Feline cardiomyopathy Flashcards
What endocrine disease is associated with secondary cardiomyopathies?
Hyperthyroidism
List the four presentations
i. Incidental (Stage B)
ii. Acute CHF +/- pleural effusion (Stage c acute)
iii. Aortic thromboembolism (Stage C/D)
iv. Sudden cardiac death (SCD)
What is a gallop rhythm?
when a third heart sound (S3) is audible (dt rapid filling of the ventricle)
What diagnostics are appropriate for a asymptomatic cat with a gallop rhythm?
i. Measure systolic BP
ii. Full feline blood screen w/ total T4 and cardiac biomarkers (NT-pro BNP)
iii. Thoracic imaging
iv. Echocardiogram
What are some medications you could use to prevent thrombus formation?
Clopidogrel
Rivaroxaban
Actions for acute stage C management
- stabilisation
- elimination of hypervolaemia (congestion) w/ medications (Frusemide, butorphanol, O2)
- Accurate diagnosis and ID of complications
Treatment of stable Stage C
i. Diuretic (Frusemide +/- Spironolactone)
ii. Ace inhibitor (Benazepril)
iii. Anti-thrombotic (Clopidogrel, Rivaroxaban)
iv. A drug to slow heart rate and improve cardiac relaxation (B-blocker or Ca-channel blocker)
Which drug is commonly used if there is supraventricular tachycardia OR systolic anterior motion of the mitral valve and why?
B-blockers as rate control is important
If congestion heart failure is severe B-blockers are not commonly used. Why?
May worsen CHF dt slowing heart too much
Atenolol dose
12.5mg/kg q24h PO
Diltiazem dose
1-3mg/kg q8h PO
Why is polypharmacy an issue in cats?
- difficult to pill
- transdermal formulations are unproven
What function and structural cardiac changes result from systemic hypertension?
- Most commonly left ventricular concentric hypertrophy in response to pressure overload
- Diastolic dysfunction is usu. recorder
- Arrhythmias
How can renal disease cause secondary heart disease?
–> systemic hypertension –> secondary changes to cardiac structure/function
Where do 90% of TE lodge?
aortic trifurcation/iliac arteries
List 5 ddx to sudden on set HL paralysis?
- FATE
- Trauma
- IVDD
- Spinal lymphoma
- Fibrocartilageous emboli
what is the prognosis of FATE?
Variable - some re-canalise quickly and others never recover.
Risk of recurrence is high.
Actions of acute FATE
i. analgesia: butorphanol/buprenorphine/fentanyl CRI
ii. anti-thrombotic tx
iii. IVFT (rel. contraindicated in CHF but may reduce reperfusion injury)
iv. Monitor lytes/renal function
v. confirm cardiac dx
