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InFocus

A ROUND-UP OF THE WORLD-WIDE LITERATURE

Establishing guidelines on
resuscitation following cardiac
arrest in dogs
Manuel Boller, University of
Pennsylvania and Daniel Fletcher,
Cornell University

Retaining full neurological function in
patients resuscitated following cardiac
arrest remains an elusive goal in both
human and veterinary medicine. A
special issue of JVECC is devoted to the
results of the RECOVER
(REassessment Campaign On
VEterinary Resuscitation) project to
develop guidelines on the clinical
management of canine and feline
patients.

Led by staff at two major US
veterinary schools but involving more
than 100 board certified clinicians from
all around the world, the project reviews
evidence on current practice and
highlights gaps in understanding.
Although contributors assessed evidence
resulting from the long-established
International Liaison Committee on
Resuscitation (ILCOR) guidelines
developed by human cardiologists, they
placed a high premium on species-
specific studies in veterinary patients.

The authors emphasise that
producing guidelines is only the first step,
further work is planned in developing
standardised training tools, creating
registries and evaluating outcomes to
address the many deficiencies in current
knowledge.

Journal of Veterinary Emergency and Critical
Care
22 (1): special issue.

Safety and efficacy of an
implantable defibrillator
device in dogs
Romain Pariaut and others,
Louisiana State University

Implantable cardioverter defibrillators
are programmed to detect ventricular
arrhythmias in cardiac patients and to
stop them by delivering an electric shock.
The authors investigate the effects of
such a device in canine patients and
compare the results of different shock
waveform configurations. The device
reliably produced acceptable
defibrillation threshold values, based on a
10 J safety margin below the maximum
device output. There was no apparent
benefit from using a fixed-pulse
configuration compared with the
standard fixed-tilt waveform. There was
some evidence of myocardial damage
from repeated shocks but this was not
considered clinically significant.

Journal of Veterinary Cardiology 14 (3): 389-
398.

Screening for dilated
cardiomyopathy in Great
Danes Stephenson and others,
Royal Veterinary College, London

The Great Dane breed is known to be
predisposed to dilated cardiomyopathy
but there is little published data on the
progression, clinical manifestations and
inheritance in the UK population. The
authors carried out echocardiographic
studies in 107 client-owned dogs. The
prevalence of DCM in this population
was 35.6% although when different
reference intervals were used for M
mode left ventricular dimensions, the
prevalence increased to 47%. There was
also a 54% prevalence of ventricular
arrhythmias. The findings support the
view that this is a condition with an
autosomal dominant mode of
inheritance.
Journal of Veterinary Internal Medicine 26
(5): 1,140-1,147.

Seasonal patterns in dogs
presenting with congestive
heart failure
Gary Steinberg and others,
University of Illinois

Studies from human hospitals around
the world suggest that there are daily,
weekly, monthly and seasonal patterns in
the numbers of patients presenting with
congestive heart failure. The authors
examined the records at a veterinary
teaching hospital to assess whether
similar patterns occur in veterinary
patients. They found that dogs
presenting with congestive heart failure
were more common on Mondays and
Tuesdays, and between 9 am and 12 am,
and during the months of September,
October and November. These findings
may be helpful in educating clients and in
preparing staff to deal with variations in
their caseload.

Journal of Veterinary Emergency Care 22 (3):
341-346.

Haemostatic and fibrinolytic
markers in dogs with right-
sided congestive heart failure
Andrea Zoia and others, University
College, Dublin

Many humans with cardiomyopathy will
also have systemic hypercoagulability
associated with platelet activation,
increased prothrombin activity and
endothelial dysfunction. The authors
investigated whether similar changes
occurred in dogs with ascites secondary
to right-sided congestive heart failure.
Affected dogs had higher levels of
plasma fibrin-fibrinogen degradation
products than healthy dogs or those with
left-sided heart failure. Ten of the 18
affected dogs also had concurrent
hypofibrinogenaemia, two of which also
had clinical signs of bleeding.

Journal of the American Veterinary Medical
Association
241 (10): 1,336-1,343.

Pericardial autograft
reconstruction following right
atrial haemangiosarcoma resection Fei Verbeke and others, Ghent
University, Belgium

Haemangiosarcomas are highly
malignant tumours originating from the
vascular epithelium with predilection
sites in the spleen, right atrium and skin.
This abnormality was identified as the
cause of a mass in the right atrium of a
six-year-old intact male Bordeaux which
presented with a history of lethargy,
exercise intolerance, abdominal
distension and partial anorexia. The
authors describe how the mass was
removed using total venous inflow
occlusion and the defect restored with a
non-vascularised pericardial autograft.
The dog had a disease-free interval of
seven months and was euthanased nine
months post-operatively

Canadian Veterinary Journal 53 (10): 1,114-
1,118.

Effects of sedation on left
atrial echocardiographic
variables in healthy cats
Jessica Ward and others, Ohio State
University

Administration of sedatives is often
required to ensure patient compliance
when carrying out echocardiography
procedures in cats. But there is little
published information on the effects of
such treatment on echocardiographic
parameters in this species. The authors
investigated the effects of two sedation
protocols, using acepromazine and
butorphanol or those two agents
together with ketamine. Heart rate
increased following administration of the
three-component combination and non-
invasive systolic blood pressure
decreased following acepromazine and
butorphanol only. However, those
changes that were observed do not
appear to be clinically significant.

Journal of Feline Medicine and Surgery 14
(10): 678-685.

Echocardiographic and tissue
Doppler imaging in Sphynx
cats
Valerie Chetboul and others,
Maisons-Alfort Veterinary School,
France

The Sphynx or Canadian hairless breed
first emerged in the 1960s and has
become increasingly popular. The breed
is susceptible to skin conditions and
muscular dystrophy but there have been
no reports of hypertrophic
cardiomyopathy in these cats. The
authors carried out echocardiographic
examinations of 114 Sphynx cats of
which 39 (34.2%) showed evidence of
either congenital heart defects or
hypertrophic cardiomyopathy. There was
an increased prevalence of defects with
age and evidence of a possible autosomal
dominant inheritance with incomplete
penetrance for HCM.

Journal of Veterinary Cardiology 14 (4):
497-509.

Radiographic findings in the
diagnosis of pericardial
effusion in dogs
Carlo Guglielmini and others,
University of Teramo, Italy

Pericardial effusion can alter the shape
and size of the cardiac silhouette on
radiographic examination although the
image may appear normal or only
mildly abnormal in some cases. The
authors investigated the accuracy of
radiographic vertebral heart scores and
the sphericity index in dogs with
pericardial effusion. They found that
the cardiac silhouettes were larger and
more rounded compared with dogs
with other cardiac disorders without
pericardial effusion. However, objective
radiographic indices of cardiac size and
roundness were only moderately
accurate at distinguishing dogs with this
condition from other cardiac patients.
Journal of the American Veterinary Medical
Association
241 (8): 1,048-1,055.

Clinical findings in 31 cases
of aortic thrombosis in dogs
Geri Lake-Bakaar and others,
University of California, Davis

Aortic thrombo-embolism is common
in cats, causing acute hind-limb paresis,
pain, absent femoral pulses and nail-
bed cyanosis. But there are few detailed
reports of this condition in dogs. The
authors examined records from 31
canine cases with a clinical or post-
mortem diagnosis of aortic thrombosis.
Their findings confirm that this is a rare
condition in dogs, accounting for only
0.0005% of admissions during the
study. The presenting signs appear to be
different from those in cats, with 48%
of cases involving chronic disease.
These cases appeared to have a longer
medial survival time than dogs with
acute onset disease.

Journal of the American Veterinary Medical
Association
241 (7): 901-915.

Mitochondrial dysfunction in
myocardial tissue from
anaesthetised dogs
Meg Sleeper and others, University
of Pennsylvania

Studies in humans and laboratory
animal species have shown that
inhalation anaesthesia can depress
mitochondrial function in cardiac
tissue. The authors investigated
whether similar effects were detectable
in dogs, by examining mitochondrial
complex I and IV activity in myocardial
tissue from dogs given inhalation
anaesthesia in comparison with samples
from healthy dogs and those with
juvenile-onset dilated cardiomyopathy.
They found a significance decrease in
activity in the anaesthetised dogs and
this effect should be considered when
preparing dogs with myocardial disease
for surgical treatment.

American Journal of Veterinary Research

73 (11): 1,759-1,764.

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