Cardio - Lab Testing

Question 1

T/F: Routine labwork is generally useful for the diagnosis of cardiac disease

Answer 1

False

Question 2

What is routine labwork useful for?

Answer 2

To screen for concurrent diseases that can affect the CV system or complicate tx of the disease

Question 3

What are some concurrent diseases that can be seen on routine labwork?

Answer 3

Hyper/hypothyroidism, CKD, hyper/hypoadrenocorticism, anemia/polycythemia, hyperaldosteronism, SIRS/sepsis

Question 4

Routine labs are useful to monitor for _____ of cardiac meds.

Answer 4

side effects

Question 5

What are the routine labs?

Answer 5

CBC, chem, U/A, T4

Question 6

What common CV meds are concerning and why?

Answer 6

Furosemide, enalapril, benazepril, spironolactone;

We are dehydrating our patients on purpose, i.e. causing increased renal values and electrolyte abnormalities

Question 7

What does furosemide alter?

Answer 7

Increases BUN/crea and bicarb

Decreases Cl, K, Mg, Na

Question 8

What does enelapril/benazepril and spironolactone alter?

Answer 8

Increases BUN/crea and K+

Question 9

What test cannot be used to monitor renal function in patients receiving diuretics?

Answer 9

USG - we already know the pet is isosthenuric

Question 10

What is cTnI?

Answer 10

Protein attached to actin/tropomyosin in the cardiac sarcomere

Question 11

cTnI is a _____ protein and is released when myocytes are _____.

Answer 11

leakage, damaged

Question 12

What is cTnI sensitive and specific for?

Answer 12

myocardial injury

Question 13

What can cTnI NOT specify?

Answer 13

What caused the injury

Question 14

What is the normal range for cTnI?

Answer 14

< 0.2 ng/ml (check with lab)

Should not see free range in blood; if see this it means there is myocyte damage

Question 15

What cardiac conditions may cause an increase in cTnI?

Answer 15

Myocarditis, thoracic/cardiac trauma, cardiotoxicity, cardiac HSA in dogs, occult DCM in Dobermans, severe heart disease/CHF in dogs and cats

Question 16

What are some non-cardiac decreases with which we may see increased cTnI?

Answer 16

CKD (decreased GFR), GDV, IMHA, anemia

Question 17

When might you use a cTnI test (in general)?

Answer 17

Patients with a clinical suspicion of myocarditis

Question 18

When might you use the cTnI test in dogs?

Answer 18

Pericardial effusion (when no mass is seen on echo);

Asymptomatic Dobermans

Question 19

When might you use the cTnI test in cats?

Answer 19

Dyspneic cats (CHF vs. resp disease), HCM

Question 20

What is NT-proBNP?

Answer 20

(B-type natriuretic peptide)

Hormone synthesized and released from the ventricles in response to myocardial stretch

Question 21

What does NT-proBNP cause?

Answer 21

Diuresis, natriuresis, vasodilation

Question 22

NT-proBNP is naturally anti-_____.

Answer 22

RAAS

Question 23

NT-proBNP is the inactive form of _____.

Answer 23

C-BNP

Question 24

What value does Idexx use?

Answer 24

NT-proBNP

Question 25

What value does Antech use?

Answer 25

C-BNP

Question 26

What cardiac diseases can cause an increase in NT-proBNP?

Answer 26

DMVD, DCM, HCM

Question 27

Magnitude of NT-proBNP increase correlates with _____ of heart disease.

Answer 27

severity

Question 28

What non-cardiac diseases cause NT-proBNP elevation?

Answer 28

Day-to-day variation, CKD (decreased GFR), critical illness, PHT

Question 29

When might you use a NT-proBNP test in cats?

Answer 29

Asymptomatic cats with murmurs, dyspneic cats

Question 30

What type of NT-proBNP test has a higher cutoff value and when might you use it?

Answer 30

Bedside SNAP test (~220 pmol/L);

used in dyspneic cats to determine CHF vs. respiratory disease

Question 31

When might you use an NT-proBNP test in dogs?

Answer 31

Dogs with CHF - prognosis/monitoring