Carlo Guglielmini

Feline aelurostrongylosis and canine angiostrongylosis : A challenging diagnosis for two emerging verminous pneumonia infections

Aelurostrongylus abstrusus and Angiostrongylus vasorum (Nematoda, Metastrongyloidea) are causative agents of verminous feline and canine pneumonia. Both are presently emerging in several geographical areas and are of major clinical importance. Given the range of parasitic and non-parasitic pathogens which may cause cardio-respiratory distress in dogs and cats, the unequivocal specific diagnosis of both diseases is pivotal for unravelling their epidemiology and central to therapy and control. Several conventional clinico-pathologic, diagnostic imaging and parasitological approaches are currently used in practice, but all have major limitations in the specific diagnosis of these diseases. Serological methods have shown promise in the diagnosis of A. abstrusus and A. vasorum infections, but no clinically useful tests are currently available. Additionally, there have been major advances in the development of novel molecular diagnostic tools for feline aelurostrongylosis, but efforts to develop molecular diagnostic tests are still preliminary for angiostrongylosis. This article provides a review of A. abstrusus and A. vasorum infections in cats and dogs, focusing on the advantages and shortcomings of classical diagnostic methodologies and on present diagnostic advances as well as future perspectives instrumental to epidemiological and clinical studies.

Occurrence of fatal canine Angiostrongylus vasorum infection in Italy

Two cases of fatal canine angiostrongylosis, occurred in a short-time between them in Italy, are described. Both animals presented with severe cardio-respiratory signs and died shortly after admission. At necropsy, both dogs showed lung haemorrhagic lesions, thrombosis of the pulmonary arteries and dilatation of the right heart chambers. Adult nematodes, identified as Angiostrongylus vasorum, were recovered from the heart and/or the pulmonary arteries of the dead animals. The present report focuses on the clinical and parasitological aspects of the two cases and underlines that canine angiostrongylosis should be included in the differential diagnosis of dogs with cardio-pulmonary disorders in southern Europe.

Serum Cardiac Troponin I Concentration in Dogs with Precapillary and Postcapillary Pulmonary Hypertension

BACKGROUND Pulmonary hypertension (PH) is a disease condition leading to right-sided cardiac hypertrophy and, eventually, right-sided heart failure. Cardiac troponin I (cTnI) is a circulating biomarker of cardiac damage. HYPOTHESIS Myocardial damage can occur in dogs with precapillary and postcapillary PH. ANIMALS One hundred and thirty-three dogs were examined: 26 healthy controls, 42 dogs with mitral valve disease (MVD) without PH, 48 dogs with pulmonary hypertension associated with mitral valve disease (PH-MVD), and 17 dogs with precapillary PH. METHODS Prospective, observational study. Serum cTnI concentration was measured with a commercially available immunoassay and results were compared between groups. RESULTS Median cTnI was 0.10 ng/mL (range 0.10-0.17 ng/mL) in healthy dogs. Compared with the healthy population, median serum cTnI concentration was increased in dogs with precapillary PH (0.25 ng/mL; range 0.10-1.9 ng/mL; P < .001) and in dogs with PH-MVD (0.21 ng/mL; range 0.10-2.10 ng/mL; P < .001). Median serum cTnI concentration of dogs with MVD (0.12 ng/mL; range 0.10-1.00 ng/mL) was not significantly different compared with control group and dogs with PH-MVD. In dogs with MVD and PH-MVD, only the subgroup with decompensated PH-MVD had significantly higher cTnI concentration compared with dogs with compensated MVD and PH-MVD. Serum cTnI concentration showed significant modest positive correlations with the calculated pulmonary artery systolic pressure in dogs with PH and some echocardiographic indices in dogs with MVD and PH-MVD. CONCLUSIONS AND CLINICAL IMPORTANCE Serum cTnI is high in dogs with either precapillary and postcapillary PH. Myocardial damage in dogs with postcapillary PH is likely the consequence of increased severity of MVD.

Cardiovascular diseases in the ageing dog: diagnostic and therapeutic problems.

Increased life expectancy is a common scenario for dogs living in the third millennium, since many advances in canine medicine and surgery, as well as in nutrition and preventive health care, have taken place over the last few decades. According to a study conducted on a population of 9248 subjects, cardiac diseases are the second most prevalent cause of death in the dog, accounting for a percentage of 16.3% (Eichelberg and Seine, 1996). A complete understanding of the pathophysiological mechanisms of cardiovascular diseases in the geriatric dog should include the complete knowledge of diseases primarily involving the cardiovascular system, as well as those affecting other systems with a known influence on cardiovascular function, in addition to a clear understanding of the modifications of the cardiovascular structure and function associated with advanced age. Age-related changes of canine cardiovascular function include decreased blood flow, blood velocity, and arterial compliance and distensibility (Miller et al., 1976; Haidet et al., 1996), as well as increased ventricular systolic and diastolic stiffness associated with prolonged duration of myocardial contractility (Templeton et al., 1976, 1979). A decline in cardiovascular responsiveness to beta-adrenergic stimulation has also been demonstrated in aged dogs (Yin et al., 1979; Haidet 1993). Progressive loss of organ reserve and adaptability, probably due to functional changes in the catecholaminergic system, was proposed as an inciting mechanism for cardiovascular diseases in older dogs by Strasser and colleagues (1997). However, unlike human beings, primary systemic hypertension (i.e. occurring in the absence of any underlying endocrine or renal disease) does not appear to be a common clinical problem in healthy geriatric dogs (Meurs et al., 2000). Furthermore, arteriosclerosis and related ischaemic heart disease are uncommon in the dog, but their real incidence may be underestimated (Falk and Jonsson, 2000). The precise relationship between the above-mentioned negative modifications of cardiovascular function and the development of specific cardiovascular diseases is difficult to ascertain. A recent study reported the overall prevalence of cardiac pathological alterations observed in beagle dogs employed as control subjects in four life-span studies at

ULTRASONOGRAPHIC AND PATHOLOGIC FEATURES OF INTESTINAL SMOOTH MUSCLE HYPERTROPHY IN FOUR CATS

The ultrasonographic findings for four cats with intestinal smooth muscle hypertrophy are described. In two cats, intestinal smooth muscle hypertrophy was associated with chronic enteritis. In the remaining two cats, intestinal smooth muscle hypertrophy affected the intestinal tract proximal to stenosis due to alimentary lymphoma and an intestinal foreign body, respectively. Moderate increased thickness of the affected intestinal wall, measuring 7–8 mm, was evident on abdominal ultrasonographic examination of all subjects. In addition, the ultrasonographic five‐layered feature of the intestinal wall was maintained, and only the muscular layer appeared thickened. Abdominal ultrasound allowed a presumptive diagnosis of intestinal smooth muscle hypertrophy that was confirmed histologically in all cats.

Evaluation of a portable meter to measure ketonemia and comparison with ketonuria for the diagnosis of canine diabetic ketoacidosis.

BACKGROUND The diagnosis of canine diabetic ketoacidosis (DKA) usually is based on measurement of urinary acetoacetate (ketonuria). In humans, this test is less sensitive and specific than blood 3-beta-hydroxybutyrate (ketonemia) evaluation. HYPOTHESIS Ketonemia measurement using a portable meter is more accurate than ketonuria determination with a dipstick to diagnose canine DKA. ANIMALS Seventy-two client-owned diabetic dogs with ketonemia, ketonuria, or both. METHODS Prospective observational study. Based on blood bicarbonate concentration and anion gap, dogs were divided into 2 groups: patients with DKA (n= 25); patients with diabetic ketosis (n= 47). Sensitivity, specificity, and positive and negative likelihood ratio (LR) at different cut-off points were determined for both ketonemia and ketonuria. Receiver operating characteristic (ROC) analysis was used to assess the accuracy of each diagnostic test to diagnose DKA. RESULTS With regard to ketonemia, cut-off values of 2.3 and 4.3 mmol/L revealed 100% sensitivity and 100% specificity, respectively, whereas cut-off values of 2.8 and 3.5 mmol/L showed a -LR of 0.05 and a + LR of 13.16, respectively. With regard to ketonuria, a cut-off value of 1+ revealed 92% sensitivity, 40% specificity, and -LR of 0.20, whereas a cut-off value of 3+ revealed 44% sensitivity, 94% specificity, and +LR of 6.89. The areas under the ROC curves for the ketonemia and ketonuria tests were significantly different (0.97 and 0.81, respectively, P= .003). CONCLUSIONS AND CLINICAL IMPORTANCE Measurement of ketonemia is accurate and more effective than measurement of ketonuria to diagnose canine DKA.

Hypertrophy of intestinal smooth muscle in cats

Pathological findings of four cats with severe and diffuse smooth muscle hypertrophy of the small intestine (MHSI) are reported and compared to those of five cats with segmental MHSI secondary to neoplastic obstruction and four controls. Histology demonstrated a constant association between idiopathic MHSI and submucosal fibrosis and chronic lymphoplasmacytic enteritis. Morphometry (gut diameter, thickness and area of muscular layers, number and density of smooth muscle nuclei) and MIB-1-immunolabelling showed that the thickness increase was mostly due to hypertrophy, but hyperplasia was also evident. Microbiology from ileal content samples was performed in two cats with primary MHSI, and Campylobacter spp. were isolated, which were also demonstrated by immunohistochemistry and ultrastructure. The association of chronic enteritis with idiopathic MHSI suggests that factors released in intestinal inflammation may also act as hypertrophy stimuli for smooth muscle cells.

Radiographic features of cardiogenic pulmonary edema in dogs with mitral regurgitation: 61 cases (1998-2007)

OBJECTIVE To evaluate radiographic distribution of pulmonary edema (PE) in dogs with mitral regurgitation (MR) and investigate the association between location of radiographic findings and direction of the mitral regurgitant jet (MRJ). DESIGN Retrospective case series. ANIMALS 61 dogs with cardiogenic PE and MR resulting from mitral valve disease (MVD; 51 dogs), dilated cardiomyopathy (9), and hypertrophic cardiomyopathy (1). PROCEDURES Thoracic radiographs of dogs with Doppler echocardiographic evidence of MR were reviewed for location (diffuse, perihilar, or focal) of PE. Also, direction (central or eccentric) of the MRJ, as evaluated by Doppler color flow mapping (DCFM), and distribution (symmetric or asymmetric) of radiographic findings were evaluated. RESULTS Diffuse, perihilar, and focal increases in pulmonary opacity were observed in 11 (18.0%), 7 (11.5%), and 43 (70.5%) of 61 dogs, respectively. Radiographic evidence of asymmetric PE in a single lung lobe or 2 ipsilateral lobes was found in 21 dogs, with involvement of only the right caudal lung lobe in 17 dogs. Doppler color flow mapping of the MRJ was available for 46 dogs. Of 31 dogs with a central MRJ, 28 had radiographic findings indicative of symmetric PE. Of 15 dogs with eccentric MRJ, 11 had radiographic evidence of asymmetric PE, and all of these dogs had MVD. CONCLUSIONS AND CLINICAL RELEVANCE In dogs with cardiogenic PE, a symmetric radiographic distribution of increased pulmonary opacity was predominantly associated with a central MRJ, whereas an asymmetric radiographic distribution was usually associated with eccentric MRJ, especially in dogs with MVD.

Bone density of the arm and forearm as an age indicator in specimens of stranded striped dolphins (stenella coeruleoalba)

The age of odontocetes living in the wild is determined mainly by analysis of dentine layers in sections of the teeth. We examined a series of specimens from striped dolphins (Stenella coeruleoalba, Meyen, 1833) that had stranded along the Italian coast of the Mediterranean sea. The present study analyzes and describes bone density in the arm and forearm of the stranded specimens, and correlates the data with total body length of the animal and age as determined by the number of dentine layers in sections of the teeth. According to our model, age can be predicted on the basis of bone density and total body length of the stranded animal. This is the first study to use bone density as a biological parameter to understand the wear and tear of life in the sea. The results suggest that bone density is a new tool for recording age in wild odontocetes. Anat Rec 267:225–230, 2002.

Accuracy of radiographic vertebral heart score and sphericity index in the detection of pericardial effusion in dogs

OBJECTIVE To evaluate the diagnostic accuracy of radiographically derived measurements of vertebral heart score (VHS) and sphericity index (SI) in the detection of pericardial effusion (PE) in dogs. DESIGN Retrospective case-control study. Animals-51 dogs with PE associated with various cardiac disorders, 50 dogs with left- or right-sided cardiac disorders without PE, 50 dogs with bilateral cardiac disorders without PE, and 50 healthy dogs. PROCEDURES Measurements of VHS on lateral (lateral VHS) and ventrodorsal (ventrodorsal VHS) radiographs, SI on lateral (lateral SI) and ventrodorsal (ventrodorsal SI) radiographs, and global SI (mean of lateral SI and ventrodorsal SI) were obtained. Receiver operating characteristic curves were calculated to evaluate the diagnostic accuracy of the radiographic indexes at differentiating dogs with PE from those with other cardiac disorders without PE. RESULTS Measurements of lateral and ventrodorsal VHS were significantly higher in dogs with PE, compared with values for all dogs without PE. Measurements of lateral, ventrodorsal, and global SI were significantly lower in dogs with PE, compared with values for all dogs without PE. Cutoff values of > 11.9, > 12.3, and ≤ 1.17 for lateral VHS, ventrodorsal VHS, and global SI, respectively, were the most accurate radiographic indexes for identifying dogs with PE. CONCLUSIONS AND CLINICAL RELEVANCE Cardiac silhouettes of dogs with PE were larger and more rounded, compared with those of dogs with other cardiac disorders without PE. Objective radiographic indexes of cardiac size and roundness were only moderately accurate at distinguishing dogs with PE from dogs with other cardiac disorders without PE.