Un cas de situs inversus complet associé à une communication interventriculaire et des anomalies oculaires chez une chienne croisée de 3 ans

A case of complete situs inversus associated with an interventricular communication and ocular abnormalities in a 3-year-old mixed-breed female dog. A 3-year-old female dog was referred for exploration of a murmur concomitant with lethargy. An echocardiogram reveals an inversion of the position of the cardiac chambers and the presence of an interventricular communication. A computed tomography examination of the thorax and abdomen highlights the known cardiac abnormalities as well as the association of a complete situs inversus. The clinical examination also reveals ocular malformations (deviation of the eyeballs and asymmetry of the fundus). This article highlights the variety of abnormalities that can be associated with the complete inversion of the organs and demonstrates that there may be variants to the more classic picture usually encountered in humans (respiratory manifestations related to Kartagener syndrome).(Translated by Dr Serge Messier).

Siewert-Kartagener's syndrome in a dog

Siewert-Kartagener's syndrome, a type of primary ciliary dyskinesia, is a complex disease comprising situs inversus, rhinosinusitis, and bronchiectasis. Situs inversus totalis is a condition in which all organs in the thoracic and abdominal cavities are reversed. Furthermore, primary ciliary dyskinesia, an autosomal genetic disease, may coexist with situs inversus totalis. Reports on Siewert-Kartagener's syndrome in veterinary medicine are limited. We report a rare case of primary ciliary dyskinesia with Siewert-Kartagener's syndrome in a dog, concurrently infected with canine distemper virus and type-2 adenovirus. This case highlights that situs inversus totalis can cause primary ciliary dyskinesia, and concurrent infections are possible.

Situs inversus totalis associated with subaortic stenosis, restrictive ventricular septal defect, and tricuspid dysplasia in an adult dog

A rare association between situs inversus totalis (SIT), restrictive ventricular septal defect, severe subaortic stenosis, and tricuspid dysplasia was observed in an adult mixed-breed dog. Primary ciliary dyskinesia and Kartagener's syndrome were excluded. After 15 mo the dog died suddenly. The association between SIT and congenital heart diseases is discussed.

Abdominal situs inversus in a Holstein calf

Situs inversus is a rare congenital anomaly wherein the normal, left-right organ location is inverted. The anatomical inversion (heterotaxy) is usually detected in routine radiography or other medical interventions. A 5-month-old Holstein heifer calf was identified as a suspected situs inversus totalis during abdominal surgery. Following surgery the calf did not gain weight. On admission to the Ontario Veterinary Hospital, it was given a routine clinical examination and a detailed cardiovascular, Doppler ultrasound examination, which appeared normal. Because of declining health and chronic bloating in the heifer, euthanasia was performed. A detailed post-mortem dissection was carried out. No heart or lung anomalies were detected. Other thoracic organs were normal, except for a helical coil of the esophagus as it traversed the diaphragm. The rumen was located entirely on the right side of the abdomen and had a large area of adhesion to the parietal peritoneal wall. The left kidney was abnormally placed: retroperitoneal and cranial to the right. There were two spleens. The caudal vena cava was distended and twisted to the left. Thus the calf was situs inversus abdominalis. This suggests that the development of laterality in the early embryo may include both timing and positional regulation.

Primary ciliary dyskinesia with situs inversus totalis, hydrocephalus internus and cardiac malformations in a dog

A nine-month-old golden retriever bitch was presented with exercise intolerance and recurrent nasal discharge. Based on clinical, radiographic and ultrasonographic examination, a diagnosis of rhinitis, situs inversus totalis and tricuspid valve insufficiency was established. The results of video- and electron microscopy studies of the respiratory epithelium were compatible with primary ciliary dyskinesia (PCD). However, no evidence of a primary ultrastructural defect of the cilia was found. The dog was euthanased because of the poor prognosis. At necropsy, a hydrocephalus internus and a subaortic stenosis were additionally diagnosed. PCD, in combination with situs inversus, has been previously reported in golden retrievers, but without a concomitant hydrocephalus internus. Furthermore, concomitant occurrence of internal cardiac malformation and PCD has not previously been reported in the dog.

A canine case of partial heterotaxia detected by radiography and ultrasound

With radiography and ultrasound, reversed positioning of the fundus ventriculi and pylorus, a duodenum running on the left side, transposition of the kidneys, and normal thoracic organs were found in a 5-month-old miniature dachshund that presented with anorexia and weight loss. The case was diagnosed as partial heterotaxia. Gross observation revealed partial heterotaxia, polysplenia, abnormal lobulation of the liver, and absence of the greater omentum. These findings were consistent with those observed in asplenia-polysplenia syndrome in humans.

Case report on situs inversus totalis in two Sprague-Dawley rats

We macro- and microscopically examined two cases of congenital visceral transposition (situs inversus totalis) in SD rats. We also investigated the possibility of situs inversus in association with immotile-cilia syndrome. The rats had grown normally with no clinical signs of disease. Although all organs including the vascular system were located opposite to the normal position and displayed a mirror image on macroscopic observation, no abnormality was found in any of the organs on microscopic examination. Electron-microscopic observation revealed in neither animal any structural abnormalities of the cilia and flagella, which are one of the diagnostic characterizations of immotile-cilia syndrome. Congenital transposition of the viscera is rare and there are few reports examining complications with situs inversus in rats. This report will be helpful in accumulating information on this condition.

Spectrum of heart malformations in mice with situs solitus, situs inversus, and associated visceral heterotaxy

BACKGROUND

We present a study of the heart malformations found in a collection of mouse fetuses of the iv/iv strain between days 16.5 and 18.5 of gestation.

METHODS AND RESULTS

One hundred hearts were serially sectioned and studied by segmental analysis with a light microscope. Forty additional hearts were analyzed with a scanning microscope. Forty percent of the hearts were found to be malformed. The most frequently occurring heart malformations were persistence of the sinus venosus (9%), common atrium (17%), common atrioventricular canal (24%), double-outlet right ventricle (12%), Fallot's tetralogy (8%), and transposition of the great arteries (5%). These malformations do not usually occur in isolation but rather appear in the formation of complex cardiopathies. The most severe and frequent is the combination of persistence of sinus venosus, common atrium, common atrioventricular canal, and double-outlet right ventricle; this is the "bulboventricular heart." The morphology of each lesion, as well as the degree of association, is similar to that found in human hearts with complex cardiopathies. Some of these cardiopathies appear to be directly related to formation of the cardiac loop. The iv/iv mouse appears to constitute an excellent model with which to study the etiology and pathogenesis of complex heart defects in humans. These hearts show a high phenotypic variability in the presentation of heart lesions. From a genetic viewpoint, there is a basic defect--the bulboventricular heart--which can be considered congenital. The other malformations can be considered formes frustes of the defect type.

CONCLUSIONS

The iv gene is a developmental gene that affects basic developmental mechanisms. In this regard, heart lesions may not be the primary result of the abnormal gene activity but rather are secondary to defective interactions during cardiac development.

Situs inversus in homozygous mice without immotile cilia

Mice homozygous for the mutation situs inversus, iv, are characterized by situs inversus in 50 percent of the individuals. We have investigated the ultrastructure and motility of tracheal cilia and sperm tails in homozygous individuals with and without situs inversus. We found no abnormalities of ciliary structure. Therefore, ciliary immotility is not an essential correlate of situs inversus.

Clinical, pathologic, and ultrastructural features of situs inversus and immotile-cilia syndrome in a dog

Situs inversus, rhinitis, and bronchitis were diagnosed in a 7-month-old male Golden Retriever. Electron microscopic examination of tracheal and bronchial biopsy specimens revealed 9% of the cilia with abnormal axonemal pattern and 1.2% with a fibrous ring between the circle of microtubular doublets and the cell membrane. A permanent response to treatment with antibiotics was not obtained and the dog was euthanatized. At necropsy the thoracic and abdominal organs were found to be in reversed position. Microscopic examination revealed evidence of chronic bronchitis as well as cystic and distended distal tubules of the kidneys. Foci of fibrosis were observed in the renal cortex. The diagnosis was immotile-cilia syndrome.

Hepatoencephalopathy associated with situs inversus of abdominal organs and vascular anomalies in a dog

Throughout its life, a 1-year-old Doberman Pinscher dog had had gastrointestinal disorders and episodes of circling. It was less active than its littermates, and it usually seemed lethargic. When 3 months old, the pup had been anesthetized for ear cropping and it had remained anesthetized for 32 hours. Behavioral problems were apparent when the dog was 11 months old. Two weeks later the behavioral problems accentuated to the point that the dog developed "temper tantrums" and became aggressive toward its owner. On the basis of clinicopathologic and contrast radiographic findings, hepatoencephalopathy due to persistent patent ductus venosus was diagnosed and the dog was euthanatized. Situs inversus abdominalis and multiple vascular anomalies were found at necropsy. Gross and microscopic studies of the viscera were correlated with corrosion casts of the vasculature. In addition to changes in organ position, 3 spleens and malformation of the pancreas were observed. Vascular anomalies were: (1) The portal vein was contiguous with the common hepatic vein by way of a patent ductus venosus; branches of the portal vein were not given off to the liver; (2) the caudal vena cava was continued by the azygos vein, and a cranial segment of the caudal vena cava was absent; (3) the hepatic artery was larger than normal; (4) the left gastric artery arose anomalously from the cranial mesenteric artery; and (5) histologic and radiographic study of the liver did not reveal any interlobular branches of the portal vein; however, hypoplastic branches of the gastroduodenal vein did enter the liver and were demonstrated on a corrosion cast.