CHF - Cats

Question 1

Hypothermia or hyperthermia in CHF in cats?

Answer 1

Hypothermia

Normal is 100.5 to 102.5 F

Question 2

Why we may not hear heart murmur in a cat with CHF?

Answer 2

Mostly they dont have MVD and instead have RCM,HCM,DCM

Question 3

1st step for cat with CHF?

Answer 3

Oxygen

Donot take XRAY, hold them or put IV Catheter

Question 4

____ ml/kg of fluid to result in radiographic detection of pleural effusion

Answer 4

10

Memorise tip: amount equal to your shortcut for 1/4th bolus

Question 5

_____ ml/kg of effusion to result in altered physical exam

Answer 5

20-30

** if you get less than that on centesis then the problem could be some thing else such as cancer, pulmonary edema

Question 6

Best ICS space for thoracocentesis?

Answer 6

7-10th ICS

Go ventral third

Connecting dots: for pericardiocentesis in dogs, its Tap on RIGHT side of the chest between 4th and 6th ICS

Question 7

Avoid _____ and _____ ICS in thoracocentesis

Answer 7

4-6th - heart

13th - diaphragm

Question 8

What size needle for thoracocentesis?

Answer 8

21 g ; 5/8th inch

1 inch if obese

Question 9

What size syringe recommended for thoracocentesis?

Answer 9

10 -20 ml

Bigger will collapse the tubing

Question 10

4 main thumbrules for Rx of CHF in cats?

Answer 10

Oxygen
Minimal pet handling
Furosemide
Thoracocentesis if needed

Question 11

Good dose of Furosemide for cats?

Tell in mg/kg

Answer 11

2 mg/kg is good dose

Otherwise it is 1-2 mg/kg

Shortcut : LB/100 upto 2X

In dogs, it is 1-4 mg/kg

Question 12

Furosemide cause ↑ or ↓ in K

Answer 12

↓ K i..e Hypokalemia

Connecting dots: terbutaline too

Question 13

Author prefers to do TC first before XRAY if CHF and pleural effusion suspected. T/F

Answer 13

T

As XRAY can be detrimental

Question 14

Basis of deciding thoracocentesis without US on board.

Answer 14

Dull lung sounds on auscultation

Question 15

What type of breathing in pleural effusion?

Answer 15

Rapid,shallow,dull

Connecting dots: in asthma = deep with expiratory shift

Question 16

2 Main causes of pleural effusion in cats?

Answer 16

Cardiomyopathy
Cancer

Each ~ 30%

Question 17

6 main causes of pleural effusion in cats?

Answer 17

Cardiomyopathy
Cancer
FIP
Pyothorax
Chylothorax
Other diseases

Question 18

How often to repeat dose of furosemide in cats?

Answer 18

Every 1-2 hours until stable → then decrease to every 8-12 hours

Question 19

Standard maintenance dose of oral furosemide in cats ?

Answer 19

1-2 mg/kg PO SID-BID

In dogs dose is same but frequency is BID-TID

Question 20

Do cats need sedation mostly for TC?

Answer 20

Most cats will tolerate it best

Question 21

Medication options for sedation in cats for TC i.e. the two main meds?

Answer 21

Butorphanol +/- midazolam/diazepam

Question 22

Dose shortcut for butorphanol and midazolam if needed in cat with TC?

Answer 22

Lb/100 for both

(For seizures, midazolam shortcut is lb/50)

Question 23

Which ICS correlates to heart?

Answer 23

4-6 ICS

Question 24

For TC, do we poke in front or rib or behind?

Answer 24

Front

Question 25

Average survival time of Cats with CHF?

Answer 25

1-2 yr

Question 26

Differential for pleural effusion if cat is having DEEP pattern with EXPIRATORY push?

Answer 26

Asthma

Question 27

Cats with pleural effusion have EXPIRATORY PUSH. T/F

Answer 27

F ; it is seen in asthma In pleural effusion, it is rapid and shallow breathing NOT DEEP!!!!!

Question 28

Shortcut for furosemide injection Lb/_____

Answer 28

Lb/100 upto 2X IV or IM every 1-2 hr until stable and then reduce to q8-12h

Question 29

Is dose in ml of furosemide and butorphanol same in cats?

Answer 29

Yes, both lb/100 Furosemide can be given upto 2x