Inflamação sistêmica e disfunção endotelial em cães com insuficiência cardíaca congestiva / Systemic Inflammation and Endothelial Dysfunction in Dogs with Congestive Heart Failure

Systemic Inflammation and Endothelial Dysfunction in Dogs with Congestive Heart Failure

1. S.M. Cunningham^*, 
2. J.E. Rush, 
3. L.M. Freeman

Article first published online: 10 APR 2012

DOI: 10.1111/j.1939-1676.2012.00923.x

Copyright © 2012 by the American College of Veterinary Internal Medicine

Issue

Journal of Veterinary Internal Medicine

Volume 26, Issue 3, pages 547–557, May-June 2012

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Keywords:

• Cardiomyopathy;
• C-reactive protein;
• Reactive hyperemia;
• Valvular disease

Background

Congestive heart failure (CHF) is associated with endothelial dysfunction in people and in dogs with experimentally induced CHF, but this is not well characterized in dogs with naturally occurring CHF.

Hypothesis/Objectives

To evaluate endothelial function via assessment of reactive hyperemia (RH) in healthy dogs and dogs with CHF, and to assess for relationships with plasma biomarkers of vascular function and clinical markers of disease severity.

Animals

Twenty client-owned animals with CHF due to myxomatous mitral valve disease (n = 15) or dilated cardiomyopathy (n = 5) and 17 healthy control dogs.

Methods

Prospective case-controlled observational study. Dogs underwent blood sampling, echocardiography, and Doppler assessment of brachial artery velocity (VTI) at baseline and during reactive hyperemia (RH-VTI). RH-VTIs between control dogs and dogs with CHF were compared, and the relationships between RH-VTI, clinical parameters, and plasma biomarkers were assessed.

Results

Dogs with CHF (96.5 ± 51.7%) had an attenuated % increase in VTI during RH compared to healthy controls (134.8 ± 58.7%; P = .04). Increasing ISACHC class (R² = 0.24; P = .004), plasma NT-proBNP (R² = 0.15; P = .03) and CRP (R² = 0.2; P = .02) were associated with reduced RH-VTI. Increased plasma CRP, NO_x, and NT-proBNP concentrations were found in dogs with CHF (P < .02 for all). No differences were detected in other plasma markers.

Conclusions and Clinical Importance

Dogs with CHF have an attenuated RH response, and increased plasma CRP and NO_x concentrations. Doppler assessment of RH velocity could represent a novel noninvasive method of evaluating endothelial function in the dog.

Biomarcadores hemostáticos em cães com insuficiência cardíaca congestiva crônica / Hemostatic Biomarkers in Dogs with Chronic Congestive Heart Failure

Hemostatic Biomarkers in Dogs with Chronic Congestive Heart Failure

1. Inge Tarnow DVM^1,†, 
2. Torkel Falk¹, 
3. Anna Tidholm⁴, 
4. Torben Martinussen³, 
5. Asger L. Jensen², 
6. Lisbeth H. Olsen¹, 
7. Henrik D. Pedersen⁵, 
8. Annemarie T. Kristensen²

Article first published online: 5 FEB 2008

DOI: 10.1111/j.1939-1676.2007.tb02989.x

© 2007 American College of Veterinary Internal Medicine

Issue

Journal of Veterinary Internal Medicine

Volume 21, Issue 3, pages 451–457, May 2007

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Keywords:

• Chronic valvular disease;
• Coagulation;
• Dilated cardiomyopathy;
• Thrombosis

Background:Chronic congestive heart failure (CHF) in humans is associated with abnormal hemostasis, and abnormalities in hemostatic biomarkers carry a poor prognosis. Alterations in hemostatic pathways can be involved in the pathogenesis of CHF in dogs, and microthrombosis in the myocardium could contribute to increased mortality.

Hypothesis:That plasma concentration or activity of hemostatic biomarkers is altered in dogs with CHF and that these factors predict mortality.

Animals:Thirty-four dogs with CHF caused by either dilated cardiomyopathy (DCM, n = 14) or degenerative valvular disease (CDVD, n = 20) compared with 23 healthy age-matched control dogs were included in this study. Dogs with CHF were recruited from 2 referral cardiology clinics, and control dogs were owned by friends or colleagues of the investigators.

Methods:Clinical examination and echocardiography were performed in all dogs. Plasma fibrinogen and D-dimer concentrations, antithrombin and protein C activity, and thrombin-antithrombin complex (TAT) were measured in all dogs.

Results:Dogs with CHF had significantly higher fibrinogen (P= .04), D-dimer (P= .002), and TAT concentration (P < .0001), lower antithrombin (P < .0001) and protein C activity (P < .001) compared with control dogs. None of the hemostatic biomarkers were associated with risk of death.

Conclusions and Clinical Importance: There is evidence of a procoagulant state in dogs with CHF. The lack of predictive value for survival might be due to the small number of dogs examined. Further studies are necessary to investigate the presence and importance of microthrombosis in dogs with CHF.

Parabéns para o blog... 1000 acessos / Congratulations to the blog 1000 views

Podcast de terapia intensiva veterinária do Royal Veterinary College de Londres / Small animal intensive care medicine podcast from Royal Veterinary College of London

http://www.rvc.ac.uk/Review/Podcasts/RVC_Podcast_34.m4a

Concentração de troponina I, arteriosclerose miocardica e fibrose em cães com insuficiência cardíaca congestiva secundária a degeneração mixomatosa de valva mitral / Cardiac Troponin-I Concentration, Myocardial Arteriosclerosis, and Fibrosis in Dogs with Congestive Heart Failure because of Myxomatous Mitral Valve Disease

Cardiac Troponin-I Concentration, Myocardial Arteriosclerosis, and Fibrosis in Dogs with Congestive Heart Failure because of Myxomatous Mitral Valve Disease

1. T. Falk^1,*, 
2. I. Ljungvall³, 
3. N.E. Zois¹, 
4. K. Höglund⁴, 
5. L.H. Olsen², 
6. H. D Pedersen⁵,
7. J. Häggström³

Article first published online: 3 APR 2013

DOI: 10.1111/jvim.12075

Copyright © 2013 by the American College of Veterinary Internal Medicine

Issue

Journal of Veterinary Internal Medicine

Early View (Online Version of Record published before inclusion in an issue)

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Keywords:

• Biomarkers;
• Cardiac disease;
• Dogs;
• Naturally occurring heart disease

Background

Few previous studies have investigated the association between biomarkers and cardiac disease findings in dogs with naturally occurring myxomatous mitral valve disease (MMVD).

Aim

To investigate if histopathological changes at necropsy could be reflected by in vivo circulating concentrations of cTnI and aldosterone, and renin activity, in dogs with naturally occurring congestive heart failure because of MMVD.

Animals

Fifty privately owned dogs with MMVD and heart failure.

Methods

Longitudinal Study. Dogs were prospectively recruited and examined by clinical and echocardiographical examination twice yearly until time of death. Blood was stored for batched analysis of concentrations of cTnI and aldosterone, and renin activity. All dogs underwent a standardized necropsy protocol.

Results

cTnI were associated with echocardiographic left ventricular end-diastolic dimension (P < .0001) and proximal isovolumetric surface area radius (P < .004). Furthermore, in vivo cTnI concentrations reflected postmortem findings of global myocardial fibrosis (P < .001), fibrosis in the papillary muscles (P < .001), and degree of arterial luminal narrowing (P < .001) Aldosterone or renin activity did not reflect any of the cardiac disease variables investigated.

Conclusion and clinical importance

Cardiac fibrosis and arteriosclerosis in dogs with MMVD are reflected by circulating cTnI concentration, but not by aldosterone concentration or renin activity. Cardiac troponin I could be a valuable biomarker for myocardial fibrosis in dogs with chronic cardiac diseases.

Obstrução intestinal por corpo estranho em cães e gatos / Gastrointestinal foreign bodies in dogs and cats: a retrospective study of 208 cases

Gastrointestinal foreign bodies in dogs and cats: a retrospective study of 208 cases

1. G. Hayes^†

Article first published online: 8 OCT 2009

DOI: 10.1111/j.1748-5827.2009.00783.x

© 2009 British Small Animal Veterinary Association

Issue

Journal of Small Animal Practice

Volume 50, Issue 11, pages 576–583, November 2009

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Objectives

To establish predilection sites of obstruction and to investigate clinical factors associated with a poor outcome.

Methods

A retrospective study of 208 consecutive cases over a 48-month period from first-opinion practice.

Results

Overall, 91 per cent of cases recovered with higher survival rates from discrete foreign bodies (94 per cent in dogs and 100 per cent in cats) as opposed to linear foreign bodies (80 per cent in dogs and 63 per cent in cats). English bull terriers, springer spaniels, Staffordshire bull terriers, Border collies and Jack Russell terriers were over-represented. In dogs, 63 per cent of obstructions occurred in the jejunum but foreign objects were encountered at all points along the gastrointestinal tract. A longer duration of clinical signs, the presence of a linear foreign body and multiple intestinal procedures were associated with significantly increased mortality. Neither the degree of obstruction (partial or complete) nor the location of the foreign body was shown to have a significant influence on survival.

Clinical Significance

Prompt presentation, diagnosis and surgical intervention improve the outcome of gastrointestinal obstruction by foreign bodies. At surgery, the minimal number of intestinal procedures should be performed to restore the integrity of the alimentary tract.

Alterações hemostáticas em gatos com doença hepática / Haemostatic abnormalities in cats with naturally occurring liver diseases

The Veterinary Journal

Volume 193, Issue 1, July 2012, Pages 103–108

Haemostatic abnormalities in cats with naturally occurring liver diseases

• Brigitte Dircks, 
• Ingo Nolte, 
• Reinhard Mischke^, 

• Small Animal Clinic, University of Veterinary Medicine Hanover, Bünteweg 9, 30559 Hannover, Germany

Abstract

Alterations in the haemostatic system were characterized in cats with different naturally occurring liver diseases. The study looked at 44 healthy cats and 45 cats with different liver diseases confirmed histologically or cytologically (neoplasia, n = 9; inflammation, n = 12; hepatic lipidosis, n = 13; other degenerative liver diseases, n = 11). The following parameters were evaluated: platelet count; prothrombin time; activated partial thromboplastin time; thrombin time; factor (F) II, FV, FVII, FX, and FXIII activities; fibrinogen concentration; activities of antithrombin, protein C, plasminogen, and α₂-plasmin inhibitor, and D-dimer concentration.

In cats with liver diseases, 44/45 (98%) had one or more abnormalities of the coagulation parameters measured. In cats with inflammatory liver diseases, increased D-dimer concentrations and decreased FXIII activity were the most consistent abnormalities and were found in 83% and 75% of cats, respectively. The most common abnormality in cats with neoplastic liver disease was FXIII deficiency (78%). The most consistent abnormalities in cats with hepatic lipidosis were increased FV activity and D-dimer concentration with 54% of cats having values above the reference range for both parameters. Cats with miscellaneous degenerative liver disease most frequently showed FXIII deficiency (64%). The results of this study show that alterations of single haemostatic components are a frequent finding in cats with liver disease. Activation of haemostasis with subsequent consumptive coagulopathy (rather than decreased synthesis) seems to be responsible for these alterations. Increased blood levels of different haemostatic components in cats with inflammatory lesions may be related to an acute phase reaction.

Keywords

• Cat; 
• Haemostasis; 
• Liver disease; 
• D-dimers; 
• Factor XIII

Experiência clínica com nutrição parenteral pronta para uso livre de lipideos em cães: 70 casos / Clinical experience with a lipid-free, ready-made parenteral nutrition solution in dogs: 70 cases

Retrospective Study

Clinical experience with a lipid-free, ready-made parenteral nutrition solution in dogs: 70 cases (2006–2012)

1. Isuru Gajanayake BVSc, DACVIM, MRCVS^1,*, 
2. Claire E. Wylie BVM&S, MSc, PhD, MRCVS², 
3. Daniel L. Chan DVM, DACVECC, DACVN, MRCVS¹

Article first published online: 5 MAR 2013

DOI: 10.1111/vec.12029

© Veterinary Emergency and Critical Care Society 2013

Issue

Journal of Veterinary Emergency and Critical Care

Early View (Online Version of Record published before inclusion in an issue)

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Abstract

Objective

To review the clinical use of a lipid-free, ready-made amino acid and glucose parenteral nutrition (PN) solution in dogs.

Design

Retrospective study of dogs from 2006 to 2012 that received this form of PN.

Setting

University veterinary teaching hospital.

Animals

Seventy dogs presented to the hospital for treatment of various diseases in which PN was used as part of patient management. Dogs were administered PN at the discretion of the primary clinician.

Intervention

A lipid-free, ready-made solution containing amino acid (59 g/L) and dextrose (100 g/L) was administered intravenously as a constant rate infusion to provide nutritional support.

Measurements and Main Results

PN was provided for a median of 2.2 days (range 0.5–9.5 days) in the 70 dogs, totaling 168 days of PN. The PN provided a median of 5.5 g/100 kcal of protein (range 1–9.5 g/100 kcal) and a median of 2.2 mg/kg of bodyweight per minute (range 0.8–5.2 mg/kg/min) of glucose, which reflected a median of 57% of the resting energy requirement (range 9–100%). Metabolic complications developed in 43 of 67 dogs where these data were recorded, but the development of hyperkalemia was the only complication associated with a poor outcome (eg, death or euthanasia). Mechanical complications were seen in 28 dogs, and all but one of these occurred when PN was delivered through peripheral catheters. Septic complications were confirmed in 5 dogs.

Conclusions

This form of PN is suitable for clinical use and can provide both protein and calories to ill dogs. It was, however, associated with a high rate of complications and requires careful patient monitoring.

Os efeitos da decúbito, sedação e bandagem torácica sobre a capacidade residual funcional em cães sadios de tórax profundo / The effect of body position, sedation, and thoracic bandaging on functional residual capacity in healthy deep-chested dogs

The effect of body position, sedation, and thoracic bandaging on functional residual capacity in healthy deep-chested dogs

Elizabeth A. Rozanski, Daniela Bedenice, Jennifer Lofgren, Julie Abrams, Jonathan Bach, and Andrew M. Hoffman

Can J Vet Res. 2010 January; 74(1): 34–39.

The objective of this study was to determine the effect of body position, chest wrap, and sedation on functional residual capacity (FRC) in 6 healthy dogs. Functional residual capacity was determined by helium dilution (re-breathing) whilst in different clinically relevant conditions. These conditions included the standing (sternal) and lateral positions in unsedated dogs and then again both standing and lateral following chest bandaging, and sedation with acepromazine, IV and butorphanol, IV. The mean FRC at each measurement point was determined, as was the change in FRC (delta FRC) from one measurement point to another. Analysis of variance (ANOVA) with repeated measures with Fisher’s LSD post hoc test was used to evaluate the effect of interventions. The differences in delta FRC were evaluated using a t-test or Wilcoxon rank-sum test. P < 0.05 was considered significant. The mean FRC at baseline, defined as standing, unsedated and unwrapped, was 75.3 ± 23.8 mL/kg. Body position or sedation had the most profound effect on FRC with right lateral recumbency lowering FRC by a median of 20.4 mL/kg and sedation lowering FRC by a median of 19.8 mL/kg. Common clinical procedures and positioning result in lowered FRC in healthy deep-chested dogs. In critically ill or injured dogs, the iatrogenic loss of FRC through chest bandaging, sedation, or body position may be clinically relevant.

Patogenia e desfecho associado a obstrução biliar extra-hepatica em gatos / Pathogenesis and outcome of extrahepatic biliary obstruction in cats

Pathogenesis and outcome of extrahepatic biliary obstruction in cats

1. P. D. Mayhew, 
2. D. E. Holt, 
3. R. C. McLear, 
4. R. J. Washabau

Article first published online: 10 FEB 2006

DOI: 10.1111/j.1748-5827.2002.tb00067.x

Issue

Journal of Small Animal Practice

Volume 43, Issue 6, pages 247–253, June 2002

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Extrahepatic biliary obstruction (EHBO) was confirmed at surgery or necropsy in 22 cats. Biliary or pancreatic adenocarcinoma was diagnosed by histopathology in six cats and one cat had an undiagnosed mass in the common bile duct. The remaining 15 cats had at least one of a complex of inflammatory diseases including pancreatitis, cholangiohepatitis, cholelithiasis and cholecystitis. The most common clinical signs were jaundice, anorexia, lethargy, weight loss and vomiting. Hyperbilirubinaemia was present in all cases. Distension of the common bile duct and gall bladder was the most commonly observed finding on abdominal ultrasound. Nineteen cats underwent exploratory laparotomy for biliary decompression and diversion. Mortality in cats with underlying neoplasia was 100 per cent and, in those with non-neoplastic lesions, was 40 per cent. Long-term complications, in those that survived, included recurrence of cholangiohepatitis, chronic weight loss and recurrence of obstruction. Based on these findings, the prognosis for EHBO in cats must be considered guarded.