Bacterial endocarditis

Question 1

Pathophysiology

Answer 1

• Circulating bacteraemia
• Chronic bacterial infection elsewhere (e.g. mastitis, metritis, pneumonia, lameness etc.)
• Truperella pyogenes
  ◦ Also staphs, streps and G-ves
• Adhesion to endothelium
  ◦ No prior endothelial damage
  ◦ Can occur on mural endocardium
• Predilection sites:
  ◦ Right AV (tricuspid) valve
  ◦ Left AV (mitral) valve

Question 2

Clinical signs

Answer 2

• Ante-mortem diagnosis = challenging
• Murmur +/- palpable thrill
• Persistent tachycardia
• Ill thrift
• Milk drop
  ◦ May be episodic

Question 3

Diagnosis

Answer 3

• difficult to do while animal is still alive
• ultrasound
• blood culture but would have to get from 3 diferent places so not done commonly

Question 4

Treatment

Answer 4

• Long-term antibiotic therapy
  ◦ Minimum 3 weeks
  ◦ Penicillin/amoxicillin are abs of choice
• Furosemide if CHF present
• Analgesia

Question 5

Prognosis

Answer 5

• Guarded
  ◦ Return to normal heart sounds and rate = good prognostic sign
  ◦ Better if diagnosed and treated early
• Signs of CHF = poor prognosis