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Kuo MYW, Häggström J, Gordon SG, Höglund K, Côté E, Lu TL, Dirven M, Rishniw M, Hung YW, Ljungvall I. Veterinary echocardiographers' preferences for left atrial size assessment in dogs: the BENEFIT project. J Vet Cardiol 2023; 51:157-171. [PMID: 38128421 DOI: 10.1016/j.jvc.2023.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/13/2023] [Accepted: 11/05/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION/OBJECTIVES Veterinary echocardiographers' preferences for left atrial (LA) size assessment in dogs have never been systematically investigated. The primary aim of this international survey study was to investigate echocardiographers' preferences for LA size assessment in dogs. The secondary aim was to investigate echocardiographers' preferences for assessing LA size in subgroups based on geographic, demographic, and professional profiles. ANIMALS, MATERIALS, AND METHODS An online survey instrument was designed, verified, and distributed globally to the veterinary echocardiographers. RESULTS A total of 670 echocardiographers from 54 countries on six continents completed the survey. Most echocardiographers (n = 621) used linear two-dimensional (2D)-based methods to assess LA size, 379 used subjective assessment, and 151 used M-mode-based methods. Most commonly, echocardiographers combined linear 2D-based methods with subjective assessment (n = 222), whereas 191 used linear 2D-based methods alone. Most echocardiographers (n = 436) using linear 2D-based methods preferred the right parasternal short-axis view and indexed the LA to the aorta. Approximately 30% (n = 191) of the echocardiographers who performed linear measurements from 2D echocardiograms shared the same preferences regarding dog position, acquisition view, indexing method, and identification of the time-point used for the measurement. The responses were comparably homogeneous across geographic location, training level, years of performing echocardiography, and type of practice. DISCUSSION/CONCLUSION Most veterinary echocardiographers assessed LA size in dogs using linear 2D echocardiography from a right parasternal short-axis view, and by indexing the LA to the aorta. The respondents' preferences were similar across geographic, demographic, and professional backgrounds.
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Affiliation(s)
- M Y-W Kuo
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - J Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - S G Gordon
- Department of Small Animal Clinical Science, Texas A&M University, College Station, TX, USA
| | - K Höglund
- Department of Anatomy, Physiology and Biochemistry, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - E Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada
| | - T-L Lu
- Chuan Animal Hospital, Taipei, Taiwan
| | - M Dirven
- Evidensia Södra Animal Hospital, Kungens Kurva, Sweden
| | - M Rishniw
- Veterinary Information Network, Davis, CA, USA
| | - Y-W Hung
- Cardiospecial Veterinary Hospital, Taipei, Taiwan
| | - I Ljungvall
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Kuo MYW, Häggström J, Gordon SG, Höglund K, Côté E, Lu TL, Dirven M, Rishniw M, Hung YW, Ljungvall I. Veterinary echocardiographers' preferences for left atrial size assessment in cats: the BENEFIT project. J Vet Cardiol 2023; 51:145-156. [PMID: 38128420 DOI: 10.1016/j.jvc.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 10/13/2023] [Accepted: 11/05/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION/OBJECTIVES Veterinary echocardiographers' preferences for left atrial (LA) size assessment in cats have not been systematically investigated. The primary aim of this prospective exploratory study was to investigate echocardiographers' preferences concerning LA size assessment in cats. A secondary aim was to investigate echocardiographers' preferences for assessing LA size in subgroups based on geographic, demographic, and professional profiles. ANIMALS, MATERIALS, AND METHODS An online survey instrument was designed, verified, and distributed globally to veterinary echocardiographers. RESULTS A total of 655 veterinary echocardiographers from six continents and 54 countries, working in specialty practice (56%) and in general practice (38%), provided data. Linear two-dimensional (2D) technique was favored by most echocardiographers (n = 612) for LA size assessment. Most commonly, respondents combined linear 2D with subjective assessment (n = 227), while 209 used linear 2D-based methods alone. Most echocardiographers using linear 2D-based methods preferred the right parasternal short-axis view and to index the LA to the aorta (Ao). Approximately 10% of the respondents obtained LA dimensions from a right parasternal long-axis four-chamber view. Approximately one-third of echocardiographers that made linear measurements from 2D echocardiograms shared the same preferences regarding cat position, acquisition view, indexing method and time point identification for the LA measurement. The responses were comparably homogeneous across geographic location, level of training, years performing echocardiography, and type of practice. DISCUSSION/CONCLUSION Most veterinary echocardiographers assessed LA size in cats using linear 2D echocardiography from a right parasternal short-axis view, and indexed LA to Ao. Respondents' preferences were similar over geographic, demographic, and professional backgrounds.
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Affiliation(s)
- M Y-W Kuo
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - J Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - S G Gordon
- Department of Small Animal Clinical Science, Texas A&M University, College Station, TX, USA
| | - K Höglund
- Department of Anatomy, Physiology and Biochemistry, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - E Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada
| | - T-L Lu
- Chuan Animal Hospital, Taipei, Taiwan
| | - M Dirven
- Evidensia Södra Animal Hospital, Kungens Kurva, Sweden
| | - M Rishniw
- Veterinary Information Network, Davis, CA, USA
| | - Y-W Hung
- Cardiospecial Veterinary Hospital, Taipei, Taiwan
| | - I Ljungvall
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Agarwal D, Côté E, O'Sullivan L, Meurs KM, Steiner J. Investigation of the cardiac effects of exercise testing on apparently healthy Boxer dogs. J Vet Intern Med 2023; 37:1667-1678. [PMID: 37578273 PMCID: PMC10472998 DOI: 10.1111/jvim.16830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Holter electrocardiographic monitoring is a cornerstone of diagnostic testing for arrhythmogenic cardiomyopathy (ACM) in Boxer dogs, but physical activity during monitoring is not controlled. In humans, exercise testing (ExT) can identify latent tachyarrhythmias associated with cardiomyopathy, and exercise increases serum cardiac troponin-I concentrations ([hs-cTnI]). These effects have not yet been investigated in Boxer dogs. HYPOTHESIS/OBJECTIVES Subjecting Boxer dogs to brief, moderate-intensity ExT can identify changes in Holter recordings and [hs-cTnI] compared to baseline results. ANIMALS Thirty overtly healthy, client-owned Boxer dogs. METHODS Prospective interventional study. Dogs underwent baseline diagnostic testing including 24-hour Holter monitoring and [hs-cTnI], followed by brief ExT (accompanied, brisk stair-climbing and -descending for <5 minutes). RESULTS Eleven dogs (37%) had >100 premature ventricular complexes (PVCs)/24 hours at baseline (3), ExT (3), or both (5). After ExT, these dogs had more PVCs/24 hours and greater increases in [hs-cTnI] compared to those with ≤100 PVCs/24 hours. Dogs with the striatin mutation had more PVCs/24 hours and a greater increase in [hs-cTnI] after ExT than did dogs without the striatin mutation. CONCLUSIONS AND CLINICAL IMPORTANCE Exercise testing may improve the binary classification of Boxer dogs with or without ACM by increasing the number of PVCs and [hs-cTnI] in affected dogs to a greater degree than in unaffected dogs. This effect also is associated with presence or absence of the striatin mutation. Exercise should be a controlled variable when screening Boxer dogs for ACM.
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Affiliation(s)
- Deepmala Agarwal
- Department of Companion Animals, Atlantic Veterinary CollegeUniversity of Prince Edward Island, 550 University AvenueCharlottetown, Prince Edward Island C1A 4P3Canada
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary CollegeUniversity of Prince Edward Island, 550 University AvenueCharlottetown, Prince Edward Island C1A 4P3Canada
| | - Lynne O'Sullivan
- Department of Companion Animals, Atlantic Veterinary CollegeUniversity of Prince Edward Island, 550 University AvenueCharlottetown, Prince Edward Island C1A 4P3Canada
| | - Kathryn M. Meurs
- Department of Clinical Sciences, College of Veterinary MedicineNorth Carolina State University, 1060 William Moore DriveRaleigh, North Carolina 27607USA
| | - Jörg Steiner
- Gastrointestinal LaboratorySchool of Veterinary Medicine and Biomedical Sciences, TAMU 4474, Texas A&M UniversityCollege Station, Texas 77843‐4474USA
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Hubbard IM, Hamilton TR, Côté E. Surgical removal of an embolized intravenous catheter fragment from the axillobrachial vein of a dog. Can Vet J 2022; 63:1217-1220. [PMID: 36467374 PMCID: PMC9648480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
An 8-month-old neutered male miniature Australian shepherd was examined for evaluation and treatment of suspected embolization of a peripheral intravenous catheter fragment. Embolism had occurred after the catheter cannula was accidentally cut during removal from the right cephalic vein. Radiographs showed migration of the fragment to the proximolateral right brachium. Surgical exploration, assisted by fluoroscopy, localized the fragment to the axillobrachial vein, where the tip was visualized within the vessel lodged against the wall. A venotomy was performed, allowing the fragment to be extracted from the peripheral vessel before it could migrate farther. The dog recovered from surgery without complication and was discharged the following day. Key clinical message: In the case reported here, the axillobrachial vein was a clinically important location on the migration path of a cephalic intravenous catheter embolus. Fluoroscopy allowed for quick localization of an embolized intravenous catheter fragment within a peripheral vein and directed open surgical retrieval of the foreign body. A peripheral catheter fragment can be retrieved surgically from a vein in a limb even when a tourniquet has not been applied immediately.
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Ettorre L, Longchamp J, Longchamp A, Trunfio R, D'Amico R, Wuarin L, Côté E, Deslarzes-Dubuis C, Déglise S. Preliminary experience with the new off-the-shelf 4 inner branches E-nside for the treatment of complex aortic disease. Br J Surg 2022. [DOI: 10.1093/bjs/znac189.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Objective
In case of complex aortic aneurysmal disease, fenestrated or branched EVAR (b/f-EVAR) is considered as a valid and safe alternative to open surgery. However, one the main limitation is the time required for manufacture, limiting its use in emergent situations. The new off-the-shelf 4 inner branches E-nside (Jotec, Hechingen, Germany) has been developed to offer a solution in such circumstances. The aim of this study was to report our preliminary monocentric experience with this new device.
Methods
Retrospective analysis of prospective data retrieved from 1 center between November 2020 and January 2022 was done. Endpoints were technical success, postoperative morbidity, rate of endoleak and any aneurysm-related re-interventions during follow-up.
Results
In this study, 15 patients (mean age 73 years, range 59–90) were identified. There was a majority of male (9/15) and all of them but 3 were asymptomatic. The mean aneurysmal diameter was 60 mm (range 50–100). There were 3 cases of juxtarenal aortic aneurysms (20%), 1 Crawford type I (7%), 4 type II (27%), 4 type III (27%) and 3 type IV (20%) aneurysms. In 7 cases, a 2-steps procedure was done with a TEVAR first followed by Enside implantation. There was a technical success in 93% with 1 open conversion for a mesenterical bypass. There was no death in the post-operative period. During the post-operative period, 33% of patients (5/15) presented complications with 3 complications related to the femoral or iliac access and 2 cases of spinal cord ischemia (13%). One case occurred in an emergent setting of a type III aneurysm rupture. The other case was the open conversion and the patient also developed a colic ischemia and finally died 4 months alter. The mean length of stay was 9 days. During the follow-up, 2 reinterventions were necessary, 1 for a type Ic endoleak with distal prolongation of the stent and 1 renal stent occlusion treated by relining. The overall target vessel patency was 98%.
Conclusion
The use of the off-the-shelf 4 inner branches E-nside appears to be safe with good technical success for the treatment of complex aortic aneurysmal disease. It is associated with an acceptable rate of complications and allows for treatment of a wide variety of diseases in an emergent setting. Further patients and longer follow-up are required to better evaluate the exact role of this new device.
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Affiliation(s)
- L Ettorre
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - J Longchamp
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - A Longchamp
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - R Trunfio
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - R D'Amico
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - L Wuarin
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - E Côté
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - C Deslarzes-Dubuis
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - S Déglise
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
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Kiesworo K, Longchamp J, Brusa J, Côté E, Agius T, Macarthur M, Mitchell S, Deslarzes C, Corpataux JM, Allagnat F, Collet TH, Ozaki CK, Déglise S, Longchamp A. Design of the OptiSurg trial: Multicenter open-label randomized controlled trial of time restricted feeding (TRF) vs regular dietary advices in patient undergoing femoral endarterectomy. Br J Surg 2022. [DOI: 10.1093/bjs/znac189.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Objective
Vascular patients suffer some of the highest complications rates. Surprisingly, there is no uniformly accepted medical therapy to reduce complications in these patients. Time restricted feeding (TRF) is an approach that emphasizes energy intake limited to certain windows of time within the 24-hour cycle, without restrictions on any calories or macronutrients. In healthy young human, TRF improves cardio-metabolic fitness. However, there is a lack of research on TRF in patient undergoing surgery, and suffering from cardiovascular diseases. This study aims to investigate the feasibility and efficacy of a pre-operative 2-week, 10-hour TRF in patient undergoing vascular surgery.
Methods
The OptiSurg Study is a randomized open-label clinical trial, that plan to enroll 40 patients, undergoing elective femoral endarterectomy. Only Fontaine stage II peripheral artery disease, and a BMI ≥ 20 kg/m2 are included. Patients are randomized with a 1:1 ratio to either the control or intervention group. The control group receives diet nutritional counselling (standard of care, SOC). The intervention group receives the same SOC and a self-selected 10-hour TRE window. After the surgery, patients will be on SOC only, and followed every 3 months up to 1 year. Primary endpoint is a composite of death, myocardial infarction, stroke, and surgical re-intervention at 1 month post-operative. Blood glucose, body weight, body composition, biomarkers (neuroendocrine, inflammatory and metabolic), sleep and quality of life will also be examined. Temporal calorie intake is monitored with the smartphone application myCircadianClock preoperatively. VascuQoL-6 is used to monitor quality of life.
Results
9 participants were enrolled since the start of the recruitment in February 2021, 4 were randomized in the 8 hours TRF intervention, and 5 to SOC. They all completed the study: 7 men and 2 women, age 73, 53–87 (median, min-max) years. Using the myCircadianClock app, adherence to the TRF was >90% (Figure 1).
Conclusion
Our preliminary experience seems to demonstrate that a 2-week TRF regimen before vascular surgery is feasible. The complete results will be disseminated through future peer-reviewed manuscripts, reports and presentations.
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Affiliation(s)
- K Kiesworo
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - J Longchamp
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - J Brusa
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - E Côté
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - T Agius
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - M Macarthur
- Department of Health Sciences and Technology , ETH Zurich, Zurich, Switzerland
| | - S Mitchell
- Department of Health Sciences and Technology , ETH Zurich, Zurich, Switzerland
| | - C Deslarzes
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - J-M Corpataux
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - F Allagnat
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - T-H Collet
- Department of Endocrinology, Geneva University Hospital , Geneva, Switzerland
| | - C-K Ozaki
- Brighamn and Women's Hospital Vascular Surgery, , Boston, USA
| | - S Déglise
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - A Longchamp
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
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Schober KE, Fox PR, Abbott J, Côté E, Luis‐Fuentes V, Matos JN, Stern JA, Visser L, Scollan KF, Chetboul V, Schrope D, Glaus T, Santilli R, Pariaut R, Stepien R, Arqued‐Soubeyran V, Toaldo MB, Estrada A, MacDonald K, Karlin ET, Rush J. Retrospective evaluation of hypertrophic cardiomyopathy in 68 dogs. J Vet Intern Med 2022; 36:865-876. [PMID: 35322461 PMCID: PMC9151492 DOI: 10.1111/jvim.16402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There is a lack of clinical data on hypertrophic cardiomyopathy (HCM) in dogs. HYPOTHESIS/OBJECTIVES To investigate signalment, clinical signs, diagnostic findings, and survival in dogs with HCM. ANIMALS Sixty-eight client-owned dogs. METHODS Retrospective multicenter study. Medical records were searched between 2003 and 2015. The diagnosis of left ventricular (LV) hypertrophy was made by echocardiographic examination. RESULTS Three hundred and forty-five dogs with LV hypertrophy were identified, of which 277 were excluded. The remaining 68 dogs were 0.3 to 14 years old and predominantly <10 kg (85%), and without a sex predilection. Twenty-four % were Shih Tzu and 24% terrier breeds. Most (80%) had a systolic heart murmur. Owner-determined exercise intolerance (37%) and syncope (18%) were most commonly reported signs. The majority (84%) of dogs had symmetrical LV hypertrophy, whereas asymmetrical septal and LV free wall hypertrophy was observed in 9% and 6% of dogs, respectively. Isolated basal interventricular septal hypertrophy was not observed. Commonly recorded were systolic anterior motion of the mitral valve (60%) and LV diastolic dysfunction (89% of dogs where diastolic function was evaluated). Six dogs died unexpectedly, and 3 developed congestive heart failure. Known survival times were between 1 day and 114 months after diagnosis. CONCLUSIONS AND CLINICAL IMPORTANCE Hypertrophic cardiomyopathy in dogs should be considered as a differential diagnosis if LV hypertrophy is identified. Small breed dogs are overrepresented, and it is uncommon for dogs with HCM to develop CHF although sudden death can occur.
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Affiliation(s)
- Karsten E. Schober
- Department of Veterinary Clinical SciencesThe Ohio State UniversityColumbusOhioUSA
| | - Phillip R. Fox
- Department of CardiologyThe Animal Medical CenterNew YorkNew YorkUSA
| | - Jonathan Abbott
- Department of Small Animal Clinical SciencesUniversity of TennesseeKnoxvilleTennesseeUSA
| | - Etienne Côté
- Ecole Nationale Vétérinaire d'Alfort, Unite de Cardiologie d'Alfort (UCA)Université Paris‐EstMaisons‐AlfortFrance
| | | | - Jose Novo Matos
- Clinical Sciences and ServicesRoyal Veterinary CollegeLondonUK
- Clinic for Small Animal Internal MedicineUniversity of ZürichZürichSwitzerland
| | - Joshua A. Stern
- Department of Medicine and EpidemiologyUniversity of CaliforniaDavisCaliforniaUSA
| | - Lance Visser
- Department of Medicine and EpidemiologyUniversity of CaliforniaDavisCaliforniaUSA
| | | | - Valerie Chetboul
- Atlantic Veterinary CollegeUniversity of Prince Edward IslandPrince Edward IslandCanada
| | - Donald Schrope
- Department of CardiologyOradell Animal HospitalParamusNew JerseyUSA
| | - Tony Glaus
- Clinic for Small Animal Internal MedicineUniversity of ZürichZürichSwitzerland
| | | | - Romain Pariaut
- Department of Clinical SciencesCornell College of Veterinary MedicineIthacaNew YorkUSA
| | - Rebecca Stepien
- Department of Medical SciencesUniversity of Wisconsin School of Veterinary MedicineMadisonWisconsinUSA
| | - Vanessa Arqued‐Soubeyran
- Ecole Nationale Vétérinaire d'Alfort, Unite de Cardiologie d'Alfort (UCA)Université Paris‐EstMaisons‐AlfortFrance
| | - Marco Baron Toaldo
- Clinic for Small Animal Internal MedicineUniversity of ZürichZürichSwitzerland
| | - Amara Estrada
- Department of Small Animal Clinical SciencesUniversity of FloridaGainesvilleFloridaUSA
| | | | - Emily T. Karlin
- Cummings School of Veterinary MedicineTufts UniversityNorth GraftonMassachusettsUSA
| | - John Rush
- Cummings School of Veterinary MedicineTufts UniversityNorth GraftonMassachusettsUSA
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Côté E, Weisse C, Lamb K, Tozier E. Computed tomographic assessment of principal bronchial anatomy in dogs of various thoracic conformations: 93 cases (2012-2017). J Am Vet Med Assoc 2022; 260:1-10. [PMID: 35417410 DOI: 10.2460/javma.20.12.0716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To better understand spatial relationships between principal bronchi and other intrathoracic structures by use of CT images of dogs of various somatotypes. ANIMALS 93 dogs that underwent thoracic CT. PROCEDURES Information was collected from medical records regarding signalment and physical examination and echocardiographic findings. Two investigators recorded multiple measurements on a thoracic axial CT image from each dog. RESULTS Thoracic height-to-width ratio (H:W) was associated with left principal bronchus (LPB) and right principal bronchus (RPB) H:W, aortic-LPB separation, focal LPB narrowing, and aortic-vertebral overlap. Thoracic H:W was not associated with dog age, weight, sex, or brachycephalic breed. Twenty-five (27%) dogs had focal LPB narrowing, compared with 5 (5%) dogs with focal RPB narrowing (P < 0.001). Ten of 25 dogs had overlap or contact between vertebrae, aorta, LPB, and heart, suggesting a cumulative compressive effect on the LPB, while 15 had LPB-aorta contact and lack of contact between the aorta and thoracic vertebrae, suggesting an aortic constrictive effect on the LPB. None had LPB narrowing without contact from surrounding structures. Inter-rater agreement was high. CLINICAL RELEVANCE In dogs that underwent CT and were not selected for clinical suspicion of bronchial disease, principal bronchial morphology was associated with thoracic conformation. Focal LPB narrowing occurred more often than RPB narrowing. Focal LPB narrowing occurred with evidence of extraluminal compression, with or without contact between aorta and vertebrae. Brachycephalic breed could not be used for predicting thoracic H:W.
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Affiliation(s)
- Etienne Côté
- 1Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Chick Weisse
- 2Department of Interventional Radiology & Endoscopy, The Animal Medical Center, New York, NY
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Côté E, O'Sullivan ML, Agarwal D, Santilli R. Left Atrial Tachycardia and Third-Degree Atrioventricular Block in a Dog. CASE 2022; 6:83-86. [PMID: 35492289 PMCID: PMC9050603 DOI: 10.1016/j.case.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
SVT may affect only the LA in the dog. Spectral and 2D Doppler echocardiography help confirm that an SVT is confined to the LA. Left atrial SVT was identified by comparing MV and TV inflows via spectral Doppler.
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Côté E, Zwicker LA, Anderson EL, Stryhn H, Yu J, Andersen E. Effects of dexmedetomidine and its reversal with atipamezole on echocardiographic measurements and circulating cardiac biomarker concentrations in normal cats. J Am Vet Med Assoc 2022; 260:1-9. [PMID: 35175929 DOI: 10.2460/javma.21.06.0299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the effects of dexmedetomidine (DXM) and its subsequent reversal with atipamezole (APM) on the echocardiogram and circulating concentrations of cardiac biomarkers in cats. ANIMALS 14 healthy cats. PROCEDURES Cats underwent echocardiography and measurements of circulating cTn-I and NT-proBNP concentrations before (PRE) and during (INTRA) DXM sedation (40 µg/kg IM) and 2 to 4 (2H POST) and 24 (24H POST) hours after reversal with APM. RESULTS Administering DXM significantly decreased heart rate, right ventricular and left ventricular (LV) outflow tract velocities, and M-mode-derived LV free-wall thickness; increased LV end systolic diameter and volume; and caused valvar regurgitation. While sedative effects resolved within 25 minutes of APM reversal, the evolution of echocardiographic changes was mixed: LV ejection fraction and mitral valvar regurgitation score were different at 2H POST than at both INTRA and PRE (partial return toward baseline), LV end-diastolic volume was different PRE to INTRA and INTRA to 2H POST but not different PRE to 2H POST (full return toward baseline), and M-mode-derived LV free-wall thickness was significantly different from PRE to INTRA and PRE to 2H POST (no return toward baseline). Serum cTn-I and plasma NT-proBNP concentrations increased significantly with DXM, which remained significant 2H POST. CLINICAL RELEVANCE Administration of DXM and APM reversal produced changes in echocardiographic results and in circulating cTn-I and NT-proBNP concentrations. Understanding these changes could help veterinarians differentiate drug effects from cardiac disease.
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Affiliation(s)
- Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Lesley A Zwicker
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Erin L Anderson
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Henrik Stryhn
- Department Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Jenny Yu
- Department Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Erin Andersen
- Veterinary Teaching Hospital, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
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Domenegato BM, Côté E, Agarwal D, O'Sullivan ML, Reveler ED, Dobbin E, McMahon E. Effects of handling and storage on potassium concentration in plasma and serum samples obtained from cats. J Am Vet Med Assoc 2021; 260:187-193. [PMID: 34890359 DOI: 10.2460/javma.20.09.0530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare potassium concentrations in feline plasma and serum samples analyzed promptly after collection or after 20 to 28 hours of refrigerated storage. ANIMALS 41 cats. PROCEDURES A venous blood sample was obtained from each cat. Aliquots were placed in 2 tubes without anticoagulant (blood was allowed to clot to derive serum) and 2 tubes with heparin (to derive plasma). One serum and 1 plasma sample were kept at room temperature and analyzed within 60 minutes after collection (baseline); the other serum and plasma samples were analyzed after 20 to 28 hours of refrigerated storage. At both time points, serum and plasma potassium concentrations were measured. RESULTS Median baseline serum potassium concentration (4.3 mmol/L) was significantly higher than median baseline plasma potassium concentration (4.1 mmol/L). The median difference between those values was 0.4 mmol/L (95% CI, 0.2 to 0.5 mmol/L). Compared with their respective baseline measurements, the median serum plasma concentration (4.8 mmol/L) and median plasma potassium concentration (4.6 mmol/L) were higher after 20 to 28 hours of refrigeration. CLINICAL RELEVANCE Results indicated that with regard to potassium concentration in feline blood samples, clotting or refrigerated storage for 20 to 28 hours results in a significant artifactual increase. Detection of an unexpectedly high potassium concentration in a cat may represent pseudohyperkalemia, especially if the blood sample was placed in a no-additive tube, was stored for 20 to 28 hours prior to analysis, or both.
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Affiliation(s)
- Briana M Domenegato
- Veterinary Teaching Hospital, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Deepmala Agarwal
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - M Lynne O'Sullivan
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Elaine D Reveler
- Veterinary Teaching Hospital, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Elizabeth Dobbin
- Diagnostic Services, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Ellen McMahon
- Diagnostic Services, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
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Abstract
PRACTICAL RELEVANCE The feline cardiomyopathies are the most prevalent type of heart disease in adult domestic cats. Several forms have been identified (see Parts 2 and 3), with hypertrophic cardiomyopathy (HCM) being the most common. Clinically the cardiomyopathies are often indistinguishable. Cats with subclinical cardiomyopathy may or may not have characteristic physical examination findings (eg, heart murmur, gallop sound), or radiographic cardiomegaly. Cats with severe disease may develop signs of heart failure (eg, dyspnea, tachypnea) or systemic arterial thromboembolism (ATE; eg, pain and paralysis). Sudden death is possible. Treatment usually does not alter the progression from subclinical to clinical disease and often the treatment approach, once clinical signs are apparent, is the same regardless of the type of cardiomyopathy. However, differentiating cardiomyopathy from normal variation may be important prognostically. PATIENT GROUP Domestic cats of any age from 3 months upward, of either sex and of any breed, can be affected. Mixed-breed cats are most commonly affected but certain breeds are disproportionately prone to developing HCM. DIAGNOSTICS Subclinical feline cardiomyopathies may be suspected based on physical examination findings, thoracic radiographs and cardiac biomarker results but often the disease is clinically silent. The definitive clinical confirmatory test is echocardiography. Left heart failure (pulmonary edema and/or pleural effusion) is most commonly diagnosed radiographically, but point-of-care ultrasound and amino terminal pro-B-type natriuretic peptide (NT-proBNP) biomarker testing can also be useful, especially when the stress of taking radiographs is best avoided. KEY FINDINGS Knowledge of pathophysiological mechanisms helps the practitioner identify the feline cardiomyopathies and understand how these diseases progress and how they manifest clinically (heart failure, ATE). Existing diagnostic tests have strengths and limitations, and being aware of these can help a practitioner deliver optimal recommendations regarding referral. CONCLUSIONS Several types of feline cardiomyopathies exist in both subclinical (mild to severe disease) and clinical (severe disease) phases. Heart failure and ATE are the most common clinical manifestations of severe cardiomyopathy and are therapeutic targets regardless of the type of cardiomyopathy. The long-term prognosis is often guarded or poor once overt clinical manifestations are present. AREAS OF UNCERTAINTY Some cats with presumed cardiomyopathy do not have echocardiographic features that fit the classic cardiomyopathies (cardiomyopathy - nonspecific phenotype). Although no definitive treatment is usually available, understanding how cardiomyopathies evolve remains worthy of investigation.
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Affiliation(s)
- Mark D Kittleson
- School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California, Davis, and Veterinary Information Network, 777 West Covell Boulevard, Davis, CA 95616, USA
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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Kittleson MD, Côté E. The feline cardiomyopathies: a rich tapestry of disease. J Feline Med Surg 2021; 23:1007. [PMID: 34693807 DOI: 10.1177/1098612x211051606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Kittleson MD, Côté E. The Feline Cardiomyopathies: 3. Cardiomyopathies other than HCM. J Feline Med Surg 2021; 23:1053-1067. [PMID: 34693805 PMCID: PMC8723175 DOI: 10.1177/1098612x211030218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Practical relevance: Although feline hypertrophic cardiomyopathy (HCM) occurs more commonly,
dilated cardiomyopathy (DCM), restrictive cardiomyopathy (RCM),
arrhythmogenic right ventricular cardiomyopathy (ARVC), left ventricular
noncompaction (LVNC) and cardiomyopathy – nonspecific phenotype (NCM;
formerly unclassified cardiomyopathy) are all recognized in domestic
cats. Patient group: Any adult domestic cat, of either sex and of any breed, can be affected. Diagnostics: The non-HCM cardiomyopathies are rarely suspected in subclinically affected
cats, so most are first identified when a cat presents with signs of heart
failure or systemic thromboembolic disease. The definitive clinical
confirmatory test for these other feline cardiomyopathies is
echocardiography. Key findings: ‘Cardiomyopathy – nonspecific phenotype’ is a catch-all term that groups
hearts with myocardial changes that either do not meet the criteria for any
one type of cardiomyopathy (HCM, RCM, DCM, ARVC, LVNC) or meet the
echocardiography criteria for more than one type. RCM is characterized by
diastolic dysfunction due to fibrosis that results in a restrictive
transmitral flow pattern on Doppler echocardiography and usually marked left
or biatrial enlargement. DCM is characterized by decreased myocardial
contractility and is rare in cats. When it occurs, it is seldom due to
taurine deficiency. However, since taurine-deficient DCM is usually
reversible, a diet history should be obtained, whole blood and plasma
taurine levels should be measured and taurine should be supplemented in the
diet if the diet is not commercially manufactured. ARVC should be suspected
in adult cats with severe right heart enlargement and right heart failure
(ascites and/or pleural effusion), especially if arrhythmia is present.
Feline LVNC is rare; its significance continues to be explored. Treatment of
the consequences of these cardiomyopathies (management of heart failure,
thromboprophylaxis, treatment of systemic arterial thromboembolism) is the
same as for HCM. Conclusions: While these other cardiomyopathies are less prevalent than HCM in cats, their
clinical and radiographic presentation is often indistinguishable from HCM.
Echocardiography is usually the only ante-mortem method to determine which
type of cardiomyopathy is present. However, since treatment and prognosis
are often similar for the feline cardiomyopathies, distinguishing among the
cardiomyopathies is often not essential for determining appropriate
therapy. Areas of uncertainty: The feline cardiomyopathies do not always fit into one distinct category.
Interrelationships among cardiomyopathies in cats may exist and
understanding these relationships in the future might provide critical
insights regarding treatment and prognosis.
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Affiliation(s)
| | - Etienne Côté
- Department of Companion Animals, Atlantic
Veterinary College, University of Prince Edward Island, Charlottetown,
Prince Edward Island, Canada
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15
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Abstract
Practical relevance: Hypertrophic cardiomyopathy (HCM) is the most common form of feline
cardiomyopathy observed clinically and may affect up to approximately 15% of
the domestic cat population, primarily as a subclinical disease.
Fortunately, severe HCM, leading to heart failure or arterial
thromboembolism (ATE), only occurs in a small proportion of these cats. Patient group: Domestic cats of any age from 3 months upward, of either sex and of any
breed, can be affected. A higher prevalence in male and domestic shorthair
cats has been reported. Diagnostics: Subclinical feline HCM may or may not produce a heart murmur or gallop sound.
Substantial left atrial enlargement can often be identified radiographically
in cats with severe HCM. Biomarkers should not be relied on solely to
diagnose the disease. While severe feline HCM can usually be diagnosed via
echocardiography alone, feline HCM with mild to moderate left ventricular
(LV) wall thickening is a diagnosis of exclusion, which means there is no
definitive test for HCM in these cats and so other disorders that can cause
mild to moderate LV wall thickening (eg, hyperthyroidism, systemic
hypertension, acromegaly, dehydration) need to be ruled out. Key findings: While a genetic cause of HCM has been identified in two breeds and is
suspected in another, for most cats the cause is unknown. Systolic anterior
motion of the mitral valve (SAM) is the most common cause of dynamic left
ventricular outflow tract obstruction (DLVOTO) and, in turn, the most common
cause of a heart murmur with feline HCM. While severe DLVOTO is probably
clinically significant and so should be treated, lesser degrees probably are
not. Furthermore, since SAM can likely be induced in most cats with HCM, the
distinction between HCM without obstruction and HCM with obstruction (HOCM)
is of limited importance in cats. Diastolic dysfunction, and its
consequences of abnormally increased atrial pressure leading to signs of
heart failure, and sluggish atrial blood flow leading to ATE, is the primary
abnormality that causes clinical signs and death in affected cats. Treatment
(eg, loop diuretics) is aimed at controlling heart failure. Preventive
treatment (eg, antithrombotic drugs) is aimed at reducing the risk of
complications (eg, ATE). Conclusions: Most cats with HCM show no overt clinical signs and live a normal or
near-normal life despite this disease. However, a substantial minority of
cats develop overt clinical signs referable to heart failure or ATE that
require treatment. For most cats with clinical signs caused by HCM, the
long-term prognosis is poor to grave despite therapy. Areas of uncertainty: Genetic mutations (variants) that cause HCM have been identified in a few
breeds, but, despite valiant efforts, the cause of HCM in the vast majority
of cats remains unknown. No treatment currently exists that reverses or even
slows the cardiomyopathic process in HCM, again despite valiant efforts. The
search goes on.
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Affiliation(s)
- Mark D Kittleson
- School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California, Davis, and Veterinary Information Network, 777 West Covell Boulevard, Davis, CA 95616, USA
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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16
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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17
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Lu TL, Côté E, Kuo YW, Wu HH, Wang WY, Hung YW. Point-of-care N-terminal pro B-type natriuretic peptide assay to screen apparently healthy cats for cardiac disease in general practice. J Vet Intern Med 2021; 35:1663-1672. [PMID: 33993546 PMCID: PMC8295655 DOI: 10.1111/jvim.16156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 12/25/2022] Open
Abstract
Background Point‐of‐care (POC) N‐terminal pro B‐type natriuretic peptide (NT‐proBNP) ELISA test has been evaluated for screening cats for cardiac disease in the referral veterinary setting but less is known about its use in general practice (GP). Objectives To evaluate the diagnostic utility of a POC NT‐proBNP ELISA in cats seen in GPs. Animals Two hundred and seventeen apparently healthy cats from 21 GPs. Methods This was a prospective, cross‐sectional study. Cardiac auscultation and POC NT‐proBNP ELISA were done by veterinarians at their GPs. After enrollment at GPs, cats were sent to a cardiology referral hospital for cardiac auscultation and echocardiographic diagnosis. Results were interpreted based on whether cats had normal or abnormal echocardiographic findings. Results Point‐of‐care NT‐proBNP ELISA results differentiated cats in the abnormal group from those in the normal group with a sensitivity of 43%, specificity of 96%. In cats with a heart murmur at GPs, POC NT‐proBNP ELISA results differentiated cats in the abnormal group from those in the normal group with a sensitivity of 71% and a specificity of 92%. Conclusion and Clinical Importance In apparently healthy cats in GPs, positive POC NT‐proBNP results are associated with heart disease, warranting an echocardiogram, but negative results do not reliably exclude heart disease. These results suggest POC NT‐proBNP is not an effective screening test for apparently healthy cats in GPs, although its performance is improved if it is used only in cats that have a heart murmur.
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Affiliation(s)
- Ta-Li Lu
- Cardiospecial Veterinary Hospital, Taipei, Taiwan, ROC
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Yu-Wen Kuo
- Cardiospecial Veterinary Hospital, Taipei, Taiwan, ROC
| | - Hao-Han Wu
- Cardiospecial Veterinary Hospital, Taipei, Taiwan, ROC
| | - Wen-Yen Wang
- Cardiospecial Veterinary Hospital, Taipei, Taiwan, ROC
| | - Yong-Wei Hung
- Cardiospecial Veterinary Hospital, Taipei, Taiwan, ROC
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19
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Luis Fuentes V, Abbott J, Chetboul V, Côté E, Fox PR, Häggström J, Kittleson MD, Schober K, Stern JA. ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats. J Vet Intern Med 2020; 34:1062-1077. [PMID: 32243654 PMCID: PMC7255676 DOI: 10.1111/jvim.15745] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 02/14/2020] [Indexed: 12/24/2022] Open
Abstract
Cardiomyopathies are a heterogeneous group of myocardial disorders of mostly unknown etiology, and they occur commonly in cats. In some cats, they are well‐tolerated and are associated with normal life expectancy, but in other cats they can result in congestive heart failure, arterial thromboembolism or sudden death. Cardiomyopathy classification in cats can be challenging, and in this consensus statement we outline a classification system based on cardiac structure and function (phenotype). We also introduce a staging system for cardiomyopathy that includes subdivision of cats with subclinical cardiomyopathy into those at low risk of life‐threatening complications and those at higher risk. Based on the available literature, we offer recommendations for the approach to diagnosis and staging of cardiomyopathies, as well as for management at each stage.
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Affiliation(s)
- Virginia Luis Fuentes
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
| | - Jonathan Abbott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
| | - Valérie Chetboul
- Alfort Cardiology Unit (UCA), Université Paris-Est, École Nationale Vétérinaire d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), Maisons-Alfort cedex, France
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | | | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Mark D Kittleson
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, California, USA
| | - Karsten Schober
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Joshua A Stern
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, California, USA
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Bazié W, Vitry J, Boucher J, Côté E, Trottier S, Gilbert C. Extracellular vesicles and their microRNA contents are biomarkers of HIV-1 disease progression. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)31032-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Lemeunier N, da Silva-Oolup S, Olesen K, Shearer H, Carroll LJ, Brady O, Côté E, Stern P, Tuff T, Suri-Chilana M, Torres P, Wong JJ, Sutton D, Murnaghan K, Côté P. Reliability and validity of self-reported questionnaires to measure pain and disability in adults with neck pain and its associated disorders: part 3-a systematic review from the CADRE Collaboration. Eur Spine J 2019; 28:1156-1179. [PMID: 30879185 DOI: 10.1007/s00586-019-05949-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 03/10/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To determine the reliability and validity of self-reported questionnaires to measure pain and disability in adults with grades I-IV neck pain and its associated disorders (NAD). METHODS We updated the systematic review of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders and systematically searched databases from 2005 to 2017. Independent reviewers screened and critically appraised studies using standardized tools. Evidence from low-risk-of-bias studies was synthesized according to best evidence synthesis principles. Validity studies were ranked according to the Sackett and Haynes classification. RESULTS We screened 2823 articles, and 26 were eligible for critical appraisal; 18 were low risk of bias. Preliminary evidence suggests that the Neck Disability Index (original and short versions), Whiplash Disability Questionnaire, Neck Pain Driving Index, and ProFitMap-Neck may be valid and reliable to measure disability in patients with NAD. We found preliminary evidence for the validity and reliability of pain measurements including the Body Pain Diagram, Visual Analogue Scale, the Numeric Rating Scale and the Pain-DETECT Questionnaire. CONCLUSION The evidence supporting the validity and reliability of instruments used to measure pain and disability is preliminary. Further validity studies are needed to confirm the clinical utility of self-reported questionnaires to assess pain and disability in patients with NAD. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- N Lemeunier
- Institut Franco-Européen de Chiropraxie (IFEC), 72 chemin de la Flambère, 31300, Toulouse, France.
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada.
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada.
| | - S da Silva-Oolup
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - K Olesen
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - H Shearer
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
| | - L J Carroll
- School of Public Health, University of Alberta, 4075 Research Transition Facility, 8308 - 114 St., Edmonton, AB, T6G 2E1, Canada
| | - O Brady
- School of Physical Therapy and Rehabilitation Sciences, Morsani College of Medicine, University of South Florida, 3515 E. Fletcher Ave, Tampa, FL, USA
| | - E Côté
- Department of Ophthalmology and Vision Sciences, University of Toronto, 340 College St., Toronto, ON, M5T 3A9, Canada
| | - P Stern
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - T Tuff
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - M Suri-Chilana
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - P Torres
- Rehabilitation Centre, San Cristobal Clinic, Santiago Spine Group, Santiago, Chile
| | - J J Wong
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - D Sutton
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
| | - K Murnaghan
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
| | - P Côté
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
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Chung W, Côté E, Roland R. Tetralogy of Fallot with concurrent patent foramen ovale and tricuspid valve dysplasia in a dog. Can Vet J 2018; 59:993-996. [PMID: 30197443 PMCID: PMC6091122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The echocardiographic findings of a young Pomeranian-cross dog with tetralogy of Fallot, patent foramen ovale, and tricuspid valve dysplasia are described. Ongoing medical management of hypoxemia and erythrocytosis was carried out and the dog survived to 2 years of age. Treatment options for tetralogy of Fallot are discussed.
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Affiliation(s)
- Wilson Chung
- Atlantic Veterinary College, 550 University Avenue, Charlottetown, Prince Edward Island C1A 4P3 (Chung, Côté); Metropolitan Veterinary Associates - Cardiology, 2626 Van Buren Avenue, Norristown, Pennsylvania 19403, USA (Roland)
| | - Etienne Côté
- Atlantic Veterinary College, 550 University Avenue, Charlottetown, Prince Edward Island C1A 4P3 (Chung, Côté); Metropolitan Veterinary Associates - Cardiology, 2626 Van Buren Avenue, Norristown, Pennsylvania 19403, USA (Roland)
| | - Risa Roland
- Atlantic Veterinary College, 550 University Avenue, Charlottetown, Prince Edward Island C1A 4P3 (Chung, Côté); Metropolitan Veterinary Associates - Cardiology, 2626 Van Buren Avenue, Norristown, Pennsylvania 19403, USA (Roland)
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Fox PR, Keene BW, Lamb K, Schober KA, Chetboul V, Luis Fuentes V, Wess G, Payne JR, Hogan DF, Motsinger-Reif A, Häggström J, Trehiou-Sechi E, Fine-Ferreira DM, Nakamura RK, Lee PM, Singh MK, Ware WA, Abbott JA, Culshaw G, Riesen S, Borgarelli M, Lesser MB, Van Israël N, Côté E, Rush JE, Bulmer B, Santilli RA, Vollmar AC, Bossbaly MJ, Quick N, Bussadori C, Bright JM, Estrada AH, Ohad DG, Fernández-Del Palacio MJ, Lunney Brayley J, Schwartz DS, Bové CM, Gordon SG, Jung SW, Brambilla P, Moïse NS, Stauthammer CD, Stepien RL, Quintavalla C, Amberger C, Manczur F, Hung YW, Lobetti R, De Swarte M, Tamborini A, Mooney CT, Oyama MA, Komolov A, Fujii Y, Pariaut R, Uechi M, Tachika Ohara VY. International collaborative study to assess cardiovascular risk and evaluate long-term health in cats with preclinical hypertrophic cardiomyopathy and apparently healthy cats: The REVEAL Study. J Vet Intern Med 2018; 32:930-943. [PMID: 29660848 PMCID: PMC5980443 DOI: 10.1111/jvim.15122] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 01/04/2018] [Accepted: 02/24/2018] [Indexed: 12/31/2022] Open
Abstract
Background Hypertrophic cardiomyopathy is the most prevalent heart disorder in cats and principal cause of cardiovascular morbidity and mortality. Yet, the impact of preclinical disease is unresolved. Hypothesis/Objectives Observational study to characterize cardiovascular morbidity and survival in cats with preclinical nonobstructive (HCM) and obstructive (HOCM) hypertrophic cardiomyopathy and in apparently healthy cats (AH). Animals One thousand seven hundred and thirty client‐owned cats (430 preclinical HCM; 578 preclinical HOCM; 722 AH). Methods Retrospective multicenter, longitudinal, cohort study. Cats from 21 countries were followed through medical record review and owner or referring veterinarian interviews. Data were analyzed to compare long‐term outcomes, incidence, and risk for congestive heart failure (CHF), arterial thromboembolism (ATE), and cardiovascular death. Results During the study period, CHF, ATE, or both occurred in 30.5% and cardiovascular death in 27.9% of 1008 HCM/HOCM cats. Risk assessed at 1, 5, and 10 years after study entry was 7.0%/3.5%, 19.9%/9.7%, and 23.9%/11.3% for CHF/ATE, and 6.7%, 22.8%, and 28.3% for cardiovascular death, respectively. There were no statistically significant differences between HOCM compared with HCM for cardiovascular morbidity or mortality, time from diagnosis to development of morbidity, or cardiovascular survival. Cats that developed cardiovascular morbidity had short survival (mean ± standard deviation, 1.3 ± 1.7 years). Overall, prolonged longevity was recorded in a minority of preclinical HCM/HOCM cats with 10% reaching 9‐15 years. Conclusions and Clinical Importance Preclinical HCM/HOCM is a global health problem of cats that carries substantial risk for CHF, ATE, and cardiovascular death. This finding underscores the need to identify therapies and monitoring strategies that decrease morbidity and mortality.
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Affiliation(s)
- Philip R Fox
- Department of Cardiology and Caspary Research Institute, The Animal Medical Center, New York, New York, U.S.A
| | - Bruce W Keene
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, U.S.A
| | | | - Karsten A Schober
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, U.S.A
| | - Valerie Chetboul
- Alfort Cardiology Unit, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort Cedex, France
| | - Virginia Luis Fuentes
- Department of Veterinary Clinical Sciences and Services, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Gerhard Wess
- Clinic of Small Animal Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Jessie Rose Payne
- Department of Veterinary Clinical Sciences and Services, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Daniel F Hogan
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, Indiana, U.S.A
| | - Alison Motsinger-Reif
- Department of Statistics, North Carolina State University, Raleigh, North Carolina, U.S.A
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Emilie Trehiou-Sechi
- Alfort Cardiology Unit, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort Cedex, France
| | - Deborah M Fine-Ferreira
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, Missouri, U.S.A
| | - Reid K Nakamura
- Advanced Veterinary Care Center, Lawndale, California, U.S.A
| | - Pamela M Lee
- Department of Cardiology and Caspary Research Institute, The Animal Medical Center, New York, New York, U.S.A
| | - Manreet K Singh
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California-Davis, Davis, California, U.S.A
| | - Wendy A Ware
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, Iowa, U.S.A
| | - Jonathan A Abbott
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia, U.S.A
| | - Geoffrey Culshaw
- Royal (Dick) SVS Hospital for Small Animals, The University of Edinburgh, Roslin, Midlothian, United Kingdom
| | - Sabine Riesen
- Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Michele Borgarelli
- Department of Clinical Sciences, Kansas State University, Manhattan, Kansas, U.S.A
| | | | | | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - John E Rush
- Department of Clinical Sciences, Tufts University, Cummings School of Veterinary Medicine, North Grafton, Massachusetts, U.S.A
| | - Barret Bulmer
- Tufts Veterinary Emergency Treatment & Specialties, Walpole, Massachusetts, U.S.A
| | | | | | | | - Nadine Quick
- Clinic of Small Animal Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Claudio Bussadori
- Department of Cardiology, Clinica Veterinaria Gran Sasso, Milan, Italy
| | - Janice M Bright
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, U.S.A
| | - Amara H Estrada
- Department of Small Animal Clinical Sciences, University of Florida, Gainesville, Florida
| | - Dan G Ohad
- Department of Clinical Sciences, The Koret School of Veterinary Medicine, Rehovot, Israel
| | | | | | - Denise S Schwartz
- Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
| | - Christina M Bové
- Department of Clinical Studies, University of Guelph, Guelph, Ontario, Canada
| | - Sonya G Gordon
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, U.S.A
| | - Seung Woo Jung
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California-Davis, Davis, California, U.S.A
| | - Paola Brambilla
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - N Sydney Moïse
- Department of Clinical Sciences, Cornell University, Ithaca, New York, U.S.A
| | | | - Rebecca L Stepien
- Department of Medical Sciences, University of Wisconsin School of Veterinary Medicine, Madison, Wisconsin, U.S.A
| | | | | | - Ferenc Manczur
- Department of Internal Medicine, University of Veterinary Medicine, Budapest, Hungary
| | | | - Remo Lobetti
- Bryanston Veterinary Hospital, Bryanston, South Africa
| | - Marie De Swarte
- University College Dublin Veterinary Hospital, University College Dublin, Dublin, Ireland
| | - Alice Tamborini
- University College Dublin Veterinary Hospital, University College Dublin, Dublin, Ireland
| | - Carmel T Mooney
- University College Dublin Veterinary Hospital, University College Dublin, Dublin, Ireland
| | - Mark A Oyama
- Department of Clinical Studies, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | | | - Yoko Fujii
- Azabu University, Sagamihara, Kanagawa, Japan
| | - Romain Pariaut
- Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, U.S.A
| | - Masami Uechi
- Jasmine Animal Cardiovascular Center, Yokohama, Kanagawa, Japan
| | - Victoria Yukie Tachika Ohara
- Department of Medicine, Surgery and Zootechnics for Small Species, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Lichtenberger J, Meurs KM, Côté E. Preliminary Assessment of a Novel 14-Day Electrocardiographic Adhesive Patch Monitor in Dogs. J Am Anim Hosp Assoc 2018; 54:138-143. [PMID: 29558214 DOI: 10.5326/jaaha-ms-6626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cardiac arrhythmias often are transient and might not be detected using conventional electrocardiographic (ECG) techniques. The adhesive patch monitor (APM) is a single-lead, lightweight, up to 14-day continuous ambulatory ECG monitor. This study aimed to prospectively assess its usability in four boxer dogs considered either to be healthy or to have arrhythmogenic right ventricular cardiomyopathy. Optimal recording was obtained by placing the APM on the left side of the animal's thorax, at the fifth intercostal space, slightly dorsal to the costochondral junction, and oriented either vertically or parallel to the long axis of the heart. In three dogs, the APM remained attached for 14 days. One dog removed the APM after 59 hr. Skin irritation was documented in all dogs and resolved spontaneously after removal of the APM. The analyzable time was >93% of the total wear time and recordings provided an unambiguous rhythm diagnosis at rest. Walking, running, or playing caused intermittent motion artifact that could impair ECG interpretation. APM results were comparable to those obtained with 24-hr Holter monitoring. Extended continuous ECG monitoring with the APM is feasible in boxer dogs and provides interpretable recordings.
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Affiliation(s)
- Jonathan Lichtenberger
- From the Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada (J.L., E.C.); and the Department of Veterinary Clinical Sciences, North Carolina State University, Raleigh, North Carolina (K.M.M.)
| | - Kathryn M Meurs
- From the Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada (J.L., E.C.); and the Department of Veterinary Clinical Sciences, North Carolina State University, Raleigh, North Carolina (K.M.M.)
| | - Etienne Côté
- From the Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada (J.L., E.C.); and the Department of Veterinary Clinical Sciences, North Carolina State University, Raleigh, North Carolina (K.M.M.)
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Abstract
Congestive heart failure (CHF) is a well-known disorder in feline practice, having been recognized as the most common clinical syndrome in cats with hypertrophic cardiomyopathy, for example. This article identifies the reasons why an accurate diagnosis of CHF is important and the means by which to obtain one; pharmacologic and nonpharmacologic methods for controlling signs of CHF; and recommendations for follow-up evaluations, monitoring, and troubleshooting.
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Affiliation(s)
- Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island C1A4P3, Canada
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26
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Lemeunier N, da Silva-Oolup S, Chow N, Southerst D, Carroll L, Wong JJ, Shearer H, Mastragostino P, Cox J, Côté E, Murnaghan K, Sutton D, Côté P. Reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders: Part 1-A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) Collaboration. Eur Spine J 2017; 26:2225-2241. [PMID: 28608175 DOI: 10.1007/s00586-017-5153-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 04/24/2017] [Accepted: 05/20/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To determine the reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders. METHODS We updated the systematic review of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders. We also searched the literature to identify studies on the reliability and validity of Doppler velocimetry for the evaluation of cervical arteries. Two independent reviewers screened and critically appraised studies. We conducted a best evidence synthesis of low risk of bias studies and ranked the phases of investigations using the classification proposed by Sackett and Haynes. RESULTS We screened 9022 articles and critically appraised 8 studies; all 8 studies had low risk of bias (three reliability and five validity Phase II-III studies). Preliminary evidence suggests that the extension-rotation test may be reliable and has adequate validity to rule out pain arising from facet joints. The evidence suggests variable reliability and preliminary validity for the evaluation of cervical radiculopathy including neurological examination (manual motor testing, dermatomal sensory testing, deep tendon reflexes, and pathological reflex testing), Spurling's and the upper limb neurodynamic tests. No evidence was found for doppler velocimetry. CONCLUSIONS Little evidence exists to support the use of clinical tests to evaluate the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders. We found preliminary evidence to support the use of the extension-rotation test, neurological examination, Spurling's and the upper limb neurodynamic tests.
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Affiliation(s)
- Nadège Lemeunier
- Institut Franco-Européen de Chiropraxie, 72 chemin de la Flambère, 31300, Toulouse, France. .,UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada.
| | - S da Silva-Oolup
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - N Chow
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada.,Michael G. DeGroote Institute for Pain Research and Care, McMaster University, 1280 Main St. West, Hamilton, ON, Canada
| | - D Southerst
- Occupational and Industrial Orthopaedic Centre, Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, 63 Downing Street, New York, NY, 10014, USA
| | - L Carroll
- School of Public Health, University of Alberta, 116 St and 85 Ave, Edmonton, AB, T6G 2R3, Canada
| | - J J Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
| | - H Shearer
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada.,Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - P Mastragostino
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - J Cox
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - E Côté
- Faculty of Medicine, University of Toronto, 27 King's College Cir, Toronto, ON, M5S 1A1, Canada
| | - K Murnaghan
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - D Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
| | - P Côté
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada.,Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, Canada
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27
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Shen L, Estrada A, Côté E, Powell M, Winter B, Lamb K. Aortoseptal angle and pressure gradient reduction following balloon valvuloplasty in dogs with severe subaortic stenosis. J Vet Cardiol 2017; 19:144-152. [DOI: 10.1016/j.jvc.2016.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 10/17/2016] [Accepted: 10/31/2016] [Indexed: 10/20/2022]
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Abstract
The well recognized cardiac effects of severe hyperkalemia include progressive rhythm and conduction disturbances such as bradycardia, spiked and narrow T waves, widening QRS complex, widening and flattening P wave, disappearance of the P wave, and cardiac arrest. Paradoxically, a heart rate greater than 200 beats/min may coexist with hyperkalemia in some cats. This report describes three cats with moderate to severe hyperkalemia and concurrent rapid heart rate. In each cat, the serum potassium (K+) concentration was ≥7.5 mEq/dl with a concurrent heart rate>200 beats/min. In each cat, nine-lead electrocardiograms demonstrate an absence of P waves and a wide-complex tachycardia. Hyperkalemia should be considered in the differential diagnosis when a feline electrocardiogram demonstrates a wide-complex tachycardia without identifiable P waves.
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Affiliation(s)
- Brian C Norman
- California Animal Hospital, 1736 South Sepulveda Boulevard, Suite B, Los Angeles, CA 90025, USA.
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29
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Zwicker LA, Matthews AR, Côté E, Andersen E. THE EFFECT OF DEXMEDETOMIDINE ON RADIOGRAPHIC CARDIAC SILHOUETTE SIZE IN HEALTHY CATS. Vet Radiol Ultrasound 2016; 57:230-6. [DOI: 10.1111/vru.12346] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 11/10/2015] [Accepted: 11/11/2015] [Indexed: 11/29/2022] Open
Affiliation(s)
- Lesley A. Zwicker
- Department of Companion Animals, Atlantic Veterinary College; University of Prince Edward Island; Charlottetown Canada
| | | | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College; University of Prince Edward Island; Charlottetown Canada
| | - Erin Andersen
- Department of Companion Animals, Atlantic Veterinary College; University of Prince Edward Island; Charlottetown Canada
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Gordon SG, Côté E. Pharmacotherapy of feline cardiomyopathy: chronic management of heart failure. J Vet Cardiol 2015; 17 Suppl 1:S159-72. [DOI: 10.1016/j.jvc.2015.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 02/28/2015] [Accepted: 03/05/2015] [Indexed: 10/22/2022]
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Côté E, Edwards NJ, Ettinger SJ, Luis Fuentes V, MacDonald KA, Scansen BA, Sisson DD, Abbott JA. Management of incidentally detected heart murmurs in dogs and cats. J Vet Cardiol 2015; 17:245-61. [DOI: 10.1016/j.jvc.2015.05.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 05/06/2015] [Accepted: 05/11/2015] [Indexed: 11/27/2022]
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Côté E, Edwards NJ, Ettinger SJ, Fuentes VL, MacDonald K, Scansen BA, Sisson DD, Abbott JA. Incidentally detected heart murmurs in dogs and cats: executive summary 2015. J Small Anim Pract 2015; 56:593-4. [DOI: 10.1111/jsap.12405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 08/31/2015] [Indexed: 11/28/2022]
Affiliation(s)
- E. Côté
- Working Group of the American College of Veterinary Internal Medicine Specialty of Cardiology on Incidentally-Detected Heart Murmurs
| | - N. J. Edwards
- Working Group of the American College of Veterinary Internal Medicine Specialty of Cardiology on Incidentally-Detected Heart Murmurs
| | - S. J. Ettinger
- Working Group of the American College of Veterinary Internal Medicine Specialty of Cardiology on Incidentally-Detected Heart Murmurs
| | - V. L. Fuentes
- Working Group of the American College of Veterinary Internal Medicine Specialty of Cardiology on Incidentally-Detected Heart Murmurs
| | - K. A. MacDonald
- Working Group of the American College of Veterinary Internal Medicine Specialty of Cardiology on Incidentally-Detected Heart Murmurs
| | - B. A. Scansen
- Working Group of the American College of Veterinary Internal Medicine Specialty of Cardiology on Incidentally-Detected Heart Murmurs
| | - D. D. Sisson
- Working Group of the American College of Veterinary Internal Medicine Specialty of Cardiology on Incidentally-Detected Heart Murmurs
| | - J. A. Abbott
- Working Group of the American College of Veterinary Internal Medicine Specialty of Cardiology on Incidentally-Detected Heart Murmurs
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Côté E, Edwards NJ, Ettinger SJ, Fuentes VL, MacDonald KA, Scansen BA, Sisson DD, Abbott JA. Management of incidentally detected heart murmurs in dogs and cats. J Am Vet Med Assoc 2015; 246:1076-88. [DOI: 10.2460/javma.246.10.1076] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Javard R, Bélanger MC, Côté E, Beauchamp G, Pibarot P. Comparison of peak flow velocity through the left ventricular outflow tract and effective orifice area indexed to body surface area in Golden Retriever puppies to predict development of subaortic stenosis in adult dogs. J Am Vet Med Assoc 2014; 245:1367-74. [DOI: 10.2460/javma.245.12.1367] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Belanger MC, Côté E, Beauchamp G. Association between aortoseptal angle in Golden Retriever puppies and subaortic stenosis in adulthood. J Vet Intern Med 2014; 28:1498-503. [PMID: 24965966 PMCID: PMC4895594 DOI: 10.1111/jvim.12390] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 04/02/2014] [Accepted: 05/07/2014] [Indexed: 11/29/2022] Open
Abstract
Background Predicting subaortic stenosis (SAS) in adult Golden Retriever dogs (GRs) by evaluating them as puppies is hampered by the progressive expression of the SAS phenotype in youth. In some children who develop SAS as adults, an abnormal aortoseptal angle (AoSA) precedes development of stenosis. Objectives To determine the normal AoSA in young adult GRs using echocardiography; to assess the value of AoSA in GR puppies for predicting development of the SAS phenotype. Animals Forty‐eight 2‐ to 6‐month‐old GR puppies. Methods Prospective study. Puppies were recruited from clients and breeders. Puppies were evaluated with a physical examination and an echocardiogram, and this evaluation was repeated when they were 12–18‐month‐old adults. Puppies were classified as unaffected (WNL) or affected (SAS) retroactively, based on their results as adults. Results In WNL young adult GRs, mean ± SD AoSA was 152.3 ± 6.5°. Mean ± SD AoSA in SAS puppies (144.9 ± 8.6°) was significantly different from mean AoSA in WNL puppies (155.7 ± 8.8°, P < .01). No puppy with AoSA >160° had the SAS phenotype as a young adult; 93% (75.7–99.1%) of puppies with AoSA <145° had the SAS phenotype as young adults. Peak LVOT velocity increased significantly between evaluations (P < .0001) whereas AoSA did not (P = .45). Conclusion and Clinical Significance A steep AoSA in GR puppies is associated with the SAS phenotype in young adulthood. Some GR puppies have an abnormal AoSA that persists in young adulthood and is detectable before peak LVOT velocity reaches levels consistent with SAS.
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Affiliation(s)
- M C Belanger
- Department of Clinical Sciences, School of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
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37
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Côté E, Schwarz LA, Sithole F. Thoracic radiographic findings for dogs with cardiac tamponade attributable to pericardial effusion. J Am Vet Med Assoc 2013; 243:232-5. [DOI: 10.2460/javma.243.2.232] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Legge CH, López A, Hanna P, Côté E, Hare E, Martinson SA. Histological characterization of dilated cardiomyopathy in the juvenile toy Manchester terrier. Vet Pathol 2013; 50:1043-52. [PMID: 23456967 DOI: 10.1177/0300985813480509] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Dilated cardiomyopathy (DCM), the most common form of cardiomyopathy in the dog, most often occurs in certain breeds. The objective of this study was to describe a rapidly progressive form of DCM that has been recently recognized in juvenile Toy Manchester Terrier dogs (TMTs). The clinical history and gross findings were reviewed in a group of 14 TMTs, and histologic sections of heart were examined in 12 of those 14 TMTs with DCM. Histochemical and histomorphometric analyses were employed to compare the heart in TMTs affected by DCM with that of control dogs. TMTs ranged in age from 10 to 58.3 weeks, with males and females being equally affected. Affected TMT hearts contained foci of degeneration and loss of myofibers with fibrosis and mild lymphoplasmacytic infiltrates. Less prominent features included foci of acute myofiber degeneration and necrosis with or without intralesional mineralization and mild to moderate suppurative and lymphoplasmacytic infiltrates. Morphometric quantification demonstrated that the right ventricle was more severely affected (P ≤ .05) than the left ventricle with variable involvement of the interventricular septum. Immunohistochemistry for canine parvovirus was negative in all heart samples. However, the absence of parvoviral antigen does not rule out a possible viral or autoimmune cause. The presence of these myocardial lesions among closely related dogs suggests a genetic contribution to this disease process in the TMT.
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Affiliation(s)
- C H Legge
- Department of Pathology and Microbiology, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island, Canada C1A 4P3
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Pelosi A, Côté E, Eyster GE. Congenital coronary-pulmonary arterial shunt in a German shepherd dog: diagnosis and surgical correction. J Vet Cardiol 2011; 13:153-8. [PMID: 21636339 DOI: 10.1016/j.jvc.2011.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 03/07/2011] [Accepted: 03/18/2011] [Indexed: 01/08/2023]
Abstract
BACKGROUND A 10 week-old intact female German shepherd dog was examined because of a heart murmur. METHODS An echocardiogram revealed an extracardiac left-to-right shunt. An angiogram identified shunting between the aorta and the pulmonary artery in an unusual location. RESULTS Thoracotomy was performed to better identify and correct the lesion; a tubular shunt between the left coronary artery and the pulmonary artery was found and ligated in a closed-heart procedure. The murmur resolved immediately upon ligation and the dog's heart size normalized over a period of several months after surgery. CONCLUSION In the dog, surgical correction of a coronary artery-pulmonary artery shunt can be performed without complications and can be associated with reversal of cardiac remodeling.
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Affiliation(s)
- Augusta Pelosi
- College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA.
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Gallay J, Bélanger MC, Hélie P, Côté E, Johnson TO, Peters ME. Cardiac leiomyoma associated with advanced atrioventricular block in a young dog. J Vet Cardiol 2011; 13:71-7. [DOI: 10.1016/j.jvc.2010.11.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2010] [Revised: 10/14/2010] [Accepted: 11/10/2010] [Indexed: 11/15/2022]
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Clancey N, Burton S, Horney B, MacKenzie A, Nicastro A, Côté E. Evaluation of platelet function in dogs with cardiac disease using the PFA-100 platelet function analyzer. Vet Clin Pathol 2009; 38:299-305. [DOI: 10.1111/j.1939-165x.2009.00138.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
BACKGROUND Ventricular tachyarrhythmias occur in association with cardiac and extracardiac disorders in many species of animals, but information identifying concurrent disorders in cats with such arrhythmias is scarce. METHODS We investigated coexisting diseases by retrospectively evaluating medical records of cats with ventricular tachyarrhythmias seen during a 51-month period at 1 institution. For comparative purposes, we evaluated records of dogs with similar arrhythmias during the same time period. All cats and dogs had premature ventricular complexes, accelerated idioventricular rhythm, ventricular tachycardia, or some combination of these arrhythmias, and all had undergone echocardiography during the same visit that led to the diagnosis of ventricular tachyarrhythmia. RESULTS AND CONCLUSIONS Most (102/106; 96%) cats had at least 1 echocardiographically apparent abnormality concurrent with ventricular tachyarrhythmias. Ventricular tachyarrhythmias in cats were most commonly associated with myocardial disease (eg, left ventricular concentric hypertrophy [n = 66], restrictive or unclassified cardiomyopathy [n = 17], and dilated cardiomyopathy [n = 6]). When comparing dogs and cats that had ventricular tachyarrhythmias and were diagnosed on the same clinical service of the same institution, an echocardiographically apparent cardiac lesion was seen more often in cats (102/106, 96%) than in dogs (95/138, 69%) (P < .001).
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Affiliation(s)
- E Côté
- Angell Animal Medical Center, Boston, MA, USA
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Affiliation(s)
- Cynthia L Collins
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, C1A 4P3 Canada
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Abstract
An 11-month-old, female Scottish terrier was presented with a history of a heart murmur. The electrocardiogram showed signs of left ventricular enlargement, and radiography confirmed generalized cardiomegaly. Echocardiography revealed four equally sized aortic valve cusps. A ventricular septal defect, with systolic left-to-right shunting, and aortic regurgitation into both ventricles were also present. The dog was free of clinical signs 1 year after diagnosis.
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Affiliation(s)
- Frank Kettner
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
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Abstract
The asymmetric shape of the heart, small acoustic window, and range of interindividual variation in normal and abnormal states all can limit the extent of echocardiographic studies in small animal medicine. Beyond these uncontrollable variables, however, there are a number of additional potentially complicating factors that the echocardiogapher controls. Understanding and handling this second category of variables is critical for optimizing the quality and diagnostic value of echocardiographic studies. These variables range from such simple issues as proper restraint and an indissociable association between echocardiographic findings and clinical information, to specific points relating to simultaneous electrocardiogram display, good visualization of cardiac structures using multiple overlapping imaging planes, and avoidance of oblique or tangential views. The basic overview presented here aims to describe these commonly encountered, clinically relevant points in a way that helps veterinarians improve the quality of echocardiograms they perform.
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Affiliation(s)
- Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PEI, Canada.
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Côté E, Gelens H. Exam question is music to students' ears. J Am Vet Med Assoc 2005; 226:512. [PMID: 15742684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Côté E, Harpster NK, Laste NJ, MacDonald KA, Kittleson MD, Bond BR, Barrett KA, Ettinger SJ, Atkins CE. Atrial fibrillation in cats: 50 cases (1979-2002). J Am Vet Med Assoc 2004; 225:256-60. [PMID: 15323383 DOI: 10.2460/javma.2004.225.256] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine signalment, clinical signs, diagnostic findings, treatment, and outcome for cats with atrial fibrillation (AF). DESIGN Retrospective study. ANIMALS 50 cats. PROCEDURE Medical records of cats that met criteria for a diagnosis of AF (ECG consisting of at least 2 leads, clear absence of P waves, supraventricular rhythm, and convincingly irregularly irregular rhythm) and had undergone echocardiography were reviewed. RESULTS There were 41 males (37 castrated) and 9 females (7 spayed). Forty-one were of mixed breeding; 9 were purebred. Mean +/- SD age was 10.2 +/- 3.7 years. The most common chief complaints were dyspnea, aortic thromboembolism, and lethargy. In 11 cats, AF was an incidental finding. Mean +/- SD ventricular rate was 223 +/- 36 beats/min. The most common echocardiographic abnormalities were restrictive or unclassified cardiomyopathy (n = 19), concentric left ventricular hypertrophy (18), and dilated cardiomyopathy (6). Mean +/- SD left atrial-to-aortic diameter ratio (n = 39) was 2.55 +/- 0.80. The most common thoracic radiographic findings were cardiomegaly, pleural effusion, and pulmonary edema. Median survival time (n = 24) was 165 days (range, 0 to 1,095 days). Eight of 24 cats lived for > or = 1 year after a diagnosis of AF was made. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that AF occurs primarily in older adult male cats with structural heart disease severe enough to lead to atrial enlargement. Atrial fibrillation in these cats was most commonly first detected when signs of decompensated cardiac disease were evident, but also was commonly identified as an incidental finding.
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Affiliation(s)
- Etienne Côté
- Angell Memorial Animal Hospital, 350 S Huntington, Boston, MA 02130, USA
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Abstract
OBJECTIVE To assess the frequency of heart murmurs in overtly healthy cats. DESIGN Prospective study. SAMPLE POPULATION 103 healthy domestic cats. PROCEDURE Background information and physical characteristics were assessed in cats that were candidates for blood donation during an 8-month period. For cats with heart murmurs, additional information collected included murmur timing, grade, point of maximal intensity, and presence of additional heart sounds. RESULTS Heart murmurs were detected in 22 of the 103 (21%) cats. Echocardiography was performed in 7 of those 22 cats. The echocardiogram was considered normal in 1 cat; in the other 6 cats, diagnoses included hypertrophic cardiomyopathy (interventricular septal hypertrophic form [IVSH]; n = 4), left ventricular concentric hypertrophy with valvular disease (1), and equivocal IVSH (1). Thirteen cats had more than 1 examination during the study; 3 of them developed heart murmurs. There were no significant differences in age, sex, breed, coat color, eye color, or heart rate between cats with and without murmurs. Among the 103 cats, there were 6 pairs of siblings from 6 multiple-cat households and 16 cats from 7 multiple-cat households in which the cats were not related; the proportion of cats with murmurs was higher in the related cats (5/12) than in the unrelated cats (3/16), but the difference was not significant. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that heart murmurs are detectable in a large proportion of overtly healthy cats and that many murmurs appear to be caused by structural heart disease that is in a clinically latent state.
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Affiliation(s)
- Etienne Côté
- Section of Cardiology, Angell Memorial Animal Hospital, 350 S Huntington Ave, Boston, MA 02130, USA
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Affiliation(s)
- Lillian Good
- Angell Memorial Animal Hospital, Boston, MA 02130, USA
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