Electrocardiographic findings in dogs with motor vehicle-related trauma

Cardiac laceration following non-penetrating chest trauma in dog and cat

Cardiac laceration with non-penetrating chest trauma is reported as a common cause of death in human following rapid deceleration in high-speed vehicular accident. In contrast, in veterinary medicine, traumatic rupture of heart and great-vessel structures appears to be an uncommon cause of death. Here we report three cases of cardiac laceration following non-penetrating chest trauma in a one cat and two dogs. In two of these cases, necropsy revealed a rupture of the heart associated with fractures of the ribs and lung contusion; only one case did not exhibit any external chest injury but revealed pericardial tear associated with hemothorax following rupture of the right auricle of the heart. However, in all three presented cases, the thoracic location of the injuries allowed to conclude that the cause of the cardiac rupture was due to a direct impact of the chest wall with a high speed object and consequent transmission of the kinetic force and compression of the heart between left and right thorax. These case reports underline the importance of a systematic and complete macroscopic evaluation of the heart in all cases of death following non-penetrating chest trauma in dog and cat such as in human. They also highlight how, in clinical and forensic practice, the cardiac injury following blunt chest trauma should be ruled out even in the cases of absence of external chest injury.

Severe blunt trauma in dogs: 235 cases (1997-2003)

OBJECTIVE

To evaluate population characteristics, injuries, emergency diagnostic testing, and outcome of dogs with blunt trauma requiring intensive care in an urban hospital.

DESIGN

Retrospective study 1997-2003.

SETTING

All data obtained from the University of Pennsylvania - Matthew J. Ryan Veterinary Hospital.

ANIMALS

Dogs admitted to the intensive care unit for treatment following blunt trauma.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Of the 235 dogs that met inclusion criteria, 206 (88%) survived and 29 (12%) did not survive. Blunt vehicular trauma accounted for 91.1% of cases. Mild hyperglycemia and hyperlactatemia was common in both survivors and nonsurvivors. The chest was the most common region traumatized and the prevalence of polytrauma was 72.3%. Initial weight, vital signs, PCV, total plasma protein, BUN, glucose, lactate, acid-base status, and electrolytes did not differ between survivors and nonsurvivors. Nonsurvivors were significantly more likely to have had head trauma (P=0.008), cranium fractures (P<0.001), recumbency at admission (P<0.001), development of hematochezia (P<0.001), clinical suspicion of acute respiratory distress syndrome (P<0.001), disseminated intravascular coagulation (P<0.001), multiorgan dysfunction syndrome (P<0.001), development of pneumonia (P<0.001), positive-pressure ventilation (P<0.001), vasopressor use (P<0.001), and cardiopulmonary arrest (P<0.001).

CONCLUSIONS

Outcome of severe blunt trauma in dogs treated with intensive care is very good. Despite the high survival rate, several features associated with poor outcome were identified. Neither admission lactate nor glucose was able to predict outcome.

Eletrocardiografia pré-operatória em 474 cães

Foram realizadas avaliações eletrocardiográficas pré-operatórias em 474 cães, machos e fêmeas, com o objetivo de analisar a frequência de alterações eletrocardiográficas e sua relação com indicação cirúrgica, sexo, idade, raça, peso, escore corporal (obesidade), histórico e sinais físicos de doenças cardíacas. As alterações eletrocardiográficas foram observadas em 220 animais (46%), sendo mais frequentes nos machos (n=116; 52,7%). O aumento na duração do QRS foi a alteração mais observada (n=54; 24,5%). Sugere-se o exame eletrocardiográfico de rotina na avaliação pré-cirúrgica, independentemente de idade, peso, histórico ou sinais físicos de cardiopatia.

Comparison of Acute Hemodynamic Effects of Lidocaine and Procainamide for Postoperative Ventricular Arrhythmias in Dogs

Heart rate and systolic, diastolic, and mean pressures were measured in two groups of dogs during treatment of postoperative ventricular arrhythmias either with intravenous (IV) 2% lidocaine hydrochloride or procainamide hydrochloride. Hemodynamic parameters were not significantly changed after IV administration of either drug. Additionally, changes in hemodynamic parameters for dogs treated with 2% lidocaine were not significantly different from those of dogs treated with procainamide. When dosed appropriately in the clinical setting, one bolus of IV procainamide was safe for the treatment of postoperative ventricular arrhythmias.

Evaluation of spontaneous variability in the frequency of ventricular arrhythmias in Boxers with arrhythmogenic right ventricular cardiomyopathy

OBJECTIVE

To evaluate spontaneous variability in the frequency of ventricular arrhythmias and assess the influence of day of ECG recording and day of week on arrhythmia frequency in Boxers affected with arrhythmogenic right ventricular cardiomyopathy (ARVC).

DESIGN

Prospective study.

ANIMALS

10 Boxers with ARVC with prior ambulatory ECG recordings that included > or = 500 ventricular premature complexes/24 h.

PROCEDURE

Consecutive 24-hour ambulatory ECG recordings were obtained during a 7-day period in each dog. The number of ventricular premature complexes and grade of the arrhythmia were obtained from each recording. For each dog, the number of ventricular premature complexes for each recording was evaluated to identify any differences relative to the day of recording (recording 1 to 7) and day of the week (Monday through Sunday).

RESULTS

Spontaneous variability accounted for as much as 80% of the change in frequency of ventricular premature complexes in dogs with frequent arrhythmias; this value was almost 100% in dogs with less frequent arrhythmias. Grade of arrhythmia was less variable but was also inversely related to frequency of arrhythmia. No significant differences in frequency values were identified among days of recording or among days of the week.

CONCLUSIONS AND CLINICAL RELEVANCE

Changes of < or = 80% in the frequency of ventricular arrhythmias may be within the limit of spontaneous variability in dogs with ARVC. This degree of variability should be considered in evaluations of ambulatory ECG recordings, particularly in the assessment of the efficacy of antiarrhythmic drugs.

Feline orthopedics

Although many aspects of canine care do cross over to the feline patient, the adage "cats are not small dogs" holds more true today than ever. The area of feline orthopedics is no different. The purpose of this article is to familiarize the reader with the more common feline orthopedic problems. Although many nonsurgical aspects are covered, the majority of text discusses surgical orthopedic problems. In addition, situations considered unique to the feline patient are addressed, including preoperative, perioperative, and postoperative concerns. Diagnostics and implant systems are also covered.