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Topic:Hemodynamics

Hemodynamics in horses refers to the study of blood flow and the forces involved in circulation within the equine cardiovascular system. It encompasses the examination of heart function, blood pressure, and the distribution of blood to various tissues and organs. Key parameters in equine hemodynamics include cardiac output, vascular resistance, and blood volume. These factors are integral to understanding how horses respond to exercise, stress, and various health conditions. This page aggregates peer-reviewed research studies and scholarly articles that explore the mechanisms, measurement techniques, and clinical implications of hemodynamic processes in equine physiology and veterinary medicine.
Evaluation of the effects of medial saphenous venous pressures as an indirect method of measurement of intra-abdominal pressures in the horse.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    October 8, 2020   Volume 30, Issue 6 660-669 doi: 10.1111/vec.13000
Munsterman AS, Gillen AM, Coleridge MOD, Hanson RR.To evaluate the effect of changes in intra-abdominal pressure (IAP) on medial saphenous venous pressure (MSVP) and hemodynamics in normal horses. Methods: Experimental, in-vivo study. Methods: University Teaching Hospital. Methods: Convenience sample of 7 mixed breed horses; 5 geldings, and 2 mares. Methods: Pneumoperitoneum was induced in horses under standing sedation with carbon dioxide gas using a laparoscopic insufflator for a total of 60 minutes to simulate clinical elevation in IAP. Pressure was increased stepwise to 20 mm Hg over 30 minutes, and maintained at that pressure for 30 minu...
Irregular hearts and performance horses.
Equine veterinary journal    October 6, 2020   Volume 52, Issue 6 782-786 doi: 10.1111/evj.13316
Physick-Sheard PW, Slack J.No abstract available
Evaluation of the effects of intraabdominal hypertension on equine central venous pressure.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    September 15, 2020   Volume 30, Issue 6 653-659 doi: 10.1111/vec.13001
Munsterman AS, Gillen AM, Coleridge MOD, Hanson RR.To evaluate the effect of changes in intraabdominal pressure (IAP) on central venous pressure (CVP) in normal horses. Methods: Experimental, in vivo study. Methods: University Teaching Hospital. Methods: Convenience sample of 7 mixed breed horses-5 geldings and 2 mares. Methods: Pneumoperitoneum was induced in horses under standing sedation with carbon dioxide gas using a laparoscopic insufflator for a total of 60 minutes to simulate clinical elevation in IAP. Pressure was increased stepwise to 20 mm Hg over 30 minutes, and maintained at that pressure for 30 minutes to evaluate the effect of ...
The effect of intra-articular mepivacaine administration prior to carpal arthroscopy on anesthesia management and recovery characteristics in horses.
Veterinary surgery : VS    August 31, 2020   Volume 49, Issue 7 1343-1349 doi: 10.1111/vsu.13501
Gaesser AM, Varner KM, Douglas HF, Barr CA, Hopster K, Levine DG.To evaluate the effects of intra-articular (IA) mepivacaine administration prior to carpal arthroscopy on anesthetic drug requirements, blood pressure support, hemodynamic variables, and quality of recovery in horses. Methods: Experimental, analytical, cohort study. Methods: Twenty-two horses (n = 11 horses/group). Methods: Horses were anesthetized by using the same protocol, but an IA injection of mepivacaine or saline was performed before carpal arthroscopy. End-tidal isoflurane concentration, heart rate, and mean arterial pressure were recorded at specific time points. Quality of recovery w...
Effect of position on transdiaphragmatic pressure and hemodynamic variables in anesthetized horses.
Canadian journal of veterinary research = Revue canadienne de recherche veterinaire    August 18, 2020   Volume 84, Issue 3 205-211 
Youngblood CD, Hodgson DS, Beard WL, Song Y, Prakash P, Heflin LV.Recumbency affects respiratory mechanics and oxygenation in anesthetized horses. Changes in pleural and abdominal pressures that can impair ventilation have not been described in all recumbencies. The objective of this study was to determine the effects of patient positioning on transdiaphragmatic pressure and selected hemodynamic variables. Horses were maintained under total intravenous general anesthesia with nasal oxygen supplementation. Transnasal balloon catheters in the stomach and thoracic esophagus were used to measure intrathoracic and gastric pressures in standing horses and in anest...
Doppler indices of the equine fetal carotid artery throughout gestation.
Theriogenology    July 12, 2020   Volume 156 196-204 doi: 10.1016/j.theriogenology.2020.07.009
Bucca S, De Oliveira IRS, Cunanan JC, Vinardell T, Troedsson MHT.Assessment of pregnancy viability in the equine patient is currently based on gestational profiles of limited prognostic value. In recent years Doppler technology has been applied to uterine and umbilical arteries of pregnant mares to monitor fetal responsive haemodynamics, suggestive of compromise. To date, uterine artery Doppler indices failed to provide sufficient evidence of pregnancy viability and the umbilical cord of the equine fetus is inconsistently visualized past 250 days gestation. The objectives of this study were to: i) evaluate intracranial blood flow impedance by Doppler examin...
Physiologic effects of furosemide in combination with water restriction when administered at 4 and 24 hours prior to high-intensity treadmill training.
Journal of veterinary pharmacology and therapeutics    June 1, 2020   Volume 43, Issue 6 565-576 doi: 10.1111/jvp.12881
Knych HK, Wilson WD, Vale A, Kass PH, Steffey EP, Jones JH, Arthur RM.Although controversial, due to its reported effectiveness in attenuating bleeding associated with exercise-induced pulmonary hemorrhage (EIPH), furosemide is currently a permitted race day medication in most North American racing jurisdictions. The objective of this study was to assess the efficacy of furosemide in reducing the presence and severity of EIPH when administered 24 hr prior to strenuous treadmill exercise. Eight exercised Thoroughbred horses received saline or 250 mg of furosemide either 4 or 24 hr prior to high-speed treadmill exercise in a balanced 3-way cross-over design. Bl...
Behavioral and Cardiopulmonary Effects of a Constant Rate Infusion of Remifentanil-Xylazine for Sedation in Horses.
Journal of equine veterinary science    May 8, 2020   Volume 91 103111 doi: 10.1016/j.jevs.2020.103111
Pallarols NB, Lamuraglia R, Guglielminetti A, Ortiz de Elguea MF, Carossino M, Funcia JP.Xylazine and remifentanil in constant rate infusion (CRI) could be used for sedation in horses without adverse effects. The objective was to evaluate behavioral and cardiopulmonary effects of an intravenous (IV) infusion of xylazine and remifentanil for sedation in horses. Xylazine (0.8 mg/kg IV) followed after 3 minutes by a CRI of xylazine and remifentanil (0.65 mg/kg/h and 6 μg/kg/h, respectively) was administered in 10 healthy horses for 60 minutes. Sedation, ataxia, and cardiopulmonary, hematological, and blood gases variables were evaluated. Heart rate decreased significantly durin...
Dexmedetomidine and Bupivacaine Association in Caudal Epidural Injection in Mares.
Journal of equine veterinary science    April 22, 2020   Volume 91 103015 doi: 10.1016/j.jevs.2020.103015
Sampaio BFB, DeRossi R, Vieira N, Milan B, Ávila LG.The objective of the study was to compare the effects of caudal epidural bupivacaine and dexmedetomidine (DEX) combination, with bupivacaine or DEX plain for perineal analgesia in mares. Six healthy saddle mares weighing 330-370 kg and aged 10-15 years were used in this study. Each mare was assigned to receive three treatments: 0.04 mg/kg 0.25% bupivacaine (BP), 2 μg/kg DEX (DX), or 0.02 mg/kg bupivacaine and 1 μg/kg DEX (BPDX). The order of treatments was randomized. All drugs were injected into the caudal epidural space (Co1-Co2) through a 16-G Tuohy epidural needle. After the epidur...
Age-related differences in blood pressure, ultrasound-derived arterial diameters and arterial wall stiffness parameters in horses.
Equine veterinary journal    April 10, 2020   Volume 52, Issue 6 868-875 doi: 10.1111/evj.13263
Vera L, Van Steenkiste G, Decloedt A, Chiers K, van Loon G.Arterial rupture mainly affects older horses. The reason why older horses are more prone to arterial rupture and which underlying vascular changes predispose older horses to aortic rupture is still unclear. Objective: To investigate the effect of ageing on the equine arterial wall and blood pressure. Methods: Cohort study. Methods: Non-invasive blood pressure measurement using a tail cuff and vascular ultrasound from aorta, common carotid artery and external iliac artery was performed in 50 healthy young (3-7 years) and 50 healthy old Warmblood horses (>18 years). Arterial diameters and c...
A comparative study on the equine and camelid antivenoms upon cardiovascular changes induced with Hemiscorpius lepturus venom in rats.
Iranian journal of basic medical sciences    March 7, 2020   Volume 22, Issue 12 1440-1444 doi: 10.22038/IJBMS.2019.14052
Fatemikia H, Kamyab M, Movahed A, Sadeghi M, Kim E, Behdani M, Mohammadpour Dounighi N, Shahrivar M, Seyedian R.In this study, the neutralizing abilities of the equine and the recently introduced camelid antivenoms on the hemodynamic parameters (inotropism, chronotropism, and arrhythmogenicity) were assessed following envenomation by venom in rats. Methods: At first, the electrophoretic profiles of both products were obtained by using the SDS-PAGE method (12.5%) and stained with Coomassie blue and silver nitrate. Secondly, different doses of the camelid antivenom (10, 50, and 100 µl) were given intravenously in 10 min before venom injection (400 µg/rat). The neutralizing potencies of camelid and equi...
Cerebral Computed Tomography Scan Demonstrating Ischemic Stroke in a Filly After Intravenous Antibiotic Administration.
Journal of equine veterinary science    February 14, 2020   Volume 88 102953 doi: 10.1016/j.jevs.2020.102953
Saliou G, d'Ablon X, Théaudin M, Saliou T, Bourassi S.Performing a brain computerized tomography scan (CT scan) on a foal requires specific equipment and anesthesia for large animals. However, the information obtained may demonstrate lesions responsible for the neurological deficits. Especially, CT scan findings may help to understand a mechanism of cerebral ischemia. Indeed, categories of cerebral ischemia are divided in three types: territorial infarctions (downstream of the territory of an artery), watershed infarctions (slow-flow at the junction of two arterial territories), and lacunar infarctions (small-vessel occlusions). Hypersensitivity ...
Acute kidney injury due to Leptospira interrogans in 4 foals and use of renal replacement therapy with intermittent hemodiafiltration in 1 foal.
Journal of veterinary internal medicine    January 30, 2020   Volume 34, Issue 2 1007-1012 doi: 10.1111/jvim.15713
Fouché N, Graubner C, Lanz S, Schweighauser A, Francey T, Gerber V.Four 2-month-old foals were presented to an equine hospital with acute kidney injury caused by Leptospira interrogans infection. Clinical signs were nonspecific and included lethargy, fever, and unwillingness to nurse. The most important hematologic and clinicopathologic findings were azotemia, anemia, thrombocytopenia, hyponatremia, and hypochloremia. The diagnosis was based on urinary real-time PCR, serology using a microscopic agglutination test, or both. The most important serovars involved were L. interrogans serogroup australis serovar Bratislava and Australis. Treatment consisted of IV ...
Agreement between invasive and oscillometric arterial blood pressure measurements using the LifeWindow multiparameter monitor and two cuff sizes in anesthetized adult horses.
Veterinary anaesthesia and analgesia    January 24, 2020   Volume 47, Issue 3 315-322 doi: 10.1016/j.vaa.2020.01.001
Rousseau-Blass F, Pigé C, Pang DS.To assess agreement between oscillometric noninvasive blood pressure (NIBP) measurements using LifeWindow monitors (LW9xVet and LW6000V) and invasive blood pressure (IBP). To assess the agreement of NIBP readings using a ratio of cuff width to mid-cannon circumference of 25% and 40%. Methods: Prospective, randomized clinical study. Methods: A total of 43 adult horses undergoing general anesthesia in dorsal recumbency for different procedures. Methods: Anesthetic protocols varied according to clinician preference. IBP measurement was achieved after cannulation of the facial artery and connectio...
Reference Values and Repeatability of B-Mode and M-Mode Echocardiographic Parameters in Healthy Donkey (Equus asinus)-The Guide to Assess Healthy Heart.
Journal of equine veterinary science    January 16, 2020   Volume 88 102929 doi: 10.1016/j.jevs.2020.102929
Farag AMM, Ibrahim HMM.Donkey (Equus asinus), the cheapest form of agricultural power in Egypt, is used principally as draught or pack animals and may also be ridden, or used for threshing, raising water, milling, and other work. The aim of the present study was to provide B-mode and M-mode echocardiographic reference ranges from a sample of population of donkeys (E. asinus) based on the probability theory and statistics. In the present study, B-mode and 2-dimensional guided M-mode echocardiography were performed on 44 clinically healthy donkeys (E. asinus) (22 males and 22 females), without any neither clinical nor...
Prevalence of Electrolyte Disturbances and Perianesthetic Death Risk Factors in 120 Horses Undergoing Colic Surgery.
Journal of equine veterinary science    November 12, 2019   Volume 84 102843 doi: 10.1016/j.jevs.2019.102843
Adami C, Westwood-Hearn H, Bolt DM, Monticelli P.The objective of this study was to determine the prevalence of intraoperative electrolyte disturbances and risk factors associated with perianesthetic death in horses undergoing colic surgery. The files of 120 horses meeting the inclusion criteria were reviewed. Data retrieved from the medical records, including demographic data and the occurrence of electrolyte disturbances and other intraoperative complications, were analyzed with a two step-approach by univariate and multivariate logistic regression models. Hypocalcemia was the most represented electrolyte disturbance (52.5%), followed by h...
A 1D computer model of the arterial circulation in horses: An important resource for studying global interactions between heart and vessels under normal and pathological conditions.
PloS one    August 21, 2019   Volume 14, Issue 8 e0221425 doi: 10.1371/journal.pone.0221425
Vera L, Campos Arias D, Muylle S, Stergiopulos N, Segers P, van Loon G.Arterial rupture in horses has been observed during exercise, after phenylephrine administration or during parturition (uterine artery). In human pathophysiological research, the use of computer models for studying arterial hemodynamics and understanding normal and abnormal characteristics of arterial pressure and flow waveforms is very common. The objective of this research was to develop a computer model of the equine arterial circulation, in order to study local intra-arterial pressures and flow dynamics in horses. Morphologically, large differences exist between human and equine aortic arc...
Measurement of peripheral muscle oxygen saturation in conscious healthy horses using a near-infrared spectroscopy device.
Veterinary anaesthesia and analgesia    August 7, 2019   Volume 46, Issue 6 789-795 doi: 10.1016/j.vaa.2019.07.001
Gingold BM, Killos MB, Griffith E, Posner L.Maintaining adequate muscle tissue oxygenation is of paramount importance during equine general anesthesia. The objectives of this study were to assess the feasibility, reliability and repeatability of near-infrared spectroscopy (NIRS) muscle oximetry using the Inspectra m650 in conscious healthy adult horses. Methods: Prospective, observational study. Methods: A group of 30 healthy client-owned adult horses admitted to the equine hospital between July 2017 and July 2018. Methods: The probe of an Inspectra m650 NIRS tissue oximeter was placed on the hairless surface of five muscle sites (omotr...
Effects of pentoxifylline supplementation to semen extender on post-breeding inflammation response assessed by endometrial cytology and vascular perfusion in mares.
Animal reproduction science    July 17, 2019   Volume 208 106128 doi: 10.1016/j.anireprosci.2019.106128
Tsunoda RH, Serrano-Recalde EC, Arruda RP, Oliveira BMM, Pinto SCC, Celeghini ECC.The aim was to evaluate effects of addition of pentoxifylline to skimmed milk semen extender on uterine inflammatory response. Thirty-six estrous cycles of 15 mares were randomly divided into five groups for artificial insemination (AI): Control: mimicking the AI procedure (n = 7); Extender: deposition of skimmed milk based extender (n = 7); Extender + PTX: skimmed milk based extender plus pentoxifylline (7.18 mM; n = 8); Semen: semen diluted with extender without pentoxifylline (n = 7), and Semen + PTX: semen diluted with extender containing pentoxifylline (n = 7). M...
Near-Newtonian Blood Behavior – Is It Good to Be a Camel?
Frontiers in physiology    July 17, 2019   Volume 10 906 doi: 10.3389/fphys.2019.00906
Windberger U, Auer R, Seltenhammer M, Mach G, Skidmore JA.From a certain level of exercise-intensity onward, hematocrit increases in horses, which brings more oxygen carriers into the bloodstream. Camels, however, when used in competitive racing could be even in need of iron supplementation and blood transfusions due to a severe reduction of their available hematocrit compared to their resting hematocrit. Since the extrinsic and intrinsic mechanical properties of camel erythrocytes (RBC) are so different compared to RBCs of other mammals, the question arises whether this observation might be a response to endurance exercise aiming at keeping the RBC ...
Echocardiographic Evaluation of Myocardial Function in Standardbreds During the First Year of Race Training.
Journal of equine veterinary science    July 8, 2019   Volume 80 40-48 doi: 10.1016/j.jevs.2019.07.001
Gehlen H, Schlaga A.Several studies have shown the effect of training on myocardial deformation parameters in human athletes. The aim of this prospective, longitudinal study was echocardiographic evaluation of myocardial velocities and deformation in horses during the first year of training. Twelve Standardbred yearlings were examined using tissue Doppler imaging (TDI) and two-dimensional speckle tracking (2D-ST) during the first year of race training (short axis of left and right ventricle). The first examination was performed before the beginning of training (n = 12). At the last time point, horses were fully ...
Diagnostic value of noninvasive pulse pressure measurements in Warmblood horses with aortic regurgitation.
Journal of veterinary internal medicine    April 2, 2019   Volume 33, Issue 3 1446-1455 doi: 10.1111/jvim.15494
Boegli J, Schwarzwald CC, Mitchell KJ.Noninvasive blood pressures (NIBP) and pulse pressures (PP) have not been published in horses with aortic and mitral regurgitation (AR or MR). Objective: To investigate NIBP and PP in healthy Warmblood horses and horses with AR and MR and propose PP cutoffs to identify and stage AR severity. Methods: Seventy-three Warmblood horses (healthy, 10; AR, 31; MR, 32). Methods: Retrospective study. All horses had NIBP and an echocardiogram recorded. Cases were categorized based on severity of regurgitation. Pulse pressures were compared among healthy, MR, and AR groups and among AR severity groups. Cu...
Assessment of the Cardiovascular System in Horses During Prepurchase and Insurance Examinations.
The Veterinary clinics of North America. Equine practice    March 11, 2019   Volume 35, Issue 1 191-204 doi: 10.1016/j.cveq.2018.11.002
Reef VB.Arrhythmias detected on prepurchase examination should be confirmed with an ECG. Exercising ECG determines if the arrhythmia is overdriven during exercise or is a safety concern. An echocardiogram is needed in all horses with a grade 3/6 or louder mid to late systolic, holosystolic, or pansystolic murmur or any holodiastolic decrescendo murmur to identify the cardiac abnormality and its hemodynamic impact. Most horses with arrhythmias and murmurs have a normal performance career and life expectancy and are insurable. Risks for sudden death and congestive heart failure associated with the commo...
Cardiac Monitoring in Horses.
The Veterinary clinics of North America. Equine practice    March 11, 2019   Volume 35, Issue 1 205-215 doi: 10.1016/j.cveq.2018.12.003
Shih AC.Monitoring variables of cardiac performance in horses is challenging owing to patient size, temperament, and anatomic peculiarities. Blood pressure is a major determinant of afterload, but it is not a reliable surrogate of cardiac performance and tissue perfusion. Cardiac output, together with arterial and venous oxygen content, provides insight as to the adequacy of delivery of blood and oxygen to the body as a whole and can be used to gauge the fluid responsiveness and cardiovascular status of the patient. Measurement of intracardiac pressures serves to assess cardiac filling pressures, myoc...
Pericardial Disease, Myocardial Disease, and Great Vessel Abnormalities in Horses.
The Veterinary clinics of North America. Equine practice    March 11, 2019   Volume 35, Issue 1 139-157 doi: 10.1016/j.cveq.2018.12.005
Decloedt A.Pericardial, myocardial, and great vessel diseases are relatively rare in horses. The clinical signs are often nonspecific and vague, or related to the underlying cause. Physical examination usually reveals tachycardia, fever, venous distension or jugular pulsation, a weak or bounding arterial pulse, ventral edema, and abnormal cardiac auscultation such as arrhythmia, murmur, or muffled heart sounds. The prognosis depends on the underlying cause and the disease progression, and ranges from full recovery to poor prognosis for survival. This article focuses on the etiology, diagnosis, prognosis,...
Equine Echocardiography.
The Veterinary clinics of North America. Equine practice    February 27, 2019   Volume 35, Issue 1 43-64 doi: 10.1016/j.cveq.2018.12.008
Schwarzwald CC.This article provides an overview on the principles of transthoracic echocardiography in horses. Indications for echocardiography, equipment, and technical considerations are discussed and a systematic approach for a complete echocardiographic examination in horses is described. Methods for assessment of chamber dimensions, allometric scaling of measurements, assessment of systolic and diastolic ventricular function, assessment of atrial function, hemodynamic assessment, and evaluation of valvular regurgitation are explained, focusing on traditional 2-dimensional (2D), motion-mode, and Doppler...
Effects of ventilation mode and blood flow on arterial oxygenation during pulse-delivered inhaled nitric oxide in anesthetized horses.
American journal of veterinary research    February 26, 2019   Volume 80, Issue 3 275-283 doi: 10.2460/ajvr.80.3.275
Auckburally A, Grubb TL, Wiklund M, Nyman G.OBJECTIVE To determine the impact of mechanical ventilation (MV) and perfusion conditions on the efficacy of pulse-delivered inhaled nitric oxide (PiNO) in anesthetized horses. ANIMALS 27 healthy adult horses. PROCEDURES Anesthetized horses were allocated into 4 groups: spontaneous breathing (SB) with low ( 70 mm Hg. Data were collected after a 60-minute equilibration period and at 15 and 30 minutes during PiNO administration. Variables included Pao, arterial oxygen saturation and content, oxygen delivery, and physiologic dead space-to-tidal volume ratio. Data were analyzed with Shapiro-Wilk, ...
The pharmacokinetics and pharmacodynamics of intravenous hydromorphone in horses.
Veterinary anaesthesia and analgesia    November 22, 2018   Volume 46, Issue 3 395-404 doi: 10.1016/j.vaa.2018.11.001
Reed R, Barletta M, Mitchell K, Hanafi A, Bullington A, Knych H, Quandt J, Ryan C, Giguère S.Describe the pharmacokinetics and pharmacodynamics of intravenous hydromorphone in healthy horses. Methods: Masked, randomized, cross-over, Latin square design. Methods: A group of eight healthy adult horses METHODS: Horses were administered each of four treatments with an 8 day washout. Treatments groups included intravenous hydromorphone 0.02 mg kg (LD), 0.04 mg kg (MD), 0.08 mg kg (HD) and saline (P). Blood samples for hydromorphone analysis were obtained for 24 hours after treatment. Plasma hydromorphone was quantified and pharmacokinetic parameters were determined using non-compartmental ...
Alfaxalone for total intravenous anaesthesia in horses.
Veterinary anaesthesia and analgesia    October 28, 2018   Volume 46, Issue 2 188-199 doi: 10.1016/j.vaa.2018.09.047
Goodwin WA, Pasloske K, Keates HL, Ranasinghe MG, Woldeyohannes S, Perkins N.To determine the suitability of alfaxalone total intravenous (IV) anaesthesia in horses and concurrently evaluate infusion rates, cardiovascular effects, pharmacokinetics and the quality of the anaesthetic recovery period. Methods: Prospective, experimental study. Methods: Eight Standardbred horses. Methods: Horses were premedicated with IV acepromazine (0.03 mg kg) and xylazine (1 mg kg) and anaesthesia was induced with guaifenesin (35 mg kg) and alfaxalone (1 mg kg). Anaesthesia was maintained for 180 minutes using an IV infusion of alfaxalone at a rate determined by a horse's response to a ...
Cardiovascular images: vascular hamartoma of the mitral valve in a horse.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology    October 18, 2018   Volume 20, Issue 6 399-404 doi: 10.1016/j.jvc.2018.09.002
DiVincenzo MJ, Bonagura JD, Rings L, Burns TA, Cianciolo RE, Kohnken R.An 8-month-old Hanoverian gelding was presented with a history of cardiac murmurs that were not apparent as a foal nor reported at the time of castration. Major echocardiographic findings included mitral valvular thickening, functional stenosis, and mitral regurgitation of sufficient severity to cause diastolic and systolic cardiac murmurs, left-sided volume overload, and pulmonary hypertension. Due to the hemodynamic severity of the lesion and poor prognosis for future performance and longevity, euthanasia was elected. On gross postmortem examination, there was focal fibrous epicarditis affec...