Clinical features and outcome of dogs and cats with bidirectional and continuous right‐to‐left shunting patent ductus arteriosus
Abstract Background Studies describing the clinical progression of animals with reverse patent ductus arteriosus (PDA) are lacking. Objectives To describe the signalment, presenting signs, echocardiographic features, and survival in a group of dogs and cats with bidirectional and continuous right‐to...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-03-01
|
| Series: | Journal of Veterinary Internal Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jvim.16072 |
| _version_ | 1811237774930477056 |
|---|---|
| author | Victoria Greet Elizabeth F. Bode Joanna Dukes‐McEwan Pedro Oliveira David J. Connolly Julia Sargent |
| author_facet | Victoria Greet Elizabeth F. Bode Joanna Dukes‐McEwan Pedro Oliveira David J. Connolly Julia Sargent |
| author_sort | Victoria Greet |
| collection | DOAJ |
| description | Abstract Background Studies describing the clinical progression of animals with reverse patent ductus arteriosus (PDA) are lacking. Objectives To describe the signalment, presenting signs, echocardiographic features, and survival in a group of dogs and cats with bidirectional and continuous right‐to‐left PDA. Animals Forty‐six client‐owned animals included, comprising 43 dogs and 3 cats with bidirectional or continuous right‐to‐left PDA. Methods Retrospective multicenter study. Medical records and echocardiographic findings reviewed from animals diagnosed with bidirectional or continuous right‐to‐left PDA. Impact of ductal morphology, spectral Doppler flow profile, PCV, sildenafil treatment at presentation, sildenafil dose, severity of pulmonary hypertension, general anesthesia with or without surgery and the presence of right‐sided congestive heart failure (R‐CHF) on crude mortality rate were evaluated via Mantel‐Cox log rank comparison of Kaplan‐Meier survival curves. Univariable and multivariable Cox proportional hazards analysis was performed, and hazard ratio (HR) (95% confidence intervals [CI]) was presented. Results Hindlimb collapse was the most common presenting sign in dogs (n = 16). Clinical signs in cats were variable. Median survival time was 626 days in dogs (range 1‐3628 days). Dogs with R‐CHF had a shorter median survival time (58 days vs 1839 days, P = .03). Dogs treated with sildenafil at initial presentation survived longer (1839 days vs 302 days, P = .03), which was the only independent predictor of survival (HR 0.35, CI 0.15‐0.86, P = 0.021). Conclusions and Clinical Importance Dogs and cats with reverse PDA have a variable clinical presentation and prognosis. Survival time was longer in animals prescribed sildenafil at diagnosis. Dogs with R‐CHF at presentation have a worse overall outcome. |
| first_indexed | 2024-04-12T12:30:15Z |
| format | Article |
| id | doaj.art-dc0b41f486544698aad94a1d0d4e8c75 |
| institution | Directory Open Access Journal |
| issn | 0891-6640 1939-1676 |
| language | English |
| last_indexed | 2024-04-12T12:30:15Z |
| publishDate | 2021-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj.art-dc0b41f486544698aad94a1d0d4e8c752022-12-22T03:33:03ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762021-03-0135278078810.1111/jvim.16072Clinical features and outcome of dogs and cats with bidirectional and continuous right‐to‐left shunting patent ductus arteriosusVictoria Greet0Elizabeth F. Bode1Joanna Dukes‐McEwan2Pedro Oliveira3David J. Connolly4Julia Sargent5Southern Counties Veterinary Specialists Unit 6 Forest Corner Farm UKCVS Referrals, ChesterGates Veterinary Specialists, E&F Telford Court Chester UKDepartment of Small Animal Clinical Science, Small Animal Teaching Hospital, Institute of Veterinary Science University of Liverpool Chester UKDavies Veterinary Specialists, Hitchin Hertfordshire UKClinical Science and Services, Royal Veterinary College Hertfordshire UKClinical Science and Services, Royal Veterinary College Hertfordshire UKAbstract Background Studies describing the clinical progression of animals with reverse patent ductus arteriosus (PDA) are lacking. Objectives To describe the signalment, presenting signs, echocardiographic features, and survival in a group of dogs and cats with bidirectional and continuous right‐to‐left PDA. Animals Forty‐six client‐owned animals included, comprising 43 dogs and 3 cats with bidirectional or continuous right‐to‐left PDA. Methods Retrospective multicenter study. Medical records and echocardiographic findings reviewed from animals diagnosed with bidirectional or continuous right‐to‐left PDA. Impact of ductal morphology, spectral Doppler flow profile, PCV, sildenafil treatment at presentation, sildenafil dose, severity of pulmonary hypertension, general anesthesia with or without surgery and the presence of right‐sided congestive heart failure (R‐CHF) on crude mortality rate were evaluated via Mantel‐Cox log rank comparison of Kaplan‐Meier survival curves. Univariable and multivariable Cox proportional hazards analysis was performed, and hazard ratio (HR) (95% confidence intervals [CI]) was presented. Results Hindlimb collapse was the most common presenting sign in dogs (n = 16). Clinical signs in cats were variable. Median survival time was 626 days in dogs (range 1‐3628 days). Dogs with R‐CHF had a shorter median survival time (58 days vs 1839 days, P = .03). Dogs treated with sildenafil at initial presentation survived longer (1839 days vs 302 days, P = .03), which was the only independent predictor of survival (HR 0.35, CI 0.15‐0.86, P = 0.021). Conclusions and Clinical Importance Dogs and cats with reverse PDA have a variable clinical presentation and prognosis. Survival time was longer in animals prescribed sildenafil at diagnosis. Dogs with R‐CHF at presentation have a worse overall outcome.https://doi.org/10.1111/jvim.16072congenital heart diseasepolycythemiaright‐sided congestive heart failuresildenafil |
| spellingShingle | Victoria Greet Elizabeth F. Bode Joanna Dukes‐McEwan Pedro Oliveira David J. Connolly Julia Sargent Clinical features and outcome of dogs and cats with bidirectional and continuous right‐to‐left shunting patent ductus arteriosus Journal of Veterinary Internal Medicine congenital heart disease polycythemia right‐sided congestive heart failure sildenafil |
| title | Clinical features and outcome of dogs and cats with bidirectional and continuous right‐to‐left shunting patent ductus arteriosus |
| title_full | Clinical features and outcome of dogs and cats with bidirectional and continuous right‐to‐left shunting patent ductus arteriosus |
| title_fullStr | Clinical features and outcome of dogs and cats with bidirectional and continuous right‐to‐left shunting patent ductus arteriosus |
| title_full_unstemmed | Clinical features and outcome of dogs and cats with bidirectional and continuous right‐to‐left shunting patent ductus arteriosus |
| title_short | Clinical features and outcome of dogs and cats with bidirectional and continuous right‐to‐left shunting patent ductus arteriosus |
| title_sort | clinical features and outcome of dogs and cats with bidirectional and continuous right to left shunting patent ductus arteriosus |
| topic | congenital heart disease polycythemia right‐sided congestive heart failure sildenafil |
| url | https://doi.org/10.1111/jvim.16072 |
| work_keys_str_mv | AT victoriagreet clinicalfeaturesandoutcomeofdogsandcatswithbidirectionalandcontinuousrighttoleftshuntingpatentductusarteriosus AT elizabethfbode clinicalfeaturesandoutcomeofdogsandcatswithbidirectionalandcontinuousrighttoleftshuntingpatentductusarteriosus AT joannadukesmcewan clinicalfeaturesandoutcomeofdogsandcatswithbidirectionalandcontinuousrighttoleftshuntingpatentductusarteriosus AT pedrooliveira clinicalfeaturesandoutcomeofdogsandcatswithbidirectionalandcontinuousrighttoleftshuntingpatentductusarteriosus AT davidjconnolly clinicalfeaturesandoutcomeofdogsandcatswithbidirectionalandcontinuousrighttoleftshuntingpatentductusarteriosus AT juliasargent clinicalfeaturesandoutcomeofdogsandcatswithbidirectionalandcontinuousrighttoleftshuntingpatentductusarteriosus |