Treatment of Congenital Pulmonic Stenosis in Two Dogs by Balloon Valvuloplasty

Balloon valvuloplasty was performed on two dogs with pulmonic valve stenosis. Immediately following balloon valvuloplasty, peak right ventricular systolic pressure declined from 92 to 44 mm Hg in the first dog and from 108 to 46 mm Hg in the second dog. The peak systolic pressure gradient across the pulmonic valve declined from 60 to 12 mm Hg in the first dog and from 84 to 22 mm Hg in the second dog. Hemodynamic improvement was sustained in both dogs at the time of recatheterization 3 months later. Both dogs tolerated the procedure well and there were no serious complications. It was concluded that balloon valvuloplasty offers an alternative to surgery for the treatment of valvular pulmonic stenosis in dogs. The exact indications for and limitations of balloon valvuloplasty must await the results of additional and more long-term studies.     

An Open Patch-Graft Technique for Correction of Pulmonic Stenosis in the Dog

An open patch-graft technique for correction of pulmonic stenosis was performed in four dogs. A synthetic patch-graft was presutured to a partial-thickness incision in the right ventricular outflow tract and to the pulmonary artery along its cranial border. The pulmonary artery and right ventricle were incised during venous inflow occlusion, and dysplastic pulmonic valve leaflets were excised. The arteriotomy was closed by suturing the caudal margin of the incision to the patch-graft. The entire procedure was performed during mild hypothermia (30 degrees - 32 degrees C). The mean circulatory arrest time was 5.5 +/- 0.2 minutes. The mean systolic pressure gradient across the pulmonic valve before surgery was 121 +/- 29 mm Hg; after surgery it was 9 +/- 2 mm Hg.     

Mitral Stenosis in 15 Dogs

Mitral stenosis was diagnosed in 15 young to middle-aged dogs. There were 5 Newfoundlands and 4 bull terriers affected, suggesting a breed predisposition for this disorder. Clinical signs included cough, dyspnea, exercise intolerance, and syncope. Soft left apical diastolic murmurs were heard only in 4 dogs, whereas 8 dogs had systolic murmurs characteristic of mitral regurgitation. Left atrial enlargement was the most prominent radiographic feature. Left-sided congestive heart failure was detected by radiographs in 11 dogs within 1 year of diagnosis. Electrocardiographic abnormalities varied among dogs and included atrial and ventricular enlargement, as well as atrial and ventricular arrhythmias. Abnormalities on M-mode and two-dimensional echocardiograms included abnormal diastolic motion of the mitral valve characterized by decreased leaflet separation, valve doming, concordant motion of the parietal mitral valve leaflet, and a decreased E-to-F slope. Increased mitral valve inflow velocities and prolonged pressure half-times were detected by Doppler echocardiography. Cardiac catheterization, performed in 8 dogs, documented a diastolic pressure gradient between the left atrial, pulmonary capillary wedge, or pulmonary artery diastolic pressures and the left ventricular diastolic pressure. Necropsy showed mitral stenosis caused by thickened, fused mitral valve leaflets in 5 dogs and a supramitral ring in another dog. The outcome in affected dogs was poor; 9 of 15 dogs were euthanatized or died by 2 1/2 years of age.     

Balloon Valvuloplasty for Treatment of Pulmonic Stenosis in English Bulldogs with an Aberrant Coronary Artery

Background: English Bulldogs (EB) with pulmonic stenosis (PS) sometimes have an aberrant coronary artery (CA) type R2A encircling the pulmonary artery (PA). Balloon valvuloplasty (BV) is treatment of choice for severe PS, but is considered to be contraindicated in dogs with aberrant CA. Hypothesis: Conservative BV in EB with aberrant CA is safe and improves clinical signs and quality of life. Animals: Four client‐owned EB with severe PS were retrospectively reviewed/analysed. Methods: Retrospective study: Case records, echocardiography, BV, and follow‐up investigations of EB diagnosed with severe PS and treated with BV were reviewed. The ratios of PA to aortic (Ao) velocity time integral (VTI) were calculated to assess progression/improvement of PS. Results: An aberrant CA was confirmed on angiography in all EB. Conservative BV was performed, using a balloon of the size of the PA annulus or smaller (0.6–1 × PA annulus size). All dogs survived the procedure, but only a mild reduction in pressure gradient was achieved. There was an improvement in PA to Ao VTI in 3 of 4 dogs (P≤ .017), which were free of evidence of congestive heart failure (CHF) 5, 10, and 15 months after BV. One dog that had right‐sided CHF when BV was performed died due to progressive right‐sided CHF within 3 months. Conclusions: Conservative BV in EB might be safe and might improve quality and quantity of life.     

The Cryosurgical Treatment of Pigmentary Keratitis in Dogs An Experimental and Clinical Study

Forty normal dogs were exposed to double freezes of a 1 cm diameter area of their central corneas using a liquid nitrogen spray. Postoperative sequelae and final histopathologic results were evaluated. All eyes suffered epithelial damage and developed corneal edema, but dogs followed for 3 weeks returned to a normal or near normal condition. Nine clinical cases of pigmentary keratitis were subsequently treated by cryosurgery. The complications following this technique were similar to those seen in the experimental dogs. Reduction in corneal pigmentation and improvement of vision occurred in all cases.     

Experimental Pyelonephritis in Dogs

Both E. coli and S. aureus were simultaneously injected into the left renal arteries of 55 female dogs. The arteries were occluded for 10 minutes prior to the injection and 10 minutes after. The renal veins were occluded during the injection and for 10 minutes after.

Ten animals did not survive longer than 24 hours. Ten of 45 developed neither renal lesions nor bacteriuria; of the remaining 35 which did, five were killed on each of the second, seventh and fourteenth days, and their renal lesions were assessed. Eighteen of the remaining 2 which developed bacteriuria were killed 3 to 12 weeks following surgery when bacteria could no longer be recovered from the urine. Only two dogs had persistent bacteriuria 12 weeks after surgery. All animals which developed bacteriuria had gross lesions in the left kidney but not the right.

Naturally occurring renal lesions were found in 17 of 78 random-source dogs at laparotomy. E. coli was cultured from the urine of five of these dogs but not from the kidneys. These lesions were morphologically similar to experimental ones.

It is concluded that with this method renal lesions similar to spontaneous ones can be produced, but care must be taken to exclude the relatively large percentage of random-source dogs with naturally occurring lesions from any study.

Various forms of infectious nephritis have been reported to be among the commonest diseases of dogs (1, 2). The successful production of chronic pyelonephritis in dogs depends on a variety of factors in addition to injecting bacteria into either the renal artery or ureter. Thus, ureteral obstruction, renal anoxia and reduced pulse pressure increased the susceptibility to renal infection (3, 4, 6, 7, 8).

Our laboratory has been concerned with the production of experimental pyelonephritis in dogs so that the efficacy of various treatments could be studied. The present work was undertaken to standardize methods of producing the disease and to compare experimental renal lesions with naturally occurring ones.

     

Closed Transventricular Dilation of Discrete Subvalvular Aortic Stenosis in Dogs

Discrete subvalvular aortic stenosis with peak systolic pressure gradients of more than 60 mm Hg was treated by closed transventricular dilation in six young dogs. Peak systolic pressure gradients were measured by direct catheterization before surgery, immediately after dilation, and 3 months after surgery. Maximum instantaneous pressure gradients were measured by continuous wave Doppler echocardiography before surgery and 6 weeks to 9 months after surgery. All dogs survived the procedure, and two dogs were clinically normal after 9 and 14 months. Two dogs died at week 6 and month 7. One dog was receiving medication for pulmonary edema 15 months after surgery. One dog underwent open resection of the subvalvular ring at month 3, and was clinically normal 6 months after the second procedure. Complications included intraoperative ventricular fibrillation in one dog, and mild postoperative aortic insufficiency in one dog. Closed transventricular dilation resulted in an immediate 83% decrease in the peak systolic pressure gradient from a preoperative mean of 97 +/- 22 mm Hg to a mean of 14 +/- 15 mm Hg. However, systolic pressure gradients measured by direct catheterization at month 3 (77 +/- 26 mm Hg), and by Doppler echocardiography at week 6 to month 9 (85 +/- 32 mm Hg) were not significantly different from preoperative values, which suggested recurrence of the aortic stenosis. Closed transventricular dilation should not be considered a definitive treatment for discrete subvalvular aortic stenosis in dogs, but may be useful in young dogs with critical aortic stenosis as a bridge to more definitive surgery.     

Popliteal Tendon Transposition for Stabilization of the Cranial Cruciate Ligament Deficient Stifle Joint in Dogs: An Experimental Study

Popliteal tendon transposition was performed in five dogs with surgically induced cranial cruciate ligament rupture. After a lateral approach to the stifle joint, the popliteal tendon was severed distal to the sesamoid bone and transposed cranially onto the tibial crest to mimic the sagittal orientation of the cranial cruciate ligament. The origin of the popliteal tendon on the lateral femoral condyle was preserved. Lameness was not clinically detectable 2 months after surgery. At 6 months postoperatively, there was minimal radiographic and histopathologic evidence of degenerative joint disease in the stifle joints that had underwent surgery. There was no gross or microscopic evidence of meniscal damage found at necropsy 6 months after surgery. Biome-chanical studies are warranted before recommending the procedure.     

Comparison of Three Methods for Relief of Pain After Ear Canal Ablation in Dogs

This study compared three methods of pain relief in dogs that had total ear canal ablation with lateral bulla osteotomy. The hypothesis was that systemic opioids with preoperative local nerve blocks would provide superior pain relief. Thirty-one dogs with chronic otitis externa were included in the study. Dogs were randomly assigned to one of three protocols: systemic opioids alone (10 dogs, group 1), systemic opioids with bupivacaine splash block (11 dogs, group 2), and systemic opioids with preoperative local bupivacaine nerve blocks (10 dogs, group 3). Twenty-one dogs had bilateral ear ablation and 10 had unilateral ablation. Pain was assessed preoperatively, at extubation, 2 hours postextubation, and 1 day postoperatively by a single observer blinded to the analgesic protocol used. Pain scores were not significantly different within or between groups, nor did unilateral versus bilateral ablation have a significant effect on the score. Mean scores were less than 3 (scale 1 to 5) for all groups at all observation times. Rough recoveries were noted in 30% of group 1 dogs, 0% of group 2, and 20% of group 3 dogs. Ninety-four percent of dogs were moderately to heavily sedated at extubation. Sixty percent of group 3 dogs remained moderately to heavily sedated 2 hours postextubation. Rectal temperature, pulse rate, respiratory rate, and postoperative change in serum Cortisol levels were not significantly different between groups. Postoperative increase in blood glucose was significantly higher in groups 1 and 3 compared with preoperative levels. Twenty-three percent of the dogs required additional analgesia or tranquilization after surgery, as determined by the anesthetist; 1 dog in group 1, 2 in group 2, and 4 in group 3. Each of the three analgesic protocols provided similar pain relief in dogs undergoing total ear canal ablation.     

Swine Hearts: Quantitative Anatomy of the Right Ventricle

The right ventricle was studied in 75 anatomically normal swine hearts, using, in all, nine geometric and volumetric parameters: ventricular-wall thickness, length of the right-ventricular inflow and outflow tracts, and volume of the right-ventricular inflow and outflow tracts. The data for these parameters were compared with previously published patterns for human hearts and volumetric data were compared with patterns of normality found in human hearts. As in the human heart, the ventricular inflow tract in swine hearts was significantly shorter than the outflow tract (P < 0.0001).     

肉鸡腹水综合征患鸡右心组织钙含量的研究

利用原子吸收分光光度法和焦锑酸钾组化电镜技术,测定肉鸡右心室壁总钙和右心室组织细胞内游离Ca2+含量和分布。结果显示肉鸡腹水综合征患鸡右心室壁总钙含量为(71.2±6.5)mg/kg,显著高于低温未发病和健康肉鸡(分别为58.0±4.4,46.8±3.1,P<0.01)。电镜观察发现Ca2+沉淀颗粒主要散在分布于患鸡心肌胞浆、肌浆网、线粒体等部位,腹水综合征患鸡Ca2+颗粒的沉积量比健康肉鸡显著增多。结果提示心肌细胞内Ca2+的异常可能与肉鸡腹水综合征的发生发展有关。     

Influence of Beta Blockers on Survival in Dogs with Severe Subaortic Stenosis

Background

Subaortic stenosis (SAS) is one of the most common congenital cardiac defects in dogs. Severe SAS frequently is treated with a beta adrenergic receptor blocker (beta blocker), but this approach largely is empirical.

Objective

To determine the influence of beta blocker treatment on survival time in dogs with severe SAS.

Methods

Retrospective review of medical records of dogs diagnosed with severe, uncomplicated SAS (pressure gradient [PG] ≥80 mmHg) between 1999 and 2011.

Results

Fifty dogs met the inclusion criteria. Twenty‐seven dogs were treated with a beta blocker and 23 received no treatment. Median age at diagnosis was significantly greater in the untreated group (1.2 versus 0.6 years, respectively; P = .03). Median PG at diagnosis did not differ between the treated and untreated groups (127 versus 121 mmHg, respectively; P = .2). Cox proportional hazards regression was used to identify the influence of PG at diagnosis, age at diagnosis, and beta blocker treatment on survival. In the all‐cause multivariate mortality analysis, only age at diagnosis (P = .02) and PG at diagnosis (P = .03) affected survival time. In the cardiac mortality analysis, only PG influenced survival time (P = .03). Treatment with a beta blocker did not influence survival time in either the all‐cause (P = .93) or cardiac‐cause (P = .97) mortality analyses.

Conclusions

Beta blocker treatment did not influence survival in dogs with severe SAS in our study, and a higher PG at diagnosis was associated with increased risk of death.     

Resection of Subvalvular Aortic Stenosis Surgical and Perioperative Management in Seven Dogs

Open heart surgery was performed during cardiopulmonary bypass (CPB) to surgically correct subvalvular aortic stenosis in seven dogs. After initiation of total CPB, cardiac arrest was induced by antegrade and retrograde administration of blood cardioplegia. The subvalvular fibrous stenosis was resected through a transverse aortotomy. Intraoperatively and postop-eratively, dobutamine, nitroprusside, lidocaine, blood(-products), and crystalloid solutions were used to manage hypotension and optimize cardiac index.
Aortic cross-clamp time varied from 73 to 166 minutes, and duration of CPB varied from 130 to 210 minutes, latrogenic incision into the mitral valve in two dogs was the most significant introperative complication. Postoperative complications included: hypoproteinemia (n = 7), premature ventricular depolarization (n = 6), increased systemic vascular resistance index (n = 5), increased O₂ extraction (n = 3), pulmonary edema (n = 2), and decreased cardiac index (n = 1). All seven dogs were discharged alive and in stable condition. Six dogs are alive and in stable condition after a mean follow up of 15.8 months.
This is the first detailed report of CPB in a series of clinical veterinary patients. Using the techniques described in this paper, open heart surgery of considerable duration can be performed successfully in dogs with significant myocardial hypertrophy and endomyocardial fibrosis secondary to subvalvular aortic stenosis.     

37℃热应激对实验性大肠杆菌病肉鸡肺动脉压和右心功能的影响

160只商品代AA肉仔鸡于29日龄时随机均分为常温对照组、热应激对照组、常温感染组和热应激感染组．研究了37℃热应激对实验性感染大肠杆菌肉鸡肺动脉压和右心功能的影响。结果37℃热应激1～3d极显著降低（P〈0．01）肉鸡感染大肠杆菌引起的肺动脉高压，肺动脉收缩压、舒张压和平均肺动脉压分别下降了34．78％、45．83％、40．48％。热应激3、7d，感染大肠杆菌肉鸡右心室收缩压显著下降（P〈0．05，P〈0．01），分别下降了26．60％、28．00％，右心室收缩和舒张压最大变化速率显著下降（P〈0．05），分别下降了77．50％，50．77％和75．00％、50．58％。结果表明，37℃热应激可以拮抗肉鸡感染大肠杆菌引起的肺动脉高压，降低感染肉鸡死亡率，但使右心功能下降。