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Hellemans A, Devriendt N, Duchateau L, Devreese KMJ, De Somer F, Bosmans T, Mampaey G, Smets P. Evaluation of the use of a heparin dose-response test in dogs to determine the optimal heparin dose during intravascular procedures and assessment of the in vitro heparin response in healthy dogs. Vet Med Sci 2024; 10:e1326. [PMID: 37987511 PMCID: PMC10951632 DOI: 10.1002/vms3.1326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/05/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND No guidelines for administering and monitoring anticoagulants intraprocedurally are currently available in dogs, despite the prevalence of procedures necessitating systemic anticoagulation with heparin. OBJECTIVES To evaluate an activated clotting time (ACT)-based heparin dose-response (HDR) test to predict the individual required heparin dose in dogs during intravascular procedures, and to investigate both the in vitro heparin - ACT and in vitro heparin - factor anti-Xa activity (anti-Xa) relationships in dogs. METHODS Blood was collected from eight healthy beagles undergoing a cardiac procedure and utilised to establish baseline ACT and for in vitro evaluation. Subsequently, 100 IU/kg heparin was administered intravenously (IV) and ACT was remeasured (HDR test). The required heparin dose for an ACT target response ≥300 s was calculated for each individual and ACT was remeasured after administration of this dose. For in vitro testing, a serial heparin blood dilution (0-0.5-1-2-4 international unit (IU)/mL) was prepared and ACT and anti-Xa were determined using whole blood and frozen plasma, respectively. RESULTS The HDR test overestimated the required heparin dose in 3/7 dogs. In vitro, ACT and anti-Xa increased significantly with increasing blood heparin concentration. Heparin - ACT was nonlinear in 4/8 dogs at heparin concentrations >2 IU/mL, whereas heparin - anti-Xa remained linear throughout the tested range. CONCLUSIONS The HDR test poorly estimated the required heparin dose in dogs. This is most likely attributed to a nonlinear heparin - ACT relationship, as observed in vitro. Anti-Xa is a promising alternative for ACT; however, unavailability as a point-of-care test and lack of in vivo target values restrict its current use.
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Affiliation(s)
- A. Hellemans
- Faculty of Veterinary MedicineSmall Animal DepartmentGhent UniversityMerelbekeBelgium
| | - N. Devriendt
- Faculty of Veterinary MedicineSmall Animal DepartmentGhent UniversityMerelbekeBelgium
| | - L. Duchateau
- Faculty of Veterinary MedicineBiometrics Research CenterGhent UniversityMerelbekeBelgium
| | - K. M. J. Devreese
- Coagulation LaboratoryFaculty of MedicineDepartment of Diagnostic SciencesGhent University HospitalGhent UniversityGhentBelgium
| | - F. De Somer
- Faculty of Medical SciencesDepartment of Cardiac SurgeryGhent UniversityGhentBelgium
- Experimental Research Laboratory of Cardiac Surgery and Circulatory PhysiologyFaculty of Medical SciencesGhent UniversityGhentBelgium
| | - T. Bosmans
- Faculty of Veterinary MedicineSmall Animal DepartmentGhent UniversityMerelbekeBelgium
| | - G. Mampaey
- Faculty of Veterinary MedicineSmall Animal DepartmentGhent UniversityMerelbekeBelgium
| | - P. Smets
- Faculty of Veterinary MedicineSmall Animal DepartmentGhent UniversityMerelbekeBelgium
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Kim G, Ji Y, Jeong HG, Lee T, Lee K, Yoon H. Case report: Imaging features of aorta-right atrial tunnel in a dog using two-dimensional echocardiography and computed tomography. Front Vet Sci 2023; 10:1160390. [PMID: 37465274 PMCID: PMC10352079 DOI: 10.3389/fvets.2023.1160390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/19/2023] [Indexed: 07/20/2023] Open
Abstract
A 7-year-old castrated male Pomeranian dog weighing 5 kg presented with a right-sided continuous murmur without any clinical signs. Thoracic radiographs indicated cardiomegaly and right atrial (RA) bulging. Echocardiography revealed a tunnel originating from the right coronary sinus of Valsalva and terminating in the RA. Contrast echocardiography revealed pulmonary arteriovenous anastomoses. Computed tomography (CT) demonstrated a tortuous shunting vessel that originated from the aorta extending in a ventral direction, ran along the right ventricular wall, and was inserted into the RA. Based on these diagnostic findings, the dog was diagnosed with the aorta-RA tunnel. At the 1-year follow-up visit without treatment, the dog showed no significant change except for mild left ventricular volume overload and mildly decreased contractility. To the best of our knowledge, this is the first case report of an aorta-RA tunnel that has been described in detail using echocardiography and CT in a dog. In conclusion, the aorta-RA tunnel should be included in the clinical differential diagnoses if a right-sided continuous murmur is heard or shunt flow originating from the aortic root is identified.
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Affiliation(s)
- Geunha Kim
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
| | - Yewon Ji
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
| | | | - Taekwon Lee
- Animal Medical Center, Jeonju, Republic of Korea
| | - Kichang Lee
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
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Agudelo CF, Jekl V, Hauptman K, Crha M, Kocaturk M. A case of a complete atrioventricular canal defect in a ferret. BMC Vet Res 2021; 17:45. [PMID: 33482816 PMCID: PMC7821679 DOI: 10.1186/s12917-020-02736-2] [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: 11/02/2020] [Accepted: 12/25/2020] [Indexed: 11/24/2022] Open
Abstract
Background Atrioventricular canal defect is a rare congenital disorder of the heart and describes the presence of an atrial septal defect, a variable presentation of ventricular septal alterations including ventricular septal defect malformations in the mitral and tricuspid valves. The defect has been described in human beings, dogs, cats, pigs, and horses. Case presentation This paper describes the case of a complete atrioventricular canal defect in a four-year-old intact male pet ferret (Mustela putorius furo), which was presented due to posterior weakness, ataxia, and decreased appetite. A loud systolic murmur, dyspnea, and hind limb paraparesis were detected during the clinical examination. Thoracic radiographs showed generalized cardiomegaly and lung edema. ECG showed sinus rhythm with prolonged P waves and QRS complexes. Echocardiography showed a large atrial septal defect, atrioventricular dysplasia, and a ventricular septal defect. Palliative treatment with oxygen, furosemide, spironolactone, enalapril, diltiazem, and supportive care was chosen as the therapy of choice. The ferret recovered gradually during hospitalization. A follow-up examination at three and six months showed stabilization of cardiac function. Conclusions To the authors knowledge, this is the first time an atrioventricular canal defect has been described in a pet ferret.
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Affiliation(s)
- Carlos F Agudelo
- Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Palackého tř. 1946/1, 612 42, Brno, Czech Republic.
| | - Vladimír Jekl
- Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Palackého tř. 1946/1, 612 42, Brno, Czech Republic.,Department of Pharmacology and Pharmacy, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic.,Jekl & Hauptman Veterinary Clinic, Brno, Czech Republic
| | - Karel Hauptman
- Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Palackého tř. 1946/1, 612 42, Brno, Czech Republic.,Department of Pharmacology and Pharmacy, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic.,Jekl & Hauptman Veterinary Clinic, Brno, Czech Republic
| | - Michal Crha
- Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Palackého tř. 1946/1, 612 42, Brno, Czech Republic
| | - Meric Kocaturk
- Department of Internal Medicine, Uludag University Faculty of Veterinary Medicine, Bursa, Turkey
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Pulmonary artery banding in a kitten with a partial atrioventricular septal defect. J Vet Cardiol 2019; 24:20-27. [PMID: 31405551 DOI: 10.1016/j.jvc.2019.05.003] [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: 10/23/2018] [Revised: 05/02/2019] [Accepted: 05/07/2019] [Indexed: 11/22/2022]
Abstract
A 9-month-old kitten with increased resting respiratory rate and exercise intolerance was diagnosed with a congenital partial atrioventricular septal defect causing pulmonary over circulation and presumed pulmonary hypertension based on echocardiogram. Invasive pressure measurements and contrast angiography confirmed this diagnosis. The cat underwent pulmonary artery banding under general anesthesia. Findings of echocardiogram 10 days postoperatively suggested reduced left-to-right shunt volume. Echocardiographic findings were static 4 months postoperatively.
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Di Girolamo N, Palmieri C, Baron Toaldo M, Nicoletti A, Spattini G, Zeyen U, Selleri P. First Description of Partial Atrioventricular Septal Defect in a Rabbit. J Exot Pet Med 2018. [DOI: 10.1053/j.jepm.2017.10.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Goya S, Kanno N, Teshima K, Anndo T, Fujioka T. Surgery for partial atrioventricular septal defect with pulmonary hypertension in an adult dog. J Vet Med Sci 2018; 80:1183-1189. [PMID: 29877312 PMCID: PMC6068305 DOI: 10.1292/jvms.17-0509] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 4-year-old, 5.9-kg female Japanese Spitz presented with syncope and exercise intolerance. Echocardiography revealed an ostium primum atrial septal defect (ASD), a cleft mitral valve,
mitral valve regurgitation (MR), and tricuspid regurgitation (TR) (velocity: 3.6 m/sec, pressure gradient: 52 mmHg), leading to a diagnosis of partial atrioventricular septal defect (AVSD)
with moderate pulmonary hypertension (PH). Open-heart surgery using cardiopulmonary bypass was performed through right atriotomy. The cleft of the mitral valve was sutured with polypropylene
and the AVSD was closed using an autologous pericardial patch fixed with glutaraldehyde. No postoperative pulmonary hypertensive crisis occurred. Shunting flow through the ASD, TR and PH had
completely disappeared 2 months postoperatively; however, moderate MR persisted. The dog is still alive 5 years postoperatively without clinical signs.
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Affiliation(s)
- Seijirow Goya
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu-shi, Tokyo 183-8509, Japan
| | - Nobuyuki Kanno
- Veterinary Cardiovascular Medicine and Surgery Unit, Laboratory of Veterinary Internal Medicine, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Kenji Teshima
- Laboratory of Veterinary Anesthesiology & Respiratory Research, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Takanori Anndo
- Heart Will Animal Hospital, 1-2-14 Okidai, Tobata, Kitakyushu, Fukuoka 804-0064, Japan
| | - Takahiro Fujioka
- ASAP Animal Clinic, 3597-1 Kannda, Nougata-shi, Fukuoka 822-0001, Japan
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Pelosi A, Anderson LK, Paugh J, Robinson S, Eyster GE. Challenges of cardiopulmonary bypass-a review of the veterinary literature. Vet Surg 2012; 42:119-36. [PMID: 23164065 DOI: 10.1111/j.1532-950x.2012.01008.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cardiopulmonary bypass (CPB) has been used in veterinary medicine in experimental surgery and to address congenital and acquired diseases. We review the veterinary literature and expose common challenges of CPB in dogs and cats. Specifically, we describe the most specific elements of this technique in veterinary patients. The variety in animal size has made it difficult to standardize cannulation techniques, oxygenators, and priming volumes and solutions. The fact that one of the most common cardiovascular disorders, mitral valve disease, occurs predominantly in small dogs has limited the use of bypass in these patients because of the need for small, low prime oxygenators and pumps that have been unavailable until recently. Coagulation, hemostasis, and blood product availability have also represented important factors in the way CPB has developed over the years. The cost and the challenges in operating the bypass machine have represented substantial limitations in its broader use.
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Affiliation(s)
- Augusta Pelosi
- Small Animal Clinical Sciences, Michigan State University, East Lansing, MI 48824-1314, USA.
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Yamano S, Uechi M, Tanaka K, Hori Y, Ebisawa T, Harada K, Mizukoshi T. Surgical Repair of a Complete Endocardial Cushion Defect in a Dog. Vet Surg 2011; 40:408-12. [DOI: 10.1111/j.1532-950x.2011.00797.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rioja E, Beaulieu K, Holmberg DL. Anesthetic management of an off-pump open-heart surgery in a dog. Vet Anaesth Analg 2009; 36:361-8. [PMID: 19470140 DOI: 10.1111/j.1467-2995.2009.00465.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBSERVATIONS A 9 year-old, 40 kg, female spayed Bouvier des Flandres was anesthetized for surgical removal of an intra-cardiac mass. Pre-anesthetic work-up included thoracic radiographs, which revealed moderate pleural effusion, and cardiac ultrasound, which identified a mass attached to the wall of the right ventricular outflow tract (RVOT). The mass caused dynamic obstruction of the RVOT during systole. The dog was pre-medicated with intravenous (IV) hydromorphone (0.05 mg kg(-1)). Following pre-oxygenation, anesthesia was induced with ketamine (3.75 mg kg(-1), IV) and diazepam (0.18 mg kg(-1), IV). Anesthesia was maintained with isoflurane in oxygen, an intravenous constant rate infusion (CRI) of fentanyl (10-30 microg kg(-1) hour(-1)) and a CRI of lidocaine (50-200 microg kg(-1) minute(-1)). A right lateral thoracotomy was performed. The heart was stopped transiently with a cold cardioplegic solution for 7.83 minutes to allow the removal of the mass through an open-heart procedure. No cardiopulmonary bypass was used. The heart was successfully restarted after cardiopulmonary resuscitation with internal cardiac massage and internal defibrillation. The dog recovered uneventfully from anesthesia without any apparent neurological sequelae. Post-operative analgesia consisted of intercostal nerve blocks with bupivacaine, CRIs of fentanyl (2-5 microg kg(-1) hour(-1)) and lidocaine (40 microg kg(-1) minute(-1)) and with oral meloxicam (0.1 mg kg(-1)). Five days following surgery, the dog was discharged from the hospital. Histopathology and immunohistochemistry of the mass identified an ectopic thyroid carcinoma. CONCLUSIONS This case showed the feasibility of whole body hypothermia and using a cold cardioplegic solution to induce cardiac arrest for a short open-heart procedure.
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Affiliation(s)
- Eva Rioja
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
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Tanaka R, Shimizu M, Hoshi K, Soda A, Saida Y, Takashima K, Yamane Y. Efficacy of open patch-grafting under cardiopulmonary bypass for pulmonic stenosis in small dogs. Aust Vet J 2009; 87:88-93. [DOI: 10.1111/j.1751-0813.2009.00389.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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