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Large animal cardiovascular disease Flashcards

1
Q

How do LA cardiac ptx usually present?

A

often non-specific clinical complaint
decreased muscle mass or milk production
increased resp. rate/effort
decreased exercise tolerance

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2
Q

What is crucial info when approaching LA cardiac ptx?

A

signalmnt
onset
duration/progression of chief complaint
diet and supplements
housing envr.
repro status
deworming programme
hx of illness
presence of other animals with similar signs

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3
Q

What does pale mucous membrane indicate?

A

anaemia
decreased CO

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4
Q

What does hyperaemic mucous membranes indicate?

A

secondary to spesis
peripheral vasodilation
hyperdynamic output

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5
Q

What does prolonged CRT indicate?

A

diminished cardiac output and/or shock

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6
Q

What can jugular pulses/fill indicate?

A

pulses higher than lower 1/3 are abnormal
distention and increased pulsation: Rheart abnormality/arrhythmia

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7
Q

What does ventral (brisket) oedema indicate?

A

common sign of heart failure (R>L)

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8
Q

What do hyperkinetic pulses indicate?

A

increase systolic pressure, decreased diastolic pressure or both

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9
Q

What do hypokinetic pulses indicate?

A

diminution of cardiac output, systemic vasodilation in shock

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10
Q

What does muffled sounds indicate on auscultation?

A

pericardial/pleural effusion

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11
Q

What does washing machine murmur indicate on auscultation?

A

gas/fluid/fibrin within pericardium

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12
Q

What is pericarditis?

A

inflammation of the pericardium that results in fluid/exudate accumulation between visceral and parietal pericardium

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13
Q

What are the causes of pericarditis?

A

trauma
haematogenous spread (septicaemia)
extension of lung/pleural infection
viral infection
neoplasia
mare reproductibe loss syndrome: actinobacillus
idiopathic

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14
Q

What is traumatic reticuloperitonitis?

A

TPR is from penetration of the reticulum by a foreign body

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15
Q

What are the possible outcomes of an ingested object in LA?

A
  1. attach to magnet previously administered
  2. penetrate reticular wall without entering peritoneal cavity causing focal reticulitis/mild dz
  3. perforate reticular wall/entrance to peritoneal cavity causing acute localised TRP
  4. perforate reticular wall/entrance to peritoneal/thoracic cavity causing pericarditis, myocarditis, abscess, vagal indigestion, etc.
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16
Q

What are the early clinical signs of traumatic pericarditis?

A

fever
anorexia
depression
cranial abdominal, reticular, thoracic pain
elbows abducted, reluctant to move
positive williams test, bar test and pinch test

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17
Q

What are the later signs of traumatic pericarditis?

A

Rsided constrictive heart failure
venous congestion
peripheral oedema

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18
Q

What are the cardiovascular clinical signs of traumatic pericarditis?

A

tachycardia
muffled heart sounds
+/- washing machine murmur
venous distention
raised jug pulse
waek pulses

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19
Q

What are the consequences of fluid in the pericardial sac?

A

leads to cardiac compression
when pressure in sac is greater than heart = reduced ventricular filling and diastolic dysfunction
RCHF

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20
Q

What is the use of bloodwork, xray and ultrasound in diagnosing traumatic pericarditis?

A

Blood: suggestive but absence of abnormalities doesnt rule it out
xray: limited to referral practices, useful to ID FB, see enlarged heart
US: dtecet abnormal reticular body, pericardial effusion

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21
Q

What is the tx for traumatic pericarditis?

A

removing FB or preventing further trauma/penetration (magnet)
thoracotomy and marsupialisation of pericardial sac with lavage and debridement

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22
Q

What is the most common cardiac tumour in LA?

A

lymphosarcoma

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23
Q

What are the clinical signs of cardiac neoplasia?

A

Nonspecific: depend on site of tumour and other sites of manifestation
anorexia, depression, weight loss, fever

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24
Q

What are signs of cardiac neoplasia when there is pericardial involvement?

A

tachycardia
pain
jugular distention
peripheral oedema
weak pulses

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25
What are the signs of cardiac neoplasia when there is myocardial involvement?
tachycardia cardiac arrhythmias cardiac murmur CHF: peripheral oedema, ascites, diarrhoea
26
What causes lymphosarcoma in cattle?
bovine leukemia virus cardiac involvement common with adult/enzootic form NOTIFIABLE DISEASE
27
What are the common characteristics of lymphoma?
predilection for RA myocardium RAP increases, jug distention pericardial effusion, often haemorrhagic Rside HF cytology w/neoplastic cells
28
What causes pericarditis in pigs?
haemophilus/glaesserella parasuis (glasser's dz) strep. suis
29
What are the clinical signs of pericarditis in pigs?
fever depression fibrinous poly serositis effusions in CNS, pleura. peritoneum and synovia
30
What causes pericardial effusion in horses?
majority are idiopathic minority are infectious - equine viral arteritis (notifiable) equine influenza - strep. pneumoniae, e.coli, actinobacillus equuli - tend to develop fibrinous effusion
31
What are the clinical signs of pericardial effusion in horses?
venous distention ventral oedema muffled heart sounds pericardial friction rubs (difficult to hear) pleural effusion: dyspnoea, dullness on percussion, smaller lung field on auscultation
32
What tools can we use to diagnose pericardial effusion in horses?
echocardiography: fluid +/- fibrin in pericardial sac, compression of cardiac chambers ECG: small complexes Cytology of fluid
33
What is the tx and prognosis of pericardial effusion in horses?
repeated pericardial drainage and lavage +/- antibio esp. if RA is collapsing good provided tx is early and aggressive constrictive dz may occur in chronic cases
34
What is Cor Pulmonale?
secondary to pulmonary hypertension leads to RV hypertrophy, dilation or failure
35
What are the causes of Cor Pulmonale?
High mountain disease/high altitude disease/brisket disease chronic pulmonary disease equine chronic/severe asthma
36
What are clinical signs of Cor Pulmonale?
subQ oedema of brisket, ventral thorax, submandibular areas and limbs lethargy weakness bulging eyes diarrhoea collapse and death jugular pulse/distention dyspnoea, tachypnoea Split S2 murmur: tricuspid regurg. or pulm. ejection
37
What is tx and prognosis or cor pulmonale?
if high altitude sickness, move to lower pasture prognosis usually hopeless because of underlying chronic irreparable lung pathology
38
What are 3 types of vascular dz?
aneurysms embolism thrombosis
39
What are aneurisms?
vascular dilations: weakening of outer elastic coat of blood vessels
40
What causes aneurysms?
trauma sepsis parasites ageing degenerative vascular disease
41
What is an embolism?
foreign material carried in the bloodstream
42
What causes embolism?
often from thrombus but can include catheters and other FB
43
What is thrombosis?
formation of clot that obstructs blood flow in the circulatory system
44
What causes thrombosis?
trauma venous stasis catheterization needle penetration thrombogenic solutions bacterial contamination cellulitis lymphangitis
45
What is thrombophelbitis in horses?
pain, swelling thickening of vein ususally associated with catheter or after its removal
46
When are horses more at risk for thrombophlebitis?
if animal is sick or hypercoagulable state
47
What are signs of thrombophlebitis?
pain swelling thickening of vein bilateral jugular veneous thrombosis can lead to marked swelling of head can lead to embolism/showering fever, murmur
48
What is the tx for thrombophlebitis?
remove catheter hot packing broad spectrum AB anti-inflammatory drugs anti-coagulant therapy
49
Why is prompt tx of bacterial endocarditis vital?
large proliferative "vegetative" lesions may develop, limiting prospects for return to normal valve function
50
What organisms cause bacterial endocarditis in ruminants?
enterococci streptococci actinomyces pyogenes
51
What area of the heart is affected by bacterial endocarditis in ruminants?
tricuspid and pulmonc valves RV endocardium
52
What organisms cause bacterial endocarditis in horses?
pasteurella actinobacillus streptococci rhodococcus equi
53
What areas of the heart are affected by bacterial endocarditis in horses?
mainly mitral and aortic (mitral more) tricuspid valve usually only following jugular thrombophelbitis
54
What organisms cause bacterial endocarditis in pigs?
staph aureus actinobacillus suis erysipelothrix rhusiopathiae
55
What area of the heart is affected by bacterial endocarditis in pigs?
mitral, aortic usually PM findings
56
What are the clinical signs of bacterial endocarditis?
CHF with murmur fever cardiac murmur tachycardia tachypnoea
57
What is the lab findings with bacterial endocarditis?
hyperfibrinogenaemia/SAA anaemia leucocytosis
58
What is the tx for bacterial endocarditis?
broad spectrum AB based on sensitivity tx of farm animals usually not economically viable
59
What is the prognosis for bacterial endocarditis?
guarded even after bacterial cure permanent structural damage to valve septic emboli may shed to distant sites
60
What is Equine Exercise Induced Pulmonary Haemorrhage (EIPH)?
bleeding from lungs during exercise blood detected on trachea-bronchoscopic exam after exercise or RBC in bronchoalveolar lavage fluid
61
What does EIPH cause?
accumulation of varying volumes of blood in pulmonary interstitium and airways occurs in majority of thoroughbred and standardbred racehorses and in many others undergoing strenuous exercise
62
What are the clinical signs of EIPH?
Epistaxis poor performance US/XR changes to thorax coughing increased RR resp. distress behavioural changes
63
What happens pathophyiologically in EIPH?
pulmonary capillary stress failure, the capillary transmural pressure exceeds the threshold value during exercise circulating blood volume can increase up to 50% due to splenic reserve of RBCs
64
What part of the lungs is primarily affected and why in EIPH?
caudo-dorsal lobes higher blood flow mehanical forces highest displacement of diaphragm causes fall in alveolar pressure = greater transmural capillary pressures
65
What are predisposing conditions to EIPH?
in young TBs its a physiological response to strenuous exercise prevalence increases with age and in males conditions that increase pulmonary vasc. resistance: lower resp tract dz, upper resp tract obstruction, cardiac dz
66
How do we treat EIPH?
identity + tx any predisposing URT, LRT, cardiac dz break haemorrhage-inflammation cycle (modify training, dust-free, furosemide)
67
What is the prognosis of EIPH?
good to fair if spontaneous and has minimal impact on performance or if associated with resp. infection/predisposing cause that can be identified + treated poor for idiopathic bleeders with performance limitations

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