Evaluation of shock waveform configuration on the defibrillation capacity of implantable cardioverter defibrillators in dogs

BackgroundImplantable cardioverter defibrillators (ICD) are programmed to detect ventricular arrhythmias and terminate them by delivering an electrical shock. A defibrillation threshold (DFT) at least 10 J below the maximum device output is recommended for successful therapy. Shock waveform configuration is a programmable parameter used to achieve a low DFT. It is hypothesized that a fixed-pulse configuration results in lower defibrillation energy requirements than a fixed-tilt configuration.Animals10 mongrel dogs.Materials and methodsICD generator and transvenous lead were surgically implanted. Defibrillation threshold was determined using a protocol guided by the upper limit of vulnerability. Fixed-pulse and fixed-tilt (50%/50%) waveform configurations were tested in a random order. Plasma cardiac troponin I (cTnI) was measured for signs of myocardial injury.ResultsThe experiment was completed in 9 dogs. Overall mean DFT value was 424 ± 88 V (9.2 ± 3.9 J). Mean differences among voltage, energy and impedance at the DFT for fixed-pulse (422 ± 97 V, 9.1 ± 4.2 J, 62.6 ± 13.8 Ω) and fixed-tilt (426 ± 83 V, 9.3 ± 3.8 J, 62.8 ± 18.5 Ω) configurations were not statistically significant (All P > 0.21). Cardiac TnI concentration changed from 0.03 ng/mL (95% CI: 0.02–0.04) at baseline to 0.11 ng/mL (95 CI: 0.08–0.16) after DFT was obtained with the first waveform configuration and 0.19 ng/mL (95% CI: 0.13–0.28) at the end of the study period. There were no significant changes in heart rate, end-tidal CO2 and blood pressure over time (all P > 0.09).ConclusionThe tested ICD device and lead placement reliably produced acceptable DFT values, based on a 10-J safety margin below the maximum device output. A benefit of fixed-pulse configuration could not be demonstrated over the standard fixed-tilt waveform. Signs of acute myocardial damage from repeated high-voltage shocks and episodes of ventricular fibrillation seemed of limited clinical significance.     

水飞蓟宾对镉致小鼠急性肝损伤的保护作用

探讨水飞蓟宾对镉致小鼠急性肝损伤的保护作用及其机制。将30只小鼠随机分成3组:正常对照组、镉组、水飞蓟宾干预组。正常对照组、镉组小鼠每日灌胃1%羧甲基纤维素钠悬混液,水飞蓟宾干预组小鼠经口给予100 mg·kg~(-1)水飞蓟宾,每日灌胃1次,连续灌胃7 d,于最后一次灌胃后1 h,正常对照组小鼠腹腔注射生理盐水0.01 mL·g~(-1),镉组及水飞蓟宾干预组小鼠一次性腹腔注射4 mg·kg~(-1)氯化镉,24 h后摘小鼠眼球取血,处死小鼠。检测血清丙氨酸转移酶(ALT)、天冬氨酸转移酶(AST)活性;制作肝组织切片,H.E染色,观察各组小鼠肝组织形态学变化;免疫组化检测肝组织HSP70蛋白表达;肝组织匀浆液检测一氧化氮(NO)含量及髓过氧化物酶(MPO)活性。结果显示,镉组小鼠血清ALT和AST活性与正常对照组比较显著升高,肝细胞出现变性、坏死,水飞蓟宾干预组小鼠血清ALT和AST活性与镉组比较显著降低,同时,肝细胞变性、坏死明显减轻;免疫组化检测结果显示,镉组小鼠肝组织热应激蛋白(HSP70)表达与正常对照组比较显著降低(P0.05),而水飞蓟宾干预组小鼠肝细胞HSP70蛋白表达与镉组比较均极显著升高(P0.01);与正常对照组比较,染镉组小鼠肝组织一氧化氮(NO)含量及髓过氧化物酶(MPO)活性均极显著升高(P0.01),水飞蓟宾干预组小鼠与镉组小鼠比较,肝组织NO含量和MPO活性极显著降低(P0.01)。结果表明,水飞蓟宾能减轻镉毒性导致的小鼠肝组织细胞急性损伤,其机制可能与水飞蓟宾降低NO含量及MPO活性,促进染镉小鼠肝组织细胞HSP70蛋白表达有关。     

Effect of benazepril on survival and cardiac events in dogs with asymptomatic mitral valve disease: a retrospective study of 141 cases

BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) improve quality of life and extend the life span of dogs with naturally acquired ISACHC class II-III congestive heart failure (CHF). However, their effects on asymptomatic heart disease remain controversial. HYPOTHESIS: Benazepril (BNZ), an ACEI, could have beneficial effects at the asymptomatic stage of degenerative mitral valve disease (MVD). ANIMALS: Dogs with ISACHC class Ia MVD and moderate-to-severe mitral regurgitation (MR) assessed by the color Doppler mapping technique at entry (Day 0) were retrospectively included. METHODS: Dogs were assigned to the treated group (BNZ group) if they received BNZ (and no other cardiac medication) from Day 0 or to the untreated group (UT group) if they did not receive any cardioactive treatment until occurrence of CHF. RESULTS: A total of 141 dogs were included in the study, 66 in the BNZ group (dosage: 0.30 +/- 0.13 mg/kg) and 75 in the UT group. In the population (n = 93) including all breeds except Cavalier (CKC) and King Charles Spaniels (KC), median survival time to all causes of death in the BNZ group (n = 34, 3.3 years) was significantly longer than in the UT group (n = 59, 1.9 years) as was time to cardiac event (P < .05). Conversely, no effect of the BNZ treatment was observed in the CKC and KC population. CONCLUSIONS AND CLINICAL RELEVANCE: BNZ had beneficial effects in asymptomatic dogs other than CKC and KC affected by MVD with moderate-to-severe MR. Breed distribution should be taken into account for interpretation of clinical trials performed in dogs with cardiac disease.     

Effects of lactated Ringer solution and prednisolone sodium succinate on dogs with induced hemorrhagic shock.

Hemorrhagic shock was induced in nonsplenectomized dogs by removing 41% of their blood volume over a 15-minute period. Hemodynamic and metabolic variables were determined prior to and for 3 hours after completion of hemorrhage. One group of 5 dogs was not treated. After the 30-minute sample was collected, a second group of 5 dogs was given lactated Ringer solution (LRS) at 88 ml/kg of body weight, IV. A third group of 5 dogs was given LRS (88 ml/kg, IV) and prednisolone sodium succinate (11 mg/kg, IV) 30 minutes after hemorrhage. The IV administration of LRS was completed within 15 minutes. The glucocorticoid was administered as an IV bolus after 500 ml of LRS had been given. The large volume and administration of LRS significantly (P = 0.05) improved many of the hemodynamic and metabolic effects of acute hemorrhage and hemorrhagic shock. At one time or another during the 2.5-hour observation period after the initiation of treatment, mean arterial pressure, cardiac index, systemic vascular resistance, heart rate, respiratory rate, lactate, glucose, and arterial and venous blood gas values were significantly (P = 0.05) improved, compared with baseline values. The addition of prednisolone sodium succinate to the treatment regimen improved the effectiveness of LRS alone only in some dogs at random sampling times. Significant trends were not observed except, possibly, the improvement of venous pH and A-V pH and PCO2 differences.     

Effect of carprofen, etodolac, meloxicam, or butorphanol in dogs with induced acute synovitis

OBJECTIVE: To compare the analgesic and anti-inflammatory effect of single doses of carprofen, etodolac, meloxicam, and butorphanol in dogs with induced acute synovitis (acute pain model) via kinetic gait analysis and orthopedic evaluation and examine measurement of serum C-reactive protein (CRP) concentration as an indicator of treatment efficacy. ANIMALS: 12 Beagles and 6 additional Beagles that were used only in serum CRP analyses. PROCEDURE: Acute synovitis was induced in right stifle joints of dogs via intra-articular injection of monosodium urate solution. Treatments included butorphanol (0.2 mg/kg, i.v.), carprofen (4 mg/kg, PO), etodolac (17 mg/kg, PO), or meloxicam (0.2 mg/kg, PO); control dogs received no treatment. The procedure was repeated (3-week intervals) until all dogs received all treatments including control treatment. Lameness was assessed on a biomechanical force platform and via orthopedic evaluations of the stifle joints; blood was collected to monitor serum CRP concentration. RESULTS: Compared with control dogs, treated dogs had significantly different vertical ground reaction forces and weight-bearing scores. Greatest improvement in lameness was observed in carprofen-treated dogs. Etodolac had the fastest onset of action. Compared with butorphanol treatment, only carprofen and etodolac were associated with significantly lower pain scores. An increase in serum CRP concentration was detected after intra-articular injection in all dogs; this change was similar among groups. CONCLUSIONS AND CLINICAL RELEVANCE: Carprofen, etodolac, and meloxicam had greater efficacy than butorphanol in relief of acute pain. Carprofen was most effective overall. In this acute pain model, serum CRP analysis was not useful to assess drug efficacy.     

Effect of routine cardiovascular catheterization on cardiac troponin I concentration in dogs

ObjectiveTo determine changes in cardiac troponin I concentration (cTnI) associated with cardiovascular catheterization in dogs.Animals, materials and methodscTnI was measured after transarterial coil embolization of patent ductus arteriosus (PDA), balloon valvuloplasty (BV), and pacemaker implantation (PACE). Dogs undergoing ovariohysterectomy (OHE) were used as a control, with 15 animals in each group. Blood for the cTnI assay was collected at baseline (T0), at 5 h (T5), 24 h (T24) and 10 days (T240) post-procedure. The effects of age, duration and difficulty of the procedure were evaluated.ResultsThere was no difference in cTnI concentration at T0 for any of the groups. There was a significant increase in cTnI concentration for BV and PACE, but not PDA at T5 and T24. PACE at T24 and T240 also had higher cTnI than control. Dogs with longer procedure times had significantly higher concentration of cTnI. There was no correlation between the difficulty of the procedure or peri-procedure complications and cTnI.ConclusioncTnI increased during some cardiovascular catheterization procedures, but returned to normal values at 24–240 h. Patients undergoing long catheterization procedures have increased risk for myocardial injury, but this was not related to short-term prognosis.     

Serum amylase and isoamylases and their origins in healthy dogs and dogs with experimentally induced acute pancreatitis

Agarose-gel electrophoresis was used to study isoamylases in tissues and sera of healthy dogs and the sera of dogs with experimentally induced acute pancreatitis. Three or 4 isoamylases were found in the serum of healthy dogs; they were numbered 1 to 4 with respect to their degree of anodal migration. Peak 4 isoamylase, the slowest migrating (most cathodal), was the major isoamylase fraction in sera and tissues of healthy dogs. Peak 3 was identified as a pancreas-specific isoamylase. Absolute total serum amylase and total isoamylase concentrations increased significantly in dogs with pancreatitis compared with values for control dogs (sham-operated). The relative increase in peak 3 isoamylase was greater than that seen with total amylase or the other isoamylases. The decrease in total serum amylase and isoamylase concentrations paralleled each other; however, peak 3 remained proportionally high longer than did total amylase and the other isoamylase fractions. These findings indicate that measurement of peak 3 isoamylase concentrations may be of diagnostic value in dogs with suspected pancreatitis with normoamylasemia and in dogs with extrapancreatic hyperamylasemia.     

Myocardial damage in dogs affected by heartworm disease (Dirofilaria immitis): Immunohistochemical study of cardiac myoglobin and troponin I in naturally infected dogs

It has recently been reported that dogs affected by canine heartworm disease (Dirofilaria immitis) can show an increase in plasma levels of myoglobin and cardiac troponin I, two markers of muscle/myocardial injury. In order to determine if this increase is due to myocardial damage, the right ventricle of 24 naturally infected dogs was examined by routine histology and immunohistochemistry with anti-myoglobin and anti-cardiac troponin I antibodies. Microscopic lesions included necrosis and myocyte vacuolization, and were associated with loss of staining for one or both proteins. Results confirm that increased levels of myoglobin and cardiac troponin I are indicative of myocardial damage in dogs affected by heartworm disease.     

Use of laparoscopy for diagnosing experimentally induced acute pancreatitis in dogs

Diagnosis of acute pancreatitis in dogs remains a significant challenge despite the development of advanced diagnostic methodologies. Visual inspection and pancreas biopsy using laparoscopy are generally considered to be procedures free of complications when conducted on healthy animals. However, the usefulness of laparoscopy for diagnosing acute pancreatitis has not been assessed. In the present study, the efficacy of laparoscopy for diagnosing acute pancreatitis in dogs was evaluated in animals with experimentally induced acute pancreatitis. Gross appearance of the pancreatic area was examined by laparoscopy to survey for the presence of edema, adhesions, effusion, pseudocysts, hemorrhage, and fat necrosis. Laparoscopic biopsy was performed and the histopathologic results were compared to those of pancreatic samples obtained during necropsy. The correlation between laparoscopy and histopathologic findings of the pancreas was evaluated. The presence of adhesions, effusion, and hemorrhage in the pancreatic area observed by laparoscopy significantly correlated with the histopathologic results (p < 0.05). There was no significant relationship between the histopathologic and laparoscopic biopsy findings. Results of this study suggested that laparoscopic evaluation of gross lesions has clinical significance although the laparoscopic biopsy technique has some limitations. This method combined with additional diagnostic tools can be effective for diagnosing acute pancreatitis in dogs.     

Suppressive effect of hyaluronan on chondrocyte apoptosis in experimentally induced acute osteoarthritis in dogs

Dogs receiving anterior cruciate ligament transection (ACLT) were treated with either intravenous (IV) or intraarticular (IA) administration of hyaluronan (HA), and differences in appearance of chondrocyte apoptosis of the stifle joint were investigated. Chondrocyte apoptosis was detected using flow cytometry as well as by staining with TdT-mediated dUTP nick end labeling (TUNEL). The percentage of apoptotic chondrocytes in dogs with ACLT was significantly higher than that in intact (non-ACLT) dogs. Dogs treated with IA or IV injection of HA after ACLT had fewer apoptotic chondrocytes than non-treated dogs after ACLT. It was suggested that ACLT-induced apoptosis of chondrocytes was suppressed by HA administration of either IA or IV.     

不同时机空肠内营养对犬急性胰腺炎治疗效果的研究

旨在研究空肠内营养疗法对犬急性胰腺炎的治疗时机。采用主胰管内保持一定压力逆行注入5%牛磺胆酸钠胰蛋白酶混合液(1 m L/kg)诱导犬急性胰腺炎模型。急性胰腺炎犬随机分为肠外营养组(TPN)、24 h肠内营养组(EN-1)、72 h肠内营养组(EN-2)、120 h肠内营养组(EN-3)和假手术组(S),每组6只犬。诱导后,EN组分别在24、72、120 h实施空肠营养,治疗期为7 d。造模后第2、4、6、8天观察胰淀粉酶、D-乳酸、血浆内毒素、白细胞(WBC)、中性粒细胞、C-反应蛋白等指标确定合适的营养时机。试验第8天取各组犬胰腺组织行HE染色观察其组织病理学改变;取空肠、回肠组织作HE染色,观察肠黏膜形态。结果:造模后,TPN组、EN组淀粉酶含量明显高于S组,第8天后EN组相比TPN组淀粉酶含量虽有降低,但无统计学差异(P0.05)。在D-乳酸、血浆内毒素、C-反应蛋白、白细胞方面,S组各时间点均低于EN组、TPN组(P0.05);EN-1在第4天与TPN组、EN-2组、EN-3组比较有显著性差异(P0.05),EN-2组在第6天与TPN组、EN-3组比较有显著性差异(P0.05),EN-3在第8 d与TPN组比较有统计学差异(P0.05)。从组织病理学可以看出,EN组胰腺组织、肠黏膜损伤较TPN组轻,肠绒毛较TPN完整;EN组肠内营养启动越早,绒毛越整齐、小肠黏膜越厚。研究表明,早期肠内营养并没有加重犬AP的病情,120 h内启动肠内营养治疗犬AP安全有效。     

Urinary alkaline phosphatase and 7-glutamyl transferase as indicators of acute renal damage in dogs

Urinary alkaline phosphatase (AP) and 7-glutamyl transferase (GGT) levels were measured in normal dogs, dogs with chronic renal failure, and dogs with acute renal failure, as confirmed by renal histology. The median values for urinary AP were 5–8 iu/litre/mmol creatinine for normal dogs, 6–7 for dogs with chronic renal failure and 49-4 for dogs with acute renal failure. The median values for urinary GGT were 3–4 iu/litre/mmol creatinine for normal dogs, 4–9 for dogs with chronic renal failure and 9-6 for dogs with acute renal failure. The results suggest that urinary AP can be used as an indicator of acute renal damage in the dog. GGT was shown to be less useful. No clear correlations were found between urinary enzyme levels and the extent of morphological kidney damage.     

Effect of acute gastric dilatation on gastric myoelectic and motor activity in dogs.

OBJECTIVE: To investigate the effects of experimentally induced acute gastric dilatation on electrical and mechanical activities of the stomach in dogs. ANIMALS: 7 healthy dogs. PROCEDURE: Electrodes and strain-gauge force transducers were implanted on the serosal surface of the antrum and pylorus. Eight days later, baseline gastric electrical and contractile activities were recorded. The dogs were anesthetized and mechanically ventilated to maintain normocapnia while the stomach was distended (intragastric pressure, 30 mm Hg) for 180 minutes, using a thin compliant bag. Gastric electrical and contractile activities were recorded again on days 1 and 10 after dilatation. Recordings were analyzed to determine gastric slow-wave frequency, slow-wave dysrhythmia, propagation velocity of slow-waves, coupling of contractions to slow waves, motility index on the basis of relative contractile amplitudes, and onset of contractions after a standardized meal. RESULTS: Electrical or contractile activities were not significantly different 18 hours after acute gastric dilatation (day 1). Arrhythmias were evident before and after gastric dilatation in dogs from which food was withheld and in dogs after consumption of a meal. CONCLUSIONS: Variables for assessing gastric electrical and contractile activities were unaffected 18 hours after acute gastric dilatation. CLINICAL RELEVANCE: Analysis of results of this study indicated that altered electrical and contractile activities in dogs with short-term gastric dilatation are not likely to be secondary to the process of acute gastric dilatation.     

Serum pancreatic polypeptide and amylase concentrations in dogs with experimentally induced acute pancreatitis

Serum concentrations of immunoreactive pancreatic polypeptide (IPP) were measured serially for 7 days after experimental induction of acute hemorrhagic pancreatitis in dogs by infusion of oleic acid into the pancreatic duct. The mean serum IPP concentrations in dogs with pancreatitis were increased significantly (P = 0.013) for 96 hours after induction of pancreatitis. Providing food at 108 hours resulted in significant increases (P = 0.032) in mean serum IPP concentrations in sham-operated control dogs compared with dogs with induced pancreatitis. This was attributed to cephalic-phase release of IPP due to a conditioned response that resulted from feeding immediately after each blood sampling. Mean serum IPP concentrations returned to base line more quickly than did mean serum amylase concentrations in dogs with pancreatitis.     

Comparison of heartworm extract-induced shock and endotoxin-induced shock in dogs by determination of serum tumor necrosis factor concentrations

OBJECTIVE: To compare the mechanisms of heartworm (HW) extract-induced shock and endotoxin-induced shock in dogs by determination of serum tumor necrosis factor (TNF) concentrations. ANIMALS: 11 mixed-breed dogs (7 without and 4 with HW infections). PROCEDURE: Eight dogs were treated with 2 ml of HW extract IV, and 3 dogs were given endotoxin (Escherichia coli lipopolysaccharide [LPS]) at 40 or 400 microg/kg of body weight, IV. Changes in clinical and hematologic findings and serum TNF concentrations were examined from before treatment to 120 minutes after treatment in dogs given HW extract or from before treatment to 180 minutes after treatment in dogs given LPS. Tumor necrosis factor concentration was determined by cytotoxic assay, using WEHI-164 murine sarcoma cells, and plasma endotoxin concentration was determined in 2 dogs treated with HW extract, using the endotoxin-specific chromogenic test. RESULTS: Eight dogs developed shock 3 to 16 minutes after HW extract treatment. Rectal temperature did not change during examination. Serum TNF concentration was detected at a low concentration only 60 and 120 minutes after HW extract treatment, and plasma endotoxin was not detected during examination. In dogs treated with LPS, rectal temperature increased to > 40 C in 2 of 3 dogs, and serum TNF concentration began to increase 30 minutes after LPS treatment, reaching a maximum concentration by 60 minutes. CONCLUSIONS: The cause and mechanism of HW extract-induced shock may be different from those of endotoxin-induced shock, because TNF, which was a pivotal mediator in endotoxin-induced shock, increased minimally in serum of dogs treated with HW extract.     

Effects of ketamine constant rate infusions on cardiac biomarkers and cardiac function in dogs

Objective

To evaluate the effects of ketamine continuous rate infusions (CRI) at two dose rates on cardiovascular function and serum creatine kinase MB isoenzyme (CK-MB) and troponin I in healthy conscious dogs.

Effect of skin graft preparation and graft survival on the secondary contraction of full-thickness skin grafts in dogs

The effects of 4 skin grafting techniques and graft survival on the secondary contraction of full-thickness skin grafts were evaluated. A total of 48 skin grafts were done on 12 dogs, with 2 skin grafts placed on both sides of the thorax of each dog. The grafting techniques included the sheet graft, sheet graft with continuous low-level suction provided by a butterfly catheter and evacuated glass tube, pie-crust graft, and nonexpanded mesh graft. Graft viability was assessed by visual inspection 10 days after surgical operation. Thirty skin grafts (64%) had a viability of 90% or greater. The final area of these grafts ranged from 73% to 119% of the original area. The secondary graft contraction followed a similar pattern for all graft types. During the first 10 days after surgical operation, the grafts contracted to 83% of their original area. Enlargement of the grafts began between 10 and 21 days after surgical operation. By 12 weeks, the grafts had attained a mean value of 96% of the original area. A significant difference in final area was not observed among graft types. Grafts with a high percentage of viability generally contracted less than those with larger areas of necrosis, but statistical relationship between viability and degree of contraction could not be proven. The results of the present study indicate that full-thickness skin grafts may be successfully done in dogs and that the grafts can be expected to undergo minimal postoperative contraction when graft survival is nearly complete.     

The effect of hypothyroidism on cardiac function in dogs

The thyroid hormones have direct and indirect effects on the heart. So it is possible that depression of left ventricular function is associated with hypothyroidism. This publication describes cardiac findings (auscultation, electrocardiography, echocardiography) in ten hypothyroid dogs. Low heart rates, reduced R-amplitudes and bradycardic arrhythmias (first and second-degree AV block) were found on the electrocardiogram before treatment. On the echocardiograms most of the dogs showed reduced contractillity and reduced left ventricular wall thickness. Seven dogs were reexamined after levothyroxine supplementation. Effects of treatment were increased heart rates and R-amplitudes as well as disappearance of the bradycardic arrhythmias in electrocardiographic examination. The echocardiographic examination showed increased contractility and increased left ventricular wall thickness.     

Comparison of histamine release induced by morphine and oxymorphone administration in dogs

Cardiovascular effects (vasodilatation, hypotension) of morphine administration have been attributed to central actions and peripheral histamine release. In the study reported here, we compared plasma histamine (Hm) concentrations after morphine sulfate and oxymorphone HCl administration in conscious dogs. Five healthy adult dogs (mean body weight, 10.1 kg) were randomly administered morphine (2 mg/kg of body weight, IV) or oxymorphone (0.2 mg/kg, IV) by a 5-second bolus injection at weekly intervals. Venous blood samples (5 ml) were collected from jugular veins before and at 1, 2, 5, 15, 30, and 60 minutes after drug administration. Behavioral changes were recorded. Plasma was analyzed by a radioenzymatic technique, using purified histamine N-methyltransferase as an enzyme catalyst (sensitivity of assay, 40 pg Hm/ml). Mean base-line Hm value for all dogs was 0.55 ng/ml. The mean Hm value was significantly higher (P less than 0.05) than the base-line value at 1, 2, 5, 15, and 60 minutes after morphine administration (531.4, 251.0, 113.0, 31.5, and 1.0 ng of Hm/ml, respectively), but there were no significant increases in histamine values from base-line values at any time after oxymorphone administration. All dogs given morphine and 1 dog given oxymorphone showed excitatory behavior; 2 dogs given morphine and 3 dogs given oxymorphone salivated profusely.