Clinical presentation, cardiovascular findings, etiology, and outcome of myocarditis in dogs: 64 cases with presumptive antemortem diagnosis (26 confirmed postmortem) and 137 cases with postmortem diagnosis only (2004-2017)

Lakhdhir, Sarifa; Viall, Austin; Alloway, Elizabeth; Keene, Bruce; Baumgartner, Kristen; Ward, Jessica

Abstract Introduction To describe presentation, cardiovascular abnormalities, etiology, and outcome of canine myocarditis in geographic areas not endemic for Trypanosoma or Leishmania. Animals Sixty-four (presumed antemortem diagnosis) and 137 (postmortem diagnosis only) client-owned dogs at two tertiary care facilities. Materials and Methods Medical records of dogs with clinical or histopathological diagnosis of myocarditis were reviewed retrospectively. Results Common examination findings in dogs with a presumed antemortem diagnosis included fever (21%) and heart murmur (19%). Median cardiac troponin I was 12.2 ng/mL (range 0.2-808.0 ng/mL), and troponin exceeded 1.0 ng/mL in 26/29 (90%) dogs. Ventricular ectopy was the most common arrhythmia (54%), while decreased left ventricular systolic function was the most common echocardiographic abnormality (56%). An infectious etiology was diagnosed in 35/64 (55%) dogs. Confirmed infectious etiologies included bacterial sepsis (n = 9) or extension of endocarditis (3), toxoplasmosis or neosporosis (3), parvovirus (2), and one case each of bartonellosis, trypanosomiasis, leptospirosis, and dirofilariasis. Median survival time was 4 days (range 0 - 828 days) for all dogs, versus 82 days for dogs who survived at least two weeks following diagnosis. Presence of pericardial effusion or azotemia were significant predictors of nonsurvival. The most common inflammatory infiltrate on histopathology was neutrophilic (47%), and 20/137 (15%) dogs had concurrent bacterial endocarditis on postmortem. Conclusions Bacterial infection was the most common confirmed etiology of myocarditis in this study. Prognosis for canine myocarditis is guarded and similar to that reported for infective endocarditis. Criteria for the antemortem diagnosis of canine myocarditis are suggested.