TREATMENT PRINCIPLES IN PULMONARY HYPERTENSION IN DOGS

Year 2022, Volume: 5 Issue: 1, 220 - 236, 31.05.2022

Ali Bilgili , Basak Hanedan

https://doi.org/10.52538/iduhes.1103323

Abstract

Pulmonary hypertension is defined as abnormal high pressure within pulmonary vasculature. Pulmonary arterial hypertension is a life threatening disorder characterized by high pressure in the pulmonary artery and a progressive pulmonary vascular resistance that can be resulted in right heart failure and death. Initial clinical signs in case of pulmonary arterial hypertension are respiratory distress, fatigue, syncope, and decrease of exercise capacity. When severity of disease is increasing, high tension during right heart contraction, increase of right ventricle diameter, decrease of stroke volume, decrease of cardiac contractility and impairment in contact with pulmonary artery of right ventricle develop. Standard method for the diagnosis of pulmonary hypertension is the direct measurement of pulmonary artery pressure by catheterization of right heart. The diagnosis of pulmonary hypertension requires the detailed evaluation including anamnesis, clinical signs, echocardiographic parameters supporting pulmonary hypertension and the results of other diagnosis tests. The treatment of pulmonary hypertension includes strategies to decrease disease progression and risk of complications. In the context of the article, the diagnosis and treatment methods in cases of pulmonary hypertension in dogs are discussed in a detailed manner. In addition, detailed knowledge was presented about drugs used as ancillary therapy in the event of the pulmonary hypertension due to different diseases in dogs.

Keywords

Pulmonary Hypertension, Pulmonary Hypertension, Dog, Treatment

Köpeklerde akciğer yüksek tansiyonunda sağaltım prensipleri

Abstract

Akciğer yüksek tansiyonu, akciğer damarı içinde anormal yüksek basınç olarak tanımlanır. Akciğer arterinde yüksek tansiyon sağ kalp yetmezliği ve ölümle sonuçlanabilen akciğer arterinde basınç artışı ve akciğer damar direncinde ilerleyen artışla karakterize yaşamı tehdit eden bir bozukluktur. Akciğer arterinde tansiyon artışı halinde ilk klinik bulgular solunum güçlüğü, yorgunluk, bayılma, egzersiz kapasitesinde belirgin azalmadır. Hastalığın şiddeti arttıkça sağ kalpte kasılma sırasında gerilim artışı, sağ ventrikül çapında artma, kalbin her atımında sol ventrikülden atılan kan miktarında azalma, kalbin kasılma gücünde azalma ve sağ ventrikül akciğer arter bağlantısında bozulma vardır. Akciğer yüksek tansiyonunun tanısı için standart metot sağ kalbin kateterizasyonuyla akciğer arter basıncının doğrudan değerlendirilmesidir. Akciğer yüksek tansiyonunun tanısı anamnez, klinik bulgular, akciğer yüksek tansiyonunu destekleyen ekokardiyografik parametreler ve diğer tanı testlerinin sonuçlarını içeren kapsamlı değerlendirmeyi gerektirir. Akciğer yüksek tansiyonunun sağaltımı hastalığın ilerlemesi ya da komplikasyonlarının riskini azaltma uygulamalarını içerir. Bu makale kapsamında köpeklerde akciğer yüksek tansiyonu olgularında tanı ve sağaltım yöntemleri ayrıntılı şekilde ele alındı. Ayrıca köpeklerde farklı hastalıklara bağlı akciğer yüksek tansiyonu gelişmesi durumunda tansiyonu düşürmek için kullanılan ilaçlar hakkında ayrıntılı bilgiler sunuldu.

Keywords

Akciğer Yüksek Tansiyonu, Köpek, Sağaltım

References

• Referans 1 Akabane, R., Sato, T., Sakatani, A., Miyagawa, Y., Tazaki, H., & Takemura, N. (2018). Pharmacokinetics of single‐dose sildenafil administered orally in clinically healthy dogs: effect of feeding and dose proportionality. Journal of Veterinary Pharmacology and Therapeutics, 41(3), 457-462.
• Referans 2 Akabane, R., Sakatani, A., Ogawa, M., Nagakawa, M., Miyakawa, H., Miyagawa, Y., & Takemura, N. (2020). The effect of sildenafil on pulmonary haemodynamics in a canine model of chronic embolic pulmonary hypertension. Research in Veterinary Science, 133, 106-110.
• Referans 3 Bach, J. F., Rozanski, E. A., MacGregor, J., Betkowski, J. M., & Rush, J. E. (2006). Retrospective evaluation of sildenafil citrate as a therapy for pulmonary hypertension in dogs. Journal of Veterinary Internal Medicine, 20, 1132-1135.
• Referans 4 Blanco, I., Gimeno, E., Munoz, P. A., Pizarro, S., Gistau, C., Rodriguez-Roisin, R., ... & Barberà, J. A. (2010). Hemodynamic and gas exchange effects of sildenafil in patients with chronic obstructive pulmonary disease and pulmonary hypertension. American Journal of Respiratory and Critical Care Medicine, 181(3), 270-278.
• Referans 5 Brown, A. J., Davison, E., & Sleeper, M. M. (2010). Clinical efficacy of sildenafil in treatment of pulmonary arterial hypertension in dogs. Journal of Veterinary Internal Medicine, 24(4), 850-854.
• Referans 6 Borgarelli, M., Abbott, J., Braz‐Ruivo, L., Chiavegato, D., Crosara, S., Lamb, K., ... & Haggstrom, J. (2015). Prevalence and prognostic importance of pulmonary hypertension in dogs with myxomatous mitral valve disease. Journal of Veterinary Internal Medicine, 29(2), 569-574.
• Referans 7 Caivano, D., Dickson, D., Pariaut, R., Stillman, M., & Rishniw, M. (2018). Tricuspid annular plane systolic excursion-to-aortic ratio provides a bodyweight-independent measure of right ventricular systolic function in dogs. Journal of Veterinary Cardiology, 20(2), 79-91.
• Referans 8 Carlson, J. A., Achen, S. A., Saunders, A. B., Gordon, S. G., & Miller, M. W. (2013). Delayed embolization of an Amplatz® canine duct occluder in a dog. Journal of Veterinary Cardiology, 15(4), 271-276.
• Referans 9 Chapman, R. W., Corboz, M. R., Malinin, V. S., Plaunt, A. J., Konicek, D. M., Li, Z., & Perkins, W. R. (2020). An overview of the biology of a long-acting inhaled treprostinil prodrug. Pulmonary Pharmacology & Therapeutics, 65, 102002.
• Referans 10 Ciuca, L., Meomartino, L., Piantedosi, D., Cortese, L., Cringoli, G., Rinaldi, L., & Lamagna, B. (2019). Irreversible ocular lesions in a dog with Angiostrongylus vasorum infection. Topics in Companion Animal Medicine, 36, 4-8.
• Referans 11 Corcoran, B. M., King, L. G., Schwarz, T., Hammond, G., & Sullivan, M. F. (2011). Further characterisation of the clinical features of chronic pulmonary disease in West Highland white terriers. The Veterinary Record, 168, 355.
• Referans 12 Cote, E., & Ettinger, S. J. (2001). Long‐term clinical management of right‐to‐left (“reversed”) patent ductus arteriosus in 3 dogs. Journal of Veterinary Internal Medicine, 15(1), 39-42.
• Referans 13 Delcroix, M., & Naeije, R. (2010). Optimising the management of pulmonary arterial hypertension patients: emergency treatments. European Respiratory Review, 19(117), 204-211.
• Referans 14 den Toom, M. L., Grinwis, G., van Suylen, R. J., Boroffka, S. A., de Jong, P., van Steenbeek, F. G., & Szatmári, V. (2018). Pulmonary veno-occlusive disease as a cause of severe pulmonary hypertension in a dog. Acta Veterinaria Scandinavica, 60(1), 1-8.
• Referans 15 Croix, C. M., & Steinhorn, R. H. (2016). New thoughts about the origin of plexiform lesions. American Journal of Respiratory and Critical Care Medicine, 193(5), 484-485.
• Referans 15 Dias-Junior, C.A., Vieira TF, Moreno H Jr, Evora PR, & Tanus-Santos JE. (2005). Sildenafil selectively inhibits acute pulmonary embolism-induced pulmonary hypertension. Pulmonary Pharmacology and Therapeutics, 18, 181-186.
• Referans 17 Frumkin, L. R. (2012). The pharmacological treatment of pulmonary arterial hypertension. Pharmacological Reviews, 64(3), 583-620.
• Referans 18 Galiè, N., Hoeper, M. M., Humbert, M., …. & Simonneau, G. (2009). Guidelines for the diagnosis and treatment of pulmonary hypertension: the 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 the International Society of Heart and Lung Transplantation (ISHLT). European Heart Journal, 30, 2493-2537.
• Referans 19 Gessler, T. (2018). Inhalation of repurposed drugs to treat pulmonary hypertension. Advanced Drug Delivery Reviews, 133, 34-44.
• Referans 20 Glaus, T. M., Sigrist, N., Hofer-Inteeworn, N., Kuemmerle-Fraune, C., Mueller, C., Geissweid, K., ... & Novo Matos, J. (2016). Unexplained bleeding as primary clinical complaint in dogs infected with Angiostrongylus vasorum. Schweizer Archiv für Tierheilkunde, 158(10), 701-709.
• Referans 21 Helm, J. R., Morgan, E. R., Jackson, M. W., Wotton, P., & Bell, R. (2010). Canine angiostrongylosis: an emerging disease in Europe. Journal of Veterinary Emergency and Critical Care, 20(1), 98-109.
• Referans 22 Jaffey, J. A., Leach, S. B., Kong, L. R., Wiggen, K. E., Bender, S. B., & Reinero, C. R. (2019). Clinical efficacy of tadalafil compared to sildenafil in treatment of moderate to severe canine pulmonary hypertension: a pilot study. Journal of Veterinary Cardiology, 24, 7-19.
• Referans 23 Jiang, R., Zhao, Q. H., Wu, W. H., Zhang, R., Yuan, P., Gong, S. G., ... & Liu, J. M. (2018). Efficacy and safety of a calcium sensitizer, levosimendan, in patients with right heart failure due to pulmonary hypertension. The Clinical Respiratory Journal, 12(4), 1518-1525.
• Referans 24 Johnson, L., Boon, J., & Orton, E. C. (1999). Clinical characteristics of 53 dogs with Doppler‐derived evidence of pulmonary hypertension: 1992–1996. Journal of Veterinary Internal Medicine, 13(5), 440-447.
• Referans 25 Johnson, L. R., & Stern, J. A. (2020). Clinical features and outcome in 25 dogs with respiratory‐associated pulmonary hypertension treated with sildenafil. Journal of Veterinary Internal Medicine, 34(1), 65-73.
• Referans 26 Kellihan, H. B., & Stepien, R. L. (2010). Pulmonary hypertension in dogs: diagnosis and therapy. The Veterinary Clinics of North America. Small Animal Practice, 40, 623-641.
• Referans 27 Kellihan, H. B., & Stepien, R. L. (2012). Pulmonary hypertension in canine degenerative mitral valve disease. Journal of Veterinary Cardiology, 14(1), 149-164.
• Referans 28 Kellihan, H. B., Waller, K. R., Pinkos, A., … & Bates, M. L. (2015). Acute resolution of pulmonary alveolar infiltrates in 10 dogs with pulmonary hypertension treated with sildenafil citrate: 2005-2014. Journal of Veterinary Cardiology, 17, 182-191.
• Referans 29 Kellum, H. B, & Stepien, R. L. S. (2007). Sildenafil citrate therapy in 22 dogs with pulmonary hypertension. Journal of Veterinary Internal Medicine, 21, 1258-1264.
• Referans 30 Kleber, F. X., Bollmann, T., Borst, M. M., Costard‐Jäckle, A., Ewert, R., Kivikko, M., ... & Wikström, G. (2009). Repetitive dosing of intravenous levosimendan improves pulmonary hemodynamics in patients with pulmonary hypertension: results of a pilot study. The Journal of Clinical Pharmacology, 49(1), 109-115.
• Referans 31 Lahm, T., Douglas, I. S., Archer, S. L., Bogaard, H. J., Chesler, N. C., Haddad, F., ... & Hassoun, P. M. (2018). Assessment of right ventricular function in the research setting: knowledge gaps and pathways forward. An Official American Thoracic Society Research Statement. American Journal of Respiratory and Critical Care Medicine, 198(4), e15-e43.
• Referans 32 Moore, K. W., & Stepien, R. L. (2001). Hydroxyurea for treatment of polycythemia secondary to right‐to‐left shunting patent ductus arteriosus in 4 dogs. Journal of Veterinary Internal Medicine, 15(4), 418-421.
• Referans 33 Mondritzki, T., Boehme, P., Schramm, L., Vogel, J., Mathar, I., Ellinghaus, P., ... & Truebel, H. (2018). New pulmonary hypertension model in conscious dogs to investigate pulmonary-selectivity of acute pharmacological interventions. European Journal of Applied Physiology, 118(1), 195-203.
• Referans 34 Morita, T., Nakamura, K., Osuga, T., Kawamoto, S., Miki, S., Sasaoka, K., & Takiguchi, M. (2020). Acute effects of intravenous pimobendan administration in dog models of chronic precapillary pulmonary hypertension. Journal of Veterinary Cardiology, 32, 16-27.
• Referans 35 Murphy, L. A., Russell, N., Bianco, D., & Nakamura, R. K. (2017). Retrospective evaluation of pimobendan and sildenafil therapy for severe pulmonary hypertension due to lung disease and hypoxia in 28 dogs (2007–2013). Veterinary Medicine and Science, 3(2), 99-106.
• Referans 36 Naeije, R., & Manes, A. (2014). The right ventricle in pulmonary arterial hypertension. European Respiratory Review, 23(134), 476-487.
• Referans 37 Nakatani, M., Shirotani, T., Kobayashi, K., Satomi, S., Ikeda, Y., Kuniyoshi, T., ... & Motooka, T. (1999). Effects of low dose pimobendan in patients with cor-pulmonale. Journal of Cardiology, 34(2), 79-83.
• Referans 38 Noordegraaf, A. V., & Galie, N. (2011). The role of the right ventricle in pulmonary arterial hypertension. European Respiratory Review, 20(122), 243-253.
• Referans 39 Ohte, N., Cheng, C. P., Suzuki, M., & Little, W. C. (1997). The cardiac effects of pimobendan (but not amrinone) are preserved at rest and during exercise in conscious dogs with pacing-induced heart failure. Journal of Pharmacology and Experimental Therapeutics, 282(1), 23-31.
• Referans 40 Paradies, P., Spagnolo, P. P., Amato, M. E., Pulpito, D., & Sasanelli, M. (2014). Doppler echocardiographic evidence of pulmonary hypertension in dogs: a retrospective clinical investigation. Veterinary Research Communications, 38(1), 63-71.
• Referans 41 Paradies, P., Sasanelli, M., Capogna, A., Mercadante, A., Rubino, G. T. R., & Bussadori, C. M. (2021). Is pulmonary hypertension a rare condition associated to angiostrongylosis in naturally infected dogs?. Topics in Companion Animal Medicine, 43, 100513.
• Referans 42 Pariaut, R., Saelinger, C., Strickland, K. N., Beaufrère, H., Reynolds, C. A., & Vila, J. (2012). Tricuspid annular plane systolic excursion (TAPSE) in dogs: reference values and impact of pulmonary hypertension. Journal of Veterinary Internal Medicine, 26(5), 1148-1154.
• Referans 43 Pulido, T., Zayas, N., de Mendieta, M. A., Plascencia, K., & Escobar, J. (2016). Medical therapies for pulmonary arterial hypertension. Heart Failure Reviews, 21, 273-283.
• Referans 44 Pyle, R. L., Abbott, J., & MacLean, H. (2004). Pulmonary hypertension and cardiovascular sequelae in 54 dogs. International Journal of Applied Research in Veterinary Medicine, 2(2), 99-109.
• Referans 45 Reinero, C. (2019). Interstitial lung diseases in dogs and cats part I: the idiopathic interstitial pneumonias. Veterinary Journal, 243, 48-54.
• Referans 46 Reinero, C., Visser, L. C., Kellihan, H. B., Masseau, I., Rozanski, E., Clercx, C., ... & Scansen, B. A. (2020). ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs. Journal of Veterinary Internal Medicine, 34(2), 549-573.
• Referans 47 Ren, X., Johns, R. A., & Gao, W. D. (2019). Right heart in pulmonary hypertension: from adaptation to failure. Pulmonary Circulation, 9(3), 1-20.
• Referans 48 Roels, E., Merveille, A. C., Moyse, E., Gomart, S., Clercx, C., & Mc Entee, K. (2019). Diagnostic value of the pulmonary vein-to-right pulmonary artery ratio in dogs with pulmonary hypertension of precapillary origin. Journal of Veterinary Cardiology, 24, 85-94.
• Referans 49 Roels, E., Fastrès, A., Merveille, A. C., Bolen, G., Teske, E., Clercx, C., & Mc Entee, K. (2021). The prevalence of pulmonary hypertension assessed using the pulmonary vein‐to‐right pulmonary artery ratio and its association with survival in West Highland white terriers with canine idiopathic pulmonary fibrosis. BMC Veterinary Research, 17(1), 1-7.
• Referans 50 Runo, J. R., & Loyd, J. E. (2003). Primary pulmonary hypertension. The Lancet, 361(9368), 1533-1544.
• Referans 51 Saetang, K., & Surachetpong, S. D. (2020). Short-term effects of sildenafil in the treatment of dogs with pulmonary hypertension secondary to degenerative mitral valve disease. Veterinary World, 13(10), 2260.
• Referans 52 Sahara, M., Takahashi, T., Imai, Y., Nakajima, T., Yao, A., Morita, T., ... & Nagai, R. (2006). New insights in the treatment strategy for pulmonary arterial hypertension. Cardiovascular Drugs and Therapy, 20(5), 377-386.
• Referans 53 Schober, K. E., & Baade, H. (2006). Doppler echocardiographic prediction of pulmonary hypertension in West Highland white terriers with chronic pulmonary disease. Journal of Veterinary Internal Medicine, 20(4), 912-920.
• Referans 54 Schrope, D. P. (2015). Prevalence of congenital heart disease in 76,301 mixed-breed dogs and 57,025 mixed-breed cats. Journal of Veterinary Cardiology, 17(3), 192-202.
• Referans 55 Silverstein, D., Greene, C., Gregory, C., Lucas, S., & Quandt, J. (2000). Pulmonary alveolar proteinosis in a dog. Journal of Veterinary Internal Medicine, 14(5), 546-551.
• Referans 56 Stamm, J. A., Risbano, M. G., & Mathier, M. A. (2011). Overview of current therapeutic approaches for pulmonary hypertension. Pulmonary Circulation, 1(2), 138-159.
• Referans 57 Tjostheim, S. S., Kellihan, H. B., Grint, K. A., & Stepien, R. L. (2019). Effect of sildenafil and pimobendan on intracardiac infections in four dogs. Journal of Veterinary Cardiology, 23, 96-103.
• Referans 58 Tobias, A. H., & Stauthammer, C. D. (2010). Minimally invasive per-catheter occlusion and dilation procedures for congenital cardiovascular abnormalities in dogs. The Veterinary Clinics of North America. Small Animal Practice, 40(4), 581-603.
• Referans 59 Vezzosi, T., Domenech, O., Iacona, M., Marchesotti, F., Zini, E., Venco, L., & Tognetti, R. (2018). Echocardiographic evaluation of the right atrial area index in dogs with pulmonary hypertension. Journal of Veterinary Internal Medicine, 32(1), 42-47.
• Referans 60 Visser, L. C., Wood, J. E., & Johnson, L. R. (2020). Survival characteristics and prognostic importance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension. Journal of Veterinary Internal Medicine, 34(4), 1379-1388.
• Referans 61 Wang, Y., Wang, C., Yang, Y., & Pang, B. (2010). Effect of recombinant single-chain urokinase-type plasminogen activator on experimental pulmonary embolism. Clinical and Applied Thrombosis/Hemostasis, 16(5), 537-542.
• Referans 62 Watanabe, E., Shiga, T., Matsuda, N., Kajimoto, K., Naganuma, M., Kawai, A., & Kasanuki, H. (2003). Low-dose systemic phosphodiesterase III inhibitor pimobendan combined with prostacyclin therapy in a patient with severe primary pulmonary hypertension. Cardiovascular Drugs and Therapy, 17(4), 375-379.
• Referans 63 Winter, R. L., Remaks, J. D., & Newhard, D. K. (2020). Development of Spontaneous Echocardiographic Contrast After Transarterial Occlusion of a Patent Ductus Arteriosus in an Adult Dog With Concurrent Pulmonary Hypertension. Frontiers in Veterinary Science, 7, 103.
• Referans 64 Yang, H. J., Oh, Y. I., Jeong, J. W., Song, K. H., Koo, T. S., & Seo, K. W. (2018). Comparative single-dose pharmacokinetics of sildenafil after oral and rectal administration in healthy beagle dogs. BMC Veterinary Research, 14(1), 1-6. Yoshida, T., Mandour, A. S., Matsuura, K., Shimada, K., El-Husseiny, H. M., Hamabe, L., ... & Tanaka, R. (2021). Changes in the pulmonary artery wave reflection in dogs with experimentally-induced acute pulmonary embolism and the effect of vasodilator. Animals, 11(7), 1977.
• Referans 65 Zhang, Y., Liu, H., Zhang, Y., Wu, Q., Zhang, Y., Zhang, J., ... & Zhong, Z. (2018). Efficacy evaluation of reteplase in a novel canine acute pulmonary thromboembolism model developed by minimally invasive surgery and digital subtraction angiography. Drug Design, Development and Therapy, 12, 3717.