Journal of Threatened Taxa |
www.threatenedtaxa.org | 26 October 2020 | 12(14): 17000–17002
ISSN 0974-7907 (Online) | ISSN 0974-7893
(Print)
doi: https://doi.org/10.11609/jott.6098.12.14.17000-17002
#6098 | Received 04 May 2020 | Final received
19 September 2020 | Finally accepted 25 September 2020
Medetomidine may cause heart
murmur in Cougars and Jaguars: case report
Thiago Cavalheri
Luczinski 1, Gediendson
Ribeiro de Araújo 2, Matheus Folgearini Silveira
3, Murillo Daparé Kirnew
4, Roberto Andres Navarrete 5, Jorge Aparecido
Salomão-Jr 6, Letícia
Alecho Requena 7,
Jairo Antonio Melo dos Santos 8, Marcell Hideki Koshiyama
9, Cristiane Schilbach Pizzutto
10 & Pedro Nacib Jorge-Neto11
1,2,6,7,10,11 Instituto Reprocon
/ R. João Vieira de Meneses, 1064, Campo Grande – MS,
79052-280, Brazil.
1,6,9,10,11 Faculty of Veterinary Medicine
and Animal Science, University of São Paulo / Av. Prof.
Dr. Orlando Marques de Paiva, 87, São Paulo – SP,
05508-270, Brazil.
1,8 NEX – No Extinction Scientific
Breeding Center / Fazenda Duas
Pontes – BR 70, km 34, Corumbá de Goiás
– GO, 72960-000, Brazil.
2 Biosciences Institute, Federal
University of Mato Grosso do Sul / Av. Senador Filinto Muller, 1555, Campo Grande - MS, 79070-900, Brazil.
3 Federal Institute of Education,
Science and Technology of Santa Catarina – Araquari
Campus / Rodovia BR 280, km 27, Araquari
- SC, 89245-000, Brazil.
4,5 School of Agricultural and
Veterinarian Science, São Paulo State University / Via Prof Paulo Donato Castelane Castellane s/n, Jaboticabal - SP, 14884-900, Brazil.
9 Veterinary Medicine Course, Mater
Dei College / Rua Mato Grosso, 200, Pato Branco – PR, 85501-200, Brazil
1 luczinski@yahoo.com.br, 2 gediendson@gmail.com,
3 matheusmedvet@gmail.com, 4 murillo_kirnew@yahoo.com.br,
5 roberto.ampuero@hotmail.com, 6
jorgesalomaojr@hotmail.com, 7 le.requena.vet@gmail.com, 8
hemogaso@gmail.com,
9 vetcardio@gmail.com, 10 cspizzutto@yahoo.com.br,
11 pepovet@usp.br (corresponding author)
Abstract: We report heart murmur in Jaguars
and Cougars found during reproductive procedures for semen and oocyte
collection. Two male Cougars (n=2) and
three female Jaguars (n=3) were examined.
Anesthesia was performed with ketamine and
medetomidine in males. Females also received
propofol and were maintained with isoflurane. The animals were evaluated during anesthetic monitoring with multiparameter monitor alongside
clinical examination, ambulatory electrocardiogram and echocardiogram. All animals presented mitral valve regurgitation
under anesthesia, but without morphological changes
in the cardiac structure or hemodynamic changes. Medetomidine may cause transitory heart
murmur in healthy Jaguars and Cougars.
Keywords: α-2 adrenoceptor
agonist, mitral valve regurgitation, trivial tricuspid valve regurgitation.
Editor: R.G. Jani, College of Veterinary
Science & Animal Husbandry, Anand, India. Date
of publication: 26 October 2020 (online & print)
Citation: Luczinski, T.C., G.R. de Araujo, M.F. Silveira, M.D. Kirnew, R.A. Navarrete, J.A. Salomão-Jr,
L.A. Requena, J.A.M.D. Santos, M.H. Koshiyama, C.S. Pizzutto, P.N.
Jorge-Neto (2020).
Medetomidine may cause heart murmur in Cougars and
Jaguars: case report. Journal of
Threatened Taxa 12(14): 17000–17002. https://doi.org/10.11609/jott.6098.12.14.17000-17002
Copyright: © Luczinski et al. 2020. Creative
Commons Attribution 4.0 International License.
JoTT allows unrestricted use, reproduction,
and distribution of this article in any medium by providing adequate credit to
the author(s) and the source of publication.
Funding: This study was financed in part by the Coordenação
de Aperfeiçoamento de Pessoal
de Nível Superior - Brasil (CAPES) - Finance Code 001
(MD Kirnew); and Instituto Reprocon (TC Luczinski; GR Araujo; LA Requena; CS Pizzutto and PN Jorge-Neto).
Competing interests: The authors declare no competing interests.
Ethic statement: The present study was conducted with authorization
for scientific activities issued by SISBIO/ICMBio/MMA
under no. 57293-2 and approved by the Ethic Committee on Animal Use of the
School of Veterinary Medicine and Animal Science of the University of São Paulo
(CEUA/ FMVZ/USP) under protocol no. 6249300517.
Acknowledgements: The authors acknowledge the following institutions and
persons: NEX - No Extinction; NEX Santa Rosa and Mr. Pedro Camargo; and Fazenda
Talisman.
Objective
The objective of the present short communication is to
report heart murmur as a secondary clinical finding in Jaguars Panthera onca and
Cougars Puma concolor anesthetized for
reproductive procedures with the association of ketamine and medetomidine.
Study design
This study was conducted in Brazil at NEX Santa Rosa
(Amparo – SP; -22.588°S–46.786°W) with authorization for scientific activities
issued by SISBIO/ICMBio/MMA under no. 57293-2 and
approved by the Ethic Committee on Animal Use of the School of Veterinary
Medicine and Animal Science of the University of São Paulo (CEUA/FMVZ/USP)
under protocol nº. 6249300517. The
experiment was conducted in conjunction with efforts to collect oocytes by
laparoscopic ovum pick-up (LOPU) and pharmacological semen collection for
different projects. Data partially shown
for Jaguars (Jorge-Neto et al. 2020) and for semen
biobank (Miranda et al. 2019).
Animals
To perform the reproductive procedure (semen and
oocyte collection) five adult animals (n=5) from two different species were
used: two male Cougars (n=2) and three female Jaguars (n=3), aged between one
and 10 years old, weighing between 35 and 80 kg, all healthy, with good
corporal score and no clinical signal of diseases.
Methods
Animals were fasted for 12h for water and 24h for food
before procedures. Weights were
estimated and chemical restraint was performed for both males and females using
anesthetic darts fired with a blowpipe and containing
Ketamine (5.0mg/kg; im) and Medetomidine (0.1mg/kg; im) (Araujo et al. 2018,
2020). Females also received intravenous administration of
Propofol (2.0 to 3.0 mg/kg) (Jorge-Neto et al. 2020)
for anesthetic induction and intubating were
maintained with Isoflurane, as females were submitted to LOPU procedure (Jorge-Neto et al. 2020).
The procedure was performed at NEX Santa Rosa, where
the two male Cougars and the three female Jaguars were evaluated during anesthetic monitoring with multiparameter monitor alongside
clinical examination, ambulatory electrocardiogram and transthoracic
echocardiogram (Figure 1 & 2). Electrocardiography recordings were
performed during a five-minute period on lateral recumbency during chemical
restraint and heart rate, rhythm and morphology were analyzed. Echocardiograph examinations were performed
by three operators equipped with several phased-array transducers (GE Vivid IQ;
General Electrics, Chicago, IL, USA) that matched the size of the animal. Echocardiograph assessment criteria included
two-dimensional, M-mode and Doppler examinations using recommended imaging
planes and adaptations for proper cardiovascular diagnostic purpose. The same standardized imaging protocol was
used for each examination.
After all procedures – none less than 40 minutes due
to Ketamine action – anesthesia was reverted using
Yohimbine (0.4 mg/kg; im) (Araujo et al. 2015).
Results and Discussion
During cardiovascular evaluation two animals – one
Jaguar and one Cougar – presented grade II/VI and III/VI left apical systolic
heart murmur under anesthesia, auscultated on mitral
focus. A six-year-old female Jaguar
weighing 59kg presented mitral valve insufficiency with mean 5.46m/s velocity
on color doppler flow measurement within 4.9cm2
area of regurgitation on a 12.6cm2 left atrium planimetric
measurement in echocardiographic evaluation.
A six-year-old male Cougar weighing 47.5kg presented mean 7.06m/s mitral
valve insufficiency velocity on color doppler flow
measurement within 0.9cm2 area of regurgitation on a 10.6cm2
left atrium planimetric measurement. The
other animals, a male Cougar and two female Jaguars, presented mitral valve
regurgitation during echocardiographic examination within a low range pressure
gradient, without either morphological changes in the cardiac structure or hemodynamic
changes.
Trivial tricuspid valve regurgitation was observed in
one male Cougar with murmur and one female Jaguar with no apparent structural
cause in the echocardiographic study.
Those findings were reported on normal cats within dexmedetomidine use
on anesthetic protocol (Carvalho et al. 2019). In a study conducted by Romagnoli
et al. (2016), the preload increased, as expressed by increased left
ventricular diastolic dimensions and atrial area. Considering left ventricular systolic
function, cardiac output appeared reduced and left ventricular posterior wall
thickness in systole decreased after sedation due to the medetomidine
effect. The left ventricular dilation
could have produced a mitral annulus stretch with the subsequent loss of complete
closure of the mitral leaflets during left ventricular contraction.
In domestic cats, an insidious mitral murmur finding
on cardiac auscultation is reported and is related to stress due to transient
catecholaminergic stimulation in myocardial tissue. Associated with this physiological finding,
dynamic right (Rishniw & Thomas 2002) and/or left
outflow trac obstruction occurs, resulting in low
grade murmur auscultated in left apical mitral focus (Cote et al. 2004). During late recovery, the murmur was not reevaluated in those animals.
All animals were stable during anesthesia,
maintaining a heart rate of 75 ± 10 bpm; peripheral oxy-hemoglobin
saturation (SpO2) >97%; systolic blood pressure (SBP) between 110 and 125
mmHg; and mean arterial pressure (MAP) between 75 and 85 mmHg. The pressure tended to get a little higher
due to peripheral vasoconstriction.
Both Cougars and Jaguars returned safely from the anesthesia, with no changes – such as excitement and
delirium stage – and returned to the enclosures, normally receiving food and
water.
It is interesting to consider these parameters – heart
murmur, mitral valve reflux and trivial tricuspid valve regurgitation – in
order to make the procedure safer. In
clinical procedures with anesthesia using alpha-2-adrenergic
agonists, researchers frequently observe the occurrence of heart murmurs in
apparently healthy cats. After recovery
from anesthesia, they have no symptoms of heart
disease. A comparative study with an anesthetic protocol without alpha-2-agonist will be
conducted by this group for further clarification.
Conclusion
Medetomidine in large neotropical felids may cause
heart murmur in healthy animals as a side effect, but without clinical or anesthetic concerns.
Heart murmur showed no risk to the animal in this situation, as it is a
transitory event.
Clinical relevance
The clinical relevance of these changes – heart
murmur, mitral valve reflux, and trivial tricuspid valve regurgitation – is
just to show that it can occur with use of medetomidine and without damage to
the health of healthy animals. With the doses used, these changes are transient
without compromising the cardiac hemodynamics of
these individuals.
References
Araujo, G.R., T.A.R. Paula, T. Deco-Souza,
R.M. Garay, L.C.F. Bergo,
A.C. Csermak-Júnior, L.C. Silva & S.V.P. Alves
(2015). Ocelot and oncilla spermatozoa can
bind hen egg perivitelline membranes. Animal Reproduction Science 163: 56–62. https://doi.org/10.1016/j.anireprosci.2015.09.018
Araujo, G.R, T.A.R. Paula, T. Deco-Souza,
R.G. Morato, L.C.F. Bergo, L.C. Silva, D.S. Costa
& C. Braud (2018). Comparison of semen samples collected from wild and
captive jaguars (Panthera onca)
by urethral catheterization after pharmacological induction. Animal
Reproduction Science 195(July 2017): 1–7. https://doi.org/10.1016/j.anireprosci.2017.12.019
Araujo, G.R., T.A.R. Paula, T. Deco-Souza,
R.G. Morato, L.C.F. Bergo, L.C. Silva, P.N.
Jorge-Neto & B.F.B. Sampaio (2020). Colheita farmacológica de sêmen de onças-pardas (Puma concolor: Mammalia: Carnivora: Felidae). Arquivo
Brasileiro de Medicina Veterinária e Zootecnia 72(2): 437–442. https://doi.org/10.1590/1678-4162-11030
Carvalho, E.R., T. Champion, F. Ambrosini, G.A. Silva, G.C. Freitas & R.G.D.C. Vilani (2019). Dexmedetomidine low dose followed by constant rate
infusion and antagonism by atipamezole in isoflurane-anesthetized cats: an
echocardiographic study. Veterinary Anaesthesia and Analgesia 46(1):
43–54. https://doi.org/10.1016/j.vaa.2018.09.040
Cote, E., A.M. Manning, D.
Emerson, N.J. Laste, R.L. Malakoff & N.K.
Harpster (2004). Assessment of
the prevalence of heart murmurs in overtly healthy cats. Journal of the
American Veterinary Medical Association 225(3): 384–388. https://doi.org/10.2460/javma.2004.225.384
Jorge-Neto,
P.N., T.C. Luczinski, G.R. Araújo, J.A. Salomão Júnior, A.S. Traldi,
J.A.M. Santos, L.A. Requena, M.C.M.
Gianni, T. Deco-Souza, C.S. Pizzutto
& H. Baldassarre (2020). Can jaguar (Panthera onca) ovulate without copulation? Theriogenology
147: 57–61. https://doi.org/10.1016/j.theriogenology.2020.02.026
Miranda, G.M., M.L. Coelho, G.R. Araujo, M.C.C. Silva, P.N. Jorge Neto, A.C. Csermak Jr, J.A. Salomão Jr & T. Deco-Souza
(2019). Sperm bank of free living jaguars:
a tool for the ex situ conservation. In: Anais
do XXVIII Encontro e XXII Congresso da Associação Brasileira de Veterinários de
Animais Selvagens 1: 38–41
Rishniw, M. & W.P. Thomas (2002). Dynamic right ventricular outflow obstruction: A new
cause of systolic murmurs in cats. Journal of Veterinary Internal Medicine
16(5): 547–552. https://doi.org/10.1111/j.1939-1676.2002.tb02385.x
Romagnoli, N., D. Zambelli, M. Cunto,
C. Lambertini, D. Ventrella & M.B. Toaldo (2016). Non-invasive evaluation of the haemodynamic effects of
high-dose medetomidine in healthy cats for semen collection. Journal of
Feline Medicine and Surgery 18(4): 337–343. https://doi.org/10.1177/1098612X15583345