Dilatation of the right atrium in a dog with polymyositis and myocarditis

A nine-year-old, female, neutered golden retriever was referred for investigation of weakness. Immune-mediated polymyositis with mixed mononuclear cell inflammation and fibrosis was diagnosed in muscle biopsy specimens from several sites. A soft tissue opacity was noted radiographically cranial to the cardiac silhouette. The dog failed to respond to treatment with prednisolone and was euthanased. At post-mortem examination, the structure observed radiographically was showed to be an enlarged right atrium. Histopathological examination of samples collected at post-mortem confirmed polymyositis. Additionally, mononuclear cell infiltrations and fibrosis were observed in areas of endocardium and/or myocardium in the walls of all four cardiac chambers. Myocarditis has not been reported previously in canine polymyositis but is well recognised in people. Enlargement of the right atrium has also been reported in association with polymyositis and myocarditis in people.     

Cerebral infarction and myocardial fibrosis in a white-handed gibbon (Hylobates lar).

A white-handed gibbon (Hylobates lar) lost the use of its right hand. Complete blood count, serum chemistry profile, electrocardiographic findings, blood pressure, and radiographic work-up were normal, but the gibbon died 2 days later. The gibbon was serologically positive for herpes simplex I and Epstein-Barr virus. Necropsy and histopathology showed acute infarction of the right cerebrum and multifocal to coalescing severe myocardial fibrosis.     

Congestive cardiomyopathy in a dog associated with pregnancy

A two-year-old, six-week postpartum female dog was presented with acute congestive heart failure for treatment. The patient collapsed and suddenly died. Postmortem examination revealed an enlarged, dilated heart with thin ventricular walls. Histologically, scattered multifocal areas of myocardial degeneration and necrosis with fibrosis were seen in the myocardium. This case of acute cardiomyopathy in a female dog six weeks postpartum is similar to the well-described, postpartum cardiomyopathy in man. The etiology of this case was not ascertained.     

Congenital ocular anomalies and ventricular septal defect in a dromedary camel (Camelus dromedarius).

A 5-wk-old female dromedary camel (Camelus dromedarius) was clinically diagnosed with bilateral corneal dermoids, incomplete congenital cataracts, a left persistent hyaloid artery (PHA), and a ventricular septal defect (VSD). The corneal dermoids were removed by lamellar keratectomy, and vision improved in the left eye. Thirteen months after dermoid surgery, the calf was presented for enlargement of the right eye. Glaucoma was confirmed in the right eye, and corneal fibrosis and cataract were noted in the left eye. Persistence of the VSD was confirmed by cardiac ultrasonography. The calf was euthanized, and necropsy findings confirmed VSD. Histopathologic examination revealed bilateral corneal thinning and fibrosis, cataracts with retrolental fibroplasia, and retinal dysplasia. Additional changes in the right globe were anterior segment dysgenesis, ruptured lens capsule, chronic phacoclastic uveitis, and retinal separation. The PHA was confirmed in the left eye.     

Unexpected death in an adult dog with anomalous origin of the left coronary artery from the pulmonary trunk

A two-year-old female miniature poodle died unexpectedly while romping with its owner. Anomalous origin of the left coronary artery from the left pulmonic sinus was discovered at necropsy. Histologically, the right ventricle was unremarkable, but multifocal to coalescing necrosis and fibrosis occurred in the myocardium and endocardium of the left ventricle. Medial hypertrophy of small muscular pulmonary arteries was observed in the lung. The cardiac lesions were similar to those of children with anomalous origin of the left coronary artery from the pulmonary trunk. Pulmonary hypertension, which is suggested by the pulmonary arterial medial hypertrophy, could have increased left ventricular myocardial perfusion and delayed the ischemic myocardial damage that resulted in the death of this dog.     

Experimental viral myocarditis: parvoviral infection of neonatal pups

Myocarditis was produced in seronegative five-day-old pups by oral and by intraperitoneal inoculation of canine parvovirus. The disease was subclinical. Histologic lesions were compatible with, but less extensive than, those seen in naturally occurring canine parvoviral myocarditis. In pups necropsied 23 days after inoculation, scattered cardiac myocytes contained intranuclear inclusion bodies, and virus-infected myocytes were demonstrated by immunofluorescence. Degeneration and loss of cardiac myocytes usually was not associated with a cellular infiltrate. At 51 days after inoculation, the myocardium contained an extensive lymphocytic infiltrate which was sometimes associated with fragmented myocytes, and was often contiguous with areas of interstitial fibrosis. At 108 days after inoculation, inflammatory lesions had regressed, and there were multifocal areas of myocardial fibrosis.     

Arrhythmogenic right ventricular cardiomyopathy in a dog

An 8-month-old Labrador retriever bitch was evaluated for sudden-onset, progressive abdominal distension. Physical examination revealed an exaggerated inspiratory effort, severe ascites, bilateral jugular vein distension, and hypokinetic femoral arterial pulses. Thoracic auscultation detected tachycardia with muffled heart sounds, without audible cardiac murmurs. Thoracic radiographs identified severe right ventricular enlargement and pleural effusion. The electrocardiogram was consistent with incomplete right bundle branch block or right ventricular enlargement. Echocardiography demonstrated severe right ventricular and atrial dilation, secondary tricuspid regurgitation, and thinning and hypocontractility of the right ventricular myocardium. Left heart chamber sizes were slightly decreased, with normal left ventricular contractility. A diagnosis of arrhythmogenic right ventricular cardiomyopathy was reached, based on the characteristic clinical, electrocardiographic, radiographic and echocardiographic findings, and the exclusion of other causes of isolated right ventricular failure. Treatment effected good control of clinical signs, until acutely decompensated congestive right heart failure led to euthanasia after 4 months. Arrhythmogenic right ventricular cardiomyopathy is a well-described clinical entity in humans, and has previously been documented in 3 male dogs. The condition is characterised by progressive fibro-adipose replacement of right ventricular myocardium, while the left ventricle usually remains unaffected. It should be considered a differential diagnosis in any young dog presented with isolated right heart failure, syncope, or unexplained ventricular tachyarrhythmias. This article reports the 1st case of arrhythmogenic right ventricular cardiomyopathy in a female dog, and highlights its echocardiographic features.     

Atherosclerosis with multifocal myocardial infarction in a Pacific walrus (Odobenus rosmarus divergens Illiger).

A 25-yr-old male captive walrus (Odobenus rosmarus divergens Illiger) died after suffering from periods of inactivity, anorexia, and weight loss for 8 wk. Necropsy revealed prominent, generalized atherosclerosis of cardiac arteries with widespread chronic myocardial infarction. Severe disseminated myocardial fibrosis most likely resulted in insidious cardiac failure that was ultimately the cause of death. Bouts of abdominal pain and disseminated cutaneous ulcers that had been observed 3 and 4 days before death, respectively, were attributed to circulatory failure and thrombosis. The cause of the vascular lesions remains unknown. When compared with humans, atherosclerosis is rare in animals and has not been described in a walrus.     

IMAGING DIAGNOSIS—MULTIMODALITY FINDINGS IN AN ADULT DOG WITH PRIMARY SARCOMA OF THE PULMONARY ARTERY AND MYOCARDIAL METASTASES

Intravascular pulmonary artery sarcomas in combination with myocardial metastasis are rare in dogs. We describe the radiographic, echocardiographic, and electrocardiographic‐gated (ECG‐gated) computed tomographic angiography (CTA) findings in a dog with pulmonary artery sarcoma. All imaging studies demonstrated severe main pulmonary artery enlargement. Echocardiography and ECG‐gated CTA revealed a mass occluding the lumen of the right pulmonary artery. In addition, CTA revealed focal left ventricular myocardial contrast enhancement and parenchymal lung changes. Postmortem examination confirmed the presence of a large thrombus associated with arteriosclerosis and an intravascular sarcoma in the right pulmonary artery with metastases to the myocardium, lungs and brain.     

Clinical and pathologic findings in dogs with atherosclerosis: 21 cases (1970-1983)

Atherosclerosis was diagnosed on necropsy in 21 dogs in a 14-year period. Nine dogs died and 12 were euthanatized because of complications associated with the disease. The mean age was 8.5 +/- 0.5 years; 18 dogs were male. Three breeds (Miniature Schnauzer, Doberman Pinscher, and Labrador Retriever) had a higher prevalence of the disease than other breeds in the canine necropsy population of The Animal Medical Center. Most common clinical signs were lethargy, anorexia, weakness, dyspnea, collapse, and vomiting. Hypercholesterolemia, lipidemia, and hypothyroidism were common in affected dogs tested, and protein electrophoresis revealed high values for alpha 2 and beta fractions in all dogs tested. Electrocardiography indicated conduction abnormalities and myocardial infarction in 3 of 7 dogs. Necropsy revealed that affected arteries (including coronary, myocardial, renal, carotid, thyroidal, intestinal, pancreatic, splenic, gastric, prostatic, cerebral, and mesenteric) were yellow-white, thick and nodular, and had narrow lumens. Myocardial fibrosis and infarction also were observed in the myocardium. Histologically, affected arterial walls contained foamy cells or vacuoles, cystic spaces, mineralized material, debris with or without eroded intima, and degenerated muscle cells.     

Myocardial collagen deposition and inflammatory cell infiltration in cats with pre-clinical hypertrophic cardiomyopathy

The histological features of feline hypertrophic cardiomyopathy (HCM) have been well documented, but there are no reports describing the histological features in mild pre-clinical disease, since cats are rarely screened for the disease in the early stages before clinical signs are apparent. Histological changes at the early stage of the disease in pre-clinical cats could contribute to an improved understanding of disease aetiology or progression. The aim of this study was to evaluate the histological features of HCM in the left ventricular (LV) myocardium of cats diagnosed with pre-clinical HCM. Clinically healthy cats with normal (n = 11) and pre-clinical HCM (n = 6) were identified on the basis of echocardiography; LV free wall dimensions (LVFWd) and/or interventricular septal wall (IVSd) dimensions during diastole of 6–7 mm were defined as HCM, while equivalent dimensions <5.5 mm were defined as normal. LV myocardial sections were assessed and collagen content and inflammatory cell infiltrates were quantified objectively. Multifocal areas of inflammatory cell infiltration, predominantly lymphocytes, were observed frequently in the left myocardium of cats with pre-clinical HCM. Tissue from cats with pre-clinical HCM also had a higher number of neutrophils and a greater collagen content than the myocardium of normal cats. The myocardium variably demonstrated other features characteristic of HCM, including arteriolar mural hypertrophy and interstitial fibrosis and, to a lesser extent, myocardial fibre disarray and cardiomyocyte hypertrophy. These results suggest that an inflammatory process could contribute to increased collagen content and the myocardial fibrosis known to be associated with HCM.     

Ureteral obstruction and hydronephrosis in a cat associated with retroperitoneal infarction

A 9-month-old cat was presented for routine vaccination before rehoming. Physical examination revealed a palpable mass in the cranial abdomen. The right kidney was severely enlarged (6cmx4cm) on plain abdominal radiographs, and failed to opacify normally during intravenous urography. Ultrasonography demonstrated a hydronephrotic right kidney. During exploratory coeliotomy, a retroperitoneal mass was identified, adherent to the caudal edge of the right kidney, enveloping the ureter and blocking urine outflow. The ureter caudal to the mass was of normal size. Right ureteronephrectomy was performed; the mass was subsequently freed from adhesions to the caudal vena cava and sublumbar muscles and excised. Histopathological examination revealed the mass to be composed of both normal and necrotic adipose tissue and fibrous tissue surrounding the ureter and a thrombosed, recanalised vessel. This appearance was consistent with an area of infarction and fibrosis with obstruction of the ureter. The cat was clinically well 3 months postoperatively.     

Cardiomyopathy in stranded pygmy and dwarf sperm whales

Necropsy and histologic examinations were performed in 23 pygmy sperm whales (Kogia breviceps) and 6 dwarf sperm whales (Kogia simus) that had been stranded singly or in cow-calf pairs along the southeastern coastline of the United States. At necropsy, the gross findings in the adult whales included pale, flabby right ventricles. Microscopically, lesions in the hearts of the whales were characterized by moderate to extensive myocellular degeneration, atrophy, and fibrosis. Similar changes were not seen in 5 of 6 sexually immature whales or in the whale calves. Hepatic changes were consistent with heart failure. The cause of the myocardial lesions was not determined. The systemic effects of failing myocardium probably were a major reason for the stranding of the adult whales.     

Effect of long-term administration of a prostacyclin analogue (beraprost sodium) on myocardial fibrosis in Dahl rats

Beraprost sodium (BPS) is an orally active prostacyclin analogue. The effects of BPS on the heart, including coronary circulation improvement, myocardial and vascular protection and anti-fibrosis effect on myocardium interstitium, have previously been demonstrated. However, the effects of BPS on hemodynamics, cardiac function and myocardial contractility in patients in the hypertrophic phase have not been clarified. Therefore, in the present study, the effects of BPS under long-term administration were investigated using the hypertension model of salt-sensitive Dahl rats. Six-week-old Dahl rats were divided into three groups, an 8% high salt diet group treated with BPS (BPS group), an untreated 8% high salt diet group (HHF group) and an untreated 0.3% low salt diet group (Control group), and observations were conducted until 17 weeks of age. In the BPS and HHF groups, the survival rates after 11 weeks of high salt diet intake were 87.5% and 47.1%, respectively (p<0.05). At 17 weeks of age, the atrial systolic peak velocity/early diastolic peak velocity and heart weight index of the BPS group decreased significantly compared with the HHF group (p<0.05). The HHF group exhibited significantly more severe myocardial fibrosis mainly in the endocardial layer of the left and right ventricles compared with the BPS and Control groups (p<0.05). In the present study, long-term BPS administration preserved diastolic function and prevented myocardial interstitial fibrosis in the non-compensatory phase. The results of the present study suggest that BPS is effective for treatment of hypertensive cardiac hypertrophy.     

Alterations in the organisation, ultrastructure and biochemistry of the myocardial collagen matrix in doberman pinschers with dilated cardiomyopathy

Remodelling of the collagen matrix of the myocardium has been implicated in the pathogenesis of dilated cardiomyopathy, a major cause of heart failure in Doberman pinschers. The aim of this study was to characterise the myocardial collagen matrix of Dobermans. In clinically normal Dobermans there was evidence of focal fibrosis. Collagen cross-links were altered in both diseased and clinically normal Doberman myocardium as compared with myocardium from control dogs. Extensive remodelling, in the form of a loss of collagen tethers, increased collagen synthesis and alterations in the collagen cross-links, occurs in diseased Doberman myocardium. Changes in the collagenous matrix are also present in apparently normal Dobermans. These changes are likely to be involved in the progression of the disease and may explain the predisposition of this breed to dilated cardiomyopathy.     

Chronic myocardial infarction due to arteriosclerosis of coronary arteries followed by acute thromboembolism of caudal abdominal aorta in a cat

A 10-year-old cat with the paresis of hind limbs was initially diagnosed as a hypertrophic cardiomyopathy followed by acute thromboembolism of caudal abdominal aorta from the findings of the medical examinations. However, this case was proved to be an chronic myocardial infarction due to arteriosclerosis of coronary arteries by the pathologic diagnosis. In the left ventricular, the hypertrophy and the narrowing were slight, and a coagulative infarction was seen obviously. The intramural coronary arteriosclerosis showed thickening of the wall due to medial hyperplasia by fibrosis, and arterial stenosis. Myocardial infarction and arteriosclerosis are scarcely any reports of these lesions in cats. This case is valuable for an extremely rare case of myocardial infarction in the cat.     

Use of a multiplex polymerase chain reaction to rapidly differentiate Neospora caninum from Toxoplasma gondii in an adult dog with necrotizing myocarditis and myocardial infarct.

This report describes a 3-year-old male castrated Mastiff dog that died unexpectedly with locally extensive, acute, necrotizing myocarditis and myocardial infarction. Intralesional protozoal tachyzoites in the affected myocardium were confirmed to be Neospora caninum by a novel multiplex polymerase chain reaction (PCR) and immunohistochemistry. Protozoal organisms were not identified in other tissues by histology, immunohistochemistry, or PCR. The multiplex PCR assay was used to quickly provide preliminary results on fresh myocardium to differentiate N. caninum and Toxoplasma gondii. Neosporosis is an uncommon cause of myocarditis in adult dogs and differential diagnoses for myocarditis in this population of dogs are reviewed.     

Left ventricular myxosarcoma in a dog

An entire male Neopolitan mastiff, aged two years and eight months, presented with a history of chronic diarrhoea and weight loss. The diarrhoea had been present for approximately 12 months and had progressively worsened, with weight loss developing over an eight-week period prior to presentation. No primary gastrointestinal or metabolic cause for the diarrhoea could be identified. Echocardiography revealed a large, multilocular, cyst-like structure within the pericardium compressing the heart and displacing it to the right. The mass was surgically excised from the left ventricular myocardium. Histopathological examination showed it to be a low-grade malignant myxosarcoma. The dog made a full recovery and was still clinically normal nine months postoperatively, with no evidence of tumour recurrence or metastases. However, 11 months postsurgery, the clinical signs of diarrhoea and weight loss returned. Tumour recurrence with local metastasis was diagnosed and the dog was euthanased 358 days after the original surgery.     

Myocardial fibrosis in a horse with polymorphic ventricular tachycardia observed during general anesthesia

Ventricular dysrhythmias are more commonly associated with myocardial disease than are supraventricular dysrhythmias. Management of arrhythmias under general anesthesia is difficult because of the dysrhythmogenic effects of the anesthetic drugs. This report describes a severe ventricular dysrhythmia observed in a pony under general anesthesia, with a severe and old myocardial fibrosis found on postmortem examination.     

Polymerase chain reaction analysis for viruses in paraffin-embedded myocardium from dogs with dilated cardiomyopathy or myocarditis

OBJECTIVE: To perform polymerase chain reaction (PCR) analysis on paraffin-embedded myocardium from dogs with dilated cardiomyopathy (DCM) and dogs with myocarditis to screen for canine parvovirus, adenovirus types 1 and 2, and herpesvirus. SAMPLE POPULATION: Myocardial specimens from 18 dogs with an antemortem diagnosis of DCM and 9 dogs with a histopathologic diagnosis of myocarditis were evaluated. PROCEDURE: Paraffin-embedded myocardial specimens were screened for viral genome by PCR analysis. Positive-control specimens were developed from cell cultures as well as paraffin-embedded tissue specimens from dogs with clinical and histopathologic diagnoses of viral infection with canine parvovirus, adenovirus types 1 and 2, and herpesvirus. The histologic characteristics of all myocardial specimens were classified regarding extent, location, and type of inflammation and fibrosis. RESULTS: Canine adenovirus type 1 was amplified from 1 specimen from a dog with DCM. Canine parvovirus, adenovirus type 2, and herpesvirus were not amplified from any myocardial specimens. Histologic analysis of specimens from dogs with DCM revealed variable amounts of fibrosis; myocardial inflammation was observed in 1 affected dog. Histopathologic analysis of specimens from dogs with myocarditis disclosed variable degrees of inflammation and fibrosis. CONCLUSIONS AND CLINICAL RELEVANCE: Viral agents canine parvovirus, adenovirus types 1 and 2, and herpesvirus are not commonly associated with DCM or active myocarditis in dogs. Additional studies evaluating for nucleic acid from viruses that less commonly affect dogs or different types of infectious agents may be warranted to gain insight into the cause of DCM and myocarditis in dogs.