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Background: Focused cardiac ultrasound (FCU) helps detect occult heart disease in human patients. Hypothesis: Focused cardiac ultrasound by a nonspecialist practitioner (NSP) will increase the detection of occult heart disease in asymptomatic cats compared with physical examination and ECG. Animals: Three hundred forty‐three client‐owned cats: 54 excluded and 289 analyzed. Methods: Multicenter prospective cohort study. Twenty‐two NSPs were trained to perform FCU. Cats without clinical signs of heart disease were recruited, and NSPs performed the following in sequential order: physical examination, ECG, FCU, and point‐of‐care N‐terminal pro‐B‐type natriuretic peptide assay (POC‐BNP). After each step, NSPs indicated yes, no, or equivocal as to whether they believed heart disease was present. The level of agreement between the NSP diagnosis and a blinded cardiologist's diagnosis after echocardiogram was evaluated using Cohen's kappa test. Results: Cardiologist diagnoses included 148 normal cats, 102 with heart disease, and 39 equivocal ones. Agreement between NSP and cardiologist was slight after physical examination (kappa 0.253 [95% CI, 0.172‐0.340]), did not increase after ECG (0.256 [0.161‐0.345]; P =.96), increased after FCU (0.468 [0.376‐0.558]; P =.002), and the level of agreement was similar after POC‐BNP (0.498 [0.419‐0.580]; P =.67). In cats with mild, moderate, and marked occult heart disease, the proportion of cats having a NSP diagnosis of heart disease after FCU was 45.6%, 93.1%, and 100%, respectively. Conclusions and Clinical Importance: Focused cardiac ultrasound performed by NSPs increased the detection of occult heart disease, especially in cats with moderate to marked disease. Focused cardiac ultrasound appears to be a feasible and useful tool to assist NSPs in the detection of heart disease in cats. [ABSTRACT FROM AUTHOR]

Background: Pathophysiologic mechanisms for the development and progression of degenerative mitral valve disease (DMVD) remain elusive. Increased concentrations of circulating trimethylamine N‐oxide (TMAO) and its precursors choline and l‐carnitine are associated with the presence and severity of heart disease in people. Objectives: To determine if differences exist in plasma concentrations of TMAO, choline, or l‐carnitine among dogs with DMVD and congestive heart failure (CHF), dogs with asymptomatic DMVD, and healthy control dogs. Animals Thirty client‐owned dogs: 10 dogs with CHF secondary to DMVD, 10 dogs with asymptomatic DMVD, and 10 healthy control dogs. Methods: A pilot cross‐sectional study in which echocardiography was performed and fasting plasma concentrations of TMAO, choline, and l‐carnitine (total and fractions) were measured. Results: TMAO (P = .03), total l‐carnitine (P = .03), carnitine esters (P = .05), and carnitine esters to free carnitine ratio (E/F ratio; P = .05) were significantly higher in dogs with CHF compared to those with asymptomatic DMVD. TMAO (P = .02), choline (P = .01), total l‐carnitine (P = .01), carnitine esters (P = .02), free carnitine (P = .02), and E/F ratio (P = .009) were significantly higher in dogs with CHF compared to healthy controls. Conclusions and Clinical Importance: Dogs with CHF secondary to DMVD had higher concentrations of TMAO compared to both asymptomatic DMVD dogs and healthy controls. Larger prospective studies are warranted to determine if TMAO plays a role in the development or progression of DMVD or CHF. [ABSTRACT FROM AUTHOR]

Objective To determine whether a training course in focused echocardiography can improve the proficiency of noncardiology house officers in accurately interpreting cardiovascular disease and echocardiography findings in dogs entering the emergency room setting. Design Prospective, blinded, educational study. Setting University veterinary teaching hospital. Study Subjects House officers underwent training in focused echocardiography. Fifteen dogs, including normal dogs and dogs with stable congenital or acquired cardiac disease, were used as study subjects during the laboratory session. Interventions A 6-hour curriculum on focused echocardiography was developed that included didactic lectures, clinical cases, and hands-on echocardiography. Measurements and Main Results Pre- and postcourse written examinations were administered to participants. House officers attended didactic lectures that were subsequently followed by a hands-on laboratory session and practical examination, which involved performing transthoracic echocardiography on dogs with and without cardiovascular disease. Twenty-one house officers completed the focused echocardiography training course. Written examination scores were 57 ± 12% before and 75 ± 10% after training ( P < 0.001). Following the course, 97% of participants in the practical examination were able to obtain the correct right parasternal short- or long-axis view. Posttraining, most participants correctly identified pleural effusion (90%) and pericardial effusion (95%) and discriminated normal atrial size from atrial enlargement (86%). However, successful identification of a cardiac mass, volume status, and ability to recognize a poor quality study as nondiagnostic remained relatively low. Most trainees responded that the length of hands-on laboratory training was too abbreviated and that the course should be > 6 hours. Conclusion A focused echocardiography training course improved knowledge and yielded acceptable proficiency in some echocardiographic findings commonly identified in the emergency room. This training course was not able to provide the skills needed for house officers to accurately assess fluid volume status, identify cardiac masses, ventricular enlargement or hypertrophy, and certain cardiac diseases. [ABSTRACT FROM AUTHOR]

Objective--To determine reference values for kaolin-activated thromboelastography in echocardiographically normal cats. Animals--30 healthy cats without evidence of cardiomyopathy on echocardiographic examination. Procedures--All cats underwent echocardiographic examination, the findings of which were reviewed by a board-certified cardiologist. Cats that struggled (n = 10) received mild sedation with butorphanol and midazolam IM to permit phlebotomy without interruption in jugular venous blood flow. Blood samples were collected for analysis of thromboelastography variables, PCV, total solids concentration, platelet count, activated partial thromboplastin time, prothrombin time, fibrinogen concentration, and antithrombin concentration. Results--All 4 thromboelastography variables had < 5% mean intra-assay variability. Mean values were as follows: reaction time, 4.3 minutes; clotting time, 1.6 minutes; α angle, 66.5°; and maximum amplitude, 56.4 mm. Compared with nonsedated cats, cats that required sedation had a significantly shorter clotting time and greater α angle, whereas reaction time and maximum amplitude were not significantly different. Conclusions and Clinical Relevance--Kaolin-activated thromboelastography was a reliable test with unremarkable intra-assay variability in echocardiographically normal cats. Sedation may affect certain thromboelastography variables, but the effect is unlikely to be clinically important. It remains unknown whether subclinical cardiomyopathy has a significant effect on thromboelastography variables in cats. [ABSTRACT FROM AUTHOR]

Background: Apparently healthy dogs of various breeds eating nontraditional, high‐pulse diets can have larger left ventricular diameter, lower systolic function, and more ventricular premature complexes (VPCs) compared with dogs eating traditional, low‐pulse diets. It is unknown whether Irish Wolfhounds eating high‐pulse diets have similar cardiac abnormalities. Hypothesis/Objectives: To compare electrocardiographic and echocardiographic findings between Irish Wolfhounds eating high‐ or low‐pulse diets. Animals: Ninety‐seven Irish Wolfhounds. Methods: Retrospective study of Irish Wolfhounds that had echocardiography performed at dog shows between October 2018 and May 2021. Demographic information, echocardiographic measurements, cardiac rhythm (1‐minute lead II rhythm strip), and main diet were recorded retrospectively. Diets were classified as high‐pulse or low‐pulse based on the presence and location of pulses (peas, lentils, chickpeas, or dry beans) on the ingredient list. Results: Thirty‐five of 97 Irish Wolfhounds (36%) were eating high‐pulse diets and 62 of 97 (64%) were eating low‐pulse diets. There were no significant differences between diet groups in echocardiographic measurements. A significantly higher percentage of dogs in the high‐pulse diet group (6/35 [17%]) had VPCs compared with those in the low‐pulse diet group (1/62 [2%]; effect size = 0.15 [95% confidence interval: 0.004‐0.31]; P =.005). Conclusions and Clinical Importance: In this retrospective study of apparently healthy Irish Wolfhounds, high‐pulse diets were associated with a higher prevalence of VPCs which could represent early cardiac abnormalities. [ABSTRACT FROM AUTHOR]

Background: A recent study showed higher high‐sensitivity cardiac troponin I (hs‐cTnI) concentrations in healthy dogs eating grain‐free (GF) compared to those eating grain‐inclusive (GI) diets. Hypothesis/Objectives: Healthy dogs with subclinical cardiac abnormalities eating GF diets at baseline will show improvements in cardiac biomarkers and echocardiographic variables after diet change, whereas healthy dogs eating GI diets at baseline will not improve. Animals: Twenty healthy dogs with subclinical cardiac abnormalities (12 Golden Retrievers, 5 Doberman Pinschers, 3 Miniature Schnauzers). Methods: This prospective study included dogs with increased hs‐cTnI or N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) concentrations, or echocardiographic abnormalities. Mixed modeling was used to evaluate echocardiographic, hs‐cTnI, and NT‐proBNP differences between groups (GF or GI diet at baseline) over time (1 y after diet change). Results: Ten GF and 10 GI dogs were evaluated. There were statistically significant time: group interactions for hs‐cTnI (P =.02) and normalized left ventricular internal systolic diameter (LVIDsN; P =.02), with GF dogs showing larger decreases in these variables than GI dogs. Median (range) hs‐cTnI (ng/mL) for GF dogs was 0.141 (0.012‐0.224) at baseline and 0.092 (0.044‐0.137) at 1 y, and for GI dogs was 0.051 (0.016‐0.195) at baseline and 0.060 (0.022‐0.280) at 1 y. Median LVIDsN for GF dogs was 1.01 (0.70‐1.30) at baseline and 0.87 (0.79‐1.24) at 1 y, and for GI dogs was 1.05 (0.84‐1.21) at baseline and 1.10 (0.85‐1.28) at 1 y. Conclusions and Clinical Importance: Decreased hs‐cTnI and LVIDsN in GF dogs after diet change supports reversibility of these subclinical myocardial abnormalities. [ABSTRACT FROM AUTHOR]

Objective--To compare morphometric measurements and serum insulin-like growth factor (IGF-1) concentration in cats with and without hypertrophic cardiomyopathy (HCM), and assess the hypothesis that cats with HCM have larger body size and skeletal features and higher serum IGF-1 concentrations than healthy cats. Animals--25 cats with HCM and 22 healthy control cats. Procedures--Physical examination and echocardiography were performed to classify cats into the HCM and control groups. Data collected from each cat included diet history, body weight, body condition score, lengths of the humerus and 4th and 12th thoracic vertebrae, heart size, head length and width, and abdominal circumferences. Comparisons of these variables were made between groups. Results--Body condition score in HCM-affected and control cats did not differ significantly. However, median head width; lengths of the head, 4th and 12th thoracic vertebrae, and humerus; and body weight in the HCM-affected group were significantly greater than values in the control group. Median serum concentration of IGF-1 was not significantly different between groups. Conclusions and Clinical Relevance--These data suggested that among the study cats, those with HCM were skeletally larger, but not more obese, than healthy cats. Whether this was attributable to differences in early growth or other causes requires additional investigation. [ABSTRACT FROM AUTHOR]

Background: Associations of diet with dilated cardiomyopathy are under investigation. Objectives: That cardiac assessment would show abnormalities in healthy dogs eating grain‐free (GF) diets or diets with Food and Drug Administration (FDA)‐listed ingredients of concern (peas, lentils, or potatoes) as top 10 ingredients (FDA‐PLP), but not in dogs eating grain‐inclusive (GI) diets or diets without FDA‐listed ingredients of concern (PLP) in the top 10 ingredients (NoFDA‐PLP). Animals One hundred eighty‐eight healthy Doberman Pinschers, Golden Retrievers, Miniature Schnauzers, and Whippets. Methods: This study was an observational cross‐sectional study. Echocardiograms, cardiac biomarkers, and blood and plasma taurine concentrations were compared between dogs eating GF (n = 26) and GI (n = 162) diets, and between FDA‐PLP (n = 39) and NoFDA‐PLP (n = 149) diets, controlling for age and breed. Demographic characteristics, murmurs, genetic status, and ventricular premature complexes (VPCs) during examination were compared between dogs eating different diet types. Results: No differences in echocardiographic variables, N‐terminal pro‐B‐type natriuretic peptide or whole blood taurine were noted between dogs eating different diet types. Dogs eating GF diets had higher median high‐sensitivity cardiac troponin I (hs‐cTnI) (GF 0.076 ng/mL [Interquartile range (IQR), 0.028‐0.156] vs. GI 0.048 [IQR, 0.0026‐0.080]; P <.001) and higher median plasma taurine (GF 125 nmol/mL [IQR, 101‐148] vs GI 104 [IQR, 86‐123]; P =.02) than dogs eating GI diets. Dogs eating FDA‐PLP diets had higher median hs‐cTnI (0.059 ng/mL [IQR, 0.028‐0.122]) than dogs eating NoFDA‐PLP diets (0.048 [IQR, 0.025‐0.085]; P =.006). A greater proportion of dogs eating FDA‐PLP diets (10%) had VPCs than dogs eating NoFDA‐PLP diets (2%; P =.04). Conclusions and Clinical Importance: Higher hs‐cTnI in healthy dogs eating GF and FDA‐PLP diets might indicate low‐level cardiomyocyte injury. [ABSTRACT FROM AUTHOR]

Objective: To describe a case of multifocal brain abscessation as a sequela from bacterial endocarditis in a dog with a 4-month history of immune-mediated thrombocytopenia (ITP) and treatment with immunosuppressive therapies. Case summary: An 8-year-old spayed female Kerry Blue Terrier weighing 13 kg was presented for evaluation of progressive neurologic deficits after a 4-month history of immunosuppressive treatment of ITP. Brain magnetic resonance imaging revealed lesions consistent with multiple central nervous system abscesses and rupture of an abscess into an adjacent ventricle. Staphylococcus species were cultured from blood and cerebral spinal fluid and a vegetative lesion of the mitral valve was identified by echocardiographic examination. Intensive care, intravenous antibiotics, and supportive therapy led to resolution of clinical signs. Resolution of the vegetative lesion on the mitral valve was documented by serial echocardiographic examination. The dog was clinically normal 11 months after treatment. New or unique information provided: Bacterial endocarditis can be an occult infection and difficult to diagnose. Emboli from endocarditis are common, but those that affect the spleen and kidneys are often clinically silent in dogs. This case represents the first report of multifocal brain abscessation (documented with magnetic resonance imaging) as a sequela from bacterial endocarditis. [ABSTRACT FROM AUTHOR]