Pulmonary hypertension in the dog

Canine pulmonary hypertension is a clinical condition that needs to be adequately investigated and recognised because of the lack of specific clinical signs, the potential for rapid and irreversible deterioration of pulmonary vascular function and the development of right-sided heart failure. In recent years, many studies have been published on pulmonary hypertension, improving the understanding of its pathophysiology, the accuracy of diagnostic tests and the management of affected patients. This article provides updated information on pulmonary hypertension and serves as a resource for veterinarians regarding the interpretation of diagnostic tests and the clinical management of affected dogs

Prognostic value of echocardiographic indices of left atrial morphology and function in dogs with myxomatous mitral valve disease

Background: The prognostic relevance of left atrial (LA) morphological and functional variables, including those derived from speckle tracking echocardiography (STE), has been little investigated in veterinary medicine. Objectives: To assess the prognostic value of several echocardiographic variables, with a focus on LA morphological and functional variables in dogs with myxomatous mitral valve disease (MMVD). Animals: One-hundred and fifteen dogs of different breeds with MMVD. Methods: Prospective cohort study. Conventional morphologic and echo-Doppler variables, LA areas and volumes, and STE-based LA strain analysis were performed in all dogs. A survival analysis was performed to test for the best echocardiographic predictors of cardiac-related death. Results: Most of the tested variables, including all LA STE-derived variables were univariate predictors of cardiac death in Cox proportional hazard analysis. Because of strong correlation between many variables, only left atrium to aorta ratio (LA/Ao > 1.7), mitral valve E wave velocity (MV E vel > 1.3 m/s), LA maximal volume (LAVmax > 3.53 mL/kg), peak atrial longitudinal strain (PALS < 30%), and contraction strain index (CSI per 1% increase) were entered in the univariate analysis, and all were predictors of cardiac death. However, only the MV E vel (hazard ratio [HR], 4.45; confidence interval [CI], 1.76-11.24; P <.001) and LAVmax (HR, 2.32; CI, 1.10-4.89; P =.024) remained statistically significant in the multivariable analysis. Conclusions and Clinical Importance: The assessment of LA dimension and function provides useful prognostic information in dogs with MMVD. Considering all the LA variables, LAVmax appears the strongest predictor of cardiac death, being superior to LA/Ao and STE-derived variables

Survey of Methicillin-resistant coagulase positive Staphylococcus spp. carriage in healthy dogs and dogs with skin disease

Canine skin diseases (SD) are very common in the veterinary practice and are often complicated by recurrent bacterial infection. Affected dogs usually need multiple cycles of antibiotic treatments (AT) that can lead to development of multidrug resistant strains [1]. Coagulase-positive staphylococci (CPS) are the most often isolated pathogens from canine SD. The aim of this study is to assess the prevalence of multidrug and methicillin resistant coagulase-positive staphylococci (MRScp) isolated from healthy dogs and dogs with SD, and to evaluate the correlation with clinical scores and previous AT. Forty-nine dogs were enrolled: 25 healthy and 24 with SD. Clinical history and previous AT were recorded. After a complete physical examination, clinical scores (CADESI-3 and pruritus) were calculated. Skin swabs from mouth, ear, genitalia, axilla and skin lesions, when present, were cultured in a nutrient and in a selective medium for MRScp. Suspected Staphylococcus colonies were identified by Maldi-Tof MS and specific PCR; methicillin resistance was confirmed by a PCR targeting mecA gene. Susceptibility tests and genetic typing, including spa-typing, SCCmec-typing and MLST were performed on isolates. Normal distribution of data was tested with Shapiro-Wilk test. Data were analyzed using ANOVA and z-test if normally distributed, otherwise with Mann-Whitney Test. Correlations between bacterial resistance and clinical scores or previous AT were assessed by Spearman test. P-value <0.05 was considered significant. Ninety-five strains of CPS were isolated from 229 samples. A total of 13/95 strains were MRScp and were identified as Staphylococcus pseudintermedius. Among them, 10 were multidrug resistant and two were isolated from healthy dogs. The Sequence Type 71, spa-type t02 e SCCmec type II-III, which represents the main clonal strain in Europe [2], was the most frequently identified genetic type (11/13) also in this study. Staphylococci were more commonly isolated from axilla, genitalia and ear conduct of dogs with SD compared with healthy dogs (p<0.001). Four out of the 6 MRScp positive dogs had received AT in the previous 6 months. No significant correlations between clinical scores or previous AT and methicillin resistance was found. Although the low number of dogs included in the study could have affected the results of the investigated correlations, this study confirms the role of Staphylococcus pseudintermedius in canine pyoderma and shows that pet dogs may play a significant role as MRScp carriers. Furthermore, close attention should be also paid also to the control of healthy dogs

Prevalence and prognostic role of L wave and selected clinical and echocardiographic variables in dogs with atrial fibrillation

Background: Information regarding the frequency of L waves and their prognostic relevance in dogs with secondary atrial fibrillation (AF) is limited. Hypothesis/objectives: To determine whether L waves occur and ascertain their prognostic role, as well as the role of other clinical and echocardiographic variables in dogs with AF. Animals: Fifty-five dogs with AF associated with myxomatous mitral valve disease or dilated cardiomyopathy. Methods: Retrospective, multicenter observational study. In addition to L waves analysis, other clinical and echocardiographic variables, including type of antiarrhythmic treatment, were evaluated. A survival analysis was performed to test for predictors of cardiac death and all-cause mortality using Cox proportional hazards regression models. Results: L waves were evident in 33/55 dogs (60%, 95% confidence interval [CI]&nbsp;=&nbsp;47%-72%) but their presence did not influence outcome. Increased left ventricular end-systolic diameter normalized for body weight (LVSDn) was a significant predictor of both cardiac death (hazard ratio [HR]&nbsp;=&nbsp;4.41, 95% CI&nbsp;=&nbsp;1.18-16.54; P&nbsp;=&nbsp;.03) and all-cause mortality (HR&nbsp;=&nbsp;9.39, 95% CI&nbsp;=&nbsp;2.49-35.32; P &lt; .001). Heart rate assessed during echocardiography (Echo-HR) represented an additional significant predictor of cardiac death (HR&nbsp;=&nbsp;1.01, 95% CI&nbsp;=&nbsp;1.00-1.01; P&nbsp;=&nbsp;.04) and all-cause mortality (HR&nbsp;=&nbsp;1.01, 95% CI&nbsp;=&nbsp;1.00-1.01; P&nbsp;=&nbsp;.04). Conclusions and clinical importance: L waves occurred frequently in dogs with AF, but held no prognostic relevance. Conversely, LVSDn and Echo-HR represented independent predictors of negative outcome in these animals

Echocardiographic predictors of first onset of atrial fibrillation in dogs with myxomatous mitral valve disease

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Facing complications of direct anterior approach in total hip arthroplasty during the learning curve

This study aims to evaluate complications and early postoperative clinical outcomes of direct anterior approach (DAA) in total hip arthroplasty (THA)

Development of an artificial intelligence-based method for the diagnosis of the severity of myxomatous mitral valve disease from canine chest radiographs

An algorithm based on artificial intelligence (AI) was developed and tested to classify different stages of myxomatous mitral valve disease (MMVD) from canine thoracic radiographs. The radiographs were selected from the medical databases of two different institutions, considering dogs over 6 years of age that had undergone chest X-ray and echocardiographic examination. Only radiographs clearly showing the cardiac silhouette were considered. The convolutional neural network (CNN) was trained on both the right and left lateral and/or ventro-dorsal or dorso-ventral views. Each dog was classified according to the American College of Veterinary Internal Medicine (ACVIM) guidelines as stage B1, B2 or C + D. ResNet18 CNN was used as a classification network, and the results were evaluated using confusion matrices, receiver operating characteristic curves, and t-SNE and UMAP projections. The area under the curve (AUC) showed good heart-CNN performance in determining the MMVD stage from the lateral views with an AUC of 0.87, 0.77, and 0.88 for stages B1, B2, and C + D, respectively. The high accuracy of the algorithm in predicting the MMVD stage suggests that it could stand as a useful support tool in the interpretation of canine thoracic radiographs

Risk factors for atrial fibrillation in dogs with dilated cardiomyopathy

IntroductionAtrial fibrillation secondary to dilated cardiomyopathy (DCM) frequently affects large-breed dogs. The aim of the present study was to identify risk factors for the development of atrial fibrillation in dogs of different breeds with an echocardiographic diagnosis of DCM.MethodsIn this multicenter retrospective study, we searched the electronic databases of five cardiology referral centers for dogs with an echocardiographic diagnosis of DCM. A comparison of clinical and echocardiographic variables was performed between dogs developing atrial fibrillation and those not developing atrial fibrillation and the ability to distinguish between these two groups of dogs was evaluated by receiver operating characteristic curve analysis. Univariate and multivariable logistic regression analysis estimated the odds ratio (OR) with 95% confidence interval (CI) of developing atrial fibrillation.ResultsWe included 89 client-owned dogs with occult and overt echocardiographic DCM. Of these, 39 dogs (43.8%) had atrial fibrillation, 29 dogs (32.6%) maintained a sinus rhythm, and 21 dogs (23.6%) showed other cardiac arrhythmias. Left atrial diameter had high accuracy (area under the curve = 0.816, 95% CI = 0.719–0.890) to predict the development of atrial fibrillation at the cut-off of &gt;4.66 cm. After multivariable stepwise logistic regression analysis, only increased left atrial diameter (OR = 3.58, 95% CI = 1.87–6.87; p &lt; 0.001) and presence of right atrial enlargement (OR = 4.02, 95% CI = 1.35–11.97; p = 0.013) were significant predictors of atrial fibrillation development.DiscussionAtrial fibrillation is a common complication of DCM in the dog and is significantly associated with increased absolute left atrial diameter and right atrial enlargement