recorded in the left compared to the right common carotid artery.
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Affiliation(s)
- Carlo Guglielmini
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, University of Padova, Agripolis, I-35020 Legnaro (PD), Italy
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32
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Waldrop JE, Stoneham AE, Tidwell AS, Jakowski RM, Rozanski EA, Rush JE. Aortic Dissection Associated with Aortic Aneurysms and Posterior Paresis in a Dog. J Vet Intern Med 2003. [DOI: 10.1111/j.1939-1676.2003.tb02438.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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