Matheus Matioli Mantovani

Eisenmenger syndrome is a severe complication of uncorrected congenital cardiac defects characterized by pulmonary arterial hypertension and right-to-left shunting. Three dogs were evaluated for clinical signs consistent with this condition, including syncope, cyanosis, exercise intolerance, and respiratory distress. Two dogs were diagnosed with Eisenmenger syndrome secondary to reversed patent ductus arteriosus, and one dog was diagnosed with Eisenmenger syndrome secondary to a ventricular septal defect. All dogs underwent clinical evaluation, hematologic testing, and Doppler echocardiography, which identified shunt reversal, right ventricular remodeling, pulmonary artery dilation, and additional findings consistent with advanced pulmonary arterial hypertension. Differential cyanosis was observed in dogs with reversed patent ductus arteriosus, whereas generalized cyanosis predominated in the dog with ventricular septal defect. Medical management was instituted in all cases using sildenafil citrate, with dose adjustments required during follow-up in two dogs. One dog with ventricular septal defect developed marked secondary erythrocytosis requiring therapeutic phlebotomy and adjunctive hydroxyurea therapy. Clinical improvement was observed after initiation of treatment, including reduction or resolution of syncopal episodes and improvement in exercise tolerance. Two dogs maintained prolonged clinical stability for up to two years following diagnosis. Outcomes were variable and were not clearly predicted by initial hematologic severity in this small series. These cases illustrate the clinical heterogeneity and unpredictable outcome of Eisenmenger syndrome in dogs and suggest that individualized medical management, centered on sildenafil titration and monitoring of secondary erythrocytosis, may support prolonged clinical stability in selected patients.

The cardiac evaluation of wild animals is still a wide and largely unknown field for several species. Thus, the objectives of this study were to evaluate cardiac function through echocardiography and obtain echocardiographic values for crab-eating foxes under pharmacological restraint. This study was done with eight males and two females under pharmacological containment of intramuscular acepromazine with meperidine followed by intravenous propofol. In the two-dimensional mode, the diameter of the aorta and left atrium and the LA/Ao ratio were obtained. In M-mode, the internal diameter of the left ventricle was measured during diastole and systole, and the shortening fraction was calculated. In the transmitral flow using the pulsed Doppler mode, we analyzed the E-wave velocity peak, A-wave velocity peak, and E/A ratio. The analysis of the isovolumetric relaxation time was performed in the apical view of five chambers using an intermediate flow between mitral influx and aortic flow, and the E-wave deceleration time was calculated. The measurements of position and dispersion of all variables were calculated, and the respective confidence intervals were set at 95%. The Doppler echocardiographic values are closer to domestic dogs, the left ventricle internal diameter in diastole was lower, and the ejection fraction was closer to that of maned wolf (Chrysocyon brachyurus). Cardiology parameters found in this study can be used as specific values for this species in the evaluation of cardiac function, as well as in other additional studies in wild animal cardiology.

Background: The use of doxorubicin in chemotherapy has been associated with cardiotoxicity and heart failure. Physical exercise produces favorable morphofunctional adaptations in the cardiovascular system and may reverse cardiac dysfunction in patients undergoing chemotherapy. Objective: To assess the effects of physical training on myocardial structure, cardiac function, and exercise tolerance in Wistar rats initiated after the onset of cardiotoxicity-induced cardiotoxicity. Methods: This study investigated 30 adult male Wistar rats randomly divided into four groups: control (C), exercise (EX), doxorubicin [...] Abstract Background: The use of doxorubicin in chemotherapy has been associated with cardiotoxicity and heart failure. Physical exercise produces favorable morphofunctional adaptations in the cardiovascular system and may reverse cardiac dysfunction in patients undergoing chemotherapy. Objective: To assess the effects of physical training on myocardial structure, cardiac function, and exercise tolerance in Wistar rats initiated after the onset of cardiotoxicity-induced cardiotoxicity. Methods: This study investigated 30 adult male Wistar rats randomly divided into four groups: control (C), exercise (EX), doxorubicin

A tetralogia de Fallot é uma doença cardíaca congênita caracterizada por quatro alterações, sendo elas a dextroposição da aorta, defeito do septo interventricular, hipertrofia concêntrica do ventrículo direito e estenose da valva pulmonar. O objetivo deste trabalho foi relatar um caso de tetralogia de Fallot em um cão da raça Shih Tzu. Um canino, da raça Shih Tzu, de 1 ano e 6 meses de idade, foi atendido com queixa principal de episódios de desmaio e dificuldade de respirar que se iniciaram aos 6 meses de idade. Foi realizada oxigenoterapia para estabilizar a angústia respiratória do animal, e o paciente foi encaminhado para ecodopplercardiograma no qual foi constatada a presença das quatro alterações condizentes com a tetralogia de Fallot, o grau de estenose pulmonar foi classificado como moderado e no hemograma foi evidenciada a presença de policitemia absoluta. Como o animal apresentou hematócrito acima de 70% foi indicada a flebotomia e o uso do propanolol na dose de 0,5 mg/Kg, três vezes ao dia como indicado na literatura. Após o tratamento foi observada melhora do quadro clínico. Na impossibilidade de acompanhar o paciente aumentou-se a dose de propranolol para 1mg/Kg/ a cada 8 horas. O caso relatado contribuiu para a literatura escassa sobre essa enfermidade em pequenos animais, especialmente na raça Shih Tzu.

Bacterial urinary tract infections (UTI) are among the most frequent infectious diseases of small animals. Although antimicrobial therapy is recommended for treating bacterial UTIs, the current consensus is that treatment may not be necessary for asymptomatic animals. The aim of this study was to evaluate the diagnostic ability of urinalysis to detect bacteriuria and to compare it with urine culture (gold standard method) to assess the risk of false-positive results. A retrospective study was conducted from January 2016 to July 2019 and urine samples of 119 dogs were analyzed. Diagnostic validation was performed for urinalysis, based on the morphological classification and intensity of bacteriuria. Agreement between the results was assessed using the kappa (k) index. When the presence of cocci was used as a diagnostic criterion to suggest bacteriuria, it was observed that the agreement (k = -0.006) was lower than that expected by chance. However, a poor agreement (k = 0.22) was also found for bacilli during urinalysis (k = 0.23). A significant degree of agreement was observed in cases with high intensity of bacteriuria. Therefore, urine culture must be performed for conclusive evidence of bacteriuria to avoid false-positive results during urinalysis.

Microcirculatory disorders are one of the most common systemic alterations in septic patients, which can occur even in the presence of normal macro-hemodynamic parameters. Several anesthetic protocols have been indicated for sepsis. A drug frequently used in critically ill human patients is dexmedetomidine, a potent and selective alpha 2-agonist with sedative, analgesic and muscle relaxant properties that promotes blood pressure increase and peripheral vasoconstriction. The objective of the present study was to compare dexmedetomidine and fentanyl constant rate infusions in septic dogs using microcirculatory, hemodynamic and metabolic parameters. Thirty-three bitches with pyometra submitted to therapeutic ovariohysterectomy (OHE) and triaged with the quick SOFA score were included in the study. The animals were randomized into two groups treated with either dexmedetomidine (3 μg/kg/h) or fentanyl (5 μg/kg/h) constant rate infusions during isoflurane anesthesia and under mechanical ventilation. Hemodynamic, microcirculatory, ventilatory and metabolic parameters were recorded before, during and after anesthesia. The data were submitted to a normality test, then groups were compared using the unpaired Wilcoxon test or the t student test when necessary. All microcirculatory parameters were not significantly different between groups. Dexmedetomidine constant rate infusion provided superior blood pressure values and lactate clearance results, suggesting that it did not impair peripheral oxygen transport and organ perfusion, and both groups had similar clinical outcomes such as mortality and occurrence of hypotension and bradyarrhythmias. Similar values of microcirculatory parameters and higher blood pressure demonstrated that dexmedetomidine does not compromise microcirculation compared to fentanyl, it improves macro-hemodynamics instead.

Cardiac output (CO) is an important haemodynamic parameter to monitor in patients during surgery. However, the majority of the techniques for measuring CO have a limited application in veterinary practice due to their invasive approach and associated complexity and risks. Transoesophageal echocardiography (TEE) is a technique used to monitor cardiac function in human patients during surgical procedures and allows CO to be measured non-invasively. This prospective clinical study aimed to compare the transoesophageal echocardiography using a transgastric view of the left ventricular outflow tract (LVOT) and the thermodilution (TD) technique for the assessment of CO during mean arterial pressure of 65–80 mmHg (normotension) and <65 mmHg (hypotension) in dogs undergoing elective surgery. Eight dogs were pre-medicated with acepromazine (0.05 mg/kg, IM), tramadol (4 mg/kg, IM) and atropine (0.03 mg/kg, IM), followed by anaesthetic induction with propofol (3–5 mg/kg IV) and maintenance with isoflurane associated with a continuous infusion rate of fentanyl (bolus of 3 μg/kg followed by 0.3 μg/kg/min). The CO was measured by TEE (COTEE) and TD (COTD) at the end of expiration during normotension and hypotension (induced by isoflurane). There was a strong positive correlation between COTEE and COTD ​​(r = 0.925; P < 0.0001). The bias between COTD and COTEE was 0.14 ± 0.29 L/min (limits of agreement, −0.44 to 0.72 L/min). The percentage error of CO measured by the two methods was 12.32%. In addition, a strong positive correlation was found between COTEE and COTD during normotension (r = 0.995; P < 0.0001) and hypotension (r = 0.78; P = 0.0223). The results of this study indicated that the transgastric view of the LVOT by TEE was a minimally invasive alternative to clinically monitoring CO in dogs during anaesthesia. However, during hypotension, the CO obtained by TEE was less reliable, although still acceptable.