Paramus, NJ, United States
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Murphy L.A.,Oradell Animal Hospital | Russell N.J.,Advanced Veterinary Care Center | Dulake M.I.,VCA West Los Angeles Animal Hospital | Nakamura R.K.,Veterinary Medical Surgical Group Orange County
Journal of Feline Medicine and Surgery | Year: 2014

A 4-year-old female spayed domestic longhair cat was referred for dyspnea. Further diagnostics revealed severe pleural effusion and a peritoneopericardial diaphragmatic hernia (PPDH). Following surgical correction of the PPDH the pleural effusion persisted. Re-check echocardiogram 4 weeks after initial evaluation revealed leftward deviation of the interventricular septum and interatrial septum occurring with inspiration. There were also exaggerated phasic changes in trans-tricuspid flow velocities suggestive of constrictive pericardial disease. Cardiac catheterization was performed and revealed elevated pressures in the right atrium and right ventricle. Constrictive pericarditis (CP) and epicarditis was confirmed at surgery, where subtotal pericardiectomy was performed with epicardial decortication. The cat continued to develop recurrent pleural effusion after surgery, although the volume and frequency of recurrence slowed over time. This is the first reported case of CP following PPDH repair in a cat. © ISFM and AAFP 2014.


PubMed | Oradell Animal Hospital, United Veterinary Specialty and Emergency, Veterinary Specialty and Emergency Center and Advanced Critical Care
Type: Journal Article | Journal: Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) | Year: 2016

To describe the utility of Yunnan Baiyao (YB) alone or in combination with epsilon aminocaproic acid (EAC) for the treatment of dogs with echocardiographically identified right atrial (RA) masses and pericardial effusion (PE).Retrospective case-controlled study.Two private practice referral hospitals.Client-owned dogs with RA masses and PE identified echocardiographically over a 3-year period.None.There were 67 dogs identified with RA masses and PE during the study period. Sixteen dogs were treated with YB alone while 8 dogs were treated with YB in combination with EAC in addition to pericardiocentesis. Forty-three dogs were treated with pericardiocentesis alone and were considered to be the control group. There was no difference between the groups in regards to signalment, physical examination abnormalities, and diagnostic test results on presentation. There was no significant difference between the 2 groups with respect to number of pericardiocenteses performed and there were no side effects attributed to the YB or EAC in any of the dogs. Median time to recurrence of clinical signs was not significantly different between the treatment (12 d, range 1-186 d) and control group (14.5 d, range 1-277 d). The median survival of dogs treated with YB alone or in combination with EAC (18 d, range 1-186 d) was also not significantly improved compared to dogs treated with pericardiocenteses alone (16 d, range 1-277 d).This study suggests YB alone or in combination with EAC is relatively safe but does not significantly delay recurrence of clinical signs or improve survival in dogs with RA masses and PE. Due to the small cohort size, further prospective studies evaluating these drugs and their effects on hemostasis in dogs with RA masses and PE are warranted.


Shmuel D.L.,Oradell Animal Hospital
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) | Year: 2013

To review and summarize current information regarding the pathophysiology and clinical manifestations associated with anaphylaxis in dogs and cats. The etiology, diagnosis, treatment, and prognosis is discussed. Anaphylaxis is a systemic, type I hypersensitivity reaction that often has fatal consequences. Many of the principal clinical manifestations involve organs where mast cell concentrations are highest: the skin, the lungs, and the gastrointestinal tract. Histamine and other deleterious inflammatory mediators promote vascular permeability and smooth muscle contraction; they are readily released from sensitized mast cells and basophils challenged with antigen. Anaphylaxis may be triggered by a variety of antigens including insect and reptile venom, a variety of drugs, vaccines, and food. Anaphylaxis is a clinical diagnosis made from a collection of signs and symptoms. It is most commonly based on pattern recognition. Differential diagnoses include severe asthma, pheocromocytoma, and mastocytosis. Epinephrine is considered the drug of choice for the treatment of anaphylaxis. It acts primarily as a vasopressor in improving hemodynamic recovery. Adjunctive treatments include fluid therapy, H1 and H2 antihistamines, corticosteroids, and bronchodilators; however, these do not substitute for epinephrine. Prognosis depends on the severity of the clinical signs. The clinical signs will vary among species and route of exposure. The most severe clinical reactions are associated when the antigen is administered parenterally. © Veterinary Emergency and Critical Care Society 2013.


Hemmelgarn C.,Oradell Animal Hospital
Compendium (Yardley, PA) | Year: 2013

Heatstroke is a common veterinary emergency that, depending on the severity of injury, can progress to a life-threatening condition. Heatstroke can be classic (nonexertional) or exertional. Classic heatstroke develops when the body is exposed to high external temperatures, whereas exertional heatstroke is caused by strenuous exercise. Thermoregulation is the intrinsic ability of the body to maintain core body temperature within normal limits through an intricate balance of heat conservation and heat dissipation. Severe disease ensues when persistent hyperthermia causes injury to the body for which these mechanisms can no longer adequately compensate. The first stages of heatstroke are characterized by initial thermoregulation, acute phase response, and activation of heat shock proteins. The organ systems most commonly affected during heatstroke are the gastrointestinal tract and the coagulation, renal, cardiac, pulmonary, and central nervous systems.


Hemmelgarn C.,Oradell Animal Hospital
Compendium (Yardley, PA) | Year: 2013

Heatstroke is a complex disease process that, in its most severe form, can result in multiorgan dysfunction and death. Heatstroke stems from the failure of the body's thermoregulatory mechanisms, resulting in cellular damage and death. The organ systems most commonly affected in this disease process include the gastrointestinal tract and the coagulation, renal, cardiac, pulmonary, and central nervous systems. Heatstroke is diagnosed based on the patient history, physical examination, and clinicopathologic findings. Treatment should be instituted immediately to improve patient outcome and includes active cooling, fluid resuscitation, and supportive care. Patients with altered mental status, hypoglycemia, prolonged prothrombin time, and prolonged activated partial thromboplastin time at admission have increased mortality rates. Additional negative prognostic indicators include elevated serum creatinine level, delayed admission to the hospital, seizures, and obesity.


Schrope D.P.,Oradell Animal Hospital
Journal of Veterinary Cardiology | Year: 2010

A 10-year-old cat presented with a history of unexplained ascites. Ultrasound and angiography identified an isolated stenosis of the middle hepatic vein resulting in Budd-Chiari Syndrome. Balloon dilation of the stenosis was attempted but the patient expired. Necropsy revealed a discrete membranous stenosis at the junction of the caudal vena cava and the middle hepatic vein. The literature was reviewed to assess clinical and diagnostic findings, as well as therapeutic options in humans with hepatic vein stenosis. © 2010 Elsevier B.V. All rights reserved.


Schrope D.P.,Oradell Animal Hospital
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology | Year: 2015

OBJECTIVE: Assess the prevalence of congenital heart disease (CHD) in a large population of mixed-breed dogs and cats.ANIMALS: 76,301 mixed-breed dogs and 57,025 mixed-breed cats.METHODS: Retrospective review of records and examinations based on specified diagnostic criteria.RESULTS: Among mixed-breed dogs, the prevalence of CHD was 0.13% (51.4% female) and of innocent murmurs was 0.10% (53.0% male). Pulmonic stenosis was the most common defect followed by patent ductus arteriosus, aortic stenosis, and ventricular septal defect. Among mixed-breed cats, prevalence of CHD was 0.14% (55.2% male) and of innocent murmurs was 0.16% (54.4% male). When the 25 cats with dynamic left or right ventricular outflow obstruction were counted with cases of innocent murmurs, the overall prevalence was 0.2%. Ventricular septal defects were the most common feline CHD followed closely by aortic stenosis and hypertrophic obstructive cardiomyopathy. There was no overall sex predilection for CHD in mixed-breed cats or dogs, and no significant difference in CHD prevalence between cats or dogs. Among dogs, subvalvular aortic stenosis and mitral valve dysplasia had a male predisposition while patent ductus arteriosus had a female predisposition. Among cats, valvular pulmonic stenosis, subvalvular and valvular aortic stenosis, and ventricular septal defects had a male predisposition while pulmonary artery stenosis had a female predisposition.CONCLUSIONS: The prevalence of CHD in a mixed-breed dogs and cats is lower than for prior studies, perhaps due to the lack of purebreds in the study population or actual changes in disease prevalence. Copyright © 2015 Elsevier B.V. All rights reserved.


Schrope D.P.,Oradell Animal Hospital
Journal of Veterinary Cardiology | Year: 2013

Objectives To evaluate signalment, echocardiographic, electrocardiographic, and radiographic findings as well as natural history in a group of cats with atrioventricular septal defects (AVSD). Animals 26 client owned cats. Methods Medical records were reviewed retrospectively for signalment, morphologic type of AVSD, presence of concurrent congenital heart disease (ConcCHD), diagnostic findings, and natural history. Results Seventeen cats had an isolated AVSD; 13/17 had a partial and 4/17 had a complete AVSD. Double outlet right atrium (DORA) was diagnosed in 4/17 cats. Of those with a partial AVSD, 7/13 had an atrial communication while 6/13 had a ventricular communication. Congestive heart failure (CHF) developed in 5/17 cats; all 3 cats diagnosed with a DORA not lost to follow-up developed pulmonary edema. Sudden death was documented in 4/17 (23.5%). The 5 year survival was 53.0% (9/17). Concurrent congenital heart disease was identified in 9/26 cats with 7/9 having a conotruncal abnormality. Electrocardiography was performed in 14 cats with 11/14 diagnosed with a conduction disturbance. Conclusions Overall the echocardiographic and electrocardiographic findings with AVSD are similar to that seen in humans. Cats may have a higher prevalence than humans of partial AVSD with ventricular communication only as well as a higher prevalence of DORA. Cats with an AVSD have an overall guarded prognosis although some can live for a protracted time. © 2013 Elsevier B.V. All rights reserved.


PubMed | Oradell Animal Hospital
Type: Journal Article | Journal: Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) | Year: 2016

To review the human and veterinary literature regarding gastrointestinal (GI) dysmotility disorders in respect to pathogenesis, patient risk factors, and treatment options in critically ill dogs and cats.GI dysmotility is a common sequela of critical illness in people and small animals. The most common GI motility disorders in critically ill people and small animals include esophageal dysmotility, delayed gastric emptying, functional intestinal obstruction (ie, ileus), and colonic motility abnormalities. Medical conditions associated with the highest risk of GI dysmotility include mechanical ventilation, sepsis, shock, trauma, systemic inflammatory response syndrome, and multiple organ failure. The incidence and pathophysiology of GI dysmotility in critically ill small animals is incompletely understood.A presumptive diagnosis of GI dysmotility is often made in high-risk patient populations following detection of persistent regurgitation, vomiting, lack of tolerance of enteral nutrition, abdominal pain, and constipation. Definitive diagnosis is established via radioscintigraphy; however, this diagnostic tool is not readily available and is difficult to perform on small animals. Other diagnostic modalities that have been evaluated include abdominal ultrasonography, radiographic contrast, and tracer studies.Therapy is centered at optimizing GI perfusion, enhancement of GI motility, and early enteral nutrition. Pharmacological interventions are instituted to promote gastric emptying and effective intestinal motility and prevention of complications. Promotility agents, including ranitidine/nizatidine, metoclopramide, erythromycin, and cisapride are the mainstays of therapy in small animals.The development of complications related to GI dysmotility (eg, gastroesophageal reflux and aspiration) have been associated with increased mortality risk. Institution of prophylaxic therapy is recommended in high-risk patients, however, no consensus exists regarding optimal timing of initiating prophylaxic measures, preference of treatment, or duration of therapy. The prognosis for affected small animal patients remains unknown.


PubMed | Oradell Animal Hospital
Type: Journal Article | Journal: Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) | Year: 2016

To describe a case of hemoperitonium in a dog with Bartonellosis and peliosis hepatis (PH) lesions that resolved following antimicrobial therapy.A 3-year-11-month-old 22.5 kg female spayed mixed breed dog presented for progressive lethargy and vomiting. An abdominal ultrasonographic examination revealed moderate ascites, which when sampled was nonclotting hemorrhagic fluid. An exploratory laparotomy revealed a large volume of nonclotted blood in the dogs abdomen and blood-filled vesicular lesions dispersed diffusely along multiple lobes of the liver. Biopsies revealed lesions indicative of PH. Serology testing for Bartonella species was positive. Treatment with azithromycin resulted in Bartonella serology negative status and no further evidence of hemoperitonium at recheck examination 12 months after initial presentation.This is the first reported case of PH and hemoperitoneum in a Bartonella species serology positive dog wherein treatment with azithromycin resulted in serology negative status. There have been no subsequent episodes of hemoperitoneum in the 12 months since treatment.

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