Heart Diseases 1

Question 1

Anal Sac Disease

Answer 1

◦ Abnormality of the paired anal sacs at anal opening

◦ Causes pain and discomfort

Question 2

Anal Sac Disease Etiology:

Answer 2

◦	Small breed dogs more prevalent.
◦	Over weight
◦	Failure of glands to express normally.
◦	Poor muscle tone.
◦	Gland hyper secretion.

Question 3

Anal Sac Disease Clinical Signs

Answer 3

◦ Scooting perianum on the ground.
◦ Licking and chewing perianum.
◦ Painful perianal swelling.
◦ Draining tract in perianum.

Question 4

Anal Sac Disease Diagnosis:

Answer 4

◦ Clinical Signs.

◦ Rectal palpation of anal glands.

Question 5

Treatment for anal sac disease

Answer 5

◦ Flush duct and anal gland.
◦ Express anal gland.
◦ Antibiotics.
◦ Anti inflammatory drugs.

Question 6

Anal Sac Disease Prevention:

Answer 6

◦ Weight loss.
◦ Anal gland expression.
◦ High fiber meals to increase stool diameter.

Question 7

Congestive Heart Failure (CHF)

Answer 7

Failure of heart to pump blood from the left side to meet metabolic needs or prevent pooling of blood in the pulmonary venous circulation.

Question 8

CHF Etiology

Answer 8

◦ Pump Failure (Muscle Failure) left ventricle.
◦ Pressure overload.
◦ Volume overload of the left heart.

Question 9

Pressure overload of CHF

Answer 9

 Systemic hypertension.

 Subaortic stenosis.

Question 10

Volume overload of the left heart.

Answer 10

 Mitral valve dysplasia
 Patent Ductus Arteriosis (PDA)
 Ventral Septal Defect (VSD)

Question 11

CHF Clinical Signs

Answer 11

◦	Weakness
◦	Lethargy
◦	Exercise intolerence
◦	Coughing: soft, often on waking.
◦	Tachypnea
◦	Increased CRT
◦	Possible heart murmur

Question 12

CHF Diagnosis

Answer 12

◦	History
◦	Clinical signs
◦	Auscultation
◦	Radiographs
◦	Echocardiography

Question 13

CHF Treatment:

Answer 13

◦	Diuretics
◦	Restriction of sodium intake  
◦	ACE inhibitors: Enalapril  
◦	Diuretics: Furosemide
◦	Other heart meds:
	Digoxin
	Calcium channel blockers
	Beta blockers

Question 14

Dilated Cardiomyopathy Dogs

Answer 14

 Dilation or enlargement of left or right chambers of the heart.
 Thinning of the chamber walls.
 Dysfunction of the heart muscle resulting in reduced cardiac output.
 Dysfunction of heart valves resulting in CHF.

Question 15

Causes of cardiomyopathy in dogs:

Answer 15

◦ Majority are idiopathic.
◦ Most common in large breed dogs:
 Dobermans, Great Danes, Boxers.
◦ Probably an abnormality of the contractile protiens in the heart muscle.

Question 16

Clinical signs of Cardiomyopathy in dogs:

Answer 16

◦	Coughing
◦	Increased respiratory rate.
◦	Weight loss
◦	Lethargy, weakness.
◦	Abdominal distention
◦	Syncope: fainting due to lack of oxygen to the brain.

Question 17

Diagnosis of Cardiomyopathy

Answer 17

◦ Radiographs: cardiomegally (enlarged heart).
◦ Echocardiogram: Ventricular and atrial dilation.
◦ Electrocardiogram (EKG): abnormal rhythm and QRS complexes.
◦ Radiograph of DCM
◦ Echocardiogram of DCM

Question 18

Treatment of Cardimyopathy

Answer 18

◦ Enalapril: ACE inhibitor that dialates the vessels.
◦ Spironolactone: improve cardiac muscle function.
◦ Pimobendan: positive ionotrop that improves cardiac muscle function.
◦ Lasix: To treat pulmonary edema.
◦ Prognosis with Cardiomyopathy
◦ Always fatal.
◦ Death occurs 6 to 24 months following diagnosis.

Question 19

Heart Worm Disease

Answer 19

 Caused by infection with heart worms, Dirofilariaimmitus.
 Larval form of the parasite, microfilaria, is carried by mosquitoes.
 Microfilaria go through several stages before reaching adulthood in the chambers of the heart.

Question 20

Signs of Heart worm infection

Answer 20

◦	Coughing.
◦	Increased heart rate (tachycardia).
◦	Exercise intolerance.
◦	Weight loss.
◦	Signs of Right sided CHF.

Question 21

Diagnosis of Heartworm disease

Answer 21

◦ ELISA test for heartworm antigen, ie: Snap test.
◦ Knotts test: looks for microfilaria. Used to confirm weak positive Snap tests.
◦ Radiographs: Enlarged pulmonary artery and “tortuous” arteries in the lung lobes.

Question 22

Treatment of Heartworm disease

Answer 22

◦ Melarsomine dihydrochloride (Immiticide): Kills the adult worms.
◦ Hospitalization during treatment to prevent stress.
◦ Treat R-CHF.
◦ Heart worm preventative drugs to kill the microfilaria.

Question 23

New Combined Treatment Protocol

Answer 23

◦ Heartworm preventative used to decrease the microfilaria for 3 to 4 months prior to Immiticide treatment.
◦ Used in dogs that are not critically ill.
◦ Idea is to kill the worms less than 4 months old that can’t be killed by Immiticide.
◦ Strict exercise limitation necessary to prevent pulmonary embolism from the dying parasites.

Question 24

Prevention of Heart worm disease

Answer 24

	Heart worm preventative drugs Monthly:
◦	Ivermectin: Heartgard
◦	Selamectin: Revolution
◦	Milabamycin: Interceptor
◦	Hypertrophic Cardiomyopathy

Question 25

Diagnosis of HW

Answer 25

Clinical signs
	Auscutltation
	Radiographs
	Ultrasound
	Electrocardiogram (ECG)

Question 26

Treatment of HW

Answer 26

o Treat cardiac abnormalities.
Drugs used include diuretics (furosemide), beta blockers (propanolol), calcium channel blockers (diltiazem) , vasodilators (enalapril), aspirin

Question 27

Enalapril
Spironolactone
Pimobendan
Lasix

Answer 27

Enalapril: ACE inhibitor that dialates the vessels.
◦ Spironolactone: improve cardiac muscle function.
◦ Pimobendan: positive ionotrop that improves cardiac muscle function.
◦ Lasix: To treat pulmonary edema.

Question 28

Diagnosis of Hypertrophic Cardiomyopathy

Answer 28

Clinical signs
Auscultation
Radiographs
Ultrasound
Electrocardiogram (ECG)

Question 29

Treatment of Hypertrophic Cardiomyopathy

Answer 29

o Treat cardiac abnormalities. Drugs used include diuretics (furosemide), beta blockers (propanolol), calcium channel blockers (diltiazem) , vasodilators (enalapril), aspirin