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LAIM: Cardiology > Food Animal - Cardiac Disease > Flashcards

Food Animal - Cardiac Disease Flashcards

1
Q

List the causes of acquired valvular disease in cattle.

A
  • Degenerative changes.
  • Infection (bacterial or viral endocarditis or myocarditis).
  • Inflammation.
  • Trauma.
  • Myocardial dz (cardiomyopathy).
  • Neoplasia (esp lymphoma).
  • Idiopathic.
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2
Q

Chronic bacterial infection can predispose to bacterial endocarditis. List three common chronic bacterial infections that have been linked with endocarditis in cattle.

A
  • Foot abscesses.
  • Rumenitis.
  • Reticular abscesses.
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3
Q

What is the most common bacterial isolate from bacterial endocarditis lesions in cattle?

A

Trueperella pyogenes.

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4
Q

Which valve is most commonly affected in cattle with bacterial endocarditis?

A

Tricuspid valve.

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5
Q

List the clinical signs of valvular disease in cattle.

A
  • Murmur: varies with valve affected; often quiet to no murmur in cattle with bacterial endocarditis.
  • Cardiac enlargement –> greater area for auscultation +/- arrhythmias e.g. a fib.
  • CHF: tachycardia, coughing, respiratory distress, jugular v distension, abnormal jugular pulsation, subcutaneous oedema, mammary v distension, crackles/moist lung sounds; wt loss, anorexia, fever, mastitis.
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6
Q

Describe echocardiographic findings in cattle with acquired valvular disease.

A

Regurgitant jet, increased chamber dimensions, valvular lesions.
Valvular insufficiency: mild jet 2/3 receiving chamber.

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7
Q

List potential CBC, MBA and urinalysis findings in cattle with bacterial endocarditis.

A
  • CBC: anaemia, neutrophilia, hyperfibrinogenaemia.
  • MBA: hyperglobulinaemia, inc liver enzymes.
  • Urinalysis: pyuria or haematuria.
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8
Q

Describe the pathophysiology of congestive heart failure (CHF) in cases of acquired valvular disease in cattle.

A

Valvular incompetence –> volume overload of recipient chamber –> increased EDV –> compensatory dilation and increased ED pressure +/- hypertrophy –> decreased contractile ability –> CHF.

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9
Q

Describe the pathophysiology of bacterial endocarditis in cattle.

A

Localised infection –> bacterial endocarditis –> disseminated sepsis –> cull.

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10
Q

List the components of bacterial valvular vegetative lesions in cattle.

A

Blood cells, fibrin, necrotic tissue, bacteria.

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11
Q

Outline the treatment and prognosis for bacterial endocarditis lesions in cattle.

A
  • Antibiotics (gram +ve), aspirin/LMWH to prevent platelet adhesion, furosemide if CHF, digoxin to improve contractility.
  • Px is guarded to poor (they present with advanced dz).
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12
Q

Define High Mountain Disease (a.k.a. Brisket Dz) of cattle.

A

Hypoxic vasoconstriction from high altitude dwelling.

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13
Q

What factors can exacerbate the signs of HMD and what does this combination of factors lead to?

A
  • Pneumonia, lungworms, prolonged exposure to cold temperatures, ingestion of locoweed.
  • HMD + factors above –> cor pulmonale (effect of lung dysfunction on the heart).
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14
Q

Describe the pathophysiology of HMD in cattle.

A

High altitude (>6000ft) +/- respiratory dz +/- locoweed –> pulmonary a constriction in response to hypoxia –> pulmonary hypertension –> pressure overload on RV –> RV hypertrophy, dilation or failure.

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15
Q

List the latin name and toxic principal of Locoweed.

A
  • Plant: different oxytropis and astragalus species.

- Toxin: swainsonine; causes myocardial damage.

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16
Q

List the clinical signs of Brisket Disease in cattle.

A
  • Subcutaneous brisket oedema, oedema of ventral thorax, limbs, submandibular space.
  • Lethargy, weakness, pulling eyes, diarrhoea, collapse, death, jugular v distension or pulsations, dyspnoea, tachypnoea.
  • Auscultation: tachycardia, +/- gallop rhythm, +/- split S2, +/- murmur related to tricuspid or pulmonic regurg.
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17
Q

List four differential diagnoses for Brisket Disease in cattle.

A
  • Bacterial endocarditis of the tricuspid valve.
  • Cardiomyopathy.
  • Lymphoma.
  • Traumatic reticuloperitonitis-pericarditis.
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18
Q

Describe the epidemiology of HMD in cattle.

A
  • Occurs in 0.5-5% native high-altitude cattle; higher % if lowland cattle moved to high altitudes.
  • Mainly occurs in calves and yearlings.
  • Complex inheritance with breeds/pedigrees resistant or susceptible.
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19
Q

Outline the treatment and prognosis for HMD in cattle.

A
  • Remove from high altitude, treat primary dz process, InO2 +/- digoxin, furosemide.
  • Px poor once CHF has developed; can potentially reverse for pulmonale.
20
Q

Outline methods to prevent HMD in cattle.

A

Select cattle for breeding at high altitudes that are resistant to HMD, remove susceptible cattle to low altitudes, avoid locoweed, vaccinate against respiratory viruses, deworm to prevent lungworm.

21
Q

Define myocarditis.

A

Inflammation of the myocardium.

Occurs secondary to bacteraemia, septicaemia, pericarditis, endocarditis.

22
Q

List the infectious organisms capable of causing myocarditis in cattle.

A
  • Bacterial: Clostridium chauvoei, Mycobacteria.
  • Fungal: FMD.
  • Parasitic: Toxoplasmosis, Cysticercosis, Sarcocystis.
23
Q

Define cardiomyopathy.

A

Subacute or chronic disease of the ventricular myocardium without valvular disease, congenital abnormalities or pulmonary disease.

24
Q

In what breed of cattle is hereditary Dilated Cardiomyopathy (DCM) reported?

A

Holstein-Friesian.

25
Q

In what breed of cattle is a hereditary (non-DCM) cardiomyopathy reported?

A

Curly-coated Poll Hereford.

26
Q

Which neoplasia may cause a cardiomyopathy through myocardial invasion in cattle?

A

Lymphoma or fibrosarcoma.

27
Q

List toxins associated with the development of cardiomyopathies in large animals.

A

Monensin, lasolacid, salinomycin, cassia occidentalis (coffee senna), gossypol (cotton), phalaris, vitamin E/selenium deficiency, copper deficiency (primary or secondary to high sulphates), excessive molybdenum.

28
Q

List the clinical signs associated with myocarditis in cattle,

A
  • CSx depend on extent of disease, location of inflammation and systemic illness.
  • +/- fever, cardiac arrhythmias (supraventricular or ventricular), gallop rhythm, murmur, signs of CHF.
29
Q

List the clinical signs of DCM in cattle.

A
  • Heart-related: peripheral oedema, jugular dilation/pulse, tachycardia, arrhythmias, murmurs, tachypnoea, pleural/pericardial effusion.
  • Extra-cardiac: poor exercise tolerance, decreased milk production, increased liver enzymes, DA, diarrhoea, anorexia.
30
Q

List differential diagnoses for cardiomyopathies in cattle.

A

Bacterial endocarditis, congenital heart defects, for pulmonale, nutritional myodegeneration, cardiac neoplasia, thoracic abscess, pericarditis, pleuritis, diaphragmatic hernia.

31
Q

Outline diagnostic tests which should be performed in cattle with suspected myocarditis or cardiomyopathies.

A
  • CBC/MBA: +/- neutrophilia, dec albumin, inc BUN, inc creatinine, inc GGT, inc SDH, inc TBili, inc CTnI.
  • Echo/ECG: variable - WNL or changes consistent with DCM, CHF, arrhythmias.
  • Urinalysis: haemoglobinuria is suggestive of monensin, gossypol, nutritional myodegeneration.
  • Test serum for BLV, alpha-tocopherol, glutathione peroxidase and Cu; test whole blood for Se.
32
Q

Describe the treatment and prognosis for cattle with myocarditis or cardiomyopathies.

A
  • Myocarditis: tx underlying dz if recognised, control complications (arrhythmias, CHF, shock), Vit E if ionophore toxicity, corticosteroids may be beneficial.
  • Px for myocarditis good if no CSx CHF, guarded if CHF.
  • DCM: +ve inotrope (digoxin), diuretics (furosemide), vasodilators (ACE-I), rest.
33
Q

Define pericarditis.

A

Inflammation of the pericardium, resulting in accumulation of fluid or exudate between the visceral and parietal pericardium.

34
Q

List the causes of pericarditis in cattle.

A
  • Traumatic reticuloperitonitis-pericarditis (TRP).
  • Neoplasia.
  • Idiopathic.
35
Q

Describe typical cardiac auscultation findings in a cow with pericarditis.

A

Tachycardia, muffled heart sounds, absent lung sounds in the ventral thorax; ‘washing machine murmur’: splashing sounds attributed to gas and fluid accumulation in the pericardium secondary to anaerobic infection.

36
Q

Describe the clinical signs seen in cattle with pericarditis.

A
  • Non-specific: fever, inappetence, depression, weight loss.
  • More specific: peripheral oedema, jugular distension and pulses, tachypnoea, dyspnoea, elbow adducted, expiratory grunt, reluctance to move.
37
Q

How do you diagnose a case of pericarditis in large animals?

A
  • CBC/MBA: variable findings dependant on underlying disease and chronicity.
  • Elevated CTnI or myocardial CK/LDH.
  • Rads: in TRP metallic FB and fluid and gas accumulation may be identified.
  • Echo: confirms Dx –> fluid, fibrin, gas in pericardial sac.
  • Fluid analysis following pericardiocentesis: TRP –> mixed bacteria, yellow, could odour, TP >3.5g/dL, WBC >2500/ul; idiopathic: hemorrhagic, sterile.
38
Q

Describe the pathophysiology of pericarditis.

A

Fluid accumulates in the pericardial sac –> increased pericardial pressure –> increased end diastolic pressure -> impaired ventricular filling, increased atrial pressure, decreased venous return, decreased diastolic perfusion to myocardium –> decreased contractibility, SV, CO –> CHF.

39
Q

Describe the treatment for TRP in cattle.

A

Px is poor; salvage procedures only: drain pericardium, perform rib resection at 5th intercostal space.

40
Q

Describe the treatment of Idiopathic Haemorrhagic Pericarditis in cattle.

A

Drain pericardial sac.

Corticosteroids may result in resolution in some cases.

41
Q

How common are cardiac neoplasias in large animals?

A

Uncommon. More common to see secondary involvement from adjacent structures i.e. lungs, pleura, LNs, diaphragm.

42
Q

What is the most common cardiac neoplasia of cattle and where in the heart is it most commonly observed?

A

Lymphoma.

Right atrium.

43
Q

List the clinical signs observed in cattle with cardiac neoplasia.

A

Non-specific and related to chronic disease; progress to cardiac signs related to involvement of pericardium or myocardium.

44
Q

How is cardiac neoplasia diagnosed in cattle?

A
  • CBC/Chem: non-sepcific changes.
  • Test for BLV: only 1-5% BLV positive cattle develop lymphosarcoma.
  • Echo.
  • Definitive diagnosis via histopathology following necropsy.
45
Q

What is the prognosis for cattle with cardiac neoplasia?

A

Hopeless.

LAIM: Cardiology (7 decks)

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