The LeishVet group has formed recommendations designed primarily to help the veterinary clinician in the management of canine leishmaniosis. The complexity of this zoonotic infection and the wide range of its clinical manifestations, from inapparent infection to severe disease, make the management of canine leishmaniosis challenging. The recommendations were constructed by combining a comprehensive review of evidence-based studies, extensive clinical experience and critical consensus opinion discussions. The guidelines presented here in a short version with graphical topic displays suggest standardized and rational approaches to the diagnosis, treatment, follow-up, control and prevention of canine leishmaniosis. A staging system that divides the disease into four stages is aimed at assisting the clinician in determining the appropriate therapy, forecasting prognosis, and implementing follow-up steps required for the management of the leishmaniosis patient.

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LeishVet guidelines for the practical management of canine leishmaniosis

http://cdmalaboratorio.com.br/link/cfd3e86518d586ae1c32d4e53a65464d13d42d3c.pdf

Directions for the diagnosis, clinical staging, treatment and prevention of canine leishmaniosis

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1939-1676.2009.0392.x

Guidelines for the Diagnosis and Treatment of Canine Chronic Valvular Heart Disease

This report, issued by the ACVIM Specialty of Cardiology consensus panel, revises guidelines for the diagnosis and treatment of myxomatous mitral valve disease (MMVD, also known as endocardiosis and degenerative or chronic valvular heart disease) in dogs, originally published in 2009. Updates were made to diagnostic, as well as medical, surgical, and dietary treatment recommendations. The strength of these recommendations was based on both the quantity and quality of available evidence supporting diagnostic and therapeutic decisions. Management of MMVD before the onset of clinical signs of heart failure has changed substantially compared with the 2009 guidelines, and new strategies to diagnose and treat advanced heart failure and pulmonary hypertension are reviewed.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jvim.15488

ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs.

Background: There are few studies evaluating the natural history and prognostic variables in chronic mitral valve disease (CMVI) in a heterogeneous population of dogs

Objectives: To estimate survival and prognostic value of clinical and echocardiographic variables in dogs with CMVI of varying severity Five hundred and fifty-eight dogs belonging to 36 breeds were studied

Methods: Dogs were included after clinical examination and echocardiography Long-term outcome was assessed by telephone interview with the owner

Results: The mean follow-up time was 227 ± 136 months, and the median survival time was 195 ± 132 months In univariate analysis, age>8 years, syncope, HR>140 bpm, dyspnea, arrhythmias, class of heart failure (International Small Animal Cardiac Health Council), furosemide therapy, end-systolic volume-index (ESV-I)>30 mL/m2, left atrial to aortic root ratio (LA/Ao)>17, E wave transmitral peak velocity (Emax)>12 m/s, and bilateral mitral valve leaflet engagement were associated with survival time when all causes of death were included For the cardiac-related deaths, all the previous variables except dyspnea and EDV-I>100 mL/m2 were significantly associated with survival time Significant variables in multivariate analysis (all causes of death) were syncope, LA/Ao>17 m/s, and Emax>12 m/s For cardiac-related death, the only significant variable was LA/Ao>17

Conclusions and Clinical Importance: Mild CMVI is a relatively benign condition in dogs However, some clinical variables can identify dogs at a higher risk of death; these variables might be useful to identify individuals that need more frequent monitoring or therapeutic intervention

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1939-1676.2007.0008.x

Survival Characteristics and Prognostic Variables of Dogs with Mitral Regurgitation Attributable to Myxomatous Valve Disease

Proposed guidelines for the diagnosis of canine idiopathic dilated cardiomyopathy.

Comparison of primary mitral valve disease in German Shepherd dogs and in small breeds.

Background: Systolic dysfunction associated with chronic mitral valve insufficiency (CMVI) has been demonstrated in experimental animal models and large breed (LB) dogs but has been reported as an uncommon finding in small breed (SB) dogs with naturally occurring disease. It has been suggested the myocardial failure could be, in part, because of an insufficient increase in left ventricular mass.



Hypothesis: To test if SB and LB dogs with CMVI and moderate heart failure have systolic dysfunction and if they have adequate eccentric hypertrophy.



Animals: Data from 38 SB and 18 LB dogs affected with CMVI were compared retrospectively with results from 2 groups of normal dogs (17 SB and 32 LB)



Methods: Systolic function was investigated echocardiographically by using percentage fractional shortening (FS), the ratio between observed and expected end-systolic diameter (ESD/ESDe), and end-systolic volume index (ESVI). Left ventricular hypertrophy was estimated by using the ratio between the thickness of the left ventricular free wall and the radius in diastole (h/R).



Results: Both affected SB and LB dogs had a significantly increased FS and ESVI (FS% SB 45.6 + 8.04 versus 40.06 + 8.9, P < .05; FS% LB 33.64 + 8.61 versus 27.3 + 7.3 P < .05; ESVI SB 30.0 ± 2.3 mL/m2 versus 21.18 ± 13.9 mL/m2, P < .05; ESVI LB 83.22 ± 43.84 mL/m2 versus 36.43 ± 13.30 mL/m2 versus P < .001). The h/R in affected animals was decreased (0.53 ± 0.11 versus 0.41 ± 0.12, P < .05 SB; 0.47 ± 0.11 versus 0.38 ± 0.09, P < .05, LB).



Conclusions and Clinical Importance: Data from this study indicate that dogs with moderate heart failure caused by CMVI have systolic dysfunction. Inadequate hypertrophy of the left ventricle may be, in part, responsible for this finding.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1939-1676.2007.tb02929.x

Decreased Systolic Function and Inadequate Hypertrophy in Large and Small Breed Dogs with Chronic Mitral Valve Insufficiency

Objective—To histologically identify glomerular lesions in dogs infected with Leishmania organisms. Animals—41 dogs (17 sexually intact males and 14 sexually intact and 10 ovariohysterectomized females) that had positive results when tested for leishmaniosis as determined by use of serologic evaluation (indirect fluorescent antibody test, titers of 1:80 to 1:640) and direct microscopic identification of the protozoal organisms. Procedure—Urine samples were collected by use of cystocentesis and examined by qualitative SDSagarose gel electrophoresis (AGE). All dogs had nonselective (glomerular) or mixed (glomerular and tubular) proteinemia. Specimens were obtained from each dog during ultrasound-assisted renal biopsy and used for histologic examination. Each specimen was stained with H&E, periodic acid–Schiff, Goldner's trichrome, methenamine silver, and Congo Red stains. Specimens were adequate for evaluation when they contained at least 5 glomeruli/section, except for specimens stained with Congo Red in w...

Glomerular lesions in dogs infected with Leishmania organisms

Case records of 30 dogs in which valvular pulmonic stenosis (PS) was treated by balloon dilation were reviewed retrospectively. Physical examination, thoracic radiographs, 9-lead ECG, echocardiography, and Doppler studies were performed in all dogs. Two-dimensional and Doppler echocardiography were repeated after 24 h and 1 year after treatment. Dogs were divided into 2 groups based on their valvular anatomy on echocardiography and aortic:pulmonary ratio: 18 had type A PS with normal annulus diameter and aortic:pulmonary ratio 1.2. Most dogs in the type B group were brachycephalic and had no poststenotic dilatation on thoracic radiographs. Of the dogs with type A stenosis, 100% survived valvuloplasty with resolution of clinical signs. At 1-year follow-up, 94.4% were still alive and remained asymptomatic. Of those with type B stenosis, 66.6% had favorable outcome postvalvuloplasty. At 1-year follow-up, 66.6% of dogs were alive, and resolution of clinical signs was obtained in 50%. This study revealed the immediate and long-term efficacy of balloon valvuloplasty in dogs with PS.

Michele Borgarelli

Papers

Proposed guidelines for the diagnosis of canine idiopathic dilated cardiomyopathy.

Comparison of primary mitral valve disease in German Shepherd dogs and in small breeds.

Decreased Systolic Function and Inadequate Hypertrophy in Large and Small Breed Dogs with Chronic Mitral Valve Insufficiency

Glomerular lesions in dogs infected with Leishmania organisms

Balloon Valvuloplasty in 30 Dogs with Pulmonic Stenosis: Effect of Valve Morphology and Annular Size on Initial and 1-Year Outcome