Comparison of pharmacodynamic variables following oral versus transdermal administration of atenolol to healthy cats

OBJECTIVE: To describe the disposition of and pharmacodynamic response to atenolol when administered as a novel transdermal gel formulation to healthy cats. ANIMALS: 7 healthy neutered male client-owned cats. PROCEDURES: Atenolol was administered either orally as a quarter of a 25-mg tablet or as an equal dose by transdermal gel. Following 1 week of treatment, an ECG and blood pressure measurements were performed and blood samples were collected for determination of plasma atenolol concentration at 2 and 12 hours after administration. RESULTS: 2 hours after oral administration, 6 of 7 cats reached therapeutic plasma atenolol concentrations with a mean peak concentration of 579 +/- 212 ng/mL. Two hours following transdermal administration, only 2 of 7 cats reached therapeutic plasma atenolol concentrations with a mean peak concentration of 177 +/- 123 ng/mL. The difference in concentration between treatments was significant. Trough plasma atenolol concentrations of 258 +/- 142 ng/mL and 62.4 +/- 17 ng/mL were achieved 12 hours after oral and transdermal administration, respectively. A negative correlation was found between heart rate and plasma atenolol concentration. CONCLUSIONS AND CLINICAL RELEVANCE: Oral administration of atenolol at a median dose of 1.1 mg/kg every 12 hours (range, 0.8 to 1.5 mg/kg) in cats induced effective plasma concentrations at 2 hours after treatment in most cats. Transdermal administration provided lower and inconsistent plasma atenolol concentrations. Further studies are needed to find an effective formulation and dosing scheme for transdermal administration of atenolol.     

Hypercoagulability in cats with cardiomyopathy

BACKGROUND: Arterial thromboembolism (ATE) is a common complication of feline cardiomyopathy; however, the pathogenesis of ATE is unknown. HYPOTHESIS: Systemic activation of the coagulation cascade (hypercoagulability) and endothelial injury promote ATE in cardiomyopathic cats. ANIMALS: Healthy cats (n = 30) and 3 groups of cardiomyopathic cats: Group (1) left atrial enlargement only (LAE [n = 11]), ie, left atrial to aortic ratio >1.4; Group (2) LAE with spontaneous echocardiographic contrast, atrial thrombi or both (SEC-T [n = 16]); and Group (3) acute ATE with LAE (n = 16). METHODS: Hypercoagulability was defined by 2 or more laboratory abnormalities reflecting coagulation factor excess (high fibrinogen concentration or Factor VIII coagulant activity), inhibitor deficiency (low antithrombin activity), or thrombin generation (high thrombin-antithrombin complex [TAT] and d-dimer concentrations). High von Willebrand factor antigen concentration (vWF : Ag) was considered a marker of endothelial injury. Data were analyzed using nonparametric statistics. RESULTS: The 3 groups of cats with cardiac disease had higher median fibrinogen concentrations than did the healthy cats. Criteria of hypercoagulability were found exclusively in cats with SEC-T (50%) and ATE (56%). Hypercoagulability was not associated with left atrial size or congestive heart failure (CHF). ATE cats had significantly higher median vWF : Ag concentration than did the other groups. CONCLUSION AND CLINICAL IMPORTANCE: Systemic hypercoagulability is evident in many cardiomyopathic cats, often without concurrent CHF or overt ATE. Hypercoagulabilty may represent a risk factor for ATE. High vWF : Ag in ATE cats was attributed to downstream endothelial injury from the occlusive thrombus.     

Association of body weight and body condition with survival in dogs with heart failure

BACKGROUND: Obesity is a risk factor for cardiovascular disease in people, but overweight and obese human heart failure patients have improved survival compared with normal--or underweight controls--the obesity paradox. The purpose of this study was to determine if there is an association of body weight and body condition with survival in dogs with heart failure. HYPOTHESIS: That body condition and changes in body weight are predictors of survival in dogs with heart failure. ANIMALS: One hundred and eight dogs with heart failure (International Small Animal Cardiac Health Council stages 2, 3a, or 3b) secondary to dilated cardiomyopathy or chronic valvular disease. METHODS: Medical records were reviewed, and data regarding initial body weight and body condition score (BCS), subsequent changes in body weight, and treatment were collected. Survival times were determined for dogs that were discharged from the hospital and lived >24 hours. RESULTS: Survival was significantly different between dogs that gained, lost, or maintained body weight over the course of their disease (P= .04), with dogs that gained weight surviving the longest. BCS and medications were not significantly associated with survival time; however, n-3 fatty acid intake was associated with longer survival time (P= .009). CONCLUSIONS AND CLINICAL IMPORTANCE: These results suggest that changes in body weight might be an important consideration in the survival of dogs with heart failure.     

ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs

This report, issued by the ACVIM Specialty of Cardiology consensus panel, revises guidelines for the diagnosis and treatment of myxomatous mitral valve disease (MMVD, also known as endocardiosis and degenerative or chronic valvular heart disease) in dogs, originally published in 2009. Updates were made to diagnostic, as well as medical, surgical, and dietary treatment recommendations. The strength of these recommendations was based on both the quantity and quality of available evidence supporting diagnostic and therapeutic decisions. Management of MMVD before the onset of clinical signs of heart failure has changed substantially compared with the 2009 guidelines, and new strategies to diagnose and treat advanced heart failure and pulmonary hypertension are reviewed.     

Extracardiac intrapericardial myxosarcoma causing right ventricular outflow tract obstruction in a dog

A 13-year-old male castrated pomeranian cross was referred for evaluation of episodes of collapse and a suspected cardiac mass. The presence of a mass at the base of the heart within the pericardial space was confirmed by echocardiography. Additional diagnostics included computed tomography, ultrasound-guided fine-needle aspirate, and thoracic radiographs. The mass was surgically debulked and diagnosed as myxosarcoma via histopathology. This case report describes the diagnostic imaging, laboratory findings, and short-term positive clinical outcome of a dog with a myxosarcoma in a previously undescribed location.     

Seasonal and circadian variation in presentation of cats with congestive heart failure

Objective– To determine if cats with congestive heart failure (CHF) are presented to a referral clinic more frequently during different seasons, months, days, or times. Design– Retrospective study. Setting– University small animal hospital. Animals– One hundred and eighty‐six cats with CHF. Interventions– None. Measurements and Main Results– The medical records of 186 cats, presented for 238 episodes of CHF between July 1, 1997 and June 30, 2002, were reviewed. An episode of CHF was defined as documented clinical evidence of pulmonary edema, pleural effusion, pericardial effusion, or ascites attributed to a cardiac origin by a board‐certified cardiologist. Chi‐square tests revealed statistically significant differences in presentation between different days of the week, with Thursday being the most common day, and between different hours of the day, with the peak between 10 am to 4 pm . Evaluation of presentation for CHF by season of the year identified more cats in December, January, and February although this did not achieve statistical significance. No significant difference was identified for presentation based on the day of the month or the month of the year. Conclusions– In this population of cats, there was daily, weekly and, possibly, seasonal variation in the frequency of presentation of cats with CHF. Additional studies are warranted to confirm these findings and to determine the cause for these differences.     

Surgical treatment of osteomyelitis and sequestration of the ilium by a cranial partial hemipelvectomy in an alpaca cria

A 12-week-old female alpaca cria weighing 10 kg presented with a 2-month history of left hindlimb lameness associated with osteomyelitis and sequestration of the shaft and wing of the left ilium. The affected segment of the ilium was surgically removed. Bacteriological culture revealed a small number of mixed aerobic and anaerobic bacteria. The cria recovered well, was discharged from the hospital 8 days after surgery and was paddock sound without complications 8 months later. Osteomyelitis and sequestration of long bones has been reported in alpacas, but further investigation is necessary to define the prevalence and pathogenesis and to develop specific recommendations for prevention and treatment.