Clinica Veterinaria Gran Sasso

Milano, Italy

Clinica Veterinaria Gran Sasso

Milano, Italy
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Domenech O.,Clinica Veterinaria Gran Sasso | Silva J.,Clinica Veterinaria Gran Sasso | Oliveira P.,Clinica Veterinaria Gran Sasso | Sala E.,Busto Arsizio Hospital | Bussadori C.,Clinica Veterinaria Gran Sasso
Journal of Veterinary Cardiology | Year: 2011

Objectives: Determine whether valve morphology, pulmonary annulus diameter, aortic/pulmonic annulus ratio, balloon-to-annulus ratio (BAR), pre-pulmonary balloon valvuloplasty (PBV), Doppler gradient, and residual Doppler gradient are independent predictors of immediate and long-term results after PBV in dogs as in humans. Animals, materials and methods: Retrospective study. Medical records of dogs that underwent PBV, from January 1999 to December 2008 were reviewed. All dogs with pre- and immediate (24 h) post-PBV echocardiographic examination were included. 126 dogs were selected. Immediate outcome was optimal when the dog survived the PBV and Doppler gradient was ≤50 mmHg. Long-term outcome (1 year) was optimal when the dog survived at least 1-year follow-up without symptoms and Doppler gradient was ≤50 mmHg. Results: Only pre-PBV Doppler gradient was identified as a significant independent predictor of immediate results (P < 0.001; OR 0.97, CI 0.96-0.98). Pre-PBV Doppler gradient and residual Doppler gradient were the only independent predictors of long-term results (P = 0.036; OR 0.98, CI 0.96-0.99 and P = 0.005; OR 0.95, CI 0.92-0.98, respectively). Conclusion: In dogs as in humans higher pre-PBV Doppler gradient is one of the most important independent predictor of suboptimal immediate and long-term results after PBV and must be considered before scheduling this procedure. Moreover higher valvar residual Doppler gradient is an important independent predictors of suboptimal long-term results. © 2010 Elsevier B.V. All rights reserved.

Bussadori R.,Clinica Veterinaria Gran Sasso | Provera A.,Clinica Veterinaria Gran Sasso | Martano M.,Ospedale DidatticoVeterinario ODV | Morello E.,Ospedale DidatticoVeterinario ODV | And 5 more authors.
Veterinary Journal | Year: 2011

Conventional treatment of idiopathic chylothorax (IC) involves thoracic duct (TD) ligation (with/without lymphagiography) combined with subphrenic pericardiectomy. Nine dogs and four cats with IC, which received intrathoracic omentalisation with TD en bloc ligation (not preceded by lymphangiography) and subphrenic pericardiectomy, were evaluated retrospectively. Seven of nine dogs and 3/4 cats were still alive and disease-free at the time of reporting (range 10-53 and 19-31. months, respectively). Clinical signs of IC did not decrease after the first surgery in one cat and one dog; in another dog clinical signs recurred after 5. months. Overall efficacy rate of this one-stage combined procedure was 77% (6. months), 73% (12. months), and 57% (24. months). Where a second surgery was performed in case of failure, the success rate in dogs was 89% (6. months) and 80% (24. months). Addition of pleural omentalisation to TD en bloc ligation and subphrenic pericardiectomy does not seem to improve results when compared with published data and at present does not seem advisable as a first choice. © 2010 Elsevier Ltd.

PubMed | University of Minnesota, Royal Veterinary College University of London, University of Pennsylvania, Clinica Veterinaria Gran Sasso and 9 more.
Type: Consensus Development Conference | Journal: The Journal of small animal practice | Year: 2015

There is a growing understanding of the complexity of interplay between renal and cardiovascular systems in both health and disease. The medical profession has adopted the term cardiorenal syndrome (CRS) to describe the pathophysiological relationship between the kidney and heart in disease. CRS has yet to be formally defined and described by the veterinary profession and its existence and importance in dogs and cats warrant investigation. The CRS Consensus Group, comprising nine veterinary cardiologists and seven nephrologists from Europe and North America, sought to achieve consensus around the definition, pathophysiology, diagnosis and management of dogs and cats with cardiovascular-renal disorders (CvRD). To this end, the Delphi formal methodology for defining/building consensus and defining guidelines was utilised.Following a literature review, 13 candidate statements regarding CvRD in dogs and cats were tested for consensus, using a modified Delphi method. As a new area of interest, well-designed studies, specific to CRS/CvRD, are lacking, particularly in dogs and cats. Hence, while scientific justification of all the recommendations was sought and used when available, recommendations were largely reliant on theory, expert opinion, small clinical studies and extrapolation from data derived from other species.Of the 13 statements, 11 achieved consensus and 2 did not. The modified Delphi approach worked well to achieve consensus in an objective manner and to develop initial guidelines for CvRD.The resultant manuscript describes consensus statements for the definition, classification, diagnosis and management strategies for veterinary patients with CvRD, with an emphasis on the pathological interplay between the two organ systems. By formulating consensus statements regarding CvRD in veterinary medicine, the authors hope to stimulate interest in and advancement of the understanding and management of CvRD in dogs and cats. The use of a formalised method for consensus and guideline development should be considered for other topics in veterinary medicine.

PubMed | University of Turin, Clinica Veterinaria Gran Sasso and Clinica Veterinaria Rome Sud
Type: Journal Article | Journal: The Journal of small animal practice | Year: 2015

To describe a modified technique of semitendinosus muscle transposition for the repair of ventral perineal hernia.Retrospective review of case records of dogs with ventral perineal hernia that were treated by transposing the medial half of the longitudinally split semitendinosus muscle of one limb. The transposition of the internal obturator muscle was used when uni- or bilateral rectal sacculation was also present in addition to ventral perineal hernia; colopexy and vas deferens pexy were also performed.Fourteen dogs were included. In addition to ventral perineal hernia, unilateral and bilateral perineal hernia was also present in five and six of the dogs, respectively. The mean follow-up time was 890 days. Ventral perineal hernia was successfully managed by the modified semitendinosus muscle transposition with minor complications in all the dogs included in the study.Despite the small number of dogs included, the unilateral transposition of the medial half of the longitudinally split semitendinosus muscle consistently supported the ventral rectal enlargement in perineal hernia without obvious adverse effects.

Di Marcello M.,Centro Medico Veterinario Cellatica | Terzo E.,University College Dublin | Locatelli C.,University of Milan | Palermo V.,University of Edinburgh | And 5 more authors.
Journal of Veterinary Internal Medicine | Year: 2014

Background: Quantitative and semiquantitative methods have been proposed for the assessment of MR severity, and though all are associated with limitations. Measurement of vena contracta width (VCW) has been used in clinical practice. Objective: To measure the VCW in dogs with different levels of MR severity. Animals: Two hundred and seventy-nine dogs were classified according to 5 levels of MR severity. Methods: This was a retrospective study. EROA and regurgitant volume calculated by the PISA method, were measured and indexed to BSA. Descriptive statistics were calculated for VCW and VCW index for all categories of MR severity. Spearman's rank correlation coefficients (ρs) were calculated to compare the results of the different methods (VCW and VCW index vs RV PISA, RV PISA index, EROA, EROA index), and between VCW and VCW index versus MR severity. Results: All Spearman's rank correlation coefficients were significant (P < .001). The median values of VCW resulted of 2.9 mm (IQR 3.4-2.5) and of 4.6 mm (IQR 5.4-4.1) in the groups previously classified as mild-to-moderate and moderate-to-severe, respectively. The median values of VCW index resulted of 4.4 mm/m2 (IQR = 5.5-4.2) in mild-to-moderate MR and of 10.8 mm/m2 (IQR = 12.8-9.4) in moderate-to-severe MR. Conclusion and Clinical Importance: This is not a validation study against any previously validated invasive gold standard, the VCW method has proved easy to employ and it might be an additional tool in quantifying disease severity that supports, rather than replace, data coming from other techniques in daily clinical practice and research. © 2014 by the American College of Veterinary Internal Medicine.

PubMed | Clinica Veterinaria Gran Sasso and University of Milan
Type: Journal Article | Journal: Journal of veterinary internal medicine | Year: 2016

Patent ductus arteriosus (PDA) is one of the most common congenital heart defects in dogs. Advanced echocardiographic techniques such as speckle-tracking echocardiography (STE) have not been extensively used to evaluate cardiac function in affected dogs.Advanced echocardiographic techniques are more sensitive than standard echocardiographic techniques in analyzing systolic function in dogs with PDA.Forty-four client-owned dogs: 34 dogs with PDA (preoperative evaluation) and 10 healthy sex- and weight-matched controls.Prospective study. Dogs were recruited over a 2-year period. Complete echocardiographic evaluation was performed, including conventional (end-diastolic volumes indexed to body surface area in B and M-mode [EDVIB /M ], end-systolic volumes indexed to body surface area in B and M-mode [ESVIB /M ], allometric scaling in diastole and systole [AlloD/S], pulmonary flow to systemic flow [Qp/Qs], ejection fraction [EF] and fractional shortening [FS]) and speckle-tracking echocardiography ([STE]: global longitudinal, radial and circumferential strain [S] and strain rate [SR]).Dogs with PDA had significantly different EDVIB /M , ESVIB /M , AlloD/S, Qp/Qs and all STE-derived parameters (global longitudinal S and SR, global circumferential S and SR, global radial S and SR)compared to healthy dogs. No correlation was found between standard techniques (EDVIB /M , ESVIB /M , AlloD/S, Qp/Qs) and STE-derived parameters (global longitudinal, circumferential and radial S and SR).Conventional parameters routinely used to assess systolic function (EF and FS) were not different between the groups; STE-derived parameters identified subtle changes in cardiac systolic function and contractility between the 2 groups of dogs. Based on these findings, STE may be a more appropriate tool to assess cardiac contractility in dogs with PDA.

PubMed | Clinica Veterinaria Gran Sasso and University of Milan
Type: Journal Article | Journal: Journal of veterinary internal medicine | Year: 2016

Patent ductus arteriosus (PDA) is 1 of the most common congenital heart defects in dogs and percutaneous closure is effective in achieving ductal closure; PDA closure is associated with abrupt hemodynamic changes.A marked decrease in standard parameters of systolic function as assessed by M- or B-mode echocardiography after PDA closure was identified in previous studies. Speckle tracking echocardiography can provide further insight into the effect of PDA closure on cardiac mechanics in dogs affected by PDA.Twenty-five client-owned dogs with PDA.Prospective study. Dogs were recruited over a 2-year period. Complete echocardiographic evaluation was performed before and 24 hours after PDA closure, including standard (end-diastolic volumes indexed to body surface area in B- and M-mode [EDVIB /M ], end-systolic volumes indexed to body surface area in B- and M-mode [ESVIB /M ], allometric scaling in diastole [AlloD] and systole [AlloS], pulmonary flow to systemic flow [Qs/Qp], ejection fraction [EF], and fractional shortening [FS]), and advanced speckle-tracking echocardiography (STE): global longitudinal, radial, circumferential and transverse strain (S), and strain rate (SR).Patent ductus arteriosus closure was associated with statistically significant decreases in EDVIM /B and ESVIM /B , AlloD and AlloS, SI, EF, and FS. A statistically significant decrease in the absolute values of radial, transverse, and circumferential S and SR was observed, whereas longitudinal S and SR did not change significantly.Patent ductus arteriosus closure by percutaneous approach is associated with marked decreases of conventional echocardiographic parameters as a result of the changes in loading conditions, but no evidence of systolic dysfunction was identified by means of STE, as none of the S and SR values were below reference ranges. In the short term, contractility is enhanced in the long axis (long S/SR values were not statistically different before and after closure) and decreases to normal values in short axis (circumferential, radial, and transversal S/SR decreased to normal reference range).

PubMed | Clinica Veterinaria Gran Sasso and University of Milan
Type: | Journal: Research in veterinary science | Year: 2016

Advanced two-dimensional echocardiographic techniques allow strain (S) analysis of regional function and thus can provide information on regional myocardial deformation. Feature-tracking echocardiography (FTE) is based on a mono-dimensional technology and may offer more detailed information about septal deformation because it can analyse the activity of left- and right-sided septal fibres separately. The present study aimed to quantify global and regional (free wall and septal) right ventricular (RV) longitudinal S and strain rate (SR). We also investigated the relationships of S and SR with age, sex, weight, breed (sighthound breed vs other breeds), and heart rate. Cine loops were acquired from the left apical four-chamber view, optimized for the RV, in 60 dogs. The within-day and between-day intra-observer coefficient of variation for global RV S and SR in normal dogs using FTE was acceptable (<8.5%). Global longitudinal S (GLS) and SR showed a significant correlation with breed. GLS showed a significant weak positive correlation with weight. Global longitudinal SR showed a significant moderate negative correlation with heart rate. No correlation was found between GLS/SR and age. There was no significant difference between male and female dogs. This study shows, for the first time, that a novel FTE algorithm represents a promising and feasible non-invasive technique to assess RV myocardial function (free wall and septal deformation) in dogs. Based on our results, sighthound breeds appear to need specific reference values.

Mavropoulou A.,Clinica Veterinaria Gran Sasso | Guazzetti S.,Local Health Unit | Borghetti P.,University of Parma | De Angelis E.,University of Parma | Quintavalla C.,University of Parma
Veterinary Journal | Year: 2016

Inflammation plays an important role in the pathogenesis of congestive heart failure (CHF). In humans with CHF, increased production and high plasma concentrations of tumour necrosis factor-α (TNF-α), interleukin (IL)-6, IL-1, IL-8 and transforming growth factor-β (TGF-β) have been associated with disease progression and a negative prognosis. The aim of this study was to investigate whether differences in cytokine blood mRNA expression exist between clinically healthy dogs and dogs with myxomatous mitral valve disease (MMVD); to determine if the expression was related to the severity of MMVD, and to detect any correlations with echocardiographic parameters of cardiac remodelling. Twenty-three dogs with MMVD of varying severity and six clinically healthy dogs were included in the study. Whole blood samples were obtained for measurement of mRNA expression of IL-1α, IL-1β, IL-6, IL-8, TGF-β1, TNF-α by reverse transcriptase-PCR (RT-PCR).There were statistically significant differences between clinically healthy dogs and dogs with MMVD for IL-8 and TGF-β1 gene expression. IL-8 expression increased with increasing MMVD severity and TGF-β1 expression was higher in asymptomatic dogs with echocardiographic signs of cardiac remodelling (American College Veterinary Internal Medicine class B2) than in all other groups. These results could suggest the involvement of these cytokines at different stages of the disease. © 2016 Elsevier Ltd.

PubMed | Clinica Veterinaria Gran Sasso
Type: Journal Article | Journal: Journal of veterinary internal medicine | Year: 2014

Subaortic stenosis (SAS) is a common congenital heart disease in Boxers. Doppler-derived aortic peak velocity (AoPV) is a diagnostic criterion for the disease.To investigate the influence of emotional stress during echocardiographic examination on AoPV in normal and SAS-affected Boxers. To evaluate the effects of aortic root diameters on AoPV in normal Boxers. DOGS: Two hundred and fifteen normal and 19 SAS-affected Boxers.The AoPV was recorded at the beginning of echocardiographic examination (T0), and when the emotional stress of the dog was assumed to decrease based on behavioral parameters and heart rate (T1). AoPV0-AoPV1 was calculated. In normal dogs, stroke volume index was calculated at T0 and T1. Aortic root diameters were measured and their relationship with AoPV and AoPV0-AoPV1 was evaluated.In normal dogs, AoPV was higher at T0 (median, 1.95 m/s; range, 1.60-2.50 m/s) than at T1 (median, 1.76 m/s; range, 1.40-2.20 m/s; P < .0001; reduction 9.2%). The stroke volume index at T0 also was greater than at T1 (P < .0001). Weak negative correlations were detected between aortic root size and aortic velocities. In SAS-affected dogs, AoPV0 was higher than AoPV1 (P < .0001; reduction 7.3%).Aortic peak velocity was affected by emotional stress during echocardiographic examination both in SAS-affected and normal Boxers. In normal Boxers, aortic root size weakly affected AoPVs, but did not affect AoPV0-AoPV1. Stroke volume seems to play a major role in stress-related AoPV increases in normal Boxers. Emotional stress should be taken into account when screening for SAS in the Boxer breed.

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