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The anesthetic management in patients with subaortic stenosis and mitral valve disease should involve intensive monitoring and the anesthesiologist’s main concern is to ensure oxygen delivery and tissue perfusion. Since anesthetic procedures in such patients are rare, there is no previous report about the anesthetic management. A 5.5-year old, 32-kg Boxer, suffering a severe heart disease due to a final stage subaortic stenosis and mitral insufficiency, was anesthetized for an ovariohysterectomy to remove an ovarian tumor that was producing high-volume ascites. Methadone (0.3 mg kg−1) was administered intramuscularly (IM) for pre-anesthetic medication, etomidate (1.3 mg kg−1) and midazolam (0.2 mg kg−1) were used for the induction of anesthesia and after endotracheal intubation, anesthesia was maintained with sevoflurane vaporized in oxygen and air. Fentanyl (5–10 μg kg−1 h−1) and paracetamol (15 mg kg−1) were administered to improve analgesia. Previous persistent atrial fibrillation was refractory to medication (digoxin, diltiazem, and pimobendan) and continued during the anesthetic procedure. Dobutamine (1.5–5 μg kg−1 minute−1) helped to maintain mean arterial blood pressure above 60 mmHg. Epidural morphine (0.1 mg kg−1) and incisional bupivacaine (2 mg kg−1) were administered at the end of surgery to provide postoperative analgesia. Anesthesia was otherwise uneventful, and recovery was considered excellent.Keywords: Anesthesia, Atrial fibrillation, Dog, Mitral, Subaortic stenosis

Heartworm associated respiratory disease is a pulmonary syndrome in cats that results from the vascular and parenchymal inflammatory response associated with the arrival and death of Dirofilaria immitis worms into the distal pulmonary arteries. This parasite harbors intracellular Wolbachia, an endosymbiont bacteria. The association between the parasite and the bacteria is obligatory. Some studies suggest the involvement of Wolbachia in the development of the inflammatory reaction and in the polarization of the host immune response against the parasite. Barometric whole-body plethysmography is a non-invasive pulmonary function test that allows a dynamic study of breathing patterns and is useful to study airway disease and the response to different treatments. The aim of this prospective non-blinded study was to compare the influence of Wolbachia upon the respiratory function variables in a population of cats seropositive to D. immitis by use of Barometric whole-body plethysmography. Fourteen seropositive cats to Wolbachia and eight seronegative cats were put into the plethysmograph chamber and different respiratory variables were measured. The results were analyzed and compared between the two groups of animals. Significant differences were found for bronchoconstriction index variables PAU (pause) (P-value0.05) and Penh (enhanced pause) (P-value0.05). The results obtained in our study suggest that Wolbachia seems to produce a greater acute inflammatory response at bronchial, vascular and parenchymal level worsening the state of broncho-reactivity associated with the presence of seropositivity to D. immitis in cats.

Caro-Vadillo, A., Ynaraja-Ramirez, E. and Montoya-Alonso, J.A. 2006. Effect of short-term treatment with perindopril, torsemide and restricted-sodium diet in dogs with atrioventricular valvular insufficiency. J. Appl. Anim. Res., 29: 105–108. To evaluate the effects of perindopril, torsemide and a low-sodium diet on clinical response in dogs with moderate congestive heart failure, forty-six dogs with moderate congestive heart failure (International Small Animal Cardiac Health stage II) due to mitral valve disease were taken. During 4 weeks all the patients received 0.2 mg/kg perindopril (Coversyl, Servier) SID, 0.2 mg/kg torsemide (Sutril, Novag) SID and a moderate-sodium diet (k/d, Hill's). The treatment was safe, effective and well-tolerated and no major side-effects were observed. There were no significant changes in measured haematological and biochemical variables, including serum electrolyte concentrations and urinary fractional excretion of electrolytes. At the end of the study, all the pa...

OBJECTIVES To compare cardiac output measured by oesophageal Doppler and by thermodilution monitoring and to correlate the Doppler cardiac output-generated minute distance with thermodilution cardiac output in healthy anaesthetised beagle dogs. MATERIALS AND METHODS Prospective experimental study. Six healthy adult beagle dogs were pre-medicated with intramuscular acepromazine (0 · 05 mg/kg) and methadone (0 · 3 mg/kg). Anaesthesia was induced with intravenous propofol (dose-effect) and maintained with isoflurane in oxygen. Simultaneously, a constant rate infusion of dopamine (3 µg/kg/minute) was administered to the dogs to prevent hypotension. The minute distance, Doppler and thermodilution cardiac outputs were assessed at three different end-tidal concentrations of isoflurane (1 · 0, 1 · 3 and 2 · 0%). RESULTS Correlation between Doppler and thermodilution cardiac output (r2 = 0 · 582) and between minute distance and thermodilution cardiac output (r2 = 0 · 658) were moderately good, but the limits of agreement between Doppler and thermodilution cardiac outputs were above the recommended values (±39%, for a recommended value up to 30%). CLINICAL SIGNIFICANCE Doppler and minute distance cannot be considered as an alternative method to thermodilution to monitor cardiac output in the healthy anaesthetised dog.

Cardiac steatosis and apoptosis are key processes in diabetic cardiomyopathy, but the underlying mechanisms have not been elucidated, leading to a lack of effective therapy. The mineralocorticoid receptor blocker, eplerenone, has demonstrated anti-fibrotic actions in the diabetic heart. However, its effects on the fatty-acid accumulation and apoptotic responses have not been revealed. Methods: Non-hypertensive Zucker Diabetic Fatty (ZDF) rats received eplerenone (25 mg/kg) or vehicle. Zucker Lean (ZL) rats were used as control (n = 10, each group). After 16 weeks, cardiac structure and function was examined, and plasma and hearts were isolated for biochemical and histological approaches. Cultured cardiomyocytes were used for in vitro assays to determine the direct effects of eplerenone on high fatty acid and high glucose exposed cells. Results: In contrast to ZL, ZDF rats exhibited hyperglycemia, hyperlipidemia, insulin-resistance, cardiac steatosis and diastolic dysfunction. The ZDF myocardium also showed increased mitochondrial oxidation and apoptosis. Importantly, eplerenone mitigated these events without altering hyperglycemia. In cultured cardiomyocytes, high-concentrations of palmitate stimulated the fatty-acid uptake (in detriment of glucose assimilation), accumulation of lipid metabolites, mitochondrial dysfunction, and apoptosis. Interestingly, fatty-acid uptake, ceramides formation and apoptosis were also significantly ameliorated by eplerenone. Conclusions: By blocking mineralocorticoid receptors, eplerenone may attenuate cardiac steatosis and apoptosis, and subsequent remodelling and diastolic dysfunction in obese/type-II diabetic rats, This work was supported by national grants from Ministerio de Educación y Ciencia (SAF2009-08367), Comunidad de Madrid (CCG10-UAM/BIO-5289), FISS (PI10/00072), and a grant from by Pfizer (NY, USA), Spanish Ministry of Economy and Competitiveness (MINECO) CTQ2011-23562. These grants were used to provide consumables and animals required. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. AF received funding from the European Union Seventh Framework Programme [FP7/2007-2013] under grant agreement nº 264864

Aims The addition of an aldosterone receptor antagonist on top of current optimal therapy (based on angiotensin II inhibition) has demonstrated an important clinical benefit in heart failure patients with systolic dysfunction. Whether this finding also applies to heart failure patients with preserved systolic function is unknown. Therefore, we have studied the effect of adding eplerenone to standard pharmacological heart failure therapy (angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and diuretic and β-blocker) in the progression of heart failure in spontaneously hypertensive heart failure (SHHF) rats. Methods and results Two-month-old SHHF rats were randomized to receive no treatment (SHHF group), a standard heart failure therapy (quinapril-torasemide-carvedilol; ST-SHHF group), or the combination of eplerenone and standard heart failure therapy (Eple+ST-SHHF group) for 20 months. Untreated SHHF was characterized by progressive left ventricular hypertrophy, fibrosis, and myocardial contractile and relaxation abnormalities, leading to pulmonary congestion. Despite similar blood pressure control, the addition of eplerenone to standard heart failure therapy further prevented left ventricular hypertrophy, contractile and relaxation alterations, and pulmonary congestion than standard heart failure therapy alone. ST-SHHF and Eple + ST-SHHF rats showed similar inhibition of structural extracellular matrix proteins collagen I, collagen III and fibronectin and metalloproteinase (MMP)-2, MMP-7, MMP-12, and MMP-13. However, only the coadministration of eplerenone with standard heart failure therapy normalized the expression of matricellular proteins thrombospondin 1, tenascin C, periostin, and secreted protein acidic rich in cysteine/osteonectin to values comparable to normotensive rats. Conclusion In a hypertensive heart failure rat model, the addition of eplerenone to conventional heart failure therapy further improves cardiac structural and functional parameters, delaying the progression of heart failure. These beneficial effects of eplerenone were associated with normalization of matricellular protein expression.

The aim of the present study was to retrospectively evaluate survival in a population of 62 boxer dogs with arrhythmogenic right ventricular cardiomyopathy (ARVC), without left ventricular systolic failure, based on the following factors: age at diagnosis, presence of syncopal episodes, Holter arrhythmia classification and administered treatment. Medical records of boxer dogs with a diagnosis of ARVC between 2000 and 2010 were reviewed. Results showed that median survival time (MST) was longer in younger ARVC dogs than in the older ones P

Heartworm Associated Respiratory Disease (HARD) is a pulmonary syndrome that results from the vascular and parenchymal inflammatory response associated with the arrival and death of Dirofilaria immitis in the distal pulmonary arteries. Barometric whole-body plethysmography (BWBP) is a non-invasive pulmonary function test (PFT) that allows a dynamic study of breathing patterns and is useful to study airway disease and the response to different treatments. The aim of this prospective non-blinded study was to compare respiratory function variables between healthy cats and HARD cats (seropositive to D. immitis) by use of BWBP. Twenty-five healthy cats and six HARD cats were put into the plethysmograph chamber and different respiratory variables were measured. The results were analyzed and compared between the two groups of animals. There were significant differences for bronchoconstriction index variables Pause (P-value

Aims Although statins may provide potential therapeutic pathways for patients with heart failure with preserved ejection fraction (HFpEF), no studies have evaluated statins in combination with standard HF therapy, which would reflect clinical practice more closely. To address this question, we evaluated whether rosuvastatin added to a standard HF therapy provides additional improvement in cardiac structure and function in rats with hypertensive heart failure (SHHF). Methods and results Two-month-old SHHF rats were randomly assigned to four groups: (i) non-treated SHHF rats; (ii) rosuvastatin-treated SHHF rats; (iii) SHHF rats treated with quinapril plus torasemide plus carvedilol (considered as standard HF therapy); and (iv) SHHF rats treated with the combination of standard HF therapy and rosuvastatin. The administration of a standard anti-hypertensive HF therapy to SHHF rats for 17 months attenuated left ventricular (LV) chamber dilatation, cardiac hypertrophy, fibrosis, and inflammation compared with non-treated SHHF rats. Rosuvastatin alone prevented LV dilatation and cardiac inflammation similar to standard HF therapy-treated SHHF, despite being unable to normalize blood pressure (BP) or influence cardiac hypertrophy. However, and importantly, the addition of rosuvastatin to the standard HF therapy further prevented LV dilatation, preserved cardiac function, and normalized inflammation. Conclusion These data show that the use of rosuvastatin plus a standard HF therapy results in a significant additional improvement in HF and cardiac remodelling in a rat model of HFpEF. These beneficial effects were independent of BP and plasma lipid changes, and seem to be due, at least in part, to decreased myocardial inflammation.

FUNGAL pneumonia may develop in dogs and cats as a result of the inhalation of fungi, especially spores, and subsequent fungal infection in the lung (Norris 2004). This short communication describes an unusual case of fungal pneumonia due to Penicillium brevicompactum in a dog with laryngeal paralysis and distemper. To the authors’ knowledge, this is the first report of acute pneumonia in dogs caused by P brevicompactum. A seven-month-old intact male Staffordshire bull terrier, weighing 20 kg, was referred to the Veterinary Teaching Hospital of the Complutense University (Madrid, Spain) with a one-month history of progressive inspiratory dyspnoea during exercise or periods of stress and one episode of collapse. The dog had been treated previously with antimicrobial drugs with no positive response. Physical examination revealed severe inspiratory dyspnoea, stridor, extension of the head and neck, orthopnoea, forceful expiratory effort and cyanotic mucous membranes. Initial evaluation, carried out under light anaesthesia due to the respiratory distress comprised a complete blood count, serum biochemistry profile, cervical and thoracic radiographs and laryngoscopy. No abnormalities were noted in the haematological or biochemical analyses. Oxygen saturation, measured by pulse oximetry, was 94 per cent. Indirect fluorescent antibody tests for ehrlichiosis and leishmaniosis were negative. Thoracic radiographs revealed a diffuse interstitial and alveolar pattern affecting mainly the right cranial and middle lung lobes (Fig 1). Aspiration pneumonia was considered one of the main differential diagnoses. Cervical radiographs were normal. Laryngoscopy revealed bilateral laryngeal paralysis without everted laryngeal saccules. After endoscopic examination, blood samples were taken to rule out hypothyroidism and myasthenia gravis as potential causes of laryngeal paralysis. Serological analysis by ELISA was positive for canine distemper virus (CDV), and urinary excretion of CDV was also detected. A bronchoalveolar lavage (BAL) was performed to ascertain the aetiology of the lung condition. Cytological examination of over 200 cells revealed a preponderance of macrophages (85 per cent), including a high number of foamy cells, nondegenerative neutrophils (8 per cent), lymphocytes (4 per cent) and eosinophils (3 per cent). There were also red blood cells, and ciliated and non-ciliated respiratory epithelial cells. In addition, the sample showed an increase in the amount of mucus. Sabouraud’s dextrose agar plates (SGA; Difco) supplemented with chloramphenicol and gentamicin, and Columbia sheep blood agar plates were inoculated with BAL fluid. After eight days’ incubation aerobically and anaerobically at 32°C, a pure culture of a filamented fungus was obtained on the plates incubated under aerobic conditions. According to the keys and description of the species summarised by De Hoog and others (2000), Penicillium brevicompactum was identified (Fig 2). Bacterial growth was not observed. The final diagnosis was laryngeal paralysis, mycotic pneumonia (probably due to aspiration) and distemper. Initial therapy consisted of oxygen supplementation with nasal catheters, intravenous corticosteroids (0·5 mg/kg) and sedation for 24 hours before surgical treatment of the laryngeal paralysis by unilateral (right) arytenoid lateralisation. In addition, 5 mg/kg itraconazole (Canadiol; Esteve) and 70 mg/kg N-acetylcysteine (Fluimucil; Zambon) were administered orally twice daily. The dog was re-evaluated 10 days after discharge. The owner reported a substantial reduction in respiratory dyspnoea and improvement in exercise tolerance. The dog was active without inspiratory stridor. Thoracic radiographs showed a notable improvement in the pulmonary pattern. Five weeks later, the dog appeared to be clinically normal. The owner reported only altered vocalisation. A mild bronchial pattern was visible with no other persisting radiographic abnormalities. FIG 1: Radiographs showing (a) lateral and (b) dorsoventral projections of the thorax of a dog. A mixed alveolar and diffuse interstitial pattern is visible, affecting mainly the right cranial and middle lung lobes. The lateral projection also shows a mild infiltration of the dorsal part of the caudal lung lobes (a)

A previously healthy Scottish terrier developed verminous pneumonia due to Filaroides hirthi. The disease was diagnosed on the basis of cytology of a transtracheal wash, which contained 17 per cent eosinophils and a large number of parasite larvae. Treatment with 50 mg/kg bodyweight fenbendazole daily for three weeks eliminated the parasites and improved the clinical condition of the dog.

Cada vez son más los trabajos científicos en los que se determinan distinas sustancias que pueden se útiles como marcadores de lesión miocárdica. Dentro de estos marcadores, las troponinas, y en concreto la troponina I, exclusiva de los miocitos y la troponina C, se describen como marcadores esenciales para el diagnóstico de infarto de miocardio en medicina humana, así como para establecer actuaciones terapéuticas propias en estos casos. En medicina veterinaria existen algunos trabajos en los que se determina la concentración de estas troponinas. El objetivo del presente artículo es hacer una revisión de los trabajos encontrados en la bibliografía sobre la determinación de troponinas para esablecer su posible utilidad en la clínica diaria..

PRIMARY cardiac tumours are rare in human and veterinary medicine and tumour-specific diagnosis has been made most often at postmortem examination. In veterinary medicine, cardiac tumours are sporadic, with a prevalence of 0·17 to 0·19 per cent in dogs (Ware 1995, Ware and Hopper 1999). The most commonly reported tumours in dogs are haemangiosarcomas and chemodectomas, although other types of cardiac neoplasm have been reported (Bright and others 1990, Ware and Hopper 1999). Cardiac chondrosarcomas are extremely rare in veterinary medicine. Although different subtypes of chondrosarcoma are reported in human medicine (Casadei and others 1991), there are few reports of this tumour in dogs (Greenlee and Liu 1984, Albers and others 1997, LaRock and others 1997). This short communication describes the clinical and pathological features of a cardiac chondrosarcoma in a dog. A 12-year-old intact female poodle weighing 8 kg was presented to the Veterinary Teaching Hospital of the Complutense University of Madrid with a history of gradual dyspnoea and exercise intolerance. On physical examination the dog was dull, with a moderately distended abdomen, severe tachypnoea, expiratory dyspnoea and abdominal breathing. The mucous membranes were pale, its rectal temperature was normal, heart sounds were muffled but the rhythm was regular, the femoral pulses were weak and jugular distension was evident. A red blood cell count was within the normal reference range, whereas a white blood cell (WBC) count was moderately increased (20·3 x 109 WBC/litre, reference range 6 x 109 to 16 x 109 WBC/litre), with neutrophilic predominance. The plasma protein, glucose, urea, creatinine, gamma glutamyl transferase, alkaline phosphatase, cholesterol, calcium, potassium and sodium levels were all within the reference ranges. Left lateral and dorsoventral thoracic radiographs showed a moderate amount of pleural fluid and the cranioventral border of the heart was obscured. An electrocardiogram showed a normal sinus rhythm, 120 bpm with no anomalies. Twodimensional Doppler and colour Doppler echocardiography were performed using an ultrasound machine (AU3 ultrasound machine; Esaote) and a 10 MHz transducer. Twodimensional echocardiography showed dilatation of the right atrium and ventricle, a paradoxical septal motion of the ventricular septum and a hyperechoic tissue in the right inflow tract (Fig 1). The mass was homogeneous and appeared to be attached to the tricuspid valve septal leaflet and moved with the valve, without causing occlusion of right atrium or ventricle. Continuous-wave Doppler revealed an obstructive flow pattern through the right ventricular inflow. A presumptive diagnosis of a cardiac tumour was made and, because of the poor prognosis, the owners decided to have the dog euthanased. At postmortem examination, a 3 x 4 x 4 cm pedunculated white mass was found in the lumen of the right ventricle. It was attached to the ventricular septum and appeared to arise from the mural endocardium near the tricuspid valve. The cut surface of the mass was shiny and white, with multifocal friable and firm regions, and some irregular cavities (Fig 2). The liver had a moderately accentuated lobular pattern, but the other viscera had no macroscopic changes. Grossly, visible metastases were not detected. Tissue samples from all major organs were fixed in 10 per cent buffered formalin for routine histological processing. Haematoxylin and eosin stain, and Ki-67 immunohistochemical procedures were performed. The anti-Ki-67 monoclonal MIB-1 antibody is a nuclear proliferation marker useful for studying cell proliferation in neoplastic lesions. The monoclonal MIB-1 antibody reacts with the Ki-67 nuclear antigen associated with cell proliferation. This reaction is found throughout the cell cycle (G1, S, G2, M phases) and is absent in resting (G0) cells. Histologically, the mass was composed of intersecting bundles of fusiform cells in a variably collagenous stroma closely associated with numerous lobules of cartilaginous tissue, but no myxomatous component was observed. The fusiform tumour cells had marked anisokaryosis. The neoplastic tissue appeared to arise from the mesenchymatous subendocardial tissue (Fig 3). This observation was similar to a soft tissue chondrosarcoma of mesenchymal subtype (Casadei and others 1991) and to a primary mesenchymal chondrosarcoma in the pericardium of a dog (LaRock and others 1997). The histology of the mass was similar to cardiac chondrosarcomas (Greenlee and Liu 1984, Southerland and others 1993, Albers and others 1997, LaRock and others Veterinary Record (2004) 155, 678-680

Objective: To study the effect of sitagliptin on glucose and fatty-acids uptake in the myocardium of type-II diabetic rats. Background: The energy source in the heart shifts from fatty-acids to glucose after damage. However, fatty-acids are used as the only substrate available in the diabetic myocardium. Sitagliptin improves hyperglycemia and insulin resistance, but it is unknown whether it could influence the cellular transporters for both glucose and fatty-acids. Methods: Non-obese, non-hypertensive type-II diabetic rats (Goto-Kakizaki; GK) were treated with sitagliptin (10 mg/kg/day) or vehicle. A group of wistar rats were used as control. (N=10 rats, each). After 20 weeks, cardiac structure and function were measured by Echo-Doppler, and glucose uptake was examined by positron emission tomography (PET). Then, hearts were isolated and processed for protein and RNA extracts. Plasmas were used to evaluate metabolic parameters. Results: GK rats developed hyperglycemia (452 vs. 208 mg/dl, for GK and wistar, respectively. p

TORSEMIDE is a loop diuretic of the pyridine-sulfonylurea class. It is one of the most powerful loop diuretics, and clinical trials in human beings have proven its efficacy due to the greater elimination of sodium and water in urine than that provided by furosemide, with a much lower loss of potassium (Dunn and others 1995). Although there are several trials providing evidence of ion excretion by torsemide in human medicine (Goebel 1993, Patterson and others 1994, Stringer and others 1994, Blose and others 1995, Dunn and others 1995, Fowler and Murray 1995, Vargo and others 1995) there have been no reports in the veterinary literature. This short communication describes a study to assess the effect of 28 days’ treatment with torsemide on serum and urine electrolytes in dogs with moderate to severe congestive heart failure (CHF) due to chronic valve disease. Eighteen dogs with CHF secondary to chronic volume overload caused by chronic valve disease, classified as phase 2 to 3 according to the Scandinavian modified New York Heart Association classification (Kvuart and others 2002), were studied by the Cardiology Service of the Faculty of Veterinary Medicine, Complutense University, Madrid; consent was obtained from all the owners. The diagnosis of chronic valvular disease was made based on the dog’s clinical history, complete physical examination, six-lead electro cardiographic study, radiological study and echocardiographic study. Peripheral blood pressure was measured using a non-invasive indirect oscillometric method (Dinamap), and blood and urine analyses, including specific gravity, were performed in order to rule out dogs with disease other than CHF. The dogs had not received any other treatment for heart failure within two months before entering the trial. Patients with signs of other systemic disease were excluded. The dogs were randomly assigned to a treatment group or a control group, and all dogs were also treated with 0·2 mg/kg angiotensin converting enzyme (ACE) inhibitor, perindopril (Coversyl; Sevier) orally once a day, for the duration of the study. In the treatment group (10 dogs), 0·2 mg/kg torsemide (Sutril; Ferrer grupo) was administered orally, in one daily morning dose. The control group comprised eight dogs that received perindopril alone. Only one of the investigators was aware of which animals were in which group. All the dogs were fed three times a day with a commercial low-sodium diet (k/d; Hill’s) according to the manufacturer’s instructions, taking into account the bodyweight of each dog; water was given ad libitum. Blood samples and urine samples for ion measurement were taken from all the dogs on day 0 and on day 28 at the end of the study period. The blood samples were taken from the jugular vein and the urine samples were obtained using a bladder catheter. The last blood and urine samples were collected between two and four hours after oral ingestion of the medicines. The levels of sodium, potassium and chloride ions were determined using an ion analyser (Krone Microlyte), the level of calcium was determined by a cresolftaleina-complexona method using a kit (Calcio-Boehringer Mannheim), the level of phosphorus was determined using the molibdato test for ultraviolet (Boehringer Mannheim) and the level of magnesium was determined by colorimetric assessment without deproteinisation using a kit (bioMerieux). The excretion fraction was calculated to determine the concentration of ions in the urine. All the dogs were reviewed weekly, and a record was kept of possible secondary effects or intolerance to treatment, especially hypotension, anorexia or an increase in cardiac clinical signs. Statistical analysis was carried out using the program SPSS v 12.0 (Statistical Software). Mean values were compared using the parametric Student’s t test. The results were expressed as the mean (sd) values; in all cases, the results were considered statistically significant if P

En este artículo, los autores pretenden disipar nuestras dudas acerca del coste de los equipos de electrocardiografía, si son o no rentables y qué modelos son los más adecuados. In this article the authors try to help us about the cost of an electrocardiographic equipment, íf it is or it is not profitabe and what models are the best.

En el presente trabajo, los autores revisan sus primeras experiencias clínicas sobre la utilización de una combinación de un agonista alfa-2 central: medetomidina y un agente selectivo de reversión: atipamezol, en la sedación, contención farmacológica, premedicación y anestesia de perros y gatos en la clínica diaria. Se aportan los datos de los pacientes incluidos en el estudio, los procedimientos clínicos a los que fueron sometidos, los efectos secundarios encontrados con el uso de tales medicamentos y la forma de evitarlos en la medida de lo posible o enfrentarse a ellos cuando se presentan. In this paper the authors review their first clinical experiences with a combination of an alpha-2 adrenergic central agonist: medetomidine and its reversal agent: atipamezole, in the sedation, premedication and anaesthesia of dogs and cats in clinical practice. The authors summarize data obtained from patients, the clinical procedures done, the undesirable side effects found with their use and which is their actual approach in arder to prevent them or how they manage those secondary effects when they re already present.

Programa de Doctorado de Clínica e Investigación Terapéutica