Seol-Gi Park

Metanephrine-secreting adrenocortical carcinoma has been rarely described in humans and, to our knowledge, has not been previously confirmed in dogs. A 12-year-old castrated male Maltese was referred for an incidentally detected left adrenal mass. The dog had persistent systemic hypertension (160-210 mmHg) and urinary normetanephrine and metanephrine-to-creatinine ratios above the reference range, findings suggestive of pheochromocytoma. Computed tomography revealed a homogeneously enhancing adrenal mass without overt vascular invasion. After preoperative phenoxybenzamine therapy, laparoscopic adrenalectomy was performed. Histopathology demonstrated adrenocortical carcinoma with vascular tumor emboli. Immunohistochemistry demonstrated diffuse Melan-A positivity and chromogranin A negativity, with synaptophysin immunoreactivity in corresponding tumor regions on serial sections, supporting adrenocortical origin with partial neuroendocrine differentiation. Postoperatively, urinary catecholamine metabolite concentrations normalized, and serial blood pressure monitoring at approximately monthly re-evaluations documented no recurrence of systemic hypertension without antihypertensive therapy over an 11-month postoperative follow-up period, supporting the adrenal cortical tumor as the source of the preoperative biochemical and hemodynamic abnormalities.

Background: Gastric dilatation (GD) and heartworm disease (HW) can significantly impact cardiovascular function, necessitating timely intervention. This study evaluated hemodynamic changes in these conditions using impedance cardiography (ICG), a non-invasive technique for real-time monitoring. Methods: Cardiac parameters were measured using ICG in healthy controls, HW, and GD groups at baseline, during intervention, and post-treatment. Statistical analyses involved repeated measures ANOVA with post hoc comparisons, and relative changes (%) quantified hemodynamic improvements. Results: A significant increase in cardiac index (CI) occurred post-treatment in both HW (+14.71%, p = 0.0102) and GD (+28.53%, p = 0.0336) groups. Cardiac output (CO) exhibited an increasing trend, though without significance (p > 0.05). Mean arterial pressure (MAP) remained stable, although the GD group exhibited an upward trend post decompression (p = 0.1213). Conclusions: Heartworm extraction and gastric decompression induced measurable cardiovascular improvements, with distinct recovery patterns. Non-invasive monitoring effectively captured cardiovascular changes, suggesting its utility as an adjunctive tool in clinical assessment.

Heartworm (HW) disease, caused by Dirofilaria immitis, is a life-threatening ailment in dogs. HW disrupts blood flow and decreases cardiac output (CO). The accurate monitoring of CO during HW extraction is pivotal for patient survival and overall health. Objective: This study aimed to assess the efficacy of using impedance cardiography (ICG) as a non-invasive approach for monitoring CO during interventional HW extraction. Methods: Two cases of HW infections were treated via surgical extraction. The CO and mean arterial pressure (MAP) were monitored using the ICG technique during the anesthesia stabilization, extraction process, and post-extraction phases. Results: In Case 1, the CO increased by 115% post-procedure, and in Case 2, the CO increased by 116%. In contrast, the MAP varied between the two cases. The ICG method provided real-time CO data without major disruptions during the extraction surgery. Conclusion: The ICG technique for CO monitoring during interventional HW extractions is effective.

Park SG, et al. J Vet Sci. 2021 Feb;22(2):e16. https://doi.org/10.4142/jvs.2021.22.e16