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Cardiopulmonary > Canine Cardiomyopathies and Myocarditis > Flashcards

Canine Cardiomyopathies and Myocarditis Flashcards

1
Q

What are the three main canine cardiomyopathies?

A

Dilated Cardiomyopathy
Arrhythmogenic Right Ventricular Cardiomyopathy
Atrial Standstill

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2
Q

What type of cardiomyopathy is common in Dobermans and other large breed dogs?

A

DCM

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3
Q

Which breed inherits ventricular arrhythmias (rare)?

A

German Shepherd

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4
Q

Which breeds are predisposed to juvenile DCM?

A

Portugese Water Dog

Great Dane

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5
Q

What are three infectious causes of myocarditis?

A

Chagas disease
Parvovirus
Lyme disease

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6
Q

What are the two most common nutritional deficiences leading to cardiomyopathy in dogs?

A

Taurine

Carnitine

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7
Q

What drug can cause toxic cardiomyopathy in dogs?

A

Doxyrubricin

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8
Q

What four metabolic states can commonly cause cardiomyopathy and systolic dysfunction?

A

Muscular dystropy
Hypothyroidism
Hyperthyroidism
Tachycardia

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9
Q

What is dilated cardiomyopathy (DCM)?

A

Primary heart muscle disease characterized by cardiac dilatation and systolic dysfunction of one or both ventricles

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10
Q

What are the five hypothesized causes of canine cardiomyopathy?

A 
Familial/genetic
Immune-mediated
Viral
Metabolic
Nutritional
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11
Q

T/F: Canine cardiomyopathy is better understood than human cardiomyopathy

A

False; we’ve only pinpointed a few genes

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12
Q

Small dogs are more likely to get ___ (DCM/CVD), while large dogs are more likely to get (DCM/CVD)

A

CVD

DCM

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13
Q

T/F: There are breed-specific types of DCM

A 
True
Doberman
Boxer
English Cocker Spaniel
American Cocker Spaniel
Irish Wolfhound
Portuguese Water Dog
Great Dane
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14
Q

Large breed, male, middle aged dogs are a typical candidate for ___

A

DCM

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15
Q

What is the pathogenesis of DCM?

A

Neurohormonal activation -> proliferation of cardiac myocytes and fibroblasts and sodium and water retention -> increased preload -> cardiac remodeling (hypertrophy, dilatation, fibrosis, sphericity) -> Abnormal systolic, diastolic functions and arrhythmias

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16
Q

What are the three occult signs of DCM?

A

Arrhythmias
Systolic dysfunction
Sudden death

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17
Q

What are the six clinical signs of DCM?

A 
Weakness
Exercise intolerance
Syncope
Weight loss
CHF
Sudden cardiac death
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18
Q

What five signs of DCM should one look for on a physical exam?

A 
Systolic murmur or S3 gallop (S3 is blood filling ventricle)
Arrhythmia (pulse deficit)
Weak arterial pulses
Left sided CHF
Biventricular CHF occasionally occurs
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19
Q

What is seen on ECG of a dog with DCM?

A

Often, nothing

May see tachyarrhythmia (VT, AF)

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20
Q

What is seen on radiographs of a dog with DCM?

A

Nothing until overt diation present

Rads can’t assess function

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21
Q

What is seen on an echocardiograph of a dog with DCM?

A

Can see LV systolic dysfunction
Mitral regurgitation
LA enlargement

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22
Q

What are biomarkers?

A

Substances that can give information about organ function or dysfunction

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23
Q

What is atrial natriuretic peptide (ANP) useful for?

A

It is increased in Dobermans with occult and overt DCM

Not sensitive in other breeds

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24
Q

What are brain natriuretic peptide and N-terminal pro-BNP useful for?

A

NTproBNP increased in overt DCM

BNP sensitive screen for dogs with occult DCM

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25
Q

What is troponin I (cTNI) useful for?

A

Increased in overt and occult DCM in Doberman

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26
Q

In American cocker spaniels, there is an association between low plasma ___ and DCM. How is this treated?

A

Taurine

Supplement taurine and L-carnitine

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27
Q

T/F: Female dalmations are more predisposed to DCM than males

28
Q

What is the most commonly represented breed with DCM?

A

Doberman pinschers

29
Q

T/F: Nearly 50% of Doberman pinschers will develop DCM in their lifetime

30
Q

When/how do Doberman pinschers develop DCM? What are the two most likely outcomes?

A

Autosomal dominant inheritance (PDK4)
Adult-onset (usually around 5yrs)
Sudden death
CHF

31
Q

What is the main sign in the occult phase of DCM for Dobermans?

A

Progressive LV dysfunction

32
Q

What does PDK4 do?

A

It plays a regulatory role in cardiac energy metabolism and fatty acid oxidation

33
Q

T/F: Approximately 25% of Great Danes will develop DCM

34
Q

T/F: DCM is an X linked dominant inheritance

A

False; X linked recessive

35
Q

T/F: DCM is an autosomal recessive sex-linked allele inheritance in Irish Wolfhounds

36
Q

T/F: Atrial fibrillation precedes DCM in many large breed dogs?

A

True (Great Danes, Irish Wolfhounds, Newfoundlands)

37
Q

T/F: Univentricular CHF is most common in Irish Wolfhounds with DCM

A

False; Biventricular is most common

38
Q

T/F: Newfoundlands often have DCM with no appreciable heart murmur

39
Q

T/F: DCM is an autosomal recessive trait in Portuguese Water Dogs

40
Q

What drugs can be used to treat occult DCM?

A 
ACE inhibitors (Benazapril - Dobermans)
Beta blockers (Carvedilol) - use cautiously with gradual increase, not for active CHF
Pimobendan - the miracle drug
41
Q

What drugs that provide inotropic support can be given for dogs with overt DCM? (3)

A

Dobutamine
Pimobendan
Digoxin

42
Q

What drugs provide a neurohormonal blockade for dogs with overt DCM? (2)

A

ACE inhibitors

Spirinolactone

43
Q

What drugs reduce preload in dogs with overt DCM? (1 and lifestyle change)

A

Furosemide

Low Na diet

44
Q

What drugs reduce afterload in dogs with overt DCM? (2)

A

ACE inhibitors

Pimobendan

45
Q

What drugs help control ventricular arrhythmia in dogs with overt DCM? (4)

A

Lidocaine
Mexilitine
Sotalol
Amiodarone

46
Q

What drugs help control supraventricular arrhythmias in dogs with overt DCM? (3)

A

Digoxin
Diltiazem
Amiodarone

47
Q

What class I drugs (Na channel blockers) help treat ventricular arrhythmias?

A

Lidocaine (IV)
Mexilitine (oral, can cause nausea)
Procainamide (IV slowly)

48
Q

What class III drugs (K channel blockers) help treat ventricular arrhythmias?

A 
Sotalol
Amiodarone (neutropenia, liver dysfunction)
49
Q

What is arrhythmogenic right ventricular cardiomyopathy?

A

Fibrous fatty infiltrate of the right ventricular free wall
Previously known as “boxer cardiomyopathy”
Ventricular arrhythmias, syncope, and sudden death
Ventricular systolic dysfunction and dilation also seen

50
Q

How do boxers inherit ARVC?

A

Autosomal dominant trait

Deletion of gene encoding for striatin production

51
Q

What signs characterize the classes of ARVC?

A

Class I: asymptomatic
Class II: collapse and syncope
Class III: left sided CHF (rare, usually right side first)

All classes have RV arrhythmias

52
Q

How is ARVC diagnosed?

A 
Arrhythmia (not always)
Biomarkers (cTNI - VPCs)
Echocardiogram
Holter monitor
ECG - VPCs - singlet, runs, etc.
53
Q

How is ARVC treated? (7)

A 
Sotalol
Mexilitine
Amiodarone
Fish oils
Pimobendan
ACE inhibitors
Diuretics
54
Q

What is atrial standstill?

A

Destruction and fibrous infiltration of the atrial myocardium results in an inability to transmit signal. See only nodal escape rhythm (Equally positive and negative QRS wave, large T)

55
Q

What signs are associated with atrial standstill? (4)

A

Exercise intolerance
Weakness
Syncope
R CHF

56
Q

When are German Shepherds most at risk for inherited ventricular arrhythmias?

A

12 weeks to 18 months

57
Q

What causes inherited ventricular arrhythmias in German Shepherds and how is it treated?

A

Abnormal sympathetic innervation of the ventricular myocardium
Mexilitine - Sotalol combination

58
Q

T/F: Plasma cTNI is often elevated with myocardial injury

59
Q

What are three causes of protozoal myocarditis?

A

Leishmania
Neospora caninum
Toxoplasma gondii

60
Q

What are two viral causes of myocarditis?

A

Parvovirus

West Nile

61
Q

What are two parasitic causes of myocarditis?

A

Trypanosoma cruzi

Borrelia bergdorferi

62
Q

T/F: Hypertrophic Cardiomyopathy is usually a primary disease in dogs

A

False; secondary

63
Q

T/F: Hypothyroidism can cause systolic dysfunction and increased RV dimensions

64
Q

T/F: myocardial infarction is one of the most common cardiac issues in dogs

A

False; people!

65
Q

Doxorubricin toxicity leads to what three cardiac changes?

A

Myocardial damage
Systolic dysfunction
DCM +/- CHF

Cardiopulmonary (12 decks)

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