Acquired valvular disease

Question 1

Explain why, although uncommon, the diagnosis of bacterial endocarditis is more straightforward in cats than in dogs

Answer 1

There is no endocardiosis in cats which is the main differential in dogs when nodules are observed on the heart valves
- aortic and mitral valves are mainly affected

Question 2

What are the clinical signs of bacterial endocarditis

Answer 2

Usually, cats present with signs referrable to valvular incompetence
- cardiac decompensation
- locomotor abnormalities suggestive of either thromboembolic disease or inflammatory arthritis

Cats may not necessarily show signs of bacterial infection or sepsis (i.e., pyrexia, inflammatory leukogram)

Question 3

How would you make a presumptive diagnosis of bacterial endocarditis

Answer 3

A presumptive diagnosis is made by visualization of vegetative lesions on valvular cups via echocardiography
- especially if the animal has presented with a new heart murmur and pyrexia

Cats tend to be older (median age 9 years)

Question 4

What is the typical treatment for bacterial endocarditis

Answer 4

Therapy is aimed at:
- alleviating signs of congestive heart failure
- treating the underlying infection

Amoxicilline/clavulanate combined with a fluoroquinolone is likely to be efficacious

Question 5

What is the prognosis for bacterial endocarditis

Answer 5

The prognosis is generally poor
- most cats die from congestive heart failure