Creatine kinase (CK) is a muscle enzyme that is very sensitive to muscle damage. Therefore, serum CK is measured particularly to confirm suspected myopathy. Since 2013, this enzyme has been included in the routine chemistry profile in our hospital. Soon thereafter, the subjective impression developed that its elevation did not correlate to and was not explainable with the actual clinical problem. Therefore, the aim of this retrospective study was to investigate in which clinical cases the CK elevation was adequate and in which cases without clinical evidence of muscle damage the CK was so markedly elevated that it implied a clinically relevant muscle damage. For this purpose, we evaluated the CK values of 1641 cats presented in the years 2013/2014 at our university animal hospital. The CK was comprehensibly elevated in cats with trauma and various diseases with obvious and traceable muscle damage like thrombo-embolic damage or seizures. In addition, the CK was elevated in diseases where concomitant muscle damage is perceivable like in cats with hypertrophic cardiomyopathy. However, the CK also was commonly and sometimes dramatically elevated in cats of essentially any disease group without any comprehensible skeletal muscular lesion. These results confirm the hypothesis that the diagnostic value of this parameter is most questionable. A CK elevation does not allow any conclusion regarding its original diagnostic purpose, i.e. to confirm the presence of a clinically relevant myopathy. Die Kreatinkinase (CK) ist ein Muskelenzym, welches sehr sensitiv bei Muskelschäden ansteigt. Entsprechend wird die Serum-CK insbesondere bei Verdacht auf und zur Bestätigung einer Myopathie bestimmt. Am Tierspital Zürich wird die CK seit 2013 routinemässig im Chemieprofil mitbestimmt. Bald entwickelte sich der subjektive Eindruck, dass die Erhöhung nicht mit den vorliegenden klinischen Problemen korrelierte oder zu erklären war. Ziel dieser retrospektiven Arbeit war es daher, den diagnostischen Nutzen einer erhöhten CK bei Katzen zu untersuchen. Die zentralen Fragen waren, bei welchen klinischen Grundproblemen die CK adä quat erhöht, und wie oft und bei welchen Grunderkrankungen die CK ohne erkennbare Myopathie so stark erhöht war, dass es einen klinisch bedeutsamen Muskelschaden implizierte. Hierzu wurden die CK-Werte von 1641 Katzen ausgewertet, welche in den Jahren 2013/2014 am Tierspital Zürich vorgestellt wurden. Die CK war nachvollziehbar erhöht bei Katzen mit Trauma und verschiedenen Erkrankungen mit offensichtlicher oder erklärbarer Muskelschädigung wie thrombo-embolischer Schädigung oder Epilepsie. Die CK war ebenfalls erhöht bei Erkrankungen, wo theoretisch eine Muskelschädigung vorliegen mag, wie bei Katzen mit hypertropher Kardiomyopathie. Daneben war die CK aber auch bei Katzen mit ganz unterschiedlichen Erkrankungen und ohne jegliche nachvollziehbare Skelett muskelläsion sehr oft und teils dramatisch erhöht. Die Resultate bestätigen die Hypothese, dass die diagnostische Aussagekraft dieses Parameters kritisch zu hinter...

N-terminal pro-b-type natriuretic peptide (NTproBNP) is a cardiac biomarker used to detect myocardial wall stress. Physical activity and cardiac disease can affect serum NTproBNP concentrations. In people, different types of physical activity have different effects on NTproBNP. Our hypothesis was that physical activity and training have an effect on NTproBNP concentrations depending on the type of exercise and the intensity. Seven German Shepherd dogs (GSD) under military training performing short bursts of fast-paced interval exercise and seven Eurohounds (EHs) training for racing competition with endurance exercise were included in the study. Blood samples were taken at enrollment (T0) and after a two-month (T2mth) training period; on both occasions, the samples were acquired before and after physical exercise. An echocardiographic evaluation was performed at T0. Echocardiographic heart size was larger in the EHs compared to the GSDs. The NTproBNP concentration was higher in the EHs than in the GSDs before and after exercise at T0 and T2mth. Echocardiographic parameters of heart size and wall thickness correlated with NTproBNP at T0 before and after exercise. Exercise induced an elevation of NTproBNP in the EHs at T0 and T2mth, while in the GSDs this was observed only at T0. In the EHs, post exercise was associated with higher NTproBNP at T2mth compared to T0, while in the GSDs the opposite pattern was noticed. From our study, the serum NTproBNP concentration differs between breeds. Intense physical activity causes an increase in NTproBNP. A two-month training period does not affect the NTproBNP concentration at rest. Intense physical activity may increase NTproBNP above the reference range in individual dogs.

Caval syndrome due to infection with Dirofilaria (D.) immitis is a life-threatening situation, needing immediate therapeutic intervention. Severe pulmonary hypertension due to dirofilariosis was diagnosed echocardiographically in a 3.6 kg dog with heart failure and moderate hemolytic anemia. A ball of adult worms was visualized in the tricuspid valve area. Using a modified pigtail catheter, these worms were removed under fluoroscopic guidance by a transvenous approach. Already intraoperatively the hemodynamic condition improved. Subsequently, additional routine adulticide treatment was performed without complications. Over the following weeks the severe pulmonary hypertension normalized slowly but steadily. Manual extraction of adult D. immitis can be achieved with relatively simple tools and allows rapid stabilization of a critically sick patient.

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