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Objective: To demonstrate hypercoagulability with a benchtop viscoelastic monitor in cats with congestive heart failure (CHF) and/or aortic thromboembolism (ATE) compared to controls., Methods: 97 cats were enrolled throughout this prospective observational cohort study from September 2022 through October 2023. Cats were grouped by diagnosis of CHF, ATE, ATE plus CHF, or controls. Enrollment required diagnosis of heart disease and no previous antithrombotic therapy. The results of viscoelastic testing with the benchtop viscoelastic coagulation monitor (VCM Vet [VCM]; Entegrion) were compared between groups using factorial analysis of variance., Results: Cats with heart disease had significantly higher clot times when compared to controls (control: mean, 285.3 [SD, 172.6]; CHF: mean, 391.7 [SD, 106.8]; ATE: mean, 415.9 [SD, 109.2]; and ATE plus CHF: mean, 368.6 [SD, 232.6]). Heart disease cats were noted to have significantly lower 45-minute lysis index values (control: median, 100 [range, 93 to 100]; CHF: median, 99 [range, 89 to 100]; ATE: median, 98 [range, 88 to 100]; and ATE plus CHF: range, 98 [91 to 100]). Age was a covariate to this variable, and when applied to analysis, statistical significance was lost. No significant difference in any other variables were noted., Clinical Relevance: The hypercoagulability of ATE and CHF cats was not detected by the VCM. Further research with other coagulation monitors is required in this population.

An 11-year-old male neutered American bulldog was presented for evaluation of thrombocytopenia, acute onset of ataxia, and vomiting. A new murmur was auscultated on physical examination. Transthoracic echocardiographic examination revealed a bicuspid aortic valve, vegetative lesions on the aortic valve, and continuous shunting from the aortic root to the left atrium through an aorta to left atrial fistula. The dog was euthanized due to its guarded prognosis and critical condition. Pathological examination confirmed presence of a bicuspid aortic valve, aorto-left atrial fistula, and aortic infective endocarditis. Antemortem blood culture revealed two unusual organisms: Achromobacter xylosoxidans and Fusobacterium mortiferum., Competing Interests: Conflict of Interest Statement The authors do not have any conflict of interest to disclose., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Practical Relevance: Feline aortic thromboembolism (FATE) is commonly encountered in clinical medicine, especially in emergency situations. This often devastating syndrome usually develops secondarily to severe heart disease, and has short- and long-term consequences., Clinical Features: The clinical presentation of FATE is consistent with peripheral ischemic neuropathy, usually in both pelvic limbs. Diagnosis is relatively straightforward, but can be assisted with Doppler ultrasound, point-of-care ultrasound or infrared thermal imaging., Recent Advances and Future Prospects: Interpretation of survival rates in cats with FATE has been hampered by historically high admission euthanasia, but recent studies suggest a survival rate with supportive care of 30-40%. Moreover, with advances in post-FATE thromboprophylaxis, median survival times of over 1 year are being achieved. Future directions include use of thrombolytic agents and treatment of common FATE sequelae such as acute kidney injury and reperfusion injury., Outline: This article, aimed at small animal veterinarians, including emergency practitioners, reviews key aspects of the clinical presentation, diagnosis and treatment options for FATE, with a view to guiding client and veterinarian decision-making. Three case studies are included to illustrate the practical application of information presented in the review., Evidence Base: There are limited prospective studies on FATE, although the recent literature reflects a resurgence in clinical research interest in the past few years. Advances in FATE treatment will benefit many cats and it is important that research efforts continue to identify appropriate treatment modalities., Competing Interests: Conflict of interestThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: Atherosclerosis is a chronic lipid-driven inflammatory disease of the arterial wall. Due to its cardiovascular ischemic complications, it is one of the most common causes of death in people. However, atherosclerosis is seldomly reported in dogs., Animal: A 10-year-old male mixed-breed dog., Clinical Presentation, Progression, and Procedures: Severe acute kidney injury associated with thrombosis of the abdominal aorta., Treatment and Outcome: Treatment included renal replacement therapy, antithrombotic therapy, and supportive care. However, the dog developed neurological and respiratory complications and was euthanized due to worsening kidney function and lack of improvement of the thrombosis. Postmortem examination confirmed the presence of aortic thromboembolism and renal infarcts. Histology revealed severe chronic-active atherosclerosis of the distal aorta and renal arteries., Clinical Relevance: Aortic thrombosis is uncommon in dogs, and it is often associated with underlying conditions such as protein-losing nephropathy, endocrine disorders, cardiac disease, or hypercoagulability. In this case, no specific underlying cause was identified and atherosclerosis was considered the primary cause of the thrombosis.

A dog was presented for lameness, fever, and extreme lethargy. On physical exam, a new heart murmur, arrhythmia, and joint effusion were detected. These findings were not detected two months prior. A diagnostic work-up confirmed septic suppurative inflammation in multiple joints. Echocardiogram revealed aortic valvular endocarditis along with a communication, as a consequence of a fistula, that extended from just below the aortic sinotubular junction to the left atrial lumen. Due to a poor prognosis, humane euthanasia was elected. Necropsy and histopathology confirmed infective endocarditis of the aortic valve and an aorto-left atrial fistulous tract extending from the left coronary sinus of the aortic valve to the lumen of left atrium., (Published by Elsevier B.V.)

Background: Aortic and aortoiliac thrombosis in dogs causes disease and death., Objective: To describe the procedure and outcomes for stenting the caudal aorta and aortoiliac trifurcation., Animals: Seven client-owned dogs that underwent aortic/aortoiliac stenting for treatment of thrombosis., Methods: Retrospective multi-center investigation. Medical records were reviewed for dogs that underwent stenting of the aorta or aortoiliac trifurcation between 2008 and 2020. Information collected included history, signalment, clinicopathologic data, diagnostic imaging, procedure reports, and outcomes., Results: Seven dogs with an occlusive thrombus located at or near the aortic trifurcation were included. Four of 7 dogs were non-ambulatory. Hind limbs were paretic in 5 dogs, paralyzed in 1 dog, and claudication alone was noted in 1 dog. Five of the 7 dogs had protein-losing nephropathy (PLN). Of 5 dogs with PLN, 1 had protein-losing enteropathy (PLE) and controlled hypothyroidism and 1 had caudal aortic chondrosarcoma. Two dogs had no identified underlying disease. Angiography was performed before catheter directed thrombolysis and stent placement. No deaths occurred during the procedure. Postoperative complications included pain (4/7), bruising and edema (3/7), bruising only (1/7), and edema only (1/7). Median survival time (MST) of the 7 dogs was 264 days (range, 1-1053 days). Five of 7 dogs were ambulatory within 2 days of stenting and survived to discharge with a MST of 425 days (range, 208-1053 days)., Conclusions and Clinical Importance: Stenting of the aorta and aortoiliac trifurcation can provide an apparently safe and effective treatment with rapid return to ambulation for some dogs with aortic thrombosis., (© 2022 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Background: Feline aortic thromboembolism (FATE) is a fatal disease where a blood clot gets lodged into the aortic trifurcation., Methods: Fifteen cats with a sudden onset of hind limb paresis/paralysis, vocalization, and pain were admitted to the surgery clinic. A full case history was obtained and clinical, orthopedic, neurologic, radiographic, electrocardiographic, and echocardiographic examinations were performed for each cat. The treatment protocol included daily administration of multiple anticoagulant drugs with different mode of actions and meloxicam for 7 successive days. Prophylactic anticoagulant therapy (clopidogrel and acetylsalicylic acid) was continued for 6 months. All data were statistically analyzed and the correlation between time of admission and treatment outcome was tested using Pearson's correlation coefficient., Results: The case history and clinical, orthopedic, and neurologic examinations revealed a sudden onset of hind limb paralysis ( n = 12) or paresis ( n = 3) associated with vocalization and pain, absence of trauma, cold and pale paws of hind limbs ( n = 13, 86.7%) or cyanosed hind paws ( n = 2, 13.3%), absence of femoral pulsation, shallow and rapid open-mouth respiration (61 ± 8 breaths/minutes), hypothermia (37.9°C ± 0.6°C) and tachycardia (155 ± 12 beats/minutes), with a muffled heart sound in four cats (26.7%). Radiography revealed no abnormalities in the hind limbs, pelvis, and spines, cardiomegaly in five cats (33.3%), mild pleural effusion and vascular pattern of the lung in six cats (40%), and Valentine's heart shape in four cats (26.7%). Electrocardiography (ECG) revealed an R-wave< 0.9 mV, prolongation of QRS interval in five cats (33.3%), and conduction disturbance in four cats (26.7%). Echocardiography was consistent with hypertrophic cardiomyopathy (HCM) in five cats (33.3%). A statistically significant ( p = 0.023) strong negative correlation ( r = -0.6) was reported between time of admission and subsequent early treatment and recovery from clinical signs. The treatment was successful in nine cats (60%), while four cats (26.7) were euthanized and two cats (13.3%) were subjected to hind limb amputation, at the owners' requests., Conclusion: Clinical signs, radiography, ECG, and echocardiography are valuable for diagnosis of FATE. The outcome of the multiple anticoagulants therapy depends mainly upon early diagnosis and treatment within the first 6 hours from the onset of clinical signs.

Objective: To describe the clinical presentation of a dog with fatal hemorrhage from an aortoesophageal fistula (AEF) immediately following endoscopic removal of an osseous esophageal foreign body., Case Summary: A 12-year-old, male mixed-breed dog presented to a university hospital with a 6-day history of gagging, hematemesis, and anorexia. Physical examination upon arrival was unremarkable. Blood work revealed leukocytosis without anemia. Thoracic radiographs from the referring veterinarian demonstrated the presence of an osseous esophageal foreign body at the level of the heart base. Subsequently, esophagoscopy was performed under general anesthesia. A triangular-shaped, osseous esophageal foreign body was visualized at the level of the heart base and successfully removed. Following its removal, a deep, nonbleeding, presumably nonperforated, esophageal ulcer was revealed. While recovering from anesthesia, the dog's condition acutely deteriorated, with absence of spontaneous respiration, severe tachycardia, hypotension, white-pale mucous membranes, and hypothermia. Severe anemia was present, with hypovolemic shock likely secondary to acute, postprocedural bleeding. Medical management included rapid packed red blood cell transfusion, crystalloid fluid therapy, and tranexamic acid. Despite initial stabilization, several hours later, the dog suffered cardiac arrest and cardiopulmonary resuscitation (CPR) was unsuccessful. At postmortem examination, a 1-mm AEF was identified on the ventral aspect of the aorta that communicated with the overlying esophagus., New or Unique Information Provided: Aortoesophageal fistulas should be considered in any patient with severe bleeding following esophagoscopy. A history of hematemesis in a dog with an esophageal foreign body should raise suspicion of an AEF and dictate case management accordingly., (© Veterinary Emergency and Critical Care Society 2020.)

Background: Echocardiography is the most frequently used non -invasive diagnostic tool to evaluate cardiac anatomy and function in domestic species but increasingly also in non -domestic species, especially since cardiac disease is being recognized as an important cause of death in captive primates. The purpose of this cross -sectional study was to investigate the feasibility of transthoracic echocardiography in healthy squirrel monkeys as well as to provide species specific normal values for standard echocardiographic measurements. A secondary aim was to determine plasma and serum levels of the cardiac biomarkers, N -terminal pro -brain natriuretic peptide (NT -proBNP) and cardiac troponin T (cTnT). Furthermore, a commercial, non -invasive, smartphone -based ECG (AliveCor Vet TM) monitoring device was used to evaluate the heart rate and rhythm and to diagnose possible arrhythmias., Results: In this study, transthoracic echocardiography of 14 squirrel monkeys was performed in right and left lateral recumbency. Similar standard right parasternal and left apical images were obtained as in dogs and cats and normal values for routine two -dimensional, time motion mode and Doppler mode measurements were generated. Thirteen animals were considered healthy and one squirrel monkey was identified with significant aortic dilation and regurgitation and consequently values obtained from this animal were not used when species specific normal values were calculated. NT -ProBNP and cTnT concentrations were available for 7 of the 13 healthy monkeys with NT -proBNP concentrations below detection limit in all animals and a mean cTnT concentration of 0.049 ng/mL. Electrocardiography was performed in all squirrel monkeys. The mean heart rate was 172 bpm. Frequent supraventricular premature beats were diagnosed in the squirrel monkey suffering from significant aortic dilation and regurgitation., Conclusion: This study presents echocardiographic normal values and additional cardiovascular data in anaesthetised Saimiri monkeys, fundamental from both the perspective of zoo animal health care as well as scientific research, since the squirrel monkey is often used as an animal model for human disease.

Objectives: Thrombolytic therapy is a treatment of choice for people with acute ischemic events, but is uncommonly administered for feline aortic thromboembolism (FATE). This study reports selected clinical data and outcomes of acute FATE treated with tissue plasminogen activator (TPA). A reference group treated with current standard of care (SOC) was analyzed for comparison., Methods: This was a retrospective study of FATE in two academic hospitals. TPA-treated cats with two or more limbs (n = 16) affected were compared with a SOC-treated group with two or more limbs affected (n = 38). A limb score based on motor function and pulse quality was calculated for each group., Results: Limb score and proportion of congestive heart failure at admission was similar in both groups. Time from FATE to admission was shorter in the TPA group, with a median of 3 h (range 0-6 h) vs 6 h (range 0-48 h; P = 0.0004). The most common regimen received for TPA was 1 mg/kg over 1 h. Other treatments were similar to those of the SOC group and included analgesia, thromboprophylaxis and furosemide. Documented complications for TPA-treated cats included reperfusion injury (5/10) and acute kidney injury (AKI; 3/10). Discharge proportion rate was 44% (TPA) vs 29% (SOC; P = 0.351). There were no differences in short-term survival rate (56.2% vs 39.5%; P = 0.369), clinical improvement (56.2% vs 31%; P = 0.122), rates of reperfusion injury (50% vs 50%; P = 1.00) or AKI (30% vs 27%; P = 1.00) between the TPA-treated and SOC groups, respectively., Conclusions and Relevance: Survival and complication rates of TPA-treated cats and SOC-treated cats for acute FATE were similar.

A 4-year-old intact male mini lop rabbit (Oryctolagus cuniculus) was presented with a 2-week history of severe progressive lethargy. A right parasternal continuous heart murmur and an irregular rhythm were detected on physical examination. Echocardiography identified vegetative aortic and tricuspid valve (TV) endocarditis. There was an aortocavitary fistula between the right sinus of Valsalva into the right ventricle, creating a left-to-right intracardiac shunt. Based on the echocardiographic findings, it was suspected that the infection originated in the aortic valve, eroded through the periannular tissue, and secondarily infected the TV. Pleural and peritoneal effusion secondary to right-sided congestive heart failure was also found during the echocardiogram. Atrial fibrillation, conducted with a left bundle branch block morphology, was identified using electrocardiography. Necropsy findings directly correlated with the echocardiographic diagnosis; marked periodontal disease was also identified. Aerobic culture of the aortic and tricuspid vegetations resulted in significant growth of Haemophilus parainfluenzae. Haemophilus spp. belong to a group of similar gram-negative coccobacillus bacteria (HACEK group), which can act as an uncommon cause of endocarditis in humans. HACEK endocarditis is most commonly associated with oral infection and/or dental procedures in people. This is the first case report of a rabbit with periannular complications of infective endocarditis. It remains unknown whether dental disease resulted in endocarditis in this patient., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Objectives The objective of this study was to evaluate the diagnostic accuracy of infrared thermography in cats with acute pelvic paralysis to differentiate feline aortic thromboembolism (FATE) from non-ischaemic conditions. Methods Thermographic images were prospectively obtained at admission from cats presented for acute bilateral pelvic paralysis. Based on the final diagnosis, cats were divided into a FATE and a control group (ischaemic and non-ischaemic related pelvic paralysis, respectively). The maximum (T max ), minimum (T min ) and average (T av ) temperatures were determined for each of the four limbs within a hand-drawn region of interest on the dorsal limb extremity. Temperature differences between the forelimb (non-affected) and hindlimb (affected) with the highest temperature (ΔT), with the lowest temperature (δT) and from the right and left side (RightΔT and LeftΔT, respectively) were calculated. Results The FATE and control groups included 10 and six cats, respectively. In the FATE group, right hindlimb mean T max (23.6°C ± 1.9), left hindlimb mean T max (23.6°C ± 2.2) and mean T av (22.7°C ± 2.2) were significantly lower than in the control group (26.6°C ± 3.5 [ P = 0.042]; 26.6°C ± 2.4°C [ P = 0.024] and 25.7°C ± 2.0 [ P = 0.020], respectively). ΔT, δT, RightΔT and LeftΔT were significantly higher in the FATE group than in the control group. A cut-off value of 2.4°C for RightΔT max and LeftΔT max allowed discrimination between the FATE and control groups with a sensitivity of 80% and 90%, respectively, a specificity of 100% for both, a positive predictive value of 100% for both, and a negative predictive value of 75% and 86%, respectively. Conclusions and relevance A minimal difference of 2.4°C between ipsilateral affected and non-affected limbs has an excellent specificity and high sensitivity for FATE diagnosis. Infrared thermography seems to be a promising, useful, easy, non-invasive and rapid method for detecting aortic thromboembolism in cats, particularly in emergency situations.

OBJECTIVE To assess signalment and concurrent disease processes in dogs with aortic thrombotic disease (ATD). DESIGN Retrospective case-control study. ANIMALS Dogs examined at North American veterinary teaching hospitals from 1985 through 2011 with medical records submitted to the Veterinary Medical Database. PROCEDURES Medical records were reviewed to identify dogs with a diagnosis of ATD (case dogs). Five control dogs without a diagnosis of ATD were then identified for every case dog. Data were collected regarding dog age, sex, breed, body weight, and concurrent disease processes. RESULTS ATD was diagnosed in 291 of the 984,973 (0.03%) dogs included in the database. The odds of a dog having ATD did not differ significantly by sex, age, or body weight. Compared with mixed-breed dogs, Shetland Sheepdogs had a significantly higher odds of ATD (OR, 2.59). Protein-losing nephropathy (64/291 [22%]) was the most commonly recorded concurrent disease in dogs with ATD. CONCLUSIONS AND CLINICAL RELEVANCE Dogs with ATD did not differ significantly from dogs without ATD in most signalment variables. Contrary to previous reports, cardiac disease was not a common concurrent diagnosis in dogs with ATD.

Objective: To review information regarding etiology, pathophysiology, and treatment options for aortic thrombotic disease in dogs., Etiology: Diseases resulting in hypercoagulable states can cause thrombus formation in the distal aorta, and account for the majority of cases of aortic thrombosis (ATh) in dogs, although a substantial number of cases have no identifiable underlying cause. Aortic thromboembolism (ATE) also occurs but appears to be much less frequently documented., Diagnosis: The presentation of ATh and ATE in dogs is more varied compared to cats. Diagnosis can be challenging due to nonspecific clinical signs. Definitive diagnosis involves direct visualization of the thrombus, which is often obtained via ultrasound; however, other imaging modalities such as computed tomography scans can be utilized., Therapy: The optimal treatment for aortic thrombotic disease in dogs has yet to be determined. Although not always possible, treatment of concurrent diseases that may promote thrombosis is an important aspect of thrombus resolution. A recent retrospective study reported positive results with long-term warfarin therapy; however, other studies have not reported similar results. Unfractionated or low-molecular weight heparins are additional anticoagulants that have been utilized. Platelet inhibitor therapy should also be considered in combination with anticoagulant therapy., Prognosis: Survival for dogs with ATh or ATE is reported to be between 50% and 60%. Dogs that present with chronic clinical signs appear to have a better prognosis than those who are acutely affected or those who are severely affected., (© Veterinary Emergency and Critical Care Society 2016.)

A middle-aged cat was presented with vomiting, diarrhea, and pelvic limb paresis. Radiography showed cardiomegaly, interstitial pulmonary infiltration, distended intestinal loops, and portal venous gas. Hypertrophic cardiomyopathy (HCM) was confirmed. On CT, thrombi were identified at the abdominal aorta, superior mesenteric artery, bilateral renal arteries, and cauda vena cava at the level of the iliac vein bifurcation. Dilated and gas-filled loops of bowel with a "paper thin wall" were observed on CT images and were considered indicative of necrotic bowel. This case report describes the CT findings of acute mesenteric ischemia associated with HCM in a cat., (© 2014 American College of Veterinary Radiology.)

A two month-old female Simmental calf was presented with sensomotoric dysfunction and recumbency. Neurologic examination revealed dysfunction of the cerebral cortex and paralysis of both hind limbs. Examination of the skeletal system revealed a marked reduction of the skin temperature of both hind limbs and the absence of femoral pulse. Examination of cerebrospinal fluid yielded physiological parameters. The radiographic examination of the vertebral column, hip and femur on both sides revealed no evidence of alteration of the bone structures. Thiamine pyrophosphate test indicated thiamine deficiency. Based on these findings a tentative diagnosis of cerebrocortical necrosis and aortic thrombosis were made and the animal was euthanised. Post mortem examination yielded thrombosis of the abdominal aorta cranial to the branching of the iliac arteries and consecutive necrosis of the skeletal muscle of the hind limbs. Possible causes of pathogenesis are discussed.

Atherosclerosis is a major contributor to the overall United States mortality rate, primarily in the form of heart attacks and stroke. Unlike the human disease, which is believed to be multifactorial, pigeon atherosclerosis is due to a single gene autosomal recessive trait. The White Carneau (WC-As) strain develops atherosclerotic plaques without the presence of known environmental risk factors such as diet and classic predictors such as blood pressure or blood cholesterol levels. With similar parameters, the Show Racer (SR-Ar) is resistant to plaque development. Thiazolidinediones, including rosiglitazone, activate the peroxisome proliferator-activated receptor gamma (PPARγ) raising cellular sensitivity to insulin. The effect of rosiglitazone was evaluated in aortic smooth muscle cells (SMC) from these 2 pigeon breeds. Primary SMC cultures were prepared from WC-As and SR-Ar squabs. Cell monolayers, which achieved confluence in 7 d, were treated with 0 or 4 µM rosiglitazone for 24 h. Cellular lipid accumulation was evaluated by oil red O staining. Control WC-As cells had significantly higher vacuole scores and lipid content than did the SR-Ar control cells. Rosiglitazone treatment decreased WC-As lipid vacuoles significantly compared with the control cells. On the other hand, lipid vacuoles in the treated and untreated SR-Ar cells did not differ significantly. The effect of rosiglitazone on WC-As SMC gene expression was compared with control SMC using representational difference analysis. Significant transcript increases were found for caveolin and RNA binding motif in the control cells compared with the rosiglitazone-treated cells as well as cytochrome p450 family 17 subfamily A polypeptide 1 (CYP171A) in the rosiglitazone-treated cells compared with the control cells. Although rosiglitazone was selected for these experiments because of its role as a PPARγ agonist, it appears that the drug also tempers c-myc expression, as genes related to this second transcription factor were differentially expressed. Both PPARγ and c-myc appear to affect WC-As SMC gene expression, which may relate to disease development, progression, or both., (Poultry Science Association Inc.)

Spontaneous atherosclerosis in the White Carneau (WC-As) pigeon is inherited as a single gene disorder, and its progression closely mirrors the human disease. Representational difference analysis and microarray were used to identify genes that were differentially expressed between the susceptible WC-As and resistant Show Racer (SR-Ar) aortic tissue. The RNA extracted from 1-d-old squab aortas was used to make cDNA for each experiment. Fifty-six unique genes were found using representational difference analysis, with 25 exclusively expressed in the WC-As, 15 exclusive to the SR-Ar, and 16 nonexclusive genes having copy number variation between breeds. Caveolin and β-actin were expressed in the WC-As, whereas the proteasome maturation protein and the transcription complex CCR4-NOT were exclusive to the SR-Ar. Microarray analysis revealed 48 genes with differential expression. Vascular endothelial growth factor and p53 binding protein were among the 17 genes upregulated in the WC-As. Thirty-one genes were upregulated in the SR-Ar including the transforming growth factor-β signaling factor SMAD2 and heat shock protein 90. Genes representing several biochemical pathways were distinctly different between breeds. The most striking divergences were in cytoskeletal remodeling, proteasome activity, cellular respiration, and immune response. Actin cytoskeletal remodeling appears to be one of the first differences between susceptible and resistant breeds, lending support to the smooth muscle cell phenotypic reversion hypothesis of human atherogenesis.

Spirocerca lupi is a common cause of vomiting, regurgitation, and sudden death in dogs that live in tropical or subtropical regions. Sudden death due to aortic rupture may occur with no preceding clinical signs. The purpose of this prospective study was to compare radiographic and computed tomographic (CT) characteristics of aortic lesions in a cohort of 42 dogs with endoscopically confirmed spirocercosis. Dorsoventral and right lateral recumbent thoracic radiographic findings were compared with pre- and postcontrast thoracic CT findings. Aortic mineralization was detected using CT in 18/42 dogs (43%). Three dogs had faint diffuse aortic wall mineralization. Using CT as the reference standard, radiographs had a sensitivity and specificity of 6% and 96%, respectively, for detecting aortic mineralization. A total of 20 aortic aneurysms were detected using CT in 15/42 dogs (36%). Using CT as the reference standard, radiographs had a sensitivity and specificity of 86% and 56%, respectively, for detecting aortic aneurysms. Respiratory motion, aortic displacement by esophageal masses and Spirocerca nodules adjacent to the aorta mimicked aneurysm formation on radiographs. Aortic thrombi were seen in two dogs in postcontrast CT images. Findings from this study indicated that aortic mineralization and aneurysm formation are common in dogs with spirocercosis. Findings also supported the use of pre- and postcontrast CT as effective methods for detecting and characterizing these lesions., (© 2013 Veterinary Radiology & Ultrasound.)

Persistent right aortic arch (PRAA) in cats is an uncommon vascular anomaly with clinical signs referable to oesophageal obstruction. To our knowledge no reports of axial skeletal malformations concomitant to PRAA have been reported in cats. The aim of this study is to depict a new clinical feature in cats affected by PRAA. In the study six cats with a diagnosis of vascular ring anomaly were enrolled. A complete physical examination, a neurological examination and a total body radiograph were performed on each animal. Four of the six cats showed contemporary PRAA and skeletal malformations. Additionally, for the first time, a genetic test was performed on one subject to detect DNA alterations in the homologous DiGeorge region of cat. The percentage of skeletal malformations reported in the normal population was compared with animals with PRAA and showed a higher frequency. Genetic testing failed to demonstrate a correlation between PRAA and DiGeorge genomic deletion. A review of veterinary and human diseases that presented both conditions was assessed. The few animals enrolled do not allow definitive conclusions. Further studies are required to corroborate the correlation between PRAA and axial skeletal malformations in cats.

Objective: To describe clinical signs, treatment, and outcome of aortic thrombosis in dogs., Design: Retrospective case series., Animals: 31 dogs with aortic thrombosis., Procedures: Records were retrospectively reviewed and data collected regarding signalment, historical signs, physical examination findings, laboratory testing, definitive diagnosis, and presence of concurrent disease., Results: The records of 31 dogs with clinical or postmortem diagnosis of aortic thrombosis were reviewed. Onset of clinical signs was acute in 14 (45%) dogs, chronic in 15 (48%), and not documented in 2 (6%). Femoral pulses were subjectively weak in 6 (19%) dogs and absent in 17 (55%). Frequent laboratory abnormalities included high BUN concentration (n = 13), creatinine concentration (6), creatine kinase activity (10), and D-dimer concentration (10) and proteinuria with a urine protein-to-creatinine concentration ratio > 0.5 (12). Concurrent conditions included neoplasia (n = 6), recent administration of corticosteroids (6), and renal (8) or cardiac (6) disease. Median survival time was significantly longer for dogs with chronic onset of disease (30 days; range, 0 to 959 days) than for those with acute onset of clinical signs (1.5 days; range, 0 to 120 days)., Conclusions and Clinical Relevance: Results suggested that aortic thrombosis is a rare condition in dogs and accounted for only 0.0005% of hospital admissions during the study period. The clinical signs for dogs with aortic thrombosis differed from those seen in feline patients with aortic thromboembolism. Median survival time was significantly longer for dogs with chronic disease than for dogs with acute disease. Despite treatment, outcomes were typically poor, although protracted periods of survival were achieved in some dogs.

Objectives: The pathogenesis and presentation of aortic thrombosis (AT) in dogs is not well characterized and an effective antithrombotic therapy for AT in dogs has not been identified. Our goal is to report the clinical presentation and results of therapies in dogs with AT., Animals: Twenty-six client-owned dogs., Methods: Retrospective review of medical records of dogs diagnosed with AT between 2003 and 2010., Results: Twenty-six dogs had an apparent primary mural aortic thrombus. None had structural heart disease at diagnosis. Twenty dogs were ambulatory with varying degrees of pelvic limb dysfunction. Duration of ambulatory dysfunction was 7.8 weeks (range 1 day-52 weeks). A majority of dogs (58%) had no concurrent conditions at diagnosis. Fourteen dogs were treated with a standard warfarin protocol for a median period of 22.9 months (range 0.5-53 months). Ambulatory function improved in all dogs treated with warfarin. Time until clinical improvement was 13.9 days (range 2-49 days). Dogs treated with warfarin did not become non-ambulatory, die or undergo euthanasia related to AT, or have a known serious hemorrhagic event., Conclusions: The pathogenesis of AT in dogs is distinct from that of aortic thromboembolism (ATE) in cats. Aortic thrombosis in dogs is more likely to involve local thrombosis in the distal aorta with embolization to the arteries of the pelvic limb resulting in chronic progressive ambulatory dysfunction. Chronic warfarin administration is well-tolerated and appears to be an effective short-term and long-term therapy for dogs with AT., (Copyright © 2012 Elsevier B.V. All rights reserved.)

A Bulldog puppy that died at 1 day of age was presented for postmortem evaluation. Macroscopically, there was marked hypoplasia of the ascending, transverse, and proximal segments of the descending thoracic aorta and almost complete secondary thrombosis of the left ventricle causing a functional stenosis of the left atrioventricular valve. Separately, there was right atrioventricular valve dysplasia with secondary dilation of the right atrium. Microscopically, the left ventricular outflow tract was occluded by chondroid metaplasia, fibrosing recanalization of a left-ventricular thrombus, and isolated Purkinje fiber degeneration and necrosis.

Reasons for Performing Study: Aortoiliac thrombosis (AIT) is a progressive vascular disease characterised by an exercise-induced hindlimb lameness. After developing a surgical technique, a follow-up study was required., Objectives: To assess the surgical results of a surgical thrombectomy in horses with AIT, a chronic arterial occlusive disease of the aorta and its caudal arteries., Methods: Seventeen cases showed the typical signs of AIT and diagnosis was confirmed by Doppler-ultrasonography. Average age of the horses was 12 years. Seven stallions, 6 mares and 4 geldings were included., Results: The thrombus was located in the left hindlimb (5 cases), the right hindlimb (9 cases) or in both hindlimbs (3 cases). Two cases were operated on both limbs with a few days between surgeries. Nine (53%) horses regained their athletic performance and 2 horses were able to work for at least 30 min without complaint, instead of the initial 5 min prior to surgery. During surgery one horse had to be subjected to euthanasia because the thrombus was too tightly attached to the arterial wall and could not be removed. Two horses were subjected to euthanasia post operatively due to severe myopathy and one due to a femoral fracture during recovery. Two reocclusions of the treated artery occurred 4 months after surgical intervention: one horse was reoperated and, due to the extent of the thrombus and quality of the arterial wall, the horse was subjected to euthanasia; the other horse was subjected to euthanasia without a second surgery. A severe complication was the appearance of AIT in the contralateral limb after surgery as result of occlusion caused by an embolus loosened by the procedure. Post anaesthetic myopathy was seen in 4 (24%) of the cases and could be so severe that euthanasia had to be considered., Conclusion and Potential Relevance: Surgical intervention by means of a thrombectomy in horses with AIT should be considered; 65% of the horses regained athletic activity and 53% of the operated horses in this study performed at their previous level. Adequate padding, correct positioning, prevention of intraoperative hypotension and keeping surgery time as short as possible, are important parameters to prevent post operative myopathy.

Contrast enhanced magnetic resonance angiography (MRA) can provide noninvasive relatively rapid three-dimensional high-detailed vascular images over large anatomic areas. There are few descriptions of the use of contrast-enhanced MRA in veterinary patients. This is a report illustrating the use of contrast-enhanced MRA to localize the full extent of distal aortic, external iliac, and femoral artery thrombi confirmed surgically in four dogs. Distal aorta contrast-enhanced MRA was anatomically accurate in detecting the full extent of thrombi involving the aorta, external iliac and femoral arteries in these four canine patients. This procedure can provide important information for surgery.

Aortic occlusion is a rare vascular disorder in the dog. This report describes the clinical feature of an aged Boxer with complete occlusion of the abdominal aorta caused by an intraluminal thrombus. Angiography evidenced a collateral circulation, represented by the internal thoracic artery, the cranial epigastric artery and the caudal epigastric artery, providing adequate blood flow to the pelvis and pelvic limbs. This vascular network has only recently been recognised as one of the major collateral pathways for arterial blood supply to the pelvis and lower extremities in humans with chronic aorto-iliac occlusive disease (CAOD). Furthermore, a femoral artery Doppler waveform, characterised by low amplitude, a monophasic systolic wave with blunted parabolic flow profile and a small spectral window, peculiar to humans with CAOD, is documented for the first time in a dog with aortic occlusion.

A primary intimal aortic angiosarcoma was diagnosed in a 4-year-old, spayed female German Shepherd that presented for complications of thromboembolic disease because of infarcts in multiple organs. On gross examination, aneurysmal dilatation of the aorta was associated with a friable, necrotic mass attached to the endothelial surface, which partially occluded the aortic lumen. On histologic examination, plump neoplastic spindle cells formed a plaque-like mass arising from the intima that merged with a large accumulation of fibrin and necrotic debris, and projected into the lumen. Neoplastic cells invaded periaortic vessels and were seen in some infarct-associated thromboemboli. Tumor cells expressed vimentin and CD31, with infrequent, patchy staining with factor VIII-related antigen; tumor cells were negative for cytokeratin and smooth-muscle actin. Aortic angiosarcoma is a rare malignancy in humans. This is the first description of a primary intimal aortic angiosarcoma in a dog, with immunohistochemical evidence of endothelial origin.

Objectives: To characterise the clinical presentation and neurological abnormalities in dogs affected by aortic thromboembolism., Methods: The medical records of 13 dogs diagnosed with aortic thromboembolism as the cause of the clinical signs, and where a complete neurological examination was performed, were reviewed retrospectively., Results: The onset was acute in only four dogs, chronic in five dogs (with all of these presenting as exercise intolerance) or chronic with acute deterioration in four dogs. Dogs with an acute onset of clinical signs were more severely affected exhibiting neurological deficits, while dogs with a chronic onset of disease predominantly presented with the exercise intolerance and minimal deficits. The locomotor deficits included exercise intolerance with pelvic limb weakness (five of 13), pelvic limb ataxia (one of 13), monoparesis (two of 13), paraparesis (two of 13), non-ambulatory paraparesis (two of 13) and paraplegia (one of 13). There was an apparent male predisposition and the cavalier King charles spaniel was overrepresented., Clinical Significance: The rate of onset of clinical signs appears to segregate dogs affected by aortic thromboembolism into two groups, with different clinical characteristics and outcomes. Dogs with an acute onset of the clinical signs tend to be more severely affected, while dogs with a chronic onset predominantly present with exercise intolerance. It is therefore important to consider aortic thromboembolism as a differential diagnosis in dogs with an acute onset of pelvic limb neurological deficits and in dogs with longer standing exercise intolerance.

The purpose of this prospective clinical trial was to evaluate the safety and efficacy of a commercially available rheolytic thrombectomy system in the treatment of naturally occurring feline aortic thromboembolic disease. All 6 cats enrolled in the investigation were affected at the level of the distal aorta and had signs of the disease affecting both pelvic limbs. Cats were anesthetized and an arteriotomy was performed on 1 carotid artery to gain access to the arterial system. Selective arterial angiography was used to confirm the presence of thromboembolic disease. The thrombectomy system was advanced to the level of the thrombus using fluoroscopic guidance. Repeat angiography was used intermittently to assess progress of thromboembolus dissolution throughout the procedure. The use of the rheolytic thrombectomy system resulted in successful thrombus dissolution in 5 of 6 cats. Three of 6 cats survived to discharge. Both of these results compare favorably with conventional therapies used in the treatment of this disease. Feline distal aortic thromboembolism is a frustrating disease that warrants a guarded to poor prognosis. Rheolytic thrombectomy may provide veterinarians with an alternative therapy in the treatment of thromboembolic diseases, including feline distal aortic thromboembolism.

A 2-year-old male castrated Cavalier King Charles Spaniel was presented with paraplegia, cold caudal extremities and lack of femoral pulses. A 2cm long thrombus occluding the aortic trifurcation and a 3cm long abdominal aortic aneurysm with a thrombus were detected by ultrasonographic examination. The clinical and ultrasonographic findings were consistent with aortic thromboembolism. Anti-thrombotic and vasodilative therapy was not helpful and the dog was euthanized 3 days after the onset of paraplegia. A thrombus in the aortic trifurcation, multiple thoracic and abdominal aneurysms and a distal mediastinal esophageal granuloma containing Spirocera lupi worms were found on necropsy. The abdominal aortic aneurysms formed by S. lupi larval migration are believed to be responsible for the formation of the thrombus that occluded the aortic trifurcation. This is the first report of aortic thromboembolism associated with S. lupi infection.

In 2 successive matings of the same dam and sire in a Greyhound kennel, 1 of 6 puppies and 2 of 6 puppies were born with persistent right aortic arch (PRAA) in the first and second litters, respectively. Many congenital heart defects in dogs are believed to be heritable; however, proof of this has been difficult to obtain. Genetic predisposition to PRAA has been reported in German Shepherd Dogs and Irish Setters. The occurrence of PRAA in related Greyhounds within a kennel suggested a genetic predisposition to PRAA in a breed with which it has not been associated previously. Although the number of matings available for analysis was insufficient to conclusively prove a genetic basis for these observations, the occurrence of PRAA in puppies arising from successive matings of the same dam and sire strongly suggests that some lines of dogs of various breeds may be genetically predisposed to PRAA.

Aortic and cardiac mineralization was found in 21 of 3443 (0.61%) canine thoracic radiographs. In none of 786 feline thoracic radiographs reviewed were such lesions present. Mineralizations were superimposed on the ascending aorta (19 dogs) or on the caudal cardiac silhouette (2 dogs). In 2 of 4 dogs mineralization was identified echocardiographically dorsal to the aortic valve in close proximity to coronary arteries. Computed tomography confirmed mineralization of the aortic arch and root in 2 of 2 dogs. Necropsy and histopathologic examination in 1 dog revealed multiple nodular aortic tunica media calcifications with adjacent areas of degeneration. Lesions were significantly overrepresented in older dogs and in Rottweilers, and regarded as dystrophic calcification, caused either by age-related degenerative changes or chronic disease-related processes. There was no evidence of clinical significance attributed to the mineralization in any dog. Aortic and cardiac mineralization should be recognized as an incidental, non-significant finding in dogs of advanced age and differentiated from pleural and pulmonary structures.

A feline domestic shorthair queen and her 3 offspring were all diagnosed with asymptomatic hypertrophic cardiomyopathy (HCM). The family has been followed for 13 years, and 3 cats have died of aortic thromboembolism (ATE). This communication documents the long-term progression of HCM in these cats that presented with mild left ventricular hypertrophy and hyperdynamic systolic ventricular function, developed progressive left atrial enlargement, and eventually resulted in hypodynamic left ventricular systolic function with relative left ventricular chamber dilation at the time of ATE.

The inheritance pattern for susceptibility to spontaneous (noninduced) aortic atherosclerosis in pigeons was determined by crossbreeding and backcrossing experiments with atherosclerosis-susceptible White Carneau and atherosclerosis-resistant Show Racer breeds. Susceptibility, assessed by the presence of grossly visible lesions at the celiac bifurcation of the aorta at 3 years of age, demonstrated an inheritance pattern consistent with an autosomal recessive Mendelian trait. Cell culture studies indicated that susceptibility is a constitutive property of aortic cells as evidenced by vacuole formation and lipid content in smooth muscle cells from various tissues in susceptible pigeons.

Six dogs had signs of pelvic limb weakness, pain and collapse as a result of occlusion of the distal aorta and/or the iliac arteries by a thrombus. Antemortem diagnosis was made on the basis of clinical signs, angiography and ultrasonography. Five dogs had concurrent disease that probably predisposed to thrombosis, including hyperadrenocorticism (three dogs), neoplasia and cardiac disease. Two dogs died shortly after the episode of thrombosis. Dogs that survived the acute episode received aspirin in an attempt to prevent thrombosis occurring again and all regained pelvic limb function. For dogs that survived longer than one month after the acute episode, repeat thrombosis was uncommon; hence the prognosis was related to the underlying disease. Aortic and iliac thrombosis in dogs is an uncommon condition that usually arises secondarily to a predisposing disease process; it carries a more favourable prognosis than feline aortic thromboembolism.

The clinical case records of 44 cats with distal aortic thromboembolism were reviewed. These detailed 49 separate episodes of thromboembolism. Of the 44 cats, 33 (75%) were neutered males, and 43 (98%) were domestic shorthairs. The mean age was 8.7 years (age range 2-16 years). Evidence of pre-existing heart disease had been noted in 23% of cases. Heart failure was a concurrent diagnosis in 51% of episodes and 36% of these cases survived their thromboembolic episodes. Overall, cats survived 39% of the episodes. Cats died during 28% of the episodes, while 33% of the episodes resulted in the cats being euthanased. The median survival time was 6 months. Seventeen per cent of cats on prophylactic aspirin therapy experienced an episode of re-embolisation. Forty-three per cent of episodes occurred in the spring., (Copyright 1999 European Society of Feline Medicine.)

A 12-year-old, neutered female, Siberian Husky dog presented with a hind limb weakness of one month duration. To facilitate making a diagnosis multiple imaging modalities were performed. These modalities included radiography, ultrasonography, magnetic resonance imaging (MRI), magnetic resonance angiography (MRA) and selective angiography of the abdominal aorta. In this dog, the MRI/MRA studies provided the first documentation of the external iliac thrombi and the collateral circulation via the lumbar arteries. At necropsy, an aortoiliac thrombus caused by a mineralized arteriosclerotic plaque was noted.