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!Small Animal Medicine > K9 Myocardial Diseases > Flashcards

K9 Myocardial Diseases Flashcards

1
Q

Dilated Cardiomyopathy (DCM)

A

Common cardiac dz
Large and giant breeds and cocker spaniel
Male, middle aged to older (4-10y)

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2
Q

Possible causes of DCM

A

Familial or genetic (cytoskeletal proteins)- Boxer, doberman and PWD
Immune-mediated (B-receptor, a, B-MHC, ADP-ATO translocator protein)
Taurine deficiency (cocker, goldens)
Carnitine deficiency (boxers)

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3
Q

Pathophysiology of DCM

A

Systolic pump failure
MR secondary
Diastolic failure
Arrhythmias
L-CHF and biventricular failure

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4
Q

Gross pathology of DCM

A

Moderate to marked dilation of 4 chambers (left heart more severely)
Myocardium thin, pale and flabby
Thin papillary muscles

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5
Q

CS associated with DCM (advancing order)

A

No CS → exercise intolerance, syncope, resp. distress, abdominal distension, WL (cachexia) →
Sudden death (20-30% boxers and dobermans)

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6
Q

Genotypic stage of DCM

A

Normal heart
No CS

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7
Q

Occult stage of DCM

A

Abnormal heart and no CS
May last years, sudden death may be first CS
ID of this stage is important
Sinus arrhythmias and sinus with VPC singlet

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8
Q

Overt stage of DCM

A

Abnormal heart
CS: heart failure and arrhythmias
Sinus tachycardia, a fib and ventricular tachycardia

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9
Q

PE on a pet with DCM

A

Tachycardia/ tachypnea, pulse deficits and weak femoral pulses
Soft systolic murmur, S3 gallop
Jug venous distension, abdominal distension with fluid, harsh resp sounds and cool extremities

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10
Q

DX DCM

A

NT-proBNP elevated or normal with occult DCM
unnecessary if murmur present

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11
Q

What else is seen with ECG rhythms (DCM)

A

LVE and LAE (tall R waves and wide P waves)
Conduction disturbances
Small complexes with pleural effusion

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12
Q

Thoracic radiographs associated with DCM

A

Generalized cardiomegaly
Pulm. venous congestion, pulm edema and pleural effusion

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13
Q

Chronic oral therapy management of DCM

A

Diuretics, Ionotropes and ACE-1,
anti- arrhythmia drugs if needed
Stacked drugs: diuretics, vasodilators

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14
Q

Emergent therapy for DCM

A

Oxygen, IV Lasix, dobutamine, nitroprusside,

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15
Q

Prognosis for DCM

A

Poor to guarded
Hours to 2 yrs

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16
Q

DCM in Dobermans

A

2 causative genetic mutations: pyruvate dehydrogenase kinase (DCM1 and DCM2)
Risk highest with both mutations

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17
Q

Prevalence of DCM in Dobermans

A

45-63%
Adult onset (acquired)- 2-15 yrs of age
Ventricular arrhythmias: 90%
Sudden death: 30-50%

18
Q

T/F: L-CHF more common than biventricular failure with DCM in Dobermans

A

TRUE

19
Q

Occult stage of DCM in Dobermans

A

Long (2-4 yrs)
Screen with echo and Holter monitoring: systolic dysfunction

20
Q

Tx of DCM for Dobermans

A

Pimobendan if systolic dysfunction
Mexiletine or sotalol for ventricular arrhythmia

21
Q

DCM in large breed dogs

A

Irish wolfhounds, great danes, newfoundlands
Inherited, sudden death possible
CHF and a fib.

22
Q

Juvenile DCM

A

Portuguese water dogs
Normal @ birth then systolic dysfunction develops at 8-10w
Rapid progression to CHF then death @ 14-20w

23
Q

Arrhythmogenic right ventricular cardiopathy (ARVC)

A

Inherited dz in boxers (+ english bulldogs) @ 6y
RV most affected and electrical system

24
Q

ARVC pathophysiology

A

Replacement of myocardium by fat and fibrous tissue
Ventricular arrhthymias (syncope, sudden death)

25
Q

Symptoms ARVC

A

Asymptomatic with VPCs (m-y)
Syncope, resp. distress, abdominal distention (m-y)
Ventricular dilation and myocardial failure (CHF)
Sudden death possible

26
Q

DX ARVC

A

Genetic test: striatin a desmosomal protein
ECG: upright VPCs in lead 2

27
Q

What does an echocardiography show with ARVC?

A

Can be normal
Systolic dysfunction, ventricular dilation, atrial enlargement

28
Q

Tx of ARVC

A

Ven. tachy: sotalol, mexiletine
CHF: furosemide, pimobendan, ACE-1

29
Q

Nutritional cardiomyopathy

A

Taurine deficiency: Genetic predisposition in cocker spaniels and goldens

30
Q

Dx of Nutritional cardiomyopathy

A

Echo: systolic dysfunction
Measure plasma or serum taurine levels (low)
Thoracic rads if CS of CHF

31
Q

Tx of Nutritional cardiomyopathy

A

Taurine supplementation
Positive ionotropes
Manage CHF

32
Q

What diet is associated with nutritional cardiomyopathy

A

Boutique, exotic, grain free diets (BEG diets)- linked to some goldens

33
Q

Prognosis of Nutritional cardiomyopathy

A

Improve or normalize with diet change and temporary or long-term taurine supplementation

34
Q

Myocarditis

A

Trauma, infectious or immune dz of myocardium
Infectious myocarditis more common

35
Q

What causes myocarditis

A

Radiation, heat stroke, hypothermia, trauma
Parvo
Trpanosoma cruzi (Chagas’ dz)
Toxoplasma
Neospora
Sepsis/ endocarditis
Borrelia burgdorferi
Bartonella spp.

36
Q

Infectious myocarditis

A

Parvo: young puppies, acute to peracute death
Protozoal: Arrhythmias and R-CHF in chr. stage

37
Q

Hx and CS of infectious myocarditis

A

Atypical signalment
Exercise intolerance, lethargy, syncope, sudden death
CHF without known cardiac dz
Arrhythmias and ADR

38
Q

Dx of infectious myocarditis

A

ECG: tachy and bradyarrhythmias, AV block
Echo: systolic dysfunction, eccentric hypertrophy and pericardial effusion
Cytology of effusion, CBC/ chem, blood smear, serology, cardiac troponin 1 level

39
Q

Doxorubicine (adriamycin) toxicity

A

Systolic dysfunction, conduction disturbances, arrhythmias
If cumulative dose >240 mg/m

40
Q

Tachycardia-induced cardiomyopathy

A

Caused by HR > 180 bpm for 2-3w

41
Q

Infiltrative cardiomyopathy

A

Lymphoma

42
Q

Hypertrophic cardiomyopathy

A

Rare in dogs
Dalmations predisposed

!Small Animal Medicine (37 decks)

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