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The purpose of this study was to evaluate the clinical response and side effects of tissue plasminogen activator (tPA) for the treatment of feline arterial thromboembolism (ATE). Previous reports of conservative and thrombolytic therapy were used to provide a historical control group of cats with ATE. The study was terminated due to a high frequency of adverse outcomes. tPA was administered to 11 cats with clinical signs of ATE for a median duration of 4.0 h (range 2-12h) prior to treatment. Pulses were restored in 40% of limbs within 4h and 53% within 24h. Motor function was restored to 33% of limbs within 24h. Adverse effects were seen in 11/11 cats following administration of tPA including azotemia (n=5), neurological signs (n=5), cardiac arrhythmias (n=5), hyperkalemia (n=4), acidosis (n=2) and sudden death in one cat. Ultimately, three cats (27%) were discharged alive from the hospital. While signs compatible with thrombolysis were noted in many cats following tPA administration, a high rate of side effects and low rate of hospital discharge were noted in this study., (Copyright 2009 ESFM and AAFP. Published by Elsevier Ltd. All rights reserved.)

Objective: To determine whether multiple organ dysfunction syndrome (MODS) could be identified in dogs with sepsis secondary to gastrointestinal tract leakage, and whether the number of affected organ systems was significantly associated with mortality rate., Design: Multicenter retrospective case series., Animals: 114 dogs., Procedures: Medical records for dogs treated surgically because of sepsis secondary to gastrointestinal tract leakage between 2003 and 2007 were reviewed. Sepsis was diagnosed on the basis of results of bacterial culture of peritoneal fluid, gross evidence of gastrointestinal tract leakage at surgery, or both. Renal dysfunction was defined as a > or = 0.5 mg/dL increase in serum creatinine concentration after surgery. Cardiovascular dysfunction was defined as hypotension requiring vasopressor treatment. Respiratory dysfunction was defined as a need for supplemental oxygen administration or mechanical ventilation. Hepatic dysfunction was defined as a serum bilirubin concentration > 0.5 mg/dL. Dysfunction of coagulation was defined as prolonged prothrombin time, prolonged partial thromboplastin time, or platelet count < or = 100,000/microL., Results: 89 (78%) dogs had dysfunction of 1 or more organ systems, and 57 (50%) dogs had MODS. Mortality rate increased as the number of dysfunctional organ systems increased. Mortality rate was 70% (40/57) for dogs with MODS and 25% (14/57) for dogs without., Conclusions and Clinical Relevance: Results indicated that MODS, defined as dysfunction of at least 2 organ systems, can be identified in dogs with sepsis and that organ system dysfunction increased the odds of death.

Case Description: 2 castrated male Labrador Retrievers (dogs 1 and 2) were evaluated 3 to 4 years after placement of a permanent pacemaker. Dog 1 was evaluated because of a large volume of chylous pleural effusion. Dog 2 was admitted for elective replacement of a pacemaker., Clinical Findings: Dog 1 had mild facial swelling and a rapidly recurring pleural effusion. Previously detected third-degree atrioventricular block had resolved. Cranial vena cava (CVC) syndrome secondary to pacemaker-induced thrombosis and stricture of the CVC was diagnosed on the basis of results of ultrasonography, computed tomography, and venous angiography. Dog 2 had persistent third-degree atrioventricular block. Intraluminal caval stricture and thrombosis were diagnosed at the time of pacemaker replacement. Radiographic evidence of pleural effusion consistent with CVC syndrome also was detected at that time., Treatment and Outcome: Dog 1 improved after treatment with unfractionated heparin and a local infusion of recombinant tissue-plasminogen activator. Balloon venoplasty was performed subsequently to relieve the persistent caval stricture. In dog 2, balloon dilatation of the caval stricture was necessary to allow for placement of a new pacing lead. Long-term anticoagulant treatment was initiated in both dogs. Long-term (> 6 months) resolution of clinical signs was achieved in both dogs., Clinical Relevance: Thrombosis and stricture of the CVC are possible complications of a permanent pacemaker in dogs. Findings suggested that balloon venoplasty and anticoagulation administration with or without thrombolytic treatment can be effective in the treatment of dogs with pacemaker-induced CVC syndrome.

Objective: To determine whether serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration is useful in discriminating between cardiac and noncardiac (ie, primary respiratory tract disease) causes of respiratory signs (ie, coughing, stertor, stridor, excessive panting, increased respiratory effort, tachypnea, or overt respiratory distress) in dogs., Design: Multicenter cross-sectional study., Animals: P 115 dogs with respiratory signs., Procedures: Dogs with respiratory signs were solicited for study. Physical examination, thoracic radiography, and echocardiography were used to determine whether respiratory signs were the result of cardiac (ie, congestive heart failure) or noncardiac (ie, primary respiratory tract disease) causes. Serum samples for NT-proBNP assay were obtained at time of admission for each dog. Receiver-operating characteristic curves were constructed to determine the ability of serum NT-proBNP concentration to discriminate between cardiac and noncardiac causes of respiratory signs., Results: Serum NT-proBNP concentration was significantly higher in dogs with cardiac versus noncardiac causes of respiratory signs. In dogs with primary respiratory tract disease, serum NT-proBNP concentration was significantly higher in those with concurrent pulmonary hypertension than in those without. A serum NT-proBNP cutoff concentration > 1,158 pmol/L discriminated between dogs with congestive heart failure and dogs with primary respiratory tract disease with a sensitivity of 85.5% and a specificity of 81.3%., Conclusions and Clinical Relevance: Measuring serum NT-proBNP concentration in dogs with respiratory signs helps to differentiate between congestive heart failure and primary respiratory tract disease as an underlying cause.

Objective: To describe a population of dogs with vehicular trauma and to determine whether age, type and severity of injury, or preexisting disease were associated with outcome., Design: Retrospective case series., Animals: 239 dogs evaluated at a university referral hospital after vehicular trauma over a 12-month period., Procedures: Patient characteristics, including age, outcome, animal trauma triage (ATT) score, treatments performed, hospital stay, cost, and preexisting disease, were recorded from medical records of dogs that had vehicular trauma. Dogs were assigned to a young, middle-aged, or geriatric age group. Categoric and continuous variables were compared between survivors and nonsurvivors to identify possible associations., Results: 239 dogs (126 males and 113 females) were evaluated following vehicular trauma during 2001: young (n = 149), middle-aged (68), and geriatric (22). The median ATT score was 3 (range, 0 to 15). Sixteen dogs had preexisting disease. Hospital stay ranged from < 1 to 28 days (median, 3 days). Cost ranged from $77 to $10,636 (median, $853). Two hundred six dogs were discharged. Twenty-six dogs were euthanatized, and 7 died. Dogs that died or were euthanatized had significantly higher ATT scores. The ATT score also was associated with a significantly higher cost of care. Dogs with multiple injuries had significantly higher ATT scores, had increased cost of care, and were significantly more likely to die or be euthanatized., Conclusions and Clinical Relevance: Increased injury severity in dogs was associated with increased mortality rates and higher cost of treatment.

Objective: To evaluate whether games of popular professional football teams have an effect on small animal emergency room caseload and percentage of dogs and cats that subsequently are hospitalized, are euthanatized, or die following admission to veterinary emergency rooms located within a dedicated fan base., Design: Prospective study., Animals: 818 dogs and cats admitted to the emergency room., Procedures: During the 2007 New England Patriots (NEP) football season, small animal emergency room caseload was recorded for Sunday (4-hour blocks, 8:00 AM until 12:00 midnight) and Monday night (7:00 PM to 11:00 PM). Number of dogs and cats that subsequently were hospitalized, died, or were euthanatized was recorded. Mean game importance rating (GIR) was determined for NEP games (scale, 1 [mild] to 3 [great])., Results: Percentage of dogs and cats admitted from 12:00 noon to 4:00 PM on Sundays during NEP games (mean GIR, 1.7) versus non-NEP games was not different. Mean +/- SD percentage of dogs and cats admitted from 4:00 PM to 8:00 PM on Sundays during NEP games (mean GIR, 2.4) versus non-NEP games was significantly different (18 +/- 5% and 25 +/- 7% of daily caseload, respectively). Percentage of dogs and cats admitted from 8:00 PM to 12:00 midnight on Sundays during NEP games (mean GIR, 2.1) versus non-NEP games was not different. Game type (NEP vs non-NEP) during emergency room admission did not influence whether dogs and cats subsequently were hospitalized, died, or were euthanatized., Conclusions and Clinical Relevance: Professional sporting events may influence veterinary emergency room caseloads.

Background: Circulating plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration facilitates emergency diagnosis of congestive heart failure (CHF) in people. Its utility to discriminate between dyspneic cats with CHF vs. primary respiratory disease requires further assessment. Our objectives were to determine if NT-proBNP (1) differentiates dyspneic cats with CHF vs. primary respiratory disease; (2) increases with renal insufficiency; (3) correlates with left atrial dimension, radiographic cardiomegaly, and estimated left ventricular filling pressure (E/E(a))., Methods: NT-proBNP was measured in 167 dyspneic cats (66 primary respiratory disease, 101 CHF) to evaluate (1) relationship with clinical parameters; (2) ability to distinguish CHF from primary respiratory disease; (3) optimal cut-off values using receiver operating characteristic (ROC) curve analysis., Results: NT-proBNP (1) was higher (median and inter-quartile [25th-75th] percentile) in CHF (754 pmol/L; 437, 1035 pmol/L) vs. primary respiratory disease (76.5 pmol/L; 24, 180 pmol/L) cohorts (P<0.001); (2) positively correlated in CHF cats with increased inter-ventricular septal end-diastolic thickness (rho=0.266; P=0.007) and LV free wall thickness (rho=0.218; P=0.027), but not with radiographic heart size, left atrial size, left ventricular dimensions, E/E(a) ratio, BUN, creatinine, or thyroxine; (3) distinguished dyspneic CHF cats from primary respiratory disease at 265 pmol/L cut-off value with 90.2% sensitivity, 87.9% specificity, 92% positive predictive value, and 85.3% negative predictive value (area under ROC curve, 0.94)., Conclusions: NT-proBNP accurately discriminated CHF from respiratory disease causes of dyspnea.

Objective: To define the role and education of the traditional pharmacist who supports the needs of the veterinarian (hereafter referred to as veterinary pharmacist) and a pharmacist who practices solely in veterinary pharmacy (here after referred to as veterinary pharmacy specialist)., Methods: The Delphi technique involving 7 panels of 143 experts was employed to reach consensus on the definition of the roles and education of the veterinary pharmacist and veterinary pharmacy specialist., Results: The veterinary pharmacy specialist's role included dispensing medications, complying with regulations, advocating for quality therapeutic practices, and providing consultative services, research, and education. The perceived role of the veterinary pharmacist was viewed as being somewhat narrower. Compared to veterinary pharmacists, a more in-depth education in veterinary medicine was viewed as essential to the role development of veterinary pharmacy specialists., Conclusions: The authors hope their research will promote widespread awareness of the emerging field of veterinary pharmacy and encourage schools to offer increased access to clinically relevant professional training programs.

Objective: To compare morphometric measurements and serum insulin-like growth factor (IGF-1) concentration in cats with and without hypertrophic cardiomyopathy (HCM), and assess the hypothesis that cats with HCM have larger body size and skeletal features and higher serum IGF-1 concentrations than healthy cats., Animals: 25 cats with HCM and 22 healthy control cats., Procedures: Physical examination and echocardiography were performed to classify cats into the HCM and control groups. Data collected from each cat included diet history, body weight, body condition score, lengths of the humerus and 4th and 12th thoracic vertebrae, heart size, head length and width, and abdominal circumferences. Comparisons of these variables were made between groups., Results: Body condition score in HCM-affected and control cats did not differ significantly. However, median head width; lengths of the head, 4th and 12th thoracic vertebrae, and humerus; and body weight in the HCM-affected group were significantly greater than values in the control group. Median serum concentration of IGF-1 was not significantly different between groups., Conclusions and Clinical Relevance: These data suggested that among the study cats, those with HCM were skeletally larger, but not more obese, than healthy cats. Whether this was attributable to differences in early growth or other causes requires additional investigation.

Objective: To describe the relative importance of pets' quality versus quantity of life among owners of dogs with heart disease., Design: Prospective questionnaire-based clinical study., Sample Population: Owners of 201 dogs with heart disease., Procedures: Owners each completed a questionnaire that was designed to ascertain the relative importance of quality versus quantity of life for their pet and to assess the owners' willingness to trade survival time for quality of life, if that were possible. Analyses were performed to evaluate factors associated with owner willingness to trade time for quality of life., Results: Most owners (170/197 [86%]) were willing to trade survival time for quality of life for their heart disease-affected dogs; of those owners, 88 (52%) were willing to trade 6 months. Owners were highly concerned with detection of perceived pet suffering and their pet's ability to interact with them. Owners whose pets had respiratory difficulty or fainting episodes and were treated on an outpatient basis had a greater willingness to trade survival time than owners of dogs that were treated on an emergency basis. Among owners willing to trade time for quality of life, younger owners and those whose pets had fainting episodes were willing to trade the most amount of time., Conclusions and Clinical Relevance: Results indicated that quality of life is highly important to owners of dogs with heart disease. Owners' priorities partly depend on owner age and the pet's clinical circumstances; ongoing client-veterinarian communication is important to optimize treatment success as perceived by owners.

Background: Boxer dogs are routinely screened by echocardiography to exclude congenital and acquired heart disease. Individuals of a given breed may span a large range of body sizes, potentially invalidating linear regression of M-mode measurements against body weight. Echocardiographic ratio indices (ERIs) provide a novel method of characterizing echocardiographic differences between Boxers and other dog breeds., Hypothesis: ERIs obtained from overtly healthy Boxer dogs presented for cardiac screening will be different from ERIs established for normal non-Boxer dogs, and those differences will be unrelated to aortic velocity or systolic blood pressure., Animals: Eighty-one Boxers with no outward clinical signs of heart disease were studied., Methods: All dogs were examined by 2-dimensional, M-mode, and Doppler echocardiography. M-mode measurements were used to perform ERI calculations, and the indices in Boxers were compared between Boxers with varying severity of arrhythmia and those of normal non-Boxer dogs., Results: Differences in weight-based ERIs, which reflect increased thickness of the left ventricular free wall (LVW) and interventricular septum (IVS) and smaller aortic size, were found in overtly healthy Boxer dogs compared with normal non-Boxer dogs. ERIs of left atrial and LV cavity size in overtly healthy Boxers were not significantly different from those of non-Boxer dogs., Conclusions and Clinical Importance: Boxer dogs may have an increased relative thickness of the LVW and IVS that is independent of aortic size, aortic velocity, or arterial blood pressure, and this morphology should be taken into consideration when screening Boxers by echocardiography.

Objective: To determine whether serum N-terminal pro-B-type natriuretic (NT-proBNP) concentration could be used to identify cardiac disease in dogs and to assess disease severity in affected dogs., Design: Cross-sectional study., Animals: 119 dogs with mitral valve disease, 18 dogs with dilated cardiomyopathy, and 40 healthy control dogs., Procedures: Serum NT-proBNP concentration was measured with an ELISA validated for use in dogs. Results of physical examination, thoracic radiography, echocardiography, and serum biochemical analyses were recorded for dogs with cardiac disease., Results: Serum NT-proBNP concentration was significantly higher in dogs with cardiac disease than in control dogs, and a serum NT-proBNP concentration > 445 pmol/L could be used to discriminate dogs with cardiac disease from control dogs with a sensitivity of 83.2% and specificity of 90.0%. In dogs with cardiac disease, serum NT-proBNP concentration was correlated with heart rate, respiratory rate, echocardiographic heart size, and renal function. For dogs with cardiac disease, serum NT-proBNP concentration could be used to discriminate dogs with and without radiographic evidence of cardiomegaly and dogs with and without congestive heart failure., Conclusions and Clinical Relevance: Results suggested that serum NT-proBNP concentration may be a useful adjunct clinical test for diagnosing cardiac disease in dogs and assessing the severity of disease in dogs with cardiac disease.

Background: Obesity is a risk factor for cardiovascular disease in people, but overweight and obese human heart failure patients have improved survival compared with normal--or underweight controls--the obesity paradox. The purpose of this study was to determine if there is an association of body weight and body condition with survival in dogs with heart failure., Hypothesis: That body condition and changes in body weight are predictors of survival in dogs with heart failure., Animals: One hundred and eight dogs with heart failure (International Small Animal Cardiac Health Council stages 2, 3a, or 3b) secondary to dilated cardiomyopathy or chronic valvular disease., Methods: Medical records were reviewed, and data regarding initial body weight and body condition score (BCS), subsequent changes in body weight, and treatment were collected. Survival times were determined for dogs that were discharged from the hospital and lived >24 hours., Results: Survival was significantly different between dogs that gained, lost, or maintained body weight over the course of their disease (P= .04), with dogs that gained weight surviving the longest. BCS and medications were not significantly associated with survival time; however, n-3 fatty acid intake was associated with longer survival time (P= .009)., Conclusions and Clinical Importance: These results suggest that changes in body weight might be an important consideration in the survival of dogs with heart failure.

Background: Arterial thromboembolism (ATE) is a common complication of feline cardiomyopathy; however, the pathogenesis of ATE is unknown., Hypothesis: Systemic activation of the coagulation cascade (hypercoagulability) and endothelial injury promote ATE in cardiomyopathic cats., Animals: Healthy cats (n = 30) and 3 groups of cardiomyopathic cats: Group (1) left atrial enlargement only (LAE [n = 11]), ie, left atrial to aortic ratio >1.4; Group (2) LAE with spontaneous echocardiographic contrast, atrial thrombi or both (SEC-T [n = 16]); and Group (3) acute ATE with LAE (n = 16)., Methods: Hypercoagulability was defined by 2 or more laboratory abnormalities reflecting coagulation factor excess (high fibrinogen concentration or Factor VIII coagulant activity), inhibitor deficiency (low antithrombin activity), or thrombin generation (high thrombin-antithrombin complex [TAT] and d-dimer concentrations). High von Willebrand factor antigen concentration (vWF : Ag) was considered a marker of endothelial injury. Data were analyzed using nonparametric statistics., Results: The 3 groups of cats with cardiac disease had higher median fibrinogen concentrations than did the healthy cats. Criteria of hypercoagulability were found exclusively in cats with SEC-T (50%) and ATE (56%). Hypercoagulability was not associated with left atrial size or congestive heart failure (CHF). ATE cats had significantly higher median vWF : Ag concentration than did the other groups., Conclusion and Clinical Importance: Systemic hypercoagulability is evident in many cardiomyopathic cats, often without concurrent CHF or overt ATE. Hypercoagulabilty may represent a risk factor for ATE. High vWF : Ag in ATE cats was attributed to downstream endothelial injury from the occlusive thrombus.

Objective: To compare plasma fatty acid concentrations and the relationships of fatty acids to arrhythmias in Boxers versus Doberman Pinschers., Animals: 38 Boxers and 13 Doberman Pinschers., Procedures: Boxers and Doberman Pinschers evaluated via Holter recording and for which a blood sample was available were included. Echocardiograms were performed in 49 of 51 dogs. The number of ventricular premature complexes (VPCs)/24 h was counted and fatty acids analyzed. Plasma fatty acid concentrations and VPCs/24 h, as well as correlations between the 2 variables, were compared between the 2 breeds., Results: Compared with the Doberman Pinschers, Boxers had significantly higher plasma concentrations of gamma-linolenic acid but lower concentrations of arachidonic acid. Total n-6 fatty acids and total polyunsaturated fatty acid concentrations were higher in Doberman Pinschers. There were significant, but weak, positive correlations between VPCs and oleic acid, total n-3 fatty acids, and total n-9 fatty acids in Boxers but not in Doberman Pinschers., Conclusions and Clinical Relevance: Data suggested that plasma fatty acid concentrations may differ between Boxers and Doberman Pinschers and that the relationship between fatty acid concentrations and VPCs may be different between these 2 breeds.

Objective: To describe the disposition of and pharmacodynamic response to atenolol when administered as a novel transdermal gel formulation to healthy cats., Animals: 7 healthy neutered male client-owned cats., Procedures: Atenolol was administered either orally as a quarter of a 25-mg tablet or as an equal dose by transdermal gel. Following 1 week of treatment, an ECG and blood pressure measurements were performed and blood samples were collected for determination of plasma atenolol concentration at 2 and 12 hours after administration., Results: 2 hours after oral administration, 6 of 7 cats reached therapeutic plasma atenolol concentrations with a mean peak concentration of 579 +/- 212 ng/mL. Two hours following transdermal administration, only 2 of 7 cats reached therapeutic plasma atenolol concentrations with a mean peak concentration of 177 +/- 123 ng/mL. The difference in concentration between treatments was significant. Trough plasma atenolol concentrations of 258 +/- 142 ng/mL and 62.4 +/- 17 ng/mL were achieved 12 hours after oral and transdermal administration, respectively. A negative correlation was found between heart rate and plasma atenolol concentration., Conclusions and Clinical Relevance: Oral administration of atenolol at a median dose of 1.1 mg/kg every 12 hours (range, 0.8 to 1.5 mg/kg) in cats induced effective plasma concentrations at 2 hours after treatment in most cats. Transdermal administration provided lower and inconsistent plasma atenolol concentrations. Further studies are needed to find an effective formulation and dosing scheme for transdermal administration of atenolol.

The case reported herein describes the placement of a permanent transvenous pacemaker in an older dog with a previously undiagnosed persistent left cranial vena cava (PLCVC) and recent onset symptomatic third-degree atrioventricular (AV) block. On presentation the dog was found to have atrial flutter and third-degree AV block and echocardiography demonstrated evidence of chronic valvular disease and pulmonary arterial hypertension. The persistent left cranial vena cava was discovered via angiography when difficulties were encountered with pacemaker placement. Successful right ventricular pacing necessitated passage of the lead through the coronary sinus. The attendant complications in pacemaker placement in the presence of a PLCVC are well-described in man but, to the authors' knowledge, have not been described in companion animals.

Most cases of pericardial effusion can be diagnosed with a thorough physical examination. Physical examination findings may include muffled heart sounds, pulsus paradoxus, and jugular venous distention. Radiographs may show a globoid cardiac silhouette. Echocardiography is reliable in diagnosing pericardial effusion. Pericardiocentesis is indicated for the emergency treatment of pericardial tamponade. Pericardiectomy may improve survival in some dogs. The prognosis varies greatly, depending on the underlying cause.

Pericardial effusion is the abnormal accumulation of fluid in the pericardial space. As the fluid volume and intrapericardial pressure increase, cardiac tamponade can develop. The most common causes of pericardial effusion include cardiac hemangiosarcoma, idiopathic pericardial effusion, and chemodectoma. Understanding the underlying cause is important in providing treatment recommendations and an accurate prognosis.

Spontaneously occurring dilated cardiomyopathy in dogs and hypertrophic cardiomyopathy in cats are common diseases and are vastly underutilized as models of human cardiac disease. The goals of nutrition are no longer limited to a low-sodium diet, as research is now showing that nutrients can modulate disease and be an important adjunct to medical therapy. Deficiencies of certain nutrients can contribute to cardiomyopathies, as with taurine, but some nutrients-such as n-3 fatty acids, carnitine, and antioxidants-may have specific pharmacologic benefits. Dogs and cats with spontaneous cardiomyopathies are an exciting and promising model for studying nutritional modulation of cardiac disease.

A 1.5-year-old mixed breed dog was presented for evaluation of arrhythmia and a cranial mediastinal density was noted on thoracic radiographs. The density was determined to be a cranial vena cava aneurysm based on ultrasonographic and angiographic testing. No treatment was initiated and the dog remains asymptomatic for the cranial vena cava aneurysm at 6 years of age. Although rare, cranial vena cava aneurysm should be a differential diagnosis for dogs with cranial mediastinal abnormalities on thoracic radiographs.

Objective: To determine nutrient intake and dietary patterns in cats with cardiac disease., Design: Prospective study., Animals: 95 cats with congenital cardiac disease or primary cardiomyopathy., Procedures: Owners completed a standardized telephone questionnaire regarding their cat's diet and a 24-hour food recall to determine daily intake of calories, fat, protein, sodium, magnesium, and potassium., Results: Of the 95 cats, 18 (19%) had a history of congestive heart failure and 73 (77%) had no clinical signs of cardiac disease. Fifty-five percent (52/95) of cats had concurrent disease. Inappetance was reported in 38% (36/95) of all cats and in 72% (68/95) of cats with a history of congestive heart failure. Most (57% [54/95]) cats received treats or table scraps on a regular basis. Approximately half the cats were receiving orally administered medications, supplements, or both. Only 34% (32/68) of owners used food to administer medications to cats. Cats consumed more than the Association of American Feed Control Officials (AAFCO) minimums for protein, sodium, potassium, and magnesium, and nearly all cats consumed more than the AAFCO minimum for fat. Daily nutrient intake was variable for all of the nutrients assessed., Conclusions and Clinical Relevance: Dietary intake in cats with cardiac disease was variable, but results for dietary supplement use, food use for medication administration, and treat feeding were different from those found in a similar study of dogs with cardiac disease. This information may be useful for treating and designing nutritional studies for cats with cardiac disease.

Background: B-type natriuretic peptide (BNP) is increased in dogs with congestive heart failure (CHF)., Hypothesis: The purpose of this study was to evaluate the clinical utility of a novel canine-specific enzyme-linked immunosorbent assay of BNP for the diagnosis of CHF in dogs presenting with either cough or dyspnea., Animals: Three hundred and thirty dogs from 2 large university teaching hospitals., Methods: We prospectively measured plasma BNP concentrations in 3 groups of dogs: (1) normal adult dogs (n = 75), (2) dogs with asymptomatic heart disease (n = 76), and (3) dogs with cough or dyspnea (n = 179). The final diagnosis of dogs with cough or dyspnea and the severity of CHF (International Small Animal Cardiac Health Council Heart Failure Classification [ISACHC]) were determined by medical record review by a study cardiologist who was blinded to the results of the BNP assay., Results: Dogs with CHF had a higher median BNP concentration (24.6 pg/mL) than dogs with noncardiac causes of cough or dyspnea (2.6 pg/mL) (P < .0001). The area under the curve was 0.91 for the receiver operating curve analysis of the diagnostic accuracy of the BNP measurement to differentiate CHF from other causes of cough or dyspnea. The median BNP concentrations in dogs were 3.0 pg/mL with ISACHC I, 17.8 pg/mL with ISACHC II, and 30.5 pg/mL with ISACHC III. (P < .0001), Conclusion and Clinical Importance: Measurement of BNP is useful in establishing or in excluding the diagnosis of CHF in dogs with cough or dyspnea. B-type natriuretic peptide concentrations rose significantly as a function of severity of CHF.

Background: Omega-3 fatty acids have been shown to reduce arrhythmia in animal models and people. These effects have not been studied in dogs with spontaneously occurring arrhythmia., Hypothesis: Fish oil will reduce the frequency of ventricular arrhythmia in Boxer dogs with arrhythmogenic right ventricular cardiomyopathy (ARVC)., Animals: Twenty-four Boxers with ARVC were included in this study., Methods: Asymptomatic Boxers not receiving antiarrhythmic medications were evaluated with echocardiogram and electrocardiogram. Dogs with at least 1 ventricular premature contraction (VPC) received 24-hour ambulatory electrocardiography (AECG) recordings. Dogs with > 95 VPCs in 24 hours were randomized to 1 of 3 treatments: (1) Fish oil, 2 g; (2) Flax oil, 2 g; or (3) sunflower oil, 2 g (Control group), for 6 weeks. Investigators and owners were blinded to the treatment groups. All baseline measurements were repeated after the 6-week supplementation., Results: There were no differences at baseline for age, sex, blood pressure, weight, echocardiographic measurements, or VPCs. Median number of VPCs in 24 hours for all dogs was 543 (range, 96-40,063) at baseline and 193 (range, 6-14,825) after 6 weeks of supplementation. VPCs/24 h were reduced for the Fish oil group (baseline median = 397 [range, 249-10,587]; 6-week median = 162 [range, 16-3,781]; P = .02), but not for the Flax oil (P = .58) or Control (P = .48) groups., Conclusions and Clinical Importance: These data suggest that fish oil, but not flax oil, supplementation for 6 weeks reduces arrhythmia in Boxers with ARVC and that it could be useful in treating this common disease. Further studies are needed to determine optimal dose and duration of treatment.

A 4-year-old, late-term pregnant Himalayan queen was diagnosed with biventricular congestive heart failure characterized by pleural effusion and pulmonary edema. A cesarean section was performed, resulting in the birth of four live kittens, with one surviving to discharge. Congestive heart failure resolved rapidly following surgery. The queen remained asymptomatic for 9 years postoperatively. Volume expansion secondary to pregnancy was thought to result in cardiovascular volume overload and subsequent congestive heart failure.

Pulmonary arterial hypertension (PH) is a pathologic condition in dogs characterized by abnormally high pressures in the pulmonary circulation and has been associated with a poor outcome. Sildenafil is a type V phosphodiesterase inhibitor that produces nitric oxide mediated vasodilatation. Sildenafil treatment decreases pulmonary arterial pressure and pulmonary vascular resistance in people with PH. The purpose of this study was to describe the clinical characteristics and outcome of dogs with PH treated with sildenafil. The cardiology database was searched for dogs with PH treated with sildenafil. PH was defined as systolic pulmonary arterial pressure (PAPs) > or = 25 mmHg at rest. Medical records were reviewed for the following information: signalment, duration and type of clinical signs before treatment, underlying disease, estimated or measured PAPs, dosage and dosing interval of sildenafil, and the effect of treatment on clinical signs and pulmonary arterial pressure and survival time. Thirteen affected dogs were identified. Clinical signs included collapse, syncope, respiratory distress, and cough. Duration of clinical signs before presentation ranged from 3 days to 5 months. An underlying cause was identified in 8 dogs. The median sildenafil dosage was 1.9 mg/kg. Ten dogs received concurrent medications. Median PAPs was 90 mmHg; 8 dogs were reevaluated after therapy, and the median decrease in PAPs was 16.5 mmHg. The median survival time of all dogs was 91 days. Sildenafil appeared to be well tolerated in dogs with PH and was associated with decreased PAPs and amelioration of clinical signs in most. Sildenafil represents a reasonable treatment option for dogs with pulmonary hypertension.

Background: The potential benefits of nutritional modification in early canine cardiac disease are not known., Hypothesis: We hypothesized that echocardiographic, neuroendocrine, and nutritional variables will differ between dogs with asymptomatic chronic valvular disease (CVD) and healthy controls, and that a moderately reduced sodium diet enriched with antioxidants, n-3 fatty acids, taurine, carnitine, and arginine will alter these variables in dogs with CVD., Methods: Echocardiography was performed and blood was collected. After baseline comparison with healthy controls, all dogs with CVD were fed a low-sodium run-in diet for 4 weeks, reevaluated, and then randomized to receive either the cardiac diet or a placebo diet for 4 weeks., Results: At baseline, dogs with CVD (n = 29) had significantly lower circulating sodium, chloride, arginine, and methionine concentrations and higher plasma concentrations of atrial natriuretic peptide compared to healthy controls. In dogs with CVD, plasma aldosterone concentration and heart rate increased significantly after 4 weeks of eating the run-in diet. The cardiac diet group (n = 14) had larger increases in levels of cholesterol (P = .001), triglycerides (P = .02), eicosapentaenoic acid (P < .001), docosahexaenoic acid (P < .001), total omega-3 fatty acids (P < .001), vitamin C (P = 0.04), alpha-tocopherol (P < .001), and gamma-tocopherol (P < .001) compared to the placebo diet group (n = 15). The cardiac diet group also had larger reductions in maximal left-atrial dimension (P = .003), left-ventricular internal dimension in diastole (P = .03), and weight-based maximal left-atrial dimension (P = .03)., Conclusions and Clinical Importance: Observed changes in both blood variables and echocardiographic measurements warrant additional studies on dietary modifications in dogs with early CVD.

Objective: To develop and assess the reproducibility of a protocol to noninvasively test endothelial function in dogs on the basis of the flow-mediated vasodilation (FMD) procedure used in humans., Animals: 5 healthy spayed female dogs., Procedures: Luminal arterial diameter and blood flow velocity in the brachial and femoral arteries were measured with ultrasonography. The within-dog reproducibility of these ultrasonographic measurements was tested. An occlusion period of 1, 3, or 5 minutes with an inflatable cuff was used to create the FMD response. Measurements made at 15, 30, and 60 seconds following release of the occlusion were compared with measurements made immediately prior to each occlusion to assess the FMD response., Results: Within-dog reproducibility of measurements revealed moderate to high correlations. Change from baseline in luminal arterial diameter was most substantial when measured at 30 seconds following release of occlusion, whereas blood flow velocity changes were maximal when measured at 15 seconds following release. The brachial imaging site provided a larger number of significant FMD responses than the femoral site. The 3-minute occlusion period provided equal or better responses than the 5-minute occlusion period., Conclusions and Clinical Relevance: Ultrasonographic measurement of the FMD responses was a feasible and reproducible technique and significant changes from baseline were detected. The FMD responses in dogs were most substantial when performed at the brachial artery with blood flow velocity and luminal arterial diameter changes from baseline measured at 15 and 30 seconds, respectively, following release of a 3-minute occlusion period.

A 7.5-year-old castrated male ferret (Mustela putorius furo) was diagnosed with third-degree atrioventricular (AV) block. A monopolar epicardial pacemaker system was implanted, resulting in a regular, paced cardiac rhythm with third-degree AV block at 140 beats per minute. Over the next 2 months, the ferret developed anorexia, interstitial pneumonia, intermittent diarrhea, and hind-limb weakness and had a slow and progressive recovery. The ferret developed clinical signs of congestive heart failure 4 months after the surgery, resulting in its death 3 weeks later. Necropsy results attributed the death to cardiac failure due to extensive myocardial mineralization. To the authors' knowledge this is the first published report of surgical report of surgical pacemaker implantation in a ferret.

The purpose of the study reported here was to determine whether dogs with chronic valvular disease have increased plasma C-reactive protein concentration, compared with that in clinically normal dogs. Blood was collected from 47 dogs with physical and echocardiographic evidence of chronic valvular disease and from 20 healthy controls. C-reactive protein concentration was determined with a commercial canine C-reactive protein enzyme immunoassay. Compared with controls, dogs with chronic valvular disease had higher plasma concentration of C-reactive protein (median 2.17 microg/mL [range, 0.86-33.8 microg/mL]) versus 1.43 microg/mL [range, 0.84-4.99 microg/mL]; P < .001). C-reactive protein concentration was not related to the presence of congestive heart failure or murmur grade. The results of this study suggest that increased concentration of C-reactive protein is found in dogs with chronic valvular disease.

Studies evaluating pericardial fluid analysis in dogs to determine the etiology of pericardial effusions have yielded conflicting results. The purpose of this prospective study was to compare acid-base status, electrolyte concentrations, glucose, and lactate of pericardial fluid to peripheral blood from dogs with pericardial effusion and to compare these variables between dogs with neoplastic and nonneoplastic pericardial effusion. Acid-base status, electrolyte concentrations, glucose, hematocrit, urea nitrogen, and lactate concentrations were evaluated in peripheral blood samples and in pericardial effusion samples of 41 client-owned dogs with pericardial effusion. Common abnormal findings in the peripheral blood of dogs with pericardial effusion included hyperlactatemia (n = 38 [of 41]; 93%), hyponatremia (n = 25/41; 61%), hyperglycemia (n = 13/41; 32%), and hypermagnesemia (n = 13/41; 32%). Bicarbonate, sodium, ionized calcium, glucose, and hematocrit were all significantly lower in the pericardial fluid compared with peripheral blood, whereas lactate, chloride, and PCO2 were significantly higher in the pericardial fluid. When comparing the concentrations of variables in the pericardial fluid of dogs with neoplasia (n = 28) to those without neoplasia (n = 13), pH, bicarbonate, and chloride were significantly lower in dogs with neoplasia, whereas lactate, hematocrit, and urea nitrogen were significantly higher in the pericardial fluid of dogs with neoplasia. The difference between peripheral and pericardial glucose concentrations was significantly larger in dogs with neoplasia than in dogs without neoplasia. Although differences between variables in dogs with neoplastic and nonneoplastic pericardial effusion were documented, clinical relevance is likely limited by the degree of overlap between the 2 groups.

Objective: To compare myocardial concentrations of fatty acids in dogs with dilated cardiomyopathy (DCM) with concentrations in control dogs., Sample Population: Myocardial tissues from 7 dogs with DCM and 16 control dogs., Procedure: Myocardial tissues were homogenized, and total fatty acids were extracted and converted to methyl esters. Myocardial concentrations of fatty acids were analyzed by use of gas chromatography and reported as corrected percentages., Results: The amount of docosatetraenoic acid (C22:4 n-6) was significantly higher in myocardial samples from dogs with DCM (range, 0.223% to 0.774%; median, 0.451%), compared with the amount in samples obtained from control dogs (range, 0.166% to 0.621%; median, 0.280%). There were no significant differences between DCM and control dogs for concentrations of any other myocardial fatty acids., Conclusions and Clinical Relevance: Although concentrations of most myocardial fatty acids did not differ significantly between dogs with DCM and control dogs, the concentration of docosatetraenoic acid was significantly higher in dogs with DCM. Additional investigation in a larger population is warranted to determine whether this is a primary or secondary effect of the underlying disease and whether alterations in fatty acids may be a target for intervention in dogs with DCM.

This study compares M-mode echocardiographic ratio indices (ERIs) in dogs with mitral regurgitation due to chronic valvular disease (CVD/MR) for their ability to discriminate and quantify associated echocardiographic changes. Weight-based M-mode ERIs were determined retrospectively for 2 groups of dogs, normal (n = 47) and CVD/MR (n = 176). The CVD/MR group was further subdivided into those with (CVD/MR B, n = 74) and without (CVD/MR A, n = 102) left-sided congestive heart failure (LCHF). ERIs were compared descriptively (summary statistics) and also by receiver-operator characteristic curve areas (ROCAs) for their ability to discriminate between groups. Univariate logistic regression (LR) models were used to estimate the odds ratio for each ERI as a predictor of the CVD/MR condition as well as to predict LCHF within the CVD/MR group. A novel ERI (wdeltaA), designed to express body size-normalized short-axis stroke area, was sensitive (90%) and specific (98%) to discriminate between normal and CVD/MR at a cutoff value of 1.8 standard deviations (wdeltaA = 2.1). Prediction of LCHF within the CVD/MR group was more problematic, but an ERI expressing left atrial size (wLA) showed 76% sensitivity and 81% specificity at a cutoff value of 5.2 standard deviations (wLA = 1.55). Ours was a descriptive study of echocardiographic patterns of pathology associated with CVD/ MR and determined which ERIs are sensitive and specific for CVD/MR and for LCHE ERIs normalize echocardiographic data for body size in dogs and are well-suited to quantitative descriptions and analysis.

Alterations in antioxidant status and oxidative stress have been documented in dogs with dilated cardiomyopathy (DCM). The purpose of this study was to more broadly assess this relationship in dogs with congestive heart failure (CHF). Malondialdehyde (MDA), 8-F(2alpha)-isoprostane, protein carbonyls, reduced (GSH) and oxidized (GSSG) glutathione, vitamins A, C, and E, and oxygen radical absorbance capacity (ORAC) were measured from a single venous blood sample from dogs with CHF secondary to DCM or chronic valvular disease (CVD) and in healthy controls. Nineteen dogs with CHF (14 CVD and 5 DCM) and 12 healthy controls were enrolled in the study. Concentrations of 8-F(2alpha)-isoprostane (CHF: 44.6 pg/mL [range, 27.1-98.0 pg/mL], controls: 25.3 pg/ mL [range, 11.1-80.4 pg/mL]) but not MDA (CHF: 4.11 microM [range, 1.89-6.39 microM], controls: 3.88 microM [range, 2.14-4.72 microM]) or protein carbonyls (0.69 nmol/mg protein [range, 0.37-1.67 nmol/mg protein], controls: 0.80 nmol/mg protein [range, 0.40-1.14 nmol/mg protein]) were significantly higher in the dogs with CHF than in the controls. Vitamin E concentration (CHF: 2,215 microg/ dL [range, 916-3,499 microg/dL], controls: 2,820 microg/dL [range, 1,738-3,775 microg/dL]) and GSH:GSSG (CHF: 12.0 [range, 3.69-30.1], controls: 22.7 [range, 12.5-227]) were significantly lower, whereas ORAC (CHF: 824 micromol Trolox equivalent/L [range, 304-984], controls: 497 micromol Trolox equivalent/L [range, 258-759]) and vitamin C (CHF: 0.90 mg/dL [range, 0.55-2.02 mg/dL], controls: 0.72 mg/dL [range, 0.43-0.85 mg/dL]) concentrations were higher in dogs with CHF than in controls. Vitamin A concentrations were not different between dogs with CHF and controls. No differences in any of the parameters were detected between dogs with DCM versus those with CVD. Some antioxidant defenses are decreased in dogs with CHF, and some biomarkers of oxidative stress are increased in dogs with CHF. The effect of dietary interventions to correct this imbalance in antioxidant defenses warrants further study.

Objective: To develop and evaluate a questionnaire (functional evaluation of cardiac health [FETCH] questionnaire) for assessing health-related quality of life in dogs with cardiac disease., Design: Prospective study., Animals: 360 dogs with cardiac disease, Procedure: The questionnaire was developed on the basis of widely accepted clinical signs of cardiac disease in dogs. A FETCH score was calculated by summing responses to questionnaire items; possible scores ranged from 0 to 85. For questionnaire validation, owners of 60 dogs were asked to complete the questionnaire and provide an overall assessment of their dogs' quality of life (16 owners completed the questionnaire twice). Disease severity was assessed with the International Small Animal Cardiac Health Council (ISACHC) classification for cardiac disease. Following validation, the final questionnaire was administered to owners of the remaining 300 dogs., Results: Internal consistency of the questionnaire was good, and the FETCH score was significantly correlated with the owner-reported quality-of-life score and with ISACHC classification. For owners that completed the questionnaire twice, scores were significantly correlated. During the second phase of the study, the FETCH score ranged from 0 to 70 (median, 7) and was significantly correlated with ISACHC classification, but did not vary significantly with underlying disease. For dogs examined twice, the change in FETCH score was significantly greater for dogs in which ISACHC classification improved than for dogs in which ISACHC classification was unchanged., Conclusions and Clinical Relevance: Results suggest that the FETCH questionnaire is a valid and reliable method for assessing health-related quality of life in dogs with cardiac disease.

We report a case of primary cardiac lymphoma in a cat, causing pericardial effusion. A 13-year-old castrated male Himalayan cat was evaluated for chronic weight loss and radiographic finding of cardiomegaly. Pericardial effusion and a heart mass were detected via echocardiography. Pericardiocentesis and ultrasound-guided fine needle aspirate of the heart mass were performed under sedation. Antemortem diagnosis of cardiac lymphoma was made based on cytology of pericardial fluid. Based on physical examination, laboratory tests and abdominal radiographs, primary cardiac lymphoma was established as the presumptive clinical diagnosis. Treatment with chemotherapeutic agents was initiated.

Infantile dilated cardiomyopathy (IDCM) in Portuguese water dogs (PWD) involves an autosomal recessive trait. Based on our previous studies we have tested the hypothesis that this disorder may be correlated with taurine deficiency. The plasma taurine levels of 249 puppies from 36 litters obtained from breeders at six and nine weeks of age, an early stage when usually the clinical symptoms are not manifested, were analyzed. Additional samples were collected from sixteen puppies that we raised from four litters. These litters were born to a dam that had low plasma taurine as a puppy and two known carrier sires. From the random samples obtained from the breeders, forty-eight pups from fourteen litters and twenty-nine pups from seven litters had low plasma taurine at least at one and at two time points, respectively. Also several puppies showing low plasma taurine died due to IDCM. Furthermore, from the sixteen pups we raised, fifteen had at least low taurine level at one and seven had at two time points. Considered together, these results strongly support the view that IDCM in PWD is associated with abnormal taurine metabolism that leads to low plasma taurine at early stages before the clinical symptoms appear.

Objective: To determine plasma malondialdehyde (MDA) and serum vitamin E concentrations in dogs with immune-mediated hemolytic anemia (IMHA) and healthy control dogs., Sample Population: Serum and plasma samples from 36 dogs with IMHA and 40 healthy control dogs., Procedure: Blood samples were collected from all study dogs. Plasma MDA concentrations were measured by use of a commercial colorimetric assay, and serum vitamin E concentrations (alpha-, gamma, and delta-tocopherol concentrations) were measured via high-performance liquid chromatography., Results: Plasma MDA concentrations were significantly higher in the dogs with IMHA than in the control dogs. Compared with control dogs, serum alpha-, gamma-, and &tocopherol concentrations were significantly lower in the IMHA-affected dogs., Conclusions and Clinical Relevance: Results indicated a state of oxidative stress and reduced antioxidant reserve in dogs with IMHA; this finding provides support for further investigation of the potential benefits of antioxidant treatment in dogs with this disease.

Objective: To determine duration of administration, complications, and frequency of aortic thromboembolism associated with administration of low molecular weight heparin (dalteparin) in cats., Design: Retrospective study., Animals: 57 cats treated with dalteparin, Procedure: Data were recorded from the medical records of cats treated with dalteparin, and owners were contacted by telephone for information regarding ease of administration and possible adverse effects., Results: Dalteparin was easily administered by owners. Median dose was 99 U/kg (45 U/lb) once or twice daily. Bleeding complications were infrequent. Of 43 cats with cardiomyopathy that received owner-administered dalteparin for a median follow-up time of 172 days, 8 cats developed documented or possible arterial thromboembolism., Conclusions and Clinical Relevance: Dalteparin was easily administered by owners and was well tolerated by cats. Whether dalteparin administration can reduce the frequency or severity of arterial thromboembolism is not yet known.

Objective: To establish a focused assessment with sonography for trauma (FAST) protocol in dogs, determine whether FAST can be performed by veterinary clinicians without extensive ultrasonographic experience, and assess the frequency of free fluid (as determined via FAST) in the abdominal cavity of dogs following motor vehicle accidents (MVAs)., Design: Prospective study., Animals: 100 client-owned dogs evaluated within 24 hours of an MVA., Procedure: Dogs were placed in lateral recumbency for the FAST examination. To detect fluid in the abdomen, 2 ultrasonographic views (transverse and longitudinal) were obtained at each of 4 sites (just caudal to the xiphoid process, on the midline over the urinary bladder, and at the left and right flank regions)., Results: In the 100 dogs evaluated via FAST, free abdominal fluid was detected in 45 dogs. In 40 of those 45 dogs, abdominocentesis was performed; hemoperitoneum and uroperitoneum were diagnosed in 38 and 2 dogs, respectively. Compared with dogs that had no free abdominal fluid detected via FAST, dogs that had free abdominal fluid detected via FAST had significantly higher heart rates and serum lactate concentrations and significantly lower PCVs and total solid concentrations., Conclusions and Clinical Relevance: Results indicate that FAST is a simple and rapid technique that can be performed on dogs in an emergency setting to detect intra-abdominal free fluid and can be performed by veterinary clinicians with minimal previous ultrasonographic experience.

Alterations in lymphocyte subpopulations and in other hematologic variables have been documented in people with heart failure. The purpose of the current study was to compare flow cytometric and hematologic variables in dogs with congestive heart failure (CHF) to healthy controls. CD4+ peripheral blood mononuclear cells (PBMC) and CD8+ lymphocytes were analyzed by flow cytometry, and white blood cell count, platelet count, hematocrit, and hemoglobin were determined by a complete blood count. Twenty-five dogs with CHF (International Small Animal Cardiac Health Council [ISACHC] class 2 [n = 12] and ISACHC class 3a [n = 13]) and 13 healthy controls were enrolled in the study. Compared with the controls, dogs with CHF had markedly lower percentages of CD4+ PBMC, CD8+ lymphocytes, hematocrit, and hemoglobin, but markedly higher leukocytes, neutrophils, and platelets. There were no differences in these variables between dogs with dilated cardiomyopathy (n = 6) and those with chronic valvular disease (n = 19). Dogs in ISACHC class 3a had a markedly lower total lymphocyte number, CD4+ and CD8+ cells, and hematocrit, but markedly higher leukocyte and neutrophil numbers relative to the control group. CD4+ and CD8+ subpopulations and other blood cell variables are altered in dogs with CHF. Future studies to determine possible clinical implications of these changes are warranted.

Cardiac troponin I (cTnI) and cardiac troponin T (cTnT) are sensitive and specific markers for myocardial ischemia and necrosis. Dogs with pericardial effusion frequently have myocardial ischemia and necrosis, and these changes are more severe in dogs with hemangiosarcoma (HSA). We investigated the utility of using serum cTnI and cTnT concentrations to identify the idiopathic pericardial effusion from that associated with HSA. Blood samples for measurement of cTnI and cTnT concentrations were collected before pericardiocentesis in 37 dogs with pericardial effusion. Eighteen dogs had a mass consistent with HSA, 6 dogs had idiopathic pericardial effusion, 1 dog had mesothelioma, and 1 dog had a heart base tumor. No final diagnosis was achieved for 11 dogs. Dogs with pericardial effusion had significantly higher serum concentrations of cTnI (P < .001) but not cTnT (P = .16) than did normal dogs. Dogs with HSA had significantly higher concentrations of cTnI (2.77 ng/dL; range: 0.09-47.18 ng/dL) than did dogs with idiopathic pericardial effusion (0.05 ng/dL; range: 0.03-0.09 ng/dL) (P < .001). There was no difference in the concentration of cTnT between dogs with HSA and those with idiopathic pericardial effusion (P = .08). Measurement of cTnI may be useful in helping to distinguish between idiopathic pericardial effusion and pericardial effusion caused by HSA.

Unlabelled: Desflurane has been identified as a weak triggering anesthetic of malignant hyperthermia that, in the absence of succinylcholine, may produce a delayed onset of symptoms. The prolonged interval after exposure may occur more than 6 h after the induction of anesthesia. The unintended underdosing of this patient with dantrolene and the prompt reversal of symptoms may be an attribute of the genetic expression of a weak triggering volatile anesthetic such as desflurane., Implications: There are multiple genetic variations for malignant hyperthermia (MH) at the ryanodine receptor. Desflurane, as a sole trigger of MH, is weak, and on two occasions in the literature (including this case), less than optimal doses of dantrolene were given with a good result. There may be possible to engineer the risk of MH out of an anesthetic once the genetics of the ryanodine receptor are better understood.

A 13-year-old dog was diagnosed with hypercalcemia of malignancy associated with adenocarcinoma of the anal sacs. Hypercalcemia was treated with intravenous (IV) 0.9% sodium chloride (NaCl), furosemide, calcitonin, and pamidronate. Hypomagnesemia was documented by 72 hours following a single, IV dose of pamidronate. The dog subsequently underwent surgery to remove the primary tumors, and multiple cardiac arrhythmias occurred during anesthesia. This case documents electrolyte abnormalities in a dog following treatment with pamidronate in conjunction with other therapies used to manage hypercalcemia. The authors postulate that hypomagnesemia may have contributed to the arrhythmias that occurred during anesthesia. Electrolyte abnormalities should be anticipated and corrected following pamidronate therapy in canine patients.

Objective: To determine the dietary patterns and intake of nutrients of concern in dogs with cardiac disease., Design: Prospective study., Animals: 82 dogs with dilated cardiomyopathy (DCM) or chronic valvular disease., Procedure: Owners of dogs were contacted and given a standardized telephone questionnaire regarding diet and a 24-hour food recall to determine daily intake of calories, protein, fat, sodium, potassium, and magnesium., Results: Among the 82 dogs, 71% had no congestive heart failure (CHF), and 29% had CHF or a history of CHF. Sixty-one percent of dogs had concurrent diseases. Anorexia was or had been evident in 34% of dogs and was significantly more common in the CHF group and in dogs with DCM. Most dogs (92%) received some treats and table food, with a median percentage of daily calories from treats of 19% (range, 0% to 100%). Most owners (57%) that administered pills used human or pet foods for pill administration. Most dogs ate more than the Association of American Feed Control Officials (AAFCO) minimum values for fat and protein. Daily sodium intake varied from 14 to 384 mg/100 kcal, compared with the AAFCO minimum of 17 mg/100 kcal. A median of 25% of total daily sodium came from treats and table food (range, 0% to 100%). Dogs with CHF ate significantly more sodium, compared with dogs with no CHF., Conclusions and Clinical Relevance: Dietary intake for dogs with cardiac disease is highly variable and often not optimal.

Fifty-five dogs received packed red blood cell (PRBC) transfusions for gastrointestinal (GI) hemorrhage during a 26-month period (1999 to 2001), accounting for 11.7% of the PRBC transfusions in that time. Thirty-nine (61%) dogs had an intestinal pathology (primary or secondary) as the cause of GI hemorrhage, including intestinal masses, gastroenteritis, hepatic disease, and renal disease. Nonsteroidal and steroidal anti-inflammatory drug use was found frequently in dogs with GI hemorrhage. Sixteen (39%) dogs were identified as having immune-mediated thrombocytopenia (IMT) and associated GI hemorrhage. Dogs with IMT received more transfusions of PRBC than nonIMT dogs (P<0.03) and received a significantly larger total volume of PRBC (P<0.01) during hospitalization.