OBJECTIVE
To evaluate the diagnostic usefulness of focused cardiac ultrasonography and selected echocardiographic variables for predicting fluid responsiveness in conscious, spontaneously breathing dogs with various clinical conditions.
ANIMALS
26 dogs (15 males and 11 females) with a median age of 84 months (range, 12 to 360 months) and median body weight of 8 kg (range, 2 to 35 kg) referred for various clinical conditions.
PROCEDURES
Left ventricular end-diastolic internal diameter normalized to body weight (LVIDDn), left ventricular volume score (LVVS), left ventricular end-diastolic volume index (EDVI), aortic velocity time integral (VTIAo), and aortic peak flow velocity (VmaxAo) were echocardiographically measured before and after IV administration of a bolus of lactated Ringer solution (4 mL/kg) over a 1-minute period. Dogs were classified on the basis of the observed change in aortic stroke volume following fluid administration as responders (≥ 15%) or nonresponders (< 15%) to fluid administration. Receiver operating characteristic curves were generated for the ability of LVVS, LVIDDn, EDVI, VTIAo, and VmaxAo to predict responder status.
RESULTS
13 dogs were classified as responders and 13 as nonresponders. Areas under the receiver operating characteristic curves (95% confidence intervals) for predicting fluid responsiveness were as follows: VTIAo, 0.91 (0.74 to 0.99); LVIDDn, 0.85 (0.66 to 0.96); EDVI, 0.85 (0.65 to 0.96); LVVS, 0.85 (0.65 to 0.96); and VmaxAo, 0.75 (0.54 to 0.90).
CONCLUSIONS AND CLINICAL RELEVANCE
The evaluated echocardiographic variables were useful for noninvasive prediction of fluid responsiveness in conscious dogs and could be valuable for informing clinical decisions regarding fluid therapy.
Fluid responsiveness, defined as the response of stroke volume to fluid loading, is a tool to individualize fluid administration in order to avoid the deleterious effects of hypovolemia or hypervolemia in hospitalized patients. To evaluate the accuracy of two ultrasound indices, the caudal vena cava to abdominal aorta ratio (CVC/Ao) and the respiratory collapsibility of the caudal vena cava (cCVC), as independent predictors of fluid responsiveness in a heterogeneous population of spontaneously breathing, conscious, hospitalized dogs. A prospective, multicenter, observational, cross-sectional study was designed in twenty-five dogs. The accuracy of CVC/ Ao and cCVC in predicting fluid responsiveness was evaluated by the area under the receiver operating characteristic curve (AUROC) in a group of hospitalized dogs after receiving a mini-fluid bolus of 4 ml/kg of Hartmann's solution. Dogs with an increased aortic velocity time integral >15% were classified as fluid responders. Twenty-two dogs were finally included. Ten were classified as responders and 12 as non-responders. The AUROC curves were 0.88 for the CVC/Ao ratio (95% confidence interval, CI, 0.67-0.98; P=0.0001) and 0.54 for cCVC (95% CI 0.32-0.75; P=0.75). The CVC/Ao threshold optimized for best sensitivity (SE) and specificity (SP) values was 0.83 (SE 100%; SP 75%). In spontaneously breathing hospitalized dogs, the CVC/Ao measurement predicted stroke volume increase after a fluid bolus, while the respiratory variations in the cCVC did not discriminate between fluid responders and non-responders.
ObjectivesIn recent years echocardiography has become a good diagnostic tool in Zoo Medicine but in some cases, it is still a challenge. In Aldabra giant tortoise (Aldabrachelys gigantea) the big size of animals and the few individuals hosted in Zoo are critical points for the application of this diagnostic technique.The purposes of this research were: to evaluate the feasibility of the diagnostic imaging technique on big-sized turtles; to define the echographic parameters for this species; and to describe the morphofunctional and physiological echographic characteristics of their cardiovascular system.DesignRepeated measures in vivo.SettingUltrasonography systematic description and Doppler analysis of the cardiovascular system of Aldabra giant tortoise were carried out; B-mode examination allowed the evaluation of the kinetics of the ventricle, the atria and the atrioventricular valves.Participants4 Aldabra giant tortoises (two adult males and two young females) hosted in two zoological gardens.InterventionsEchocardiography was performed placing the animals in ventral on a restraining platform raised from the floor, to provide adequate accessibility to the thoracic windows where the probe was placed. No chemical restraint was used.Primary and secondary outcome measuresHeart rate, systolic and diastolic areas and volumes, vessel diameters and blood flow velocity were measured.ResultsHeart rate was 21±4 bpm (range 14–25 bpm). The averages of the diastolic and systolic area indexes linked to the subject weight were: 21±3 cm2 and 9±1 cm2.The aortic annulus diameter in female specimens measured 11.2±0.8 mm, while it measured 21.5±0.3 mm in male species.ConclusionResults confirm the effectiveness of echocardiography as a means to study and evaluate the cardiovascular system of this species even if more studies on a bigger number of patients would be necessary to develop the echocardiography technique.
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