Assessment of the diagnostic accuracy of circulating cardiac troponin I concentration to distinguish between cats with cardiac and non-cardiac causes of respiratory distress

Objective

To determine if serum cardiac troponin I (cTnI) concentrations can distinguish cardiac from non-cardiac causes of respiratory distress (RD) in cats.

Animals, materials and methods

53 cats. cTnI concentrations were measured in 30 cats with non-cardiac respiratory distress (RD-NC) and compared to 23 cats with RD due to congestive heart failure (RD + CHF).

Results

The RD + CHF group had higher median cTnI concentration (0.94 ng/ml interquartile range IQR 0.54-4.00, range <0.20 - 90.14) than the RD-NC group (<0.2 ng/ml IQR < 0.2-0.33, range <0.20-41.1, p < 0.001). The area under the curve (AUC) was 0.842 (95% CI 0.728-0.955) for the receiver operator curve (ROC) analysis of the accuracy of cTnI concentrations to discriminate RD + CHF from RD-NC cats. A cut-off of ≥ 0.81 ng/ml discriminated RD + CHF from RD-NC cats with a sensitivity and specificity of 65.2% and 90.0% respectively. However considerable overlap in cTnI concentrations between the 2 groups was identified.

Conclusions

Serum cTnI concentrations were different in RD + CHF compared to RD-NC cats. However the overlap in cTnI concentrations between the 2 groups reduced the clinical efficacy of the assay which therefore should not be used as a stand-alone test but in combination with other diagnostics such as echocardiography and radiography.     

Twenty-four hour Holter monitoring of unsedated healthy cats in the home environment

Objective

To determine the heart rate, rhythm, number of ventricular premature complexes (VPCs) and atrial premature complexes (APCs) in unsedated cats using Holter monitoring.

Animals, materials and methods

Twenty-three healthy client owned cats were used. Clinical examination, blood pressure measurements, echocardiographic examination and serum biochemical analysis were performed. A lightweight Holter was used in the home environment.

Results

Three-lead electrocardiographic registrations of good quality were obtained from all cats. Normal sinus rhythm was present in all cats. The median heart rate was 165 beats per minute (bpm), range 70-303 bpm. Mean heart rate varied significantly with age and gender. Sinus arrhythmia occurred intermittently in 18 cats (78%). Uncommon ventricular premature complexes occurred in 18 (78%) of the cats. The median number of VPCs per cat was 3 complexes/24 h period, range 0-146. Cats 7-15 years of age had significantly more VPCs than cats 1-6 years of age (median 6 versus 1 per 24 h period, p = 0.04). A single APC occurred in one cat (4%).

Conclusions

Cats commonly have intermittent sinus arrhythmia. Many healthy cats have rare single VPCs per 24 h period. Old cats have significantly more VPCs than young cats. The heart rate varies significantly with age and gender.     

A systematic review-meta-analysis of chilling interventions and a meta-regression of various processing interventions for Salmonella contamination of chicken

Context

The results of individual studies investigating the efficacy of chilling and other processing interventions on Salmonella prevalence or concentration in broiler chicken carcasses are inconsistent or contradictory.

Objective

Determine efficacy of chilling on reducing Salmonella prevalence or concentration on broiler carcasses using systematic review-meta-analysis, and explore sources of heterogeneity among studies investigating various processing interventions through meta-regression.

Data sources

A comprehensive search included electronic search in six databases, manual search of reference lists of topic-related articles, and consultation with five topic experts to assure that all relevant intervention research was identified.

Study inclusion

Primary intervention research, published in English, encompassing control, challenge, cohort, or before-and-after study designs investigating the efficacy of any chilling or other processing interventions on Salmonella prevalence or concentration in broiler chicken carcasses.

Risk of bias assessment and data extraction

Data pertaining to study methodology and reported results, chilling or other processing intervention parameters, populations sampled and outcomes measured were assessed for methodological soundness and extracted by two independent reviewers using pretested checklists.

Results

Random-effects meta-analyses of immersion chilling with chlorine (n = 9 trials), acetic acid (n = 16) and potable water (n = 13) trended towards reductions in the odds or log₁₀ CFU/ml of Salmonella. Significant heterogeneity (P-value ≤ 0.1 and I² > 25%) precluded the reporting of pooled summary effect estimates. Meta-regression of all processing interventions indicated that serotype, disinfectant type and treatment time and pH were significantly associated with studies reporting reductions in concentration while study design, population sampled, study setting, publication date, intervention and disinfectant type, and treatment pH were significantly associated with studies reporting reductions in prevalence. Methodological and reporting flaws were consistently observed in relevant intervention research as well as a lack of studies conducted under commercial conditions and using Salmonella concentration outcomes.

Conclusions

Chilling may be effective at reducing Salmonella concentration and prevalence, but significant heterogeneity precluded reporting of pooled summary effect estimates for many chilling interventions. Investigations into potential sources of heterogeneity among all processing interventions found that the use of other chemical disinfectants, such as organic acids and surfactants might result in larger reductions in Salmonella contamination than more commonly utilized oxidizing agents like chlorine.     

Autoantibodies to recombinant canine proinsulin in canine diabetic patients

Objective

To determine whether dogs with spontaneously-occurring diabetes mellitus demonstrate serological reactivity to proinsulin.

Sample population

Serum samples were collected from 15 newly-diagnosed diabetic, 15 insulin-treated diabetic and 15 non-diabetic control dogs.

Procedures

Canine proinsulin was cloned into a prokaryotic expression vector to generate recombinant poly-histidine-tagged protein in Escherichia coli. A Western blotting assay was developed for detection of proinsulin autoantibodies in canine sera.

Results

Reactivity to canine proinsulin was detected in 3 of 15 control dogs, 8 of 15 newly-diagnosed diabetic dogs and 6 of 15 insulin-treated diabetic patients. Of these reactors, only 1 control dog, 1 newly-diagnosed diabetic dog and 3 insulin-treated diabetic dogs recognised porcine insulin by ELISA, suggesting that the remaining proinsulin reactors might have been recognising proinsulin-specific epitopes.

Conclusions and clinical relevance

This study suggests that proinsulin autoantibodies are present in a proportion of diabetic dogs. Further work is required to refine the assay and clarify the significance of these autoantibodies.     

Expression of PDGF-β receptor in broilers with pulmonary hypertension induced by cold temperature and its association with pulmonary vascular remodeling

Objective

The purpose of the present study was to characterize the relationship between platelet-derived growth factor β receptor (PDGF-β receptor) expression and pulmonary vascular remodeling found in broilers subjected to cold temperature beginning at 14 days of age.

Method

One hundred and sixty-one-day-old mixed-sex Avian-2000 commercial broilers were randomly divided into a normal temperature group (control) and a cold temperature group (cold). All the birds were brooded in normal temperature up to day 14, with the lighting schedule at 24 h per day. Starting at day 14, birds in the cold group were moved to a pen in the cold house and subjected to low temperature, while birds in the control group were still brooded at normal temperature. On days 14, 23, 30, 37 and 44, the right/total ventricle weight ratio (RV/TV), packed cell volume (PCV), the vessel wall area to vessel total area ratio (WA/TA), mean media thickness in pulmonary arterioles (mMTPA) and the expression of PDGF-β receptor in pulmonary arterioles were measured, respectively. Cumulative pulmonary hypertension syndrome (PHS) morbidity was recorded in each group.

Results

Cool ambient temperature increased PHS morbidity of broilers. The values of WA/TA and mMTPA were also increased significantly compared with control group. PCV values in the cold temperature group were elevated from days 30 to 44, and RV/TV ratios were increased on days 37 and 44. Cold exposure enhanced PDGF-β receptor expression in pulmonary arterioles, and the PDGF-β receptor expression was significantly correlated with pulmonary vascular remodeling that was dedicated by increased WA/TA and mMTPA.

Conclusion

The results indicated that PDGF-β and its receptor were involved in the underlying mechanisms of pulmonary vascular remodeling in pulmonary hypertensive broilers.     

L-Arginine inhibiting pulmonary vascular remodelling is associated with promotion of apoptosis in pulmonary arterioles smooth muscle cells in broilers

Objective

Pulmonary vascular remodelling is one of the important pathological bases of broiler pulmonary hypertension syndrome (PHS). Nitric oxide (NO) has been found to inhibit proliferation and to induce apoptosis in pulmonary artery smooth muscle cells (SMC) in mammals with pulmonary hypertension. The present study was conducted to evaluate the effects of NO precursor l-arginine on pulmonary vascular remodelling in broilers with pulmonary hypertension induced by cold exposure and to examine whether NO-induced apoptosis in pulmonary arteriole SMC is involved in the regulatory mechanisms.

Methods

Two hundred and forty mixed-sex commercial broilers were equally assigned to three groups and reared in normal brooding temperatures before day 14. Starting on day 14 continuing until the end of the experiment, the control group was brooded in normal temperatures whereas the other two groups were subjected to low ambient temperatures with or without l-arginine added to the basal diets. Cumulative PHS mortality and body weight were recorded in each group. Right/total ventricle ratio (RV/TV), plasma NO concentration and pulmonary vascular morphological changes were analyzed. TdT-mediated dUTP-biotin nick-end labeling (TUNEL) assay was used to detect apoptosis in pulmonary arteriole SMC.

Result

l-Arginine, in group A, had no effect on body weights under cold temperature condition. Birds kept in group B had increased PHS mortality, RV/TV ratio, vessel wall area/vessel total area ratios (WA/TA) and mean media thickness in pulmonary arterioles (mMTPA) (P < 0.05). Percentages of apoptotic SMC in pulmonary arterioles in group B were not altered by cold exposure (P > 0.05). Supplemental dietary l-arginine in group A elevated plasma NO level (P < 0.05), reduced PHS mortality (P < 0.05), attenuated pulmonary vascular remodelling and increased the percentages of apoptotic SMC (P < 0.05) when compared with the group B.

Conclusion

Supplemental l-arginine partially inhibited pulmonary vascular remodelling that occurred secondary to increased pulmonary pressure; NO-induced apoptosis in arteriole SMC might contribute to its regulatory effect on pulmonary vascular structural changes.     

Doppler-derived deformation imaging in unsedated healthy adult dogs

Objectives

To evaluate feasibility, repeatability and reproducibility (R&R) of Doppler-derived deformation imaging (DI) in healthy adult dogs.

Animals, materials and methods

Forty-nine dogs underwent physical examination, ECG, blood pressure measurement and echocardiography. Doppler-derived DI parameters obtained from six selected Regions of Interest (ROI) within the left ventricle (LV) were: strain (S), systolic strain rate (SSR), strain rate E wave (SRE), and strain rate A wave (SRA). The averages of the six ROIs were calculated and labeled avS, avSSR, avSRE, and avSRA. Randomly selected dogs underwent two echocardiographic studies to evaluate intraoperator (n = 14) and interoperator (n = 17) variability.

Results

DI data were obtained in 87.2% of dogs and 77.2% of ROIs. Compared to controls, avSSR was significantly reduced in Doberman Pinchers (DP) and it was increased in dogs <30 kg, compared to dogs >30 kg. The intraoperator Coefficient of Variability (CV) for some ROIs was greater than 15% but for averaged measurements it was ≤ 5.0%. Interoperator CV varied widely but were all <15% for avSSR, avS, and avSRA.

Conclusions

The CV for Doppler-derived DI varied widely. Averaging values from multiple ROIs improved R&R. DI may help elucidate differences in LV mechanics between canine breeds.     

Quantification of pulmonary to systemic flow ratio by a Doppler echocardiographic method in the normal dog: Repeatability, reproducibility, and reference ranges

Objective

To determine if the pulmonary to systemic flow ratio (Qp/Qs) could be assessed in healthy awake dogs using Doppler echocardiography.

Background

Qp/Qs could provide reliable information in assessing the severity of intracardiac shunts (ICS) by quantifying pulmonary overcirculation. Qp/Qs has been validated against electromagnetic flowmeter methods in experimental canine models. However, its clinical applicability in awake dogs has never been assessed.

Animals, materials and methods

Six healthy dogs were used to determine the repeatability and reproducibility of the technique (Study 1); Qp/Qs was then prospectively assessed in 50 healthy dogs (Study 2). In both studies Qp/Qs was calculated in awake animals using a standardized Doppler echocardiographic method.

Results

Within- and between-day coefficients of variation for Qp/Qs were <10% (Study 1). For Study 2, a relatively wide range of Qp/Qs was found (reference range = 0.71-1.29; mean ± SD = 1.00 ± 0.15).

Conclusions

Qp/Qs can be assessed with good repeatability and reproducibility in healthy dogs. However, the wide range of Qp/Qs obtained in the healthy population may suggest a limited usefulness of this variable for accurately assessing ICS severity in diseased animals. This needs to be assessed in further prospective and longitudinal studies including a large number of animals with ICS of various grades.     

Postnatal autonomic activity in the preterm lamb

Background

Early postnatal abnormalities of autonomic nervous system (ANS) activity, including at baseline and following cardiorespiratory challenge, are involved in apneas-bradycardias of prematurity, apparent life-threatening events of infancy and sudden infant death syndrome. Literature data suggest that baseline ANS activity does not mature normally after premature birth.

Objectives

This study performed in preterm lambs was aimed at assessing ANS maturation at baseline and following laryngeal chemoreflexes (LCR), a group of reflexes triggered by the contact of liquids with the laryngeal mucosa.

Methods

Heart rate variability (HRV) and baroreflex sensitivity (BRs) were measured at baseline and after LCR during polysomnographic recordings performed in five non-sedated lambs born 15 days prematurely. Laryngeal chemoreflexes were induced by distilled water or acid (pH 2) during sleep and wakefulness on postnatal days 7 (D7) and 14 (D14, full-term equivalence).

Results

While the life-threatening cardiorespiratory events of the LCR observed at D7 were no longer present at D14, baseline and post-LCR HRV and BRs indices were significantly lower at D14 compared to D7 (up to p < 0.001). These results suggest that an initial autonomic overactivity was present at D7 and normalized at D14.

Conclusion

The autonomic cardiac and baroreflex control appears to follow a specific evolution in the preterm compared to the full-term newborn lamb, with an important initial autonomic stress, which normalizes at an age equivalent to full-term. Potential relevance of these findings in relation to anomalies of cardiac control in the early postnatal period, such as apneas-bradycardias of prematurity, apparent life-threatening events of infancy and sudden infant death syndrome, awaits further studies.     

Cardiac troponin I and C-reactive protein concentrations in dogs with severe pulmonic stenosis before and after balloon valvuloplasty

Objective

To report cardiac troponin I (cTnI) and C-reactive protein (CRP) concentrations in dogs with severe pulmonic stenosis (PS) before and after balloon valvuloplasty (BV).

Background

Increased morbidity and mortality have been reported with severe PS and histopathologic evidence of myocardial damage is demonstrated with BV. Severity of myocardial injury and inflammation associated with severe PS and BV, as assessed by cTnI and CRP, is unknown.

Animals, materials and methods

Serum cTnI and CRP concentrations were measured in dogs with severe PS (n = 23) and following BV (n = 16).

Results

Baseline cTnI and CRP were elevated in 7/23 (30.4%) and 8/23 (34.8%) dogs. Median cTnI at baseline and post-BV were 0.20 ng/mL (range, 0.20-1.29 ng/mL) and 2.85 ng/mL (range, 0.21-55.40 ng/mL), respectively. Median CRP at baseline and post-BV were 3.40 μg/mL (range, 0-14.70 μg/mL) and 11.70 μg/mL (range, 4.20-120 μg/mL), respectively. Post-BV concentrations were significantly increased compared to baseline for cTnI (p < 0.001) and CRP (p = 0.001).

Conclusions

Serum cTnI and CRP are increased in dogs with severe PS and following BV. Future studies should evaluate whether biomarkers correlate with severity and prognosis of PS or can be used to guide therapy.     

Evaluation of the Effect of Orally Administered Acid Suppressants On Intragastric pH in Cats

Background

Acid suppressant drugs are a mainstay of treatment for cats with gastrointestinal erosion and ulceration. However, clinical studies have not been performed to compare the efficacy of commonly PO administered acid suppressants in cats.

Hypothesis/Objectives

To compare the effect of PO administered famotidine, fractionated omeprazole tablet (fOT), and omeprazole reformulated paste (ORP) on intragastric pH in cats. We hypothesized that both omeprazole formulations would be superior to famotidine and placebo.

Animals

Six healthy adult DSH colony cats.

Methods

Utilizing a randomized, 4‐way crossover design, cats received 0.88–1.26 mg/kg PO q12h fOT, ORP, famotidine, and placebo (lactose capsules). Intragastric pH monitoring was used to continuously record intragastric pH for 96 hours beginning on day 4 of treatment. Plasma omeprazole concentrations at steady state (day 7) were determined by high performance liquid chromatography (HPLC) with ultraviolet detection. Mean percentage time that intragastric pH was ≥3 and ≥4 were compared among groups using ANOVA with a posthoc Tukey‐Kramer test (α = 0.05).

Results

The mean percentage time ± SD that intragastric pH was ≥3 was 68.4 ± 35.0% for fOT, 73.9 ± 23.2% for ORP, 42.8 ± 18.6% for famotidine, and 16.0 ± 14.2% for placebo. Mean ± SD plasma omeprazole concentrations were similar in cats receiving fOT compared to those receiving ORP and in a range associated with acid suppression reported in other studies.

Conclusions and Clinical Importance

These results suggest that both omeprazole formulations provide superior acid suppression in cats compared to famotidine or placebo. Fractionated enteric‐coated OT is an effective acid suppressant despite disruption of the enteric coating.     

The T wave in the V10 precordial electrocardiographic lead is negative in healthy Chihuahua dogs

Objectives

The T wave polarity in the V10 precordial electrocardiographic (ECG) lead in Chihuahuas is described as positive in the veterinary literature. The aim of this study was to investigate the polarity of the T wave in the V10 precordial ECG lead in clinically healthy Chihuahuas. Our null hypothesis was that healthy Chihuahuas have a negative T wave in V10.

Animals, materials and methods

In this prospective study, 67 healthy breeder-owned Chihuahuas were used. A physical examination, 10-lead ECG and an echocardiogram were performed on each dog.

Results

No cardio-respiratory abnormalities were revealed in any of the otherwise healthy dogs. Three out of 67 ECGs were of insufficient quality because of baseline artifacts due to movement of the animal. Two other ECGs showed a nearly iso-electric T wave in the V10 lead. The remaining 62 ECGs showed negative T waves in the V10 lead. Right ventricular hypertrophy was excluded with echocardiography in all dogs.

Conclusion

In contrast to previous reports, we found that healthy Chihuahuas have negative T wave in the V10 precordial ECG lead.     

Effects of mosapride citrate, metoclopramide hydrochloride, lidocaine hydrochloride, and cisapride citrate on equine gastric emptying, small intestinal and caecal motility

Objective

Although extensive work has been done to elucidate the beneficial and unfavorable effects of gastrointestinal prokinetic agents in humans, little is known on the effects of these agents in horses. In this study, we compared the effects of mosapride, metoclopramide, cisapride, and lidocaine on equine gastric emptying, jejunal and caecal motility and evaluated these agents’ adverse drug reactions (ADRs).

Animals

Seven healthy adult Thoroughbreds.

Procedure

Mosapride 1.0 mg/kg and 2.0 mg/kg, metoclopramide 0.2 mg/kg, and cisapride 1.0 mg/kg were dissolved in 100 mL distilled water for oral administration. Lidocaine 1.3 mg/kg was mixed with 500 mL saline for a 30-min intravenous infusion. Oral administration of 100 mL distilled water was used as control. Gastric emptying was evaluated using ¹³CO₂ breath test, and jejunal and caecal motility was assessed by electrointestinography.

Results

The present study demonstrates that mosapride at doses of 1.0 mg/kg and 2.0 mg/kg facilitates gastric emptying in horses. Improved jejunal motility was observed following administration of mosapride (1.0 mg/kg and 2.0 mg/kg), metoclopramide (0.2 mg/kg), and cisapride (1.0 mg/kg). Similarly, improved caecal motility was observed following administration of mosapride (2.0 mg/kg).

Conclusions and clinical relevance

This study shows that among the prokinetic agents studied here, only mosapride (2.0 mg/kg) promotes jejunal and caecal motility in horses. Considering mosapride ADRs profile, it is believed that this compound is useful in the treatment of diseases associated with decreased GI motility, including postoperative ileus.     

Validation of a digital audio recording method for the objective assessment of cough in the horse

Aim

To validate the use of digital audio recording and analysis for quantification of coughing in horses.

Materials and methods

Part A: Nine simultaneous digital audio and video recordings were collected individually from seven stabled horses over a 1 h period using a digital audio recorder attached to the halter. Audio files were analysed using audio analysis software. Video and audio recordings were analysed for cough count and timing by two blinded operators on two occasions using a randomised study design for determination of intra-operator and inter-operator agreement. Part B: Seventy-eight hours of audio recordings obtained from nine horses were analysed once by two blinded operators to assess inter-operator repeatability on a larger sample.

Results and conclusions

Part A: There was complete agreement between audio and video analyses and inter- and intra-operator analyses. Part B: There was >97% agreement between operators on number and timing of 727 coughs recorded over 78 h. The results of this study suggest that the cough monitor methodology used has excellent sensitivity and specificity for the objective assessment of cough in horses and intra- and inter-operator variability of recorded coughs is minimal.     

Plasma N-terminal pro-B-type natriuretic peptide concentration helps to predict survival in dogs with symptomatic degenerative mitral valve disease regardless of and in combination with the initial clinical status at admission

Objectives

Although mitral valve disease (MVD) is the most common canine heart disease, readily available prognostic markers of the disease are still lacking. The aim of this study was to evaluate the comparative ability of N-terminal pro-B-type natriuretic peptide plasma concentration (NT-proBNP) and various echocardiographic variables to predict outcome in dogs with MVD.

Animals, materials and methods

Seventy-four dogs with ISACHC classes 2 and 3 MVD (Groups A and B, respectively) were prospectively recruited. NT-proBNP and several echo-Doppler variables at inclusion were compared as predictors of outcome at 6 months in 54/74 dogs.

Results

NT-proBNP was significantly higher in Group B than in Group A (P < 0.0001), and was the only tested variable significantly different between survivor and non-survivor dogs in both groups (P < 0.05). In the whole canine population, a threshold of 1500 pmol/L could discriminate survivor from non-survivor dogs with a sensitivity and specificity of 80% and 73%, respectively. When combining ISACHC class with NT-proBNP levels, a cut-off of 1265 pmol/L was predictive of survival in Group A, whereas the cut-off was 2700 pmol/L for Group B.

Conclusions

NT-proBNP is correlated with MVD severity and could be used in combination with clinical status to predict cardiac outcome.     

The Effect of Orally Administered Ranitidine and Once‐Daily or Twice‐Daily Orally Administered Omeprazole on Intragastric pH in Cats

Background

Gastric acid suppressants frequently are used in cats with acid‐related gastric disorders. However, it is not known if these drugs effectively increase intragastric pH in cats.

Objectives

To examine the effects of PO administered ranitidine and omeprazole on intragastric pH in cats and to compare the efficacy of once‐daily versus twice‐daily dosage regimens for omeprazole.

Animals

Eight domestic shorthair cats.

Methods

Using a randomized 4‐way cross‐over design, cats were given enteric‐coated omeprazole granules (1.1–1.3 mg/kg q24h and q12h), ranitidine (1.5–2.3 mg/kg q12h), and placebo. Intragastric pH was monitored continuously for 96 hours using the Bravo^™ system¹, starting on day 4 of treatment, followed by a median washout period of 12 days. Mean percentage of time pH was ≥3 and ≥4 was compared among groups using repeated measures ANOVA.

Results

Mean ± SD percentage of time intragastric pH was ≥3 and ≥4 was 67.0 ± 24.0% and 54.6 ± 26.4% for twice‐daily omeprazole, 24.4 ± 22.8% and 16.8 ± 19.3% for once‐daily omeprazole, 16.5 ± 9.0% and 9.6 ± 5.9% for ranitidine, and 9.4 ± 8.0% and 7.0 ± 6.6% for placebo administration. Twice‐daily omeprazole treatment significantly increased intragastric pH, whereas pH after once‐daily omeprazole and ranitidine treatments did not differ from that of placebo‐treated cats.

Conclusion and Clinical Importance

Only twice‐daily PO administered omeprazole significantly suppressed gastric acidity in healthy cats, whereas once‐daily omeprazole and standard dosages of ranitidine were not effective acid suppressants in cats.     

Randomized Placebo‐Controlled Clinical Trial of a Chewable Formulation of Amlodipine for the Treatment of Hypertension in Client‐Owned Cats

Background

There is an unmet clinical need for a cat‐specific formulation of amlodipine to treat hypertensive cats.

Objectives

To assess the efficacy of chewable amlodipine tablets in reducing systolic blood pressure (SBP) in cats diagnosed with systemic arterial hypertension.

Animals

Seventy‐seven client‐owned cats with systemic hypertension were included (median age 14 years).

Methods

The study was randomized, double‐blinded, and placebo‐controlled. Forty‐two cats received 0.125–0.50 mg/kg amlodipine once daily for 28 days; 35 cats received placebo. After 28 days all cats continued with amlodipine for 2–3 months in an open‐label phase. Blood pressure was measured using high definition oscillometry. A responder was defined as a cat showing a decrease of SBP to <150 mmHg at 28 days or a decrease from baseline ≥15%.

Results

Sixty‐one cats completed the study. The responder rate was 63% in amlodipine group and 18% in placebo group. Cats receiving amlodipine were 7.9 (95% CI 2.6–24.1) times more likely to be classified as responders when compared to those receiving placebo (P < .001). From a mean (±SD) baseline value of 181 (±12) mmHg, SBP decreased to 154 (±17) mmHg with amlodipine and to 170 (±21) mmHg with placebo (P < .001). The voluntary acceptance rate of amlodipine formulation was 73%.

Conclusions and Clinical Importance

The chewable amlodipine tablet effectively reduced SBP compared with placebo in hypertensive cats, and was well‐tolerated. It can be used concomitantly with angiotensin‐converting enzyme inhibitors and in cats with chronic kidney disease.     

Evaluation of pacing site in dogs with naturally occurring complete heart block

Objective

To compare left ventricular synchronization and systolic performance with transvenous pacing of the right ventricular apex (RVA), left ventricular free wall (LVF) or simultaneous pacing of the RVA and LVF (BiV).

Animals, materials and methods

Seven canine patients with complete heart block. Prospective study evaluating effect of pacing site. Twenty four hours following implantation of transvenous BiV pacing systems, electrocardiograms and echocardiograms were assessed during pacing from the: (1) Right Atrial Appendage/RVA (RAA/RVA), (2) RAA/LVF, and (3) RAA/BiV.

Results

QRS duration was significantly shorter with BiV pacing versus LVF pacing (p < 0.001), or RVA pacing (p < 0.001). Echocardiographic indices of systolic performance fractional shortening (FS), ejection fraction (EF), cardiac output (CO) were significantly higher with BiV pacing than with pacing from the RVA (P = 0.023, 0.006, and 0.002 respectively). Cardiac output, measured by the biplane Simpson's method, was higher with LVF versus RVA pacing (P = 0.036). There was no difference in FS or EF when comparing LVF to RVA pacing. Tissue Doppler measurements of synchronization and systolic performance did not show any difference between pacing mode, but a significantly increased number of segments were seen to contract following aortic valve closure during LVF pacing (P = 0.0268) and RVA pacing (P = 0.0197) as compared to BiV pacing.

Conclusions

Findings suggest that BiV pacing improves cardiac output and systolic performance versus RVA pacing. This improvement however, is not reflected in tissue Doppler indices of synchronization and systolic performance.     

Incidence of Diabetes Mellitus in Insured Swedish Cats in Relation to Age,Breed and Sex

Background

Diabetes mellitus (DM) is a common endocrinopathy in cats. Most affected cats suffer from a type of diabetes similar to type 2 diabetes in humans. An increasing prevalence has been described in cats, as in humans, related to obesity and other lifestyle factors.

Objectives

To describe the incidence of DM in insured Swedish cats and the association of DM with demographic risk factors, such as age, breed and sex.

Animals

A cohort of 504,688 individual cats accounting for 1,229,699 cat‐years at risk (CYAR) insured by a Swedish insurance company from 2009 to 2013.

Methods

We used reimbursed insurance claims for the diagnosis of DM. Overall incidence rates and incidence rates stratified on year, age, breed, and sex were estimated.

Results

The overall incidence rate of DM in the cohort was 11.6 cases (95% confidence interval [CI], 11.0–12.2) per 10,000 CYAR. Male cats had twice as high incidence rate (15.4; 95% CI, 14.4–16.4) as females (7.6; 95% CI, 6.9–8.3). Domestic cats were at higher risk compared to purebred cats. A significant association with breed was seen, with the Burmese, Russian Blue, Norwegian Forest cat, and Abyssinian breeds at a higher risk compared to other cats. No sex predisposition was found among Burmese cats. Several breeds with a lower risk of DM were identified.

Conclusions and clinical importance

Our results verify that the Burmese breed is at increased risk of developing DM. We also identified several previously unreported breeds with increased or decreased risk of DM.