한국임상수의학회지 (Journal of Veterinary Clinics)

  • 제39권5호
  • /
  • Pages.240-245
  • /
  • 2022
  • /
  • 1598-298X(pISSN)
  • /
  • 2384-0749(eISSN)
한국임상수의학회 (The Korean Society of Veterinary Clinics)
권호 표지
DOI QR코드

DOI QR Code

Management of Pulmonary Hypertension Due to Brachycephalic Obstructive Airway Syndrome in a Dog

  • Song, Yunji (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chonnam National University) ;
  • Kim, Yeji (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chonnam National University) ;
  • Kim, Jihyun (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chonnam National University) ;
  • Kim, Kwon-Neung (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chonnam National University) ;
  • Oh, Songju (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chonnam National University) ;
  • Kim, Ha-Jung (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chonnam National University)
  • 투고 : 2022.07.17
  • 심사 : 2022.09.30
  • 발행 : 2022.10.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

A 15-year-old, neutered male, Shih-Tzu, was presented at the Chonnam National Veterinary Medical Teaching Hospital for evaluation of acute onset of persistent coughing, exercise intolerance, and abnormal heart sound. On thoracic auscultation, a split-second heart sound and a wheezing sound were detected on both sides of the chest walls. On physical examination, the dog's body condition score (BCS) was 7/9, and had stenotic nares. Thoracic radiographs revealed right-sided enlargement of the cardiac silhouette (vertebral heart score (VHS) 11.2; reference interval = 8.9-10.1), mild main pulmonary artery (MPA) bulging, mild interstitial infiltration, and hepatomegaly. The electrocardiogram showed right axis deviation, suggesting right ventricular hypertrophy. The echocardiographic study showed moderate pulmonary hypertension and moderate tricuspid regurgitation. There were no findings of a tracheobronchial disease, pulmonary thromboembolism, congenital shunt, left heart disease, or parasitic disease. Based on clinical signs and diagnostic findings, the dog was diagnosed with pulmonary hypertension secondary to brachycephalic syndrome. To rectify respiratory exacerbating factors, the dog was recommended weight control by restricting dietary intake and managing concurrent Cushing's syndrome. Treatments included sildenafil, pimobendan, furosemide, and ramipril. After five months of taking medications and weight control, the severity of pulmonary hypertension improved from moderate to mild. The clinical signs of the patient, including coughing and exercise intolerance, improved a lot. For 5 months of follow-up, the patient has not reported further recurrence of respiratory distress.

키워드

과제정보

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2020R1A2C2005364).

참고문헌

  1. Bowles D, Fry D. Pimobendan and its use in treating canine congestive heart failure. Compend Contin Educ Vet 2011; 33: E1.
  2. Campbell FE. Cardiac effects of pulmonary disease. Vet Clin North Am Small Anim Pract 2007; 37: 949-962, vii. https://doi.org/10.1016/j.cvsm.2007.05.006
  3. Currie PJ, Seward JB, Chan KL, Fyfe DA, Hagler DJ, Mair DD, et al. Continuous wave Doppler determination of right ventricular pressure: a simultaneous Doppler-catheterization study in 127 patients. J Am Coll Cardiol 1985; 6: 750-756. https://doi.org/10.1016/S0735-1097(85)80477-0
  4. Dupre G, Heidenreich D. Brachycephalic syndrome. Vet Clin North Am Small Anim Pract 2016; 46: 691-707. https://doi.org/10.1016/j.cvsm.2016.02.002
  5. Erjavec V, Vovk T, Svete AN. Evaluation of oxidative stress parameters in dogs with brachycephalic obstructive airway syndrome before and after surgery. J Vet Res 2021; 65: 201-208. https://doi.org/10.2478/jvetres-2021-0027
  6. Galie N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: the joint task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Respir J 2015; 46: 903-975. https://doi.org/10.1183/13993003.01032-2015
  7. Hendricks JC, Kline LR, Kovalski RJ, O'Brien JA, Morrison AR, Pack AI. The English bulldog: a natural model of sleep-disordered breathing. J Appl Physiol (1985) 1987; 63: 1344-1350. https://doi.org/10.1152/jappl.1987.63.4.1344
  8. Jaffey JA, Wiggen K, Leach SB, Masseau I, Girens RE, Reinero CR. Pulmonary hypertension secondary to respiratory disease and/or hypoxia in dogs: clinical features, diagnostic testing and survival. Vet J 2019; 251: 105347. https://doi.org/10.1016/j.tvjl.2019.105347
  9. Johnson L, Boon J, Orton EC. Clinical characteristics of 53 dogs with Doppler-derived evidence of pulmonary hypertension: 1992-1996. J Vet Intern Med 1999; 13: 440-447.
  10. Johnson LR, Lappin MR, Baker DC. Pulmonary thromboembolism in 29 dogs: 1985-1995. J Vet Intern Med 1999; 13: 338-345.
  11. Kellihan HB, Stepien RL. Pulmonary hypertension in dogs: diagnosis and therapy. Vet Clin North Am Small Anim Pract 2010; 40: 623-641. https://doi.org/10.1016/j.cvsm.2010.03.011
  12. Kellihan HB, Waller KR, Pinkos A, Steinberg H, Bates ML. Acute resolution of pulmonary alveolar infiltrates in 10 dogs with pulmonary hypertension treated with sildenafil citrate: 2005-2014. J Vet Cardiol 2015; 17: 182-191. https://doi.org/10.1016/j.jvc.2015.04.002
  13. Kellum HB, Stepien RL. Sildenafil citrate therapy in 22 dogs with pulmonary hypertension. J Vet Intern Med 2007; 21: 1258-1264. https://doi.org/10.1111/j.1939-1676.2007.tb01947.x
  14. Maggiore AD. Tracheal and airway collapse in dogs. Vet Clin North Am Small Anim Pract 2014; 44: 117-127. https://doi.org/10.1016/j.cvsm.2013.09.004
  15. Oechtering GU, Pohl S, Schlueter C, Schuenemann R. A novel approach to brachycephalic syndrome. 2. Laser-assisted turbinectomy (LATE). Vet Surg 2016; 45: 173-181. https://doi.org/10.1111/vsu.12447
  16. Reinero C, Visser LC, Kellihan HB, Masseau I, Rozanski E, Clercx C, et al. ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs. J Vet Intern Med 2020; 34: 549-573. https://doi.org/10.1111/jvim.15725
  17. Schober KE, Baade H. Doppler echocardiographic prediction of pulmonary hypertension in West Highland white terriers with chronic pulmonary disease. J Vet Intern Med 2006; 20: 912-920. https://doi.org/10.1111/j.1939-1676.2006.tb01805.x
  18. Serres F, Chetboul V, Gouni V, Tissier R, Sampedrano CC, Pouchelon JL. Diagnostic value of echo-Doppler and tissue Doppler imaging in dogs with pulmonary arterial hypertension. J Vet Intern Med 2007; 21: 1280-1289. https://doi.org/10.1111/j.1939-1676.2007.tb01950.x
  19. Serres FJ, Chetboul V, Tissier R, Carlos Sampedrano C, Gouni V, Nicolle AP, et al. Doppler echocardiography-derived evidence of pulmonary arterial hypertension in dogs with degenerative mitral valve disease: 86 cases (2001-2005). J Am Vet Med Assoc 2006; 229: 1772-1778. https://doi.org/10.2460/javma.229.11.1772
  20. Simonneau G, Gatzoulis MA, Adatia I, Celermajer D, Denton C, Ghofrani A, et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 2013; 62(25 Suppl): D34-D41. Erratum in: J Am Coll Cardiol 2014; 63: 746.
  21. Toom ML, Dobak TP, Broens EM, Valtolina C. Interstitial pneumonia and pulmonary hypertension associated with suspected ehrlichiosis in a dog. Acta Vet Scand 2016; 58: 46.
  22. Vezzosi T, Domenech O, Iacona M, Marchesotti F, Zini E, Venco L, et al. Echocardiographic evaluation of the right atrial area index in dogs with pulmonary hypertension. J Vet Intern Med 2018; 32: 42-47. https://doi.org/10.1111/jvim.15035
  23. West J. Respiratory physiology: the essentials. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 2012.
  24. Wykes PM. Brachycephalic airway obstructive syndrome. Probl Vet Med 1991; 3: 188-197.