CHF-Dog

Question 1

1st step is _____

Answer 1

Oxygen & cage rest

Any type

Question 2

Furosemide dose ?

____ to _____ mg/kg IV or IM

Shortcut is kg/____ upto 2X

Answer 2

1-4 mg/kg IV or IM

Shorcut(50 mg/ml): kg/25 upto 2X

Put IV catheter if possible but donot stress; Get blood sample if you are able to put IV catheter

Question 3

What to do after furosemide inj?

Answer 3

Give 15-30 min

In that time give O2 + cage rest

Question 4

What to do if improvement seen after 15-30 min?

Answer 4

** IV Catheter → +/- another laxis dose → Diagnostics i.e. BW,XRAY **

Question 5

What do to if no improvement in 15-30 min?

Answer 5

Redo a Furosemide dose

Question 6

What to do if no improvement even after redoing Laxis dose?

Answer 6

Give nitroprusside or hydralazine especially if already given 8,10,12 mg/kg total furosemide dose

Question 7

____% of cases will improve with furosemide alone and will not need nitroprusside or Hydralazine

Answer 7

95%

Question 8

What is the initial dose for hydralazine?

Answer 8

0.5 mg/kg

Question 9

What to do after giving hydralazine initial dose?

Answer 9

Give 30-60 min and assess

Assess for following:

• Breathing improved
• HR improved
• Crackles improved
• Normotensive

Question 10

Further steps regarding Hydralazine if improvement seen with initial dose?

Answer 10

Make 0.5 mg/kg as BID dose

Question 11

Further steps regarding hydralazine if no improvement with initial dose after 30-60 min?

Answer 11

Give another 0.5 mg/kg as BID dose → reassess in another 30-60 min

• • if improvement seen then make 1 mg/kg as BID dose
• • if no improvement then it is a SUPER SICK CARDIAC PATIENT

Question 12

Main point to consider before giving hydralazine ?

Answer 12

Make sure that pet is NORMOTENSIVE !!!!!

Hypotension if MAP <60 and SAP <90 mm/hg

Question 13

What about anti-anxiety medications?

Answer 13

Author considers it in some dogs who are super-anxious & hyperexcitable

Question 14

What anti-anxiety medications to use?

Answer 14

Author prefers opioids

2 options i.e. Morphine and butorphanol

Question 15

Dose of morphine & butorphanol for CHF patient for anxiety?

Answer 15

Morphine : 0.2-0.5 mg/kg IV,IM

Butorphanol : 0.1 - 0.2 mg/kg IV,IM

Question 16

If patient is on laxis it should be on pimobendan. T/F

Answer 16

T

As they fit the criteria for pimobendan i.e. high grade murmur and big VHS score

Question 17

How to decide which dog gets pimobendan?

Answer 17

• if client has $ then on basis of echo done by cardiologist

- if client does not have $ or cardiologist not available then murmur and VHS has to meet some criteria

Question 18

Criteria for starting pimobendan on basis of heart murmur grade and VHS score?

Answer 18

• Murmur of 3/6 or louder , &

• if this criteria not meet then recommend to repeat XRAY in ~4 months*

- VHS > 11.5 or incremental increase of > than 0.5 VHS per 6 months