Electrocardiography-documented sudden cardiac death due to ventricular fibrillation in a young cat without echocardiographic evidence of severe structural heart disease = Elektrocardiografie-gedocumenteerde plotse cardiale dood ten gevolge van ventriculaire fibrillatie bij een jonge kat zonder echocardiografische tekenen van ernstige structurele hartziekte

An asymptomatic three-year-old male European Domestic Shorthair cat was referred for an irregular heart auscultation. Apart from localized concentric left ventricular septal hypertrophy, echocardiography was normal. However, ventricular ectopy was observed on electrocardiography (ECG) during echocardiography. The cat died suddenly 55 minutes after the start of the subsequent Holter ECG. Analysis showed sinus rhythm interrupted by 192 single ventricular premature complexes, a ventricular couplet, two incidents of ventricular bigeminy and two runs of ventricular tachycardia (VT). The last run of VT deteriorated into ventricular fibrillation (VF) and ultimately cardiac arrest. Structural heart disease including mild feline hypertrophic cardiomyopathy or myocarditis, primary arrhythmia (channelopathy) or extra-cardiac disease were maintained as differential diagnosis. Unfortunately, a necropsy was declined leaving no definitive diagnosis available. In this case report, it is shown that VF due to ventricular ectopy is a possible cause of SCD even in asymptomatic cats with only mild echocardiographic signs of structural heart disease.Een asymptomatische, drie jaar oude, mannelijke Europese korthaar werd doorverwezen voor een onregelmatige hartauscultatie. Behalve gelokaliseerde concentrische links ventriculaire septumhypertrofie was de echocardiografie normaal. Tijdens het echocardiografisch onderzoek werd echter ventriculaire ectopie waargenomen op de elektrocardiografie (ECG). De kat overleed plotseling 55 minuten na het begin van het vervolgens uitgevoerde Holter ECG. Analyse toonde een sinusritme onderbroken door 192 enkelvoudige ventriculaire premature complexen, een ventriculair couplet, twee incidenten van ventriculaire bigeminus en tenslotte twee “runs” van ventriculaire tachycardie (VT). De laatste run ging over in ventrikelfibrillatie (VF) en uiteindelijk hartstilstand. Helaas werd een lijkschouwing afgewezen, waardoor geen definitieve diagnose kon worden gesteld. In deze casereport wordt aangetoond dat VF als gevolg van ventriculaire ectopie een mogelijke oorzaak is van plotse cardiale sterfte bij asymptomatische katten met slechts milde echocardiografische tekenen van een structurele hartziekte

Atypical enteritis causing life-threatening pneumatosis intestinalis in a dog : radiographic and ultrasonographic findings = Atypische enteritis die levensbedreigende pneumatosis intestinalis veroorzaakt bij een hond : radiografische en echografische bevindingen

A geriatric dog was presented for acute vomiting, anorexia and lethargy. Abdominal ultrasound was suggestive of the presence of gas within the small intestinal walls. Additional abdominal radiographs confirmed the ultrasonographic abnormalities, compatible with pneumatosis intestinalis. Explorative laparotomy revealed hemorrhagic lesions, thickened intestinal walls and serosal discoloration of the jejunum. Partial jejunectomy was performed and histopathology showed findings compatible with atypical bacterial enteritis. The dog recovered completely and did not show any clinical signs during a follow-up period of one year after surgery

Septic pericarditis in a complicated case of non-associated immune-mediated hemolytic anemia in a Jack Russel terrier = Septische pericarditis in een complex geval van niet-geassocieerde immuungemedieerde hemolytische anemie bij een jack russell terriër

A three-year-old, male, intact Jack Russel terrier was referred for severe regenerative anemia and was diagnosed with non-associated immune-mediated hemolytic anemia. Treatment was implemented according to the ACVIM guidelines (Swann et al., 2019). As no response was seen eleven days later despite two immunosuppressive drugs, intravenous immunoglobulins (IVIG, 1 g/kg) were administered. Three days later, septic shock and diffuse intravascular coagulation (DIC) developed. Echocardiography revealed pericardial effusion with cardiac tamponade and thrombus in the right atrium. Fluid analysis confirmed septic pericarditis. A pericardial drain was placed following immediate reoccurrence of the pericardial effusion. Despite a stable hematocrit for several days following IVIG administration, a decrease in hematocrit was subsequently noted and splenectomy was performed. In total, six blood transfusions were given. Two years after presentation and intensive follow-up, immunosuppressive therapy was tapered, and the dog had excellent quality of life

Pulmonary arteriovenous malformation and a concurrent persistent ductus arteriosus in a dobermann

Introduction - Pulmonary arteriovenous malformation (PAVM) connecting a pulmonary artery to pulmonary vein is a rare congenital disorder that has only been described in one dog.(1) This case presentation describes the radiographic and computed tomography (CT) findings, treatment and outcome in a dog with a PAVM and a concurrent persistent ductus arteriosus (PDA). Case description - A 7-week-old male Doberman was presented with tachypnea, dyspnea and a 6/6, left cranial, continuous heart murmur. Thoracic radiographs revealed severe, left-sided cardiomegaly, presence of a rounded soft tissue opacity in the caudodorsal aspect of the thoracic cavity and signs of left-sided congestive heart failure (Figure 1). Clinical signs of heart failure were medically controlled. Echocardiography and CT demonstrated a left-to-right shunting PDA in combination with a right-to-left shunt between the right caudal pulmonary artery and the right caudal pulmonary vein (Figure 2). Arterial blood gasses (ABG) revealed hypoxemia (PaO2 = 66 mmHg). Transcatheter occlusion of the PDA using an Amplatz® Canine Duct Occluder was performed. Results - Four months post-operatively, echocardiography showed normal cardiac structure and size with complete PDA closure. Thoracic radiographs revealed absence of the rounded opacity, no cardiomegaly and no vascular congestion. The previously described PAVM was no longer visualized on repeated CT and the ABG were within normal limits (PaO2 = 100mmHg). Discussion - Similar radiographic findings have been described in people with PAVM.(2,3) This is the first description of PAVM in combination with a PDA in a dog, including spontaneous disappearance of the shunt and normalization of ABG after PDA occlusion

Comparison of patent ductus arteriosus ligation with nonabsorbable versus slowly-absorbable synthetic suture material

Introduction: The objective of this study was to describe the use of synthetic suture material for closure of left-to-right shunting patent ductus arteriosus (PDA) in dogs and compare long-term results between nonabsorbable synthetic and slowly-absorbable synthetic suture material. Methods: Thirty-eight client-owned dogs referred for surgical ligation of a PDA were categorized as group NON (non-absorbable polypropylene) or group ABS (absorbable polydioxanone). Echocardiography was performed before surgical PDA closure and one day postoperatively. At least 6 months later, dogs were re-evaluated echocardiographically (Image 1) or by auscultation. Specific attention was paid to ease of passage of the suture (intraoperatively), residual flow through the duct (postoperatively), and recanalization (at long-term follow-up). Results: Median age was 4 months (range, 2-44 months) and median body weight was 6 kg (range, 1-39 kg). Minor intraoperative bleeding occurred in five of the 38 dogs (13%; n=2, ABS; n=3, NON (p=1.000)). Suture passage was uneventful in all cases. Residual flow was noted the day after surgery in three dogs (8%, n=2, ABS; n=1, NON (p=0.577)) and persisted (Image 2). Recanalization was not observed in any of the dogs at long-term follow-up Conclusion: Suture handling and knot security were excellent for both synthetic suture materials and recanalization of a closed PDA after absorption of the polydioxanone sutures was not observed. PDA suture ligation can be safely performed by using either nonabsorbable or slowly-absorbable synthetic suture material

Assessment of cardiotoxicity after combretastatin A4-phosphate administration in dogs using two-dimensional speckle tracking echocardiography

BACKGROUND Combretastatin A4-phosphate (CA4P) is a vascular disrupting agent recently described for treatment of solid tumors in dogs. Conventional echocardiography did not show signs of cardiotoxicity. However, the gold standard for assessing myocardial damage in humans receiving cardiotoxic chemotherapeutics is two-dimensional speckle tracking echocardiography (2D-STE). HYPOTHESIS/OBJECTIVES The aim of this study was to evaluate the cardiotoxic effect of CA4P in dogs, based on 2D-STE measurements. ANIMALS Echocardiographic images of healthy dogs and cancer patients that received CA4P were retrospectively reviewed. Seven healthy beagles and five cancer patients were included. METHODS Peak global longitudinal strain (GLS), peak global circumferential strain (GCS) and peak global radial strain (GRS) were measured before and 24 hours after administration of CA4P. Strain measurements were compared with cardiac troponin I (cTnI) measurements. On seven echocardiographic examinations, each strain parameter was measured by 3 observers on 3 consecutive days to obtain intra-observer and interobserver variability. RESULTS Median GCS and GLS values decreased by 17.6% (P=0.002) and 24.0% (P=0.0005), respectively. Median GRS values were not significantly different (P=0.16). The decrease in GLS was correlated with a rise in cTnI (Spearman rho = −0.63, P=0.03). The intra-observer coefficient of variation was 0.04, 0.13 and 0.09 for GCS, GRS and GLS, respectively, while the corresponding inter-observer coefficients were 0.12, 0.20 and 0.11. CONCLUSIONS AND CLINICAL IMPORTANCE Administration of CA4P has a cardiotoxic effect, which can be detected by 2D-STE strain measurements and correlates with cTnI concentrations

Successful high-resolution three-dimensional electroanatomical mapping and radiofrequency catheter ablation of a postero-septal accessory pathway in a dog using CARTO 3

A one-year and seven-month old, 28 kg, male castrated crossbreed dog was presented for supraventricular tachycardia causing recurrent episodes of anorexia and lethargy. Sotalol (2.2 mg/kg q12 h) reduced the frequency of symptomatic episodes but did not provide full relief. Three-dimensional electroanatomical mapping was performed at the Ghent University Small Animal Teaching hospital using the CARTO 3. Right atrial activation mapping identified the earliest atrial activation right postero-septal, near the tricuspid annulus. Fast retrograde ventriculo-atrial conduction during tachycardia and extrastimulus testing confirmed the presence of a concealed right postero-septal accessory pathway. Six radiofrequency catheter ablation applications were delivered and tachycardia remained uninducible. The dog recovered well from the procedure. Sotalol was stopped three weeks later and no more clinical signs were noted by the owner. Repeated twenty-four hour electrocardiography monitoring on day one and at one, three and 12 months after the procedure showed no recurrence of tachycardia