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A case report of suspected hepatopulmonary syndrome secondary to ductal plate malformation with chronic active hepatitis in a dog.

Kaneko Y, Torisu S, Hagio M, Yamaguchi R, Mizutani S, Naganobu K - J. Vet. Med. Sci. (2015)

Bottom Line: A six-month-old Papillon was diagnosed with ductal plate malformation with chronic active hepatitis and showed progressive increases in AaDO2 over the course of the following six months.From these results, we suspected that this dog had HPS.This is the first description of suspected canine HPS.

View Article: PubMed Central - PubMed

Affiliation: Veterinary Teaching Hospital, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuen Kibanadai-nishi, Miyazaki 889-2192, Japan.

ABSTRACT
Hepatopulmonary syndrome (HPS) is a respiratory complication of hepatic disease, that is well recognized in humans and defined by the presence of 1) liver disease, 2) hypoxemia and/or high alveolar-arterial oxygen gradient (AaDO2) and 3) intrapulmonary vasodilatation. The present report describes a similar case of HPS in a dog. A six-month-old Papillon was diagnosed with ductal plate malformation with chronic active hepatitis and showed progressive increases in AaDO2 over the course of the following six months. The presence of intrapulmonary vasodilatation was confirmed by agitated saline contrast transthoracic echocardiography. Also, the absence of congenital cardiac defect was confirmed by transthoracic echocardiography. From these results, we suspected that this dog had HPS. This is the first description of suspected canine HPS.

No MeSH data available.


Related in: MedlinePlus

Agitated saline contrast transthoracic echocardiography (ASC-TTE) for detection ofmicrobubbles in the left atrium (LA) and ventricle (LV) after intravascular injection ina dog. For ASC-TTE, 2 ml of 0.9% saline were mixed with 0.2ml of blood and air, agitated to generate bubbles and injected into acephalic vein as a bolus. The bubbles were detected in the right heart immediately afterintravascular injection and then in the left heart after the 5th heartbeat, which isindicative of intrapulmonary vasodilatation. (A) Four-chamber view before injection ofsaline microbubbles. (B) Microbubbles in the right atrium (RA) and ventricle (RV)immediately after injection of the contrast agent. (C) Microbubbles (arrows) in the LAand LV captured at the 21st heartbeat. (The bubbles started to appear after the 5thheartbeat, however, it is difficult to identify the bubbles in a picture. Therefore, apicture of the 21st heartbeat is used in this figure.)
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fig_004: Agitated saline contrast transthoracic echocardiography (ASC-TTE) for detection ofmicrobubbles in the left atrium (LA) and ventricle (LV) after intravascular injection ina dog. For ASC-TTE, 2 ml of 0.9% saline were mixed with 0.2ml of blood and air, agitated to generate bubbles and injected into acephalic vein as a bolus. The bubbles were detected in the right heart immediately afterintravascular injection and then in the left heart after the 5th heartbeat, which isindicative of intrapulmonary vasodilatation. (A) Four-chamber view before injection ofsaline microbubbles. (B) Microbubbles in the right atrium (RA) and ventricle (RV)immediately after injection of the contrast agent. (C) Microbubbles (arrows) in the LAand LV captured at the 21st heartbeat. (The bubbles started to appear after the 5thheartbeat, however, it is difficult to identify the bubbles in a picture. Therefore, apicture of the 21st heartbeat is used in this figure.)

Mentions: At this point, we suspected HPS, as the patient satisfied the first two criteria (liverdisease and high AaDO2) and AaDO2 had gradually increased. Therefore, weperformed agitated saline contrast transthoracic echocardiography (ASC-TTE) to examineintrapulmonary vasodilatation. Routine echocardiography revealed mild mitral regurgitation butruled out the presence of septal defect or other form of congenital heart malformation. ForASC-TTE, 2 ml of saline were mixed with 0.2 ml of thepatient’s blood and air, agitated to generate bubbles and injected into a cephalic vein as abolus. The bubbles made with agitated saline were detected in the right heart immediatelyafter injection and then in the left heart after the 5th heartbeat (Fig. 4Fig. 4.


A case report of suspected hepatopulmonary syndrome secondary to ductal plate malformation with chronic active hepatitis in a dog.

Kaneko Y, Torisu S, Hagio M, Yamaguchi R, Mizutani S, Naganobu K - J. Vet. Med. Sci. (2015)

Agitated saline contrast transthoracic echocardiography (ASC-TTE) for detection ofmicrobubbles in the left atrium (LA) and ventricle (LV) after intravascular injection ina dog. For ASC-TTE, 2 ml of 0.9% saline were mixed with 0.2ml of blood and air, agitated to generate bubbles and injected into acephalic vein as a bolus. The bubbles were detected in the right heart immediately afterintravascular injection and then in the left heart after the 5th heartbeat, which isindicative of intrapulmonary vasodilatation. (A) Four-chamber view before injection ofsaline microbubbles. (B) Microbubbles in the right atrium (RA) and ventricle (RV)immediately after injection of the contrast agent. (C) Microbubbles (arrows) in the LAand LV captured at the 21st heartbeat. (The bubbles started to appear after the 5thheartbeat, however, it is difficult to identify the bubbles in a picture. Therefore, apicture of the 21st heartbeat is used in this figure.)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4829524&req=5

fig_004: Agitated saline contrast transthoracic echocardiography (ASC-TTE) for detection ofmicrobubbles in the left atrium (LA) and ventricle (LV) after intravascular injection ina dog. For ASC-TTE, 2 ml of 0.9% saline were mixed with 0.2ml of blood and air, agitated to generate bubbles and injected into acephalic vein as a bolus. The bubbles were detected in the right heart immediately afterintravascular injection and then in the left heart after the 5th heartbeat, which isindicative of intrapulmonary vasodilatation. (A) Four-chamber view before injection ofsaline microbubbles. (B) Microbubbles in the right atrium (RA) and ventricle (RV)immediately after injection of the contrast agent. (C) Microbubbles (arrows) in the LAand LV captured at the 21st heartbeat. (The bubbles started to appear after the 5thheartbeat, however, it is difficult to identify the bubbles in a picture. Therefore, apicture of the 21st heartbeat is used in this figure.)
Mentions: At this point, we suspected HPS, as the patient satisfied the first two criteria (liverdisease and high AaDO2) and AaDO2 had gradually increased. Therefore, weperformed agitated saline contrast transthoracic echocardiography (ASC-TTE) to examineintrapulmonary vasodilatation. Routine echocardiography revealed mild mitral regurgitation butruled out the presence of septal defect or other form of congenital heart malformation. ForASC-TTE, 2 ml of saline were mixed with 0.2 ml of thepatient’s blood and air, agitated to generate bubbles and injected into a cephalic vein as abolus. The bubbles made with agitated saline were detected in the right heart immediatelyafter injection and then in the left heart after the 5th heartbeat (Fig. 4Fig. 4.

Bottom Line: A six-month-old Papillon was diagnosed with ductal plate malformation with chronic active hepatitis and showed progressive increases in AaDO2 over the course of the following six months.From these results, we suspected that this dog had HPS.This is the first description of suspected canine HPS.

View Article: PubMed Central - PubMed

Affiliation: Veterinary Teaching Hospital, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuen Kibanadai-nishi, Miyazaki 889-2192, Japan.

ABSTRACT
Hepatopulmonary syndrome (HPS) is a respiratory complication of hepatic disease, that is well recognized in humans and defined by the presence of 1) liver disease, 2) hypoxemia and/or high alveolar-arterial oxygen gradient (AaDO2) and 3) intrapulmonary vasodilatation. The present report describes a similar case of HPS in a dog. A six-month-old Papillon was diagnosed with ductal plate malformation with chronic active hepatitis and showed progressive increases in AaDO2 over the course of the following six months. The presence of intrapulmonary vasodilatation was confirmed by agitated saline contrast transthoracic echocardiography. Also, the absence of congenital cardiac defect was confirmed by transthoracic echocardiography. From these results, we suspected that this dog had HPS. This is the first description of suspected canine HPS.

No MeSH data available.


Related in: MedlinePlus