How to perform transvenous electrical cardioversion in horses with atrial fibrillation

Electrical cardioversion of atrial fibrillation is a well-established technique for restoration of sinus rhythm in humans. While transthoracic cardioversion is more commonly used, transvenous electrical cardioversion (TVEC) has been reported as having higher efficacy at substantially lower energy levels. In horses, treatment of atrial fibrillation has essentially been limited to the administration of quinidine salts either orally or intravenously. TVEC provides an alternative to quinidine salts, especially for those animals in which quinidine is neither effective nor tolerated. The present report details this technique in horses, discusses possible complications of the procedure, and provides guidance for successful outcome. Still and video images are used to illustrate details with regard to TVEC techniques in horses. Please view supplemental material for the videos.     

Arytenoid Lateralization for Treatment of Laryngeal Paralysis in 10 Cats

Objective— To describe the signalment, history, clinical signs, surgical technique, and outcome for cats with laryngeal paralysis that had arytenoid lateralization.
Study Design— Case series.
Animals— Cats with laryngeal paralysis (n=10).
Methods— Medical records (1996–2002) for cats with laryngeal paralysis that had arytenoid lateralization were reviewed for signalment, history, clinical signs, degree of paralysis, cause, concurrent medical conditions, surgical technique, and outcome. Follow-up information was obtained from owners or referring veterinarians.
Results— Of 10 cats, 9 had bilateral and 1 had unilateral laryngeal paralysis. Arytenoid lateralization were unilateral (n=7), bilateral (1), and staged bilateral procedures (2), 10 days and 3 years apart, respectively. Postoperatively, 1 cat had persistent inspiratory noise because of minimal enlargement of the rima glottidis and 2 cats required a temporary tracheostomy for management of laryngeal swelling. Three cats developed aspiration pneumonia and died 4, 7, and 150 days after surgery; all 3 had bilateral (simultaneous or staged) procedures. Of the 7 remaining cats, 4 were alive at follow-up and 3 had died of causes unrelated to arytenoid lateralization. The calculated mean survival time for all 10 cats was 406 days (median, 150 days; range, 4–1825 days).
Conclusions— Arytenoid lateralization was effective at enlarging the rima glottidis and reducing signs of airway obstruction in most cats.
Clinical Relevance— Unilateral arytenoid lateralization is a feasible option for the surgical management of cats with marked clinical signs; however, bilateral procedures should be avoided or at least performed with considerable caution because of the apparent risk for aspiration pneumonia.