Cardiovascular System Flashcards
What is the normal response to a decrease in blood pressure?
Sympathetic nervous system is activated
Increased contractility
Increased heart rate
Veno- and arterio- constriction
What is the response when cardiac output remain depressed?
activation of the RAAS system
Peripheral vasoconstriction
sodium and water retention by the kidneys
What is the most common acquired condition of older dogs?
myxomatous atrioventricular valvular degeneration
Dilated cardiomyopathy
What is the most common condition of large breed dogs?
dilated cardiomyopathy
What is more common in small breed dogs?
myxomatous atrioventricular valvular degeneration
What is the common clinical sign of left sided congestive heart failure?
Cough
What clinical sign does right sided congestive heart failure cause?
Ascites
Waterhammer pulse
strong pulse with a sharp rise and fall in pulse pressure
What kind of pulse do you find in dilated cardiomyopathy?
small weak (hypokinetic) pulse
What is responsible for S1 heart sounds?
AV valve closure
What is responsible for S2 heart sounds?
Aortic and pulmonary valves closing
What is responsible for S3 heart sounds?
passive ventricular filling
When would you hear S3 heart sounds?
left ventricular enlargement
What is responsible for S4 heart sounds?
contraction of atria
When would you hear S4 heart sounds?
hypertrophic cardiomyopathy in cats
ventricular hypertrophy secondary to aortic stenosis in dogs
When would you hear a systolic click?
mitral valve degeneration
What is responsible for the systolic click?
Mitral valve degeneration when the chordae tendinae snap tight as the degenerative mitral valve protrudes into the left atrium in midsystole
Murmur
audible vibrations produced by turbulent blood flow
Grade 1/6 murmur
very soft
over a small area
only heard after prolonged auscultation
Grade 2/6 murmur
soft
occurs over a small area
heard after a few seconds of auscultation
Grade 6/6 murmur
very loud
heard when stethoscope is held slightly off the chest wall
heard over the entire thorax
palpable thrill
What is the most common heart disease in dogs?
Mitral valve disease
What is the end result of mitral valve disease?
NOT DEATH FROM HEART FAILURE!
Die from something else!
What causes cardiac hypertrophy?
Volume or pressure overload
Eccentric hypertrophy
chronic increased diastolic pressure characterized by cells elongating by the addition of sarcomeres
Concentric hypertrophy
there is increased systolic ventricular pressure causing the sarcomeres to replicate side by side in parallel resulting in wider cells and thicker āstifferā less distensible ventricular wall
What conditions result in eccentric hypertrophy?
endocardiosis
dilated cardiomyopathy
Signs of Left sided congestive heart failure
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
Signs of Right Sided Congestive Heart Failure
Increased pressure in the anterior and posterior vena cava
Distension of the jugular and peripheral veins
Ascites
hepatomegaly
splenomegaly
pleural effusion
Clinical stages of congestive heart failure
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
What are the general principles of treating heart failure?
- Handle animals with extreme care
- Enhance oxygenation
- Reduce edema by decreasing circulating blood volume using diuretics
- reduce preload by trapping blood in the peripheral venous system
- Decrease systemic vascular resistance
- Improve cardiac contractility
- Be cautious with IV fluids
- Treat arrythmias
- Sodium Restricted diet
- Beta Blockers prolong and improve quality of life
- Frequent clinical exams
- Prognosis is variable
- Combination therapy when needed
What is the recommended drug used for sedation in animals with heart failure?
Butorphenol
What drug takes away the nausea of morphine and the anxiety?
Acepromazine
What is the goal of oxygen therapy?
Maintain PaO2 greater than 60mmHg
What percentage of O2 is administered?
30-35%
What is the most common diuretic used in heart failure?
Furosemide
What is the most important drug used in the treatment of heart failure?
Furosemide
What is the 4 keys to the treatment of heart failure?
F- Furosemide
O- Oxygen
N- Nitroglycerine
S- Sedation
What is the best way to achieve the lowest dose of Furosemide?
Decreased Sodium Intake
using an ACE inhibitor
What is the most commonly used venodilator?
Nitroglycerine cream
What is the most widely used vasodilator in the treatment of CHF?
ACE Inhibitors
What is pimobendan?
phosphodiesterase inhibitor causing arterio and veno dilation
Calcium sensitizer
inodilator
What drug is used when an animal is in cardiogenic shock?
Dobutamine CRI
Why are beta blockers used?
Prolong and improve quality of life by preventing the deleterious effects of the sympathetic nervous system
What are the beta blockers commonly used?
Carvedilol
Metoprolol
PDA
Patent Ductus Arteriosus
Which way is blood shunted in a PDA?
Normally - Left to Right: Aorta to the Pulmonary artery
What type of hypertrophy is associated with Left to Right shunting PDA?
eccentric hypertrophy
What type of heart failure is associated with a Left to Right shunting PDA?
Left Sided Congestive Heart Failure
What type of heart failure is associated with a Right to Left shunting PDA?
Right sided heart failure
What does the kidney cause in Right to Left Shunting PDA?
Kidney secretes more erythropoietin due to low PaO2 causing erythrocytosis and increased viscosity
In what breeds is PDA common?
Toy breeds
Miniature Poodles
German Sheperds
What are the usual signs of PDA?
Asymptomatic
What is the murmur associated with PDA?
Machinery murmur - loudest forward of the heart base
What kind of pulse is associated with PDA?
Water-hammer pulse or bounding pulse
In R-to-L shunting PDA where do you see cyanosis?
caudally but not in the MM of the head
What do you find on radiographs with PDA?
L-to-R shunting: Left Heart Enlargement and prominent lung vessels
R-to-L shunting: Right Heart Enlargement
What do you find on doppler with PDA?
Turbulence in the pulmonary artery just distal to the pulmonic valve
What do you find on EKG with PDA?
Signs of left or right heart enlargement
What is the treatment for PDA?
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
What is prognosis for PDA?
After surgery survival is excellent
R-to-L shunting animals can be maintained medically for 3-5 years with low levels of activity
What is the most common congenital cardiac disorder of dogs?
Aortic Stenosis
Aortic Stenosis
fibrocartilaginous connective tissue that completely or partially encircles the aortic outflow tract
What is the most common Aortic Stenosis in dogs?
Subvalvular
What type of hypertrophy is associated with Aortic Stenosis?
Left ventricular Concentric hypertrophy
What breeds are associated with Aortic Stenosis?
Newfoundlands
Boxers
Rotties
Goldens
What are the signs of Aortic stenosis?
Syncope
sudden death due to arrhythmias
Describe the murmur associated with Aortic stenosis
systolic murmur loudest over the left heart base
What arrhythmia is associated with Aortic Stenosis?
VPDs
What do you see on radiographs with Aortic Stenosis?
dilation of ascending Aorta
left ventricular and left atrial enlargement
What do you see on echocardiography with Aortic Stenosis?
Concentric left ventricular hypertrophy
What is used on ultrasound to detect hypertrophy of the left ventricle in Aortic Stenosis?
M-mode
What do you see on ECG with Aortic Stenosis?
Left ventricular enlargement
ST segment depression
VPDs
What drugs are recommended in Aortic Stenosis?
Beta Blockers
What drugs exacerbate Aortic Stenosis?
Class I antiarrythmics
What is the better choice for the treatment of ventricular arrhythmias in Aortic Stenosis?
Sotalol
What is the treatment for Aortic Stenosis?
balloon valvuloplasty
transventricular myectomy
What is the treatment for dogs with congestive heart failure from Aortic Stenosis?
Furosemide
ACE inhibitors
What is the prognosis for Aortic Stenosis?
Progressive
What is important to control in dogs with Aortic Stenosis?
Infections that can lead to endocarditis
What is the 3rd most common congenital cardiac disorder in the dog?
Pulmonic Stenosis
What is the most common Pulmonic Stenosis?
Valvular
What causes Pulmonic Stenosis?
the valve is dysplastic being thickened, asymmetrical and having hypoplastic valve annulus
What is the hypertrophy associated with Pulmonic Stenosis?
Concentric hypertrophy of the right ventricle
Why is the right atrium enlarged in Pulmonic Stenosis?
Due to elevated right ventricular filling pressures
What breeds are pulmonic stenosis seen in?
English bulldogs
Beagle
What are the signs of Pulmonic Stenosis?
exercise intolerance
weakness
syncope
sudden death
Where is the murmur heard in pulmonic stenosis?
systolic heart murmur over the left heart base
What is seen on radiography with pulmonic stenosis?
Right ventricular enlargement
post-stenotic dilation of the pulmonary truck at 1 oāclock on VD/DV views
What is seen on ECG with pulmonic stenosis?
right ventricular enlargement
What is the treatment for pulmonic stenosis?
Balloon valvuloplasty
patchgraft valvuloplasty
A right ventricle to pulmonary artery conduit placed with single right coronary type R2A anomly
What is the prognosis for pulmonic stenosis?
Good
Therapy should be considered if the clinical signs ans cardiac function worsen
Response to balloon valvuloplasty is excellent
What is the flow of blood in a ventricular septal defect?
Flow from high pressure left ventricle to low pressure right ventricle
What breeds are Ventricular septal defects common in?
Keeshonds
English Bulldogs
What species is Ventricular Septal defect common in?
Cats
What arrhythmia is common in Ventricular Septal defect?
VPDs
Describe the murmur in Ventricular Sept Defect
a systolic murmur loudest over the right sternal border
a thrill over the right hemithorax
What so you find in radiographs for ventricular septal defect?
prominent pulmonary vessels
left heart enlargement
What provides the definitive diagnosis for Ventricular septal defect?
Doppler
What is the treatment for Ventricular septal defect?
Septal defect closed with a synthetic patch
pulmonary banding
Embolization coils
Amplatz occluders
Arterial vasodilators to decrease the L-to-R Shunting
What is the prognosis for Ventricular septal defect?
Good to excellent
Can occasionally close spontaneously
What are the four factors of Tetralogy of Fallot?
Pulmonary stenosis
overriding aorta
VSD
Hypertrophy of the right ventricle
What breed is associated with Tetralogy of Fallot?
Keeshond
What are the signs associated with Tetralogy of Fallot?
exercise intolerance syncope Cyanosis Increased PCV Hyperviscosity
Describe the murmurs associated with Tetralogy of Fallot?
systolic murmur of pulmonic stenosis at the left heart base
VSD murmur on the right
What do you find on the radiographs associated with Tetralogy of Fallot?
Right heart enlargement
small pulmonary vessels
What do you find on Echocardiogram for Tetralogy of Fallot?
Right ventricular hypertrophy
overriding aorta with vessel straddling a high ventricular septal defect
What identifies Tetralogy of Fallot?
Angiography
What is the treatment for Tetralogy of Fallot?
Surgery
Beta Blockers for some patients
Hydroxurea
What drugs are contraindicated with Tetralogy of Fallot?
Vasodilators
What does Atrial septal defect cause?
Right ventricular enlargement
enlargement of pulmonary vessels
What are the signs of Atrial septal defect?
Asymptomatic
What is the most common congenital cardiac malfunction in cats and large breed dogs?
Atrioventricular (A-V) valve malformations
Atrioventricular (A-V) valve malformations
valves that are thickened or fused
papillary muscles are malpositioned, partially developed or absent
chordae tendinae are too long, too short, or absent
What occurs most common with Atrioventricular (A-V) valve malformations?
Valvular insufficiency resulting in regurg and volume overload
What is the treatment for Atrioventricular (A-V) valve malformations?
Furosemide
ACE inhibitors
Low sodium diet
What arrhythmias are common with Inherited Ventricular Arrhythmias in young german shepards?
VPDs
What are the signs associated with Inherited Ventricular Arrhythmias in young german shepards?
Frequent episodes of V-tach
sudden death
VPDs
What is the treatment for Inherited Ventricular Arrhythmias in young german shepards?
Sotalol + Mexiletine until 18months -2 years old
What is the common condition in giant and large breed dogs?
Dilated Cardiomyopathy
What is Dilated Cardiomyopathy characterized by?
Decreased myocardial contractility
Progressive dilation of the left and right ventricle with mild thinning of the ventricular walls
What breeds are usually affected by Dilated Cardiomyopathy?
Doberman Pinschers
Boxer
Arrhythmogenic Dilated cardiomyopathy
arrhythmias but with normal left ventricular contractility
What are the three stages of Dilated Cardiomyopathy?
Arrhythmogenic
Occult
Classic
Occult Dilated cardiomyopathy
left ventricular enlargement
Decreased contractility
Ventricular arrhythmias or Atrial Fibrillation are common
Classic Dilated Cardiomyopathy
Dogs are in left sided heart failure
ventricular enlargement and decreased myocardial contractility
ventricular arrhythmias or Atrial fibrillation
Signs of Dilated Cardiomyopathy
Sudden death from arrhythmias weight loss syncope dyspnea orthopnea coughing Lung sounds with pleural effusion
What type of heart failure is associated with Dilated Cardiomyopathy?
Left or right sided heart failure
Describe the murmur associated with Dilated Cardiomyopathy
Systolic murmur from mitral regurgitation due to dilation of the mitral annulus
gallop sounds are common
What are the laboratory findings associated with Dilated Cardiomyopathy?
Prerenal azotemia
increased liver enzymes from hepatic congestion
What deficiency is linked to dilated cardiomyopathy in cats?
Taurine
What is found on radiographs with Dilated cardiomyopathy?
generalized hear enlargement
Left heart enlargement
What diagnostic tool is a definitive diagnosis for Dilated Cardiomyopathy?
Left ventricular and left atrial enlargement with āflabbyā ventricular walls
What do you find on M-mode with Dilated Cardiomyopathy?
Enlarged left atrium
What arrhythmias are common in dilated cardiomyopathy?
VPDs
Atrial Fibrillation
What is the treatment for Dilated Cardiomyopathy if the animal has ālone Atrial Fibrillationā?
Beta-blockers
Diltiazem
What is the treatment for Occult Dilated Cardiomyopathy?
ACE inhibitors
Pimobendan
Beta-Blockers
What is the treatment for dogs with mild failure with Dilated Cardiomyopathy?
Furosemide
ACE inhibitors
pimobendan
Antiarrhythmics
What is the treatment for dogs with mild failures with Dilated Cardiomyopathy?
Sedation
Supplementary O2
Drain effusions and ascites
What combination of drugs improves quality of life and survival in dogs with Dilated Cardiomyopathy?
Pimobendan
Furosemide
ACE inhibitors
What is characteristics for Dilated Cardiomyopathy in Cats?
ventricular dilation
thinning of the ventricular walls
decreased contractility
What is the treatments for Dilated Cardiomyopathy in cats?
Furosemide for pulmonary edema
oxygen therapy
venodilator therapy
What is the main treatment for cats with Dilated Cardiomyopathy?
Taurine supplementation if deficient
What is the prognosis for cats with Dilated Cardiomyopathy?
poor unless taurine deficiency is the cause
What is the most common cardiomyopathy in cats?
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy in cats
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
What kind of hypertrophy does Hypertrophic cardiomyopathy in cats result in?
Concentric left ventricular hypertrophy
What breeds of cats are predisposed to hypertrophic cardiomyopathy?
Maine Coons
Ragdoll
What predisposes a cat to hypertrophic cardiomyopathy?
Genetics Hyperthyroidism Systemic hypertension toxins aortic stenosis acromegaly
What are cats with Hypertrophic cardiomyopathy predisposed to ?
Thrombus formation and emboli formation
Aortic thromboembolism
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
What are the clinical signs of Hypertrophic cardiomyopathy in cats?
Many are asymptomatic
Development of acute heart failure due to stress
Syncope/collapse
sudden death
Signs of left sided congestive heart failure
Describe the murmurs in Hypertrophic cardiomyopathy in cats
Gallop rhythms (S4) systolic murmurs
Signs of Aortic Thromboembolism
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
What laboratory findings do you see in Hypertrophic cardiomyopathy in cats?
Biomarkers in the blood such as Troponin or pro-BNP
with ATE: muscle necrosis, elevated CK, AST, and Potassium
What is the classical sign seen on Radiographs that points to Hypertrophic cardiomyopathy in cats?
āvalentine-shapedā heart due to left ventricular enlargement
What do you see on echocardiogram with Hypertrophic cardiomyopathy in cats?
marked thickening of the interventricular septum and/or left ventricular walls
What do you see on doppler with Hypertrophic cardiomyopathy in cats?
a jet across the mitral valve
What do you see on M-mode with Hypertrophic cardiomyopathy in cats?
Thickened ventricular free wall and septum
What do you see on angiography with Hypertrophic cardiomyopathy in cats?
enlarged left atrium
thickened left ventricular free wall and septum
What do you see on EKG with Hypertrophic cardiomyopathy in cats?
Left heart enlargement
VPDs
V-tach
What is the treatment for Hypertrophic cardiomyopathy in cats?
ACE inhibitors with a beta-blocker or diltiazem
Furosemide
Beta Blockers
What drugs do you used to sedate cats with Hypertrophic cardiomyopathy?
Butorphenol mixed with Acepromazine
What is the classic sign of thromboembolism?
āswirling smokeā seen in the left atrium
What does the use of Spironolactone cause in cats?
Facial dermatitis
What does reprofusion cause in cats with ATE?
Hyperkalemia
What can be used to prevent thrombus formation in cats?
unfractionated heparin
What are two drugs that are used for chronic control of ATE in cats?
Aspirin Clopidogrel (Plavix)
How do you prevent Hypertrophic cardiomyopathy in cats?
test for myosin bind protein 3 in Maine Coons and Ragdolls
What is a key prognostic factor in Hypertrophic cardiomyopathy in cats?
Left Atrial Size
What are the histiologic changes seen in boxers with Arrythmogenic right ventricular cardiomyopathy?
changes of the right myocardium: inflammation, fibrosis, and or fat infiltration and ventricular arrhythmias
What causes Arrythmogenic right ventricular cardiomyopathy in boxers?
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)
What is the signalment of Arrythmogenic right ventricular cardiomyopathy in boxers?
Boxers 6-10 years of age
What are signs of Arrythmogenic right ventricular cardiomyopathy in boxers?
sudden death weakness syncope right congestive heart failure VPDs
What laboratory finding is seen in Arrythmogenic right ventricular cardiomyopathy in boxers?
Serum cTn-1 concentrations
What can be seen on radiographs and ultrasound in Arrythmogenic right ventricular cardiomyopathy in boxers?
right ventricular enlargement
aneurysm of the infundibulum
What is the treatment for Arrythmogenic right ventricular cardiomyopathy in boxers?
Sotalol + Mexilitene
Mexilitene + Atenolol
Sotalol (alone)
What is a common degenerative disorder of the mitral valve?
Myxomatous atrioventricular valvular degeneration
What is a common disease of small and medium sized dogs?
Myxomatous atrioventricular valvular degeneration
What is the cause of Myxomatous atrioventricular valvular degeneration?
unknown but possibly due to collagen abnormality
Myxomatous atrioventricular valvular degeneration
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
What is the compensation by the heart for Myxomatous atrioventricular valvular degeneration?
Increased sympathetic tone
increased cardiac output
What does regurgitation of the Mitral valve cause?
Left atrial enlargement
What does left atrial enlargement cause?
Compression of the left main bronchus
What type of hypertrophy is present with Myxomatous atrioventricular valvular degeneration?
eccentric hypertrophy
Why does heart failure occur in Myxomatous atrioventricular valvular degeneration?
The left ventricle becomes dilated so it cannot move the required amount of blood
What breed is genetically predisposed to Myxomatous atrioventricular valvular degeneration?
Cavalier King Charles Spaniels
What are the signs that dogs with Myxomatous atrioventricular valvular degeneration present with?
Asymptomatic murmur
Large airway compression causing coughing
Syncope
Left atrial rupture and acute cardiac tamponade
Chronic congestive heart failure
What do you find on laboratory diagnostics for Myxomatous atrioventricular valvular degeneration?
Mild increases in BUN and Crea
Mild increases in Liver enzymes
Increases in Natriuretic peptides and Endothelin-1 blood concentrations
What do you find on Echocardiogram with Myxomatous atrioventricular valvular degeneration?
Enlarged left atrium
mitral valve prolapse
What is the home treatment for Myxomatous atrioventricular valvular degeneration?
Surgical repair or replacement of the valve
Furosemide
ACE inhibitor
Sodium restricted diet
What should be performed on animals to confirm Myxomatous atrioventricular valvular degeneration?
Radiographs
Echocardigraphy
What drugs are contraindicated for animals with Myxomatous atrioventricular valvular degeneration?
Antitussives
What is the hospital treatment for Myxomatous atrioventricular valvular degeneration?
Oxygen
Furosemide IV
Hydralyzine
ACE inhibitor once stable
What is the chronic treatment for Myxomatous atrioventricular valvular degeneration?
Spironolactone
Restricted sodium diet
Pimobendan
What is the treatment for Stage A of Myxomatous atrioventricular valvular degeneration?
Yearly auscultation
no drugs
Stage A of Myxomatous atrioventricular valvular degeneration
Normal dogs at high risk
Stage B of Myxomatous atrioventricular valvular degeneration?
Structural heart disease but no signs of CHF
Stage B1 of Myxomatous atrioventricular valvular degeneration?
murmur with no radiographic or echocardiographic signs of remodeling
Stage B2 of Myxomatous atrioventricular valvular degeneration?
Murmur with radiographic or echocardiographic signs of left heart enlargement
What is the treatment for Stage B1 of Myxomatous atrioventricular valvular degeneration?
No drugs or diet therapy needed
Recheck with radiographs/ultrasound yearly
What is the treatment for Stage B2 of Myxomatous atrioventricular valvular degeneration?
ACE inhibitors
Beta Blockers
Mild sodium restriction
Stage C of Myxomatous atrioventricular valvular degeneration?
Previous or currents signs of CHF
What is the at home treatment for Stage C of Myxomatous atrioventricular valvular degeneration?
Furosemide
ACE inhibitors
Pimobendan
Good nursing
What is the hospital treatment for Stage C of Myxomatous atrioventricular valvular degeneration?
Furosemide
Pimobendan
Oxygen
Remove Pleural effusions/ascites
Stage D of Myxomatous atrioventricular valvular degeneration?
End stage heart failure refractory to standard therapy
What is the hospital treatment for Stage D of Myxomatous atrioventricular valvular degeneration?
Free access to water Fluid removal Oxygen Sodium nitroprusside ACE inhibitors pimobendan
What do most dogs with Myxomatous atrioventricular valvular degeneration die from?
Other causes
Endocarditis
bacteremia when organisms colonize the endocardium and usually also one of the heart valves
Where does vegetation most often take place in a dog with endocarditis?
Aortic and mitral valves
What are the 6 bacteria that can cause endocarditis?
Bartonella spp. Streptococcus spp. Staphylococcus spp. E. coli Corynebacterium spp. Pseudomonas spp.
What is the signalment for animals with Endocarditis?
Large breed dogs
Male
4-8 years
Signs of endocarditis?
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
What are the laboratory findings of endocarditis?
Neutrophilic leukocytosis - left shift or toxic changes
Anemia of chronic inflammaion
thrombocytopenia
What is seen on echocardiography for endocarditis?
Lesions of greater than 1mm can be detected and appear as vegetations on the mitral valve and/or aortic valve
What is the treatment for endocarditis?
Controlling the arrhythmias and heart failure
Bactericidal antibiotics with high concentrations for extended period of time
antibiotic chosen based on sensitivity studies
What is the prognosis for endocarditis?
Poor but grave if heart failure develops
Pericardial effusion
presence of abnormal amount of fluid in the pericardial sac
What does pericardial effusion cause?
Cardiac tamponade
What breeds are predisposed to Hemangiosarcoma?
Goldens
German Shepards
What breeds are predisposed to Paragangliomas?
Brachycephalic breeds
Wht are the signs of pericardial effusion?
Weight loss weakness enlarging abdomen Pale MM Slow CRT muffled heart sounds poor pulses jugular distension ascites
What diagnostic imaging clearly reveals the pericardial fluid?
Echocardiography
Where are paragangliomas found?
Based of the Aorta
Where do Hemangiosarcomas occur?
Right auricle
Right atrium
Rigth ventricle
What is the treatment for pericardial effusion?
Immediate pericardiocentesis
What is indicated if the pericardial effusion is recurrent?
Pericardectomy
Percutaneous Balloon Pericardectomy
What is the prognosis for idiopathic pericardial effusion?
excellent
What is the prognosis for pericardial effusion caused by hemangiosarcoma?
Poor
What type of hypertrophy is seen with Canine heartworm?
Right ventricular eccentric hypertrophy
What type of heart failure is associated with canine heartworm?
Right side heart failure
What are the laboratory findings associaated with Canine heartworm?
Thrombocytopenia Eosinophilia Basophilia Mild Non-regenerative anemia Hyperglobulinemia INcreased liver enzymes
What signs are seen on Radiographs associated with canine heartworm?
Right ventricular enlargement
A prominent main pulmonary artery
āDā shaped cardiac silhouette
Enlarged lobar arteries
What are the goals of canine heartworm therapy?
- begin the animal on prophylaxis
- Manage signs of moderate or severe lung disease and heart failure
- Kill Microfilaria
- Adulticide therapy
Diethylcarbamazine
effective against the L3-L4 molt stage and against microfilaria
Ivermectine
kills L3-L4 annd will kill most adult worms when given over 2-3 years
Can you give Ivermectin to a collie?
Yes, to Collies over 4.5kg
Milbemycin
effective against L3 and L4 and microfilaria but NOT against adults
Selamectin
effective against L3 -L4 and moderate activity against adults and microfilaria
Moxidectin
Effective against L3-L4 and only moderate adult activity