1,721,027 research outputs found
Keratoconjunctivitis sicca exacerbation in a dog treated with systemic atenolol
No full textA 6-year-old, intact, male English cocker spaniel was referred for treatment of chronic conjunctivitis and unilateral keratitis. The dog was diagnosed with bilateral immune-mediated keratoconjunctivitis sicca, treated with topical cyclosporine 0·2% ointment and sodium hyaluronate eye drops and improved considerably. After 2 months, pulmonic stenosis was diagnosed, and the dog commenced treatment with oral atenolol; theophthalmological disease worsened dramatically within a few days. The ophthalmic signs rapidly improved after discontinuation of atenolol, and there was bilateral complete remission after 3 weeks. No oral β-blocker therapy was reintroduced, and thereafter, keratoconjunctivitis sicca was well-controlled with topical therapy
Le basi fondamentali per sviluppare un corretto “approccio orientato al problema” per la gestione dei casi clinici
Full text linkThe problem-oriented approach (POA) is a ratio- nal method to manage clinical cases globally adopted in the medical practice. The centre of this me- thod is the ‘problem’, which becomes the goal of the medical path aimed to the resolution of this evidence. Additionally, the medical record build around the ‘problem’ (POMR, problem oriented medical record) becomes an effective means to follow the evolution of this condition and it allows a persuasive management of the patient. The following scheme is develop to describe the medical action: data base collection, to arrange the initial database of patient’s problems; list of problems, where the meaning for problem is “anything that has, does, or may require health care management, and that has or could significantly affect a patient’s well-being”1, and it should be formulated by pro- gressive refinements until becomes a short list of master problems; plan formulation, including a dia- gnostic plan to verify and localize the problem and then to look for both its pathophysiologic mecha- nism and cause, and a therapeutic plan incorporating a specific, supportive, symptomatic and palliative treatment. Based on this scheme prognostic consi- deration and supplying an effective client education could be formulated. Finally, the medical action path is completed with progress notes including: subjective (S) and objective (O) data collected from the patien- t’s follow-up or monitoring, problem assessment (A) which is then re-evaluated and further diagnostic or therapeutic plan (P) revised and up-dated (the so-called SOAP). The POA is really useful to the application of the evidence-based medicine
ECG of the Month. Spontaneous regression of a third-degree atrioventricular block in a dog with aortic endocarditis.
No full textSpontaneous regression of a third-degree atrioventricular block in a dog with aortic endocarditis
Reference intervals for transthoracic echocardiography in the American Staffordshire Terrier
No full textThis study reports the echocardiographic reference intervals in the American Staffordshire Terrier (AST). The echocardiographic variables obtained in 57 healthy adult AST were compared with published data from the general canine population and other breeds. In the AST, the left ventricular volumes were lower than values reported in Boxers and Dobermans (P<0.0001), but higher than in small breeds (P<0.0001). The left ventricular ejection fraction was higher than Boxers and Dobermans (P<0.0001), but lower than small breed dogs (P=0.027). The aortic peak velocity values were similar to Boxers (P=0.55) but higher than the general canine population (P<0.0001). The reference intervals presented in this study are clinically useful for an accurate echocardiographic interpretation and screening in the AST
Comparison of M-mode and two-dimensional echocardiography in evaluating the left atrium to aorta ratio in cats
No full textAssessment of the left atrial (LA) size is crucial in cats with cardiomyopathies because LA dilation, which results from an
increased diastolic filling pressure, predisposes towards the development of congestive heart failure and arterial thromboembolism. In addition, LA dilation has been shown to be a negative prognostic
factor in cats affected by hypertrophic cardiomyopathy. The aim of this study was to evaluate the agreement between M-mode
and two-dimensional (2D) echocardiography in the assessment of LA size in cats.
The study was retrospective and observational. Cats with and without heart diseases were included. The LA and aorta (AO)
were measured in M-mode and 2D using a standard right parasternal short axis view at the aortic valve level. A left atrium
to aorta ratio (LA/AO) >1.5 was considered indicative of LA enlargement. Cohen’s kappa agreement was calculated and Bland-
Altman plots were obtained. A total of 188 client-owned cats were included: 104 with heart disease and 84 without heart disease. LA and AO dimensions in M-mode were 13.9 +/- 3.7 mm and 8.7 +/- 1.5 mm, respectively, and in 2D were 14.1 +/- 3.5 mm and 8.8 +/- 1.4 mm, respectively. Bland-Altman plots showed that the mean difference for the evaluation
of AO dimensions between 2D and M-mode was 0.1 +/- 1.0 mm and that of LA was 0.1 +/- 1.4 mm. LA/AO measured in 2D and
M-mode was 1.6 +/- 0.5 and 1.6 +/- 0.5, respectively, with a median difference between the two methods of 0.0 0.2. Cohen’s kappa yielded a good agreement between the two methods in the interpretation of LA/AO ratio (kappa = 0.760; 95% CI: 0.54–0.99), with 184 agreements out of 188 (97.6%).
In conclusion, 2D echocardiography resulted in a slightly higher estimation of the LA and AO diameters in comparison to Mmode, but not for the LA/AO. Because a good agreement was documented between M-mode and 2D evaluation of the LA/AO,
the two methods can be used interchangeably to measure this echocardiographic index in cats
Comparison of two echocardiographic views for evaluating the right pulmonary artery distensibility index in dogs.
Full text linkEchocardiographic evaluation of the right pulmonary artery distensibility
index (RPAD index) was recently described as a valuable
method for early detection and severity evaluation of
pulmonary arterial hypertension in dogs. RPAD index is calculated
as the percentage change in diameter of the right pulmonary
artery (RPA) between systole and diastole, obtained by M-mode
echocardiography from the right parasternal long axis view. The
aim of this study was to compare the RPAD index obtained by 2
different echocardiographic views in dogs. The study design was a
prospective, multicenter, observational study. Forty-five clientowned
dogs from different breeds were included: 31 dogs with
heart disease and 14 healthy dogs. Two different right parasternal
views, long axis (RPLA) and short axis (RPSA), were used to
measure the RPAD index. From the RPLA view (method 1) and
RPSA view (method 2) a short axis and a long axis image were
respectively optimized for the right pulmonary artery. The RPAD
index was calculated by M-mode as the percentage change in
diameter of the right pulmonary artery: [(systolic diameter - diastolic
diameter)/ systolic diameter]*100. Measurements were done
off-line as an average of 5 consecutive cardiac cycles by a single
investigator blinded to the dogs’ diagnosis. A Pearson and a
Bland-Altman test were used to assess correlation and agreement
between the 2 methods, respectively. Intra- and inter-observer
measurement variability was quantified by average coefficient of
variation (CV). Level of significance was set at P < 0.05. M-mode
evaluation of the RPAD index was satisfactorily obtained by both
methods in all dogs. Pearson test showed a strong positive linear
correlation between the values of RPAD index obtained from both
methods (r2 = 0.9346, P < 0.0001). Bland-Altman test showed a
good agreement between the 2 methods in estimating RPAD index
(bias = 0.51%, SD = 2.96%, 95% limits of agreement = 5.30,
6.33%). The mean difference between the 2 methods was 0.51%
(95% confidence interval = 0.35; 1.35). Intra- and inter-observer
measurement variability was clinically acceptable (CV<10%).The
study showed a good agreement between short axis and long axis
M-mode evaluation of RPA. Both methods can be used interchangeably
to evaluate RPAD index. Further studies are needed
to evaluate the RPAD index in a larger population of healthy dogs
and the diagnostic and prognostic role of this echocardiographic
parameter in dogs with different types of pulmonary hypertension
Comparison of smartphone-based and standard base-apex electrocardiography in healthy dairy cows
Full text linkBackground: There is good diagnostic accuracy of smartphone-based ECG in the evaluation of heart rate (HR), heart rhythm, and ECG values for humans, horses, dogs, and cats.
Objectives: Assess feasibility and reliability of a smartphone ECG device to evaluate HR expressed as beats per minute and ECG values in cows.
Animals: Fifty-five healthy Holstein Friesian cows.
Methods: Prospective observational study. A standard base-apex ECG was acquired for 60 seconds in each cow. A smartphone ECG tracing was recorded simultaneously using a single-lead bipolar ECG recorder. All ECGs were reviewed by 1 blinded investigator. The following ECG variables were assessed: HR, P wave duration, PR interval, QRS complex and QT interval (milliseconds), P wave, and QRS complex polarity. Agreement between standard and smartphone
ECG was evaluated by Cohen's k test and the Bland-Altman test.
Results: Smartphone ECG tracings were interpretable in 89% of the recordings. Minimal differences of no clinical relevance were found between standard and smartphone ECG tracings regarding HR and duration of ECG waves and interval. Good agreement found in the evaluation of QRS complex polarity (85%) but not for P wave polarity (k = 0.006). Artifacts were rare but of significantly higher frequency in smartphone ECG compared to standard ECG tracings (22% versus 0%; P = .005).
Conclusions and Clinical Importance: Good quality single-lead ECG tracings can be recorded by smartphone device in healthy cows. Smartphone tracings are reliable for evaluation of HR and selective ECG variables. Smartphone ECG can represent an additional tool for ECG screening in cows
A radiographic study of breed‐specific vertebral heart score and vertebral left atrial size in Chihuahuas
No full textAlthough echocardiography is the gold standard for the diagnosis of cardio-structural disease, thoracic radiography is a rapid, cost-effective, and widely accessible method for evaluating cardiac size in dogs. The vertebral heart score (VHS) and the vertebral left atrial size (VLAS) are established as objective measures of cardiomegaly on thoracic radiographs. However, several studies have shown significant variations in the VHS among different breeds. The Chihuahua is predisposed to both congenital and acquired cardiac diseases. The aim of this prospective, single-center, cross sectional study was thus to evaluate the VHS and the VLAS in healthy adult Chihuahua dogs. A total of 30 Chihuahuas were included. The VHS values in our sample population of Chihuahuas were 10.0 ± 0.6 (95% range, 8.9-11.0). This was significantly greater than the canine reference value of 9.7 ± 0.5 established by Buchanan and Bücheler (P = .002). The VLAS of Chihuahuas in our study was 1.8 ± 0.2 (95% range, 1.3-2.1). This was significantly lower than the values previously reported by Malcolm et al (2.07 ± 0.25; P = .0004). The VHS and the VLAS were not influenced by sex, body weight, short or long hair, and body condition score in normal Chihuahuas. Our results indicated that breed-specific reference values for radiographic VHS and VLAS are needed. In Chihuahuas, the values found in this study can be used as a normal reference in order to help avoid overinterpretation of cardiomegaly in these dogs
Comparison of canine plasma and serum as a source of mitochondria-rich microvesicles boosting cardiomyocyte proliferation
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