@article{defrancesco_ward_2021, title={Focused Canine Cardiac Ultrasound}, volume={51}, ISSN={["1878-1306"]}, DOI={10.1016/j.cvsm.2021.07.005}, abstractNote={Focused cardiac ultrasound (FCU) is a useful point-of-care imaging tool to assess cardiovascular status in symptomatic dogs in the acute care setting. Unlike complete echocardiography , FCU is a time-sensitive examination involving a subset of targeted ultrasound views to identify severe cardiac abnormalities and is performed as part of an integrated thoracic ultrasound including interrogation of the pleural space and lungs. When integrated with other clinical information, FCU can be helpful in the diagnosis of left-sided and right-sided congestive heart failure, pericardial effusion and tamponade, and severe pulmonary hypertension , and can provide estimates of fluid responsiveness in hypotensive dogs.}, number={6}, journal={VETERINARY CLINICS OF NORTH AMERICA-SMALL ANIMAL PRACTICE}, author={DeFrancesco, Teresa C. and Ward, Jessica L.}, year={2021}, month={Nov}, pages={1203–1216} } @article{ward_lisciandro_keene_tou_defrancesco_2017, title={Accuracy of point-of-care lung ultrasonography for the diagnosis of cardiogenic pulmonary edema in dogs and cats with acute dyspnea}, volume={250}, ISSN={["1943-569X"]}, DOI={10.2460/javma.250.6.666}, abstractNote={Abstract OBJECTIVE To determine the accuracy of a point-of-care lung ultrasonography (LUS) protocol designed to diagnose cardiogenic pulmonary edema (CPE) in dyspneic dogs and cats. DESIGN Diagnostic test evaluation. ANIMALS 76 dogs and 24 cats evaluated for dyspnea. PROCEDURES Dogs and cats were evaluated by LUS; B lines were counted at 4 anatomic sites on each hemithorax. A site was scored as positive when > 3 B lines were identified. Animals with ≥ 2 positive sites identified on each hemithorax were considered positive for CPE. Medical records were evaluated to obtain a final diagnosis (reference standard) for calculation of the sensitivity and specificity of LUS and thoracic radiography for the diagnosis of CPE. RESULTS Dogs and cats with a final diagnosis of CPE had a higher number of positive LUS sites than did those with noncardiac causes of dyspnea. Overall sensitivity and specificity of LUS for the diagnosis of CPE were 84% and 74%, respectively, and these values were similar to those of thoracic radiography (85% and 87%, respectively). Use of LUS generally led to the misdiagnosis of CPE (ie, a false-positive result) in animals with diffuse interstitial or alveolar disease. Interobserver agreement on LUS results was high (κ > 0.85). CONCLUSIONS AND CLINICAL RELEVANCE LUS was useful for predicting CPE as the cause of dyspnea in dogs and cats, although this technique could not be used to differentiate CPE from other causes of diffuse interstitial or alveolar disease. Point-of-care LUS has promise as a diagnostic tool for dyspneic dogs and cats.}, number={6}, journal={JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION}, author={Ward, Jessica L. and Lisciandro, Gregory R. and Keene, Bruce W. and Tou, Sandra P. and DeFrancesco, Teresa C.}, year={2017}, month={Mar}, pages={666–675} } @article{meurs_stern_atkins_adin_aona_condit_defrancesco_reina-doreste_keene_tou_et al._2017, title={Angiotensin-converting enzyme activity and inhibition in dogs with cardiac disease and an angiotensin-converting enzyme polymorphism}, volume={18}, ISSN={["1752-8976"]}, url={https://europepmc.org/articles/PMC5843865}, DOI={10.1177/1470320317737184}, abstractNote={Objective: The objective of this study was to evaluate angiotensin-converting enzyme (ACE) activity in dogs and with and without an ACE polymorphism in the canine ACE gene, before and after treatment with an ACE inhibitor. Methods: Thirty-one dogs (20 wild-type, 11 ACE polymorphism) with heart disease were evaluated with ACE activity measurement and systolic blood pressure before and after administration of an ACE inhibitor (enalapril). Results: Median pre-treatment ACE activity was significantly lower for ACE polymorphism dogs than for dogs with the wild-type sequence (P=0.007). After two weeks of an ACE inhibitor, ACE activity was significantly reduced for both genotypes (wild-type, P<0.0001; ACE polymorphism P=0.03); mean post-therapy ACE activity was no different between the groups. Conclusion: An ACE polymorphism is associated with lower levels of ACE activity. Dogs with the polymorphism still experience suppression of ACE activity in response to an ACE inhibitor. It is possible that the genetic status and ACE activity of dogs may impact the response of dogs with this variant to an ACE inhibitor.}, number={4}, journal={JOURNAL OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM}, author={Meurs, Kathryn M. and Stern, Joshua A. and Atkins, Clarke E. and Adin, Darcy and Aona, Brent and Condit, Julia and DeFrancesco, Teresa and Reina-Doreste, Yamir and Keene, Bruce W. and Tou, Sandy and et al.}, year={2017}, month={Oct} } @article{mclaughlin_ward_keene_2016, title={Development of a Veterinary Surgical Checklist}, volume={24}, ISSN={1064-8046}, url={http://dx.doi.org/10.1177/1064804615621411}, DOI={10.1177/1064804615621411}, abstractNote={ We describe a new surgical checklist for veterinary cardiologists based on the literature and the application of human factors design. The checklist was developed and iterated with subject-matter experts and was implemented for 4 months, during which use of the checklist was monitored, feedback was gathered, and a final survey was distributed to assess subjective experiences. Although developed for the cardiology team, the checklist also affected the anesthesia team by requiring information and responses to be transmitted across teams. Interviews, subjective reports, and observations pointed to the fact that the checklist engendered communication, particularly by requiring the thoughts and expectations of team members to be stated explicitly. }, number={4}, journal={Ergonomics in Design: The Quarterly of Human Factors Applications}, publisher={SAGE Publications}, author={McLaughlin, Anne Collins and Ward, Jessica and Keene, Bruce W.}, year={2016}, month={Aug}, pages={27–34} } @article{ward_defrancesco_tou_atkins_griffith_keene_2016, title={Outcome and survival in canine sick sinus syndrome and sinus node dysfunction: 93 cases (2002-2014)}, volume={18}, ISSN={["1875-0834"]}, DOI={10.1016/j.jvc.2016.04.004}, abstractNote={To evaluate the clinical presentation, diagnosis, treatment, and outcomes of a group of dogs with sinoatrial node abnormalities.Ninety-three client-owned dogs at a referral institution.Medical records were reviewed for clinical history, diagnostic testing, and medical or permanent artificial pacemaker (PAP) treatment. Owners or veterinarians were contacted for long-term follow-up.Sixty-one dogs were symptomatic for their bradyarrhythmia and were diagnosed with sick sinus syndrome (SSS). Thirty-two dogs were asymptomatic for their bradyarrhythmia and were diagnosed with sinus node dysfunction (SND). Miniature Schnauzers, West Highland White terriers, Cocker spaniels, and female dogs were overrepresented. Medical management with positive chronotropic drugs successfully controlled syncope long-term in 54% of SSS dogs, and acted as a bridge to PAP in 20%. Positive atropine response predicted medical treatment success. Forty-six percent of SSS dogs eventually underwent PAP implantation. Median survival time was approximately 18 months in SND and SSS dogs regardless of treatment strategy. Congestive heart failure (CHF) associated with progressive valvular heart disease occurred commonly in all groups, particularly in dogs with bradycardia-tachycardia syndrome.Sinus node dysfunction and SSS represent a spectrum of sinoatrial node disease, which for some dogs may also involve a component of autonomic dysfunction. Dogs with SND do not require treatment. Dogs with SSS often require treatment to reduce the frequency of syncope; medical management is often useful, particularly in atropine responsive dogs. Prognosis of SSS with treatment is good, though development of CHF does not appear to be mitigated by treatment.}, number={3}, journal={JOURNAL OF VETERINARY CARDIOLOGY}, author={Ward, J. L. and DeFrancesco, T. C. and Tou, S. P. and Atkins, C. E. and Griffith, E. H. and Keene, B. W.}, year={2016}, month={Sep}, pages={199–212} } @article{ward_defrancesco_tou_atkins_griffith_keene_2015, title={Complication Rates Associated with Transvenous Pacemaker Implantation in Dogs with High-Grade Atrioventricular Block Performed During versus After Normal Business Hours}, volume={29}, ISSN={["1939-1676"]}, DOI={10.1111/jvim.12512}, abstractNote={BackgroundTransvenous pacemaker implantation in dogs is associated with a relatively high complication rate. At our institution, pacemaker implantation in dogs with high‐grade atrioventricular block (HG‐AVB) frequently is performed as an after‐hours emergency.HypothesisAmong dogs with HG‐AVB, the rate of major complications is higher when pacemakers are implanted after hours (AH) compared to during business hours (BH).AnimalsClient‐owned dogs with HG‐AVB that underwent transvenous pacemaker implantation between January 2002 and December 2012 at the North Carolina State University Veterinary Teaching Hospital.MethodsRetrospective medical record review. Two‐year follow‐up was required for complications analysis.ResultsMajor complications occurred in 14/79 dogs (18%) and included lead dislodgement, lead or generator infection, lead or generator migration, and pacing failure. Incidence of major complications was significantly higher AH (10/36, 28%) compared to BH (4/43, 9%; P = .041), and all infectious complications occurred AH. Median survival time for all dogs was 27 months and did not differ between AH and BH groups for either all‐cause (P = .70) or cardiac (P = .40) mortality. AH dogs were younger than BH dogs (P = .010), but there were no other clinically relevant differences between BH and AH groups in terms of demographic, clinical, or procedural variables.Conclusions and Clinical ImportanceAt our institution, AH transvenous pacemaker placement is associated with a higher rate of major complications (especially infections) compared to BH placement. This difference may be because of a variety of human factor differences AH versus BH.}, number={1}, journal={JOURNAL OF VETERINARY INTERNAL MEDICINE}, author={Ward, J. L. and DeFrancesco, T. C. and Tou, S. P. and Atkins, C. E. and Griffith, E. H. and Keene, B. W.}, year={2015}, pages={157–163} } @article{ward_hall_christian_lewbart_2012, title={Plasma biochemistry and condition of confiscated hatchling pig-nosed turtles (Carettochelys insculpta)}, volume={7}, number={1}, journal={Herpetological Conservation and Biology}, author={Ward, J. L. and Hall, K. and Christian, L. S. and Lewbart, G. A.}, year={2012}, pages={38–45} }