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Galectin-3 (Gal-3) is a lectin associated with fibrosis and inflammation, and increased circulating concentrations are considered a risk factor for atrial fibrillation (AF) in humans. This retrospective study aimed to evaluate the serum concentration of Gal-3 in dogs with cardiac disease, both with and without AF. Dogs with AF associated with acquired heart diseases were selected, while cardiac healthy dogs and dogs with heart diseases but without AF served as controls. We statistically compared the serum concentration of Gal-3, which was assessed using a commercial canine-specific ELISA kit, among healthy dogs and dogs with heart disease with and without AF. Additionally, associations between Gal-3 and clinical and echocardiographic variables were evaluated. A total of 73 dogs were included, of which 17/73 (23.3%) were cardiac healthy and 56/73 (76.7%) had heart disease, with 26/56 (46.4%) having AF. No significant difference in Gal-3 concentration was found between cardiac healthy dogs (3.90 ± 1.65 ng/mL) and dogs with heart disease, either with or without AF (3.37 ± 1.04 ng/mL, p = 0.436 and 4.68 ± 1.80 ng/mL, p = 0.332, respectively). Gal-3 showed a significant positive correlation with age (r = 0.47, p < 0.001) and a negative correlation with body weight (r = −0.45, p < 0.001). The results of this study suggest that Gal-3 does not have an important role in the development of AF in dogs, but it is associated with advanced age.

Background: Transthoracic echocardiography represents the main noninvasive technique for evaluating cardiac morphology and function in dogs. In dogs with particular somatotypes, such as brachymorphic dogs, breed-specific echocardiographic values are needed for a proper echocardiographic interpretation. Nowadays, the Pug represents one of the most popular brachymorphic canine breeds worldwide. However, data on echocardiographic measurements in this breed are currently limited. Aim: We aimed to determine echocardiographic values in a population of apparently healthy Pugs, and to assess the possible effects of body weight, age, and sex on selected echocardiographic variables, with particular emphasis on those related to the left-sided cardiac chambers. Methods: Apparently healthy Pugs underwent a full physical examination, a one-minute six-lead electrocardiogram, and a complete transthoracic echocardiography. Twenty-four echocardiographic variables were measured combining M-mode, two-dimensional and Doppler modalities, and relative values were determined by applying the statistical procedures recommended by the Clinical and Laboratory Standards Institute. Moreover, the effect of selected demographic variables on echocardiographic measurements were tested using a linear mixed model. Results: The investigation included 86 Pugs. Echocardiographic values were provided for each variable and compared with previous veterinary literature. A statistically significant effect of body weight (e.g., end-systolic left ventricular diameter and absolute left atrial diameter), age, and sex was documented for several of the tested variables. Doppler examination demonstrated a trivial pulmonary regurgitation in 24/86 (27.9%) Pugs. Moreover, a persistent left cranial vena cava was suspected in 4/86 (4.7%) dogs. Conclusion: Echocardiographic features of the Pug were addressed and echocardiographic values made available for clinical use. Because our findings were obtained using a standardized echocardiographic analysis in a population of 86 healthy Pugs, they may act as a reliable guide for an accurate echocardiographic interpretation in this breed. [Open Vet J 2023; 13(8.000): 965-976]

Background: Furosemide is a mainstay of treatment in congestive heart failure (CHF) and is widely prescribed to dogs and cats by several formulations, including the subcutaneous one. In canine and human medicine, dermatologic adverse effects to subcutaneous furosemide (SF) have been documented; conversely, no prior case has been published describing skin reactions to this therapeutic protocol in cats. In this report, we describe, for the first time in feline medicine, a suspected dermatologic adverse effect after SF in a cat. Case Description: A 2-year-old domestic shorthair cat was presented for CHF associated with lung edema and pleural effusion. Echocardiography revealed asymmetric left ventricular myocardial thickening and severe left atrial dilation. The cat was hospitalized and initially treated with oxygen, intravenous furosemide and clopidogrel. After discharge, the route of administration of furosemide was switched from intravenous to oral. Within the following 2 weeks, the cat experienced two relapses of lung edema despite the progressive increase of furosemide dose, the addition of spironolactone and adherence to the therapeutic protocol by the owners. The dose of furosemide was further increased and its route of administration at home was switch from oral to parental. As the owner were not able to administrate intramuscular injections, SF was prescribed. This allowed preventing further episodes of lung edema. However, although the cat had never presented skin problems before, multiple well-defined circular, crusted ulcerative cutaneous lesions associated with alopecia developed at the sites of furosemide injections 2 weeks later. After ruling out several differential diagnoses for these lesions, a rare side effect to furosemide, not yet described in cats but already known in canine and human medicine, was strongly suspected as the possible cause. Therefore, the ongoing injectable formulation of furosemide was interrupted and substitute that with an alternative brand, maintaining the same dose and route of administration. Thanks to this change, the dermal ulcerations disappeared within 1 month. Subsequently, the cat experienced neither further skin problems nor recurrence of lung edema. Conclusion: Although SF is sometimes prescribed in small animal practice, it should be noticed that this may lead to dermatologic adverse reactions in the cat. [Open Vet J 2023; 13(8.000): 1027-1031]

Abstract Background Information regarding the frequency of L waves and their prognostic relevance in dogs with secondary atrial fibrillation (AF) is limited. Hypothesis/Objectives To determine whether L waves occur and ascertain their prognostic role, as well as the role of other clinical and echocardiographic variables in dogs with AF. Animals Fifty‐five dogs with AF associated with myxomatous mitral valve disease or dilated cardiomyopathy. Methods Retrospective, multicenter observational study. In addition to L waves analysis, other clinical and echocardiographic variables, including type of antiarrhythmic treatment, were evaluated. A survival analysis was performed to test for predictors of cardiac death and all‐cause mortality using Cox proportional hazards regression models. Results L waves were evident in 33/55 dogs (60%, 95% confidence interval [CI] = 47%‐72%) but their presence did not influence outcome. Increased left ventricular end‐systolic diameter normalized for body weight (LVSDn) was a significant predictor of both cardiac death (hazard ratio [HR] = 4.41, 95% CI = 1.18‐16.54; P = .03) and all‐cause mortality (HR = 9.39, 95% CI = 2.49‐35.32; P

Abstract Background Dogs with myxomatous mitral valve disease (MMVD) can experience progressive renal tubular damage and dysfunction. The prevalence of renal tubular damage is not known in dogs with stable MMVD. Objective To evaluate renal tubular damage in dogs with stable MMVD by evaluation of urinary neutrophil gelatinase‐associated lipocalin (NGAL). Animals Ninety‐eight MMVD dogs grouped according to the American College of Veterinary Internal Medicine (ACVIM) staging (group B1, n = 23; group B2, n = 27; group C + D, n = 48) and 46 healthy dogs. Methods Multicenter prospective observational study. Serum and urine chemistry including NGAL reported as uNGAL concentration (uNGAL) and normalized with urinary creatinine (uNGALC) were compared between MMVD dogs and healthy controls, and among different MMVD ACVIM stages. Results The MMVD dogs had significantly higher uNGAL and uNGALC (1204 pg/mL; range, 30‐39 732 and 1816 pg/mg; range, 22‐127 693, respectively) compared to healthy dogs (584 pg/mL; range, 56‐4072 and 231 pg/mg; range, 15‐2407, respectively; P = .002 and P

IntroductionAtrial fibrillation secondary to dilated cardiomyopathy (DCM) frequently affects large-breed dogs. The aim of the present study was to identify risk factors for the development of atrial fibrillation in dogs of different breeds with an echocardiographic diagnosis of DCM.MethodsIn this multicenter retrospective study, we searched the electronic databases of five cardiology referral centers for dogs with an echocardiographic diagnosis of DCM. A comparison of clinical and echocardiographic variables was performed between dogs developing atrial fibrillation and those not developing atrial fibrillation and the ability to distinguish between these two groups of dogs was evaluated by receiver operating characteristic curve analysis. Univariate and multivariable logistic regression analysis estimated the odds ratio (OR) with 95% confidence interval (CI) of developing atrial fibrillation.ResultsWe included 89 client-owned dogs with occult and overt echocardiographic DCM. Of these, 39 dogs (43.8%) had atrial fibrillation, 29 dogs (32.6%) maintained a sinus rhythm, and 21 dogs (23.6%) showed other cardiac arrhythmias. Left atrial diameter had high accuracy (area under the curve = 0.816, 95% CI = 0.719–0.890) to predict the development of atrial fibrillation at the cut-off of >4.66 cm. After multivariable stepwise logistic regression analysis, only increased left atrial diameter (OR = 3.58, 95% CI = 1.87–6.87; p < 0.001) and presence of right atrial enlargement (OR = 4.02, 95% CI = 1.35–11.97; p = 0.013) were significant predictors of atrial fibrillation development.DiscussionAtrial fibrillation is a common complication of DCM in the dog and is significantly associated with increased absolute left atrial diameter and right atrial enlargement.

Case series summary In this report, we provide detailed clinical, laboratory, electrocardiographic and echocardiographic descriptions of two Toxoplasma gondii -positive cats diagnosed with transient myocardial thickening (TMT) and acute myocardial injury (MI). In both cases, aetiological diagnosis was based on the antibody screening test (all cats had IgM titres ⩾1:64) and MI was demonstrated by a concomitant severe increase of the serum concentration of cardiac troponin I (5.1–23.6 ng/ml; upper hospital limit

Abstract Background Atrial fibrillation (AF) occurs in dogs with myxomatous mitral valve disease (MMVD) as a consequence of left atrial (LA) dilatation, and it affects survival and quality of life. Objectives To evaluate the usefulness of echocardiography in predicting the first occurrence of AF in dogs with MMVD. Animals Forty‐four client‐owned dogs with MMVD, 22 dogs that developed AF, and 22 dogs that maintained sinus rhythm. Methods Retrospective observational study. Medical databases were reviewed for dogs that developed AF during the year after diagnosis of MMVD (AF group). The last echocardiographic examination obtained while still in sinus rhythm was used to derive selected variables. For each dog with AF, a control dog matched for body weight, class of heart failure, and LA dimension was selected. Echocardiographic results including LA volumes and LA speckle tracking echocardiography (STE)‐derived variables were measured. Results Among the tested echocardiographic variables, only LA diameter (P = .03) and left ventricular internal diameter in diastole (P = .03) differed significantly between groups, whereas body weight‐indexed variables of cardiac dimension as well as LA volumes and volume‐derived functional variables were not different. Among the STE‐derived variables, peak atrial longitudinal strain (PALS) results differed significantly between the AF group (23.8% ± 8.6%) and the control group (30.5% ± 9.6%; P = .03). A value of PALS ≤28% predicted AF occurrence with sensitivity and specificity of 0.80 and 0.65, respectively. Conclusions and Clinical Importance Absolute cardiac diameters and LA STE (in particular, PALS) are useful echocardiographic predictors for the development of AF in dogs with MMVD.

Specific microRNAs expressions may accurately characterize different stages of canine myxomatous mitral valve disease. This preliminary pilot study aimed to (1) describe the clinical and echocardiographic parameters of Cavalier King Charles Spaniels affected by myxomatous mitral valve disease at different American College of Veterinary Internal Medicine (ACVIM) stages (B1, B2 and C) and healthy control group (ACVIM A), comparing the parameters collected during the first examination (T0) and the end of the follow-up (T1); (2) assess the association between the values of echocardiographic parameters at T1 and the expression profile of miR-30b-5p at T0. Thirty-five Cavalier King Charles Spaniels (median age 4.29 years and median weight 9 Kg) in different ACVIM stages were included (7 A, 19 B1, 6 B2 and 3 C). Inverse probability weighting analysis was performed to estimate the association of the exposure variable (miR-30b-5p) with the outcome variables (clinical and echocardiographic variables). Time was included as variable. The results pointed out that high levels of plasma miR-30b-5p corresponded to lower values of left ventricular end-diastolic diameter normalized for body weight, end-diastolic and end-systolic volumes indexed for body weight, and left atrium-to aortic root ratio. Hence, higher miR-30b-5p expressions were associated with milder forms of mitral valve disease in our study population. In contrast, the results obtained for the intensity of heart murmur, the mitral regurgitation severity, and the Mitral INsufficiency Echocardiographic score) were not statistically significant. A relationship between high abundance of miR-30b-5p and myxomatous mitral valve disease that appear echocardiographically more stable over time has been demonstrated. In conclusion, Cavalier King Charles Spaniels affected by myxomatous mitral valve disease that at the first cardiologic evaluation showed an upregulation of miR-30b-5p are expected to experience lesser variations on their echocardiographic examination between T0 and T1.

Plasmatic dimethylarginines, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) are considered biomarkers of endothelial and renal dysfunction, respectively, in humans. We hypothesize that plasmatic concentration of dimethylarginines in dogs with myxomatous mitral valve disease (MMVD) is influenced by heart disease stage. Eighty-five client-owned dogs with MMVD, including 39, 19, and 27 dogs in ACVIM stages B1, B2, and C+D, respectively, and a control group of 11 clinically healthy dogs were enrolled. A prospective, multicentric, case-control study was performed. Each dog underwent a complete clinical examination, arterial blood pressure measurement, thoracic radiography, six-lead standard electrocardiogram, transthoracic echocardiography, CBC, biochemical profile, and urinalysis. Plasmatic concentration of dimethylarginines was determined through high-performance liquid chromatography coupled with tandem mass spectrometry. Median ADMA was significantly increased in dogs of group C+D (2.5 μmol/L [2.1–3.0]) compared to those of group B1 (1.8 μmol/L [1.6–2.3]; p < 0.001) and healthy dogs (1.9 μmol/L [1.7–2.3]; p = 0.02). Median SDMA was significantly increased in dogs of group C+D (0.7 μmol/L [0.5–0.9]) compared to those of groups B1 (0.4 μmol/L [0.3–0.5]; p < 0.001), B2 (0.4 μmol/L [0.3–0.6]; p < 0.01), and the control group (0.4 μmol/L [0.35–0.45]; p = 0.001). In the final multivariable analysis, ADMA and SDMA were significantly associated with left atrium to aorta ratio (p < 0.001), and creatinine (p < 0.001), respectively. Increased plasmatic concentrations of dimethylarginines suggest a possible role as biomarkers of disease severity in dogs with decompensated MMVD.

A six-year-old Cavalier King Charles spaniel was referred with a two-month history of severe exercise intolerance and syncope. Clinical signs had developed during a local wave of coronavirus disease (COVID-19) two weeks after its family members had manifested symptoms of this viral disease and their positivity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed. Cardiologic assessment documented myocardial injury complicated by systolic dysfunction. An extensive diagnostic work-up allowed us to rule out common causes of myocardial compromise, both infective and not. Accordingly, serological and molecular tests aimed at diagnosing SARS-CoV-2 infection were subsequently performed, especially in light of the dog’s peculiar history. Results of such tests, interpreted in the light of previous findings and current knowledge from human medicine, supported a presumptive diagnosis of COVID-19-associated myocardial injury, a clinical entity hitherto poorly described in this species.

The Lorenz plot (LP), a graphical representation of heart rate variability, has been poorly studied in dogs to date. The present study aimed to describe the graphic features of LP in dogs with sinus rhythm (SR) and tachyarrhythmias, and to analyze the usefulness of its pattern recognition. One hundred and nineteen canine Holter recordings were retrospectively evaluated. Cardiac rhythms were classified as: SR; SR with frequent (>100) premature ectopies (atrial, SR-APCs; ventricular, SR-VPCs; atrial and ventricular, SR-APCs-VPCs); atrial fibrillation (AF); and AF with frequent VPCs (AF-VPCs). Lorenz plots were studied qualitatively and quantitatively, and classified by distinct LP patterns (LPPs). Repeatability and reproducibility of LPP classification and diagnostic value were determined. Recordings included: 48 SR, 9 SR-APCs, 35 SR-VPCs, 5 SR-APCs-VPCs, 4 AF, and 18 AF-VPCs. Ten LPPs were identified: comet (n = 12), torpedo (n = 3), Y-shaped (n = 6), diamond (n = 10), diamond with a central silent zone (n = 17), double side-lobe (DSL) (n = 47), triple side-lobe (n = 1), quadruple side-lobe (n = 2), fan (n = 18), and fan with DSL (n = 3). Repeatability and reproducibility of LPP classification were excellent. The DSL pattern was both highly sensitive (91.3%) and specific (94.5%) for SR with frequent premature ectopies, either APCs, or VPCs, or both. The remaining LPPs had lower diagnostic value (high specificity but low sensitivity). Distinct rhythms imprint distinct and reproducible LPPs in dogs. The majority of canine LPPs are specific but insensitive indicators of SR and tachyarrhythmias.

A 2-year-old Boxer with a history of subaortic stenosis and immunosuppressant therapy developed aortic valve infective endocarditis. On echocardiographic examination with simultaneous electrocardiographic tracing, multiple uncommon periannular complications of the aortic valve endocarditis were found, including aorto-cavitary fistula with diastolic left-to-right shunt, tricuspid valve endocarditis, and third-degree atrioventricular block. Necropsy confirmed the above echocardiographic findings. Although aortic valve endocarditis represents a well-known disease entity in dogs, the dynamic nature of this condition may allow development of complex and uncommon echocardiographic features.

An amendment to this paper has been published and can be accessed via the original article.

A 3‐month‐old, intact female Czechoslovakian wolfdog was referred for growth retardation. General physical examination revealed an IV/VI left basilar continuous murmur, a body condition score of 3/9, body weight 2.2 kg, and dermatological alterations. Transthoracic echocardiography diagnosed patent duct arteriosus. Genetic testing revealed that the dog had a LHX3 mutation, and the low concentration of insulin‐like growth factor 1 confirmed the diagnosis of pituitary dwarfism. The endocrine disorder was treated with levothyroxine, and the congenital heart disease was corrected interventionally, leading to a net improvement in the clinical condition. After 3 years, the dog was referred for polyuria, polydipsia, polyphagia and alopecia. Diagnostic workup revealed pituitary‐dependent hypercortisolism due to a pituitary macroadenoma. In addition to levothyroxine, the dog was treated with trilostane with resolution of the clinical signs. [ABSTRACT FROM AUTHOR]