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Traumatic pericarditis is one of the most significant bovine cardiac diseases. The authors describe the use of intraoperative echocardiography and successful surgical treatment of a case of traumatic pericarditis. A seven-year-old Hungarian Simmental dairy cow in late pregnancy showed severe oedema of the throat region and brisket, as well as jugular distension. Cardiac auscultation demonstrated tachycardia with a normal cardiac rhythm. The heart sounds were muffled, but no cardiac murmur or splashing sounds were heard. A large amount of echogenic fluid with some strands of fibrin was seen in the pericardial and right pleural cavities by ultrasonography. Ultrasound-guided pericardiocentesis demonstrated the presence of a thick, fetid and purulent exudate. Pericardiotomy was performed in standing position with sedation and local anaesthesia. After costal resection, intraoperative echocardiography was performed. It showed an echogenic tract between the caudal pericardium and diaphragm, but no foreign body was seen. Two weeks after the surgery, the cow delivered a healthy bull-calf. Intraoperative echocardiography — not reported earlier — can be applied to evaluate the entire bovine pericardial sac and heart. The report also demonstrates that surgical treatment of traumatic pericarditis can be successful in carefully selected cases.

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Orvosi Hetilap
Authors: Krisztián Vörös, Károly Cseh and László Kalabay

A máj által termelt fetuin-A (eredeti nevén α2-Heremans–Schmid-glikoprotein) szerteágazó funkciókkal bíró molekula. Bár negatív akutfázis-fehérje, szerepe a szubklinikus gyulladásban vitatott. Gátolja az inzulinreceptor autofoszforilációját, szérumkoncentrációja korrelál az inzulinrezisztenciával. A zsírsejtek működészavarát okozza. Szérumszintje összefügg az elhízással és a nem alkoholos zsírmájbetegséggel. Bár ezen tulajdonságai alapján azt várnánk, hogy az atherosclerosis progresszióját segíti, cardiovascularis betegségekben játszott szerepe ennél összetettebb. A fetuin-A a szöveti és a vascularis kalcifikáció természetes gátlómolekulájaként az atherosclerosisban védő szerepet tölt be. A szerzők a fetuin-A artériakalcifikációban és cardiovascularis betegségekben betöltött szerepét és prognosztikai értékét tekintik át, kitérve az ellentmondásosnak tűnő irodalmi eredmények magyarázatára és a lehetséges jövőbeni kutatási irányokra is. Orv. Hetil., 2014, 155(1), 16–23.

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The aim of the study was to establish normal reference echocardiographic values for three Hungarian dog breeds, and to determine the potential dependence of intracardiac parameters on body weight, age and gender. M-mode and two-dimensional echocardiography were performed on 95 clinically healthy dogs including 45 Hungarian Vizslas, 28 Mudis and 22 Hungarian Greyhounds. Linear intracardiac measurements included interventricular septal thickness (IVS), left ventricular internal diameter (LVID), left ventricular posterior wall thickness (LVPW) both in systole and diastole, as well as left atrial internal diameter (LAD), and aortic diameter (AOD) in early diastole. Fractional shortening (FS), end-diastolic and end-systolic left ventricular volumes (EDV and ESV), as well as LAD:AOD ratio were calculated from the linear parameters. Mean, range and standard deviation of measurements were calculated for each breed. Body weight positively correlated in all three breeds with all left ventricular dimensions, such as IVS d , IVS s , LVID d , LVIDD s , LVPW d and LVPW s parameters. LA values showed positive correlations to body weight in all three breeds. AOD and LA demonstrated a positive correlation with body weight in Hungarian Vizslas and Mudis, whilst the LAD:AOD ratio was related to body weight only in Mudis. Gender did not correlate with any of the measured echocardiographic parameters in any breeds. In Mudis, a positive correlation was found between the LAD:AOD ratio and age, as well as between the LAD:AOD ratio and E point to septal separation (EPSS).

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Acta Veterinaria Hungarica
Authors: Károly Vörös, Viktória Szilvási, Ferenc Manczur, Ákos Máthé, Jenő Reiczigel, Ingo Nolte and Stephan Hungerbühler

Chronic degenerative valve disease (CDVD) is the most common cardiac disease in dogs, usually resulting in mitral valve insufficiency (MVI). The goal of this study was to investigate the occurrence of MVI in clinically healthy Beagle populations. A total of 79 adult healthy Beagles (41 females and 38 males; age: 5.6 ± 2.7 years, range 1.4 to 11.7 years) were examined. The diagnosis of MVI was based on the detection of a systolic murmur heard above the mitral valve, and was confirmed by colour flow Doppler (CFD) echocardiography. Systolic mitral valve murmurs were detected in 20/79 dogs (25.3%), of them 11 males and 9 females with no statistically significant gender difference (P = 0.6059). The strength of the murmur on the semi-quantitative 0/6 scale yielded intensity grade 1/6 in 10 dogs, grade 2/6 in 4 dogs, and grade 3/6 in 6 dogs. Mild to moderate MVI was detected by CFD in all these 20 dogs with systolic murmurs. Of them, 17 dogs had mild and 3 demonstrated moderate MVI, showing 10–30% and 30–50% regurgitant jets compared to the size of the left atrium, respectively. The age of dogs with MVI was 7.1 ± 2.3 years, which was significantly different from that of dogs without MVI (5.1 ± 2.7 years, P = 0.0029). No significant differences in body weight (P = 0.1724) were found between dogs with MVI (13.8 ± 2.8 kg) and those without MVI (12.8 ± 3.0 kg). Mitral valve disease causing MVI is relatively common in Beagle dogs, just like in other small breed dogs reported in the literature.

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Acta Veterinaria Hungarica
Authors: Ágnes Sterczer, Jenő Reiczigel, Roland Psáder, Kinga Pápa, Károly Vörös and Ákos Pap

The efficacy of ultrasound-guided cholagogue-induced gallbladder emptying for differentiating obstructive from non-obstructive hepatobiliary diseases was studied in icteric dogs. In 7 healthy Beagle dogs, Lipofundin 20% infusion (2 ml/kg orally) evoked a vigorous gallbladder contraction of 44.2% (range: 35.3–57.6%) and proved to be a useful, well-tolerable meal for routine use. In 24 icteric dogs, gallbladder contraction was evoked by different cholagogues: the maximum reduction in gallbladder volume (%) for the three non-obstructive icteric dogs was 43.9% (range, 39.0–46.5%). The average gallbladder contraction of the 21 dogs with biliary obstruction was less than 5%. In conclusion, the stimulation of gallbladder contraction with orally applied magnesium sulphate (MgSO4) or Lipofundin can be well demonstrated by ultrasound in dogs. The examination of cholagogue-induced gallbladder emptying is a valuable technique in icteric patients to indicate surgical intervention.

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Acta Veterinaria Hungarica
Authors: Viktória Szilvási, Károly Vörös, Ferenc Manczur, Jenő Reiczigel, István Novák, Ákos Máthé and Dániel Fekete

The objective of this study was to compare the auscultatory findings using traditional and electronic sensor-based stethoscopes. Thirty-three adult healthy Beagles (20 females, 13 males, mean age: 4.8 years, range 1.4–8 years) were auscultated by four investigators with different experiences (INVEST-1, -2, -3 and -4) independently with both stethoscopes. Final cardiological diagnoses were established by echocardiography. Mitral murmurs were heard with both stethoscopes by all investigators and echocardiography revealed mild mitral valve insufficiency in 7 dogs (21%, 4 females, 3 males). The statistical sensitivity (Se) in recognising cardiac murmurs proved to be 82% using the traditional stethoscope and 75% using the electronic one in the mean of the four examiners, whilst statistical specificity (Sp) was 99% by the traditional and 100% by the electronic stethoscope. The means of the auscultatory sensitivity differences between the two stethoscopes were 0.36 on the left and 0.59 on the right hemithorax, demonstrating an advantage for the electronic stethoscope being more obvious above the right hemithorax (P = 0.0340). The electronic stethoscope proved to be superior to the traditional one in excluding cardiac murmurs and especially in auscultation over the right hemithorax. Mitral valve disease was relatively common in this clinically healthy research Beagle population.

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Acta Veterinaria Hungarica
Authors: Zoltán Dudás-Györki, Boglárka Bende, Csaba Hetyey, Ferenc Manczur, Jenő Reiczigel and Károly Vörös

The aim of the present study was to verify the validity of two-dimensional echocardiographic (2DE) measurement technique in dogs with left atrial enlargement. Thirty-one dogs with clinically and echocardiographically proven cardiac diseases were randomly selected. The left atrial right-to-left diameter ( La r−l ) and the diameter of the left atrium just above the mitral annulus ( La ama ) as well as the ratio of left atrial to aortic diameter ( La/Ao ) were measured by 2DE. The La r−l / La ama ratio was independent of body weight (R 2 = 0.0006) and age (R 2 = 0.0012), respectively. A significant linear relationship was found between La ama and La/Ao (the ratio that expresses the severity of atrial enlargement): La ama = 1.2238 La/Ao + 1.1608 (R 2 = 021; P < 0.01). There was also a positive linear relationship between La r−l and La/Ao : La r−l = 1.6876 La/Ao + 1.2648 (R 2 = 0.27; P < 0.005). In our dogs with cardiac disease, the La r−l / La ama ratio showed no significant relation to the La/Ao index (R 2 = 0.028). Thus, La r−l / La ama proved to be independent of the severity of atrial enlargement. Based on the strong relationship stated in the equation between La ama and La r−l [ La r−l / La ama = 1.31159 (95% confidence interval)], La ama can also be used for the assessment of left atrial size even in dogs with cardiac disease.

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Orvosi Hetilap
Authors: Judit Nádas, Sándor Czirják, Péter Igaz, Erika Vörös, György Jermendy, Károly Rácz and Miklós Tóth

A nyúltvelő bal ventrolateralis részének kompressziója a terápiarezisztens hypertonia okaként ritkán diagnosztizált eltérés. A neurovascularis kompresszió okozta hypertonia gyógyszerre nem reagáló eseteiben dekompressziós műtét végzése jön szóba. A 20 éves férfi betegnél a hypertonia hátterében meghúzódó okot a szekunder hypertonia egyéb lehetőségeinek kizárása, a MR-angiográfiával igazolt neurovascularis kompresszió és a vérnyomáskiugrások alatt jelentkező fokozott szimpatikus aktivitás (sinus tachycardia) bizonyította. Ismételten jelentkező hypertoniás kríziseket követően műtétre került sor, amely során a bal arteria vertebralis és az agytörzs közé izomgraft behelyezése történt. A beteg a műtét után hat hónapig panaszmentes volt, a vérnyomáscsökkentő gyógyszereket jelentősen csökkenteni lehetett, a koponya MR-angiográfia is a nyúltvelői kompresszió megszűnését mutatta. Hat hónap után a vérnyomáskiugrások újra jelentkeztek, bár ritkábban és kisebb mértékben. A műtét után 22 hónappal készült koponya MR-angiográfia lelete alapján a betegnek reoperációt javasoltak. Szakirodalmi adatok alapján dekompressziós műtét után hosszú távon fennmaradó kedvező hatás csak az esetek harmadában várható. A betegek nagyobbik hányadában a műtét a vérnyomás csökkenéséhez, a vérnyomáscsökkentő terápia kifejezettebb hatásához, a vérnyomáskiugrással járó rosszullétek ritkulásához és ezzel a betegek életminőségének javulásához vezethet. A beteg története ez utóbbi kórlefolyást példázza. Orv. Hetil., 2014, 155(21), 838–842.

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Acta Veterinaria Hungarica
Authors: Károly Vörös, Ingo Nolte, Stephan Hungerbühler, Jenő Reiczigel, Jan Ehlers, Guy Tater, Reinhard Mischke, Tanja Zimmering and Matthias Schneider

The goals of this study were to present a technique of digitalised sound recordings and phonocardiograms (dPCGs), and to analyse its diagnostic capabilities. Heart sounds of 20 dogs were auscultated in vivo (on-line) and recorded with dPCGs by two authors using a Welch Allyn Meditron Stethoscope System. Sound recordings were auscultated off-line and blindly by four different observers having various auscultatory experiences, then listened to while viewing dPCGs. The results were compared to echocardiographic diagnoses. There was a significant agreement (p < 0.001) between on-line and off-line auscultatory findings regarding the four observers, ranging from 45% to 75% (weighted kappa values: 0.72 to 0.87). The best agreement was achieved by Observer 1 having the highest experience. Significant differences (p < 0.05) were found between Observer 1 and Observer 4 (with the lowest experience) in judging the quality of the murmurs during the off-line and blind auscultation. However, there were only minimal differences (95% to 100% agreements) in dPCG analyses among the four observers regarding intensity and quality of the murmurs while simultaneously listening to and viewing the dPCGs. Significant correlations were found between the traditional ‘0 to 6 scale’ and a new ‘0 to 3 scale’ murmur intensity gradings by all observers (correlation coefficients 0.640 to 0.908; p < 0.01 to p < 0.001). Analysis of dPCGs might be a valuable, additional tool helping with the diagnosis of canine cardiac murmurs, especially for those with less cardiological experience.

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Acta Veterinaria Hungarica
Authors: Kinga Pápa, Ákos Máthé, Zsolt Abonyi-Tóth, Ágnes Sterczer, Roland Psáder, Csaba Hetyey, Péter Vajdovich and Károly Vörös

Medical records of 80 dogs diagnosed with acute pancreatitis during a 4-year period were evaluated regarding history, breed predilection, clinical signs and additional examination findings. Cases were selected if compatible clinical symptoms, increased serum activity of amylase or lipase and morphologic evidence of pancreatitis by ultrasonography, laparotomy or necropsy were all present. Like in other studies, neutered dogs had an increased risk of developing acute pancreatitis. Although breed predilection was consistent with earlier reports, some notable differences were also observed. Apart from Dachshunds, Poodles, Cocker Spaniels and Fox Terriers, the sled dogs (Laikas, Alaskan Malamutes) also demonstrated a higher risk for pancreatitis according to our results. Concurrent diseases occurred in 56 dogs (70%), diabetes mellitus (n = 29, 36%) being the most common. Clinical signs of acute pancreatitis were similar to those observed in other studies. The study group represented a dog population with severe acute pancreatitis, having a relatively high mortality rate (40%) compared to data of the literature. Breed, age, gender, neutering and body condition had no significant association with the outcome. Hypothermia (p = 0.0413) and metabolic acidosis (p = 0.0063) correlated significantly with poor prognosis and may serve as valuable markers for severity assessment in canine acute pancreatitis.

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