Canine Dilated Cardiomyopathy and Degenerative Valve Disease

Question 1

What is the prevalence and predilection of chronic valve disease (CVD)?

Answer 1

Seen in older dogs

Affects Cavaliers frequently

Question 2

A classic characteristic of CVD is ___ ___ of AV valve and valve apparatus

Answer 2

Myxomatous degeneration

Question 3

Most commonly, arrhythmias associated with CVD are ___

Answer 3

Supraventricular

Question 4

A simplification of CVD is “___ -> ___ -> ___,” while DM is “___ -> ___ -> ___.”

Answer 4

Leak, big, weak

Weak, big, leak

Question 5

How is heart failure classified into stages?

Answer 5

A - healthy, at risk for developing HF
B1 - no-minimal remodeling, murmur and regurg
B2 - significant remodeling (therapy recommended)
C - past or current signs of HF
D - end stage, signs refractory to Tx

Question 6

What is the basic definition of heart failure?

Answer 6

Inability of the heart to meet tissue perfusion needs with normal filling pressures

Question 7

Backward HF is also known as ___

Answer 7

CHF -> wet
Left - pulmonary edema
Right - Ascites, pleural effusion

Question 8

Forward heart failure leads to poor ___ ___

Answer 8

Peripheral perfusion -> cold

Question 9

What is the best diagnostic tool when determining if a cough is due to airway issues or pulmonary edema secondary to CHF?

Answer 9

Thoracic radiographs

Question 10

What is a circulating cardiac biomarker?

Answer 10

Substance elaborated by the heart that is released in proportion to the severity of the disease (BNP and NT-pro BNP)

Question 11

What does BNP stand for and when is it released?

Answer 11

B type natriuretic peptide is released when the heart is stressed (NT-pro BNP is same)

Question 12

Nt-pro BNP above ___ means CS are possibly related to HF, above ___ means very likely related to HF

Answer 12

900

1800

Question 13

What are the therapeutic rationale categories for HF and what do they mean?

Answer 13

Warm and dry - preclinical, no Tx
Warm and Wet - relieve congestion, preserve perfusion (CHF)
Cold and dry - increase peripheral perfusion (forward HF)
Cold and wet - increase peripheral perfusion, relieve congestion (forward and backward HF)

Question 14

What ACE inhibitors are often used in HF? (3)

Answer 14

Enalapril
Benazapril
Spirinolactone

Question 15

What is the most important thing to remember about Pimobendan?

Answer 15

It is a balanced vasodilator due to phosphodiesterase III inhibition

Question 16

Which drugs help reduce afterload?

Answer 16

ACEI - enalapril, benazapril
Calcium channel blockers - amlodipine
Hydralazine
Pimobendan - systemic, pulmonary

Question 17

T/F: Cough secondary to left main-stem bronchus compression in CVD is curable

Answer 17

False; care is palliative, not curative

Question 18

Stages C and D of CVD and DCM are characterized by clinical signs of ___ HF

Answer 18

Backward AND forward (cold and/or wet)

Question 19

How is congestion relieved in HF? (5)

Answer 19

Abdominocentesis
Furosemide
NA restriction
Venodilation
RAAS inhibition