The coexistence of heart murmurs and arrhythmias in an equine hospital population - a retrospective study

This study was performed to characterize the coexistence of valvar insufficiencies of the mitral, tricuspid, aortic, and pulmonary valves and their possible association with atrial fibrillation in an equine clinic population. During an 11-year period, 348 horses had been examined for cardiac arrhythmias and suspected defects of the cardiac valves at the Vetmeduni Vienna, Austria. The study population included 256 male and 92 female horses. A subpopulation of 197 (57%) horses was identified with at least one valvular disorder. In these horses, mitral valve regurgitation (MR) was reported in 124 animals (63%), aortic valve regurgitation (AR) in 101 (51%), tricuspid regurgitation (TR) in 78 (39.6%), and pulmonary regurgitation (PR) in 17 animals (8.6%). Cardiac arrhythmias were found in 130 horses (37%). The horse types that were most frequently affected by a putative valve insufficiency were the warmbloods, followed by thoroughbreds. The prevalence of insufficiencies (46%) was highest among animals between 6 and 18 years of age. There was a significant negative relationship between the occurrence of MR and AR, and AR was also significantly negatively associated with TR. Atrial fibrillation (AF) and MR coexisted most often (10 out of 38), followed by TR (8 out of 38). Although these findings were significant for the subgroup with cardiac arrhythmias, they were not significant in connection with the entire population with cardiac problems. The results of the present study showed that risk factors for being diagnosed with MR are horse type, age, and sex. MR most often occurs as an isolated defect in horses and seldom occurs in combination with AR. Additionally, MR and TR are associated with AF

A Case Report: Recurrent Cystitis in A Mare

A 20 year old Austrian Warmblood mare was presented at the clinic of Vienna Veterinary University for symptoms of polydipsia, polyuria and urinary incontinence and a repeated history of bladder infection. Sampled urine was light yellow, very cloudy, had a low specific weight (1016) and a pH of 9. The dip stick suggested very high hemoglobin concentration. The sediment showed medium numbers of rounded epithelial cells, low numbers of leukocytes. Furthermore, a remarkable quantity of calcium carbonate crystals was present. Urine and plasma chemistry and fractional clearance revealed the following: high blood urea and Ca concentration. The FE of Na and GGT/Creatinine ratio both were increased. These results suggested chronic renal insufficiency and co-existent urinary tract inflammation. Trans-abdominal ultrasound of the kidneys was performed. The left kidney was normal both in size and appearance of medulla, cortex and pyelum. The right kidney appeared morphologically modified such that the border between cortex and medulla could not be identified clearly. At cystoscopy the floor of urinary bladder could not be seen, due to the large quantities of sludge and grainy gravel deposited on it. However, cystic calculi were not identified. The apex vesicae was highly inflamed, with necrotic changes that were coated with gravel and fibrin. Both ureters were highly dilated (thicker than a finger) and appeared to secrete a cloudy fluid. The endoscopic diagnosis was advanced ulcerative sabalous cystitis, and dilated ureters. Because of the poor prognosis of the case the owner decided to have the mare be euthanized. The gross pathology showed a dilated pyelum in both kidneys. The pyelum was filled with gravel. Both ureters were dilated and filled with gravel too. The bladder wall was thickened and just in cranial to its opening, a soft conglomerate of gravel (7x5x0.5cm) was present. The urethra was also filled but not blocked with this gravel. Histopathology showed chronic interstitial nephritis, glomerulonephritis and pyelitis. The muscularis of the bladder was chronically inflamed. The final main diagnosis was chronic sabalous cystitis with subsequent chronic inflammation of the ureters and chronic interstitial nephritis