Publications by authors named "John E Rush"

107 Publications

Investigation of diets associated with dilated cardiomyopathy in dogs using foodomics analysis.

Sci Rep 2021 Aug 5;11(1):15881. Epub 2021 Aug 5.

Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, USA.

Dilated cardiomyopathy (DCM) is a disease of the heart muscle that affects both humans and dogs. Certain canine diets have been associated with DCM, but the diet-disease link is unexplained, and novel methods are needed to elucidate mechanisms. We conducted metabolomic profiling of 9 diets associated with canine DCM, containing ≥ 3 pulses, potatoes, or sweet potatoes as main ingredients, and in the top 16 dog diet brands most frequently associated with canine DCM cases reported to the FDA (3P/FDA diets), and 9 non-3P/FDA diets. We identified 88 named biochemical compounds that were higher in 3P/FDA diets and 23 named compounds that were lower in 3P/FDA diets. Amino acids, amino acid-derived compounds, and xenobiotics/plant compounds were the largest categories of biochemicals that were higher in 3P/FDA diets. Random forest analyses identified the top 30 compounds that distinguished the two diet groups with 100% predictive accuracy. Four diet ingredients distinguished the two diet groups (peas, lentils, chicken/turkey, and rice). Of these ingredients, peas showed the greatest association with higher concentrations of compounds in 3P/FDA diets. Moreover, the current foodomics analyses highlight relationships between diet and DCM in dogs that can identify possible etiologies for understanding diet-disease relationships in dogs and humans.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-021-94464-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8342479PMC
August 2021

Effect of type of diet on blood and plasma taurine concentrations, cardiac biomarkers, and echocardiograms in 4 dog breeds.

J Vet Intern Med 2021 Mar 27;35(2):771-779. Epub 2021 Feb 27.

University of Massachusetts Medical School, Worcester, Massachusetts, USA.

Background: Associations of diet with dilated cardiomyopathy are under investigation.

Objectives: That cardiac assessment would show abnormalities in healthy dogs eating grain-free (GF) diets or diets with Food and Drug Administration (FDA)-listed ingredients of concern (peas, lentils, or potatoes) as top 10 ingredients (FDA-PLP), but not in dogs eating grain-inclusive (GI) diets or diets without FDA-listed ingredients of concern (PLP) in the top 10 ingredients (NoFDA-PLP).

Animals: One hundred eighty-eight healthy Doberman Pinschers, Golden Retrievers, Miniature Schnauzers, and Whippets.

Methods: This study was an observational cross-sectional study. Echocardiograms, cardiac biomarkers, and blood and plasma taurine concentrations were compared between dogs eating GF (n = 26) and GI (n = 162) diets, and between FDA-PLP (n = 39) and NoFDA-PLP (n = 149) diets, controlling for age and breed. Demographic characteristics, murmurs, genetic status, and ventricular premature complexes (VPCs) during examination were compared between dogs eating different diet types.

Results: No differences in echocardiographic variables, N-terminal pro-B-type natriuretic peptide or whole blood taurine were noted between dogs eating different diet types. Dogs eating GF diets had higher median high-sensitivity cardiac troponin I (hs-cTnI) (GF 0.076 ng/mL [Interquartile range (IQR), 0.028-0.156] vs. GI 0.048 [IQR, 0.0026-0.080]; P < .001) and higher median plasma taurine (GF 125 nmol/mL [IQR, 101-148] vs GI 104 [IQR, 86-123]; P = .02) than dogs eating GI diets. Dogs eating FDA-PLP diets had higher median hs-cTnI (0.059 ng/mL [IQR, 0.028-0.122]) than dogs eating NoFDA-PLP diets (0.048 [IQR, 0.025-0.085]; P = .006). A greater proportion of dogs eating FDA-PLP diets (10%) had VPCs than dogs eating NoFDA-PLP diets (2%; P = .04).

Conclusions And Clinical Importance: Higher hs-cTnI in healthy dogs eating GF and FDA-PLP diets might indicate low-level cardiomyocyte injury.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jvim.16075DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995416PMC
March 2021

Effects of pimobendan in cats with hypertrophic cardiomyopathy and recent congestive heart failure: Results of a prospective, double-blind, randomized, nonpivotal, exploratory field study.

J Vet Intern Med 2021 Mar 5;35(2):789-800. Epub 2021 Feb 5.

Boehringer Ingelheim Vetmedica GmbH, Ingelheim, Germany.

Background: The benefits of pimobendan in the treatment of congestive heart failure (CHF) in cats with hypertrophic cardiomyopathy (HCM) have not been evaluated prospectively.

Hypothesis/objectives: To investigate the effects of pimobendan in cats with HCM and recent CHF and to identify possible endpoints for a pivotal study. We hypothesized that pimobendan would be well-tolerated and associated with improved outcome.

Animals: Eighty-three cats with HCM and recently controlled CHF: 30 with and 53 without left ventricular outflow tract obstruction.

Methods: Prospective randomized placebo-controlled double-blind multicenter nonpivotal field study. Cats received either pimobendan (0.30 mg/kg q12h, n = 43), placebo (n = 39), or no medication (n = 1) together with furosemide (<10 mg/kg/d) with or without clopidogrel. The primary endpoint was a successful outcome (ie, completing the 180-day study period without a dose escalation of furosemide).

Results: The proportion of cats in the full analysis set population with a successful outcome was not different between treatment groups (P = .75). For nonobstructive cats, the success rate was 32% in pimobendan-treated cats versus 18.2% in the placebo group (odds ratio [OR], 2.12; 95% confidence interval [CI], 0.54-8.34). For obstructive cats, the success rate was 28.6% and 60% in the pimobendan and placebo groups, respectively (OR, 0.27; 95% CI, 0.06-1.26). No difference was found between treatments for the secondary endpoints of time to furosemide dose escalation or death (P = .89). Results were similar in the per-protocol sets. Adverse events in both treatment groups were similar.

Conclusions And Clinical Importance: In this study of cats with HCM and recent CHF, no benefit of pimobendan on 180-day outcome was identified.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jvim.16054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995419PMC
March 2021

Retrospective study of dilated cardiomyopathy in dogs.

J Vet Intern Med 2021 Jan 21;35(1):58-67. Epub 2020 Dec 21.

Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA.

Background: The United States Food and Drug Administration is investigating possible diet-associated dilated cardiomyopathy (DCM) in dogs and cats.

Objectives: To retrospectively review DCM cases for signalment, diet information, echocardiographic changes, and survival.

Animals: Client-owned dogs (n = 71).

Methods: Medical records of dogs diagnosed with DCM between January 1, 2014 and September 30, 2018 were reviewed. Dogs were grouped into "traditional" or "nontraditional" diet categories and whether or not diet was changed after diagnosis.

Results: For dogs eating nontraditional diets, those that had their diets changed had a larger percentage decrease in normalized systolic left ventricular internal dimension (P = .03) and left atrial:aorta ratio (P < .001) compared to those that did not have their diets changed. Survival time was significantly longer for dogs with DCM eating nontraditional diets that had their diets changed (median survival, 337 days; range, 9-1307 days) compared to dogs eating nontraditional diets that did not have their diets changed (median survival, 215 days; range, 1-852 days; P = .002).

Conclusions And Clinical Importance: Dogs with DCM eating nontraditional diets can experience improvement in cardiac function after diet change but additional research is needed to examine possible associations between diet and DCM.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jvim.15972DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7848368PMC
January 2021

Echocardiographic, morphometric and biomarker changes in female cats followed from 6 to 24 months of life.

J Feline Med Surg 2021 04 28;23(4):278-286. Epub 2020 Jul 28.

Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, USA.

Objectives: The aim of the study was to evaluate cardiac size and early growth through echocardiographic, body weight (BW), body condition score (BCS), morphometric and biomarker changes in cats followed from 6 to 24 months of age.

Methods: Twenty-four female European shorthair colony cats were evaluated at birth for BW and at 6, 12, 18 and 24 months of age for BW, BCS, head length (HL) and head width (HW), N-terminal pro B-type natriuretic peptide (NT-proBNP), insulin-like growth factor-1 (IGF-1) and echocardiographic measurements.

Results: BCS, HW, left ventricular free wall in diastole, left atrium diameter and aortic diameter increased significantly between 6 and 12 months, while BW, HL and interventricular septum in diastole increased significantly between 6, 12 and 18 months, and BW decreased significantly between 18 and 24 months. NT-proBNP decreased significantly between 6 and 12 months. IGF-1 increased significantly between 6 and 12 months but decreased significantly between 12 and 18 months.

Conclusions And Relevance: This study prospectively evaluated changes in echocardiographic measurements, BW, BCS, HL, HW, IGF-1 and NT-proBNP in cats during the first 2 years of life. Results show a comparable change over time for different variables. These findings contribute to the understanding of a possible relationship between cardiac measures and body size from young age through to adulthood.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1098612X20943684DOI Listing
April 2021

Vitamin D status in cats with cardiomyopathy.

J Vet Intern Med 2020 Jul 17;34(4):1389-1398. Epub 2020 Jun 17.

Department of Statistics, College of Liberal Arts and Sciences, Iowa State University, Ames, Iowa, USA.

Background: Low vitamin D concentrations have been associated with advanced heart disease and poorer outcomes in people and dogs. Vitamin D status typically is assessed by serum 25(OH)D concentration. However, cats also produce notable amounts of a C-3 epimer of 25(OH)D (3-epi).

Hypothesis/objectives: Determine if vitamin D status, estimated by 25(OH)D alone or combined with 3-epi (summation vitD), is lower in cats with cardiomyopathy (CM) compared to clinically normal (N) cats and if indicators of disease severity are associated with vitamin D status.

Animals: Privately owned cats, 44 with CM and 56 N.

Methods: Cross-sectional observational study using clinical and echocardiographic findings, diet history, and serum 25(OH)D and 3-epi measurements.

Results: Cat age was negatively related to vitamin D status. Summation vitD was lower in CM cats (median = 47.1 ng/mL) compared to N cats (median = 58.65 ng/mL) both before (P = .03) and after (P = .04) accounting for age. However, 25(OH)D became nonsignificant between CM and N cats after age was included. Summation vitD was related positively to survival time and fractional shortening (FS), but negatively to left atrial enlargement (LAE) severity, both before and after accounting for age. For 25(OH)D alone, only survival time and FS remained significant after including age.

Conclusions And Clinical Importance: We report 25(OH)D and 3-epi concentrations in CM and N cats. Age had an important (negative) relationship to vitamin D status. After accounting for age, summation vitD was lower in CM cats. Vitamin D status was related positively to survival time and FS, but negatively to LAE severity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jvim.15833DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7379033PMC
July 2020

Validation and preliminary data from a health-related quality of life questionnaire for owners of dogs with cardiac disease.

J Vet Intern Med 2020 May 12;34(3):1119-1126. Epub 2020 May 12.

Tufts Veterinary Emergency Treatment and Specialties, Walpole, Massachusetts, USA.

Background: Cardiac disease in dogs impacts the quality of life (QoL) of their owners, but owners' QoL has not been comprehensively assessed in this population.

Objectives: To develop, validate, and provide preliminary data from a health-related QoL (hrQoL) questionnaire for owners of dogs with cardiac disease.

Subjects: A total of 141 owners of dogs with cardiac disease were studied.

Methods: An owner hrQoL (O-hrQoL) questionnaire containing 20 items related to areas of a person's life that could be impacted by caring for a dog with cardiac disease was developed and administered to owners of dogs with cardiac disease. The highest possible total score was 100, with higher scores indicating a worse hrQoL. Readability, internal consistency, face and construct validity, and item-total correlations were assessed.

Results: Median O-hrQoL score was 35 (range, 0-87). The questionnaire had good internal consistency (Cronbach's α = 0.933), construct validity (Spearman's r = 0.38-0.53; Kendall's τ = 0.30-0.43; P < .001), and item-total correlation (Spearman's r = 0.44-0.79; Kendall's τ = 0.34-0.66; all P < .001). Fifty percent of owners indicated a negative effect of dogs' cardiac disease on their own QoL, but all owners responded that caring for their dogs either had strengthened (n = 76; 53.9%) or had no effect on their relationship with their dog (n = 65; 46.1%).

Conclusions And Clinical Importance: The O-hrQoL questionnaire had good validity, and results suggest that owners' QoL is significantly impacted by caring for dogs with cardiac disease. Additional research on effective approaches to minimizing the negative effects of a dog's cardiac disease on the owner is warranted.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jvim.15791DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255686PMC
May 2020

Extracellular vesicular microRNAs as potential biomarker for early detection of doxorubicin-induced cardiotoxicity.

J Vet Intern Med 2020 May 7;34(3):1260-1271. Epub 2020 Apr 7.

Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA.

Background: Long-term use of doxorubicin (DOX) is limited by cumulative dose-dependent cardiotoxicity.

Objectives: Identify plasma extracellular vesicle (EV)-associated microRNAs (miRNAs) as a biomarker for cardiotoxicity in dogs by correlating changes with cardiac troponin I (cTnI) concentrations and, echocardiographic and histologic findings.

Animals: Prospective study of 9 client-owned dogs diagnosed with sarcoma and receiving DOX single-agent chemotherapy (total of 5 DOX treatments). Dogs with clinically relevant metastatic disease, preexisting heart disease, or breeds predisposed to cardiomyopathy were excluded.

Methods: Serum concentration of cTnI was monitored before each treatment and 1 month after the treatment completion. Echocardiography was performed before treatments 1, 3, 5, and 1 month after completion. The EV-miRNA was isolated and sequenced before treatments 1 and 3, and 1 month after completion.

Results: Linear mixed model analysis for repeated measurements was used to evaluate the effect of DOX. The miR-107 (P = .03) and miR-146a (P = .02) were significantly downregulated whereas miR-502 (P = .02) was upregulated. Changes in miR-502 were significant before administration of the third chemotherapeutic dose. When stratifying miRNA expression for change in left ventricular ejection fraction, upregulation of miR-181d was noted (P = .01). Serum concentration of cTnI changed significantly but only 1 month after treatment completion, and concentrations correlated with left ventricular ejection fraction and left ventricular internal dimension in diastole.

Conclusion And Clinical Significance: Downregulation of miR-502 was detected before significant changes in cTnI concentrations or echocardiographic parameters. Further validation using a larger sample size will be required.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jvim.15762DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255649PMC
May 2020

Cardiac cachexia in cats with congestive heart failure: Prevalence and clinical, laboratory, and survival findings.

J Vet Intern Med 2020 Jan 3;34(1):35-44. Epub 2019 Dec 3.

Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts.

Background: Cardiac cachexia is common in people and dogs with congestive heart failure (CHF). However, the prevalence and effects of cardiac cachexia in cats are unknown.

Objectives: To determine the prevalence of cachexia and its associations with clinical laboratory and survival data in cats with CHF.

Animals: One hundred twenty-five cats with CHF.

Methods: Medical records of cats evaluated during a 40-month period were retrospectively reviewed to identify cats with cardiac cachexia using 7 different definitions. Clinical, laboratory, and survival data were compared between cats with and without cachexia.

Results: Prevalence of cachexia ranged from 0 to 66.7% for the 7 definitions, with a prevalence of 41.6% using muscle condition score (MCS). Cats with cachexia (determined by MCS) were older (P < .001), more likely to have pleural effusion (P = .003), had significantly higher blood urea nitrogen (P < .001) and neutrophil concentrations (P = .01), and significantly lower body condition score (P < .001), body weights (P < .001), hematocrit (P = .007), and hemoglobin concentrations (P = .009). Survival time for cats with cachexia (determined by MCS) was significantly shorter than for cats without cachexia (P = .03). Cats that were underweight (P = .002) and cats with dilated cardiomyopathy (DCM) also had shorter survival times (P = .04).

Conclusions And Clinical Importance: The association between cachexia and reduced survival time emphasizes the importance of identifying and addressing this common problem in cats with CHF.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jvim.15672DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6979101PMC
January 2020

Pathology in Practice.

J Am Vet Med Assoc 2019 11;255(9):1023-1026

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2460/javma.255.9.1023DOI Listing
November 2019

Long-term incidence and risk of noncardiovascular and all-cause mortality in apparently healthy cats and cats with preclinical hypertrophic cardiomyopathy.

J Vet Intern Med 2019 Nov 12;33(6):2572-2586. Epub 2019 Oct 12.

Ludwig-Maximilians-University Munich, Clinic of Small Animal Medicine, Munich, Germany.

Background: Epidemiologic knowledge regarding noncardiovascular and all-cause mortality in apparently healthy cats (AH) and cats with preclinical hypertrophic cardiomyopathy (pHCM) is limited, hindering development of evidence-based healthcare guidelines.

Objectives: To characterize/compare incidence rates, risk, and survival associated with noncardiovascular and all-cause mortality in AH and pHCM cats.

Animals: A total of 1730 client-owned cats (722 AH, 1008 pHCM) from 21 countries.

Methods: Retrospective, multicenter, longitudinal, cohort study. Long-term health data were extracted by medical record review and owner/referring veterinarian interviews.

Results: Noncardiovascular death occurred in 534 (30.9%) of 1730 cats observed up to 15.2 years. Proportion of noncardiovascular death did not differ significantly between cats that at study enrollment were AH or had pHCM (P = .48). Cancer, chronic kidney disease, and conditions characterized by chronic weight-loss-vomiting-diarrhea-anorexia were the most frequently recorded noncardiovascular causes of death. Incidence rates/risk of noncardiac death increased with age in AH and pHCM. All-cause death proportions were greater in pHCM than AH (65% versus 40%, respectively; P < .001) because of higher cardiovascular mortality in pHCM cats. Comparing AH with pHCM, median survival (study entry to noncardiovascular death) did not differ (AH, 9.8 years; pHCM, 8.6 years; P = .10), but all-cause survival was significantly shorter in pHCM (P = .0001).

Conclusions And Clinical Importance: All-cause mortality was significantly greater in pHCM cats due to disease burden contributed by increased cardiovascular death superimposed upon noncardiovascular death.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jvim.15609DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6872868PMC
November 2019

Clinical and laboratory findings and survival time associated with cardiac cachexia in dogs with congestive heart failure.

J Vet Intern Med 2019 Sep 17;33(5):1902-1908. Epub 2019 Jul 17.

Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts.

Background: Cardiac cachexia, loss of muscle mass associated with congestive heart failure (CHF), is associated with increased morbidity and shorter survival times in people, but an association between cardiac cachexia and survival has not been reported in dogs.

Objectives: To determine the prevalence of cachexia and its associations with clinical, laboratory, and survival data in dogs with CHF.

Animals: Two hundred sixty-nine dogs with CHF.

Methods: Retrospective cohort study. Cachexia was defined by 1 of 2 definitions: (1) mild, moderate, or severe muscle loss or (2) weight loss of ≥5% in 12 months or less. Variables were compared between dogs with and without cachexia.

Results: One hundred thirty of 269 dogs (48.3%) had cardiac cachexia based on muscle loss, whereas 67 of 159 dogs (42.1%) with pre-evaluation body weights had cachexia based on weight loss. Dogs with cachexia (based on muscle loss) were significantly older (P = .05), more likely to have a cardiac arrhythmia (P = .02), had higher chloride concentrations (P = .04), and had a lower body condition score (P < .001), hematocrit (P = .006), hemoglobin (P = .006), and albumin (P = .004) concentrations. On multivariable analysis, cachexia (P = .05), clinically important tachyarrhythmias (P < .001), azotemia (P < .001), and being under- or overweight (both P = .003) were associated with shorter survival times.

Conclusions And Clinical Importance: Cardiac cachexia in common in dogs with CHF and is associated with significantly shorter survival. This emphasizes the importance of preventing, diagnosing, and treating muscle loss in dogs with CHF.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jvim.15566DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766489PMC
September 2019

The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats.

J Vet Intern Med 2019 Sep 17;33(5):1892-1901. Epub 2019 Jul 17.

Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Background: Focused cardiac ultrasound (FCU) helps detect occult heart disease in human patients.

Hypothesis: Focused cardiac ultrasound by a nonspecialist practitioner (NSP) will increase the detection of occult heart disease in asymptomatic cats compared with physical examination and ECG.

Animals: Three hundred forty-three client-owned cats: 54 excluded and 289 analyzed.

Methods: Multicenter prospective cohort study. Twenty-two NSPs were trained to perform FCU. Cats without clinical signs of heart disease were recruited, and NSPs performed the following in sequential order: physical examination, ECG, FCU, and point-of-care N-terminal pro-B-type natriuretic peptide assay (POC-BNP). After each step, NSPs indicated yes, no, or equivocal as to whether they believed heart disease was present. The level of agreement between the NSP diagnosis and a blinded cardiologist's diagnosis after echocardiogram was evaluated using Cohen's kappa test.

Results: Cardiologist diagnoses included 148 normal cats, 102 with heart disease, and 39 equivocal ones. Agreement between NSP and cardiologist was slight after physical examination (kappa 0.253 [95% CI, 0.172-0.340]), did not increase after ECG (0.256 [0.161-0.345]; P = .96), increased after FCU (0.468 [0.376-0.558]; P = .002), and the level of agreement was similar after POC-BNP (0.498 [0.419-0.580]; P = .67). In cats with mild, moderate, and marked occult heart disease, the proportion of cats having a NSP diagnosis of heart disease after FCU was 45.6%, 93.1%, and 100%, respectively.

Conclusions And Clinical Importance: Focused cardiac ultrasound performed by NSPs increased the detection of occult heart disease, especially in cats with moderate to marked disease. Focused cardiac ultrasound appears to be a feasible and useful tool to assist NSPs in the detection of heart disease in cats.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jvim.15549DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766524PMC
September 2019

ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs.

J Vet Intern Med 2019 May 11;33(3):1127-1140. Epub 2019 Apr 11.

Jasmine Veterinary Cardiovascular Medical Center, Yokohama, Japan.

This report, issued by the ACVIM Specialty of Cardiology consensus panel, revises guidelines for the diagnosis and treatment of myxomatous mitral valve disease (MMVD, also known as endocardiosis and degenerative or chronic valvular heart disease) in dogs, originally published in 2009. Updates were made to diagnostic, as well as medical, surgical, and dietary treatment recommendations. The strength of these recommendations was based on both the quantity and quality of available evidence supporting diagnostic and therapeutic decisions. Management of MMVD before the onset of clinical signs of heart failure has changed substantially compared with the 2009 guidelines, and new strategies to diagnose and treat advanced heart failure and pulmonary hypertension are reviewed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jvim.15488DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524084PMC
May 2019

A pilot study investigating circulating trimethylamine N-oxide and its precursors in dogs with degenerative mitral valve disease with or without congestive heart failure.

J Vet Intern Med 2019 Jan 3;33(1):46-53. Epub 2018 Dec 3.

Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts.

Background: Pathophysiologic mechanisms for the development and progression of degenerative mitral valve disease (DMVD) remain elusive. Increased concentrations of circulating trimethylamine N-oxide (TMAO) and its precursors choline and l-carnitine are associated with the presence and severity of heart disease in people.

Objectives: To determine if differences exist in plasma concentrations of TMAO, choline, or l-carnitine among dogs with DMVD and congestive heart failure (CHF), dogs with asymptomatic DMVD, and healthy control dogs.

Animals: Thirty client-owned dogs: 10 dogs with CHF secondary to DMVD, 10 dogs with asymptomatic DMVD, and 10 healthy control dogs.

Methods: A pilot cross-sectional study in which echocardiography was performed and fasting plasma concentrations of TMAO, choline, and l-carnitine (total and fractions) were measured.

Results: TMAO (P = .03), total l-carnitine (P = .03), carnitine esters (P = .05), and carnitine esters to free carnitine ratio (E/F ratio; P = .05) were significantly higher in dogs with CHF compared to those with asymptomatic DMVD. TMAO (P = .02), choline (P = .01), total l-carnitine (P = .01), carnitine esters (P = .02), free carnitine (P = .02), and E/F ratio (P = .009) were significantly higher in dogs with CHF compared to healthy controls.

Conclusions And Clinical Importance: Dogs with CHF secondary to DMVD had higher concentrations of TMAO compared to both asymptomatic DMVD dogs and healthy controls. Larger prospective studies are warranted to determine if TMAO plays a role in the development or progression of DMVD or CHF.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jvim.15347DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6335534PMC
January 2019

Vasopressor use in 41 critically ill cats (2007-2016).

Can Vet J 2018 11;59(11):1175-1180

Cummings School of Veterinary Medicine at Tufts University, 55 Willard Street, North Grafton, Massachusetts 01536, USA.

This study describes the use of vasopressors in critically ill cats. Records of 41 cats hospitalized in the ICU were evaluated. Signalment, blood pressure, underlying conditions, evidence of sepsis, type of treatment (surgical non-surgical), vasopressor type and duration, adverse events attributed to vasopressors, and survival were recorded. Twenty-one cats (51%) had an underlying disease considered amenable to surgical treatment while 20 (49%) cats did not. Evidence of sepsis was present in 24 (59%) cats. Thirty-four cats developed a Doppler blood pressure (DBP) > 80 mmHg during therapy, and 29 cats became normotensive (DBP > 90 mmHg). Seven cats did not increase their DBP to > 80 mmHg. All cats received dopamine and/or norepinephrine and 6 cats also received other vasopressors. Sixteen cats survived (39%). Surgical intervention was associated with a higher survival ( = 0.004). Critically ill hypotensive cats may benefit from administration of vasopressors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6190150PMC
November 2018

Evaluation of a quantitatively derived value for assessment of muscle mass in clinically normal cats.

Am J Vet Res 2018 Nov;79(11):1188-1192

OBJECTIVE To evaluate use of an ultrasonographically and radiographically determined value, the vertebral epaxial muscle score (VEMS), for assessing muscle mass in cats. ANIMALS 30 healthy neutered cats of various body weights and between 1 and 6 years of age. PROCEDURES Mean epaxial muscle height was calculated from 3 transverse ultrasonographic images obtained at the level of T13. Length of T4 was measured on thoracic radiographs, and the VEMS (ratio of epaxial muscle height to T4 length) was calculated and compared with body weight. Ratios of epaxial muscle height to various anatomic measurements also were compared with body weight as potential alternatives to use of T4 length. RESULTS 1 cat was excluded because of a heart murmur. For the remaining 29 cats, mean ± SD body weight was 5.05 ± 1.40 kg. Mean epaxial muscle height was 1.27 ± 0.13 cm, which was significantly correlated (r = 0.65) with body weight. The VEMS and value for epaxial muscle height/(0.1 × forelimb circumference) were not significantly correlated (r = -0.18 and -0.06, respectively) with body weight, which is important for measures used for animals of various sizes. CONCLUSIONS AND CLINICAL RELEVANCE The VEMS and value for epaxial muscle height/(0.1 × forelimb circumference) can both be used to normalize muscle size among cats of various body weights. Studies are warranted to determine whether these values can be used to accurately assess muscle mass in cats with various adiposity and in those with muscle loss.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2460/ajvr.79.11.1188DOI Listing
November 2018

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 May 16;32(3):930-943. Epub 2018 Apr 16.

Clinic of Small Animal Medicine, Ludwig-Maximilians University, Munich, Germany.

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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jvim.15122DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980443PMC
May 2018

Clinical findings and survival time in dogs with advanced heart failure.

J Vet Intern Med 2018 May 10;32(3):944-950. Epub 2018 Apr 10.

Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts.

Background: Dogs with advanced heart failure are a clinical challenge for veterinarians but there are no studies reporting clinical features and outcome of this population.

Hypothesis/objectives: To describe clinical findings and outcome of dogs with advanced heart failure caused by degenerative mitral valve disease (DMVD).

Animals: Fifty-four dogs with advanced heart failure because of DMVD.

Methods: For study purposes, advanced heart failure was defined as recurrence of congestive heart failure signs despite receiving the initially prescribed dose of pimobendan, angiotensin-converting-enzyme inhibitor (ACEI), and furosemide >4 mg/kg/day. Data were collected for the time of diagnosis of Stage C heart failure and time of diagnosis of advanced heart failure. Date of death was recorded.

Results: At the diagnosis of advanced heart failure, doses of pimobendan (n = 30), furosemide (n = 28), ACEI (n = 13), and spironolactone (n = 4) were increased, with ≥1 new medications added in most dogs. After initial diagnosis of advanced heart failure, 38 (70%) dogs had additional medications adjustments (median = 2 [range, 0-27]), with the final total medication number ranging from 2-10 (median = 5). Median survival time after diagnosis of advanced heart failure was 281 days (range, 3-885 days). Dogs receiving a furosemide dose >6.70 mg/kg/day had significantly longer median survival times (402 days [range, 3-885 days] versus 129 days [range 9-853 days]; P = .017).

Conclusions And Clinical Importance: Dogs with advanced heart failure can have relatively long survival times. Higher furosemide dose and non-hospitalization were associated with longer survival.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jvim.15126DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980388PMC
May 2018

Clinical Features of English Bulldogs with Presumed Arrhythmogenic Right Ventricular Cardiomyopathy: 31 Cases (2001-2013).

J Am Anim Hosp Assoc 2018 Mar/Apr;54(2):95-102. Epub 2018 Jan 26.

From the Department of Clinical Sciences, Tufts University Cummings School of Veterinary Medicine, North Grafton, Massachusetts (S.M.C., J.E.R.); MedVet Columbus, Worthington, Ohio (J.T.S.); New England Veterinary Cardiology, Portland, Maine (J.M.); and Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts (B.A.B.).

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an important cause of sudden death in people and boxer dogs that has recently been described in English bulldogs. The objective of this retrospective study was to describe the clinical characteristics of English bulldogs with presumed ARVC. The medical records were searched for English bulldogs examined between 2001 and 2013 with a clinical diagnosis of ARVC. The average age of the 31 dogs identified was 9.2 ± 1.6 yr (range 7-13 yr). Males were overrepresented by a factor of 2.9 to 1. At initial presentation, 5 dogs had subclinical arrhythmia, 10 dogs had clinical signs attributable to arrhythmia, and 16 dogs had congestive heart failure. Eighteen dogs (58%) had ventricular tachycardia and five (16%) also had supraventricular arrhythmias. Four dogs experienced sudden death, 2 dogs died from congestive heart failure, 11 dogs were euthanized for cardiac causes, and 2 dogs died or were euthanized for noncardiac causes. Kaplan-Meier analysis showed a median survival time of 8.3 mo. This is the first study to describe the clinical characteristics of a population of English bulldogs with presumed ARVC. Further studies are needed to better characterize the clinical features of the disease in this breed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5326/JAAHA-MS-6550DOI Listing
January 2019

Quantitative assessment of muscle in dogs using a vertebral epaxial muscle score.

Can J Vet Res 2017 Oct;81(4):255-260

Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, Massachusetts 01536, USA (Freeman, Sutherland-Smith, Prantil, Sato, Rush); Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA (Barton).

Muscle loss associated with disease (cachexia) or with aging (sarcopenia) is common in dogs, but clinically relevant methods for quantifying muscle loss are needed. We previously validated an ultrasound method of quantifying muscle size in dogs in a single breed. The goal of this study was to assess the variability and reproducibility of the Vertebral Epaxial Muscle Score (VEMS) in other dog breeds. Static ultrasound images were obtained from 38 healthy, neutered dogs of 5 different breeds between 1- and 5-years-old. The maximal transverse right epaxial muscle height and area at the level of the 13th thoracic vertebra (T13) were measured. Length of the 4th thoracic vertebra (T4) was measured from thoracic radiography. Ratios of the muscle height and area to vertebral length (height/T4 and area/T4, respectively) were calculated to account for differences in body size among breeds. Reproducibility testing was performed on 2 dogs of each breed (26% of the total) to determine intra- and inter-investigator reproducibility, as well as intra-class correlation. Mean height/T4 = 1.02 ± 0.18 and mean area/T4 = 3.32 ± 1.68. There was no significant difference for height/T4 ( = 0.10) among breeds, but breeds were significantly different in area/T4 ( < 0.001). Intra-class correlation ranged from 0.80 to 0.99. Testing showed better reproducibility for height/T4 compared to area/T4. The VEMS using height/T4 was valid and reproducible for healthy dogs of different sizes and body conformations. Studies assessing this technique in dogs with congestive heart failure and other diseases associated with muscle loss are warranted.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5644455PMC
October 2017

Evaluation of echocardiography and cardiac biomarker concentrations in dogs with gastric dilatation volvulus.

J Vet Emerg Crit Care (San Antonio) 2017 Nov 28;27(6):631-637. Epub 2017 Sep 28.

Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, 01536.

Objective: To assess abnormalities in concentrations of cardiac troponin I (cTnI), lactate, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in relation to arrhythmias, echocardiographic measurements, and survival in dogs with gastric dilatation volvulus (GDV).

Design: Prospective observational study.

Setting: University hospital.

Animals: Twenty-two dogs with naturally occurring GDV.

Samples: Concentrations of cTnI, plasma lactate, and NT-proBNP were recorded at presentation to the emergency room, the time closest to echocardiography, and the highest recorded concentrations during hospitalization.

Interventions: None.

Measurements And Main Results: Cardiac rhythms were categorized on a 0-4 scale (0 = no ventricular premature complexes [VPCs], 1 = single VPCs, 2 = bigeminy or trigeminy, 3 = couplets or triplets, and 4 = R-on-T phenomenon or ventricular tachycardia). Echocardiography was performed 6-18 hours postoperatively. Fifteen dogs had ventricular arrhythmias during hospitalization (Grade 1 [n = 9], Grade 4 [n = 6]). The highest recorded cTnI concentration was significantly higher in the dogs with Grade 4 (P = 0.002) or Grade 1 (P = 0.001) arrhythmias compared to dogs without arrhythmias. Plasma lactate was significantly correlated with left ventricular internal diameter in diastole (r = -0.52, P = 0.01) and systole (r = -0.57, P = 0.006), left ventricular free wall in diastole (LWDd, r = 0.59, P = 0.004), and interventricular septal thickness in diastole (IVDs, r = 0.65, P = 0.001). Dogs that did not survive to 1 week postdischarge (3/22) had a significantly thicker LVWd (P = 0.04) and IVSd (P = 0.05), and received significantly less fluids in the first 24 (P = 0.02) and 48 hours (P = 0.03) of hospitalization.

Conclusions: Concentrations of cTnI and NT-proBNP increased during hospitalization, but only cTnI concentrations were significantly higher in dogs with a higher arrhythmia grade. Additional research on the potential role of serial measurement of biomarkers in dogs with GDV is warranted.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/vec.12667DOI Listing
November 2017

Feline Hypertrophic Cardiomyopathy: A Spontaneous Large Animal Model of Human HCM.

Cardiol Res 2017 Aug 23;8(4):139-142. Epub 2017 Aug 23.

Department of Medicine, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA.

Hypertrophic cardiomyopathy (HCM) is a common disease in pet cats, affecting 10-15% of the pet cat population. The similarity to human HCM, the rapid progression of disease, and the defined and readily determined endpoints of feline HCM make it an excellent natural model that is genotypically and phenotypically similar to human HCM. The Maine Coon and Ragdoll cats are particularly valuable models of HCM because of myosin binding protein-C mutations and even higher disease incidence compared to the overall feline population. The cat overcomes many of the limitations of rodent HCM models, and can provide enhanced translation of information from and induced small animal models to human clinical trials. Physicians and veterinarians working together in a collaborative and interdisciplinary approach can accelerate the discovery of more effective treatments for this and other cardiovascular diseases affecting human and veterinary patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14740/cr578wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574284PMC
August 2017

A Novel Model for Teaching Primary Care in a Community Practice Setting: Tufts at Tech Community Veterinary Clinic.

J Vet Med Educ Spring 2018;45(1):99-107. Epub 2017 Sep 1.

Providing veterinary students with opportunities to develop clinical skills in a realistic, hands-on environment remains a challenge for veterinary education. We have developed a novel approach to teaching clinical medicine to fourth-year veterinary students and technical high school students via development of a primary care clinic embedded within a technical high school. The primary care clinic targets an underserved area of the community, which includes many of the participating high school students. Support from the veterinary community for the project has been strong as a result of communication, the opportunity for veterinarians to volunteer in the clinic, and the careful targeting of services. Benefits to veterinary students include the opportunity to build clinical competencies and confidence, as well as the exposure to a diverse client population. The financial model of the clinic is described and initial data on outcomes for case load, clinic income, veterinary student evaluations, and high school students' success in passing the veterinary assisting examination are reported. This clinical model, involving a partnership between a veterinary school and a technical high school, may be adoptable to other clinical teaching situations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3138/jvme.1116-174DOI Listing
May 2018

Vascular stent placement for palliation of mass-associated chylothorax in two dogs.

J Am Vet Med Assoc 2017 Sep;251(6):696-701

CASE DESCRIPTION 2 dogs with chylothorax were identified to have cardiac mass lesions obstructing the return of venous blood from the cranial vena cava. Chylous effusion was presumed to have been a result of an increase in cranial vena cava pressure affecting flow of chyle through the thoracic duct. CLINICAL FINDINGS Both dogs had tachypnea and pleural effusion requiring therapeutic thoracocentesis. Fluid analysis confirmed chylothorax. A heart-base mass was identified via echocardiography in each dog, and CT-angiographic findings confirmed obstruction to venous return in the cranial vena cava in both dogs and compression of the pulmonary artery in 1 dog. TREATMENT AND OUTCOME Each dog was anesthetized, and self-expanding endovascular stents were placed with fluoroscopic guidance. In both dogs, the site of stent placement was the cranial vena cava, and in 1 dog, an additional stent was positioned in the pulmonary artery. Chylous effusion resolved successfully in both dogs after surgery, with postoperative survival times exceeding 6 months. Complications included periprocedural arrhythmias in both dogs and eventual obstruction of the stent with tumor extension and fluid reaccumulation in 1 dog. CLINICAL RELEVANCE Endovascular stent placement may provide a useful palliative treatment for chylothorax secondary to vascular compression by a heart-base mass in dogs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2460/javma.251.6.696DOI Listing
September 2017

Prevalence of vomiting in dogs with pericardial effusion.

J Vet Emerg Crit Care (San Antonio) 2017 Mar 12;27(2):250-252. Epub 2017 Jan 12.

Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, 01536.

Background: Pericardial effusion (PE) is common in dogs. Clinical signs may be vague until cardiac tamponade and associated cardiovascular decompensation develops. Vomiting has previously been identified in some dogs, but the actual prevalence of vomiting in dogs with PE is unknown. The purpose of this study is to report the prevalence of vomiting associated with PE, and to determine if vomiting is associated with the underlying cause of effusion, presenting plasma lactate concentration, or volume of PE removed.

Key Findings: The medical records of 49 dogs diagnosed with PE were restrospectively reviewed. Data collected from the medical record included signalment, the presence or absence of vomiting, presenting plasma lactate concentration, and the etiology of the PE. Twenty-five of 49 dogs (51%) identified with PE had recently vomited. Vomiting was more common in dogs with presenting plasma lactate concentration > 5.0 mmol/L (P = 0.02) but was unrelated to the specific etiology of the PE. The volume of PE obtained via pericardiocentesis did not differ (P = 0.79) between dogs with (8.7 ± 3.4 mL/kg) and without historical vomiting (9.1 ± 4.3 mL/kg).

Significance: Vomiting is common in dogs with PE, and in particular, dogs with evidence of hypoperfusion. Pericardial effusion should be included as a differential diagnosis in dogs with a history of vomiting that present with weakness or collapse.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/vec.12570DOI Listing
March 2017

The use of rivaroxaban for the treatment of thrombotic complications in four dogs.

J Vet Emerg Crit Care (San Antonio) 2016 Sep 18;26(5):729-36. Epub 2016 Mar 18.

Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Rd, North Grafton, MA, 01536.

Objective: To describe the clinical use of rivaroxaban in the treatment of 4 dogs with vascular thrombosis, 2 with pulmonary thromboembolism and 2 with systemic thrombosis.

Case Series Summary: This report describes the use of a direct factor Xa anticoagulant newly approved in human patients for the treatment or prevention of arterial or venous thrombosis. The use of this medication in a clinical setting for canine patients with thromboembolism has not been described before. Two patients were treated with rivaroxaban for pulmonary thromboembolism. Decreases in thrombus size were seen in both patients, but one patient suffered acute respiratory distress and was euthanized while the other continued to do well at the time of this writing. The other 2 patients were treated for systemic thrombosis. Decreases in thrombus size were also noted. One patient later suffered hematochezia of unknown cause, and the other continued to do well at the time of this writing.

New Or Unique Information Provided: This is the first published report of the use of a new oral direct factor Xa anticoagulant in dogs in a clinical setting for the treatment of both pulmonary and systemic thrombosis. In this case series, we share our limited experience in the use of this new medication, our strategy in determining appropriate dosages, and our monitoring protocol.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/vec.12466DOI Listing
September 2016

Assessment of the responsiveness of the Cats' Assessment Tool for Cardiac Health (CATCH) Questionnaire.

J Vet Cardiol 2015 Dec;17 Suppl 1:S341-8

Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, MA 01536, USA.

Objectives: To evaluate the responsiveness and optimal timing of a validated health-related quality of life questionnaire, and to assess the relationship between quality of life, severity of disease, and N-terminal pro B-type natriuretic peptide (NT-proBNP) in cats with acute congestive heart failure (CHF).

Animals: Thirty client-owned cats with acute CHF.

Methods: Echocardiography, International Small Animal Cardiac Health Council (ISACHC) stage, and NT-proBNP were assessed in cats within 36 h of admission. The Cats' Assessment Tool for Cardiac Health (CATCH) Questionnaire (range of 0-80, with 80 being the worst possible score) was completed by cat owners and ISACHC stage was assessed at the time of hospital discharge, 3 days after discharge, and 7-14 days after discharge. NT-proBNP concentration was reassessed 7-14 days after discharge.

Results: The ISACHC stage at time of admission improved significantly by reevaluation 7-14 days after discharge (P < 0.001). The decrease in median NT-proBNP concentration from time of admission (655 pmol/L; range, 188 to >1500 pmol/L) to reevaluation (583 pmol/L; range, 41 to >1500 pmol/L) was not significant (P = 0.59). Median CATCH score was 26 (range, 0-70) at baseline, 19 (range, 0 to 61) at discharge, and 19 (range, 2-49) 7-14 days after discharge (P = 0.89). CATCH scores did not correlate with NT-proBNP concentrations or ISACHC stage.

Conclusions: These results suggest that the CATCH questionnaire requires further refinement for uses requiring a responsive instrument in cats with acute CHF.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jvc.2015.03.006DOI Listing
December 2015

Acute tracheal compression in a large breed dog due to a dorsal tracheal membrane abscess.

J Vet Emerg Crit Care (San Antonio) 2015 Nov-Dec;25(6):795-800. Epub 2015 Oct 16.

Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, 01536.

Objective: To describe a case of acute tracheal compression due to a dorsal tracheal membrane abscess in a dog.

Case Summary: A 3-year-old intact male Bluetick Coonhound presented for evaluation of 36 hours of marked inspiratory dyspnea and stridor. A radiographic diagnosis of tracheal collapse was made on thoracic radiographs, which was confirmed to be static compression by tracheoscopy. Dorsal extraluminal tracheal compression from a fluid filled structure adjacent to the trachea was suspected based on ultrasonography. Endoscopic-guided transtracheal fine needle aspiration yielded septic suppurative inflammation. At surgery an abscess in the dorsal tracheal membrane was identified, lanced, and lavaged, which resulted in restoration of normal tracheal diameter. The dog developed bilateral pneumothorax, which was treated medically by thoracostomy tube placement and manual evacuation of the accumulated air. Postoperative radiographs also revealed evidence of pneumomediastinum. Pneumothorax and pneumomediastinum likely occurred secondary to the surgical approach, worsened by positive pressure ventilation. Cultures of the abscess isolated a nonhemolytic Streptococcus species but with no evidence of anaerobic bacteria. The dog made a full functional recovery.

New Or Unique Information Provided: Tracheal compression is a rare diagnosis in dogs. To the authors' knowledge, this represents the first report of an abscess in the dorsal tracheal membrane, diagnosed by endoscopic-guided transtracheal fine needle aspiration, causing clinically relevant acute tracheal obstruction.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/vec.12379DOI Listing
September 2016
-->