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RUSVM Small Animal Medicine I 2016 > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

1
Q

What is the normal response to a decrease in blood pressure?

A

Sympathetic nervous system is activated
Increased contractility
Increased heart rate
Veno- and arterio- constriction

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2
Q

What is the response when cardiac output remain depressed?

A

activation of the RAAS system
Peripheral vasoconstriction
sodium and water retention by the kidneys

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3
Q

What is the most common acquired condition of older dogs?

A

myxomatous atrioventricular valvular degeneration

Dilated cardiomyopathy

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4
Q

What is the most common condition of large breed dogs?

A

dilated cardiomyopathy

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5
Q

What is more common in small breed dogs?

A

myxomatous atrioventricular valvular degeneration

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6
Q

What is the common clinical sign of left sided congestive heart failure?

A

Cough

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7
Q

What clinical sign does right sided congestive heart failure cause?

A

Ascites

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8
Q

Waterhammer pulse

A

strong pulse with a sharp rise and fall in pulse pressure

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9
Q

What kind of pulse do you find in dilated cardiomyopathy?

A

small weak (hypokinetic) pulse

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10
Q

What is responsible for S1 heart sounds?

A

AV valve closure

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11
Q

What is responsible for S2 heart sounds?

A

Aortic and pulmonary valves closing

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12
Q

What is responsible for S3 heart sounds?

A

passive ventricular filling

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13
Q

When would you hear S3 heart sounds?

A

left ventricular enlargement

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14
Q

What is responsible for S4 heart sounds?

A

contraction of atria

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15
Q

When would you hear S4 heart sounds?

A

hypertrophic cardiomyopathy in cats

ventricular hypertrophy secondary to aortic stenosis in dogs

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16
Q

When would you hear a systolic click?

A

mitral valve degeneration

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17
Q

What is responsible for the systolic click?

A

Mitral valve degeneration when the chordae tendinae snap tight as the degenerative mitral valve protrudes into the left atrium in midsystole

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18
Q

Murmur

A

audible vibrations produced by turbulent blood flow

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19
Q

Grade 1/6 murmur

A

very soft
over a small area
only heard after prolonged auscultation

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20
Q

Grade 2/6 murmur

A

soft
occurs over a small area
heard after a few seconds of auscultation

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21
Q

Grade 6/6 murmur

A

very loud
heard when stethoscope is held slightly off the chest wall
heard over the entire thorax
palpable thrill

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22
Q

What is the most common heart disease in dogs?

A

Mitral valve disease

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23
Q

What is the end result of mitral valve disease?

A

NOT DEATH FROM HEART FAILURE!

Die from something else!

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24
Q

What causes cardiac hypertrophy?

A

Volume or pressure overload

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25
Q

Eccentric hypertrophy

A

chronic increased diastolic pressure characterized by cells elongating by the addition of sarcomeres

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26
Q

Concentric hypertrophy

A

there is increased systolic ventricular pressure causing the sarcomeres to replicate side by side in parallel resulting in wider cells and thicker ā€œstifferā€ less distensible ventricular wall

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27
Q

What conditions result in eccentric hypertrophy?

A

endocardiosis

dilated cardiomyopathy

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28
Q

Signs of Left sided congestive heart failure

A 
hypotension 
pale MM
prolonged CRT
tachycardia 
weak pulses
weakness 
exercise intolerance 
prerenal azotemia because of decreased cardiac output 
pulmonary edema
coughing 
dysnea
orthopnea
tachypnea
cyanosis
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29
Q

Signs of Right Sided Congestive Heart Failure

A

Increased pressure in the anterior and posterior vena cava
Distension of the jugular and peripheral veins
Ascites
hepatomegaly
splenomegaly
pleural effusion

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30
Q

Clinical stages of congestive heart failure

A

Phase 1 - Heart disease but no clinical signs
Phase 2 - Cough, fatigue, and dyspnea with normal or strenuous exercise
Phase 3 - Cough, fatigue, dyspnea, and orthopnea at night and with any activity
Phase 4 - Cough, fatigue, dyspnea, orthopnea, and cyanosis at rest

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31
Q

What are the general principles of treating heart failure?

A
  1. Handle animals with extreme care
  2. Enhance oxygenation
  3. Reduce edema by decreasing circulating blood volume using diuretics
  4. reduce preload by trapping blood in the peripheral venous system
  5. Decrease systemic vascular resistance
  6. Improve cardiac contractility
  7. Be cautious with IV fluids
  8. Treat arrythmias
  9. Sodium Restricted diet
  10. Beta Blockers prolong and improve quality of life
  11. Frequent clinical exams
  12. Prognosis is variable
  13. Combination therapy when needed
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32
Q

What is the recommended drug used for sedation in animals with heart failure?

A

Butorphenol

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33
Q

What drug takes away the nausea of morphine and the anxiety?

A

Acepromazine

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34
Q

What is the goal of oxygen therapy?

A

Maintain PaO2 greater than 60mmHg

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35
Q

What percentage of O2 is administered?

A

30-35%

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36
Q

What is the most common diuretic used in heart failure?

A

Furosemide

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37
Q

What is the most important drug used in the treatment of heart failure?

A

Furosemide

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38
Q

What is the 4 keys to the treatment of heart failure?

A

F- Furosemide
O- Oxygen
N- Nitroglycerine
S- Sedation

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39
Q

What is the best way to achieve the lowest dose of Furosemide?

A

Decreased Sodium Intake

using an ACE inhibitor

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40
Q

What is the most commonly used venodilator?

A

Nitroglycerine cream

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41
Q

What is the most widely used vasodilator in the treatment of CHF?

A

ACE Inhibitors

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42
Q

What is pimobendan?

A

phosphodiesterase inhibitor causing arterio and veno dilation
Calcium sensitizer
inodilator

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43
Q

What drug is used when an animal is in cardiogenic shock?

A

Dobutamine CRI

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44
Q

Why are beta blockers used?

A

Prolong and improve quality of life by preventing the deleterious effects of the sympathetic nervous system

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45
Q

What are the beta blockers commonly used?

A

Carvedilol

Metoprolol

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46
Q

PDA

A

Patent Ductus Arteriosus

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47
Q

Which way is blood shunted in a PDA?

A

Normally - Left to Right: Aorta to the Pulmonary artery

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48
Q

What type of hypertrophy is associated with Left to Right shunting PDA?

A

eccentric hypertrophy

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49
Q

What type of heart failure is associated with a Left to Right shunting PDA?

A

Left Sided Congestive Heart Failure

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50
Q

What type of heart failure is associated with a Right to Left shunting PDA?

A

Right sided heart failure

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51
Q

What does the kidney cause in Right to Left Shunting PDA?

A

Kidney secretes more erythropoietin due to low PaO2 causing erythrocytosis and increased viscosity

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52
Q

In what breeds is PDA common?

A

Toy breeds
Miniature Poodles
German Sheperds

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53
Q

What are the usual signs of PDA?

A

Asymptomatic

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54
Q

What is the murmur associated with PDA?

A

Machinery murmur - loudest forward of the heart base

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55
Q

What kind of pulse is associated with PDA?

A

Water-hammer pulse or bounding pulse

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56
Q

In R-to-L shunting PDA where do you see cyanosis?

A

caudally but not in the MM of the head

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57
Q

What do you find on radiographs with PDA?

A

L-to-R shunting: Left Heart Enlargement and prominent lung vessels
R-to-L shunting: Right Heart Enlargement

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58
Q

What do you find on doppler with PDA?

A

Turbulence in the pulmonary artery just distal to the pulmonic valve

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59
Q

What do you find on EKG with PDA?

A

Signs of left or right heart enlargement

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60
Q

What is the treatment for PDA?

A

surgical correction for L-to-R shunting using Embolization coils or Amplatz Canine Duct Occluder
No surgical correction for R-to-L Shunting- correct the erythrocytosis using Sildenafil

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61
Q

What is prognosis for PDA?

A

After surgery survival is excellent

R-to-L shunting animals can be maintained medically for 3-5 years with low levels of activity

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62
Q

What is the most common congenital cardiac disorder of dogs?

A

Aortic Stenosis

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63
Q

Aortic Stenosis

A

fibrocartilaginous connective tissue that completely or partially encircles the aortic outflow tract

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64
Q

What is the most common Aortic Stenosis in dogs?

A

Subvalvular

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65
Q

What type of hypertrophy is associated with Aortic Stenosis?

A

Left ventricular Concentric hypertrophy

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66
Q

What breeds are associated with Aortic Stenosis?

A

Newfoundlands
Boxers
Rotties
Goldens

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67
Q

What are the signs of Aortic stenosis?

A

Syncope

sudden death due to arrhythmias

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68
Q

Describe the murmur associated with Aortic stenosis

A

systolic murmur loudest over the left heart base

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69
Q

What arrhythmia is associated with Aortic Stenosis?

A

VPDs

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70
Q

What do you see on radiographs with Aortic Stenosis?

A

dilation of ascending Aorta

left ventricular and left atrial enlargement

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71
Q

What do you see on echocardiography with Aortic Stenosis?

A

Concentric left ventricular hypertrophy

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72
Q

What is used on ultrasound to detect hypertrophy of the left ventricle in Aortic Stenosis?

A

M-mode

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73
Q

What do you see on ECG with Aortic Stenosis?

A

Left ventricular enlargement
ST segment depression
VPDs

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74
Q

What drugs are recommended in Aortic Stenosis?

A

Beta Blockers

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75
Q

What drugs exacerbate Aortic Stenosis?

A

Class I antiarrythmics

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76
Q

What is the better choice for the treatment of ventricular arrhythmias in Aortic Stenosis?

A

Sotalol

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77
Q

What is the treatment for Aortic Stenosis?

A

balloon valvuloplasty

transventricular myectomy

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78
Q

What is the treatment for dogs with congestive heart failure from Aortic Stenosis?

A

Furosemide

ACE inhibitors

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79
Q

What is the prognosis for Aortic Stenosis?

A

Progressive

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80
Q

What is important to control in dogs with Aortic Stenosis?

A

Infections that can lead to endocarditis

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81
Q

What is the 3rd most common congenital cardiac disorder in the dog?

A

Pulmonic Stenosis

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82
Q

What is the most common Pulmonic Stenosis?

A

Valvular

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83
Q

What causes Pulmonic Stenosis?

A

the valve is dysplastic being thickened, asymmetrical and having hypoplastic valve annulus

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84
Q

What is the hypertrophy associated with Pulmonic Stenosis?

A

Concentric hypertrophy of the right ventricle

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85
Q

Why is the right atrium enlarged in Pulmonic Stenosis?

A

Due to elevated right ventricular filling pressures

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86
Q

What breeds are pulmonic stenosis seen in?

A

English bulldogs

Beagle

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87
Q

What are the signs of Pulmonic Stenosis?

A

exercise intolerance
weakness
syncope
sudden death

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88
Q

Where is the murmur heard in pulmonic stenosis?

A

systolic heart murmur over the left heart base

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89
Q

What is seen on radiography with pulmonic stenosis?

A

Right ventricular enlargement

post-stenotic dilation of the pulmonary truck at 1 oā€™clock on VD/DV views

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90
Q

What is seen on ECG with pulmonic stenosis?

A

right ventricular enlargement

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91
Q

What is the treatment for pulmonic stenosis?

A

Balloon valvuloplasty
patchgraft valvuloplasty
A right ventricle to pulmonary artery conduit placed with single right coronary type R2A anomly

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92
Q

What is the prognosis for pulmonic stenosis?

A

Good
Therapy should be considered if the clinical signs ans cardiac function worsen
Response to balloon valvuloplasty is excellent

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93
Q

What is the flow of blood in a ventricular septal defect?

A

Flow from high pressure left ventricle to low pressure right ventricle

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94
Q

What breeds are Ventricular septal defects common in?

A

Keeshonds

English Bulldogs

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95
Q

What species is Ventricular Septal defect common in?

A

Cats

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96
Q

What arrhythmia is common in Ventricular Septal defect?

A

VPDs

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97
Q

Describe the murmur in Ventricular Sept Defect

A

a systolic murmur loudest over the right sternal border

a thrill over the right hemithorax

98
Q

What so you find in radiographs for ventricular septal defect?

A

prominent pulmonary vessels

left heart enlargement

99
Q

What provides the definitive diagnosis for Ventricular septal defect?

A

Doppler

100
Q

What is the treatment for Ventricular septal defect?

A

Septal defect closed with a synthetic patch
pulmonary banding
Embolization coils
Amplatz occluders
Arterial vasodilators to decrease the L-to-R Shunting

101
Q

What is the prognosis for Ventricular septal defect?

A

Good to excellent

Can occasionally close spontaneously

102
Q

What are the four factors of Tetralogy of Fallot?

A

Pulmonary stenosis
overriding aorta
VSD
Hypertrophy of the right ventricle

103
Q

What breed is associated with Tetralogy of Fallot?

A

Keeshond

104
Q

What are the signs associated with Tetralogy of Fallot?

A 
exercise intolerance
syncope 
Cyanosis 
Increased PCV
Hyperviscosity
105
Q

Describe the murmurs associated with Tetralogy of Fallot?

A

systolic murmur of pulmonic stenosis at the left heart base

VSD murmur on the right

106
Q

What do you find on the radiographs associated with Tetralogy of Fallot?

A

Right heart enlargement

small pulmonary vessels

107
Q

What do you find on Echocardiogram for Tetralogy of Fallot?

A

Right ventricular hypertrophy

overriding aorta with vessel straddling a high ventricular septal defect

108
Q

What identifies Tetralogy of Fallot?

A

Angiography

109
Q

What is the treatment for Tetralogy of Fallot?

A

Surgery
Beta Blockers for some patients
Hydroxurea

110
Q

What drugs are contraindicated with Tetralogy of Fallot?

A

Vasodilators

111
Q

What does Atrial septal defect cause?

A

Right ventricular enlargement

enlargement of pulmonary vessels

112
Q

What are the signs of Atrial septal defect?

A

Asymptomatic

113
Q

What is the most common congenital cardiac malfunction in cats and large breed dogs?

A

Atrioventricular (A-V) valve malformations

114
Q

Atrioventricular (A-V) valve malformations

A

valves that are thickened or fused
papillary muscles are malpositioned, partially developed or absent
chordae tendinae are too long, too short, or absent

115
Q

What occurs most common with Atrioventricular (A-V) valve malformations?

A

Valvular insufficiency resulting in regurg and volume overload

116
Q

What is the treatment for Atrioventricular (A-V) valve malformations?

A

Furosemide
ACE inhibitors
Low sodium diet

117
Q

What arrhythmias are common with Inherited Ventricular Arrhythmias in young german shepards?

A

VPDs

118
Q

What are the signs associated with Inherited Ventricular Arrhythmias in young german shepards?

A

Frequent episodes of V-tach
sudden death
VPDs

119
Q

What is the treatment for Inherited Ventricular Arrhythmias in young german shepards?

A

Sotalol + Mexiletine until 18months -2 years old

120
Q

What is the common condition in giant and large breed dogs?

A

Dilated Cardiomyopathy

121
Q

What is Dilated Cardiomyopathy characterized by?

A

Decreased myocardial contractility

Progressive dilation of the left and right ventricle with mild thinning of the ventricular walls

122
Q

What breeds are usually affected by Dilated Cardiomyopathy?

A

Doberman Pinschers

Boxer

123
Q

Arrhythmogenic Dilated cardiomyopathy

A

arrhythmias but with normal left ventricular contractility

124
Q

What are the three stages of Dilated Cardiomyopathy?

A

Arrhythmogenic
Occult
Classic

125
Q

Occult Dilated cardiomyopathy

A

left ventricular enlargement
Decreased contractility
Ventricular arrhythmias or Atrial Fibrillation are common

126
Q

Classic Dilated Cardiomyopathy

A

Dogs are in left sided heart failure
ventricular enlargement and decreased myocardial contractility
ventricular arrhythmias or Atrial fibrillation

127
Q

Signs of Dilated Cardiomyopathy

A 
Sudden death from arrhythmias
weight loss
syncope 
dyspnea
orthopnea
coughing 
Lung sounds with pleural effusion
128
Q

What type of heart failure is associated with Dilated Cardiomyopathy?

A

Left or right sided heart failure

129
Q

Describe the murmur associated with Dilated Cardiomyopathy

A

Systolic murmur from mitral regurgitation due to dilation of the mitral annulus
gallop sounds are common

130
Q

What are the laboratory findings associated with Dilated Cardiomyopathy?

A

Prerenal azotemia

increased liver enzymes from hepatic congestion

131
Q

What deficiency is linked to dilated cardiomyopathy in cats?

A

Taurine

132
Q

What is found on radiographs with Dilated cardiomyopathy?

A

generalized hear enlargement

Left heart enlargement

133
Q

What diagnostic tool is a definitive diagnosis for Dilated Cardiomyopathy?

A

Left ventricular and left atrial enlargement with ā€œflabbyā€ ventricular walls

134
Q

What do you find on M-mode with Dilated Cardiomyopathy?

A

Enlarged left atrium

135
Q

What arrhythmias are common in dilated cardiomyopathy?

A

VPDs

Atrial Fibrillation

136
Q

What is the treatment for Dilated Cardiomyopathy if the animal has ā€œlone Atrial Fibrillationā€?

A

Beta-blockers

Diltiazem

137
Q

What is the treatment for Occult Dilated Cardiomyopathy?

A

ACE inhibitors
Pimobendan
Beta-Blockers

138
Q

What is the treatment for dogs with mild failure with Dilated Cardiomyopathy?

A

Furosemide
ACE inhibitors
pimobendan
Antiarrhythmics

139
Q

What is the treatment for dogs with mild failures with Dilated Cardiomyopathy?

A

Sedation
Supplementary O2
Drain effusions and ascites

140
Q

What combination of drugs improves quality of life and survival in dogs with Dilated Cardiomyopathy?

A

Pimobendan
Furosemide
ACE inhibitors

141
Q

What is characteristics for Dilated Cardiomyopathy in Cats?

A

ventricular dilation
thinning of the ventricular walls
decreased contractility

142
Q

What is the treatments for Dilated Cardiomyopathy in cats?

A

Furosemide for pulmonary edema
oxygen therapy
venodilator therapy

143
Q

What is the main treatment for cats with Dilated Cardiomyopathy?

A

Taurine supplementation if deficient

144
Q

What is the prognosis for cats with Dilated Cardiomyopathy?

A

poor unless taurine deficiency is the cause

145
Q

What is the most common cardiomyopathy in cats?

A

Hypertrophic cardiomyopathy

146
Q

Hypertrophic cardiomyopathy in cats

A

functional abnormality of the myocytes that leads to increased cell stress and excitation and activation of trophic and mitotic factors which leads to papillary muscle and left ventricular concentric hypertrophy

147
Q

What kind of hypertrophy does Hypertrophic cardiomyopathy in cats result in?

A

Concentric left ventricular hypertrophy

148
Q

What breeds of cats are predisposed to hypertrophic cardiomyopathy?

A

Maine Coons

Ragdoll

149
Q

What predisposes a cat to hypertrophic cardiomyopathy?

A 
Genetics 
Hyperthyroidism 
Systemic hypertension 
toxins 
aortic stenosis
acromegaly
150
Q

What are cats with Hypertrophic cardiomyopathy predisposed to ?

A

Thrombus formation and emboli formation

151
Q

Aortic thromboembolism

A

stasis of blood in the lest strium predisposes affect cats to thrombus formation and some will form emboli. This dislodges and move to the iliac bifurcation where they can cause ischemia of the hind legs

152
Q

What are the clinical signs of Hypertrophic cardiomyopathy in cats?

A

Many are asymptomatic
Development of acute heart failure due to stress
Syncope/collapse
sudden death
Signs of left sided congestive heart failure

153
Q

Describe the murmurs in Hypertrophic cardiomyopathy in cats

A 
Gallop rhythms (S4)
systolic murmurs
154
Q

Signs of Aortic Thromboembolism

A 
the muscles of the limbs are hard and painful 
the limbs are cool to the touch 
The pads are hard 
the nail beds may be cyanotic 
if the nail is clipped it does not bleed
Tachypnea
open mouthed breathing 
distress
155
Q

What laboratory findings do you see in Hypertrophic cardiomyopathy in cats?

A

Biomarkers in the blood such as Troponin or pro-BNP

with ATE: muscle necrosis, elevated CK, AST, and Potassium

156
Q

What is the classical sign seen on Radiographs that points to Hypertrophic cardiomyopathy in cats?

A

ā€œvalentine-shapedā€ heart due to left ventricular enlargement

157
Q

What do you see on echocardiogram with Hypertrophic cardiomyopathy in cats?

A

marked thickening of the interventricular septum and/or left ventricular walls

158
Q

What do you see on doppler with Hypertrophic cardiomyopathy in cats?

A

a jet across the mitral valve

159
Q

What do you see on M-mode with Hypertrophic cardiomyopathy in cats?

A

Thickened ventricular free wall and septum

160
Q

What do you see on angiography with Hypertrophic cardiomyopathy in cats?

A

enlarged left atrium

thickened left ventricular free wall and septum

161
Q

What do you see on EKG with Hypertrophic cardiomyopathy in cats?

A

Left heart enlargement
VPDs
V-tach

162
Q

What is the treatment for Hypertrophic cardiomyopathy in cats?

A

ACE inhibitors with a beta-blocker or diltiazem
Furosemide
Beta Blockers

163
Q

What drugs do you used to sedate cats with Hypertrophic cardiomyopathy?

A

Butorphenol mixed with Acepromazine

164
Q

What is the classic sign of thromboembolism?

A

ā€œswirling smokeā€ seen in the left atrium

165
Q

What does the use of Spironolactone cause in cats?

A

Facial dermatitis

166
Q

What does reprofusion cause in cats with ATE?

A

Hyperkalemia

167
Q

What can be used to prevent thrombus formation in cats?

A

unfractionated heparin

168
Q

What are two drugs that are used for chronic control of ATE in cats?

A 
Aspirin
Clopidogrel (Plavix)
169
Q

How do you prevent Hypertrophic cardiomyopathy in cats?

A

test for myosin bind protein 3 in Maine Coons and Ragdolls

170
Q

What is a key prognostic factor in Hypertrophic cardiomyopathy in cats?

A

Left Atrial Size

171
Q

What are the histiologic changes seen in boxers with Arrythmogenic right ventricular cardiomyopathy?

A

changes of the right myocardium: inflammation, fibrosis, and or fat infiltration and ventricular arrhythmias

172
Q

What causes Arrythmogenic right ventricular cardiomyopathy in boxers?

A

low levels of connexin 43 and calstabin indicating dysfunction of gap junctions and leaking of calcium from the sarcoplasmic reticulum caused by a deletion in a calcium modulating gene (striatin)

173
Q

What is the signalment of Arrythmogenic right ventricular cardiomyopathy in boxers?

A

Boxers 6-10 years of age

174
Q

What are signs of Arrythmogenic right ventricular cardiomyopathy in boxers?

A 
sudden death 
weakness
syncope
right congestive heart failure 
VPDs
175
Q

What laboratory finding is seen in Arrythmogenic right ventricular cardiomyopathy in boxers?

A

Serum cTn-1 concentrations

176
Q

What can be seen on radiographs and ultrasound in Arrythmogenic right ventricular cardiomyopathy in boxers?

A

right ventricular enlargement

aneurysm of the infundibulum

177
Q

What is the treatment for Arrythmogenic right ventricular cardiomyopathy in boxers?

A

Sotalol + Mexilitene
Mexilitene + Atenolol
Sotalol (alone)

178
Q

What is a common degenerative disorder of the mitral valve?

A

Myxomatous atrioventricular valvular degeneration

179
Q

What is a common disease of small and medium sized dogs?

A

Myxomatous atrioventricular valvular degeneration

180
Q

What is the cause of Myxomatous atrioventricular valvular degeneration?

A

unknown but possibly due to collagen abnormality

181
Q

Myxomatous atrioventricular valvular degeneration

A

The thickening and contraction of the valve leaflets results in the valve becoming incompetant and there is regurgitation of blood to the atrium in systole. The choardae tendinae become thickened near the valve attachment and may rupture leading to prolapse of the valve into the atrium during systole

182
Q

What is the compensation by the heart for Myxomatous atrioventricular valvular degeneration?

A

Increased sympathetic tone

increased cardiac output

183
Q

What does regurgitation of the Mitral valve cause?

A

Left atrial enlargement

184
Q

What does left atrial enlargement cause?

A

Compression of the left main bronchus

185
Q

What type of hypertrophy is present with Myxomatous atrioventricular valvular degeneration?

A

eccentric hypertrophy

186
Q

Why does heart failure occur in Myxomatous atrioventricular valvular degeneration?

A

The left ventricle becomes dilated so it cannot move the required amount of blood

187
Q

What breed is genetically predisposed to Myxomatous atrioventricular valvular degeneration?

A

Cavalier King Charles Spaniels

188
Q

What are the signs that dogs with Myxomatous atrioventricular valvular degeneration present with?

A

Asymptomatic murmur
Large airway compression causing coughing
Syncope
Left atrial rupture and acute cardiac tamponade
Chronic congestive heart failure

189
Q

What do you find on laboratory diagnostics for Myxomatous atrioventricular valvular degeneration?

A

Mild increases in BUN and Crea
Mild increases in Liver enzymes
Increases in Natriuretic peptides and Endothelin-1 blood concentrations

190
Q

What do you find on Echocardiogram with Myxomatous atrioventricular valvular degeneration?

A

Enlarged left atrium

mitral valve prolapse

191
Q

What is the home treatment for Myxomatous atrioventricular valvular degeneration?

A

Surgical repair or replacement of the valve
Furosemide
ACE inhibitor
Sodium restricted diet

192
Q

What should be performed on animals to confirm Myxomatous atrioventricular valvular degeneration?

A

Radiographs

Echocardigraphy

193
Q

What drugs are contraindicated for animals with Myxomatous atrioventricular valvular degeneration?

A

Antitussives

194
Q

What is the hospital treatment for Myxomatous atrioventricular valvular degeneration?

A

Oxygen
Furosemide IV
Hydralyzine
ACE inhibitor once stable

195
Q

What is the chronic treatment for Myxomatous atrioventricular valvular degeneration?

A

Spironolactone
Restricted sodium diet
Pimobendan

196
Q

What is the treatment for Stage A of Myxomatous atrioventricular valvular degeneration?

A

Yearly auscultation

no drugs

197
Q

Stage A of Myxomatous atrioventricular valvular degeneration

A

Normal dogs at high risk

198
Q

Stage B of Myxomatous atrioventricular valvular degeneration?

A

Structural heart disease but no signs of CHF

199
Q

Stage B1 of Myxomatous atrioventricular valvular degeneration?

A

murmur with no radiographic or echocardiographic signs of remodeling

200
Q

Stage B2 of Myxomatous atrioventricular valvular degeneration?

A

Murmur with radiographic or echocardiographic signs of left heart enlargement

201
Q

What is the treatment for Stage B1 of Myxomatous atrioventricular valvular degeneration?

A

No drugs or diet therapy needed

Recheck with radiographs/ultrasound yearly

202
Q

What is the treatment for Stage B2 of Myxomatous atrioventricular valvular degeneration?

A

ACE inhibitors
Beta Blockers
Mild sodium restriction

203
Q

Stage C of Myxomatous atrioventricular valvular degeneration?

A

Previous or currents signs of CHF

204
Q

What is the at home treatment for Stage C of Myxomatous atrioventricular valvular degeneration?

A

Furosemide
ACE inhibitors
Pimobendan
Good nursing

205
Q

What is the hospital treatment for Stage C of Myxomatous atrioventricular valvular degeneration?

A

Furosemide
Pimobendan
Oxygen
Remove Pleural effusions/ascites

206
Q

Stage D of Myxomatous atrioventricular valvular degeneration?

A

End stage heart failure refractory to standard therapy

207
Q

What is the hospital treatment for Stage D of Myxomatous atrioventricular valvular degeneration?

A 
Free access to water 
Fluid removal 
Oxygen 
Sodium nitroprusside 
ACE inhibitors
pimobendan
208
Q

What do most dogs with Myxomatous atrioventricular valvular degeneration die from?

A

Other causes

209
Q

Endocarditis

A

bacteremia when organisms colonize the endocardium and usually also one of the heart valves

210
Q

Where does vegetation most often take place in a dog with endocarditis?

A

Aortic and mitral valves

211
Q

What are the 6 bacteria that can cause endocarditis?

A 
Bartonella spp. 
Streptococcus spp.
Staphylococcus spp. 
E. coli 
Corynebacterium spp.
Pseudomonas spp.
212
Q

What is the signalment for animals with Endocarditis?

A

Large breed dogs
Male
4-8 years

213
Q

Signs of endocarditis?

A 
history of invasive procedure or infection 
weight loss
intermittent malaise
anorexia
shifting of leg lameness
gastrointestinal disturbances
seizures
left sided congestive heart failure
Fever
murmur that develops suddenly 
bounding pulses with aortic insufficiency
214
Q

What are the laboratory findings of endocarditis?

A

Neutrophilic leukocytosis - left shift or toxic changes
Anemia of chronic inflammaion
thrombocytopenia

215
Q

What is seen on echocardiography for endocarditis?

A

Lesions of greater than 1mm can be detected and appear as vegetations on the mitral valve and/or aortic valve

216
Q

What is the treatment for endocarditis?

A

Controlling the arrhythmias and heart failure
Bactericidal antibiotics with high concentrations for extended period of time
antibiotic chosen based on sensitivity studies

217
Q

What is the prognosis for endocarditis?

A

Poor but grave if heart failure develops

218
Q

Pericardial effusion

A

presence of abnormal amount of fluid in the pericardial sac

219
Q

What does pericardial effusion cause?

A

Cardiac tamponade

220
Q

What breeds are predisposed to Hemangiosarcoma?

A

Goldens

German Shepards

221
Q

What breeds are predisposed to Paragangliomas?

A

Brachycephalic breeds

222
Q

Wht are the signs of pericardial effusion?

A 
Weight loss 
weakness
enlarging abdomen 
Pale MM
Slow CRT
muffled heart sounds
poor pulses
jugular distension
ascites
223
Q

What diagnostic imaging clearly reveals the pericardial fluid?

A

Echocardiography

224
Q

Where are paragangliomas found?

A

Based of the Aorta

225
Q

Where do Hemangiosarcomas occur?

A

Right auricle
Right atrium
Rigth ventricle

226
Q

What is the treatment for pericardial effusion?

A

Immediate pericardiocentesis

227
Q

What is indicated if the pericardial effusion is recurrent?

A

Pericardectomy

Percutaneous Balloon Pericardectomy

228
Q

What is the prognosis for idiopathic pericardial effusion?

A

excellent

229
Q

What is the prognosis for pericardial effusion caused by hemangiosarcoma?

A

Poor

230
Q

What type of hypertrophy is seen with Canine heartworm?

A

Right ventricular eccentric hypertrophy

231
Q

What type of heart failure is associated with canine heartworm?

A

Right side heart failure

232
Q

What are the laboratory findings associaated with Canine heartworm?

A 
Thrombocytopenia
Eosinophilia
Basophilia
Mild Non-regenerative anemia
Hyperglobulinemia
INcreased liver enzymes
233
Q

What signs are seen on Radiographs associated with canine heartworm?

A

Right ventricular enlargement
A prominent main pulmonary artery
ā€œDā€ shaped cardiac silhouette
Enlarged lobar arteries

234
Q

What are the goals of canine heartworm therapy?

A
  1. begin the animal on prophylaxis
  2. Manage signs of moderate or severe lung disease and heart failure
  3. Kill Microfilaria
  4. Adulticide therapy
235
Q

Diethylcarbamazine

A

effective against the L3-L4 molt stage and against microfilaria

236
Q

Ivermectine

A

kills L3-L4 annd will kill most adult worms when given over 2-3 years

237
Q

Can you give Ivermectin to a collie?

A

Yes, to Collies over 4.5kg

238
Q

Milbemycin

A

effective against L3 and L4 and microfilaria but NOT against adults

239
Q

Selamectin

A

effective against L3 -L4 and moderate activity against adults and microfilaria

240
Q

Moxidectin

A

Effective against L3-L4 and only moderate adult activity

RUSVM Small Animal Medicine I 2016 (9 decks)

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