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VMS 3010 > Diseases of the cardiovascular system IV > Flashcards

Diseases of the cardiovascular system IV Flashcards

1
Q

Name three common peripheral vascular diseases

A
  1. Dirofilariasis
  2. Aortic thromboembolism
  3. Systemic hypertension
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2
Q

What kind of worm is dirofilaria and where does it reside?

A

Large, whitish worm
* Females - ~30 cm long
* Males - ~23 cm long
* Adults reside in the pulmonary arterial system – cause
damage to pulmonary vessels and lungs

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3
Q

What is the distribution of dirofilaria?

A

Worldwide distribution of D. immitis –
though limited to regions with suitable
mosquito intermediate hosts
» Some regions have seasonal periods
of susceptibility
» Not currently in the UK – but beware
of travelling dogs and future potential
with climate change!

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4
Q

When do dirofilaria clinical signs develop in dogs?

A

Most dogs with low heartworm burden have no clinical signs
» Clinical signs seen in dogs if they have a severe allergic responses to the adult worms and/or microfilariae, or have high worm burdens
» Signs may develop 3-6 months after infection as L5 larvae reach the lungs. Signs may occur acutely with worm death

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5
Q

What are the clinical signs of dirofilaria in dogs?

A
  • Coughing
  • Exercise intolerance
  • Syncope
  • Weight loss
  • Tachypnoea, dyspnoea, abnormal respiratory sounds
  • Abnormal heart sounds
  • Congestive heart failure (ascites, hepatomegaly, jugular distension) * Pulmonary thromboembolism
  • Multi-organ involvement * Death
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6
Q

What are the hyper-acute clinical signs of dirofilaria in cats?

A

Sudden death

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7
Q

What are the chronic clinical signs of dirofilaria in cats?

A
  • Coughing
  • Dyspnoea
  • Asthma-like attacks
  • Vomiting
  • Inappetence/weight loss
  • Lethargy
  • Chylothorax
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8
Q

How would you diagnose dirofilaria on radiography?

A

» Enlarged main
pulmonary artery

» Right ventricular
enlargement

» Enlarged tortuous
caudal lobar
pulmonary arteries

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9
Q

What does mild dirofilaria look like on echocardiography?

A

Usually looks normal

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10
Q

What does moderate dirofilaria look like on echocardiography?

A

RV often dilated +/- free wall thickening

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11
Q

What does severe dirofilaria look like on echocardiography?

A

Moderate to severe RV distension

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12
Q

Where might heartworms be estimated?

A

Doppler evidence of pulmonary hypertension
can be estimated if tricuspid or pulmonic
regurgitation is identified

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13
Q

Where may heartworms be found?

A

Heartworms may be identified in the main
pulmonary artery and branches, and in the right
heart chambers and vena cavae in some cases

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14
Q

What is the specific test used for heartworms?

A

Heartworm antigen test

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15
Q

How does a heartworm antigen test work?

A
  • Heartworms must mature before either antigen or
    microfilaria tests become positive (6-7 months
    after infection) * Sensitivity is proportional to worm burden and
    specificity is nearly 100%
  • Detect female worms only (detects an antigen
    most abundant in the uteri of gravid females and
    eggs) * False negative results occur in cases of light
    infections, immature females, male-only infections,
    antigen-antibody complex-related interference, test
    malfunction, and by not following the manufacturer
    instructions!
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16
Q

What are the two specific tests for microfilaria?

A
  • Fresh blood direct smear
  • Modified Knott’s Test
17
Q

What are the two main treatments for dirofilaria?

A
  • Surgical removal (caval syndrome)
  • Supportive therapy (doxycycline, amcrocyclic lactones, exercise restrcition)
18
Q

Name 4 medicines that can be used to help prevent dirofilaria

A
  1. Ivermectin
  2. Selamectin
  3. Milbemycin oxime
  4. Moxidectin
19
Q

What is a feline aortic thromboembolism also known as?

A

Saddle thrombus
Usually caused by heart disease

20
Q

How do saddle thrombi occur?

A

Occurs when thrombo-emboli (usually
from LA) lodge in the distal aortic
bifurcation (most common), or in
brachial, visceral or cerebral arteries
» ATE is rare in dogs

21
Q

What is the pathophysiology of saddle thrombi?

A

» Virchow’s Triad
* Damage to vascular endothelium of
LA
* Sluggish blood flow (typically due to
LA enlargement with spontaneous
echo contrast of blood in the LA
* Hypercoagulability (more difficult to
identify but inflammation and altered
platelet function play a role)
» Clot forms in LA and washes down
the arterial tree

22
Q

What are the 5 main clinical signs of a feline aortic thromboembolism?

A
  1. Posterior paresis
  2. Pain
  3. Pulselessness
  4. Pallor
  5. Poikilothermia
23
Q

What specific therapy can be used for a cat with a saddle thrombus?

A
  • Prevent continued thrombus formation
  • Clopidogrel 18.75 mg/kg PO q24hr * Improving flow to infarcted organ(s) * Monitor for reperfusion injury
  • But…while it can buy some time, ATEs can and do still occur
    1. and long-term survival is poor
24
Q

What is the usual prognosis for a saddle thrombus?

A

Poor to grave (25-30% can recover completely) * Depends on presenting signs
* Single pelvic limb infarctions do much better compared to bilateral * Non-survival has been associated with hypothermia, bradycardia and absence of motor function

25
Q

What is systemic hypertension?

A

A sustained elevation in systolic BP
» There is a balance between sympathetic and
parasympathetic tone.
» Influenced by the R-R interval, inotropism and
peripheral resistance

26
Q

What are the two categories of systemic hypertension?

A
  • Secondary hypertension – more common
  • Primary (idiopathic) hypertension
27
Q

What animal is systemic hypertension more common in?

A

It is more common in older male dogs rather than females

28
Q

What conditions are most commonly associated with secondary hypertension?

A

» Kidney disease – most common
» Hyperadrenocorticism
» Adrenal tumours
» Hyperthyroidism
» Diabetes mellitus
» Cardiovascular disease

29
Q

Why would you focus on the cats eye when looking at hypertension?

A

Only part of the cats body where blood vessels are visible

30
Q

What are the main clinical manifestations of hypertension?

A
  • Renal manifestations
  • Neurological manifestations
  • Epistaxis
31
Q

What is the prognosis for hypertension?

A
  • Dependent on target organ damage
  • Treatment usually life-long
  • When well managed further complications are
    minimised

VMS 3010 (102 decks)

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