Cardiopulmonary Effects of Laparoscopic Ovariectomy of Variable Duration in Cats

OBJECTIVE

To evaluate the cardiopulmonary effects of low-pressure (6 mmHg) peritoneal insufflation of varying duration in healthy cats during ovariectomy (OVE).

STUDY DESIGN

Prospective, randomized study.

ANIMALS

Female cats (n = 24).

METHODS

After anesthesia induction, cats had short (Short LAP; n = 8) or long duration (Long LAP; n = 8) laparoscopic ovariectomy, or Open OVE (Open; n = 8) for comparison. Hemodynamic and pulmonary measurements were recorded after induction of anesthesia (T0), 5 minutes after abdominal insufflation had reached 6 mmHg of pressure (T1), after the 2nd ovary had been resected (T2), after abdominal decompression (T3), and at the end of anesthesia, after abdominal closure (T4). Hemodynamic and pulmonary variables were compared between groups.

RESULTS

Low-pressure abdominal insufflation caused cardiopulmonary changes in cats. At T1 and T2, Long LAP and Short LAP caused a significant change in PvCO2 and RC when compared with Open. During T3, RC was lower only in Long LAP. At T2, there was decrease in SV, but not CO for Long LAP when compared with Open.

CONCLUSIONS

Duration of insufflation was associated with worsening of negative cardiopulmonary effects; however, these effects were reversible and resolved by the end of the procedure.

Associations between 'valentine' heart shape, atrial enlargement and cardiomyopathy in cats

'Valentine' heart shape is a common qualifier used in veterinary radiology to describe a cardiac silhouette with focal enlargement at the level of the base of the heart in feline patients. Anecdotally, this sign has been thought to be related to biatrial enlargement and also to hypertrophic cardiomyopathy (HCM). However, to our knowledge, there has been no study performed to assess the association between cardiac chamber enlargement and cardiac disease with the 'valentine'-shaped heart. The aim of this study was to verify the association between the 'valentine' heart shape observed in ventrodorsal thoracic radiographs and the presence of singular or combined cardiac chamber enlargement, and also the presence and type of cardiomyopathy (CM) in cats. A search of the database of the Small Animal Veterinary Hospital of the University of Florida for cats with a radiology report of thoracic radiographs that contained the words 'valentine' and 'biatrial', and echocardiography performed within 1 week, was undertaken; 41 cases met the inclusion criteria. Eighty-two percent of the cats of the study sample had some form of CM. The 'valentine' heart shape was associated with biatrial enlargement in 41% of the patients in our study sample that had some form of CM and just 8% of cases diagnosed with HCM, suggesting that the 'valentine' heart shape has a low association with HCM or biatrial enlargement; however, it should be considered a sign of feline CM.

Rhabdomyosarcoma associated with the lead wire of a pacemaker generator implant

An 11-year-old female spayed Labrador Retriever was presented for a draining, painful subcutaneous mass palpated over a previously implanted pacemaker generator. Infection was suspected and the mass was removed surgically. On cut surface, the mass was friable and mottled tan to brown with firm pale tan nodules, surrounding the pacemaker lead wire adjacent to the pacemaker generator. Cytologic interpretation of impression smears was consistent with a sarcoma, and suggestive of a rhabdomyosarcoma due to the presence of strap-like cells. On histopathologic examination, a highly invasive nodular mass surrounded the pacemaker lead, composed of pleomorphic round, spindle and strap cells, and multinucleated giant cells. The population exhibited microscopic invasion into the deep portion of the fibrous capsule surrounding the pacemaker generator. There were tumor emboli within small to medium subcutaneous veins adjacent to the mass. Immunohistochemically, the neoplastic cells stained positive for α-sarcomeric actin and vimentin, and negative for α-smooth muscle actin, consistent with a rhabdomyosarcoma arising at the site of the pacemaker generator. To our knowledge, this is the first report of a rhabdomyosarcoma associated with the lead wire of a pacemaker generator in a dog.

Stem-cell therapy for dilated cardiomyopathy: a pilot study evaluating retrograde coronary venous delivery

OBJECTIVE

To evaluate retrograde coronary venous stem-cell delivery for Dobermanns with dilated cardiomyopathy.

METHODS

Retrograde coronary venous delivery of adipose-derived mesenchymal stem cells transduced with tyrosine mutant adeno-associated virus 2 to express stromal-derived factor-1 was performed in Dobermanns with dilated cardiomyopathy. Cases were followed for 2 years and electrocardiograms (ECG), echocardiograms and Holter monitoring were performed.

RESULTS

Delivery of cells was feasible in 15 of 15 dogs. One dog died following the development of ventricular fibrillation 24 hours after cell delivery. The remaining 14 dogs were discharged the following day without complications. Echocardiographic measurements of left ventricular size and function showed continued progression of disease. On the basis of Kaplan-Meier product limit estimates, median survival for dogs following stem-cell delivery was 620 days (range of 1-799 days). When including only the occult-dilated cardiomyopathy population and excluding those dogs already in congestive heart failure, median survival was 652 days (range of 46-799 days).

CLINICAL SIGNIFICANCE

Retrograde venous delivery of tyrosine mutant adeno-associated virus 2-stromal-derived factor-1 adipose-derived mesenchymal stem cells appears safe. Stem-cell therapy in dogs with occult-dilated cardiomyopathy does not appear to offer advantage compared to recently published survival data in similarly affected Dobermanns.

Effect of azotemia on serum N-terminal proBNP concentration in dogs with normal cardiac function: a pilot study

OBJECTIVES

To evaluate amino-terminal pro-B type natriuretic peptide (NT-proBNP) concentration in dogs with renal dysfunction and normal cardiac structure and function.

ANIMALS

Eight dogs with renal disease, 23 healthy control dogs.

METHODS

Serum NT-proBNP concentration was measured in healthy dogs and dogs with renal disease using an ELISA validated for use in dogs. Affected dogs were eligible for inclusion if renal dysfunction was diagnosed based on urinalysis and serum chemistry, and if they were free of cardiovascular disease based on physical exam, systolic blood pressure, and echocardiography.

RESULTS

The geometric mean serum NT-proBNP concentration was significantly higher in dogs with renal disease (617 pmol/L; 95% CI, 260-1467 pmol/L) than in healthy control dogs (261 pmol/L; 95% CI, 225-303 pmol/L; P=0.0014). There was a modest positive correlation between NT-proBNP and BUN and creatinine. Median NT-proBNP concentration was not significantly different between groups when indexed to BUN (median NT-proBNP:BUN ratio; renal, 14.2, IQR, 3.93-17.7 vs. control, 16.3, IQR, 9.94-21.2; P=0.29) or creatinine (median NT-proBNP:creatinine ratio; renal, 204, IQR, 72.6-448 vs. control, 227, IQR, 179-308; P=0.67).

CONCLUSION

Dogs with renal disease had significantly higher mean serum concentration of NT-proBNP than control dogs. Renal function should be considered when interpreting NT-proBNP results as concentrations may be falsely elevated in dogs with renal dysfunction and normal cardiac function. The effect of renal disease was lessened by indexing NT-proBNP to BUN or creatinine. Future studies in dogs with both renal and heart disease are warranted.

Evaluation of the effects of transvenous pacing site on left ventricular function and synchrony in healthy anesthetized dogs

OBJECTIVE-To compare the acute effects of cardiac pacing from various transvenous pacing sites on left ventricular (LV) function and synchrony in clinically normal dogs. ANIMALS-10 healthy adult mixed-breed dogs. PROCEDURES-Dogs were anesthetized, and dual-chamber transvenous biventricular pacing systems were implanted. Dogs were paced in single-chamber mode from the right atrial appendage (RAA) alone and in dual-chamber mode from the right ventricular apex (RVA), from the left ventricular free wall (LVFW), and simultaneously from the RVA and LVFW (BiV). Standard ECG and echocardiographic measurements, cardiac output measured with the lithium dilution method (LiDCO), and tissue Doppler-derived measurements of LV synchrony were obtained during each of the pacing configurations. RESULTS-Placement of the biventricular pacing systems was possible in 8 of the 10 dogs. The QRS duration was significantly different among all pacing sites, and the order of increasing duration was RAA, BiV, LVFW, and RVA. Pacing sites did not differ with respect to fractional shortening; however, pacing from the RVA resulted in a significantly lower ejection fraction than pacing from all other sites. During RVA and LVFW pacing, LiDCO was significantly lower than that at other sites; there was no significant difference between RAA and BiV pacing with respect to LiDCO. Although the degree of dyssynchrony was significantly lower during pacing from the RAA versus other ventricular pacing sites, it was not significantly different among sites. CONCLUSIONS AND CLINICAL RELEVANCE-Ventricular activation by RAA pacing provided the best LV function and synchrony. Pacing from the RVA worsened LV function, and although pacing from the LVFW improved it, BiV pacing may provide additional improvement.

Cardiac evaluation of anesthetized Grevy's zebras(Equus grevyi)

OBJECTIVE

To determine ECG and echocardiographic measurements in healthy anesthetized Grevy's zebras (Equus grevyi).

ANIMALS

20 healthy zebras.

PROCEDURES

Auscultation, base-apex ECG, and echocardiography were performed on anesthetized zebras.

RESULTS

Low-grade systolic murmurs were detected in the left basilar region in 4 of 20 zebras. Evaluation of ECGs from 19 zebras revealed sinus rhythm with a predominantly negative QRS complex and a mean +/- SD heart rate of 67 +/- 10 beats/min. Echocardiograms of sufficient image quality were obtained for 16 zebras. Interventricular septal thickness in diastole, left ventricular chamber in diastole and systole, left atrial diameter, and left ventricular mass were significantly and moderately correlated with estimated body weight (r values ranged from 0.650 to 0.884). Detectable swirling of blood in the right and sometimes the left ventricles was detected in 9 of 16 zebras, whereas physiologic regurgitation of blood was detected for the aortic valve in 3 zebras, pulmonary valve in 2 zebras, mitral valve in 2 zebras, and tricuspid valve in 1 zebra.

CONCLUSIONS AND CLINICAL RELEVANCE

Results of this study provide reference information for use in the cardiac evaluation of anesthetized Grevy's zebras.