Multiple retrospective analysis of survival and evaluation of 4 cardiac death predictors in a population of dogs affected by 5 degenerative mitral valve disease in ACVIM class C treated 6 with different therapeutic protocols

Clinical records of dogs with spontaneous degenerative mitral valve disease (DMVD) with clinical signs related to congestive heart failure (CHF) that had been recruited during routine clinical practice, between 2001 and 2018 at the Cardiology Unit of the Veterinary Teaching Hospital (University of Milan) were included in this retrospective cohort study. Baseline echocardiographic data were evaluated. Median survival times (MSTs) were calculated. Data on therapeutic treatment, ISACHC or ACVIM classes were reviewed based on the inclusion period and type of endpoint (i.e. cardiac death or death for other causes). The main goal of this data review was to retrospectively evaluate 259 clinical records of subjects belonging to ACVIM C class examined between 2001 to 2018 together with the 202 examined between 2010 to 2018. The MSTs of these subjects was 531 d (2001-2018) and 335.5 d (2010-2018), respectively. Univariate survival regression analysis for subjects included from 2010 to 2018 showed the following variables as being significantly related to cardiac death (CD): LA/Ao ratio (HR 2.754, p=0.000), E wave (HR 2.961, p=0.000), E/A ratio (HR 1.372, p=0.000), EDVI (HR 1.007, p=0.000), ESVI (HR 1.012, p=0.026), Allo(d) (HR 4.018, p=0.000) andAllo(s) (HR 2.674, p=0.049), age (HR 1.006, p=0.009) and PH severity (HR=1.309, p=0.012). Multivariate analysis, adjusted for age, showed that the only variable that determined a statistically significant difference in MST was PH severity (HR 1.334, p=0.033). The type of therapeutic treatment within this class was not significant for the MST of the subjects

MYXOMATOUS MITRAL VALVE DISEASE IN CAVALIER KING CHARLES SPANIEL: CLINICAL, GENETIC, AND CARDIAC BIOMARKERS STUDY

One hundred and sixty-five CKCS subjects, both healthy and affected by different stages of MMVD, were examined from November 2018 to June 2021 at the Veterinary Teaching Hospital in Lodi \u2013 University of Milan \u2013 Cardiology Section. Each dog was submitted to a clinical examination and echocardiographic, radiographic, and morphometric data were collected. Whole blood and plasma were collected for genetic analysis and biomarker (miRNA) evaluation. The objectives of this study were: 1) To describe breed-specific reference values for vertebral heart score (VHS), vertebral heart atrial size (VLAS), M-VLAS, and radiographic left atrial enlargement (RLAD) in healthy adults CKCS; 2) To conduct a genomic study on a population of Italian CKCS; 3) To characterize echocardiographic features of the mitral valve in this breed, focusing on dogs classified as American College of Veterinary Internal Medicine (ACVIM) B1, without clinical signs and without left atrial and ventricular enlargement; 4) To analyze the relationships and the prognostic value of morphometric variables in CKCS affected by MMVD; 5) To analyze the expression of miRNAs described in the literature as being involved in the pathophysiology of MMVD, and identified in dogs\u2019 plasma. Results: 1) Healthy CKCS had a median VHS of 10.08 \ub1 0.56v, a VLAS, M-VLAS and RLAD respectively of 1.79 \ub1 0.3v, 2.23 \ub1 0.44v and 1.2 \ub1 0.34v; 2). The top 1% single-nucleotide polymorphisms (SNPs) of both Wright\u2019s fixation index (FST) and cross-population extended haplotype homozygosity (XP-EHH) analyses localized 10 consensus genes on chromosomes 3-11-14-19; 3) Within class B1, older subjects showed significantly higher values of anterior mitral valve area (AMVA), width (AMVW), mitral valve annulus in diastole (MVAd) and systole (MVAs) and lower sphericity index (SI); 4) A more severe mitral regurgitant jet size and a thicker anterior mitral valve leaflet were observed in CKCS smaller than standard proposed by the Ente Nazionale della Cinofilia Italiana (ENCI) and with morphometric characteristics tending to brachycephalism; 5) miR-30b-5 was significantly higher in ACVIM B1 compared to healthy subjects (ACVIM class A) and the AUC was 0.79. According to the age of dogs, the expression of miR-30b-5p remained significantly higher in group B1<3y (2.3 folds p=0.03), B1 3-7y (2.2 folds p=0.03), and B1>7y (2.7 folds p=0.02) than in stage A. The AUCs were fair in discriminating group B1<3y and A (AUC 0.78), and B1 3-7y and A (AUC 0.78), and good in discriminating group B1>7y and A (AUC 0.82). Conclusions: 1) Findings supported previous studies recommending the use of breed-specific reference values for VHS, VLAS, M-VLAS and RLAD and provided background data for future radiographic evaluations of CKCS dogs with clinical signs of cardiac disease; 2) This genetic analysis expands the knowledge of the genetic basis of MMVD by identifying genes involved in the early onset of MMVD in CKCS; 3) This is the first study that describes measurements of the anterior mitral valve leaflet and the mitral valve annulus in the CKCS affected by MMVD at different stages. Differently aged B1 dogs have different clinical and echocardiographic patterns. Further investigations with a larger study population and an appropriate follow-up would highlight prognostic factors related to disease worsening within this heterogeneous ACVIM class; 4) The morphological study of CKCS showed that a more severe regurgitant jet size was observed in subjects with a shorter head and nose. Subjects with a smaller head stop angle had thicker anterior mitral valve leaflets. Dogs with cephalic morphology more similar to the King Charles spaniel breed, that is with a brachycephalic morphotype, showed a more severe regurgitant jet size and valvular characteristics related to worse forms of MMVD (thicker anterior mitral valve leaflet, greater mitral valve annulus and lower sphericity index); 5) miR-30b-5p increases in the plasma of asymptomatic CKCS and this can be considered a potentially promising biomarker even at an asymptomatic stage of disease, particularly at a young age

L’aldosterone breakthrough nel cane con malattia mitralica : revisione della letteratura = Aldosterone breakthrough in dogs with mitral valve disease : a review of the literature

L\u2019attivazione del sistema renina angiotensina aldosterone (RAAS) rappresenta uno dei principali meccanismi di compenso dell\u2019insuffi cienza cardiaca, fondamentale per mantenere un\u2019adeguata portata cardiaca. Nel lungo periodo per\uf2 la sua costante attivazione risulta deleteria ed anzi favorisce la progressione della patologia, rendendo necessaria la somministrazione di farmaci capaci di contrastarlo, quali gli ACE-inibitori. Tuttavia, \ue8 stato dimostrato, prima nell\u2019uomo e pi\uf9 recentemente anche nel cane, che in alcuni pazienti la terapia non \ue8 in grado di contrastare efficacemente il RAAS con conseguente innalzamento dei livelli di aldosterone. Tale fenomeno \ue8 noto con il nome di Aldosterone Breakthrough. L\u2019Autore propone una revisione della letteratura.Renin angiotensin aldosterone system activation represents one of the main compensatory mechanism of heart failure and it is essential to keep an adequate cardiac output in. However, its chronic activation becomes maladaptive and promotes heart failure progression, making necessary the administration of RAAS blockers drugs, like the ACE-inhibitors. In human beings, and more recently in dogs, a drugs\u2019 effectiveness decrease and a concurrent aldosterone increase have been evidenced. This is known as aldosterone breakthrough. The Authors propose a review of the literature

Stenosi subaortica : revisione della letteratura e presentazione di un caso clinico in un cucciolo di razza Cane Lupo Italiano = Subaortic stenosis : bibliographic review and presentation of a clinical case of Italian Wolf dog puppy

Il Cane Lupo Italiano \ue8 una razza originatasi nel 1966 dall\u2019incrocio di una femmina di Lupo dell\u2019Appennino con un cane di razza Pastore Tedesco. Si descrive un caso di stenosi subaortica tipo 3 in un soggetto di razza Cane Lupo Italiano maschio di 2 mesi d\u2019et\ue0, morto spontaneamente dopo aver manifestato grave dispnea ed astenia. L\u2019esame clinico riferiva la presenza di un soffio di V/VI grado sul focolaio aortico. L\u2019esame radiografico evidenziava edema polmonare, all\u2019esame ecocardiografico e Doppler erano presenti gravi alterazioni del tratto di efflusso del ventricolo sinistro (LVOT), compatibili con una stenosi subaortica di tipo 3, unitamente a stenosi congenita della valvola mitrale. Il flusso aortico era turbolento e ad elevata velocit\ue0. L\u2019esame necroscopico confermava il sospetto diagnostico in presenza di alterazioni a carico di diversi organi addominali, che si \ue8 ipotizzato potessero essere corresponsabili della morte improvvisa del soggetto.The Italian Wolf dog is a new dog\u2019s breed, born in 1966, from the cross of a female of wolf of the Apennines with a German Shepherd. In this case report, we describe a case of subaortic stenosis (SAS) type 3 in a male, 2 months old Italian Wolf dog, who died spontaneously after a severe episode of dyspnoea. Clinical examination revealed a V/VI grade murmur, heard best over the aortic area. Lateral chest X-ray shows pulmonary edema. At the echocardiographic examination, severe alterations of the Left Ventricular Outfl ow Tract (LVOT) were present: the aortic fl ow was turbulent and presented high velocity, together with congenital mitral stenosis. Necropsy confi rmed the pathology, associated with other congenital malformations affecting various abdominal organs, which it was hypothesized could be co-responsible for the sudden death of the subject

Survival time analisys in dogs affected by mixomatous mitral valve disease treated with different protocol: retrospective study

The management of myxomatous mitral valve disease (MMVD) in dog, belonged to any ACVIM class, should be focused to obtain a good quality of life and a longer survival time . The literature referred the effects of different therapies on survival time in dogs selected with restricted criteria (prospective cohort study).The aim of our study was to analyse the survival time in a retrospective cohort of dogs with MMVD treated with different protocols. The lengthening of MST and a good quality of life (QoL) are significant aspects of the therapeutic strategy. Both are very important for the owners. The achievement of a longer MST in our study compared to the literature might be justified by a good compliance of the owners over time, even in the case of complex protocols (group 3) [5]. Prospective studies are needed to investigate the effects of the owners\u2019 compliance besides the therapeutic protocol on the QoL and survival of MMVDiseased dogs

The traditional practices used by couples with fertility problems, affecting factors, expected benefits, and learning paths: The Turkey Sample

Objective: Studies related to traditional practices and benefits have been usually performed among women. The literature regarding the traditional practices used by men in Turkey and around the world and their expected benefits is more limited. The aim of this study was to examine the traditional practices used by couples with fertility problems, affecting factors, expected benefits, and learning paths. Materials and Methods: The descriptive study was performed between May and July 2017 in Izmir, Turkey. In total, 151 women with infertility were included. The data related to the use of this practice by men were obtained from women partners. "Personal information form" and "traditional practices evaluation form" were used to obtain the data. Results: In total, 35.8% of the women and 25.8% of the men used traditional practices. The 24.4% of women and 52.1% of men used other practices such as figs, onion cures, and hacamat, whereas 18.2% of women and 14.9% of men used various herbs. The benefits they expected from traditional practices were facilitating conception, ensuring follicle development in women, increasing sperm count, and quality and facilitating conception in men. Overall, 37.0% of women learned of these practices from their friends, 30.7% of men learned from their partners, 20.4% of women and 20.6% of men learned from the internet. Conclusion: The couples in this study widely used traditional practices to solve fertility problems and learned from their friends and partners

Angiostrongylus vasorum in a Red Panda (Ailurus fulgens): Clinical Diagnostic Trial and Treatment Protocol

Purpose: The literature refers that Angiostrongylus vasorum should always be considered in the differential diagnosis of respiratory diseases in captive red panda (Ailurus fulgens) from endemic areas, and the importance of undertaking a careful diagnostic process and timely medical treatment are crucial when the disease is suspected. The authors think that the description of this clinical case can help other colleagues in the deworming, clinical and anesthesiologic management of infected subjects. Methods: A red panda was referred to the Veterinary Teaching Hospital of the University of Milan in Lodi, due to a diagnosis of A. vasorum formulated in May 2015. The diagnosis was made after the detection of both first-stage larvae by Baermann technique and antigens by serological rapid in-clinic assay. In addition, haemochromocytometric and blood chemistry tests, echocardiography and a CT examination were carried out. Results: The subject was successfully treated by oral administration of milbemycin oxime and praziquantel (Milbemax, Novartis, Italy), respectively, at the weekly dose of 12.5 mg/subject and 125 mg/subject for three consecutive weeks, alternated with 20 days of suspension. Treatment continued with the same scheme until clinical examination carried out in Lodi in December 2018. Conclusion: The follow-up of the described clinical case demonstrates how appropriate management of the infection and the subsequent prophylaxis can correctly eliminate the parasite, thus avoiding the spread of the nematode and the onset of severe and lethal lung forms as described in the literature

Infestazione da Angiostrongylus vasorum nel panda rosso (Ailurus fulgens): review della letteratura e presentazione di un caso clinico = Angiostrongylus vasorum infestation in the red panda (Ailurus fulgens): review of the literature and presentation of a case report

L\u2019infestazione da Angiostrongylus vasorum nel panda rosso (Ailurus fulgens) determina una polmonite parassitaria ad andamento cronico potenzialmente letale. Gli Autori presentano una revisione della letteratura e un caso clinico. Un panda rosso \ue8 stato riferito all\u2019Ospedale Veterinario dell\u2019Universit\ue0 degli Studi di Milano a Lodi con una diagnosi di infestazione da A. vasorum che era stata formulata a maggio del 2015, non appena trasferito in un parco faunistico del Nord Italia. La diagnosi \ue8 stata emessa sulla base del riscontro di larve di prima et\ue0 (L1) nelle feci con tecnica di Baermann e della presenza dell\u2019antigene tramite tecnica di immunomigrazione eseguita presso un laboratorio di riferimento. Il soggetto \ue8 stato successivamente trattato con successo mediante somministrazione per via orale di milbemicina ossima e praziquantel rispettivamente alla dose settimanale di 12,5 mg/soggetto e 125 mg/soggetto per 3 settimane consecutive alternate a 20 giorni di sospensione. Il trattamento \ue8 continuato con lo stesso schema fino al controllo eseguito a Lodi a dicembre 2018. Grazie alla tecnica del rinforzo positivo e dell\u2019animal training, l\u2019animale ha assunto il farmaco regolarmente e direttamente dalle mani del Keeper nascosto in acini d\u2019uva, alimento molto gradito dai panda rossi. Non \ue8 stato riscontrato alcun effetto collaterale

Echocardiographic evaluation of the mitral valve in cavalier king charles spaniels

This prospective cross-sectional study aimed to: (1) characterize echocardiographic features of mitral valve in MMVD affected Cavalier King Charles Spaniels (CKCS), focusing on dogs classified as American College of Veterinary Internal Medicine (ACVIM) class B1; (2) compare echocardiographic data in ACVIM B1 dogs divided on the basis of age at time of MMVD diagnosis, in order to understand if different aged subjects had different echocardiographic patterns. Length (AMVL), width (AMVW) and area (AMVA) of the anterior mitral valve leaflet, mitral valve prolapse, diameters of the mitral valve annulus in diastole (MVAd) and systole (MVAs) of 90 CKCS in different ACVIM classes, 64 of which in class B1, were measured. Valvular measurements were indexed to body weight using Wesselowski\u2019s scaling exponents. The presence of heart murmur did not discriminate between A and B1 classes (p = 0.128). Heart enlargement was more frequent in males (r2 = 0.07, p = 0.013). Within class B1, older subjects showed significantly higher values of AMVA, AMVW, MVAd, MVAs and lower sphericity index (SI). Since many CKCS with MMVD have no murmur and their mitral valve has peculiarities, a specifically designed echocardiographic screening should be realized. In addition, different aged B1 dogs have different echocardiographic patterns that may imply different genetic and prognostic profiles