Gerbode type defect and third degree atrioventricular block in association with bacterial endocarditis in a dog

Gerbode type defects are rare left ventricular outflow tract–right atrial communications in people that may be congenital or acquired; they have been reported only once previously in dogs. Acquired forms in humans have been reported secondary to bacterial endocarditis, trauma, and valve replacement surgery, among other causes. We report a case of left ventricular outflow tract to right atrium and right ventricle communications (Gerbode type defect) in association with aortic and tricuspid valve bacterial endocarditis in a geriatric dog. The dog also developed third degree atrioventricular block and had underlying subaortic stenosis. The authors hypothesize that the Gerbode type defect in this case was acquired secondary to invasion and destruction of the membranous interventricular septum due to bacterial endocarditis.     

Isolation of methicillin-resistant Staphylococcus lugdunensis in a dog with endocarditis

A 4-year-old male castrated Borzoi dog presented on referral for evaluation of pleural effusion, ventricular arrhythmias, and suspected dilated cardiomyopathy. Echocardiogram identified several masses along the chordae tendineae, as well as a long the annulus of the mitral valve. A blood culture was positive for methicillin resistant Staphylococcus lugdunensis. The dog was also positive for Bartonella DNA on PCR testing. Aggressive antibiotic therapy was instituted. However, the dog continued to have recurrent pleural effusion and progressive azotemia. The dog was euthanized 39 days after diagnosis. Necropsy confirmed the presence of intracardiac abscesses, thrombosis and endocarditis. S. lugdunensis is a recently identified rare cause of endocarditis in humans characterized by intracardiac abscess formation, highly destructive valvular lesions preferentially affecting the mitral valve and a high mortality rate. This is the first reported case of S. lugdunensis isolation in a dog with endocarditis.     

Bacterial endocarditis with polyarthritis in two dogs associated with circulating autoantibodies

The clinical and pathological features of two cases of bacterial endocarditis in the dog are described. Non–organ specific autoantibodies (antinuclear factor and rheumatoid factor) were detected in the sera and their significance is discussed.     

Bacterial aortic valvular endocarditis associated with subaortic stenosis

The clinical and pathological findings in four young adult rottweiler dogs with subaortic stenosis and secondary bacterial endocarditis of the aortic valve are described. The four dogs, two males and two females, ranged in age from 18 months to three years. Three had three- to four-week histories of lethargy, anorexia, weight loss and intermittent coughing that progressively worsened. Bacterial aortic valvular endocarditis was diagnosed on the basis of physical examination and radiographic and ultrasound findings. Subaortic stenosis was not suspected clinically, but was found at necropsy. The fourth dog was known to have a subaortic stenotic ring at six months of age and developed clinical signs similar to the other dogs four weeks before euthanasia. Bacterial aortic valvular endocarditis and a subaortic stenotic ring were found at necropsy. It is suspected that the turbulence in blood flow caused by the stenotic rings damages the endocardium of the aortic valve, predisposing to the development of endocarditis.     

Clinical and echocardiographic findings in 10 dogs with vegetative bacterial endocarditis

Ten cases of bacterial endocarditis in the dog were studied by retrospective analysis of case records. Diagnosis of bacterial endocarditis was based on either strict clinical criteria or post mortem examination. A wide spectrum of presenting signs was seen including pyrexia, lameness, epistaxis, haemoptysis and dyspnoea. Haematological and biochemical abnormalities were non-specific and were attributed to the effects of septicaemia, embolism or chronic inflammation. Haemostatic abnormalities and, or, severe dysrhythmias appeared to be associated with a significantly poorer prognosis. Blood cultures were positive in four cases of eight that were cultured. Lesions compatible with bacterial endocarditis were detected in all eight cases that underwent echocardiographic examination. Right-sided vegetations present in two dogs were not detected by echocardiography. Two-dimensional echocardiography is a useful technique for the detection of vegetative endocarditis in the dog and allows rapid therapeutic intervention while blood culture results are pending.     

Ultrasonographic diagnosis of septic arthritis secondary to porcupine quill migration in a dog

A 7-year-old castrated male German Shepherd Dog was evaluated for lethargy, icterus, and sepsis. Porcupine quills had been removed from the dog's face 1 month prior to examination; progressive right forelimb lameness had developed soon after removal of the quills. Septic arthritis of the right elbow joint was diagnosed and was unresponsive to antimicrobial and anti-inflammatory treatments. At the time of referral, the dog had developed endocarditis, septicemia, and disseminated intravascular coagulation. Via ultrasonography, a foreign body consistent with a porcupine quill was detected in the medial portion of the right humeroradial joint. The dog did not respond to initial supportive treatment and died as a result of cardiac arrest. Postmortem examination confirmed the presence of a quill in the medial compartment of the right elbow joint and severe acute endocarditis with septic emboli to the kidneys and spleen. Ultrasonographic examination should be considered as a diagnostic tool when septic arthritis secondary to a foreign body is suspected in dogs.     

Echocardiographic findings in a dog with vegetative bacterial endocarditis (Case report)

Definitive diagnosis of mitral and aortic valvular endocarditis in a dog was based on echocardiograpic findings and was then confirmed by positive blood culture. Abdominal ultrasound examination revealed a renal abcess. This case illustrates that echocardiography associated with abdominal ultrasound has become an essential tool for the diagnosis of bacterial endocarditis and for the detection of sequela or initial source of bacteriemia, while waiting for blood culture results. A short review of echocardiographic and Doppler abnormalities associated with bacterial endocarditis is presented.     

Left ventricular outflow tract to left atrial fistula associated with endocarditis in a dog

A one-year-old, intact male, 28-kg, mixed-breed dog developed neurological episodes consistent with emboli. An acquired III/VI holosystolic heart murmur was ausculted in the mitral area, and valvular endocarditis with pulmonic and aortic insufficiency were noted at echocardiographic examination. An abnormal communication (i.e., fistula) between the left ventricular outflow tract (LVOT) and the left atrium adjacent to the mitral valve annulus was noted with Doppler imaging and confirmed with angiography. Infective valvular endocarditis was confirmed based on two of three blood cultures being positive for Staphylococcus intermedius. In humans, a sequela to infective endocarditis of the aortic or mitral valve, or both, is rupture of the mitral-aortic intervalvular fibrosa, resulting in a communication between the LVOT and the left atrium. This is the first report of this sequela in the dog.     

Brain abscess and bacterial endocarditis in a Kerry Blue Terrier with a history of immune-mediated thrombocytopenia

Objective: To describe a case of multifocal brain abscessation as a sequela from bacterial endocarditis in a dog with a 4‐month history of immune‐mediated thrombocytopenia (ITP) and treatment with immunosuppressive therapies. Case summary: An 8‐year‐old spayed female Kerry Blue Terrier weighing 13 kg was presented for evaluation of progressive neurologic deficits after a 4‐month history of immunosuppressive treatment of ITP. Brain magnetic resonance imaging revealed lesions consistent with multiple central nervous system abscesses and rupture of an abscess into an adjacent ventricle. Staphylococcus species were cultured from blood and cerebral spinal fluid and a vegetative lesion of the mitral valve was identified by echocardiographic examination. Intensive care, intravenous antibiotics, and supportive therapy led to resolution of clinical signs. Resolution of the vegetative lesion on the mitral valve was documented by serial echocardiographic examination. The dog was clinically normal 11 months after treatment. New or unique information provided: Bacterial endocarditis can be an occult infection and difficult to diagnose. Emboli from endocarditis are common, but those that affect the spleen and kidneys are often clinically silent in dogs. This case represents the first report of multifocal brain abscessation (documented with magnetic resonance imaging) as a sequela from bacterial endocarditis.     

Treatment of canine nasal aspergillosis with a new non-invasive technique. Failure with enilconazole

A new, non-Invasive technique recently described for the treatment of canine nasal aspergillosis was performed on four dogs. The antimycotic agent used was a 10 per cent enilconazole suspension, with the drug left in situ for a period of one hour. None of the dogs responded to single treatment. One dog died from an acute septic response secondary to pyelonephritis and bacterial endocarditis eight days after a second treatment. A second dog responded completely to a second treatment and remained free of fungal disease for a follow-up period of H months. In the remaining two dogs, extensive and profuse fungal growth was seen on rhinoscopic reexamination. Conventional treatment, with tube Implantation into the frontal sinuses and nasal irrigation for two weeks, was performed. Successful resolution of infection was obtained. Although the new, non-invasive technique was simple to carry out and well tolerated by the dogs, instillation of 10 per cent enilconazole appears to have poor therapeutic efficacy and exacerbated fungal growth in two of the animals.     

Hypertrophic osteopathy associated with infective endocarditis in an adult boxer dog

A 20-month-old, entire male boxer dog was presented with lethargy and intermittent shifting limb lameness. Diagnostic tests revealed aortic valve vegetations suggestive of infective endocarditis causing severe aortic outflow obstruction, and hypertrophic osteopathy of all four limbs. The dog was treated symptomatically and euthanased four days later. The association of infective endocarditis and hypertrophic osteopathy has been poorly documented in the veterinary literature. The pathogenesis of hypertrophic osteopathy is unknown; however, four theories have been put forth to explain this disease: pulmonary shunting, vagal nerve stimulation, humoral substances produced by neoplastic cells and megakaryocyte/platelet clump hypothesis.     

Resolution of dysrhythmias and conduction abnormalities following treatment for bacterial endocarditis in a dog

A four-year-old boxer presented with a recent history of intermittent collapse. The dog was found to have dysrhythmias and conduction abnormalities which were attributed to the presence of aortic bacterial endocarditis. These dysrhythmias and conduction abnormalities resolved following antibacterial treatment of the endocarditis. Specific antiarrhythmic therapy was not required. The short term response to therapy was good. The long term prognosis remains guarded in view of the damage the aortic valve has undergone.     

Computed tomography diagnosis of eight dogs with brain infarction

Objective Medical records of eight dogs presenting with acute onset of neurological signs and a diagnosis of brain infarction as determined by computed tomography (CT) imaging were reviewed. Design Retrospective single-centre case review Results Ischaemic infarction in the territory of the rostral cerebellar artery was identified in three spaniel-breed dogs. All cerebellar infarcts were non-haemorrhagic. Telencephalic infarcts were identified in five dogs, in the territories of the middle cerebral artery (2/5) and rostral cerebral artery (3/5). One of these dogs had an ischaemic infarction, but all other infarctions appeared haemorrhagic. All dogs were geriatric (≥8 years old), with concurrent medical conditions identified in six dogs. One dog was euthanased after diagnosis because of the severity of its neurological signs and one dog was euthanased as a result of associated renal disease 2 months after diagnosis. Six dogs were alive at least 1 year after diagnosis. Conclusions CT is useful in the diagnosis of cerebrovascular accident in dogs, which can present as a spectrum of images with early changes in attenuation and subtle mass effects detected after infarction. CT is particularly sensitive for detecting haemorrhagic infarction, but under-represent ischaemic and lacunar infarctions when compared with MRI.     

Spontaneous vegetative endocarditis due to Enterococcus faecalis in a rottweiler puppy

A 5-month-old female Rottweiler was referred because of a 5-week diarrhea and a sudden onset of a cardiac murmur auscultated by its veterinarian. Definitive diagnosis of bacterial endocarditis was based on ultrasonographic visualization of vegetative cardiac lesions and positive cultures of Enterococcus faecalis in blood and urine. Complicating findings were suppurative nephritis and renal infarction. Despite intensive supportive care, the endocarditis and clinical condition deteriorated and the dog had to be euthanized.     

Aortic endocarditis associated with a perforated septal membranous aneurysm in a boxer dog

Perimembranous ventricular septal defect is a common congenital heart disease in the dog. It can partially or completely close with age by development of a membranous ventricular septal aneurysm. Aortic endocarditis is a reported complication of ventricular septal defect and membranous ventricular septal aneurysm in human beings. This report describes a case of aortic endocarditis associated with a membranous ventricular septal aneurysm perforated by a small ventricular septal defect in a boxer dog.     

Bartonella vinsonii subsp. berkhoffii endocarditis in a dog from Saskatchewan

A dog referred for lameness was diagnosed with culture-negative endocarditis. Antibodies to Bartonella spp. were detected. Antibiotic treatment resulted in transient clinical improvement, but the dog developed cardiac failure and was euthanized. Bartonella vinsonii subsp. berkhoffii genotype IV was identified within the aortic heart valve lesions by PCR amplification and DNA sequencing.     

Aortic valvular dysplasia in a dog

A case of aortic valve dysplasia in a 6 year old male cocker spaniel is described. The dog was presented to the veterinarian because of strong dyspnea and frequent coughing. Clinical examination, EKG, radiographs and angiocardiography all pointed towards a tentative diagnosis of aortic insufficiency. Four months after the first appointment the dog was presented again with congestive heart failure, neural symptoms and strong abdominal pain. Electrocardiography and concentrations of LDH and CK were typical of myocardial infarction. Autopsy revealed a narrowing of the aortic valves in combination with a subaortic stenosis and several infarctions localized in the left ventricle as well as a recent infarction in the left kidney.